Etiology and management of urethral calculi:A systematic review of contemporary series

Objective:To conduct a systematic literature review on urethral calculi in a contemporary cohort describing etiology,investigation,and management patterns.Methods:A systematic search of MEDLINE and Cochrane Central Register of Controlled Trials(CENTRAL)databases was performed.Articles,including case reports and case series on urethral calculi published between January 2000 and December 2019,were included.Full-text manuscripts were reviewed for clinical parameters including symptomatology,etiology,medical history,investigations,treatment,and outcomes.Data were collated and analyzed with univariate methods.Results:Seventy-four publications met inclusion criteria,reporting on 95 cases.Voiding symptoms(41.1%),pain(40.0%),and acute urinary retention(32.6%)were common presenting features.Urethral calculi were most often initially investigated using plain X-ray(63.2%),with almost all radio-opaque(98.3%).Urethral calculi were frequently associated with coexistent bladder or upper urinary tract calculi(16.8%)and underlying urethral pathology(53.7%)including diverticulum(33.7%)or stricture(13.7%).Urethral calculi were most commonly managed with external urethrolithotomy(31.6%),retrograde manipulation(22.1%),and endoscopic in situ lithotripsy(17.9%).Conclusion:This unique systematic review of urethral calculi provided a summary of clinical features and treatment trends with a suggested treatment algorithm.Management in contemporary urological practice should be according to calculus size,shape,anatomical location,and presence of urethral pathology.

Smart Energy Management System Using Machine Learning

Energy management is an inspiring domain in developing of renewable energy sources.However,the growth of decentralized energy production is revealing an increased complexity for power grid managers,inferring more quality and reliability to regulate electricity flows and less imbalance between electricity production and demand.The major objective of an energy management system is to achieve optimum energy procurement and utilization throughout the organization,minimize energy costs without affecting production,and minimize environmental effects.Modern energy management is an essential and complex subject because of the excessive consumption in residential buildings,which necessitates energy optimization and increased user comfort.To address the issue of energy management,many researchers have developed various frameworks;while the objective of each framework was to sustain a balance between user comfort and energy consumption,this problem hasn’t been fully solved because of how difficult it is to solve it.An inclusive and Intelligent Energy Management System(IEMS)aims to provide overall energy efficiency regarding increased power generation,increase flexibility,increase renewable generation systems,improve energy consumption,reduce carbon dioxide emissions,improve stability,and reduce energy costs.Machine Learning(ML)is an emerging approach that may be beneficial to predict energy efficiency in a better way with the assistance of the Internet of Energy(IoE)network.The IoE network is playing a vital role in the energy sector for collecting effective data and usage,resulting in smart resource management.In this research work,an IEMS is proposed for Smart Cities(SC)using the ML technique to better resolve the energy management problem.The proposed system minimized the energy consumption with its intelligent nature and provided better outcomes than the previous approaches in terms of 92.11% accuracy,and 7.89% miss-rate.

Systematic review of risk factors,prognosis,and management of colorectal signet-ring cell carcinoma

BACKGROUND Colorectal signet-ring cell carcinoma(CSRCC)is a rare clinical entity which accounts for approximately 1%of all colorectal cancers.Although multiple studies concerning this specific topic have been published in the past decades,the pathogenesis,associated risk factors,and potential implications on treatment are still poorly understood.Besides the low incidence,historically confusing histological criteria have resulted in confusing data.Nevertheless,the rising incidence of CSRCC along with relatively young age at presentation and associated dismal prognosis,highlight the actual interest to synthesize the known literature regarding CSRCC.AIM To provide an updated overview of risk factors,prognosis,and management of CSRCC.METHODS A literature search in the MEDLINE/PubMed database was conducted with the following search terms used:‘Signet ring cell carcinoma’and‘colorectal’.Studies in English language,published after January 1980,were included.Studies included in the qualitative synthesis were evaluated for content concerning epidemiology,risk factors,and clinical,diagnostic,histological,and molecular features,as well as metastatic pattern and therapeutic management.If possible,presented data was extracted in order to present a more detailed overview of the literature.RESULTS In total,67 articles were included for qualitative analysis,of which 54 were eligible for detailed data extraction.CSRCC has a reported incidence between 0.1%-2.4%and frequently presents with advanced disease stage at the time of diagnosis.CSRCC is associated with an impaired overall survival(5-year OS:0%-46%)and a worse stagecorrected outcome compared to mucinous and not otherwise specified adenocarcinoma.The systematic use of exploratory laparoscopy to determine the presence of peritoneal metastases has been advised.Surgery is the mainstay of treatment,although the rates of curative resection in CSRCC(21%-82%)are lower compared to those in other histological types.In case of peritoneal metastasis,cytoreductive surgery with hyperthermic intraperitoneal chemotherapy should only be proposed in selected patients.CONCLUSION CSRCC is a rare clinical entity most often characterized by young age and advanced disease at presentation.As such,diagnostic modalities and therapeutic approach should be tailored accordingly.

Design and analysis of an advanced thermal management system for the solar close observations and proximity experiments spacecraft

In this paper,the mission and the thermal environment of the Solar Close Observations and Proximity Experiments(SCOPE)spacecraft are analyzed,and an advanced thermal management system(ATMS)is designed for it.The relationship and functions of the integrated database,the intelligent thermal control system and the efficient liquid cooling system in the ATMS are elaborated upon.For the complex thermal field regulation system and extreme space thermal environment,a modular simulation and thermal field planning method are proposed,and the feasibility of the planning algorithm is verified by numerical simulation.A solar array liquid cooling system is developed,and the system simulation results indicate that the temperatures of the solar arrays meet the requirements as the spacecraft flies by perihelion and aphelion.The advanced thermal management study supports the development of the SCOPE program and provides a reference for the thermal management in other deep-space exploration programs.

Improvement of the nutritional support management system for patients in intensive care units

BACKGROUND Nutritional support for patients hospitalized in the intensive care unit(ICU)is an important part of clinical treatment and care,but there are significant implementation difficulties.AIM To introduce a modified nutritional support management system for ICU patients based on closed-loop information management and psychological counseling.METHODS The division of functions,personnel training,system construction,development of an intelligent decision-making software system,quality control,and improvement of the whole process were carried out to systematically manage nutritional support for ICU patients.RESULTS Following the implementation of the whole process management system,the scores of ICU medical staff’s knowledge,attitudes/beliefs,and practices regarding nutritional support were comprehensively enhanced.The proportion of hospital bed-days of total enteral nutrition(EN)in ICU patients increased from 5.58%to 11.46%,and the proportion of EN plus parenteral nutrition increased from 42.71%to 47.07%.The rate of EN initiation within 48 h of ICU admission increased from 37.50%to 48.28%,and the EN compliance rate within 72 h elevated from 20.59%to 31.72%.After the implementation of the project,the Self-rating Anxiety Scale score decreased from 61.07±9.91 points to 52.03±9.02 points,the Self-rating Depression Scale score reduced from 62.47±10.50 points to 56.34±9.83 points,and the ICU stay decreased from 5.76±2.77 d to 5.10±2.12 d.CONCLUSION The nutritional support management system based on closed-loop information management and psychological counseling achieved remarkable results in clinical applications in ICU patients.

Ethics of Human Resources Management in the Cameroonian Health System, Medical Nomadism and the Ineffectiveness of the Fight against High Blood Pressure

Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.

Development and Application of Integrated Indicators for Assessing Healthcare Waste Management Systems in Kenyan Hospitals

Healthcare waste management (HCWM) is an important aspect of healthcare delivery globally because of its hazardous and infectious components that have potential for adverse health and environmental impacts. The paper introduces a set of indicators for assessing HCWM systems in hospitals. These indicators are: HCWM policies and standard operating procedures, management and oversight, logistics and budget support, training and occupational health and safety, and treatment, disposal and waste treatment equipment housing. By plotting a mark on a continuum which is defined as good and poor on the extremes and is connected with all other marks in a spoke arrangement, it’s possible to describe a baseline for HCWM in any specific hospital. This baseline can be used to improve awareness of the actors and policy-makers, compare the same hospital at a different point in time, to compare observations by different evaluators and to track improvements. Results suggest that in Kenya, the application of such indicators is useful for evaluating which priorities should be addressed to improve outcomes in HCWM systems. Systematic sampling technique was used to identify and collect data by use of observational checklist, interviews, visual verification and review of documents and a HCWM assessment tool. The objective is to suggest an integrated management tool as a method to identify prevailing problems with a HCWM system. The method can be replicated in other contexts worldwide, with a focus on the developing world. The integrated indicators focus on management of HCW and not its potential impact on human health and environment, an area recognized to be critical for future research.

Towards Automated Assessment of Learning Management Systems in Higher Education Institutions in Zambia

Zambia like any other country in most African regions is still grappling with the dynamics of harnessing technology for the betterment of Higher Education. The onset of the Covid 19 pandemic brought a test for the preparedness of the Zambian Higher Education Institutions (HEIs) in harnessing technology for pedagogical activities. As countries worldwide switched to electronic learning during the pandemic, the same could not be said for Zambian HEIs. Zambian HEIs struggled to conduct pedagogical activities on learning management platforms. This study investigated the factors affecting the implementation and assessment of learning Management systems in Zambia’s HEIs. With its focus on assessing: 1) system features, 2) compliance with regulatory standards, 3) quality of service and 4) technology acceptance as the four key assessment areas of an LMS, this article proposed a model for assessing learning management systems in Zambian HEIs. To test the proposed model, a software tool was also developed.

Research on Smart Energy Monitoring and Management System Based on Digital Twin Technology

Smart energy monitoring and management system lays a foundation for the application and development of smart energy. However, in recent years, the work efficiency of smart energy development enterprises has generally been low, and there is an urgent need to improve the application efficiency, resilience and sustainability of smart energy monitoring and management system. Digital twin technology provides a data-centric solution to improve smart energy monitoring and management system, bringing an opportunity to transform passive infrastructure assets into data-centric systems. This paper expounds on the concept and key technologies of digital twin, and designs a smart energy monitoring and management system based on digital twin technology, which has dual significance for promoting the development of smart energy field and promoting the application of digital twin.

Exploring Efficient Salary Management Systems:A Case Study of Hefei Yusheng Hotel Management Co.,Ltd.

The issue of brain drain poses a significant obstacle to the development of the hotel and catering industry.Attracting and retaining skilled personnel to engage in management within this sector has emerged as a primary challenge.This paper examines the current landscape of China’s catering service industry and its salary management system,identifying key challenges encountered in salary management within the industry.Drawing upon salary management theory and insights into existing challenges,the paper proposes specific treatment measures and management strategies.

Development of an Information-Based Leadership Evaluation Index System for School Management Teams:A Comprehensive Approach

In the context of educational informatization reform,there are many uncertain factors in the process of education development.To optimize the educational environment so that it can be effectively combined with information technology,teachers need to change their teaching ideas,strengthen the school’s own adaptability to informatization,and promote the development of informatization construction in schools.As a branch of information leadership,the management team should establish an evaluation index system for information leadership in order to ensure the construction of school informatization,so as to provide a boost for the integration of school resources and information technology.Based on the overview and connotation of information-based leadership of the management team,this paper explores the construction of an evaluation index system of information-based leadership of the school management team,aiming to provide references for the research of relevant personnel in the future.

Application Strategy of Digital Comprehensive Management and Maintenance System for Bridges

Effective application of digital integrated management and maintenance systems is essential for successful operation and maintenance management of bridge projects.This article analyzes the application strategy of such systems.It provides an overview of comprehensive digital management and maintenance of bridges,an analysis of the basic components of the integrated management and maintenance system,and its application strategies.This study aims to offer guidance for the application of the system and to improve the quality of modern bridge engineering management and maintenance work.

Advances in Zika virus vaccines and therapeutics:A systematic review

Zika virus(ZIKV)is the causative agent of a viral infection that causes neurological complications in newborns and adults worldwide.Its wide transmission route and alarming spread rates are of great concern to the scientific community.Numerous trials have been conducted to develop treatment options for ZIKV infection.This review highlights the latest developments in the fields of vaccinology and pharmaceuticals developments for ZIKV infection.A systematic and comprehensive approach was used to gather relevant and up-to-date data so that inferences could be made about the gaps in therapeutic development.The results indicate that several therapeutic interventions are being tested against ZIKV infection,such as DNA vaccines,subunit vaccines,live-attenuated vaccines,virus-vector-based vaccines,inactivated vaccines,virus-like particles,and mRNA-based vaccines.In addition,approved anti-ZIKV drugs that can reduce the global burden are discussed.Although many vaccine candidates for ZIKV are at different stages of development,none of them have received Food and Drug Authority approval for use up to now.The issue of side effects associated with these drugs in vulnerable newborns and pregnant women is a major obstacle in the therapeutic pathway.

Threshold-Based Software-Defined Networking(SDN)Solution for Healthcare Systems against Intrusion Attacks

The healthcare sector holds valuable and sensitive data.The amount of this data and the need to handle,exchange,and protect it,has been increasing at a fast pace.Due to their nature,software-defined networks(SDNs)are widely used in healthcare systems,as they ensure effective resource utilization,safety,great network management,and monitoring.In this sector,due to the value of thedata,SDNs faceamajor challengeposed byawide range of attacks,such as distributed denial of service(DDoS)and probe attacks.These attacks reduce network performance,causing the degradation of different key performance indicators(KPIs)or,in the worst cases,a network failure which can threaten human lives.This can be significant,especially with the current expansion of portable healthcare that supports mobile and wireless devices for what is called mobile health,or m-health.In this study,we examine the effectiveness of using SDNs for defense against DDoS,as well as their effects on different network KPIs under various scenarios.We propose a threshold-based DDoS classifier(TBDC)technique to classify DDoS attacks in healthcare SDNs,aiming to block traffic considered a hazard in the form of a DDoS attack.We then evaluate the accuracy and performance of the proposed TBDC approach.Our technique shows outstanding performance,increasing the mean throughput by 190.3%,reducing the mean delay by 95%,and reducing packet loss by 99.7%relative to normal,with DDoS attack traffic.

Survey on AI and Machine Learning Techniques for Microgrid Energy Management Systems

In the era of an energy revolution,grid decentralization has emerged as a viable solution to meet the increasing global energy demand by incorporating renewables at the distributed level.Microgrids are considered a driving component for accelerating grid decentralization.To optimally utilize the available resources and address potential challenges,there is a need to have an intelligent and reliable energy management system(EMS)for the microgrid.The artificial intelligence field has the potential to address the problems in EMS and can provide resilient,efficient,reliable,and scalable solutions.This paper presents an overview of existing conventional and AI-based techniques for energy management systems in microgrids.We analyze EMS methods for centralized,decentralized,and distributed microgrids separately.Then,we summarize machine learning techniques such as ANNs,federated learning,LSTMs,RNNs,and reinforcement learning for EMS objectives such as economic dispatch,optimal power flow,and scheduling.With the incorporation of AI,microgrids can achieve greater performance efficiency and more reliability for managing a large number of energy resources.However,challenges such as data privacy,security,scalability,explainability,etc.,need to be addressed.To conclude,the authors state the possible future research directions to explore AI-based EMS's potential in real-world applications.

Market Operation of Energy Storage System in Smart Grid:A Review

As a flexible resource,energy storage plays an increasingly significant role in stabilizing and supporting the power system,while providing auxiliary services.Still,the current high demand for energy storage contrasts with the fuzzy lack of market-oriented mechanisms for energy storage,the principle of market-oriented operation has not been embodied,and there is no unified and systematic analytical framework for the business model.However,the dispatch management model of energy storage in actual power system operation is not clear.Still,the specific scheduling process and energy storage strategy on the source-load-network side could be more specific,and there needs to be a greater understanding of the collaborative scheduling process of the multilevel scheduling center.On this basis,this paper reviews the energy storage operation model and market-based incentive mechanism,For different functional types and installation locations of energy storage within the power system,the operational models and existing policies for energy storage participation in the market that are adapted to multiple operating states are summarized.From the point of view of the actual scheduling and operation management of energy storage in China,an energy storage regulation and operation management model based on“national,provincial,and local”multilevel coordination is proposed,as well as key technologies in the interactive scenarios of source-load,network and storage.

Milestones to optimize of transjugular intrahepatic portosystemic shunt technique as a method for the treatment of portal hypertension complications

This editorial describes the milestones to optimize of transjugular intrahepatic portosystemic shunt(TIPS)technique,which have made it one of the main methods for the treatment of portal hypertension complications worldwide.Innovative ideas,subsequent experimental studies and preliminary experience of use in cirrhotic patients contributed to the introduction of TIPS into clinical practice.At the moment,the main achievement in optimize of TIPS technique is progress in the qualitative characteristics of stents.The transition from bare metal stents to extended polytetrafluoroethylene–covered stent grafts made it possible to significantly prevent shunt dysfunction.However,the question of its preferred diameter,which contributes to an optimal reduction of portal pressure without the risk of developing post-TIPS hepatic encephalopathy,remains relevant.Currently,hepatic encephalopathy is one of the most common complications of TIPS,significantly affecting its effectiveness and prognosis.Careful selection of patients based on cognitive indicators,nutritional status,assessment of liver function,etc.,will reduce the incidence of post-TIPS hepatic encephalopathy and improve treatment results.Optimize of TIPS technique has significantly expanded the indications for its use and made it one of the main methods for the treatment of portal hypertension complications.At the same time,there are a number of limitations and unresolved issues that require further randomized controlled trials involving a large cohort of patients.

Developing three-dimensional groundwater flow modeling for the Erbil Basin using Groundwater Modeling System (GMS)

This study presents the development of a comprehensive three-dimensional groundwater flow model for the Erbil Basin utilizing the Groundwater Modeling System(GMS).The Erbil Basin,situated in the Kurdistan Region of Iraq,is a vital water resource area facing increasing water demands and environ-mental challenges.The three-dimensional nature of the groundwater flow system is crucial for accurately understanding and managing water resources in the basin.The modeling process involved data collection,geological and hydrogeological characterization,conceptual model development,and numerical simulation using GMS software MODFLOW 2000 package.Various parameters such as hydraulic conductivity,recharge rates,and boundary conditions were integrated into the model to represent the complex hydrogeo-logical conditions of the basin.Model calibration was performed by comparing simulated groundwater levels with observed data from monitoring wells across the basin,using the automatic calibration method of automated Parameter Estimation(PEST).Pilot points were applied to adjust the hydraulic conductivity in the model area spatially.Sensitivity analysis was conducted to assess the influence of key parameters on model predictions and to identify areas of uncertainty.The developed three-dimensional groundwater flow model provides valuable insights into the dynamics of groundwater flow,recharge-discharge mechanisms,and potential impacts of future scenarios such as climate change and water resource management strategies.It serves as a useful tool for decision-makers,water resource managers,and researchers to evaluate differ-ent management scenarios and formulate sustainable groundwater management policies for the Erbil Basin.In conclusion,this study demonstrates the effectiveness of using GMS for developing three-dimensional groundwater flow models in complex hydrogeological settings like the Erbil Basin,contributing to improved understanding and management of groundwater resources in the region.

Forest use suitability:Towards decision-making-oriented sustainable management of forest ecosystem services

Management of forest lands considering multi-functional approaches is the basis to sustain or enhance the provi-sion of specific benefits,while minimizing negative impacts to the environment.Defining a desired management itinerary to a forest depends on a variety of factors,including the forest type,its ecological characteristics,and the social and economic needs of local communities.A strategic assessment of the forest use suitability(FUS)(namely productive,protective,conservation-oriented,social and multi-functional)at regional level,based on the provision of forest ecosystem services and trade-offs between FUS alternatives,can be used to develop management strategies that are tailored to the specific needs and conditions of the forest.The present study assesses the provision of multiple forest ecosystem services and employs a decision model to identify the FUS that sup-ports the most present and productive ecosystem services in each stand in Catalonia.For this purpose,we apply the latest version of the Ecosystem Management Decision Support(EMDS)system,a spatially oriented decision support system that provides accurate results for multi-criteria management.We evaluate 32 metrics and 12 as-sociated ecosystem services indicators to represent the spatial reality of the region.According to the results,the dominant primary use suitability is social,followed by protective and productive.Nevertheless,final assignment of uses is not straightforward and requires an exhaustive analysis of trade-offs between all alternative options,in many cases identifying flexible outcomes,and increasing the representativeness of multi-functional use.The assignment of forest use suitability aims to significantly improve the definition of the most adequate management strategy to be applied.

Research on Performance Optimization of Liquid Cooling and Composite Phase Change Material Coupling Cooling Thermal Management System for Vehicle Power Battery

The serpentine tube liquid cooling and composite PCM coupled cooling thermal management system is designed for 18650 cylindrical power batteries,with the maximum temperature and temperature difference of the power pack within the optimal temperature operating range as the target.The initial analysis of the battery pack at a 5C discharge rate,the influence of the single cell to cooling tube distance,the number of cooling tubes,inlet coolant temperature,the coolant flow rate,and other factors on the heat dissipation performance of the battery pack,initially determined a reasonable value for each design parameter.A control strategy is used to regulate the inlet flow rate and coolant temperature of the liquid cooling system in order to make full use of the latent heat of the composite PCM and reduce the pump’s energy consumption.The simulation results show that the maximum battery pack temperature of 309.8 K and the temperature difference of 4.6 K between individual cells with the control strategy are in the optimal temperature operating range of the power battery,and the utilization rate of the composite PCM is up to 90%.