Search

Abstract Background Effective self-care practices are crucial for maintaining health and well-being, as inadequate self-care can lead to increased health risks and decreased overall quality of life. To address these issues, one promising approach involves leveraging progressive web app (PWA) platforms to educate and empower individuals with necessary self-care services. This study aims to design, implement, and evaluate a national self-care PWA platform, aiming to enhance accessibility and effectiveness in promoting health and self-care practices. The platform designed to improve self-care processes can be utilized by mothers, children, adolescents, youth, adults, and patients with emotional and mental disorders. Methods This study was conducted in three phases. In the first phase, during 35 meetings with 19 health care providers including physicians and another group of professionals, the most common illnesses and conditions that require self-care were identified. Platform capabilities were then assessed based on stakeholder opinions. Subsequently, during 15 meetings 19 health care providers identified a comprehensive list of conditions benefiting from dedicated decision aids to enhance individuals’ self-care processes. In the second phase, a progressive web app platform was designed based on these common illnesses and conditions and capabilities and subsequently evaluated. To usability evaluation the platform, 26 evaluators utilized the system for two weeks. The QUIS 5.5 questionnaire was employed for evaluation, and the results were analyzed using SPSS 23. In the final phase, the system was implemented at the Smart University of Medical Sciences (SMUMS), affiliated with the Ministry of Health and Medical Education in Iran. Results Based on the most common illnesses and conditions (n = 87) and identified capabilities, the national self-care platform was designed with eight sections catering to ‘Maternal and child health services,’ ‘Mothers,’ ‘Infants,’ ‘Teenagers,’ ‘Adults,’ ‘Elderly,’ ‘Health of All Age Groups,’ ‘Patients with Mental and Emotional Health Disorders,’ and ‘General Information’ for user education. Furthermore, the platform features 54 decision aids (DA), teleconsultation services, and a self-care magazine (Access link: https://khodmoragheb.ir/ ). These features were integrated to provide comprehensive support and resources for self-care. A mean exceeding 7 was attained across all evaluated dimensions, indicating that evaluators generally agreed the platform performed well. Conclusion The designed national self-care platform offers a promising solution for managing healthcare challenges. This innovative approach addresses the specific needs of individuals and extends its reach to Persian-speaking patients worldwide, fostering a global impact. By embracing self-care practices on an international scale, this platform contributes to a more inclusive and accessible healthcare landscape for individuals in Iran, Afghanistan, Tajikistan, and beyond.

Background: Patient education (PE) is a fundamental patient right and an essential tool for improving health outcomes and enhancing patient satisfaction. However, barriers to effective PE exist, and understanding these obstacles is crucial for addressing them.Objectives: This study aimed to conduct a systematic review of the barriers to PE in Iran.Methods: A systematic review was conducted to analyze published articles on the barriers to PE in Iran, available in both English and Persian. The search was performed across multiple databases, including PubMed, Science Direct, and ProQuest, and academic search engine of Google Scholar, and Iranian databases such as MagIran, SID, IranDoc, and IranMedex, covering the period from January 1, 2000, to January 1, 2022. Specific keywords such as "barrier", "education", "learning", "client", "Iran" and "patient" were employed, resulting in a total of 185 articles related to the topic. Ultimately, 47 studies were included in the review.Results: The review encompassed 47 studies, comprising 32 descriptive, 9 qualitative, 3 intervention, and 3 review studies. The findings identified five categories of barriers: environmental barriers, nurse-related barriers, patient-related barriers, managerial barriers, and educational barriers removal.Conclusion: Educating patients presents challenges due to various barriers. To address these obstacles, it is imperative for managers to support nurses by providing necessary resources, adequate funding, dedicated nursing personnel, suitable infrastructure, and training in innovative teaching techniques.

Abstract Background The shadow curriculum is an emerging concept in curriculum studies that has not yet garnered significant attention in medical education. It includes programs and activities outside formal education to improve students’ academic performance in the formal educational system. Objective In this study, we designed and developed an online course based on the shadow curriculum and evaluated its effect on students’ learning and academic performance. Methods This study represents a form of developmental research, with the study population comprising medical and dental students from universities of medical sciences in Iran. The course was conducted at the Smart University of Medical Sciences, following the ADDIE instructional design approach in three phases. The initial two phases involved designing and implementing the program according to the students’ needs and requirements. In the third phase, we evaluated the program using the Kirkpatrick model. In the first level evaluation, the reaction of 70 students in the course was investigated. To assess the impact of the course, pre and post-tests were administered to 30 students. Finally, the effect of the course on students’ success in the comprehensive exams for basic medical sciences, dentistry, and pre-internship was analyzed by examining the passing and failing statuses of 83 and 57 students who participated in the September 2023 and February 2024 exams. Results The results indicated that the students responded positively to the program. The analysis of pre-test and post-test scores showed a significant improvement in the students’ academic performance across all the subjects presented in the course, including basic medical sciences, dentistry, and pre-internship (p

Abstract Higher education plays a critical role in driving an innovative economy by equipping students with knowledge and skills demanded by the workforce. While researchers and practitioners have developed data systems to track detailed occupational skills, such as those established by the U.S. Department of Labor (DOL), much less effort has been made to document which of these skills are being developed in higher education at a similar granularity. Here, we fill this gap by presenting Course-Skill Atlas – a longitudinal dataset of skills inferred from over three million course syllabi taught at nearly three thousand U.S. higher education institutions. To construct Course-Skill Atlas, we apply natural language processing to quantify the alignment between course syllabi and detailed workplace activities (DWAs) used by the DOL to describe occupations. We then aggregate these alignment scores to create skill profiles for institutions and academic majors. Our dataset offers a large-scale representation of college education’s role in preparing students for the labor market. Overall, Course-Skill Atlas can enable new research on the source of skills in the context of workforce development and provide actionable insights for shaping the future of higher education to meet evolving labor demands, especially in the face of new technologies.

Background: The COVID-19 pandemic caused an unprecedented mid-semester transition to virtual learning. Instructors and students had to adapt to new ways of delivering and receiving course material. Objective: The present investigation examined whether course format and sense of belongingness were associated with learning satisfaction during the COVID-19 pandemic, as well as racial/ethnic or gender identity differences in academic experiences during this time. The current study also explored student perceptions of instructor support, changes in workload, and changes in learning. Method: Undergraduate students (N = 157) responded to quantitative and qualitative items regarding their academic experiences during the first semester of the pandemic in an online survey. Results: Blended courses were associated with poorer outcomes than solely synchronous and asynchronous courses. There were no racial differences in academic experiences; however, women had more positive academic experiences than men. Greater academic and campus belongingness predicted better academic experiences. Students perceived clear, frequent instructor communication as vital to their success. Conclusion: Students' experiences with virtual learning varied depending on instructor and student factors.

This article examines the potential contribution of social enterprise to the "wicked" problem of creativity and literacy in a performative schooling environment, drawing on an ethnographic study of Ciento, a social enterprise organization that works with under-resourced young people, families, and communities in Melbourne, Australia. In light of the growing body of research on the ways in which schools navigate creativity and performativity, this article contributes new knowledge on non-school organizations that is largely missing from this conversation, as well as new insights on the operations of education-focused social enterprises in Australia. It considers the social, political, and historical factors that have shaped this unique space of educational "wickedity" and the ways in which organizational rationales and practices, as well as the experiences and views of staff and participants, indicate a complex, promising, and innovative approach to educational problem-solving.

Research suggests that English for Specific Purposes (ESP) students in English-as-a-Foreign-Language (EFL) contexts have difficulties understanding the passages in technical English textbooks of various fields of study including computer software engineering. Few experimental studies to date have investigated the effect of an online hybrid reading intervention on the reading comprehension performance of these students. To fill this gap, the present experimental study sought to assist these students with comprehending the passages of an ESP textbook entitled ''Technical English for Computer Software Engineers'', developed for computer software engineering students of a non-profit university in Babol, Iran. In doing so, an 8-session online hybrid reading intervention featuring cognitive and metacognitive strategies was administered to an experimental group (n = 30) of ESP students, while the control group (n = 30) followed the conventional approach to teaching the reading skill. To track the participants' reading comprehension, International English Language Testing System (IELTS) reading tests were used before and after the intervention. Results showed that the treatment led to a statistically significant difference between the two groups in terms of the reading comprehension and strategy use. In addition, the teachers' and students' perceptions with regard to the whole textbook were reported. Findings bear pedagogical significance for all the stakeholders.

Tyrosinase is an essential enzyme in melanin production, which plays an important role in the browning of plants and vegetables and skin diseases in humans. Therefore, the design and synthesis of tyrosinase inhibitors are important in the food industry and in treating melanin-related skin diseases. In this study, the tyrosinase inhibitory activity and the antioxidant capacity of a series of 3-hydroxypyridin-4-one derivatives that have been synthesized in the Department of Medicinal Chemistry at the Faculty of Pharmacy, Shiraz University of Medical Sciences, were assessed. The antioxidant activities were evaluated using the 1,1-diphenyl-2-picrylhydrazine (DPPH) radical scavenging method. The biological results indicated that these derivatives exhibit mild anti-tyrosinase and antioxidant properties. Docking studies were also conducted, and the results showed that the compounds have suitable binding free energy and interactions with the active site of the tyrosinase enzyme, which were not consistent with the biological results. Finally, the investigation of the pharmacokinetic characteristics and drug-likeness of the derivatives showed that they have the potential for oral bioavailability.

ackground & Objective: Evaluating the academic performance and competencies of medical students is essential in the medical field. Written tests play a big part in this situation. This study's primary goal was to comprehend medical students' experiences with their exams. Materials & Methods: The study was carried out from 2020 to 2022 at the Fasa University of Medical Sciences in the Iranian province of Fars, using a qualitative research methodology using a phenomenological approach. In-depth one-on-one interviews with the investigators were conducted with twenty-three medical students from a variety of professions, including health, medicine, nursing, operating room technology, anesthesiology technology, and medical emergencies. The interpretive phenomenological approach was used to analyze the data, including observations made during written exams and in-depth interviews. Results: The results of the study revealed four general themes that reflected the views of the medical students about their exam experiences. The themes that emerged were emotional fluctuations, stressful difficulty, coping strategies, and blessings in disguise. Conclusion: Despite the participants' initial uncertainty, the study participants saw the exams as a blessing in disguise. They saw exams as essential learning resources and a means of gaining access to stable job chances. However, because of the psychological strain and scoring direction, the exam also presented a hard challenge. Furthermore, students experienced a range of positive and negative emotional changes as a result of the test. In order to manage their test anxiety, the students used both positive and negative strategies for coping. These results have substantial implications for policies that might be implemented in the field of education.

Abstract Zic family member ZIC4 is a transcription factor that has been shown to be silenced in several cancers. However, understanding the regulation and function of ZIC4 in pediatric choroid plexus tumors (CPTs) remained limited. This study employed data mining and bioinformatics analysis to investigate the DNA methylation status of ZIC4 in CPTs and its correlation with patient survival. Our results unveiled ZIC4 methylation as a segregating factor, dividing CPT cohorts into two clusters, with hyper-methylation linked to adverse prognosis. Hyper-methylation of ZIC4 was confirmed in a choroid plexus carcinoma-derived cell line (CCHE-45) by bisulfite sequencing. Furthermore, our study demonstrated that demethylating agent and a histone methyltransferase inhibitor could reverse ZIC4 silencing. RNA sequencing and proteomic analysis showed that ZIC4 over-expression influenced genes and proteins involved in immune response, antigen processing and presentation, endoplasmic reticulum stress, and metabolism. Functionally, re-expressing ZIC4 negatively impacted cell proliferation and migration. Ultimately, these findings underscore ZIC4 hyper-methylation as a prognostic marker in CPTs and shed light on potential mechanisms underlying its tumor suppressor role in CPC. This insight paves the way for novel therapeutic targets in treating aggressive CPTs.

Introduction: Ultrasonic retrieval is a time-consuming procedure sacrificing considerable amounts of dentin. This study aimed to assess the retrieval capability of katana tip on different alloys under different lubricants regarding dentin thickness and retrieval time. Materials and Methods: Extracted premolars were used to reach 40 samples. The apical 4 mm of X2 ProTaper Next and A1 Neoniti instruments were fractured, and katana tip was utilized for retrieval, using ethylenediaminetetraacetic acid or olive oil as intracanal lubricants. Dentin thickness was assessed using cone-beam computed tomography, and the time of retrieval was recorded. Results: There was no significant difference in the retrieval capability among the groups. Different alloys and lubricants had no significant effect on dentin thickness. However, olive oil significantly reduced the retrieval time. Conclusion: Katana tip proved to be efficient enough to retrieve apically separated instruments in curved canals, with instrument’s metallurgical makeup presenting minimal effect on its capability. Katana tip and high-viscosity lubricants reduced the retrieval time, which might reduce the dentin removal amount.

Abstract Background While melanomas commonly harbor losses of 9p21, on which CDKN2A resides, the presence of additional tumor suppressor elements at this locus is incompletely characterized. Here we assess the expression levels and functional role of microRNA-876-3p (miR-876), whose gene also maps to 9p21. Methods Expression of miR-876 was assessed in human tissues and cell lines using quantitative miRNA reverse transcriptase polymerase chain reaction (qRT-PCR). MIR876 copy number was determined in The Cancer Genome Atlas (TCGA) melanoma cohort. The consequences of regulation of miR-876 expression were assessed on melanoma cell colony formation, migration, invasion, apoptosis, cell cycle progression, and drug sensitivity in culture, and on in vivo tumor growth in a xenograft model. Genome-wide transcriptomic changes induced by miR-876 overexpression were determined using RNA sequencing (RNA-Seq). Results miR-876 expression was significantly decreased in primary melanoma samples when compared with nevi, and in human melanoma cell lines when compared with human melanocytes. Analysis of the TCGA cohort revealed deletions in MIR876 in > 50% of melanomas. miR-876 overexpression resulted in decreased melanoma cell colony formation, migration, and invasion, which was accompanied by cell cycle arrest and increased apoptosis. Intra-tumoral injections of miR-876 significantly suppressed melanoma growth in vivo. RNA-Seq analysis of miR-876-treated tumors revealed downregulation of several growth-promoting genes, along with upregulation of tumor suppressor genes, which was confirmed by qRT-PCR analysis. Computational analyses identified MAPK1 (or ERK2) as a possible target of miR-876 action. Overexpression of miR-876 significantly suppressed luciferase expression driven by the MAPK1/ERK2 3’ UTR, and resulted in decreased ERK protein expression in melanoma cells. MAPK1/ERK2 cDNA overexpression rescued the effects of miR-876 on melanoma colony formation. miR-876 overexpression sensitized melanoma cells to treatment with the BRAF inhibitor vemurafenib. Conclusions These studies identify miR-876 as a distinct tumor suppressor on 9p21 that is inactivated in melanoma and suggest miR-876 loss as an additional mechanism to activate ERK and the mitogen activated protein kinase (MAPK) pathway in melanoma. In addition, they suggest the therapeutic potential of combining miR-876 overexpression with BRAF inhibition as a rational therapeutic strategy for melanoma.

Abstract Incorporating automation into wind turbine blade manufacturing is important for reducing costs to meet current offshore wind energy production goals in the United States. This work proposes a process for automating three operations in wind blade manufacturing: trimming to remove flashing left over after bonding two blade skins together, grinding to produce a desired leading‐edge shape, and sanding to prepare the blade for bonding overlamination or adding paint to the surface. The majority of this work focuses on the toolpath generation. The algorithms were tested on a 5‐m blade section, and the results were analyzed in terms of operation speed and accuracy. Finally, future work is discussed to improve the performance of the system.

Background: Midwives as one of the most effective members of the health systems play a key role in delivering health services to mothers and children who are vulnerable groups of the society. This research aimed to investigate the effect of Logotherapy on job satisfaction and Organization-Based Self-Esteem (OBSE) of employed midwives. Materials and Methods: This is a quasi-experimental study with the pretest and posttest design and a control group from all midwives employed in the public hospital of Rasht City in Iran. Fifty-six midwives fulfilling the inclusion criteria were selected and randomly divided into two groups of intervention and control. They filled job satisfaction, OBSE questionnaires, and demographic information checklist, and then, the intervention group attended Logotherapy for six sessions/90 minutes. Finally, both groups answered the instruments as posttest. Results: Results showed that the mean difference between OBSE (F 6,83 = 27, p < 0.05) and job satisfaction (t 2,62 = 27, p < 0.01) scores before and after the sessions in the intervention group was significantly more than the control group. Conclusions: Group Logotherapy increased job satisfaction and OBSE among midwives. It can be recommended for use in the clinical settings for healthcare providers.

Abstract Introduction Small Cell Lung Cancer (SCLC) can be classified into transcriptional subtypes with distinct degrees of neuroendocrine (NE) differentiation. Recent evidence supports plasticity among subtypes with a bias toward adoption of low-NE states during disease progression or upon acquired chemotherapy resistance. Here, we identify a role for SMARCA4, the catalytic subunit of the SWI/SNF complex, as a regulator of subtype shift in SCLC. Methods ATACseq and RNAseq experiments were performed in SCLC cells after pharmacological inhibition of SMARCA4. DNA binding of SMARCA4 was characterized by ChIPseq in high-NE SCLC patient derived xenografts (PDXs). Enrichment analyses were applied to transcriptomic data. Combination of FHD-286 and afatinib was tested in vitro and in a set of chemo-resistant SCLC PDXs in vivo. Results SMARCA4 expression positively correlates with that of NE genes in both SCLC cell lines and patient tumors. Pharmacological inhibition of SMARCA4 with FHD-286 induces the loss of NE features and downregulates neuroendocrine and neuronal signaling pathways while activating non-NE factors. SMARCA4 binds to gene loci encoding NE-lineage transcription factors ASCL1 and NEUROD1 and alters chromatin accessibility, enhancing NE programs. Enrichment analysis applied to high-confidence SMARCA4 targets confirmed neuron related pathways as the top GO Biological processes regulated by SMARCA4 in SCLC. In parallel, SMARCA4 also controls REST, a known suppressor of the NE phenotype, by regulating SRRM4-dependent REST transcript splicing. Furthermore, SMARCA4 inhibition drives ERBB pathway activation in SCLC, rendering SCLC tumors sensitive to afatinib. Conclusions This study nominates SMARCA4 as a key regulator of the NE state plasticity and defines a novel therapeutic strategy for SCLC.

Abstract Neuroendocrine (NE) transformation is a mechanism of resistance to targeted therapy in lung and prostate adenocarcinomas leading to poor prognosis. Up to date, even if patients at high risk of transformation can be identified by the occurrence of Tumor Protein P53 (TP53) and Retinoblastoma Transcriptional Corepressor 1 (RB1) mutations in their tumors, no therapeutic strategies are available to prevent or delay histological transformation. Upregulation of the cell cycle kinase Cell Division Cycle 7 (CDC7) occurred in tumors during the initial steps of NE transformation, already after TP53/RB1 co-inactivation, leading to induced sensitivity to the CDC7 inhibitor simurosertib. CDC7 inhibition suppressed NE transdifferentiation and extended response to targeted therapy in in vivo models of NE transformation by inducing the proteasome-mediated degradation of the MYC Proto-Oncogen (MYC), implicated in stemness and histological transformation. Ectopic overexpression of a degradation-resistant MYC isoform reestablished the NE transformation phenotype observed on targeted therapy, even in the presence of simurosertib. CDC7 inhibition also markedly extended response to standard cytotoxics (cisplatin, irinotecan) in lung and prostate small cell carcinoma models. These results nominate CDC7 inhibition as a therapeutic strategy to constrain lineage plasticity, as well as to effectively treat NE tumors de novo or after transformation. As simurosertib clinical efficacy trials are ongoing, this concept could be readily translated for patients at risk of transformation.

Abstract Nanofabrication in silicon, arguably the most important material for modern technology, has been limited exclusively to its surface. Existing lithography methods cannot penetrate the wafer surface without altering it, whereas emerging laser-based subsurface or in-chip fabrication remains at greater than 1 μm resolution. In addition, available methods do not allow positioning or modulation with sub-micron precision deep inside the wafer. The fundamental difficulty of breaking these dimensional barriers is two-fold, i.e., complex nonlinear effects inside the wafer and the inherent diffraction limit for laser light. Here, we overcome these challenges by exploiting spatially-modulated laser beams and anisotropic feedback from preformed subsurface structures, to establish controlled nanofabrication capability inside silicon. We demonstrate buried nanostructures of feature sizes down to 100 ± 20 nm, with subwavelength and multi-dimensional control; thereby improving the state-of-the-art by an order-of-magnitude. In order to showcase the emerging capabilities, we fabricate nanophotonics elements deep inside Si, exemplified by nanogratings with record diffraction efficiency and spectral control. The reported advance is an important step towards 3D nanophotonics systems, micro/nanofluidics, and 3D electronic-photonic integrated systems.

Abstract The need for intubation in methanol-poisoned patients, if not predicted in time, can lead to irreparable complications and even death. Artificial intelligence (AI) techniques like machine learning (ML) and deep learning (DL) greatly aid in accurately predicting intubation needs for methanol-poisoned patients. So, our study aims to assess Explainable Artificial Intelligence (XAI) for predicting intubation necessity in methanol-poisoned patients, comparing deep learning and machine learning models. This study analyzed a dataset of 897 patient records from Loghman Hakim Hospital in Tehran, Iran, encompassing cases of methanol poisoning, including those requiring intubation (202 cases) and those not requiring it (695 cases). Eight established ML (SVM, XGB, DT, RF) and DL (DNN, FNN, LSTM, CNN) models were used. Techniques such as tenfold cross-validation and hyperparameter tuning were applied to prevent overfitting. The study also focused on interpretability through SHAP and LIME methods. Model performance was evaluated based on accuracy, specificity, sensitivity, F1-score, and ROC curve metrics. Among DL models, LSTM showed superior performance in accuracy (94.0%), sensitivity (99.0%), specificity (94.0%), and F1-score (97.0%). CNN led in ROC with 78.0%. For ML models, RF excelled in accuracy (97.0%) and specificity (100%), followed by XGB with sensitivity (99.37%), F1-score (98.27%), and ROC (96.08%). Overall, RF and XGB outperformed other models, with accuracy (97.0%) and specificity (100%) for RF, and sensitivity (99.37%), F1-score (98.27%), and ROC (96.08%) for XGB. ML models surpassed DL models across all metrics, with accuracies from 93.0% to 97.0% for DL and 93.0% to 99.0% for ML. Sensitivities ranged from 98.0% to 99.37% for DL and 93.0% to 99.0% for ML. DL models achieved specificities from 78.0% to 94.0%, while ML models ranged from 93.0% to 100%. F1-scores for DL were between 93.0% and 97.0%, and for ML between 96.0% and 98.27%. DL models scored ROC between 68.0% and 78.0%, while ML models ranged from 84.0% to 96.08%. Key features for predicting intubation necessity include GCS at admission, ICU admission, age, longer folic acid therapy duration, elevated BUN and AST levels, VBG_HCO3 at initial record, and hemodialysis presence. This study as the showcases XAI's effectiveness in predicting intubation necessity in methanol-poisoned patients. ML models, particularly RF and XGB, outperform DL counterparts, underscoring their potential for clinical decision-making.

Background: Emergency medical services (EMS) play a crucial role as the first line of defense during emergencies and disasters. Given the current impact of climate change, EMS will need to employ innovative strategies to cope with changing conditions. This scoping review investigates how EMS can adapt to climate change in pre-hospital emergencies. Materials and Methods: In this study, peer-reviewed studies and texts on adaptive strategies of pre-hospital emergency systems published in 2023 were reviewed. Accordingly, online databases, including Web of Science, PubMed, Scopus, and Google Scholar as a search engine were searched. The selected keywords were as follows: “Medical technician,” “paramedic,” “ambulance,” “climate change,” “global warming,” “adaptation,” “mitigation,” and “resiliency” (and synonyms). Conclusion: No wide-ranging study has been conducted on the adaptation strategies of EMS against climate change and this is the first study in this field. In this study, elements and adaptation strategies against climate change were investigated. Extracting these cases and using them to improve the readiness and resilience of the pre-hospital emergency system will be effective against this phenomenon.

The electric energy demand has been increasing, following digitalization and development of urbanization, which has led to functional enhancement of home energy management system (HEMS) and its subsystems. A great amount of the produced electricity is used for household loads, whereas self-sufficient smart homes can supply all or a large portion of their electricity consumption by using renewable energy resources. In this study, an MILP model is formulated for energy scheduling on a 24-hour time horizon, to achieve the optimal performance of each home appliance for minimizing the smart home energy bill. The studied smart home can exchange electrical energy with the upstream network. A sensitivity analysis has been performed to show the impact of the changes in scheduling and energy prices on the electricity energy bill. The impact of the presence of renewable resources and electrical storage is studied on the electricity energy bill and the electrical energy sales profit of the house in different scenarios. Numerical results show that using the proposed model in the self-sufficient smart home reduces the amount of power purchased from the grid by 45%, transfers energy to the grid at some hours, and the energy bill is reduced by 65%.