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Photovoltaic energy is a well-known term nowadays, and with the continuous increase in PV demand, it has become necessary to consider the other sides that may affect the success of it, which is considered one of the real effects on the environment. The PV waste has started to create a large issue with the absence of administrative procedures in many countries. Despite the estimated life of photovoltaic panels being between 20 and 30 years, many units have already started to stop working. However, research indicates the total cost of new materials to manufacture a PV panel is around USD 90 per square meter, compared to USD 13.62 for the costs of recycling a PV module. The regulations disclosed that the problem of EoL for PV modules and their management is still not considered an issue in many countries. Therefore, SWOT analysis was used to evaluate the EoL management of waste PV modules in three regions in Washington, California, and the European Union's WEEE Directive. This study presents recommendations to strengthen regulations to manage the problems of the EoL waste, and open the way for countries and the private sector to realize the responsibility that may affect the environment.

This content used scientific inference extracted from several research studies, examples of individual projects based on biophilic design, and a descriptive presentation of approaches which applied in green buildings, to suggest some design guidelines to use the biophilia in office buildings, by analyzing the biophilic design strategies and GBRT (Green Building Rating Tools), qualifications to provide new tips and instructions to implement it into the future design. Evaluating the office environment with the biophilic method to consider the strategies is the best way to improve the office buildings for workers.

Resilience is regarded as an essential design objective of a wide range of systems in modern society. This work is based on a vision that networks of mobile energy storage systems could provide an alternative off-grid power system design for rural and underdeveloped regions. To evaluate the resiliency of networked energy storage systems under overload failure, a model of concurrent cascading failure and healing processes is developed and demonstrated. Two resilience metrics are used to evaluate the resilience of a real-world network, namely the recovery level at a specified time and the recovery time. The simulations generate system trajectories at each time step. We explore the dependence of the system behavior on different model parameters that capture key recovery strategies. The success probability of the recovery of a failed node needs to be high enough for the network to restore its original functionality. Similarly, the increase in recovery budget parameter also leads to faster and higher recovery levels. However, in most cases, there appears to be upper limits for both parameters, beyond which any further increase could not improve the recovery performance. There is an optimum portion of the loads of the active neighboring nodes that will be carried by the newly recovered node that results in the shortest recovery times or highest recovery levels. Our work sheds light on how to enhance networked systems resiliency by considering the optimization of various model parameters.

Background: Complications observed during pregnancy affect both mother and fetus, and are more commonly observed among pregnant women from developing countries. The study aims to identify the most common pregnancy and fetal complications during pregnancy, and associated risk factors with these complications. Methods: A longitudinal study was conducted from September 2017 to July 2018 among pregnant women attending and registering in primary health care clinics of the Palestinian Ministry of Health in Nablus city. Data were collected through interviews and by reviewing medical records. Women were followed up during their regular visits to the primary health care clinics. Any complication affecting either the fetus or the mother during the pregnancy period was recorded. Binary logistic regression was used to identify independent risk factors for pregnancy and fetal complications. Results: A total of 380 pregnant women were included in the study. The most common complications seen among women during pregnancy were preterm labor (PTL) (11.3%), followed by an equal number of gestational diabetes (GDM) and pregnancies induce hypertension (PIH), i.e. (7.9%). Large for gestational age (LGA) (11.6 %) and small for gestational age (SGA) (10.5%) were the most commonly observed fetal complications. Pregnant women living in camps (O.R 2.35, 95% [CI] 1.02- 5.45), nulliparity (O.R 14.9, 95% [CI] 1.09-202.5) and low parity women (O.R 16.8, 95% [CI] 1.47- 192.5) were at higher risk of having pregnancy complications. However, lower risk was noticed between women with gravida 4 (O.R 0.11, 95% [CI] 0.03-0.47) compared to women having more than 6 pregnancies. Age younger than 41 years was a protective factor against fetal complications, while parity (≤ 6 parities) especially 4 to 6 parities (OR 36.17; 95% CI 4.88-268) and active smoking mothers (OR 1.25; 95% CI 1.0-3.07) were identified as risk factors that are associated with an increased risk of fetal complications. Conclusions: Fetal and pregnancy-related complications are prevalent among Palestinian pregnant women. Increasing the awareness and improving the understanding of the identified risk factors related to these complications among the public, and specifically, females may help to reduce the prevalence of these conditions and the associated risk of these complications.

Respiratory viral infections are a significant cause of morbidity in asthma [1]. Patients with severe asthma were assumed to be at greater risk from novel coronavirus-2 (COVID-19) infection. In the global response to the COVID-19 pandemic, multiple countries enacted social containment policies. In the UK a countrywide lockdown occurred in March 2020, with stringent self-isolation (“shielding”) advice for high-risk patients, including people with severe asthma.

Introduction Severe asthma patients were assumed to be at greater risk of morbidity from infection with the novel severe acute respiratory syndrome coronavirus (COVID-19), hence, in the UK, were advised to shield. Community data on COVID-19 infection in severe asthmatics is lacking. We assessed the burden of shielding, the impact of COVID-19 and the effect of asthma medication on the UK severe asthma population. Methods Adults previously consented to inclusion in the UK Severe Asthma Registry (UKSAR) across 14 centres were contacted in June 2020 to collect data on potential COVID-19 infection, asthma control and shielding. Electronic records, where available, were reviewed for confirmation. Data was combined with clinical data from the UKSAR. Univariate and multivariate logistic regression analyses were performed to identify risk factors for COVID-19 infection. Results 1365 patients were included. 1268 (93%) were advised to shield, 1131 (89%) patients who received shielding advice followed it. Men (OR 0.4, p=0.045) and those in non-shielding households (OR 0.27, p=0.001) were less likely to follow shielding advice. 544 (47%) of patients advised to shield reported worsening of mental health; females (OR 1.59, p=0.001) and those with history of anxiety or depression (OR 2.12 p=0.001) were at greater risk. 97 (7.1%) patients had suspected/confirmed COVID-19 infection, 19 (1.39%) PCR/serology confirmed infection, 13(0.95%) were hospitalised and 2 patients (0.15%) died (table 1). 918 (67%) were on biologic therapy, 515 (37%) maintenance oral corticosteroid (mOCS). Multivariate analysis showed neither biologic therapy (OR 0.73, p=0.165) nor mOCS (OR 1.18, p=0.427) increased the risk of COVID-19 infection. Patients on biologics were less likely to require an acute course of corticosteroids for asthma symptoms (OR 0.6, p=0.002) while patients on mOCS were more likely (OR 1.96 p≤0.001). Inhaled corticosteroids (ICS) were not associated with COVID-19 infection, including high dose (2000 mcg BDP equivalent) (OR 0.64, p=0.234). Hospitalised patients were on lower median doses of ICS vs non-hospitalised patients (1000 vs 2000 mcg BDP equivalent, p=0.002). Conclusion Hospitalisation and death occurred in small numbers in our severe asthma population. From this observational data, biologic agents for asthma were not associated with increased risk of COVID-19 infection or hospitalisation.

Understanding the various effects that exist among intellectual capital, knowledge sharing, and organizational performance is the main purpose of this study. Data were gathered from 356 employees working in manufacturing companies in Jordan. In order to test the hypotheses of this study, the approach suggested by [1] was undertaken. The results of the analysis revealed that intellectual capital had a positive effect on organizational performance and knowledge sharing. The results also showed that knowledge sharing had a positive effect on organizational performance. Finally, it was found that knowledge sharing had a positive mediating effect on the relationship between intellectual capital and organizational performance. The findings of this study thus provide many benefits for researchers and practitioners despite the presence of some limitations.

Background Childhood obesity is rising in developed and developing countries, while childhood underweight is rising mainly in developing countries. Childhood underweight has been shown to increase a child’s risk of rapid weight gain. Overweight and obese children are more likely to become obese adults, which increases the risk of type-II diabetes and cardiovascular diseases. Studies concerning obesity among Palestinian children are scarce. The prevalence of obesity among Palestinian children has increased from 3 to 6% within 5 years in comparison to the worldwide rise from 1 to 7%, within 41 years. We aim to determine the current prevalence of underweight, overweight and obesity among Palestinian school-age children and to assess the role of dietary and sociodemographic factors. Methodology A cross sectional study was conducted in Palestine in 2017. A total of 1320 school-age children and their 2640 corresponding parents were recruited. A written questionnaire was filled out by the parents. Anthropometric indices were measured and categorized according to the Center for Disease Control and prevention (CDC). Results The mean ± SD age of the children was 9.5 ± 1.5 years and 48.8% were females. The prevalence of underweight, overweight and obesity among the children was approximately 7.3% (95% CI = 5.9–8.8%), 14.5% (95% CI = 12.7–16.6%) and 15.7% (95% CI = 13.8–17.8%) respectively. Multinomial logistic regression analysis demonstrated a significant correlation of waist circumference, age, gender and living place with the body mass indexes of the students. Conclusion Our findings highlighted the accelerated increase in the prevalence of underweight, overweight and obesity (37.5%) among Palestinian children within a very short time in comparison to the globe. Therefore, Interventions aiming to prevent obesity and underweight at an early stage might be vital to avoid obesity later in life and its health-related co-morbidities, e.g. type-II diabetes and cardiovascular diseases.

Introduction The elderly, with chronic obstructive pulmonary disease (COPD), are at a higher risk of hospitalisation due to acute exacerbation of COPD (AECOPD). They also often encounter multiple co-morbidities. Objectives This study was aimed to explore the occurrence of anxiety, depression and to identify the factors associated with hospital readmission among older patients after AECOPD discharge. Methods A multicentre prospective study was conducted in Malaysia (from 1st September 2012 till 31st September 2013) among older patients (≥60 years) hospitalised for AECOPD. Anxiety and depression were assessed on discharge using previously validated questionnaires, Generalized Anxiety Disorder-7 (GAD-7 and Geriatric Depression Scale (GDS-15), respectively. Patients were followed up for a period of 3 months after discharge. Results A total of 81 patients with a median age of 72 years (IQR 66.40-78.00) were recruited. Anxiety was observed in 34.57% while 38.27% had depression. Both anxiety and depression were detected in 25.93% of the patients. A history of frequent AECOPD admissions was found to be associated with developing depressive symptoms, while anxiety scores were associated with severe dyspnoea. Severe depression was more commonly identified among patients aged 60-75 and in those with a history of tuberculosis. A high readmission rate (40.74%) during the 3-month period was noticed. History of frequent AECOPD admissions (OR = 2.87; 95% CI 1.05-7.85, P = 0.040) and ischemic heart disease (IHD) (OR = 4.04; 95% CI 1.1-14.6, P = 0.032) were identified as the factors associated with the risk of hospital readmission. Conclusions Anxiety and depression were found to be relatively common among older patients with AECOPD. IHD and history of frequent COPD hospitalisation were associated with short-term readmission among the elderly.

The purpose of this study is to examine the different factors that are expected to influence the intention of hospitals to adopt cloud computing in Jordan. This study is conducted using quatititative methodology. 223 questionnaires were distributed to the IT departments of different hospitals to evaluate their ability and willingness to adopt cloud computing. The data were tested using multiple regression in order to determine whether Technology, Organizational, and Environmental factors (TOE) played a role in hospitals’ decision to consider cloud computing as a beneficial investment. The findings of this study showed that all the factors had a significant positive impact on the intention of hospitals to adopt cloud computing, with the Technological factor having the most impact on the decision made.

RESUME La chirurgie des adenomes hypophysaires n’a cesse d’evoluer depuis ses debuts, marquee par le developpement des voies d’abord transsphenoidales, l’utilisation du microscope puis plus recemment par l’avenement de l’endoscopie et de la video chirurgie. Ces interventions donnent generalement de tres bons resultats avec une faible morbidite lorsqu’elle est pratiquee par des equipes entrainees. Le traitement de ces patients necessite une etroite collaboration multidisciplinaire entre des endocrinologues, des neurochirurgiens et des radiologues habitues a cette pathologie.

Advances in spatial and spectral resolution of satellite images have led to tremendous growth in large image databases. The data we acquire through satellites, radars, and sensors consists of important geographical information that can be used for remote sensing applications such as region planning, disaster management. Spatial data classification and object recognition are important tasks for many applications. However, classifying objects and identifying them manually from images is a difficult task. Object recognition is often considered as a classification problem, this task can be performed using machine-learning techniques. Despite of many machine-learning algorithms, the classification is done using supervised classifiers such as Support Vector Machines (SVM) as the area of interest is known. We proposed a classification method, which considers neighboring pixels in a region for feature extraction and it evaluates classifications precisely according to neighboring classes for semantic interpretation of region of interest (ROI). A dataset has been created for training and testing purpose; we generated the attributes by considering pixel intensity values and mean values of reflectance. We demonstrated the benefits of using knowledge discovery and data-mining techniques, which can be on image data for accurate information extraction and classification from high spatial resolution remote sensing imagery., {"references":["A Adnan A. Y. Mustafa, Linda G. Shapiro and Mark A. Ganter,\"3D\nObject Recognition from Color Intensity Images\", 13th Int. Conf. on\nPattern Recognition, Vienna, Austria, pp. 25-30, /August, 1996.","Wang Xiang-yang, Sun Wei-wei a, Wu Zhi-fang, Yang Hong-ying,\nWang Qin-yan \"Color image segmentation using PDTDFB domain\nhidden Markov tree model\" Applied Soft Computing 29 (2015) 138–\n152.","Yang Haibo, Wang Zongmin, Zhao Hongling, Guo Yu \"Water body\nExtraction Methods Study Based on RS and GIS \" 2011 3rd\nInternational Conference on Environmental Science and Information\nApplication Technology (ESIAT 2011).","Yuqiang Wang, Renzong Ruan, Yuanjian SHE, Meichun YAN\n\"Extraction of Water Information based on Radarsat Sar and Landsat\nETM+ \" 2011 3rd International Conference on Environmental Science\nand Information Application Technology (ESIAT 2011).","U. S. Geological Survey (USGS)\" Landsat Orthorectified ETM+ Pan\nSharpened\" Sioux Falls, SD USA, USGS Earth Resources Observation\nand Science Center (EROS), https://lta.cr.usgs.gov/Tri_Dec_GLOO.","Xiaoxiao Lia, B., Soe W. Myintb, Yujia Zhangb, Chritopher Gallettib,\nXiaoxiang Zhangc,Billie L. Turner II \"Object-based land-cover\nclassification for metropolitan Phoenix, Arizona, using aerial\nphotography\" International Journal of Applied Earth Observation and\nGeoinformation 33 (2014) 321–330.","Usama Fayyad, Gregory Piatetsky-Shapiro, and Padhraic Smyth \"From\nData Mining to Knowledge Discovery in Databases \"American\nAssociation for Artificial Intelligence. All rights reserved. 0738-4602-\n1996.","I. Witten, E. Frank \"Data Mining: practical Machine Learning Tools and\nTechniques\".","J. Zahang, W. Hsu and M. L. Lee. \"An information-Driven Framework\nfor image Mining\", in proceedings of 12th International Conference on\nDatabase and Expert Systems Applications."]}

Transmission of M. ulcerans, the etiological agent of Buruli ulcer, from the environment to humans remains an enigma despite decades of research. Major transmission hypotheses propose 1) that M. ulcerans is acquired through an insect bite or 2) that bacteria enter an existing wound through exposure to a contaminated environment. In studies reported here, a guinea pig infection model was developed to determine whether Buruli ulcer could be produced through passive inoculation of M. ulcerans onto a superficial abrasion. The choice of an abrasion model was based on the fact that most bacterial pathogens infecting the skin are able to infect an open lesion, and that abrasions are extremely common in children. Our studies show that after a 90d infection period, an ulcer was present at intra-dermal injection sites of all seven animals infected, whereas topical application of M. ulcerans failed to establish an infection. Mycobacterium ulcerans was cultured from all injection sites whereas infected abrasion sites healed and were culture negative. A 14d experiment was conducted to determine how long organisms persisted after inoculation. Mycobacterium ulcerans was isolated from abrasions at one hour and 24 hours post infection, but cultures from later time points were negative. Abrasion sites were qPCR positive up to seven days post infection, but negative at later timepoints. In contrast, M. ulcerans DNA was detected at intra-dermal injection sites throughout the study. M. ulcerans was cultured from injection sites at each time point. These results suggest that injection of M. ulcerans into the skin greatly facilitates infection and lends support for the role of an invertebrate vector or other route of entry such as a puncture wound or deep laceration where bacteria would be contained within the lesion. Infection through passive inoculation into an existing abrasion appears a less likely route of entry., Author Summary Buruli ulcer, a severe skin disease in West and Central Africa results in significant disability. The causative bacterium, M. ulcerans has been detected in many aquatic sources, but how bacteria enter the skin is an enigma. Two major hypotheses for infection are 1) that bacteria are injected into the skin through the bite of an aquatic insect, or 2) that bacteria enter open wounds on a person's body. In this study, we use a guinea pig infection model to evaluate whether application of M. ulcerans to an open abrasion produces Buruli ulcer. Our results show that despite topical application of very large numbers of M. ulcerans, we are unable to produce infection in open abrasions. These results are extremely surprising because most bacteria such as Staphylococcus or Streptococcus can readily infect abrasions. In contrast, intra-dermal injection of M. ulcerans into the skin of guinea pigs consistently produced an ulcer. Our studies are the first to explore the route of infection of M. ulcerans in an experimental model. These results suggest that Buruli ulcer is not likely to be due to passive entry of bacteria into pre-existing abrasions and supports the role of biting invertebrates, puncture wounds, or lacerations as a requirement for infection.

The purpose of this study is to test the impact of supply chain management practices on supply chain performance in terms of supply chain efficiency and supply chain effectiveness. Additionally, we investigate the moderating effect of competitive intensity on the relationship between supply chain management practices and supply chain performance. Data for this research were collected from 104 manufacturing companies in Jordan. Hierarchical regressions were used to test the hypothesized relationships. The results indicate that three supply chain management practices, internal integration, information sharing, and postponement, but not supplier integration and customer integration, significantly and positively affect supply chain efficiency performance. Competitive intensity moderates the relationship between each of internal integration, supplier integration, and customer integration, and supply chain efficiency performance. The results also show that three supply chain management practices, internal integration, customer integration, and postponement, but not supplier integration and information sharing, significantly and positively affect supply chain effectiveness performance. Competitive intensity moderates the relationship between each of customer integration and information sharing, and supply chain effectiveness performance.

This study aims to examine the associated relationships between transformational leadership, corporate social responsibility, and organizational performance. A total of 217 questionnaires were gathered from employees operating the various pharmaceutical companies in Jordan and then were analysed using structural equation modelling (SEM). The results of the data were threefold. First, transformational leadership did not have a positive influence on organizational performance. Second, transformational leadership did have a positive influence on corporate social responsibility. Third, corporate social responsibility did have a positive influence on organizational performance. These findings may aid future researchers in their quest in understanding the inherent relationships that lie between the variables in question and may provide a platform for managers in their efforts to improve organizational performance.

The endoscopic approach is increasingly used for surgical treatment of pituitary adenomas. Early outcome is generally excellent, especially in experienced hands, and particularly for non invasive tumors. Treatment of these patients requires multidisciplinary collaboration among endocrinologists, radiologists and neurosurgeons.

Sana’ MH Al Aqqad, Li Li Chen, Asrul Akmal Shafie, Mohamed Azmi Hassali, Balamurugan Tangiisuran Pharmacy Practice Research Group, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia Background: Nursing home residents are mainly older people with multiple diseases and taking multiple medications. The quality use of medication and its association with health related quality of life (HRQoL) have not been reported in Malaysia. This study aims to investigate the association between the use of potentially inappropriate medications (PIMs) and the changes observed in the HRQoL among older nursing home residents. Methods: A prospective follow up study was conducted at four nongovernmental organization nursing homes in Penang, Malaysia. Older residents (≥65 years old) taking at least one prescribed medication were included. Residents with PIMs were identified by using Screening Tool of Older Person's potentially inappropriate Prescriptions (STOPP) criteria. HRQoL was assessed using EuroQol-5 dimension (EQ-5D) and EuroQol-visual analog scale (EQ-VAS) at baseline and after a 3-month follow up. The association of PIMs with HRQoL was analyzed using Mann-Whitney U test. Results: The median age of the 211 participants was 77 years (interquartile range 72–82 years) and the median number of prescription medicines was four (interquartile range three to six). The prevalence of PIMs was 23.7% and 18.6% at baseline and 3 months later, respectively. The most commonly prescribed PIMs in decreasing order were first generation antihistamine, prescriptions of duplicate drug class, glibenclamide with type 2 diabetes mellitus, and anticholinergic to treat extrapyramidal side effects of neuroleptic medications. At baseline, there was no significant difference among residents with or without PIMs in each bracket of EQ-5D, EQ-5D index, or EQ-VAS scores. Comparison of the differences in the mean score index of EQ-5D between baseline and after 3 months also showed no statistically significant differences. Conclusion: PIMs were found to be relatively common among older nursing home residents. However, no significant changes were observed in HRQoL among these residents. Further studies with a bigger sample size and longer follow up period are required to establish this association. Keywords: elderly, health related quality of life, patient safety

Background We previously established a congenic mouse strain with TALLYHO/Jng (TH) donor segment on chromosome 6 in a C57BL/6 (B6) background that harbors an obesity quantitative trait locus, tabw2. The B6.TH-tabw2 congenic mice developed increased adiposity that became exacerbated upon feeding a high fat-high sucrose (HFS) diet. To fine map the tabw2, in this study we generated and characterized subcongenic lines with smaller TH donor segments. Results We fixed four subcongenic lines, with maximum size of donor segment retained in the lines ranging from 10.8 – 92.5 Mb. For mapping, all the subcongenic mice, along with B6.TH-tabw2 congenic and B6-homozygous control mice were fed either chow or HFS diets, and their post-mortem fat pads were weighed. Mice were also characterized for energy expenditure, respiratory exchange ratio, locomotor activity, and food intake. As previously reported, B6.TH-tabw2 congenic mice showed a significantly larger fat mass than controls on both diets. On chow, a subcongenic line retaining the distal region of the TH donor congenic interval exhibited significantly larger fat mass than B6-homozygous controls, and comparable that to B6.TH-tabw2 congenic mice. Two nested subcongenic lines within that region suggested that the effect of tabw2 on obesity could be attributed to at least two subloci. On HFS diets, on the other hand, all the subcongenic mice had significantly larger fat mass than controls without genotype differences, but none of them had fat mass as large as the original congenic mice. This possibly implicates that further genetic complexity involves in the effect of tabw2 on diet-induced obesity. Significantly reduced locomotor activity was exhibited in B6.TH-tabw2 congenic and subcongenic mice compared to controls when animals were fed HFS diets. B6.TH-tabw2 congenic mice, but not subcongenic mice, also had significantly increased food intake on HFS diets. Conclusions It appears that at least two subloci explaining the tabw2 effect under chow feeding map to the distal region of the congenic interval, whereas the diet-induced obesity mediated by tabw2 is attributed to more complex genetic mechanism.