Special Services Research Articles

Evaluating the Perceived Benefits and Effectiveness of a Government Health Insurance Scheme for Chronic Kidney Disease Patients: A Study in Nellore, Andhra Pradesh.

Background Chronic kidney disease (CKD) is prevalent in India, particularly among underprivileged populations. Government initiatives such as the Dr. YSR Aarogyasri Health Insurance Scheme aim to provide affordable healthcare to economically impoverished individuals with kidney diseases. This study assessed participants' perceptions of the scheme's benefits, effectiveness, and challenges. Methods A cross-sectional study was conducted in Nellore, Andhra Pradesh, involving 100 CKD patients. Data was collected using a structured questionnaire assessing socio-demographic factors, insurance scheme's awareness, perceived benefits, and effectiveness. Multivariable logistic regression analysis was employed to identify factors influencing participants' perceptions. Results Participants aged over 40 years were more likely to perceive the Dr. YSR Aarogyasri Health Insurance Scheme positively (crude odds ratio{COR}: 9.2; 95% CI: 2.6-31.7). Males (adjusted odds ration {aOR} 1.5; 95% CI: 1.1-2.1), married individuals (aOR 1.3; 95% CI: 0.8-1.7), and those with higher education (aOR 1.9; 95% CI: 1.1-3.2) reported greater schemeeffectiveness. However, 32% of CKDpatients lacked awareness of the scheme's enrolment process, 29% believed that the eligibility criteria were too strict, and 17% of insured patients reported gaps in coverage for specific services, treatments, and medications, reducing the scheme's appeal to diseased patients. Discussion Older males and those with diabetes, who require extensive care, perceive the scheme as beneficial. However, gaps in awareness and coverage remain barriers to its full effectiveness. Conclusion While the Dr. YSR Aarogyasri Health Insurance Scheme provides critical financial relief for CKD patients, enhancing its outreach and expanding coverage could improve its impact. These findings can guide policy improvements to optimize the scheme's effectiveness and accessibility.

The Carbon Footprint of Hospital Services and Care Pathways: A State-of-the-Science Review.

Climate change is the 21st century's biggest global health threat, endangering health care systems worldwide. Health care systems, and hospital care in particular, are also major contributors to greenhouse gas emissions. This study used a systematic search and screening process to review the carbon footprint of hospital services and care pathways, exploring key contributing factors and outlining the rationale for chosen services and care pathways in the studies. This state-of-the-science review searched the MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), GreenFILE (EBSCOhost), Web of Science, Scopus, and the HealthcareLCA databases for literature published between 1 January 2000 and 1 January 2024. Gray literature was considered up to 1 January 2024. Inclusion criteria comprised original research reporting on the carbon footprint of hospital services or care pathways. Quality of evidence was assessed according to the guidelines for critical review of product life cycle assessment (LCA). PROSPERO registration number: CRD42023398527. Of 5,415 records, 76 studies were included, encompassing 151 hospital services and care pathways across multiple medical specialties. Reported carbon footprints varied widely, from carbon dioxide () equivalents () for an hour of intravenously administered anesthesia to 10,200 for a year of hemodialysis treatment. Travel, facilities, and consumables were key contributors to carbon footprints, whereas waste disposal had a smaller contribution. Relative importance of carbon hotspots differed per service, pathway, medical specialty, and setting. Studies employed diverse methodologies, including different LCA techniques, functional units, and system boundaries. A quarter of the studies lacked sufficient quality. Hospital services and care pathways have a large climate impact. Quantifying the carbon footprint and identifying hotspots enables targeted and prioritized mitigation efforts. Even for similar services, the carbon footprint varies considerably between settings, underscoring the necessity of localized studies. The emerging field of health care sustainability research faces substantial methodological heterogeneity, compromising the validity and reproducibility of study results. This review informs future carbon footprint studies by highlighting understudied areas in hospital care and providing guidance for selecting specific services and pathways. https://doi.org/10.1289/EHP14754.

Need and struggles of homeless people: A study based on Nepalese context

Homeless are these people who are unable to manage their basic needs and live under the sympathy of others. Nepal experienced an increasing trend of homeless people. This study highlights the daily challenges and necessities of homeless people in Nepal. A cross-sectional study with a Qual-Quan method applied in the Nepalese context, the data were collected Province-wise during 2023. The study further shows that the basic requirements like regular food are somehow managed from the helping hand but the cloths and shelters are very challenging to manage nowadays. The challenges are the different types of homeless age groups peoples and genders in a same care center. The health issue is a critical to manage of homeless center due to the lack of facilities and services. Government and development priorities are minimal for the homeless and nowadays homeless issue are increasing. The settlement arrangement with basic privileges is very difficult to manage through the local administration and homeless-center as lack of resources and paper documentation are too hectic and prolonged. The study further concluded as the homeless needs are hardly meet and additional supports from the multi-sectoral are in demand but the government priorities are less. However, the local community supports from the self-levels benefiting homeless centers but this is not enough to manage for long time and special care and services are essential and skill-based program and additional budget from the Government sectors to the poorer is the future requirement.

Childhood Maltreatment and Revictimization in Young Adulthood: Is Problematic Substance Use a Mediator? A Linked Survey-Register Data Study.

Victims of childhood maltreatment often experience revictimization later in life. However, there is scant knowledge of the explanatory mechanisms that generate this phenomenon. Problematic substance use is a maladaptive coping strategy that may increase the risk of revictimization after maltreatment. We used linear regressions and mediation analyses to investigate the explanatory role of problematic substance use in the association between childhood maltreatment and violent revictimization in young adulthood. We analyzed linked survey-register data on a sample of senior high school graduates in Norway (n = 3,156) who were followed longitudinally until ages 32 to 33 (2021). Ordinary least squares regression analyses showed that childhood maltreatment was associated with both problematic substance use and violent revictimization, adjusted for a wide range of covariates. Moreover, problematic substance use was associated with an increased risk of violent revictimization in young adulthood. Mediation analyses showed that about one eighth (12.0%) of the association between childhood maltreatment and violent revictimization was mediated by problematic substance use. Sensitivity tests indicated that the mediation may be susceptible to unmeasured confounding. Thus, it is unclear whether the mediating role of problematic substance use can be interpreted causally within a counterfactual framework. In conclusion, reducing problematic substance use among victims of childhood maltreatment may mitigate the risk of violent revictimization later in life. Early detection and tailored treatment of problematic substance use could be one way to prevent violent revictimization following childhood maltreatment. Therefore, equitable access to primary and specialized healthcare services is essential, both for victims of maltreatment and individuals with habits of (borderline) problematic substance use. However, the majority of the maltreatment-revictimization pathway (88.0%) is not statistically explained by substance use, which implies that other mechanisms are also at play.

Rethinking the missions and functions of public research institutes: evidence from Iranian PRIs

Abstract Public research institutes (PRIs) are pivotal in national and sectoral innovation systems and the transition to a knowledge-based economy. So, the current study has reassessed these institutes’ functions and suggested policy recommendations to augment their influence in moving toward a knowledge-based economy. The findings of this research reveal that functions such as innovation hub and specialized accelerator; strategic and problem-oriented research management platform; standard and regulatory reference; specialized technical service center; center for cooperation, transfer, and dissemination of technology; and the hub of technology and policy intelligence in a specific industrial sector are crucial functions of PRIs in transitioning to a knowledge-based economy. Additionally, to foster a conducive environment for the influence of PRIs in actualizing a knowledge-based economy, policies related to governance and division of responsibilities, stimulation of both supply and demand sides, strengthening the linkage between the supply and demand sides, and provisioning supportive environment and infrastructure are recommended.

Smallholder market access, commercialisation and livelihood outcomes in Werie Leke District of Tigray, Northern Ethiopia

ABSTRACT Agriculture plays a critical role in Ethiopia's economy but suffers from low technology, traditional practices, and low productivity, leading to persistent poverty and food insecurity among farming households. Transforming the sector requires enhanced market access to promote commercialisation. This study examines smallholder market access, commercialisation, and livelihood outcomes in Werie Leke district, Tigray, Ethiopia. Using survey data from randomly selected households, the analysis employs mean, independent sample t-tests, and Tobit regression. Results indicate that smallholders face significant market access challenges, leading to low commercialisation levels. Notably, higher commercialisation correlates with improved livelihoods. Factors influencing commercialisation include household characteristics, asset endowments, market access, cooperative membership, and access to specific livelihood services. The study recommends investing in road and market infrastructure, improving access to extension and credit services, farm inputs, irrigation, and strengthening cooperatives to enhance market access, smallholder participation, and livelihoods.

School-based support for children bereaved due to parental intimate partner homicide

ABSTRACT Internationally, there is growing recognition of the scale and consequences of intimate partner homicides (IPH). A significant, though often neglected consequence is how many children are impacted by these tragic events. In such challenging circumstances, children need stability, continuity and trusted people they can rely on for support. This paper aims to understand how best to provide school-based support for children following parental IPH by investigating the experiences of affected children, their caregivers and professionals with experience of working with these children. Semi-structured interviews were undertaken with 35 participants in Australia, the UK and Ireland (11 with lived experience, 12 caregivers and 12 professionals). We developed two key themes through the data analysis process: (1) School as a supportive place and (2) Limited access to a trusted, supportive adult at school. We found that schools can potentially be supportive, safe, stable, and consistent places for affected children, and teachers and counsellors can help provide trusted, supportive relationships for them; however, there needs to be effective resourcing within an overall policy structure. Schools are in a strategic position to identify the effects of trauma in the children’s lives and can also provide a valuable link between children and relevant specialist services. There are limitations, however, regarding both the accessibility and availability of suitable skilled and experienced practitioners who can support the children, their caregivers, and school staff. Ongoing care teams need to be established to provide the comprehensive, individualised services these children need.

The practice, nature, and impact of nurse-led type 2 diabetic foot prevention services and educational programs in Sub-Saharan Africa: a scoping review.

The objective of this study is to assess the scope of existing practice, nature, and impact of nurse-led type 2 diabetic foot prevention services and educational programmes in Sub-Saharan Africa (SSA). Type 2 diabetes mellitus (T2DM) in SSA imposes a heavy burden on current healthcare services. Complications such as foot ulcers can have a significant impact on patient care and healthcare resources. It is imperative to identify patients at risk of developing diabetic foot complications and empower them with diabetes self-management education and support from specialised foot clinics is crucial. However, the availability of such programmes and services in SSA is limited. Studies of nurse-led diabetic foot prevention services and/or educational programmes in low- or middle-income countries in SSA for adults with T2DM, written in English, between August 2013 and March 2024 were considered. Following the standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for conducting and reporting scoping reviews, searches were conducted on four electronic databases (CINAHL, ProQuest, MEDLINE, and Scopus) and Google Scholar. The titles and abstracts were scrutinised. All eligible papers were retrieved and screened for full text. The review included ten studies (across 14 papers), all of which focused on nurse-led diabetes self-management education (DSME) programmes in SSA. There are no specific educational programmes or services led by nurses that focus exclusively on diabetic foot prevention. The analysis highlighted the components of successful nurse-led DSMEs that led to positive glycaemic control and self-care behaviors, including the focus on behavior change and the DSME should be co-produced with service users. The theoretical aspects of the DSME include evidence-based, structured, interactive, culturally and linguistically appropriate group-based activities. The DSME should be delivered over a period of several weeks, and sessions should last between 1.5 and 2 h. Barriers to delivery and participation include the rainy season, stockouts, time and resources needed, and a DSME that meets diverse levels of literacy and education. There is a heightened need for nurse-led, co-produced, culturally congruent, frugal, and sustainable education interventions or programmes. There is also a need for diabetic foot screening and foot ulcer prevention services that can operate sustainably alongside these educational interventions through task-shifted, simple, and frugal initiatives.

The genesis of methods and tools of counterintelligence activities of a national special service: historical experience and prospects

The article provides a historical analysis of the methods and tools of intelligence and counterintelligence activities exploited by the national intelligence service in the sixteenth and seventeenth centuries, in the period of the Cossacks and the formation of the Ukrainian Cossack-Hetman State. The priority goal is to establish dialectical connection between the effective tools of countering the aggressor of that period and nowadays. The relevance of the article lies in the study of the counterintelligence activities of the national intelligence service of that period, the transformation of the relevant units and their powers from the Cossack period to nowadays, as it was set up in the context of the national liberation war in confrontation with external enemies. The author highlights the historical aspects of counterintelligence activities of the period under study, in particular, the methods and tools that are used in conducting naval campaigns. The article is allocated to the study of the formation and evoluation of counterintelligence activities in historical aspects, the fundamental tactics of warfare of the sixteenth and seventeenth centuries during successful naval operations in the context of retrospective changes in national special services, as well as the opportunity to use the Cossacks’ experience in the modernisation and transformation of counterintelligence tools in the context of the Russian-Ukrainian war of the twenty-first century. The researchers have introduced a historical parallel between the powerful Cossack «Gull» boats and the «SeaBaby» unmanned surface vehicles and «Mamai» high-speed maritime drones that are used by the Security Service of Ukraine in the Black Sea to repel the aggressor. The aspects of the genesis of counterintelligence methods and tools have been outlined in the study. They depict overt and covert methods and techniques of intelligence and counterintelligence, that have been used in the fight against the enemy in various forms since ancient times and have undergone long changes. It has been mentioned that the results of studying the history of the formation and functioning of national special services are of empirical impact. They can be used to improve and enhance the activities of the Security Service of Ukraine in modern realities, to conduct effective counterintelligence activities and special operations in the context of war with the aggressor and to adjust the national security strategy.

Exploring Midwives’ Roles on Managing Perinatal Mental Health: Insights into Scientific Perspective on Care Practices and Psychosocial Support

Perinatal Mental Health is prominent for the well-being of the mother and child, so consideration provides effective support and care for women in the perinatal period given by Midwives can be helped. The study aimed to synthesize primary research on midwives’ experiences of caring for women who experience perinatal mental health and well-being. Using mixed methods systematically combined with quantitative and qualitative studies. This study analys was searched on three databases, ProQuest, Pubmed, and ScienceDirect, from 2021 to 2024. The population in this study were midwives who experienced PMH in the care of pregnant. Critical Appraisal Skills Programs (CASP) were used to determine the study’s methodological quality. By contrast, the synthesis method uses the modified PEOS method. Data extraction, quality assessment, and thematic analysis were conducted using PRISMA-P guidelines. 2926 records were returned, with 10 articles meeting inclusion criteria. Participants included midwives. The findings indicate that there is a need for a sustainable development program for midwives to increase knowledge, attitudes, communication, collaboration, and assessment skills for pregnant women who experience PMH by a scientific perspective. All maternity services must provide specific services to assess and identify Perinatal Mental Health problems. Indeed, the emotional well-being of pregnant women is the goal of debriefing midwives.

НАВЧАЛЬНА ДИСЦИПЛІНА «ЗАГАЛЬНЕ І СПЕЦІАЛЬНЕ ДІЛОВОДСТВО» У ПРОФЕСІЙНІЙ ПІДГОТОВЦІ МАЙБУТНІХ ФАХІВЦІВ-ПЕНІТЕНЦІАРІЇВ

The article characterizes the peculiarities of teaching the educational discipline “General and special office management” in the context of professional training of future penitentiary specialists in higher education institutions. It is substantiated that the academic discipline “General and special office management” plays an important role in the professional training of future specialists of the State Criminal Executive Service of Ukraine, because it involves the formation of a system of theoretical knowledge, practical skills and skills to work with documents specific to each of the management functions, as well as for certain fields of activity, in particular, familiarization with the theoretical and practical issues of documentation and the rules of organization of record keeping in institutions of the criminal executive service. As a result of mastering this educational discipline, students (cadets) should develop skills and abilities related to compiling, proofreading, accounting (registration), sorting, storing, searching, processing information stored in documents, as well as copying, information transfer, document transportation inside and outside the management apparatus of an institution or organization. It has been proven that the effectiveness of mastering an educational discipline depends on the teacher’s selection of educational material, the planning and implementation of independent work by students of higher education, as well as their preparation for practical classes. The content of the lecture course is characterized, the relationships between lectures and practical classes are determined. The conditions for successful mastering by future penitentiary specialists of the educational course “General and special office management” are substantiated, in particular, the need for systematic, consistent work throughout the entire academic semester, the formation of analytical skills for working with literature, and thorough preparation for the semester exam are substantiated. It has been proven that the effectiveness of the performance of the criminal-executive service specialists in the future of their official duties, the pace of their career growth, and the intensity of professional and personal development depend in some places on the development of the skills of working with documentation. Key words: academic discipline, professional training, higher education students, lecture, independent work, future specialists, criminal-executive service.

GOVERNANCE, SUSTAINABILITY AND FAMILY LEGACY: ESG IN A 3RD GENERATION FUNERAL COMPANY

Funerária São Judas Tadeu, located in Videira, Santa Catarina, is an example of adaptation and evolution of a family business that has reached its third generation. Founded in 1977, the funeral home began as a carpentry shop that produced funeral urns and, over the years, has established itself as a reference in the sector, standing out for adding highly specialized services to the products it already produced, and for its growing commitment to the community and sustainability. This qualitative study, based on a semi-structured interview with the manager, analyzes the implementation of ESG practices in this organization, and how this work permeated the success and family succession of the company, respecting the values ​​that have always been practiced by it. Funerária São Judas Tadeu exemplifies the resilience and adaptation necessary in the funeral sector, standing out for its excellence in service and for monitoring and implementing the most modern practices in its sector, demonstrating a proactive stance in relation to market trends, not waiting for government regulations to act. Always seeking to focus on the needs of its customers, it was a regional pioneer in the implementation of several services, such as thanatopraxy, the creation of the Memorial for farewell ceremonies and the installation of the crematorium, in addition to the adoption of the protective mantle for urns, essential to prevent environmental contamination. The trajectory of Funerária São Judas Tadeu reveals that continuous innovation, concern for ESG and respect for origins are the key to a legacy that transcends generations.

Operational Regime for Maximizing the Durability in Fuel Cell Stacks

Fuel cells have a dichotomy between high performance and long durability, which is further exacerbated by the requirement for high production scale manufacturing. To bridge the aforementioned disconnects, the fuel cell system’s operational controls must be optimized to protect the fuel cell stack from being exposed to conditions that would detrimentally impact the fuel cell stack durability. For instance, Toyota has shown that the fuel cell stack is protected from platinum electrocatalyst oxidation by limiting the upper voltage during idle to 0.85 V (Toyota).[1] The operational controls landscape that must be evaluated as a function of durability are inlet coolant temperature, coolant delta temperature across the stack, coolant temperature cycling and rate, reactant stoichiometry, inlet relative humidity (RH), RH cycling and rate, back pressure, material dependent water back diffusion, cathode catalyst loading, and the load profile and rate.To better understand the impact of the fuel cell operational regime on durability, we evaluate the relative decay rates for multiple short stacks under limited stress tests: (ST1) mid power current density hold, (ST2) elevated coolant temperature/low RH load cycling (GM),[2] and (ST3) concurrently cycling coolant temperature/RH/load. The voltage decay rates are tracked over time to estimate stack lifetime. The stack voltages decrease over the time on test under all three stress test profiles, attributed to initial aging of the cathode catalyst. Polarization curves are used to evaluate decay rates intermittently during the applied stress tests, the decay rates are dependent on current densities in the polarization curve.We find that the voltage decay rate is elevated within the kinetic region of the polarization curve and lower in the mas transport region. The most aggressive stress test is ST3, due to the combined coolant temperature/RH/load cycling. Acknowledgments This material is based upon work supported by the U.S. Department of Energy’s Office of Energy Efficiency and Renewable Energy (EERE) under the Hydrogen and Fuel Cell Technologies Office’s FY2020 H2@Scale New Markets FOA, Award Number DE-EE0009248. W. Gibbons (DOE Program Manager), R. Mukunda (LBL), D. Cullen (ORNL), and KC Neyerlin (NREL).Full Legal Disclaimer: “This report was prepared as an account of work sponsored by an agency of the United States Government. Neither the United States Government nor any agency thereof, nor any of their employees, makes any warranty, express or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or usefulness of any information, apparatus, product, or process disclosed, or represents that its use would not infringe privately owned rights. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise does not necessarily constitute or imply its endorsement, recommendation, or favoring by the United States Government or any agency thereof. The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Government or any agency thereof.”

People-processing in youth welfare services: A cross-sectional approach

This paper holistically sheds light on youth welfare services, drawing upon interviews with professionals working in youth, health, social and employment services and investigating their institutionally embedded professional practices and shared features. The 38 individual and group interviews with 73 professionals were analysed thematically to determine their priorities in their work and identify what is done with young people seeking help from their services. First, the services were identified as having four functions: (1) guidance, (2) authoritative decision-making, (3) psychosocial support and (4) everyday support. These functions are prioritised differently in the services, but the services are not limited to a single service feature. This typology demonstrates that young people often need more than one form of support for diverse aspects of their lives. Second, the interviews highlighted the working method of people-processing, understood as categorising, assessing and guiding clients to other services. While earlier research has understood people-processing as a feature of specific services or organisations, it is a central method in all services. The service system’s high client volumes and requirements for efficiency make it ill-suited to long-term, relationship-based work, and there is an incentive to keep young people moving on a service pathway and process them forward.

UKHCDO gene therapy taskforce: Guidance for implementation of haemophilia gene therapy into routine clinical practice for adults.

2022 was a landmark year with two adeno-associated viral vectors (AAVs) receiving conditional marketing authorization from EMA for the treatment of persons with severe haemophilia A and severe to moderately severe haemophilia B and a third in 2024. Gene therapy is a transformative, irreversible treatment with long-lasting effects, necessitating development of new clinical pathways to ensure optimal outcomes. To develop a consensus framework and service specification for delivery of AAV gene therapy for haemophilia in adults within the UK using the hub-and-spoke model proposed by the European Association of Haemophilia and Allied Disorders and the European Haemophilia Consortium. The UK Haemophilia Centre Doctors Organisation (UKHCDO) set up a working party to develop expert consensus guidance, working with NHS England to ensure alignment with NHS England commissioning and the national service specification. These guidelines detail the patient pathway, counselling and governance requirements for the hub-and-spoke model. The national service specification requires the hub site to manage governance for AAV-based gene therapy. Proposed regional and national multidisciplinary teams will harmonize clinical practices incorporating expertise from various specialities and professional groups. Key requirements identified include standardized documentation and multidisciplinary collaboration. Nationally agreed patient information and counselling checklists will streamline the informed consent process and facilitate data collection for long-term safety and efficacy monitoring. These guidelines provide a structured framework for the delivery of liver-directed gene therapy. Whilst specific to the United Kingdom they provide a framework for the implementation of gene therapy in other countries for haemophilia and other monogenic disorders.

Perceptions of culturally and linguistically diverse exceptional students regarding their individual transition plans

Culturally and Linguistically Diverse Exceptional (CLDE) students represent a vulnerable demographic often underserved in high school transition services. These students, who have diverse backgrounds and learning exceptionalities, face significant disparities in post-secondary outcomes. Specifically, CLDE students with Learning Disabilities (LD) exhibit lower rates of employment, post-secondary education attendance, and independent living outcomes. In alternative schools, students of color and those from low-income backgrounds are disproportionately represented and often encounter structural inequities that hinder their educational success. These settings may perpetuate marginalization, particularly in special education services and transition planning. This study explored the perceptions of secondary CLDE students with LD regarding their transition planning process, comparing their views with the actual ITP documents to assess alignment and effectiveness. Survey responses and student interviews revealed that most secondary CLDE students with LD at an alternative high school had positive perceptions of their Individualized Transition Plan (ITP) process, feeling involved and supported. The ITP, a critical component of the Individualized Education Plan (IEP), is intended to guide students’ post-secondary goals. However, research indicates that ITPs for CLDE students are frequently generic and culturally exclusive, resulting in insufficient preparation for future success.

Cerebral cortical encephalitis in adults with myelin oligodendrocyte glycoprotein antibody-associated disease: A national case series.

Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is a relatively recently described disease, most commonly presenting with optic neuritis and longitudinally extensive transverse myelitis. Cerebral cortical encephalitis is a rare manifestation of MOGAD. We identified patients presenting with cerebral cortical encephalitis with positive MOG antibodies in serum across a large specialized service. Demographic and clinical information were collected. We describe clinical and laboratory characteristics, treatment response, and subsequent relapse risk in adults presenting with this phenotype. We identified eight patients meeting clinical criteria for cerebral cortical encephalitis with MOG antibodies. All had seizures; four had focal onset seizures with or without secondary generalization. Two patients exhibited encephalopathy, and six demonstrated focal neurological deficits at presentation. All had fluid-attenuated inversion recovery hyperintensities. Five of eight displayed cerebral swelling, and two of eight displayed leptomeningeal enhancement. Where cerebrospinal fluid (CSF) results were available, five of seven had CSF pleocytosis, protein was raised in two of seven, and one patient had oligoclonal bands unique to CSF. Median time to seizure control was 1.25 months, and all clinical features and magnetic resonance imaging abnormalities resolved. Four of eight patients (50%) had a clinical relapse, with a median time to relapse of 6.4 months. Cerebral cortical encephalitis appears to share similar CSF findings, steroid responsiveness, and risk of relapse with other clinical manifestations of MOGAD. This informs treatment decisions and patient counselling.

Research on the Construction of Grassroots Emergency Command System Under the Background of Informatization

Along with our economic development and public safety demand intensify., the task of fire rescue team is further expanded, and the construction of fire rescue command system becomes more and more important. This paper takes the information construction of the fire rescue team as the center, and studies the construction of the grass-roots emergency command system, aiming to promote the construction of the fire rescue system and improve the emergency rescue level of the fire rescue team. This paper takes the emergency rescue command system of the special service station of X Fire rescue detachment as the research object, and studies the construction of the basic emergency command system through literature research method and interview investigation methods.

Unlocking the Potential of Pick-Up Points in Last-Mile Delivery in Relation to Gen Z: Case Studies from Greece and Italy

Pick-up points (PUPs) have become a very attractive alternative for conventional home deliveries due to the growth of e-commerce. This paper investigates the level of satisfaction of the students (Gen Z) as well as the research, teaching, and administrative staff of the Aristotle University of Thessaloniki (AUTH), Greece, and the University of Enna “Kore”, Italy, implemented in November 2023. Optimizing the PUP users’ satisfaction is contingent upon various aspects, including but not limited to location accessibility, expedient pick-up procedures, unambiguous communication, and ensured item availability. The research recorded information about the users’ knowledge about the specific service, their level of satisfaction, their preferences on when and how they use the service, and information about the types of goods they order using the PUPs as their point of collection. The analysis of the collected data revealed very interesting findings that could be useful to the providers of this service, especially when taking into consideration that the majority of the poll’s participants are familiar with the existence of the PUPs in the Municipality of Thessaloniki, that they use this service mainly occasionally, and that the majority are quite pleased with the level of the provided services (accessibility, availability, safety, and security). For the case of Enna in Sicily, similar trends are shown: a high percentage of respondents are familiar with PUPs, and they use pick-up points occasionally and are pleased with the provided level of service. The comparative statistical analysis makes it possible to compare two contexts located in areas of the Mediterranean, i.e., two urban areas with different population sizes but with similar habits on the part of the university student cluster.

Optimal Allocation of Depots for Electric Bus Charging: Cost Minimization and Power System Impact Mitigation Using Mixed Integer Nonlinear Programming

ABSTRACTThis paper proposes a novel approach for the optimal allocation of a depot for electric buses (EBs) charging in a specific transit service, considering the impact on the power system. The main objective is to minimize the total cost, achieved by minimizing the cost of the new cables connecting the depot station to the distribution system and the upgrade cost of existing lines to meet the additional loads. The outcomes are the optimal location of the depot, the optimal electric node bus in the distribution system to supply it, and the required system upgrades. The optimization problem is formulated as a Mixed Integer Nonlinear Programming (MINLP) model and solved using the General Algebraic Modeling System (GAMS). The methodology is tested on the H16 EB service line in Barcelona, Spain, and a typical electrical distribution system. Three case studies are presented in this paper. In the first case, the impact of a single service on the distribution network is analyzed, and in the second case, three H16 EB services are assumed to serve the network. The third case handles a multi‐route, multi‐terminal bus service to allocate and supply a depot capable of accommodating all the routes. This case will also include sensitivity analysis to test the robustness and reliability of the model. Results show that for a single H16 EB service, no line upgrades were needed, and the total cost per phase was $120,000. For three H16 EB services, three lines required upgrades, and the total cost per phase increased to $718,000. In the third case, the sensitivity analysis revealed that higher demand factors lead to increased costs due to more update requirements and voltage deviations. The results demonstrate that the minimum distance between the depot and node is not always the optimal or feasible solution that would prevent the depot load installation at a weak spot and meet the power flow constraints.