Standard Time Research Articles

Evaluation of Energy Conversion and Distribution on the SI-PFI Engine Fueled by A Gasoline-Bioethanol Blend with AFR Variations

This study aims to investigate the engine performance of spark-ignition engines with port fuel injection using E50 fuel, which contains 50% gasoline or pertalite (in Indonesia) and 50% hydrate bioethanol, at air-fuel ratio variations of 10:1, 12:1, and 14:1. The experiments were conducted using a 1-cylinder, 662 cc engine research test with a constant load of 3 kg and engine speed variations of 1500 and 1800 RPM, as well as a compression ratio of 10:1 and standard ignition timing. The engine ran with E50 fuel, and the experimental results were compared with those of E0 for an air-fuel ratio of 14:1. According to the data, the fuel energy of E50 in an AFR of 14:1 is 0.11 kW higher than that of E0, and it increases by 21.6% when the engine speed increases from 1500 to 1800 RPM. The results also indicate that the efficiency of all performance indicators, such as indicative thermal efficiency, brake thermal efficiency, and mechanical efficiency, is maximized when the engine is operated at an AFR of 10:1 for E50 fuel. Additionally, the volumetric efficiency of E50 reaches its maximum when the fuel is burned at an AFR of 14:1, and it increases as the engine speed increases. However, it should be noted that the brake power decreases due to the frictional power of the fuel increase.

Quantifying Health Utility of Age-related Vocal Atrophy.

Age-related vocal atrophy (ARVA) negatively impacts voice and quality of life (QOL). This study aims to determine utility-based QOL in ARVA patients, correlate findings with traditional patient-reported outcome measures (PROMs), and generate utility-based inferences. Forty ARVA patients were prospectively recruited from a tertiary care center. Health utility was measured using standard gamble, time trade-off, and visual analog scale, assessing participants' current health states relative to defined comparison states (blindness/death). Traditional PROMs (Voice Handicap Index-10 [VHI-10] and Voice-Related Quality of Life Scale [V-RQOL]) were also collected. Descriptive and paired statistics were performed to determine health utility, and Pearson correlation assessed the association between PROMs and health utilities. Mean health utility in ARVA was 0.84 ± 0.22, 0.88 ± 0.17, and 0.62 ± 0.25 using standard gamble, time trade-off, and visual analog scale, respectively. There were positive correlations between V-RQOL and time trade-off (r = 0.66; p < 0.0001) as well as with standard gamble (r = 0.47; p = 0.002). Participants with ARVA reported no difference in health utility impact between their voice impairment and monocular blindness (Mean dif 10.9; 95% CI -1.6, 23.5; p = 0.101). Patients with ARVA were willing to part with an average 4.6 ± 6.1 years of life to restore normal voice. ARVA patients view their voice impairment as a significant health decrement, comparable to monocular blindness. These findings underscore the substantial impact of ARVA on QOL and highlight the need for continued research and new therapies. 4 Laryngoscope, 2024.

GROWTH-FRIENDLY SPINAL SURGERY: REVIEW OF THE EFFECT ON TRUNCAL GROWTH

BackgroundPediatric spinal deformity surgery affects ultimate spinal height in the growing child. This effect on ultimate spinal height has also been shown to affect pulmonary development and ultimately pulmonary function. There has been an increasing trend toward growth-friendly spinal surgery in early onset scoliosis to minimize the negative consequences of early spinal fusion surgery. Such growth-friendly techniques include VEPTR, MCGR, and Shilla. Which technique allows for the most growth after initial implantation is still not clear. MethodsAn extensive literature review on the topic of pediatric spinal growth was undertaken. Topics reviewed include: normal growth, growth after intervention by various methods, and the effect on pulmonary function. We have summarized the literature for the techniques identified and compared these with normal population data.. ResultsThe data for various surgical techniques were reviewed. These included VEPTR, standard growing rods, and MCGR. The measurement techniques for determining ultimate spinal growth varied based upon the technique for measurement and the timing of initial and final measurements. The results of attained spinal growth were not directly correlated to pulmonary function values. ConclusionsThere is still no standardized ideal time or technique for assessing the best results in this area. We suggest that some of what is called growth from growth-friendly techniques is lengthening from the initial deformity correction. This nomenclature needs to be clarified. In addition, how and when to determine ultimate spinal growth from each surgical technique and by which radiographic technique needs to be standardized.

The British Sleep Society position statement on Daylight Saving Time in the UK.

There is an ongoing debate in the United Kingdom and in other countries about whether twice-yearly changes into and out of Daylight Saving Time should be abolished. Opinions are divided about whether any abolition of Daylight Saving Time should result in permanent Standard Time, or year-long Daylight Saving Time. The British Sleep Society concludes from the available scientific evidence that circadian and sleep health are affected negatively by enforced changes of clock time (especially in a forward direction) and positively by the availability of natural daylight during the morning. Thus, our recommendation is that the United Kingdom should abolish the twice-yearly clock change and reinstate Standard Time throughout the year.

A new model describing improved bound-state and statistical properties in the framework of deformed Schrödinger equation for the improved Coshine Yukawa potential in 3D-NR(NCPS) symmetries

In this paper, within the three-dimensional non-relativistic non-commutative phase–space (3D-NR(NCPS)) symmetries, we examined the 3D deformed Schrödinger equation (3D-DSE) using the improved Coshine Yukawa potential (ICYP) model composed from Coshine Yukawa potential (CYP) ([Formula: see text]) and other terms produced from the effect of phase–space deformation ([Formula: see text] and [Formula: see text]). For this study, the 3D-DSE in the 3D-NR(NCPS) symmetry is solved and discussed with standard independent time perturbation theory and the generalized Bopp’s shifts method. For the homogeneous (H2 and N2) and heterogeneous (LiH, ScH, and HCL) diatomic molecules, it is obtained that the improved non-relativistic energy equation and eigenfunction for the ICYP in the presence of deformation phase–space are dependent on the discrete atomic quantum numbers ([Formula: see text],m), the dissociation energy [Formula: see text], the equilibrium bond length the screening parameter [Formula: see text], the deformation phase parameters ([Formula: see text]) and the deformation space parameters ([Formula: see text]). Additionally, the thermal properties of the CYP and ICYP with 3D Schrödinger equation (3D-SE) and 3D-DSE are thoroughly examined in the three-dimensional non-relativistic quantum mechanics (3D-NR(QM)) known in the literature symmetry and 3D-NR(NCPS) symmetries, including the partition function, mean energy, free energy, specific heat, and entropy. Furthermore, we discussed particular cases of thermodynamic characteristics for the ICYP model. In our study, we have shown that all the physical values related to energy and thermodynamic properties within the framework of the 3D(NR)NCPS symmetry are equal to the corresponding values within the framework of 3D-NR(QM) symmetry known in the literature, in addition to minor effects resulting from their interaction with the topological properties of the deformed phase–space. This study has multiple applications in various domains, including atomic and molecular physics.

Performance of RC beams strengthened using NSM FRP and cement based adhesives after exposure to elevated temperatures

A popular method for strengthening of reinforced concrete (RC) structures is the use of carbon fiber reinforced polymers (CFRP) bonded to the structural elements using the near surface mounted (NSM) techniques. While this method possesses many advantages, poor fire resistance as a result of the low glass transition temperatures (TG) of organic resins remains a significant drawback. Replacement of organic resins with cement based adhesives (CBA) could potentially improve the fire performance of NSM FRP systems and reduce the amount of insulation required to achieve the required fire endurance period. This paper presents an experimental program consisting of fifteen RC beams strengthened in flexure using NSM FRP bonded using CBA and subjected to the standard fire time temperature curve up to a target temperature of 600 °C. Twelve of the beams were strengthened using NSM-FRP laminates and bars including both smooth and rough FRP laminates and the remaining three specimens acted as control beams. Further, the use of plasterboard was explored as fire protection to further increase the residual strength of the specimens after heating. Results showed that the reinforced concrete beams strengthened with NSM CFRP retained 82 % to 61 % of their unheated strengthened ultimate load after heat exposure. This was a result of the superior performance of the cement-based adhesive at high temperature and the fire protection provided to the CFRP through embedment in the grooves. Moreover, the use of plasterboard as fire protection decreased the CFRP temperature by 42–24 %. The insulated beams behaved similarly to strengthened beams prior to fire exposure.

Multimodal Fusion Anomaly Detection Model for Agricultural Wireless Sensors

ABSTRACTAgricultural Internet of Things has become one of the most important data sources of agricultural big data. However, the wireless sensors equipped with agricultural Internet of Things is affected by many factors, and anomalous data inevitably exists during the data collection process. The existence of anomalous data leads to the deterioration of the agricultural data quality, which hinders the efficient development of agricultural data analysis. In order to detect anomalous data accurately for agricultural wireless sensors, in this article, we propose an anomaly detection model that combines multimodal fusion and error reconstruction. The model first adds Gaussian noise to the input sequence and converts it into standard time series and image data. Subsequently, it is processed by different modal encoders and fuses the image and sequence modal data using Temporal Cross‐modal Attention module to enhance the perception of anomalous modal information. Finally, the fused data is reconstructed, and anomalous data are identified by the image and sequence decoders. Comparison experiments with several baselines prove the validity of the model proposed in this article, ablation experiments prove the necessity of the key modules in the model, and multiple sets of experiments are also designed to discuss the effects of hyperparameters.

Studies on Effect of Genotypes and Planting Time on Growth and Corm Characters of Gladiolus

Gladiolus is an important cut flower crop, grown commercially in many parts of the globe. This flower has gained popularity owing to its incomparable beauty, attractive colours, various sizes and shapes of florets, variable spike length and long vase life. Gladiolus produces beautiful spikes from December to March in the plains and from June to September in the hills of India.Gladiolus is very rich in its varietal wealth therefore, varietal evaluation in a particular growing condition becomes necessity of time to find out suitable variety for a particular region. Improvement of any crop is a continuous process and long process as well and, in this crop, tremendous scope is available to improve the existing cultivars, besides, other economical plants, the growth and development of gladiolus is governed by its genetic makeup and environmental factors of the growing region and various management practices. Among the various agro-techniques, the optimum planting time is of outmost importance. The Present investigation efforts aim to standard time of planting and suitability of varieties for local climate and edaphic conditions of the Nalanda (Bihar). A field investigation was conducted during winter season of 2018-19 at Research Farm of Nalanda College of Horticulture, Noorsarai, Nalanda, Bihar. Corms of gladiolus cultivars viz., Red Beauty, Candyman, White Prosperity and Intrepid were planted at different planting dates. The soils of experimental site are newly formed alluvial soils with pH 7.40. The experiment consisted of 16 treatment combinations with four (04) varieties and four planting dates (D1- 25th Sept., D2- 10th October and D3- 25th Oct. and D4-10th Nov.) were laid out in split-plot-design with three replications. Minimum days to sprouting of corm (16.33 days), number of leaves per plant (11.27), length of leaves (86.87cm.) were with D2V2. However, maximum plant height (146.07 cm.) was in D2V1. Minimum days to initiation of spike (80.47 days), days taken to open first floret (95.07 days) and maximum length of spike (126.07cm.) were observed in D2V1. On the other hand, maximum numbers of florets per spike (21.20), fresh weight of flower spike (170.25 gm.), floret diameter (11.17cm.) and vase life (14.80 days) were in D2V3. Highest values for no. of corms per plant (1.40) and no. of cormels per plant (111.53) were noticed in D2V3. Besides, corm diameter (7.53 cm) and average weight of corm per plant (123.08 gm.) were found maximum in D2V1.

Electromyographic analysis of bilateral upper trapezius muscles at different levels of work-pace among sewing machine operators

Workers are driven to work faster in the industrial work environment to meet high productivity targets. An increased work pace leads to increased muscle activation. However, the effect of work pace on bilateral upper trapezius muscles during sewing machine operation in an industrial work environment has not been thoroughly investigated in experimental studies. Therefore, this research aims to conduct an experimental study to analyze the bilateral upper trapezius muscle activity of industrial sewing machine operators at different levels of work pace. Thirty subjects (15 males, and 15 females) continuously performed the sewing operation for two hours in an industrial work environment. Experiments were conducted for two levels of work pace i.e. low pace (100% of standard cycle time) and high pace (120% of standard cycle time). Electromyographic signals were recorded from the bilateral upper trapezius muscles. The EMG amplitude (RMS) among the muscles was computed. A statistically significant (p < 0.05) increase in muscle activity was observed with an increased work pace. In this study, right upper trapezius muscle activity increased by 30.4% during high work pace tasks compared to low pace, while the left upper trapezius showed a 24.12% increase. The right upper trapezius showed a mean difference of 0.696 (%MVC), and the left upper trapezius showed 0.399 (%MVC), both indicating greater activity during high-pace tasks. The increase in muscle activity with time indicated the presence of muscle fatigue among sewing machine operators. Furthermore, higher muscular activity was observed among females than males. This research highlights the critical need to balance productivity goals with the health and safety of workers, reducing the risk of muscle fatigue and associated work-related musculoskeletal disorders.

Comparison of Physically Based and Empirical Modeling of Nighttime Spatial Temperature Variability during a Heatwave in and around a City

Abstract The numerical weather prediction model HARMONIE-AROME and a multiple linear regression model (referred to in this article as the TURCLIM model after the local climate observation network) were used to model surface air temperature for 25–31 July 2018 in the City of Turku, Finland, to study their performance in urban areas and surrounding rural areas. The 0200 LT (local standard time) temperatures modeled by the HARMONIE-AROME and TURCLIM models were compared to each other and against the observed temperatures to find the model best suited for modeling the urban heat island effect and other spatial temperature variabilities during heatwaves. Observed temperatures were collected from 74 sites, representing both rural and urban environments. Both models were able to reproduce the spatial nighttime temperature variation. However, HARMONIE-AROME modeled temperatures were systematically warmer than the observed temperatures in stable conditions. Spatial differences between the models were mostly related to the physiographic characteristics: for the urban areas, HARMONIE-AROME modeled on average 1.4°C higher temperatures than the TURCLIM model, while for other land-cover types, the average difference was 0.51°C at maximum. The TURCLIM model performed well when the explanatory variables were able to incorporate enough information on the surrounding physiography. Respectively, systematic cold or warm bias occurred in the areas in which the thermophysically relevant physiography was lacking or was only partly captured by the model. Significance Statement As more and more people are living in an urban environment, the demand for accurate urban climate modeling is growing. This study aims to understand the differences between the numerical weather prediction and multiple linear regression modeling and their limitations in modeling surface air temperature in subkilometer scale. The case study shows that models are capable of predicting the spatial variation of 0200 LT nighttime temperature during a heatwave in a high-latitude coastal city. Both models are therefore valuable assets for city planners who need accurate information about the impacts of the physiography on the urban climate. The results indicate that to improve the performance of the models, more accurate physiographic description and higher spatial resolution of the models are needed.

Musical Expertise Influences the Processing of Short and Long Auditory Time Intervals: An Electroencephalography Study.

Musical expertise has been proven to be beneficial for time perception abilities, with musicians outperforming nonmusicians in several explicit timing tasks. However, it is unclear how musical expertise impacts implicit time perception. Twenty nonmusicians and 15 expert musicians participated in an EEG recording during a passive auditory oddball paradigm with 0.8- and 1.6-sec standard time intervals and deviant intervals that were either played earlier or delayed relative to the standard interval. We first confirmed that, as was the case for nonmusicians, musicians use different neurofunctional processes to support the perception of short (below 1.2 sec) and long (above 1.2 sec) time intervals: Whereas deviance detection for long intervals elicited a N1 component, P2 was associated with deviance detection for short time intervals. Interestingly, musicians did not elicit a contingent negative variation (CNV) for longer intervals but show additional components of deviance detection such as (i) an attention-related N1 component, even for deviants occurring during short intervals; (ii) a N2 component for above and below 1.2-sec deviance detection, and (iii) a P2 component for above 1.2-sec deviance detection. We propose that the N2 component is a marker of explicit deviance detection and acts as an inhibitory/conflict monitoring of the deviance. This hypothesis was supported by a positive correlation between CNV and N2 amplitudes: The CNV reflects the temporal accumulator and can predict explicit detection of the deviance. In expert musicians, a N2 component is observable without CNV, suggesting that deviance detection is optimized and does not require the temporal accumulator. Overall, this study suggests that musical expertise is associated with optimized implicit time perception.

Effect of Injection Timing on Performance and Emission of a Diesel Engine using Fuelled by Hydrogen Gas

The injection timing of pilot fuel in diesel engine working on dual fuel mode with gaseous fuel is a very important parameter at the start of ignition which affects performance and emissions of the engine. In this regard, the experiments were conducted on single cylinder 4-stroke, direct ignition diesel engine with a power of 3.50 kW at a constant speed of 1500 RPM. Kirloskar model TV1 with diesel as pilot fuel and hydrogen as gaseous fuel was employed. Experiments were conducted with the aim to determine the effect of advancing (21o bTDC) and retarding (17o bTDC) diesel fuel injection timing on the engine performance and emissions at various load conditions with the standard injection timing of 19o bTDC. The brake thermal efficiency (BTE) and exhaust emissions like NO­x, carbon monoxide (CO), carbon dioxide (CO­2) and hydrocarbon (HC) were analyzed with hydrogen (H2) as gaseous fuel. The results showed that dual mode (diesel and H2 gas) retards injection timing (17o bTDC) and gives a net increase in BTE efficiency at all load conditions with lower (20%) hydrogen substitution. At higher H2 substitution (40%), BTE is better for dual standard (19o bTDC) injection timing at all load conditions. Further NOx (ppm), HC (ppm), CO (%) and CO2 (%) emissions are significantly reduced with dual retard (17o bTDC) injection timing of the pilot fuel.

TSAM®: A Novel Application to Ambulatory Nursing Orientation.

Nursing professional development practitioners used a phased approach to apply TSAM® in ambulatory nursing orientation redesign across a regional health system in the Midwest. The team used job descriptions, practice standards, and nursing workflows with TSAM® components to develop tiered orientation objectives, resource time activities, and continuous partnership strategies that support ambulatory nursing practice. Project outcomes included creating a standardized orientation record and resource time activities across multiple clinics, strengthening stakeholder accountability, and post-implementation sustainability.

Differential prediction performance between Caribbean- and Mainland-subgroups using state-of-the-art polygenic risk scores for coronary heart disease: Findings from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

Coronary heart disease (CHD) is a leading cause of death for Hispanic/Latino populations in the United States. We evaluated polygenic risk scores (PRS) with incident myocardial infarction (MI) in a Hispanic/Latino study sample. We leveraged data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) to assess four CHD-PRS from the PGS catalog, derived using multiple methods (LDpred, AnnoPred, stacked clumping and thresholding, and LDPred2). We evaluated associations between each standardized PRS and time to adjudicated incident MI, adjusted for age, sex, first 5 principal components, and weighted for survey design. Concordance statistics (c-index) compared predictive accuracy of each PRS with, and in addition to, traditional risk factors (TRF) for CHD (obesity, hypercholesterolemia, hypertension, diabetes, and smoking). Analyses were stratified by self-reported Caribbean- (Puerto Rican, Dominican or Cuban) and Mainland- (those of Mexican, Central American, or South American) heritage subgroups. After 11 years follow-up, for 9055 participants (mean age (SD) 47.6(13.1), 62.2% female), the incidence of MI was 1.0% (n = 95). Each PRS was more strongly associated with MI among Mainland participants. LDPred2 + TRF performed best among the Mainland subgroup; HR=2.69, 95% CI [1.71, 4.20], c-index = 0.897, 95% CI [0.848, 0.946]; a modest increase over TRF alone, c-index = 0.880, 95% CI [0.827, 0.933]. AnnoPred + TRF performed best among the Caribbean sample; c-index = 0.721, 95% CI [0.647, 0.795]; however, was not significantly associated with rate of MI (HR=1.14, 95% CI [0.82, 1.60]). PRS performance for CHD is lacking for Hispanics/Latinos of Caribbean origin who have substantial proportions of African genetic ancestry, risking increased health disparities. AnnoPred, using functional annotations, outperformed other PRS in the Caribbean subgroup, suggesting a potential strategy for PRS construction in diverse populations. These results underscore the need to optimize cumulative genetic risk prediction of CHD in diverse Hispanic/Latino populations.

VWFTS-PSO: a novel method for time series forecasting using variational weighted fuzzy time series and particle swarm optimization

Variational weighted fuzzy time series models are known to perform better than traditional fuzzy time series models, due to their ability to handle outliers and noise. However, the performance of variational weighted fuzzy time series models is highly dependent on the partitioning of the universe of discourse. In this paper, we propose a novel variational weighted fuzzy model integrated with particle swarm optimization for choosing the best possible partitioning of the universe of discourse. Our approach combines the strengths of variational weighted fuzzy time series to handle uncertain and imprecise data and particle swarm optimization techniques to find the best model parameters. We evaluate the performance of the proposed approach on standard time series datasets and compare it with other forecasting methods in the literature. Our findings demonstrate that the proposed approach achieves accurate and reliable forecasts, outperforming other state-of-the-art approaches.

Analysis of Construction Worker Group Productivity at Pt. Bima Natisa Graha Contractor for Red Brick Installation Work with Time Study Method on Housing Development Project

This study aims to determine the productivity value of construction workers of PT Bima Natisa Graha red brick installation work on the construction project of housing units in residential area projects, to determine the factors that hinder the productivity of construction workers for red brick installation and to determine the productivity value of construction workers in red brick installation work after improving the factors that hinder the productivity of construction workers in red brick installation. The method to measure the productivity of construction workers in the installation of red bricks with the time study method. Time study is a method of measuring labor productivity in the field by determining the standard time of a job. The results of the study can be concluded as follows: (1) The productivity value of construction workers for red brick installation work on a housing construction project implemented by the contractor PT Bima Natisa Graha on a type 60 housing unit with a time study method of 0.378 M2 / OJ (2) Factors that hinder the productivity of construction workers are site managers, implementers and foremen from PT. Bima Natisa Graha who is rarely seen at the project site which should be in charge of giving directions in carrying out work in the field to workers so that workers joke more, talk a lot, smoke a lot, play a lot of cellphones and have coffee during working hours, this condition occurs because there is no reprimand and direction from the authorities. (3) The productivity value of construction workers for red brick installation work on a housing construction project carried out by the contractor PT Bima Natisa Graha on a type 60 housing unit with the time study method after productivity improvement is 0.496 M2 / OJ.

A robust time scale for space applications using the student’s t-distribution

Abstract In this article, the principles of robust estimation are applied to the standard basic time scale equation to obtain a new method of assigning weights to clocks. Specifically, the Student's t-distribution is introduced as a new statistical model for an ensemble of clocks that are experiencing phase jumps, frequency jumps or anomalies in their measurement links. The proposed robust time scale is designed to mitigate the effects of these anomalies without necessarily identifying them, but through applying a method of robust estimation for the parameters of a Student's t-distribution. The proposed time scale algorithm using the Student's t-distribution (ATST) is shown to achieve comparable robustness to phase jumps, frequency jumps, and anomalies in the measurements with respect to the AT1 oracle time scale. The AT1 oracle is a special realization of the AT1 time scale which corrects all anomalies by having prior knowledge of their occurrences. The similar performance of ATST and AT1 oracle suggests that the ATST algorithm is efficient for obtaining robustness with no prior knowledge or detection of the occurrences of anomalies.

Conducting two evidence syntheses in six weeks – experiences with and evaluation of a pilot project

BackgroundEvidence synthesis organisations are trying to meet commissioners’ needs for rapid responses to their evidence synthesis commissions. In this project we piloted an intensive process, working to complete evidence syntheses within six-weeks, rather than the standard lead time of 4–6 months. Our objective was to explore how researchers experience working intensively, identify barriers and facilitators, and determine how a more intensive approach to evidence synthesis could be more systematically introduced in the future.MethodsIn a pre-planning phase, an intensive work group was established, and two commissions were selected for this pilot project. The evidence synthesis process was divided into two phases: planning and intensive. The planning phase, involved scheduling the intensive phase, exploring new digital tools, and identifying peer reviewers. The intensive phase encompassed the entire evidence synthesis process. Two review teams were formed, each with a team lead supported by a process lead and leadership contact point. Throughout the project, teams engaged in reflective meetings to evaluate and adjust processes as needed.ResultsDuring the planning phase, teams identified significant uncertainties regarding scopes, research questions, and inclusion criteria. To address this, they engaged with commissioners earlier than originally planned, clarified these aspects, and prepared protocols. Despite some minor deviations from the original plan, both reviews were completed on schedule, with one team expanding their scope due to the absence of eligible studies. Teams operated flexibly, held regular meetings, and found the process seamless due to fewer interruptions. Machine learning tools facilitated rapid study selection. The process lead role, created to guide and evaluate the project, proved beneficial, providing structure and support, although clearer role delineation with the leadership contact point could have improved efficiency.ConclusionsOverall, the intensive process fostered focus and productivity, allowing teams to manage short-term deliverables effectively. The researchers preferred working intensively with one evidence synthesis over being involved with many projects at the same time. They felt that time use was more effective, and they were able to complete the tasks in a focused way. However, there are several implications that should be considered before implementing an intensive approach in future evidence syntheses.

Synergistic interactions between urban heat islands and heat waves in the Greater Kuala Lumpur and surrounding areas

AbstractThe synergistic interactions between urban heat islands (UHI) and heat waves (HW) continue to be debated. Despite the expectations of UHI intensification during HW, several studies have demonstrated variations. Notably, there is a dearth of investigations concerning the UHI–HW synergy in tropical climate cities amidst the escalating trend of more frequent and severe HW in Southeast Asia. To address this gap, our study aimed to investigate the synergies between the UHI and HW phenomena in Greater Kuala Lumpur (GKL) and its surrounding areas. We employed the advanced research version 4.2.2 of the Weather Research and Forecasting (WRF) model, coupled with a single‐layer Urban Canopy Model (UCM), to examine the impact of UHI during two heat wave events in 2016 (Case 1) and 2020 (Case 2), against the periods immediately before and after these events, which we refer to as Pre‐Post HW (PPHW), in GKL. An elevated UHI intensity (UHII) was evident during the HW in both observations and simulations, with a noticeable distinction particularly observed in Case 1. During HW, observed data indicates average UHII peaks at 1.8°C (0100 LST (UTC+8)) and 1.7°C (1500 LST) in Cases 1 and 2, respectively. In contrast, those for PPHW days for Cases 1 and 2 are 1.5°C (0000 LST) and 1.2°C (0100 LST), respectively. The maximum observed heat loads are likely to occur at noon, reaching 2.3°C at 1600 LST in Case 1 and 3.7°C at 1500 LST in Case 2. LST stands for local standard time. Heat flux component analysis from the surface energy balance model confirmed the UHI–HW synergy. A notable difference in the Bowen Ratio between urban and rural areas highlights the effect of urbanisation on heat fluxes, potentially exacerbating urban discomfort during HW. Consistent across all measurement methods, the evidence indicates a clear and positive synergy between the UHI and HW in the GKL. This study can potentially deliver valuable insights, especially in urban planning, where the implications of weather events are substantial.

Evaluating Thrombolysis Rates and Emergency Department Time Targets in Acute Ischemic Stroke: Need for Personalized Medicine.

In the era of personalized medicine, standard protocols regarding the management of acute ischemic stroke (AIS) focus on time targets alone without tailoring the protocol to the specific patient and hospital characteristics to increase IV thrombolysis rates and improve outcomes for these patients by considering organizational differences and patient-related factors that influence adherence to target times at the emergency department level. With this in mind, we evaluate the effect of achieving ED time targets from standard protocol and patient-related risk factors on the intravenous (IV) thrombolysis rate in patients with AIS in the therapeutic window. For our research, we enrolled people who arrived at the ED with signs of recent AIS with an onset of less than 4.5 h. Initially, 355 patients were included in the study, but through careful screening, only 258 were considered eligible to participate. Of the final group of 258 patients, only 46 received intravenous thrombolysis treatment. In our study, when we are analyzing ED times in patients admitted with stroke symptoms in the therapeutic window, we found statistically significantly decreased ED times for patients that performed IV thrombolysis compared to patients not performing as follows: a median of 100 min in onset-to-ED door time (p < 0.001), a door-to-physician time (ED doctor) of 4 min (p = 0.009), door-to-blood-samples of 5 min (p = 0.026), a door-to-CT time of 15.5 min (p = 0.009), and door-to-CT results of 37 min (p < 0.001). In addition, patients who received intravenous thrombolysis were found to be significantly older (p < 0.001), with lower height and weight (p < 0.001 for both) and lower Glasgow Coma Scale (GCS) scores (9 ± 4.94 vs. 13.85 ± 2.41, p < 0.001). The logistic regression analysis indicated that the onset-to-ED time (p < 0.001) and the door-to-physician time (p = 0.014) for emergency medicine physicians are significant predictors of the likelihood of administering thrombolysis. By analyzing the impact of comorbidities, we observed that dyslipidemia, chronic arterial hypertension, and diabetes mellitus are significant predictive factors for performing IV thrombolysis (the presence of dyslipidemia and diabetes mellitus are predictive factors for performing IV thrombolysis, while the presence of arterial hypertension is not). The ED time targets that significantly influenced IV thrombolysis in our study were the onset-to-ED door time and the time it takes for the ED doctor to assess the AIS patient (door-to-physician time). The IV thrombolysis rate for these patients was 17.83%, lower than expected despite achieving most ED time targets, with the presence of chronic arterial hypertension as a significant predictive patient-related factor for not performing it. Even though our reported hospital's thrombolysis rate is favorable compared to international reports, there is always room for improvement. Based on our study results, it is necessary that new protocols to customized standard protocols and ED time targets for increasing IV thrombolysis rate in patients with AIS in the therapeutic window, focusing more on patient-related factors and type of hospitals, granting personalized medicine its right. Based on our study results, it is necessary that new protocols customize standard protocols and ED time targets for increasing IV thrombolysis rate in patients with AIS in the therapeutic window, focusing more on patient-related factors and type of hospitals, granting personalized medicine its right.