This study aimed to determine whether the Hamad Medical Corporation Ambulance Service (HMCAS) personnel fulfil the pre-hospital readiness requirements for hazardous material and chemical, biological, radiological, and nuclear (HazMat-CBRN) incidents. This cross-sectional study performed an online assessment of non-specialist paramedics’ behaviour and knowledge about HazMat-CBRN incident management, followed by a ‘HazMat-CBRN incident management’ course with pre-and post-activity assessments. The validity and reliability of the knowledge assessment questions were also tested. The pre-and-post course assessement responses revealed certain deficiencies in staff knowledge. The multiple linear regression and paired groups t-test demonstrated that this was rectified after the training intervention. The results indicate that the implemented course helped HMCAS staff acquire a satisfactory level of knowledge to ensure their readiness for safe and effective responses to potential HazMat-CBRN incidents in Qatar. KEYWORDS: AmbulanceHazMat-CBRNexposureknowledgetraining
Objectives: The benefits of increased physical activity for stroke survivors include improved function and mental health and wellbeing. However, less than 30% achieve recommended physical activity levels, and high levels of sedentary behaviour are reported. We developed a multifaceted behavioural intervention (and accompanying implementation plan) targeting physical activity and sedentary behaviour of stroke survivors. Design: Intervention Mapping facilitated intervention development. Step 1 involved a systematic review, focus group discussions and a review of care pathways. Step 2 identified social cognitive determinants of behavioural change and behavioural outcomes. Step 3 linked determinants of behavioural outcomes with specific behaviour change techniques (BCTs) to target behaviours of interest. Step 4 involved intervention development informed by steps 1-3. Subsequently, an implementation plan was developed (Step 5) followed by an evaluation plan (Step 6). Setting: Community and secondary care settings, North East England. Participants: Stroke survivors and healthcare professionals (HCPs) working in stroke services. Results: Systematic review findings informed selection of nine 'promising' BCTs (e.g. problem-solving). Focus groups with stroke survivors (n = 18) and HCPs (n = 24) identified the need for an intervention delivered throughout the rehabilitation pathway, tailored to individual needs with training for HCPs delivering the intervention. Intervention delivery was considered feasible within local stroke services. The target behaviours for the intervention were levels of physical activity and sedentary behaviour in adult stroke survivors. Assessment of acceptability and usability with 11 HCPs and 21 stroke survivors/relatives identified issues with self-monitoring tools and the need for a physical activity repository of local services' and training for HCPs with feedback on intervention delivery. A feasibility study protocol was designed to evaluate the intervention. Conclusions: A systematic development process using intervention mapping resulted in a multi-faceted evidence- and theory-informed intervention (Physical Activity Routines After Stroke - PARAS) for delivery by community stroke rehabilitation teams.
Background: Investigating perceptions of control over mortality risk may be fundamental to understanding health behaviours and tackling socioeconomic gradients in health. Few studies have explored perceptions of control over different causes of death and there is a lack of qualitative risk research. Our aim was to examine participants' perceptions of control over potential causes of death and the sources that inform perceptions of risk. Method: We conducted semi-structured interviews with 24 participants (14 female and 10 male) and conducted a template analysis to analyse the transcripts. Findings: We identified six themes to represent participants' perceptions of control over potential mortality risks and the sources that inform these perceptions: Health-Related Mortality Risks, External Causes of Risk, Finding Balance, Family Medical History, Online Sources of Risk and Health-Related Information, and Health Misinformation. Dying from heart disease was broadly reported as being a controllable risk, whereas cancer was mostly discussed as uncontrollable. Gender-specific cancers were perceived as posing a significant risk to life, however controlling this risk was discussed in terms of screening and treatment, not prevention. Family medical history was discussed as an informative source for longevity predictions, but less so for specific causes of death. Most risk information is retrieved from 'Dr Google', though trusted sources, such as NHS websites, are used for validation. Health misinformation online was seen as a problem experienced by other people, rather than the individual. Conclusions: Causal pathways between behaviours and specific cancers may not be obvious to individuals. Messages emphasising the broader links between diet, alcohol and general cancer risk may highlight the controllability of cancer risk through improved health behaviours. Furthermore, given the rise in health misinformation, and the belief that it is other people not ourselves that are typically susceptible to believing misinformation online, further attempts are needed to combat this growing 'infodemic'.
Background Although laboratory studies demonstrate that training programmes using auditory rhythmical cueing (ARC) may improve gait post-stroke, few studies have evaluated this intervention in the home and outdoors where deployment may be more appropriate. This manuscript reports stakeholder refinement of an ARC gait and balance training programme for use at home and outdoors, and a study which assessed acceptability and deliverability of this programme. Methods Programme design and content were refined during stakeholder workshops involving physiotherapists and stroke survivors. A two-group acceptability and deliverability study was then undertaken. Twelve patients post-stroke with a gait related mobility impairment received either the ARC gait and balance training programme or the gait and balance training programme without ARC. Programme provider written notes, participant exercise and fall diaries, adverse event monitoring and feedback questionnaires captured data about deliverability, safety and acceptability of the programmes. Results The training programme consisted of 18 sessions (six supervised, 12 self-managed) of exercises and ARC delivered by a low-cost commercially available metronome. All 12 participants completed the six supervised sessions and 10/12 completed the 12 self-managed sessions. Provider and participant session written records and feedback questionnaires confirmed programme deliverability and acceptability. Conclusion An ARC gait and balance training programme refined by key stakeholders was feasible to deliver and acceptable to participants and providers. Trial registration ISCTRN 12/03/2018.
Background The associations of cancer with types of diets, including vegetarian, fish, and poultry-containing diets, remain unclear. The aim of this study was, therefore, to investigate the association of type of diet with all cancers and 19 site-specific incident cancers in a prospective cohort study and then in a meta-analysis of published prospective cohort studies. Methods A total of 409,110 participants from the UK Biobank study, recruited between 2006 and 2010, were included. The outcomes were incidence of all cancers combined and 19 cancer sites. Associations between the types of diets and cancer were investigated using Cox proportional hazards models. Previously published prospective cohort studies were identified from four databases, and a meta-analysis was conducted using random-effects models. Results The mean follow-up period was 10.6 years (IQR 10.0; 11.3). Compared with meat-eaters, vegetarians (hazard ratio (HR) 0.87 [95% CI: 0.79 to 0.96]) and pescatarians (HR 0.93 [95% CI: 0.87 to 1.00]) had lower overall cancer risk. Vegetarians also had a lower risk of colorectal and prostate cancers compared with meat-eaters. In the meta-analysis, vegetarians (Risk Ratio (RR): 0.90 [0.86 to 0.94]) and pescatarians (RR 0.91 [0.86; 0.96]) had lower risk of overall and colorectal cancer. No associations between the types of diets and prostate, breast, or lung cancers were found. Conclusions Compared with meat-eaters, vegetarians and pescatarians had a lower risk of overall, colorectal, and prostate cancer. When results were pooled in a meta-analysis, the associations with overall and colorectal cancer persisted, but the results relating to other specific cancer sites were inconclusive.
Background Microorganisms are known to be important drivers of biogeochemical cycling in soil and hence could act as a proxy informing on soil conditions in ecosystems. Identifying microbiomes indicative for soil fertility and crop production is important for the development of the next generation of sustainable agriculture. Earlier researches based on one-time sampling have revealed various indicator microbiomes for distinct agroecosystems and agricultural practices as well as their importance in supporting sustainable productivity. However, these microbiomes were based on a mere snapshot of a dynamic microbial community which is subject to significant changes over time. Currently true indicator microbiomes based on long-term, multi-annual monitoring are not available. Results Here, using samples from a continuous 20-year field study encompassing seven fertilization strategies, we identified the indicator microbiomes ecophysiologically informing on soil fertility and crop production in the main agricultural production base in China. Among a total of 29,184 phylotypes in 588 samples, we retrieved a streamlined consortium including 2% of phylotypes that were ubiquitously present in alkaline soils while contributing up to half of the whole community; many of them were associated with carbon and nutrient cycling. Furthermore, these phylotypes formed two opposite microbiomes. One indicator microbiome dominated by Bacillus asahii , characterized by specific functional traits related to organic matter decomposition, was mainly observed in organic farming and closely associated with higher soil fertility and crop production. The counter microbiome, characterized by known nitrifiers (e.g., Nitrosospira multiformis ) as well as plant pathogens (e.g., Bacillus anthracis ) was observed in nutrient-deficit chemical fertilizations. Both microbiomes are expected to be valuable indictors in informing crop yield and soil fertility, regulated by agricultural management. Conclusions Our findings based on this more than 2-decade long field study demonstrate the exciting potential of employing microorganisms and maximizing their functions in future agroecosystems. Our results report a “most-wanted” or “most-unwanted” list of microbial phylotypes that are ready candidates to guide the development of sustainable agriculture in alkaline soils.
The conventional hard-switching converters suffer from the limitations like the upper limit on switching frequency, high electromagnetic interference (EMI), more switching losses, large size, increased weight and low efficiency. To overcome these limitations, resonant converters are popularly used in chargers of electric vehicles (EVs). However, the detailed classification of resonant converters used in EVs is not sufficiently discussed in the literature. The guideline to select a resonant converter based topology required to charge an EV on the basis of its rating is not mentioned. To fill this gap, this paper presents a state-of-art literature survey of various resonant converter based topologies used in chargers of EVs. This paper focuses on a detailed classification of resonant converters used in the second stage of EV chargers. Further, it provides a guideline to designers to choose a converter topology used in the first stage and the second stage of EV charger required based on wattage, unidirectional and bidirectional power flow. Depending on the number of reactive elements present in a given resonant converter topology, these are classified as two-element, three-element, and multi-element resonant converters. Depending upon the connection of inductive (L) and capacitive (C) elements with respect to transformer winding, these converter topologies are further categorized as series, parallel (two-elements), inductor-inductor-capacitor (LLC) (three-element) and capacitor-inductor-inductor-capacitor (CLLC) (Multi-elements). However, the LLC type resonant converters offer high efficiency, zero-voltage switching (ZVS turn-on, turn-off) and low voltage stress on switches and high power density. Therefore, this paper mainly focuses on LLC type resonant converter topology. In addition, various modulation schemes and control schemes for LLC, CLLC resonant converter along with control of active power and reactive power are discussed for vehicle-2-grid (V2G) mode of operation.
The complex dynamics of a frictional contact interface have been the subject of many research investigations. However, a comprehensive model has not been proposed that can be easily solved and considers the effect of all parameters of interest, i.e., the variation in contact pressure, the interaction of normal and tangential direction mechanisms, and contact surface degradation. This paper proposes a generalized slip model based on the original Valanis model with the ability to generate non-symmetric hysteresis loops for frictional contact interface modelling and identification. Various numerical and simulation results are used to show the capability of the generalized Valanis model. The advantages of the model presented in this paper are its simplicity and accuracy. The model offers an explicit solution for the Hysteresis loop and is Lipschitz continuous, making it an ideal choice for real-time analyses, such as in digital twins’ applications. The model can represent both point-to-point contacts in a joint interface and the joint interface as a whole. The latter application is considered in this paper.
This paper presents a nonlinear model predictive control scheme for residual current compensation inverters in rapid earth fault current limiters to inject appropriate current to the neutral so that the fault current is compensated in distribution networks. The proposed nonlinear model predictive controller is designed to limit the fault current within a level that powerline bushfires do not ignite due to single line-to-ground faults on power distribution systems in bushfire prone areas. The nonlinear model predictive controller is designed for a T-type residual current compensation inverter in rapid earth fault current limiters based on its dynamical model where the control objective is to inject current for compensating the fault current. The control law for the residual current compensation inverter is obtained by solving an optimal control problem while using the concept of the receding horizon control scheme. The performance of the controller is evaluated through standard software-based computer and processor-in-loop simulations where results are benchmarked against backstepping and sliding mode controllers in terms of compensating both faulty phase voltage and fault current.
The hybrid indirect evaporative cooling-mechanical vapor compression (IEC-MVC) process is an emerging cooling technology that combines the advantages of IEC and MVC, i.e., effective temperature and humidity control, high energy efficiency, and low water consumption. This paper presents an experimental study of the hybrid IEC-MVC process. A 1-Rton pilot is fabricated by connecting IEC and MVC in series, and its performance is evaluated under different operating conditions (outdoor air temperature and humidity, air flowrate, compressor frequency). Results revealed that the outdoor air temperature and humidity could be lowered to 5–15 °C and 5–10 g/kg, respectively. The IEC handles 35%–50% of the total cooling load, and the energy consumption can be reduced by 15%–35% as compared to standalone MVC. Moreover, the condensate collected from the evaporator can compensate for >70% of water consumption in IEC, making the system applicable in arid regions. Based on the derived results, a simplified empirical model is developed for rapid evaluation of the IEC-MVC process, and the energy-saving potential in major cities of Saudi Arabia is estimated.
The performance of different suspended fillers (zeolite, drinking water treatment residual, biochar, woodchip and stereo-elastic packing) and their combinations in treating municipal wastewater in ecological floating beds (Eco-FBs) planted with Myriophyllum aquaticum was assessed. Six sets of enhanced Eco-FBs were developed to assess the individual and synergistic effects of combinations of the various fillers and microorganisms on nutrient elimination. The results demonstrated mean TN, NH4-N, TP and COD purification efficiencies of 99.2 ± 11.2 %, 99.82 ± 16.4 %, 98.3 ± 14.3 %, and 96.1 ± 12.3 %, respectively in the Eco-FBs strengthened with all five fillers. The corresponding purification rates were 0.89 ± 0.14, 0.75 ± 0.12, 0.08 ± 0.016, and 7.05 ± 1.09 g m−2 d−1, which were 2–3 times higher than those of the conventional Eco-FB system. High-throughput sequencing showed that some genera related to nutrient transformation, including Proteobacteria (24.13–51.95 %), followed by Chloroflexi (5.64–25.01 %), Planctomycetes (8.48–14.43 %) and Acidobacteria (2.29–11.65 %), were abundantly enriched in the strengthened Eco-FBs. Enhancement of the Eco-FBs with various fillers significantly increased microbial species richness and diversity as demonstrated by Chao1, Shannon and Simpson's indexes, particularly when all the five fillers were combined. Therefore, introducing suspended fillers into Eco-FBs is an appropriate approach for improving nutrient elimination from municipal wastewater.
We measure the impact of the bank credit disbursement on Micro, Small and Medium Enterprises (MSME) growth, incorporating the role of regional governors' characteristics in the case of 84 regions of the Russian Federation. Given the considerable heterogeneity across regions, time and reverse causality, we applied the Panel Quantile Regression via Moments (MM-QR) approach to analyze monthly frequency big data (2016M1-2021M1). Our empirical investigation demonstrates that bank credit disbursement and MSME growth follow a non-monotonic relation, implying that up to the specific size of the credit is detrimental, but after surpassing the threshold size, it is supportive to MSME growth under each quantile. Regional governors' political and economic liaison with the federal government impede MSME growth under different quantiles of MSME growth. Our findings further infer that credit market deepening along with firms' individual characteristics are crucial for enterprise performance in the current time of digital transformation. We provide several policy implications.
The effects of landuse/landcover (LULC) and climate change on hydrology and soil erosion processes are of major concern, especially in the humid tropics. In this study, an evaluation of these changes is performed in a humid tropical catchment (Vamanapuram river basin, India) using a physically based distributed model, SHETRAN. The past landuse maps and climate data from six fine resolution NASA Earth Exchange Global Daily Downscaled Projections (NEX-GDDP) are used to force the SHETRAN model. A comparison of the change in the rate of soil erosion and hydrological responses during the future climate scenarios (near: 2021–2050 and far: 2071–2100) with respect to the historical period (1980–2005) is conducted. The isolated effects of landuse, climate variability and the combined effect caused change in streamflow (1.1%, 7.9%, 9.0% respectively) and sediment load (−10.4%, 1.7%, −10.5% respectively) in the past. An ensemble mean of general circulation model (GCM) projections showed that mean temperature and average annual precipitation under representative concentration pathway RCP 4.5 (8.5) scenarios for near and far futures increased from the historic period by 0.51 °C (1.6 °C), 0.6 °C (3.2 °C) and by 9% (6%), 15% (22.8%), respectively. Under RCP4.5(8.5), the average annual streamflow increased gradually from the near to far future, by 3.2% (−1.8%) and 13.6 % (22.1%) whereas, the projected sediment load a showed change of −21.05% (−26.63%) in near future while far future indicated change by −11% (4%). The SHETRAN model has been found to be effective in evaluating climate change impacts on hydrology and sediment yield and is useful for future river basin management.
The Central Asian area is confronted with a number of acute obstacles as it attempts to transition to a long-term electrical power supply. Small-scale hydropower systems may be a viable answer to these problems. Central Asian nations' hydropower resources are allocated unevenly. Regardless, it remains the most exploitable renewable energy source in the area, with both Kyrgyzstan and Tajikistan possessing some of the world's highest hydropower potential. Nonetheless, for fossil-fuel-rich nations like Uzbekistan, Turkmenistan, and Kazakhstan, hydropower will play a significant role in the future energy balance. Furthermore, because rivers often run across many boundaries, water security plays an important role in cross-border relations between Central Asian countries. To achieve effective exploitation of small hydropower potential, technological and financial expenditures are needed to improve the levelised cost of energy (LCOE) of diverse hydroelectric equipment by increasing lifetime, improving efficiency, and increasing yearly power output. Several of these issues can be resolved by installing small and micro hydropower plants in the many minor rivers and irrigation canals. A pumped hydro energy storage system should also be tested and certified for better usability. A hydrological digital twin of relevant river system and irrigation network should be constructed to increase the understanding for performance and enable system-level improvement. Furthermore, optimal performance necessitates constant monitoring of the network, necessitating the development of intelligent monitoring employing sensors in conjunction with control systems and smart grid interactions. This review focuses on the broad and efficient use of these existing resources, which are still underutilized.
A novel feed spacer for spiral-wound membrane modules is proposed. Based upon a continuous arch-type streamline frame two feed spacers with different node designs were constructed. In the first, Arch-Hole, two elliptic cylinders form a node zone with a passage. The other, named Arch, has a solid node. Their hydrodynamics, fouling and filtration performance were compared with a commercial design. This was a classic net-type spacer with nodes of relatively substantial size. All three were manufactured using 3D printing. Computational fluid dynamics simulation showed that the Arch-Hole design gives a more uniform velocity distribution with fewer dead zones. Subsequent evaluation of this design indicated less foulant accumulation as confirmed by optical coherence tomography and the evolution of channel pressure drop. Measured adenosine triphosphate and total organic carbon values for the module with this spacer were substantially lower than the corresponding values associated with the commercial design. Crucially with the Arch-Hole design, flux values remained higher than for the other two designs. Thus use of this spacer would minimize both capital and operational costs. Compared to the commercial one, use of the Arch-Hole design would reduce the energy cost of filtration significantly beyond the 69 % found for the application considered herein.
This paper examines the nexus between sovereign environmental, social and corporate governance (ESG) issues and corporate investment decisions from a sustainable perspective. By utilising firm-level balance sheets data, country-level governance and policy uncertainty data, we find country governance has a significant positive effect on firm investment. Moreover, this paper shows that climate and migration policy uncertainty has a statistically and economically significant dampening impact on corporate investment, indicating that environmental and social prospect plays a key role in promoting business investment in the United Kingdom. In addition, the empirical evidence on the moderation analysis of corporate leverage suggests that superior environmental, social, and governance performance can help businesses relieve the burden of debt overhang on firm investment. These results provide several important implications on climate change with the objectives of the COP26 conference.
Current legislation focuses on reducing the operational carbon impact of buildings. However, the production of materials used in construction generates a considerable amount of carbon, known as embodied carbon, that accounts for a sizeable fraction of the environmental impact of a building during its lifecycle. We present a newly developed tool, pycab, which calculates the embodied carbon of a building directly at the design stage and compares it to the Royal Institute of British Architects (RIBA) 2030 Climate Challenge Target Benchmarks. As input, the tool uses standard Industry Foundation Classes (IFC) files that can be produced directly from existing Building Information Modelling (BIM) software. The pycab tool enables industry professionals to make design stage decisions that reduce the embodied carbon impact of their projects. This research demonstrates one of the many potential uses that digital tools can have in reducing the environmental impact of the construction industry.
The discharge of antibiotics and metals in estuaries is of great concern since they threaten microbial communities that are critical for maintaining ecosystem function. To understand single and combined effects of norfloxacin (0–20 μg g⁻¹) and copper (40 μg g⁻¹) on microbial ecology in estuaries, we evaluated changes in bacteria population, inhibition rates, and microbial composition in estuarine sediments over a 28-day period. Bacteria population significantly decreased following single and combined exposure to norfloxacin and copper throughout the incubation period, except on Day 28 in treatments exposed to copper, 20 μg g⁻¹ norfloxacin, or both. These three treatment groups had lower Shannon diversity and Simpson's indices on Day 28 than other treatments and the controls suggesting recovery in bacteria population did not correspond with recovery in richness and evenness. Furthermore, functional predictions revealed that the effect of time and contaminants were significantly different on some microbial community functions on Day 28, especially the combination of Cu and high concentration NFX, including aerobic chemoheterotrophy, methanol oxidation and methylotrophy. Thus, norfloxacin and copper had significant adverse effects on microbial communities in estuarine sediments; however, the combined effects were variable and depended on exposure duration and antibiotic concentration.
Gender (in)equality varies strongly across countries. However, research has not sufficiently addressed how subsidiaries of multinational companies respond to differences in gender equality between home and host countries. Based on interviews with 34 managers, our study explores how subsidiaries experience gender-related challenges in their home and host countries, what kinds of practices they implement to increase gender equality, and which role the headquarters play in the implementation of these practices. We do so by examining the cases of German subsidiaries in Japan and Japanese subsidiaries in Germany, two countries that differ greatly in gender equality. Building on our analysis, we systematically compare how subsidiaries respond to the institutional pressures from their home and host countries and develop a theoretical model that illustrates how gender diversity management in a subsidiary is contingent on the interaction of (1) global integration pressure from the headquarters and (2) the level of gender equality in the home country relative to the host country, linked via different types of collaboration and practice transfer from the headquarters. Theoretical and practical implications of our findings are discussed.
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