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BACKGROUND: Numerous studies have demonstrated that hospice palliative care interventions for cancer patients can reduce health care utilzation. In Taiwan, 20-25% of patients who require mechanical ventilation are using prolonged mechanical ventilation (PMV); however, only a limited number of studies have addressed the effectiveness of hospice palliative care for these patients. This study investigated the impact of hospice palliative care utilization on medical utilization among subjects using PMV. METHODS: By using the health insurance database of a nationwide population-based study, we identified subjects who had been on mechanical ventilation for > 21 d, were age ≥18 y between 2009 and 2017, and had received hospice palliative care. The control group was formed through 1:1 matching by using propensity scoring after excluding patients who had participated in palliative care for <15 d or for >181 d. Furthermore, we used a conditional logistic regression analysis to investigate the incidence of ICU admission, emergency department presentation, and cardiopulmonary resuscitation within 14 d before death. RESULTS: A total of 186,533 new subjects receiving PMV age ≥ 18 y were admitted between 2009 and 2017. In addition, the number of subjects receiving palliative care increased annually, rising from 0.6% in 2009 to 41.33% in 2017. The emergency department visits (odds ratio [OR] 0.68, 95% CI 0.63-0.74), ICU admission (OR 0.59, 95% CI 0.53-0.66), cardiopulmonary resuscitation (OR 0.40, 95% CI 0.35-0.46), and total hospitalization cost ($1,319.91 ± $1,821.66 versus $1,544.37 ± $2,309.27 [$USD], P < .001) were significant lower in the palliative care group. CONCLUSIONS: Subjects undergoing PMV while receiving hospice palliative care experienced significant reductions in total hospitalization costs, ICU admissions, cardiopulmonary resuscitation, and medical expenses within 14 d before death. [ABSTRACT FROM AUTHOR]

This paper introduces a simulation model designed as a decision-making tool to assess and analyze various crowd management strategies with a focus on enhancing sustainability in airport operations. This model specifically addresses the challenges and risks associated with managing passenger flows within airport terminals. By simulating different scenarios, the model aims to provide valuable insights into how to effectively handle crowd dynamics and enhance overall terminal efficiency, safety, and sustainability. This case study was conducted at Henri Coanda International Airport, ARENA 12 simulation software being used in order to model the passenger flows within the airport terminal. Two scenarios were considered: The first one involves maintaining a fixed number of security and check-in desks for the two airline groups. In contrast, the second scenario allows for a variable number of security and check-in desks for the same airline groups. By optimizing resource allocation and minimizing waiting time, this model contributes to more sustainable airport management operations. Three measures of performance (MOPs) were selected to assess the system activity: the average passenger waiting time, the average passenger number queue length, and the average utilization rate. Comparing the results, we concluded that the second scenario shows a relative improvement in almost all performance measures when compared to the first scenario. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion Despite the influence of caregivers' prognostic understanding (PU) on the end‐of‐life care for persons with dementia (PwDs), the literature on PU of caregivers of PwDs is sparse. We conducted a scoping review to understand the variation in existing definitions and measurement of caregivers' PU for PwDs. We also aimed to synthesize the prevalence of caregivers' correct PU and the factors (caregiver, PwD and healthcare related) associated with it.We systematically searched four databases—MEDLINE/PubMed, EMBASE, SCOPUS, and CINAHL. We included studies where study participants were informal caregivers, their PU was assessed, and measurement tool was implicitly described. We excluded studies where study participants were paid caregivers.Out of the 2160 studies screened, we included 15 published between 2009 and 2023. The included studies measured caregivers' PU as limited estimated life expectancy, understanding that dementia is incurable and life‐limiting. Estimated life expectancy was the most common measure of PU among caregivers to PwDs. Across studies, around 90% of caregivers acknowledged dementia as incurable, while only about 40% acknowledged it as life‐limiting. Caregivers of PwDs who were sicker (acute medical problems or functional dependence) and those who had discussed goals of care with healthcare providers were more likely to have more accurate PU for PwDs. Caregivers' with better PU were more likely to state a preference for comfort‐focused care, and their PwDs were likely to receive fewer burdensome interventions and experience greater comfort during the dying process.Our findings highlight the need for a comprehensive measure to assess the multifaceted nature of caregivers' PU, delve deeper into factors influencing caregivers' PU, and explore its impact on caregivers themselves. [ABSTRACT FROM AUTHOR]

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This systematic review of art psychotherapy literature explored how art therapy or artmaking may support patient identity after a life-limiting diagnosis. Background: Previous research shows the value of art therapy and artmaking in reducing physical and psychological symptoms at the end-of-life. Recent reports indicated that disruption to identity is a key challenge to this group of individuals. Aims: This systematic review investigated art therapy and artmaking and examined and built upon previous research undertaken with patients facing identity concerns after a terminal diagnosis. Methods: A robust and rigorous framework of criteria (PRISMA), was followed to select and review suitable research papers in order to gain new insights. Results: The results indicate that many patients struggle to cope with a changing identity alongside the demands of a terminal illness. The key findings are threefold: art therapy and artmaking can help maintain or reconstruct a pre-illness identity and art therapy in particular can help enable a positive identity transformation. Conclusions: Art therapy and artmaking hold benefits for positive identity support such as the re-evaluation and reinstatement of pre-illness roles, psychosocial-interventions and adjustment to major life changes. Implications: It is recommended that art therapy and artmaking are offered to terminal patients at diagnosis, in order to support identity concerns promptly and allow patients to focus solely on their quality of life and limited time left. It is anticipated that the findings of this systematic review will be of benefit to patients, healthcare workers, art therapists and others within the palliative care community. Plain-language summary: This review of art therapy literature explored how art therapy or artmaking may support patient identity after a life-limiting diagnosis. Previous research has showed the value of art therapy and artmaking in reducing concerns at the end-of-life. Many reports indicated that changes to identity are one of the main challenges to this group of individuals. This review aimed to compare art therapy and artmaking. It examined and added to earlier research with patients struggling with identity concerns after a terminal diagnosis. A set of standards were followed to select and review appropriate research papers. Results showed that many patients struggled to cope with a changing identity alongside the difficulties of a terminal illness. Patients tried to keep an identity that was separate from their illness and also maintain their pre-illness roles. The main findings of this systematic review are that art therapy and artmaking can help keep or restore a pre-illness identity. Art therapy in particular can help bring about a positive identity change. The conclusions are that art therapy and artmaking are beneficial for supporting identity and help patients think about and recover their pre-illness roles. Art therapy and artmaking are also seen to help patients cope with major life changes. Recommendations are that further research is undertaken with larger, more varied groups of people, particularly males. It is recommended that art therapy and artmaking are offered to terminal patients when they are diagnosed. This would allow patients to focus on their wellbeing and their limited time left with loved ones. It is likely that the findings will be helpful to patients, healthcare workers, art therapists and others within palliative care. [ABSTRACT FROM AUTHOR]

According to section IV.B.1.e of common residency program requirements from the Accreditation Council for Graduate Medical Education (ACGME), "[r]esidents must learn to communicate with patients and families to partner with them to assess their care goals, including, when appropriate, end-of-care [EOL] goals". EOL conversations are frequently appropriate for patients suffering from serious, life-threatening diseases (ie, terminal illness) or otherwise chronic health conditions with poor disease trajectories. These conversations are often followed with services and care from palliative medicine or hospice specialists depending on patients' projected prognoses (ie, 6 months or less). The focus of this patient-centered care, then, is on relieving patient and caregiver suffering, establishing clear treatment goals, and managing the physical, psychosocial, and spiritual burdens of disease. Although palliative medicine and hospice care have been shown to reduce health care costs and improve the overall care of patients who require these services, recent literature still suggests a gap in training programs being able to provide effective, educational strategies to their trainees regarding the appropriate and competent delivery of EOL conversations. Herein, this commentary will provide a discussion on what EOL is, palliative vs hospice care indications, and address current literature regarding EOL exposure within training programs while offering our personal insight and advocacy on the manner. [ABSTRACT FROM AUTHOR]

Los puertos dinamizan las actividades económicas y las gestiones inherentes a él crean externalidades tanto positivas como negativas, el concepto de puerto, muelle y terminal se confunden y en ocasiones se utilizan como si fueran conceptos idénticos cuando en realidad no lo son. En este artículo se abordará el tema de las terminales portuarias como su nombre lo indica es el sitio en donde termina las personas, y mercancías para transportarse, ese espacio físico que se convierte como puente de la cadena logística de pasajeros y mercancías y muchas veces por estar centrados en temas de calidad, de desempeño logístico en cuanto al manejo oportuno de pasajeros o de carga. Agentes externos se presentan en el escenario, exigencias internacionales y otras disposiciones que hacen de las terminales portuarias un territorio amplio por explorar. En este artículo entonces también se indaga sobre las actividades y estilos de terminales que existen y los que más se utilizan en Colombia. Se especifica las zonas portuarias y su comportamiento.

This article explores the impact of the analyst’s life-threatening illness on the analytic couple; it is informed through two theoretical lenses – Freud’s ideas about the vicissitudes of mourning, which have been elaborated on by Melanie Klein and John Steiner, and Christopher Bollas’s ideas about destiny and idiom. Clinical material will focus on my on-going work with a middle-aged man who has a history of early abandonment and loss and who struggles with being able to remain separate from his objects while being in relationship with them. [ABSTRACT FROM AUTHOR]

This paper introduces a simulation model designed as a decision-making tool to assess and analyze various crowd management strategies with a focus on enhancing sustainability in airport operations. This model specifically addresses the challenges and risks associated with managing passenger flows within airport terminals. By simulating different scenarios, the model aims to provide valuable insights into how to effectively handle crowd dynamics and enhance overall terminal efficiency, safety, and sustainability. This case study was conducted at Henri Coanda International Airport, ARENA 12 simulation software being used in order to model the passenger flows within the airport terminal. Two scenarios were considered: The first one involves maintaining a fixed number of security and check-in desks for the two airline groups. In contrast, the second scenario allows for a variable number of security and check-in desks for the same airline groups. By optimizing resource allocation and minimizing waiting time, this model contributes to more sustainable airport management operations. Three measures of performance (MOPs) were selected to assess the system activity: the average passenger waiting time, the average passenger number queue length, and the average utilization rate. Comparing the results, we concluded that the second scenario shows a relative improvement in almost all performance measures when compared to the first scenario.

Novel therapies for multiple myeloma (MM) have improved patient survival, but their high costs strain healthcare budgets. End‐of‐life phases of treatment are generally the most expensive, however, these high costs may be less justifiable in the context of a less pronounced clinical benefit. To manage drug expenses effectively, detailed information on end‐of‐life drug administration and costs are crucial. In this retrospective study, we analysed treatment sequences and drug costs from 96 MM patients in the Netherlands who died between January 2017 and July 2019. Patients received up to 16 lines of therapy (median overall survival: 56.5 months), with average lifetime costs of €209 871 (€3111/month; range: €3942–€776 185) for anti‐MM drugs. About 85% of patients received anti‐MM treatment in the last 3 months before death, incurring costs of €20 761 (range: €70–€50 122; 10% of total). Half of the patients received anti‐MM treatment in the last 14 days, mainly fully oral regimens (66%). End‐of‐life treatment costs are substantial despite limited survival benefits. The use of expensive treatment options is expected to increase costs further. These data serve as a reference point for future cost studies, and further research is needed to identify factors predicting the efficacy and clinical benefit of continuing end‐of‐life therapy. [ABSTRACT FROM AUTHOR]

The most challenging barrier to expanding connectivity of Internet to vehicle ad hoc networks is the necessity for vast proper infrastructure of roadside network. This need is problematic to meet, specifically in the early stages of vehicle network building & in zones with limited infrastructure of roadside. As a result, that solutions rely exclusively on roadside structure are unworkable. Other remedies, like cell phone networks / symmetrical communications via satellite, are also too expensive or do not deliver adequate connectivity, putting the change to a robust VANET difficulty in the later stages. We provide one method that supplements obtainable ones while avoiding the need for completely networked roadside infrastructure. To provide widespread Internet access, the approach employs satellite receive-only endpoints and a small number of (widely dispersed) wayside devices. The solution is affordable, gradual, and practical. We show numerous design possibilities that can be employed depending on the environment. [ABSTRACT FROM AUTHOR]

Copyright of Bulletin de la Societe Zoologique de France is the property of Societe Zoologique de France and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The efficiency of bulk solid and general cargo terminals, where ore, grain, and many raw materials are handled, plays a crucial role in socioeconomic development and lays the groundwork for reasonable trade costs. This study evaluates the relative performance of dry-bulk and general cargo terminals in Türkiye with interval data envelopment analysis (DEA). The dataset consists of 21 terminals operated by private companies for 2018-2021 and has been transformed into an interval form to apply interval DEA to imprecise data. The results imply that the efficiency levels of dry-bulk and general cargo terminals in the Marmara and Mediterranean tend to increase. It can be inferred that the average efficiency level of the Black Sea terminals has remained stable over the years, and the loss of efficiency in the Aegean is remarkable. The application of the Interval DEA in evaluating the efficiency of dry-bulk and general cargo terminals in the case of imprecise data can contribute significantly to the seaport efficiency literature.

Abstract Whether or not to define ‘terminal anorexia nervosa’ has been a hotly debated topic in the eating disorders field recently. Being able to have open scientific debate on important topics such as this is essential for the progress of our field—but needs to be undertaken respectfully, allowing all perspectives to be heard. My personal perspective on this topic comes from being a researcher who sees individuals with anorexia nervosa (AN) across all stages of illness and recovery, as well as having had a loved one die from AN. Although I disagree with the terminology of ‘terminal AN’ and believe that establishing criteria has the potential to cause harm, I strongly believe in showing compassion to individuals with AN across all illness stages, including those who may wish to seek end-of-life care. This is a complex issue that our field requires guidance on, and we need to work in genuine collaboration with individuals with lived experience of AN to figure out how to appropriately approach end-of-life care when it is warranted.

Introduction. Earlier studies of the frame organization of the artistic narrative allowed us to come to the conclusion that, firstly, ontological frames-determinants can predetermine the narrative structure of both extended fragments of the narrative text and small fragments limited by the semantics of the local frame; secondly, the semantic-syntactic frame can be considered as a standard linguistic unit with a standard integral structure and semantics, as well as stable naming.Materials and methods. In the proposed approach, a speech frame represents a linguistic expression as a speech action, the content and performance of which is described in a propositional aspect. The use of a metaphor in the text itself is a standard speech action that includes a metaphorical expression in the context, while the meaning of the metaphor is determined by the linguistic and pragmatic context. A metaphor (from a word to a detailed construction) can be considered as a speech action of the speaker by virtue of the fact that the act of metaphorical comparison itself, contained in a metaphor, can be described in terms of propositions. Plot-forming semantic-syntactic frames in an artistic narrative are considered as stable linguistic units with stable conventional meanings and corresponding stable names.Analysis. The semantic-syntactic frame should be considered as a standard semantic model of a typical situation (everyday, communicative), in which the structural and content elements of the semantics of the frame, namely propositions, their predicates and terms filling the terminals of the frame, correspond to certain language expressions for their representation in the surface structures of the narrative. The initial thesis is that from the point of view of the tasks of describing relevant parameters, it is advisable to present a metaphor as a model of a semantic-syntactic procedural frame.Results. Based on the results of the study, a model is proposed in which nuclear propositions describing the basic predications of metaphorical speech action are attributed to the first terminal of the frame; to the second one – the bases of metaphorical comparison; to the third one – the conditions of the linguistic context; to the fourth one – the conditions of the pragmatic context. It is concluded that the representation of a metaphor as a speech action in the form of a procedural semantic-syntactic frame allows analyzing its semantics, structure and functions as a result of performing the corresponding actions and semantic operations displayed in the proposed METAPHOR frame model.

In an article (Asaria in J Eat Disord 11:107, 2023) recently published by the Journal of Eating Disorders, I expressed my lived experience views on the concept of 'terminal anorexia nervosa' (AN), and why I believe that this is a harmful new term. The article was not a response to the original paper in which Gaudiani et al. (J Eat Disord 10:23, 2022) proposed criteria for the label. However, as a result of feedback that my article did not appreciate their criteria, I have written this follow-up paper to build on and reinforce what I previously wrote. This article outlines problems with each criterion in turn, again from my lived experience perspective. It then addresses dangerous ambiguities around how the criteria can be applied safely, and their confusing purpose in the real world. Finally, I discuss the impact of labelling AN sufferers with terms that may suggest their wholehearted allegiance to the illness, in both life and death (or 'till death do us part'). [ABSTRACT FROM AUTHOR]

Passenger's waiting time at terminal is a key constituent of travel time, as long waiting time increases the overall journey time. In Nigeria, urban-rural bus transit system is associated with long waiting time. This study evaluates bus transit users' waiting times at terminal with perceived and actual waiting times (PWT and AWT) along with associated bus service frequency (BSF). Bus public transit operating from Enugu city (as origin) to 6 local government areas (Awgu, Isi-Uzo, Nkanu west, Nsukka, Oji River and Udenu) of the state as destinations was studied. Data were collected on AWT and PWT at Old Park, Enugu for 30 days from 8 am to 6 pm (5 days per route). Data on AWT and PWT were collected based on passenger's observation and oral interview, respectively. The study discovered that transit users incurred long waiting times, with 80 - 90% of the users incurring AWT of 21 minutes to 1 hour and more, indicating a poor service quality. Also, 80 - 90% of the users overestimated their PWT by 25 - 60%. At 95% confidence level, PWT is significantly longer than AWT (P < 0.05) for all the routes. A passenger's perceived waiting time model was developed for predicting PWT based on AWT. The model developed showed that PWT is strongly correlated with AWT, with an R² = 0.9591 and F-significance < 0.05. This suggests that that AWT accounts for 96% variability in PWT. Consequently, the model developed exhibits a reasonable accuracy, hence, can be applied for prediction of passenger's perceived waiting time. The mean BSF for Enugu - Nsukka and Enugu - Oji River routes were 30 and 21 buses per day, respectively. While, the other 4 routes recorded lower values of 7 - 9 buses per day, resulting in longer waiting times than the other 2 routes. The implication of long passengers' waiting time suggests the need for shifting from unscheduled to scheduled operation and improved BSF by shortening bus headways to minimize waiting time. [ABSTRACT FROM AUTHOR]

The study analyzed the relationships between the terminal and instrumental values on attitude and behavioral intentions for organic food products in the context of Behavioral Reasoning Theory and Cognitive Hierarchical Model, i.e., Value-Attitude-Behavior. The conceptual model is based on a comprehensive review of the past research. A two-step approach was employed to evaluate the measurement and structural models with SmartPLS software for partial least square structural equation modeling. The findings revealed that for organic food products, both terminal and instrumental values influence attitude and consecutively, attitude influences behavioral intentions. However, the instrumental value exhibited greater influence on both attitude and behavioral intentions in comparison to the terminal value. The research findings may help organic food marketers to develop strategies by promotions that are aligned to the terminal and instrumental values. [ABSTRACT FROM AUTHOR]

Background: People of African and Caribbean descent experienced disproportionately high mortality from COVID-19 and have poor access to palliative care. Aim: To explore palliative care experiences of people of African and Caribbean descent during and immediately prior to the pandemic. Design: Qualitative interview study with thematic analysis. Refinement of themes/recommendations in consultation with an expert patient and public advisory group. Setting/participants: Twenty-six bereaved relatives and 13 health/social care professionals (cared for people of African and Caribbean descent) from throughout England, recruited using social media, community networks and direct advertising to over 150 organisations. Results: Three themes were identified: Representation: Participants did not see themselves reflected in the palliative care services and did not expect their needs to be understood. Mistrust of the healthcare system and perceptions of racism were common and led to anticipation of inequitable care. Personalisation: Relatives and professionals reported a lack of cultural and religious sensitivity in healthcare. Assumptions were made based on ethnicity, and services not offered to all. Awareness and education: Professionals felt they lacked the knowledge to provide care to diverse communities, but were reluctant to ask, due to fear of making mistakes. Inequitable access to services was exacerbated by, but not unique to, the pandemic. Participants recommended raising awareness of palliative services, building professional competence in culturally-sensitive care, and greater ethnic diversity within services. Conclusions: Person-centred, culturally-competent palliative care is not the norm for people of African and Caribbean descent. Expectations of inequitable care are widespread. Sustained action on multiple fronts is needed. [ABSTRACT FROM AUTHOR]

The efficiency of bulk solid and general cargo terminals, where ore, grain, and many raw materials are handled, plays a crucial role in socioeconomic development and lays the groundwork for reasonable trade costs. This study evaluates the relative performance of drybulk and general cargo terminals in Türkiye with interval data envelopment analysis (DEA). The dataset consists of 21 terminals operated by private companies for 2018-2021 and has been transformed into an interval form to apply interval DEA to imprecise data. The results imply that the efficiency levels of dry-bulk and general cargo terminals in the Marmara and Mediterranean tend to increase. It can be inferred that the average efficiency level of the Black Sea terminals has remained stable over the years, and the loss of efficiency in the Aegean is remarkable. The application of the Interval DEA in evaluating the efficiency of dry-bulk and general cargo terminals in the case of imprecise data can contribute significantly to the seaport efficiency literature. [ABSTRACT FROM AUTHOR]

Auditory feedback is a simple, low-cost training solution that can be used in rehabilitation, motor learning, and performance development. The use has been limited to the instruction of a single kinematic or kinetic target. The goal of this study was to determine if auditory feedback could be used to simultaneously train 2 lower-extremity parameters to perform a bodyweight back squat. A total of 42 healthy, young, recreationally active males participated in a 4-week training program to improve squat biomechanics. The Trained group (n = 22) received 4 weeks of auditory feedback. Feedback focused on knee flexion angle and center of pressure under the foot at maximum squat depth. The Control group (n = 20) performed squats without feedback. Subjects were tested pre, post, and 1 week after training. The Trained group achieved average target knee flexion angle within 1.73 (1.31) deg (P <.001) after training and 5.36 (3.29) deg (P <.01) at retention. While achieving target knee flexion angle, the Trained group maintained target center of pressure (P <.001). The Control group improved knee range of motion, but were not able to achieve both parameter targets at maximum squat depth (P <.90). Results from this study demonstrate that auditory feedback is an effective way to train 2 independent biomechanical targets simultaneously. [ABSTRACT FROM AUTHOR]

Whether or not to define 'terminal anorexia nervosa' has been a hotly debated topic in the eating disorders field recently. Being able to have open scientific debate on important topics such as this is essential for the progress of our field—but needs to be undertaken respectfully, allowing all perspectives to be heard. My personal perspective on this topic comes from being a researcher who sees individuals with anorexia nervosa (AN) across all stages of illness and recovery, as well as having had a loved one die from AN. Although I disagree with the terminology of 'terminal AN' and believe that establishing criteria has the potential to cause harm, I strongly believe in showing compassion to individuals with AN across all illness stages, including those who may wish to seek end-of-life care. This is a complex issue that our field requires guidance on, and we need to work in genuine collaboration with individuals with lived experience of AN to figure out how to appropriately approach end-of-life care when it is warranted. [ABSTRACT FROM AUTHOR]

In 2019, the central government made DED Revitalization of Arjosari Malang Type A Terminal. The Budget Plan (RAB) needed for overall revitalization is Rp. 80 billion. Then, based on the results of the FY 2024 needs ceiling discussion meeting on January 30, 2023, held in Jakarta, the RAB for the revitalization of the Arjosari Malang Type A Terminal is too large and needs to be streamlined again. One of the work items that can still be cost-efficient is the architectural work item. Several factors cause the cost of architectural work to be large, including materials and technology. The use of expensive materials can increase the cost of an architectural project. Related to the above, value engineering or value engineering is used with the aim of efficient costs and looking for alternative alternatives or ideas that aim to produce costs that are better or lower than the previously planned price. The results of value engineering on architectural work resulted in savings of Rp.1,718,085,568 or 8% of the initial cost of the architectural work project. [ABSTRACT FROM AUTHOR]

This paper measures economic efficiency of container throughputs with the aid of input-output efficiency ratio of selected terminals across Nigerian seaports. Productivity of a terminal does not equal to its efficiency. Different efficiencies like allocative and technical characterized economic efficiency of a port system. Overall economic efficiency means there is no delay at the port in processing container as all ship, labour and machines are optimally utilized. This research determined the overall efficiencies of container throughputs Apapa, Warri, Onne, Calabal and Tin Can Island using secondary data (2012-2022) from Nigerian Bureau of Statistics on container cargo throughputs in Nigeria. Total container outputs in (Tonnes) from different terminals with their corresponding inputs variables from number of ship per annum, cranes used and the dock workers net gang hour (ngh) were aggregated together in form of input-output ratio and arrived at each port's level of overall economic efficiency. The analysis was executed with the aid of R using Stochastic Frontier Analysis (SFA) for each termina/seaport collected data. It was found from the results that; terminals at Onne are most efficient followed by Calabar. Tin can Island terminal efficiency was a slightly higher than that of Apapa as both had a little above average mean efficiency value. Warri terminals are the least while Rivers was not considered for unavailability of data. There may be other unexplained factors causing inefficiencies of mostly Apapa, Tin Can and Warri seaports not explained but can be investigated in future research. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Chongqing University of Technology (Natural Science) is the property of Chongqing University of Technology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Psychological distress is a major concern for patients with end-stage heart failure (HF). However, psychiatric care for patients with HF is not as organized as that for patients with cancer. Therefore, the aim of this study was to elucidate and compare the barriers faced by health care providers of cardiology and oncology hospitals in providing end-of-life psychiatric care to patients with HF and cancer, respectively. Methods We conducted a cross-sectional questionnaire survey among the health care providers of Japan. Questionnaires were mailed to physicians and nurses of 427 cardiology and 347 oncology hospitals in March 2018 to assess health care providers’ perspectives. First, we compared the scores of the Palliative Care Difficulties Scale and the original scale of end-of-life psychiatric care difficulties between health care providers of cardiology and oncology hospitals. Second, we asked the health care providers to describe the barriers to providing end-of-life psychiatric care with an open-ended question and then compared the freely-provided descriptions using content analysis. Results A total of 213 cardiology and 224 oncology health care providers responded to the questionnaire. No significant differences were found between health care providers of cardiology and oncology hospitals in the frequency of experiencing barriers to providing end-of-life psychiatric care (59.8% and 62.2%, respectively). A content analysis identified the following eight barriers: “patients’ personal problems,” “family members’ problems,” “professionals’ personal problems,” “communication problems between professionals and patients,” “problems specific to end-of-life care,” “problems specific to psychiatric care,” “problems of institution or system,” and “problems specific to non-cancer patients.” The “problems specific to noncancer patients” was described more frequently by health care providers in cardiology hospitals than that in oncology hospitals. However, there were no significant differences in other items between the two. Conclusion Although health care providers of both cardiology and oncology hospitals faced barriers to providing end-of-life psychiatric care, those of cardiology hospitals particularly faced challenges pertaining to non-cancer patients, such as unpredictability of prognosis or insufficiency of guideline development. A system of psychiatric care, specifically for patients with HF, should be established.

Infeksi Virus Covid-19 sangat cepat penyebarannya di masyarakat. Media penyebarannya melalui droplet penderita yang terinfeksi Virus Covid-19. Tempat-tempat yang berpotensi menjadi tempat penyebaran Virus Covid-19 dilakukan sterilisasi dengan disinfektan. Pemerintah menghimbau masyarakat selalu menggunakan masker saat beraktivitas di luar rumah, sehingga permintaan masker meningkat dan menyebabkan harga masker sangat mahal. Terminal Samarinda-Balikpapan merupakan terminal besar di Samarinda dan banyak masyarakat yang beraktifitas disana, baik pedagang maupun para calon penumpang. Maka dari itu pengabdian masyarakat dengan melakukan penyemprotan disinfektan di terminal dan pembagian masker kain ini dilakukan. Tujuan dari kegiatan ini adalah memutus mata rantai penularan covid-19. Kegiatan ini secara tidak langsung memberikan edukasi ke masyarakat di terminal untuk berperilaku hidup bersih dan sehat. Berdasar beberapa review artikel menunjukan penyemprotan disinfektan dan penggunaan masker dapat mencegah penularan Covid-19. Kegiatan ini mendapat respon positif dari petugas terminal, pedagang, sopir dan penumpang yang ada di sana.

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Background: Psychological distress is a major concern for patients with end-stage heart failure (HF). However, psychiatric care for patients with HF is not as organized as that for patients with cancer. Therefore, the aim of this study was to elucidate and compare the barriers faced by health care providers of cardiology and oncology hospitals in providing end-of-life psychiatric care to patients with HF and cancer, respectively. Methods: We conducted a cross-sectional questionnaire survey among the health care providers of Japan. Questionnaires were mailed to physicians and nurses of 427 cardiology and 347 oncology hospitals in March 2018 to assess health care providers' perspectives. First, we compared the scores of the Palliative Care Difficulties Scale and the original scale of end-of-life psychiatric care difficulties between health care providers of cardiology and oncology hospitals. Second, we asked the health care providers to describe the barriers to providing end-of-life psychiatric care with an open-ended question and then compared the freely-provided descriptions using content analysis. Results: A total of 213 cardiology and 224 oncology health care providers responded to the questionnaire. No significant differences were found between health care providers of cardiology and oncology hospitals in the frequency of experiencing barriers to providing end-of-life psychiatric care (59.8% and 62.2%, respectively). A content analysis identified the following eight barriers: "patients' personal problems," "family members' problems," "professionals' personal problems," "communication problems between professionals and patients," "problems specific to end-of-life care," "problems specific to psychiatric care," "problems of institution or system," and "problems specific to non-cancer patients." The "problems specific to noncancer patients" was described more frequently by health care providers in cardiology hospitals than that in oncology hospitals. However, there were no significant differences in other items between the two. Conclusion: Although health care providers of both cardiology and oncology hospitals faced barriers to providing end-of-life psychiatric care, those of cardiology hospitals particularly faced challenges pertaining to non-cancer patients, such as unpredictability of prognosis or insufficiency of guideline development. A system of psychiatric care, specifically for patients with HF, should be established. [ABSTRACT FROM AUTHOR]

Electric vehicle is one of the important development directions of the automotive industry, with a broad prospect. The high-voltage wire harness plays a key role in the power system for electric vehicle. Aluminum wire harness was proposed to be crimped with the copper terminal instead of the copper wire harness, which can decrease the weight and the cost. This work proposes an electromagnetic pulse crimping technology to connect the aluminum wire harness and copper terminal of electric vehicle. A 28 kJ electromagnetic pulse crimping system for crimping aluminum wire harness and copper terminal was established and the reliable joints were obtained and tested. The microstructure analysis results show that the connection interface has a corrugated morphology, and there was no obvious effect on the plating during the high-speed collision. The energy dispersive spectroscopy analysis results show that there was metal element diffusion in the connection interface. The testing results show that the joints with good electrical performance can be obtained, which can promote the realization of the aluminum wire harness instead of the copper wire harness. This work can provide technical reference and theoretical support for the development of high-voltage wire harnesses for electric vehicle. [ABSTRACT FROM AUTHOR]

The aim is to determine the quality of the service and its relationship with customer satisfaction in the dining rooms of the Portoviejo terminal, Ecuador. The research is descriptive, correlational, and field. The value of each variable arises from the indicators of the SERVQUAL model and the Customer Satisfaction Score method. 23 dining rooms of the Portoviejo terminal participated in the study. The sample selected by probabilistic sampling was 114 diners, to whom the survey was applied. As a result, a strong positive correlation was obtained between service quality and customer satisfaction. The deficient indicators are the decoration and hygiene of the canteens and staff, the implements used in the environment where they eat food, and biosecurity measures. It is concluded that it is necessary to eliminate waste, improve cleaning, and better customer service. [ABSTRACT FROM AUTHOR]

Hydrogen energy is one of the important development directions of new energy towards the goal of carbon neutralization. Many researches have been conducted in China on the adaptability of hydrogen-mixed natural gas transportation in long-distance gas pipelines, but no comprehensive analysis has been performed for its application in terminal pipe network. In this study, the research status on the interchangeability of hydrogen-mixed natural gas in terminal application worldwide, the adaptability of equipment and material and their safety was surveyed. According to the results, the hydrogen-mixed natural gas has a good adaptability to civil gas appliances and terminal pipeline materials, but further research on interchangeability, medium stratification, leakage detection, odorization, and metering is required before supplying hydrogen-mixed natural gas to end users. Hence, suggestions were proposed in accordance with the characteristics of terminal pipe network and the demand on gas supply: (1) to conduct an interchangeability analysis based on the specific natural gas components and the working conditions of gas appliances, (2) to increase the transportation pressure to eliminate the influence of the additional pressure of high risers, and analyze the medium stratification under extreme working conditions, (3) to conduct a comprehensive analysis on the sealing performance of connectors, and optimize the layout of leakage detection equipment and odorants based on the leakage and diffusion characteristics of hydrogen, (4) to establish a hydrogen-mixed natural gas metering standard system urgently, and (5) to speed up the adaptive adjustment of hydrogen separation units and technologies of terminal pipe network. In general, the research results could provide reference for the application of hydrogen-mixed natural gas in terminal pipe network and the development of hydrogen energy industry chain.

Abstract Since liquid bulk cargoes are the most frequently handled cargo types in Turkish ports in 2019 and the latter in 2020, the loading and unloading times of liquid bulk cargoes are important in terms of handling efficiency. While a higher amount of cargo handled per unit time increases the profitability for terminal operations, the short handling time of tankers at the terminal provides an advantage for the next voyage. In this study, the process in the terminals in Turkey where 19.05% of the total liquid bulk cargo handled was reviewed as well as the reasons for the waits in this process. Thus, it was aimed to find subjects that need to be focused on to reduce the waiting times. An expert team was asked to indicate the reasons for the waits using the fishbone method. In addition, a questionnaire was applied to a sample group of 134 people who were the stakeholders of the handling process. It was found out that the reasons for the waits obtained through the questionnaire matched those determined by the fishbone method. To reach a solution, prioritization was provided by scoring the reasons that lead to waits.