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Industrial energy management is critical to ensuring efficient energy usage, market viability, and greenhouse gas emission reductions. In this study, the aim is to investigate energy management practices in paper and pulp industries (PPI) of Bangladesh. The study identifies several barriers to adopt energy management practices; "Lack of governmental attention", "Inadequate staff awareness" and "limited access to capital" are identified as the major constraints. In addition, HVAC systems and compressed air systems present higher barriers compared to electrical motor and pump systems while looking at the barriers by technology areas. On the other hand, "Owner's demand", "Commitment from the top management" and "Pressure from the customers and different non-Governmental organization" are found to be the dominant drivers of energy management in the studied PPI. Energy management practices can enhance the energy efficiency approximately by 4–5 % according to the study. Furthermore, this study reveals that the majority of PPIs are unaware of the energy service companies (ESCO) with the lack of a standardized system for energy audit, as well as a lack of trust and information, appearing to be the obstacles behind this. • Energy management practices in paper and pulp industries of Bangladesh are shown. • Barriers and drivers to energy management practices in paper and pulp industry are presented. • Barriers to energy efficiency measures by technology area are discussed. • Barriers to consult energy service companies (ESCOs) are presented. [ABSTRACT FROM AUTHOR]

This updated report on intensity modulated radiation therapy (IMRT) is part of a series of consensus-based white papers previously published by the American Society for Radiation Oncology (ASTRO) addressing patient safety. Since the first white papers were published, IMRT went from widespread use to now being the main delivery technique for many treatment sites. IMRT enables higher radiation doses to be delivered to more precise targets while minimizing the dose to uninvolved normal tissue. Due to the associated complexity, IMRT requires additional planning and safety checks before treatment begins and, therefore, quality and safety considerations for this technique remain important areas of focus. ASTRO convened an interdisciplinary task force to assess the original IMRT white paper and update content where appropriate. Recommendations were created using a consensus-building methodology, and task force members indicated their level of agreement based on a 5-point Likert scale, from "strongly agree" to "strongly disagree." A prespecified threshold of ≥75% of raters who select "strongly agree" or "agree" indicated consensus. This IMRT white paper primarily focuses on quality and safety processes in planning and delivery. Building on the prior version, this consensus paper incorporates revised and new guidance documents and technology updates. IMRT requires an interdisciplinary team-based approach, staffed by appropriately trained individuals as well as significant personnel resources, specialized technology, and implementation time. A comprehensive quality assurance program must be developed, using established guidance, to ensure IMRT is performed in a safe and effective manner. Patient safety in the delivery of IMRT is everyone's responsibility, and professional organizations, regulators, vendors, and end-users must work together to ensure the highest levels of safety. [ABSTRACT FROM AUTHOR]

• The EEG is one of the most useful technologies for brain research and clinical neurology. • The acquired traces are visibly displayed, but various studies investigate the translation of brain waves in sound. • The analog EEG was equipped with an auditory output, the pen-on-paper noise made by the writer unit, useful to facilitate the diagnosis of epileptic disorders. • Early digital EEG devices could be equipped with special software to duplicate the pen-on-paper noise digitally. • Nowadays, auditory neurofeedback has applications in therapeutic interventions, cognitive improvement, and basic research. The electroencephalogram (EEG) is one of the most useful technologies for brain research and clinical neurology, characterized by non-invasiveness and high time resolution. The acquired traces are visibly displayed, but various studies investigate the translation of brain waves in sound (i.e., a process called sonification). Several articles have been published since 1934 about the sonification of EEG traces, in the attempt to identify the "brain-sound." However, for a long time this sonification technique was not used for clinical purposes. The analog EEG was in fact already equipped with an auditory output, although rarely mentioned in scientific papers: the pen-on-paper noise made by the writer unit. EEG technologists often relied on the sound that pens made on paper to facilitate the diagnosis. This article provides a sample of analog video-EEG recordings with audio support representing the strengths of a combined visual-and-auditory detection of different types of seizures. The purpose of the present article is to illustrate how the analog EEG "sounded," as well as to highlight the advantages of this pen-writing noise. It was considered so useful that early digital EEG devices could be equipped with special software to duplicate it digitally. Even in the present days, the sonification can be considered as an attempt to modify the EEG practice using auditory neurofeedback with applications in therapeutic interventions, cognitive improvement, and basic research. [ABSTRACT FROM AUTHOR]

• Concept map has positive effects in student's critical thinking and understanding. • Quantitative analysis of concept map and open-ended exam papers in nursing education. • Concept map has comparable results with traditional assessments. This study's aim is to investigate the necessity and advantages of the use of concept map as an assessment tool in nursing education. Concept maps have been used extensively aiming mainly at effective understanding, linking together concepts and evaluating new knowledge. A class of second-year nursing degree undergraduate students (N = 32) in Greece participated in this pilot study. Concept map and open-ended exam papers were used. Quantitative statistical analysis of the concept map and open-ended exam grades was conducted. Statistical tests were used to compare all pairs of both types of papers. For the concept map papers, two different grading methods were employed to evaluate their effectiveness. The obtained results indicated that the concept map exam type provided similar scores when compared to the open-ended exam, while the grading efficiency is higher. Moreover, for the concept map exam paper, both grading methods can be applied interchangeably to provide similar scores for the students. The concept map can be a trusted assessment tool for identifying the nursing students' gaps in knowledge and comprehension, in comparison to the open-ended exam type. Nursing educators are encouraged to note the tools strengths and use it according to courses' requirements. Not applicable. [ABSTRACT FROM AUTHOR]

The use of administrative databases and clinical registries in lower extremity arthroplasty research is growing. Such observational studies are unable to fully control for confounders and cannot establish causality. However, many authors use causal language when describing their aims or findings, potentially misleading readers. We examined the prevalence of causal language and inferences in the lower extremity arthroplasty literature. We systematically identified administrative database and registry studies on hip and knee arthroplasty that were published in 4 orthopaedic journals in 2020. Articles were graded independently by two reviewers for the presence of causal language in both the title and abstract and the full text. Chi-squared analyses were conducted to determine the relationship between the causality grading and article characteristics including the journal of publication. Of 116 eligible articles, we classified 79.3% of titles and abstracts as either consistently causal or inconsistently causal, with only 20.7% as consistently noncausal. A total of 40.5% of full texts were consistently causal, 49.1% were inconsistent, and 10.3% were consistently noncausal. Chi-squared analyses revealed no statistically significant association between the title and abstract's grading and the journal (P =.720) nor with the use of a database or registry (P =.716). Causal language and inferences were present in 79.3% of titles and abstracts of lower extremity arthroplasty observational database studies published in 2020. The high prevalence of causal language and inferences in the arthroplasty literature may mislead readers. [ABSTRACT FROM AUTHOR]

Actionable incidental findings (AIFs) are common in radiologic imaging. Imaging is commonly performed in emergency department (ED) visits, and AIFs are frequently encountered, but the ED presents unique challenges for communication and follow-up of these findings. The authors formed a multidisciplinary panel to seek consensus regarding best practices in the reporting, communication, and follow-up of AIFs on ED imaging tests. A 15-member panel was formed, nominated by the ACR and American College of Emergency Physicians, to represent radiologists, emergency physicians, patients, and those involved in health care systems and quality. A modified Delphi process was used to identify areas of best practice and seek consensus. The panel identified four areas: (1) report elements and structure, (2) communication of findings with patients, (3) communication of findings with clinicians, and (4) follow-up and tracking systems. A survey was constructed to seek consensus and was anonymously administered in two rounds, with a priori agreement requiring at least 80% consensus. Discussion occurred after the first round, with readministration of questions where consensus was not initially achieved. Consensus was reached in the four areas identified. There was particularly strong consensus that AIFs represent a system-level issue, with need for approaches that do not depend on individual clinicians or patients to ensure communication and completion of recommended follow-up. This multidisciplinary collaboration represents consensus results on best practices regarding the reporting and communication of AIFs in the ED setting. [Display omitted] [ABSTRACT FROM AUTHOR]

This updated report on image guided radiation therapy (IGRT) is part of a series of consensus-based white papers previously published by the American Society for Radiation Oncology addressing patient safety. Since the first white papers were published, IGRT technology and procedures have progressed significantly such that these procedures are now more commonly used. The use of IGRT has now extended beyond high-precision treatments, such as stereotactic radiosurgery and stereotactic body radiation therapy, and into routine clinical practice for many treatment techniques and anatomic sites. Therefore, quality and patient safety considerations for these techniques remain an important area of focus. The American Society for Radiation Oncology convened an interdisciplinary task force to assess the original IGRT white paper and update content where appropriate. Recommendations were created using a consensus-building methodology, and task force members indicated their level of agreement based on a 5-point Likert scale from "strongly agree" to "strongly disagree." A prespecified threshold of ≥75% of raters who selected "strongly agree" or "agree" indicated consensus. This IGRT white paper builds on the previous version and uses other guidance documents to primarily focus on processes related to quality and safety. IGRT requires an interdisciplinary team-based approach, staffed by appropriately trained specialists, as well as significant personnel resources, specialized technology, and implementation time. A thorough feasibility analysis of resources is required to achieve the clinical and technical goals and should be discussed with all personnel before undertaking new imaging techniques. A comprehensive quality-assurance program must be developed, using established guidance, to ensure IGRT is performed in a safe and effective manner. As IGRT technologies continue to improve or emerge, existing practice guidelines should be reviewed or updated regularly according to the latest American Association of Physicists in Medicine Task Group reports or guidelines. Patient safety in the application of IGRT is everyone's responsibility, and professional organizations, regulators, vendors, and end-users must demonstrate a clear commitment to working together to ensure the highest levels of safety. [ABSTRACT FROM AUTHOR]

There are many suggestions offered within the literature to decide if a job type is a profession, some using tick box type trait and characteristics analyses to compare the actions and qualities of individuals to a predefined list. However, there is no specific way to resolve what makes or defines a profession. Writers in many disciplines, including radiography, have used these different models, sometimes with conflicting results. This paper explores the use of Bourdieu's replacement of the concept of profession with that of a 'field', meaning a network of occupants with common attributes, in this case radiographers, in an attempt to resolve this issue. In the UK, radiography practitioners and professional bodies generally use the term profession to describe radiography, and this paper explores a defence of the term for radiography. Using Bourdieu's field theory not only helps define a profession, but also explains the difficulties at the boundaries of professions, and the work needed to protect a profession as a credible entity. This paper supports the argument that radiography is a profession when using Bourdieu's field theory. Radiography continues to work to maintain its status by increasing its symbolic capital by increasing the research output and evidence base of the profession and through role extension. Radiographers can perhaps be assured that radiography is a profession when using Bourdieu's field theory. This paper shows how theoretical frameworks and concepts from outside radiography can be used to support new ways of thinking within the profession. [ABSTRACT FROM AUTHOR]

Excessive trabeculation, often referred to as "noncompacted" myocardium, has been described at all ages, from the fetus to the adult. Current evidence for myocardial development, however, does not support the formation of compact myocardium from noncompacted myocardium, nor the arrest of this process to result in so-called noncompaction. Excessive trabeculation is frequently observed by imaging studies in healthy individuals, as well as in association with pregnancy, athletic activity, and with cardiac diseases of inherited, acquired, developmental, or congenital origins. Adults with incidentally noted excessive trabeculation frequently require no further follow-up based on trabecular pattern alone. Patients with cardiomyopathy and excessive trabeculation are managed by cardiovascular symptoms rather than the trabecular pattern. To date, the prognostic role of excessive trabeculation in adults has not been shown to be independent of other myocardial disease. In neonates and children with excessive trabeculation and normal or abnormal function, clinical caution seems warranted because of the reported association with genetic and neuromuscular disorders. This report summarizes the evidence concerning the etiology, pathophysiology, and clinical relevance of excessive trabeculation. Gaps in current knowledge of the clinical relevance of excessive trabeculation are indicated, with priorities suggested for future research and improved diagnosis in adults and children. [Display omitted] • Current evidence shows that the extent of trabeculated vs compact myocardium in the adult is determined by differential (allometric) growth of each myocardial layer. Because trabeculated myocardium does not coalesce to form the compact myocardial wall, the term "left ventricular noncompaction" is inaccurate and use should be discouraged. • Excessive trabeculation, as diagnosed using existing criteria, may be present as a normal variant or as a response to preload conditions. • In adults incidentally found to have excessive trabeculation with normal myocardial function and morphology, clinical management is determined by other cardiovascular symptoms or abnormalities, without regard to trabecular pattern. • In adults diagnosed with hypertrophic or dilated cardiomyopathy where excessive trabeculation is also present, the extent of ventricular trabeculation has not been demonstrated to alter management nor prognosis. Following guidelines developed specifically for those conditions is recommended. • In infants and children, caution is warranted because fewer data are available regarding the etiology and prognosis of excessive trabeculation. Clinical evaluation for occult neuromuscular disease or another genetic/metabolic etiology may be appropriate. [ABSTRACT FROM AUTHOR]

With prolonged pandemic conditions, and emerging evidence but persisting low awareness of the importance of nutritional derangements, ESPEN has promoted in close collaboration with World Health Organization-Europe a call for papers on all aspects relating COVID-19 and nutrition as well as nutritional care, in the Society Journals Clinical Nutrition and Clinical Nutrition ESPEN. Although more COVID-related papers are being submitted and continue to be evaluated, ESPEN and WHO present the current editorial to summarize the many published findings supporting major interactions between nutritional status and COVID-19. These include 1) high risk of developing the disease and high risk of severe disease in the presence of pre-existing undernutrition (malnutrition) including micronutrient deficiencies; 2) high risk of developing malnutrition during the course of COVID-19, with substantial impact on long-term sequelae and risk of long COVID; 3) persons with obesity are also prone to develop or worsen malnutrition and its negative consequences during the course of COVID-19; 4) malnutrition screening and implementation of nutritional care may improve disease outcomes; 5) social and public health determinants contribute to the interaction between nutritional status and COVID-19, including negative impact of lockdown and social limitations on nutrition quality and nutritional status. We believe the evidence supports the need to consider COVID-19 as (also) a case of malnutrition-enhanced disease and disease-related malnutrition, with added risk for persons both with and without obesity. Similarities with many other disease conditions further support recommendations to implement standard nutritional screening and care in COVID-19 patients, and they underscore the relevance of appropriate nutritional and lifestyle prevention policies to limit infection risk and mitigate the negative health impact of acute pandemic bouts. [ABSTRACT FROM AUTHOR]

As a reflection of the scholar's mastery of basic theories and professional knowledge, the dissertation is an important yardstick for measuring the level of scientific research. At present, the problem of academic misconduct is becoming increasingly prominent, which is not only related to personal academic ethics, but also related to the overall development of the national academic and scientific research field. In the traditional method of evaluating the quality of papers, it is mainly based on the evaluation experts' comments and scores. However, there are cases that the evaluation experts' comments and scores are inconsistent in practice. To address this problem, we proposed a paper quality consistency detection model based on the nearest neighbor analysis dimensionality reduction algorithm. Compared with other traditional models, the experimental results show that the detection accuracy of XGBoost model after dimensionality reduction using nearest neighbor analysis algorithm reaches 85.81%. [ABSTRACT FROM AUTHOR]

Foster care children tend to have greater physical and mental health needs compared to those of their peers who are not in foster care due to many challenges that threaten their well-being. Yet, owing to frequent placement changes, their treatment may be fragmented. Moreover, if foster children are unable to provide important information about their own health status, and the same cannot be obtained from their families of origin, the resulting incomplete and/or inconsistent health history puts them at risk for unrecognized problems and conflicting diagnoses. Paradoxically, foster parents and resource providers often request psychotropic medications for children and youth in their care as a means of managing their behaviors. The phenomenon of inappropriate polypharmacy arises due in part to the difficulties related to integrating trauma-informed principles into the care process. It is further exacerbated by the complexity of intersecting systems in which child welfare case workers need to communicate including foster and biological parents, social service agencies, and advocates. In this second paper, we report on the same intervention as that discussed in the first paper, focusing on the effectiveness of the live 2-hour face-to-face training for child welfare staff and the 3-month web-based curriculum for leadership personnel in improving the participants' trauma responsiveness. 1. What are the child welfare staff's perceptions of their own knowledge, attitudes, and communication behaviors associated with medications used to treat mental health symptoms and monitoring for side-effects of psychotropic medication use in children? 2. What is the level of trauma responsiveness among child welfare staff? The ABC Medication Scale was employed to measure staff knowledge, attitudes, and behaviors associated with medications used to treat mental health symptoms before and after the intervention to determine if the training resulted in any improvements. Individual- and organizational-level trauma responsiveness was rated on a continuum of the Missouri Model: A Developmental Framework for Trauma-Informed Approaches. Artifacts of the web-based curriculum and qualitative interview data were analyzed by applying grounded theory methods. There was a significant increase in The ABC Medication Scale scores following the training. The qualitative findings further revealed that majority of the participants rated themselves as "trauma aware" or "trauma responsive" on the Missouri Model, while indicating that their agencies could work harder to become more fully trauma-informed. As trauma-informed child welfare workforce that understands the complexity and advocacy requirements of psychotropic medication management is needed, further longitudinal research is required is to assess the training effects over time. In particular, the aim should be to establish (a) how knowledge and attitude shifts correlate with greater degrees of trauma responsiveness, and (b) if and how such trainings translate into improved systems of support. [ABSTRACT FROM AUTHOR]

The phenomenon of inappropriate polypharmacy among the foster care population arises in part due to the challenges related to integrating trauma-informed principles into service delivery. It is further exacerbated by the complexity of intersecting systems in which child welfare case workers need to communicate, including foster and biological parents, social service agencies, and advocates. Yet, there is limited research about trauma-informed psychotropic medication management interventions for child welfare staff. This pilot study was conducted to evaluate a trauma-informed psychotropic medication management intervention and is reported in two manuscripts, pertaining respectively to the facilitators and barriers to learning, and perceived individual and institutional trauma responsiveness. The intervention comprised of a 2-hour-long training session for child welfare staff and a 3-month web-based curriculum for leadership personnel, aiming to increase their understanding of trauma-informed psychotropic medication management. In the first paper, we report on the facilitators and barriers to learning, grouped into three categories: teacher attributes, learner attributes, and situational factors. In the second paper, in addition to trauma responsiveness ratings, we also provide a detailed account of one participant's life experience and perceptions of the intervention provided, as an exemplar of the psychosocial facets of resilience. The ABC Medication Scale scores that measured staff knowledge, attitudes, and behaviors associated with medications used to treat mental health symptoms showed a significant change in scores following training. Based on these findings, we provide practical solutions to address situational factors that are worth considering when providing training for child welfare staff. Given that foster care children experience many challenges that threaten their well-being, their physical and mental health needs tend to be greater than those of their peers who are not in foster care. However, owing to the transient nature of the foster care placements, as well as continuous changes in medical providers and counselors, the screenings, supportive interventions, and treatments they receive may be fragmented. This is particularly problematic when considering that many of these children are medicated as a means of managing their behavior. Moreover, children in foster care are also more vulnerable to having the medications and diagnoses accumulate due to frequent placement changes and lack of treatment continuity. Our research was guided by the question "What are the facilitators and barriers to learning about trauma-informed psychotropic medication management?" We developed an intervention to address the issue of inappropriate polypharmacy and examined the facilitators and barriers to learning using a mixed methods design. The facilitators to learning were instructor-specific (e.g., reputation, teaching style, capacity for selecting and implementing relevant resources), learner-specific (altruism, capacity to see personal relevance in the learning situation, desire for knowledge/competence, career advancement/recognition-seeking), and situational (immediacy/on-demand resources, reinforcement of pleasant learning experience). Barriers were largely situational (workload and family demands). Based on these findings, we provide practical strategies for addressing situational factors that are worth considering when designing training curricula aimed at child welfare staff. [ABSTRACT FROM AUTHOR]

The article describes an approach to build a search index for fuzzy objects recognition in scientific and technical papers. A fuzzy object is explained as an entity described by some physical parameters. A physical parameter consists of two parts: a value, represented in various forms of digits, and a physical unit, represented as text with some digits. The approach presented in the article allows users to search not by ordinary substrings, but by physical parameters with range, less than or greater than operators. The current realisation of the approach is a web service that has functionality to perform all stages for extraction of physical parameters of a fuzzy object. These stages are the extraction of sentences, the extraction of physical parameters and the normalisation of physical parameters values. The web service can be exploited in the synchronous and asynchronous modes. The synchronous mode helps to troubleshoot the software. The asynchronous mode is designed to process papers using queues in the distributed computer systems. The current work is aimed to develop a search engine which will address the challenge of structuring information of a continuously growing number of scientific and technical papers. The search index will help to perform robust navigation among a huge number of documents for scientific workers and engineers. [ABSTRACT FROM AUTHOR]

Climate crisis is dramatically changing life on earth. Environmental sustainability and waste management are rapidly gaining centrality in quality improvement strategies of healthcare, especially in procedure-dominant fields such as gastroenterology and digestive endoscopy. Therefore, healthcare interventions and endoscopic procedures must be evaluated through the 'triple bottom line' of financial, social, and environmental impact. The purpose of the paper is to provide information on the carbon footprint of gastroenterology and digestive endoscopy and outline a set of measures that the sector can take to reduce the emission of greenhouse gases while improving patient outcomes. Scientific societies, hospital executives, single endoscopic units can structure health policies and investment to build a "green endoscopy". The AIGO study group reinforces the role of gastrointestinal endoscopy professionals as advocates of sustainability in digestive endoscopy. The "green endoscopy" can shape a more sustainable health service and lead to an equitable, climate-smart, and healthier future. [ABSTRACT FROM AUTHOR]

1 Amorphous carbon was facilely obtained via the treatment of waste papers with sulfuric acid. 2 The combination of amorphous carbon with graphitic carbon nitride leads to an increased photo-catalytic H 2 generation. 3 The enhancement in H 2 generation is resultant from the efficient separation of electrons and holes owing to the excellent electrical conductivity of amorphous carbon. Up-cycling of waste papers to value-added carbon products has significant environmental and economic benefits in real life. This work aims to recycle the waste papers to construct amorphous carbon modified graphitic carbon nitride composite photocatalysts for efficient photocatalytic hydrogen generation from water under visible light. Amorphous carbon (labeled as a-C) was yielded from the office waste papers by simple sulphuric-acid treatment and then combined with graphitic carbon nitride (g-CN) to form the g-CN/a-C composite photocatalysts by the thermolysis of a-C and melamine mixture. The addition of a-C enlarges the surface area of g-CN from 11.52 m2 g−1 of pristine g-CN to 28.12 m2 g−1 of g-CN/a-C-100. In addition, the a-C incorporation can significantly separate the electrons from the photoexcited g-CN owing to the excellent conductivity of a-C. As a result, an increased photocatalytic H 2 generation was realized under visible light exposure. The g-CN/a-C-100 sample with optimized a-C contents offers the highest photocatalytic H 2 generation rate of up to 17.1 μ mol h−1, which is ∼12 times higher than that of pristine g-CN under the same condition. The present study manifests the great potential of the recycling of office waste papers for increased photocatalytic H 2 generation. Graphical Abstract [Display omitted]. [ABSTRACT FROM AUTHOR]

The sequential combination of torrefaction and alkaline treatment is one possible design strategy for a circular economy in which torrefied cellulosic paper with enhanced wet strength is repeatedly used as a packaging material, then hydrolyzed downstream for bioethanol production after alkaline treatment. The wet-tensile strength of cellulose filter paper increased by 1533%, 2233%, 1567%, and 557% after torrefaction for 40 mins at 200 °C, 220 °C, 240 °C and 260 °C, respectively. Glucose yield decreased with increase in torrefaction severity but after treating torrefied filter samples with alkaline (NaOH) solution, glucose yield increased. For instance, the glucose yield of raw filter paper was 955 mg/g of substrate whereas it was 690 mg/g of substrate for the same filter paper sample torrefied at 200 °C. The glucose yield increased to 808 and 933 mg/g of substrate with 1% and 10% alkaline treatment, respectively. [Display omitted] [ABSTRACT FROM AUTHOR]