Due to more affordable solar and wind power, and the European Union regulations for decarbonisation of the economy, more than 40% of the Fortune 500 companies have targets related to green energy. This is one of the main reasons why multi-technology Power-Purchase Agreements (PPAs) are becoming increasingly important. However, there are risks associated with the uncertainty and variable generation patterns in wind speed and solar radiation. Moreover, there are challenges to predict intermittent wind and solar generation for the forecasting horizon required by PPAs, which is usually of several years. We propose a long-term wind and solar energy generation forecasts suitable for PPAs with cost optimisation in energy generation scenarios. We use Markov Chain Monte Carlo simulations with suitable models of wind and solar generation and optimise long-term energy contracts with purchase of renewable energy.
Abstract Background An unprecedented acceleration in digital mental health services happened during the COVID-19 pandemic. However, people with severe mental ill health (SMI) might be at risk of digital exclusion, partly because of a lack of digital skills, such as digital health literacy. The study seeks to examine how the use of the Internet has changed during the pandemic for people with SMI, and explore digital exclusion, symptomatic/health related barriers to internet engagement, and digital health literacy. Methods Over the period from July 2020 to February 2022, n = 177 people with an SMI diagnosis (psychosis-spectrum disorder or bipolar affective disorder) in England completed three surveys providing sociodemographic information and answering questions regarding their health, use of the Internet, and digital health literacy. Results 42.5% of participants reported experiences of digital exclusion. Cochrane-Q analysis showed that there was significantly more use of the Internet at the last two assessments (80.8%, and 82.2%) compared to that at the beginning of the pandemic (65.8%; ps
Electrical stimulation as a mode of external enhancement factor in wound healing has been explored widely. It has proven to have multidimensional effects in wound healing including antibacterial, galvanotaxis, growth factor secretion, proliferation , transdifferentiation, angiogenesis, etc. Despite such vast exploration, this modality has not yet been established as an accepted method for treatment. This article reviews and analyzes the approaches of using electrical stimulation to modulate wound healing and discusses the incoherence in approaches towards reporting the effect of stimulation on the healing process. The analysis starts by discussing various processes adapted in in vitro, in vivo, and clinical practices. Later it is focused on in vitro approaches directed to various stages of wound healing. Based on the analysis, a protocol is put forward for reporting in vitro works in such a way that the outcomes of the experiment are replicable and scalable in other setups. This work proposes a ground of unification for all the in vitro approaches in a more sensible manner, which can be further explored for translating in vitro approaches to complex tissue stimulation to establish electrical stimulation as a controlled clinical method for modulating wound healing.
Introduction Nigeria recently used electronic surveillance tools for epidemic diseases, one such tool is the Surveillance Outbreak Response Management and Analysis System (SORMAS); no readily available study has assessed the use of SORMAS in Nigeria. The title of this study is the usability of SORMAS for coronavirus disease among epidemiological officers in Delta State; it explored the ease of use, the effectiveness of SORMAS, its applicability, and the challenges with its use. Materials and Methods This descriptive qualitative study involved disease surveillance and notification officers (DSNOs) and their assistants DSNOs in the year 2022; 25 of them were interviewed using two audio tape recorders after consent was obtained. Ethical clearance was obtained from the appropriate body. Thematic content analysis, with the help of Analysis of Qualitative Data software, was used to analyze data. Results The findings showed that SORMAS was difficult to use for 100% of the respondents, particularly at the initial time, and subsequent use was relatively easy. About 100% of users found SORMAS to be effective for coronavirus disease 2019 surveillance and claimed it could be applied to other health diseases. About 100% of the respondents had challenges which included network problems, unavailability of adequate airtime, low technological know-how, software glitch, and hardware issues, among others. Conclusion This study helped to outline the factors affecting SORMAS use, demonstrated that SORMAS was relatively easy to use after repeated training, was deemed effective by all respondents; applied to other health diseases, and its use was affected by several challenges.
Worse socioeconomic conditions (e.g., having a migration background, lower income, and lower educational level) may lead to barriers for cancer prevention and early detection. Community-based initiatives providing tailored and accessible information are found to increase cancer screening participation and improve health outcomes for people with challenging socioeconomic conditions. To inform such initiatives, more research is needed from the perspective of those working with them. This article focuses on the Swedish “peer advisor project” in which the Regional Cancer Centre Stockholm Gotland (RCC) collaborates with community-based peer advisors to reduce cancer inequities in areas with challenging socioeconomic conditions. We aim to investigate the perspectives of people working with the peer advisor project in relation to challenges they face, strategies they use, and forms of impact they perceive their work to have. We used a participatory action research approach, involving 12 peer advisor representatives and three RCC representatives. Underlying data (interviews and participant observations) were qualitatively analyzed. Findings are presented in relation to three themes: (1) Peer advisors bridge a gap between the cancer care system and communities through dialogues with communities and RCC representatives. (2) Peer advisors navigate culturally based sensitivities through efforts to create safe spaces for discussing cancer prevention and early detection. (3) Peer advisor and RCC representatives described forms of impact in relation to personal contexts, community contexts, RCC’s organizational context, and societal context. Sustainability and structural challenges may limit the peer advisor project to create impact. We discuss that peer advisors may act as cultural brokers through dialogues with communities and the cancer care system, thereby increasing an understanding of communities’ contexts and needs. Findings from this study can inform development and implementation of similar community-based peer-to-peer initiatives in other contexts. More research is needed to investigate the long-term impact of the project including community-based perspectives.
The issue of vaccine hesitancy has posed a significant challenge during the Covid-19 pandemic, as it increases the risk of undermining public health interventions aimed at mitigating the spread of the virus. While the swift development of vaccines represents a remarkable scientific achievement, it has also contributed to skepticism and apprehension among some populations. Against this backdrop, the suspension of the AstraZeneca vaccine by the European Medicines Agency further exacerbated an already contentious debate around vaccine safety. This paper examines the Twitter discourse surrounding Covid-19 vaccines, focusing on the temporal and geographical dimensions of the discussion. Using over a year’s worth of data, we study the public debate in five countries (Germany, France, UK, Italy, and the USA), revealing differences in the interaction structure and in the production volume of questionable and reliable sources. Topic modeling highlights variations in the perspectives of reliable and questionable sources, but some similarities across nations. Also, we quantify the effect of vaccine announcement and suspension, finding that only the former had a significant impact in all countries. Finally, we analyze the evolution of the communities in the interaction network, revealing a relatively stable scenario with a few considerable shifts between communities with different levels of reliability. Our results suggest that major external events can be associated with changes in the online debate in terms of content production and interaction patterns. However, despite the AZ suspension, we do not observe any noticeable changes in the production and consumption of misinformation related to Covid-19 vaccines.
This paper deals with the modelling and assessment of the inelastic cyclic behaviour of composite members consisting of steel beams and reinforced concrete slabs, designed to European standards. The work involves the development of detailed continuum models that can simulate the asymmetric behaviour and cyclic degradation characteristics of composite members. The generated model is first validated against available experimental results then used to investigate the influence of important parameters affecting the moment-rotation relationships at the dissipative composite beam ends under cyclic loading. Based on the results, nonlinear relationships for modelling the response of composite members are proposed. It is shown that the degradation modelling parameters are most influenced by the cross-section slenderness of the structural steel and the depth of the composite beam. Together with significant asymmetry in cyclic behaviour, around 20% higher cyclic degradation observed in composite members compared to their bare steel counterparts. In addition to providing information required for the seismic design and assessment, the proposed expressions are utilised for the calibration of lumped plasticity models with cyclic degradation suitable for computationally efficient frame-level analysis.
Background Mental health conditions often go untreated, which can lead to long-term poor emotional, social physical health and behavioural outcomes, and in some cases, suicide. Mental health-related stigma is frequently noted as a barrier to help seeking, however no previous systematic review has considered evidence from the Caribbean specifically. This systematic review aimed to address two research questions: (1) What is the impact of mental health stigma on help-seeking in the Caribbean? (2) What factors underlie the relationship between stigma and help-seeking in the Caribbean? Methods A systematic search was conducted across six electronic databases (Medline, Embase, Global Health, PsychInfo, Scopus and LILACS). The search included articles published up to May 2022. Experts in the field were consulted to provide publication recommendations and references of included studies were checked. Data synthesis comprised of three components: a narrative synthesis of quantitative findings, a thematic analysis of qualitative findings, and a meta-synthesis combining these results. Results The review included nine articles (reflecting eight studies) totaling 1256 participants. A conceptual model was derived from the meta-synthesis, identifying three themes in relation to mental health stigma and help-seeking in the Caribbean: (i) Making sense of mental health conditions’; (ii) Anticipated/Experienced stigma-related experiences and (iii) Individual characteristics. Conclusion This review provides insights into the relationship between mental health stigma and help-seeking in the Caribbean based upon the current research evidence. This can be applied in the design of culturally appropriate future research, and to support policy and practice towards stigma reduction, and improved mental care help-seeking in the Caribbean.
Importance Calcium channel blocker (CCB) use has been associated with an increased risk of glaucoma in exploratory studies. Objective To examine the association of systemic CCB use with glaucoma and related traits among UK Biobank participants. Design, Setting, and Participants This population-based cross-sectional study included UK Biobank participants with complete data (2006-2010) for analysis of glaucoma status, intraocular pressure (IOP), and optical coherence tomography (OCT)–derived inner retinal layer thicknesses. Data analysis was conducted in January 2023. Exposure Calcium channel blocker use was assessed in a baseline touchscreen questionnaire and confirmed during an interview led by a trained nurse. Main Outcomes and Measures The primary outcome measures included glaucoma status, corneal-compensated IOP, and 2 OCT-derived inner retinal thickness parameters (macular retinal nerve fiber layer [mRNFL] and macular ganglion cell–inner plexiform layer [mGCIPL] thicknesses). We performed logistic regression and linear regression analyses to test for associations with glaucoma status and IOP and OCT-derived inner retinal thickness parameters, respectively. Results This study included 427 480 adults. Their median age was 58 (IQR, 50-63) years, and more than half (54.1%) were women. There were 33 175 CCB users (7.8%). Participants who had complete data for glaucoma status (n = 427 480), IOP (n = 97 100), and OCT-derived inner retinal layer thicknesses (n = 41 023) were eligible for respective analyses. After adjustment for key sociodemographic, medical, anthropometric, and lifestyle factors, use of CCBs (but not other antihypertensive agents) was associated with greater odds of glaucoma (odds ratio [OR], 1.39 [95% CI, 1.14 to 1.69]; P = .001). Calcium channel blocker use was also associated with thinner mGCIPL (−0.34 μm [95% CI, −0.54 to −0.15 μm]; P = .001) and mRNFL (−0.16 μm [95% CI, −0.30 to −0.02 μm]; P = .03) thicknesses but not IOP (−0.01 mm Hg [95% CI, −0.09 to 0.07 mm Hg]; P = .84). Conclusions and Relevance In this study, an adverse association between CCB use and glaucoma was observed, with CCB users having, on average, 39% higher odds of glaucoma. Calcium channel blocker use was also associated with thinner mGCIPL and mRNFL thicknesses, providing a structural basis that supports the association with glaucoma. The lack of association of CCB use with IOP suggests that an IOP-independent mechanism of glaucomatous neurodegeneration may be involved. Although a causal relationship has not been established, CCB replacement or withdrawal may be considered should glaucoma progress despite optimal care.
We study the relationship between ownership concentration and firm value using hand-collected data on the stakes of owner–managers before and after initial public offerings (IPOs). We instrument for the reduction in stake using market returns shortly before IPOs. Short-run market returns are plausible instruments because owners engage in market timing by selling more when prior returns are high, but high short-run returns are unlikely to directly affect firm value years after the IPO. As predicted by agency theory, a large reduction in ownership concentration at the IPO is negatively related to valuation. Future asset growth is low when owners have low stakes. This paper was accepted by Victoria Ivashina, finance. Funding: B. Larrain acknowledges funding from ANID/CONICYT Proyecto FONDECYT Regular [Grant 1180593]. Supplemental Material: The online appendix and data are available at https://doi.org/10.1287/mnsc.2021.01039 .
Purpose: To investigate the characteristics of electronic device users, specifically smartphones and tablets, in the Device & Aids Register (D.A.Re), from several low-vision rehabilitation services in Italy. Methods: We collected general and clinical information about ocular and systemic diseases, visual function, reading speed and Instrumental Activities of Daily Living (IADL) questionnaire score. Technological details of each optical and electronic device, (including screen size, touch-screen and OCR functions, text-to-speech function) were also collected. Results: 1218 patients (752 females and 466 males) were included in our analysis, mean age 71.5 (±18.8) years. Users of electronic aids (n.237) were slightly younger (67 vs 72 years, p < 0.001) than non-users (n.981), had a worse reading speed (38 vs 65 words/minute), critical print size (43 vs 28 print size, p < 0.001), poorer visual acuity (VA)(1.0 logMAR or less: 30% non-users vs 73% users, p < 0.001) and more commonly visual field restriction within 10° (23% vs 14%, p = 0.001). A similar proportion of users and non-users were retired (about 70%) and about 16-17% were employed. The use of portable electronic devices (5″or less, p < 0.001; 6″ to 18″ screen size, p = 0.017) was associated with better IADL scores, and the use of stand devices with worse IADL score (p < 0.001); Furthermore, using smartphones and tablets (193 subjects) was strongly associated with better IADL scores. Conclusion: We found that using electronic devices, and especially smartphone and tablets, were associated with better vision-related quality of life in low-vision people attending rehabilitation services. While this association does not mean causality, these findings seemed robust to confounder adjustment.
(1) Background: While spoken language learning delays are assumed for deaf and hard of hearing (DHH) children after cochlear implant (CI), many catch up with their hearing peers. Some DHH children with CIs, however, show persistent delays in language, despite protective factors being in place. This suggests a developmental language disorder (DLD). However, at present there is little consensus on how to diagnose DLD in DHH children. (2) Methods: Given the lack of consensus in this area, a set of case studies provides an appropriate first step. The goal of this paper is to show the plausibility of a DLD diagnosis, following careful analysis of protective and risk factors. A retrospective case study review was conducted for three children. Their long-term language outcomes up to four years after CI were considered in the context of access to sound, speech sound discrimination, social skills and non-verbal cognition. (3) Results: It was possible to posit DLD in one child who had experienced good access to sound, alongside good speech discrimination abilities and social development, and normal non-verbal cognition, but who presented with severe language learning difficulties. (4) Conclusions: Finding markers for DLD in DHH children is important for diagnosis and intervention. The implications for clinical practice are discussed.
This paper analyses the working practices of several feminist creative and cultural enterprises in London (which I term ‘feminist CCIs’). In particular, it shows how pandemic precarity has driven feminist CCIs towards more entrepreneurial, self-promotional, and self-branding practices in order to sustain their work. Drawing on both digital ethnographic material and interviews with 12 workers in feminist CCIs conducted online between 2020 and 2022, the article provides insights into the landscape and contemporary realities of arts and cultural funding within these fields. It considers how decades of austerity measures and cuts have forced some feminist CCIs to operate independently outside of the UK public sector funding models. Survival tactics include adopting corporate funding models, subscription and membership schemes, platformisation and digitalisation. Focusing on funding, money and subjectivity, it unpacks the contradictions these imperatives bring to feminist politics: tensions about which some feminist CCI workers themselves are aware of and critical of. In the process, this paper considers how activism, feminism, entrepreneurialism, and precarity are fused together and negotiated in this form of ‘freelance feminism’.
Identifying and annotating toxic online content on social media platforms is an extremely challenging problem. Work that studies toxicity in online content has predominantly focused on comments as independent entities. However, comments on social media are inherently conversational, and therefore, understanding and judging the comments fundamentally requires access to the context in which they are made. We introduce a study and resulting annotated dataset where we devise a number of controlled experiments on the importance of context and other observable confounders – namely gender, age and political orientation – towards the perception of toxicity in online content. Our analysis clearly shows the significance of context and the effect of observable confounders on annotations. Namely, we observe that the ratio of toxic to non-toxic judgements can be very different for each control group, and a higher proportion of samples are judged toxic in the presence of contextual information.
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