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Renewable energy technologies offer promise for addressing energy access and environmental concerns, especially in remote off-grid areas. This paper presents a comprehensive techno-economic analysis of an off-grid PV/wind/biomass hybrid system. Employing optimization techniques including the osprey optimization algorithm (OOA), zebra optimization algorithm (ZOA), and flying foxes optimization (FFO) algorithm, the study aims to determine the optimal sizing of solar PV, wind, biomass, and battery components. Using data from Tabuk, Saudi Arabia (28.38° N, 36.56° E), the study seeks to achieve optimal sizing for solar PV, wind, biomass, and battery storage components to minimize the net present cost (NPC) and ensure reliable power supply, adhering to specified loss of power supply probability (LPSP) and excess energy thresholds. Three battery types, namely, flooded lead-acid, lithium iron phosphate (LFP), and nickel iron (Ni-Fe), were analyzed. Results reveal that ZOA outperformed other algorithms, supplying electricity at a minimum cost of 0.1285 $/kWh in one configuration, with the LFP battery achieving the lowest NPC of 3.8 M$ in case studies with constrained LPSP. Across multiple simulations, ZOA displayed superior stability and convergence characteristics, evidenced by its tight objective function range and lower relative error metrics. These findings underscore the potential of this integrated approach to enhance the economic viability and operational resilience of off-grid hybrid microgrid systems, particularly in arid and semi-arid regions.

Purpose: This study aimed to assess the extent of the use and the safety of dealing withBitcoin through blockchain technology.   Method/approach: Bitcoin model applied for electronic contracts. The method of functional-cost analysis for technical and economic analysis of system development for NFT creation is used in work.   Theoretical framework: Bitcoin is a currency that depends on modern technological techniques with many advantages because they are used to send and receive money over the Internet and can be used in legitimate and illegal businesses. Therefore, quick international measures must be taken to regulate them legally through unified international conventions that regulate the ways of legal dealing with them.   Results and Conclusions: International laws must govern and regulate the use of Bitcoin, as it is a currency traded over the Internet and can be used in legitimate and illegal businesses. And that the smart contract, which is executable code that runs on top of the blockchain to facilitate, execute and enforce an agreement between untrusted parties without the involvement of a trusted third party, can be used, especially since the International legislation lacks a legal regulation of virtual currencies.   Research implications: The findings indicated the importance of stipulating special laws that regulate the use of Bitcoin.   Originality/value: This work can provide possible solutions to reduce the risks of using Bitcoin, such as stipulating laws and regulations to regulate their use internationally.

Background Accreditation is a practical approach to enhancing hospital service quality, requiring trained and competent surveyors for successful implementation. This study aimed to evaluate the training process of hospital accreditation surveyors in Iran based on the International Society for Quality in Health Care (ISQua) requirements and propose corrective measures. Methods This mixed-methods study was conducted in 2023–2024. First, the operational requirements of ISQua for surveyor training were identified and translated from existing guidelines, leading to the development of an evaluation questionnaire with four domains and 20 items. A total of 144 national accreditation surveyors completed the questionnaire, and the challenges were identified based on the analysis of the completed questionnaires. Improvement strategies for the surveyor training process were then obtained through semi-structured interviews with 17 experts in the field of accreditation. The interviews were analyzed using the inductive content analysis approach and MAXQDA software. Results The compliance rate of the Iranian hospital accreditation surveyor training program with ISQua’s requirements was estimated at 72% (± 0.39). The compliance rates in the domains of “educational program planning,” “educational program management,” “educational program implementation,” and “assessing surveyor competencies” were 76% (± 0.38), 73% (± 0.38), 71% (± 0.39), and 70% (± 0.39), respectively. The proposed improvement strategies by hospital accreditation experts were categorized into three main themes: “improving the surveyor selection and evaluation process,” “enhancing the surveyor training process,” and “revising organizational policies,” along with 20 sub-themes. Among the suggested improvements were establishing a subdivision within the accreditation office to manage surveyors, creating a surveyor management committee involving accreditation experts, allocating sufficient time for initial training, organizing periodic and continuous training programs for surveyors, and outsourcing surveyor training. Conclusions The Iranian hospital accreditation surveyor training program’s compliance with ISQua’s requirements is relatively satisfactory from the surveyors’ perspective. However, amendments are necessary in surveyor selection, training, and the current policies of the Accreditation Office at the Ministry of Health.

The selection of process parameters is crucial in 3D printing for product manufacturing. These parameters govern the operation of production machinery and influence the mechanical properties, production time, and other aspects of the final product. The optimal process parameter settings vary depending on the product and printing application. This study identifies the most suitable cluster of process parameters for producing rotating components, specifically impellers, using carbon-reinforced Polyether Ether Ketone (CF-PEEK) thermoplastic filament. A mathematical programming technique using a rating method was employed to select the appropriate process parameters. The research concludes that an infill density of 70%, a layer height of 0.15 mm, a printing speed of 60 mm/s, a platform temperature of 195 °C, an extruder temperature of 445 °C, and an extruder travel speed of 95 mm/s are optimal process parameters for manufacturing rotating components using carbon-reinforced PEEK material.

Gastroenteritis is commonly caused by viral etiologies. The inclusion of astrovirus on multiplex, syndromic gastrointestinal PCR panels allows for the detection and characterization of infected patients. This retrospective, observational, clinical study examines the epidemiology and clinical characteristics of astrovirus infections in adults from our institution in Washington D.C. (USA) over a seven-year period. Chart abstraction was performed to collect patient demographics, laboratory results, clinical presentation, and management. The overall positivity rate of astrovirus was 0.6%. Peak seasons were late winter to spring (February–April). The mean age was 32 years old (range: 18–52 years). All patients presented with gastroenteritis symptoms and were immunocompetent except one. Symptoms varied among diarrhea, abdominal pain, vomiting, and fever, but patients in age group 30–39 years experienced less vomiting (p = 0.01). Infected patients had an increase in monocytes and neutrophils and a decrease in lymphocytes (p < 0.001). Gastrointestinal co-infections were seen in 24% of our patients. In all patients, clinicians acknowledged the detection of astrovirus and discharged patients without further treatment. The median length of stay was 6 h, and no patients were admitted into the intensive care unit. We show that astrovirus infections in immunocompetent adults were associated with mild disease associated with specific cell counts and different symptoms correlated with age.

This study investigates the production of graphene-enhanced polyethylene terephthalate glycol (G-PETG) components using fused deposition modeling (FDM) and evaluates their mechanical properties, contributing to the advancement of additive manufacturing. Trials demonstrated notable improvements in mechanical performance, with optimal printing parameters identified using the Spice Logic Analytical Hierarchy Process (AHP). The effectiveness of this methodology is further compared with the Fuzzy Analytic Hierarchy Process (FAHP) combined with the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS). The study revealed significant enhancements, with the ultimate tensile strength (UTS) reaching 69.1 MPa, an average Young’s modulus of 735.6 MPa, and an ultimate compressive strength (UCS) of 85.3 MPa. These findings provide valuable insights into optimizing techniques for improving the mechanical performance of G-PETG components, advancing material applications in various industries.

Background Social determinants of health have a key role in the growth and development of children, particularly in early childhood which is mentioned from infancy to the age of six years old. These factors might cause disparities in living conditions and consequently bring about inequities regarding different aspects of development such as emotional, psychological, social, psychological, and intellectual. This research aimed to provide a model for prioritizing social factors affecting the development of children under six years. Methods We used quantitative–qualitative (mixed) method to perform data analysis. The statistical population included 12 medical experts and professionals in the field of children’s development and social determinants of health that were selected using the snowball method. In the quantitative section, a Delphi technique was applied to screen the extracted indicators. Then through applying a decision-making trial and evaluation laboratory (DEMATEL) method, the cause-and-effect interactions among main social determinants were identified. To analyze data, super decision software was used. Results According to literature review and the results obtained from focus group discussions, five dimensions including individual factors, family factors, environmental factors, governance, and global factors were identified. Based on the study findings, the criterion of “family factors” was mentioned as the most important priority affecting childhood development. Furthermore, the sub-criterion of “International Programs and Policies” received the greatest priority among other sub-criteria with a profound impact on children's healthy growth and development. Conclusion Despite the current knowledge about social determinants of health, it is required to identify the most influential socioeconomic factors on childhood development. In such a manner, political strategies for improving the health condition of children can be implemented based on scientific evidence. Due to the crucial role of family factors, environmental factors and other socio-economic conditions, health policy makers and public health practitioners should be informed of the importance of these factors in shaping the health condition of children.

This study evaluates hydrothermal liquefaction (HTL) of real-world marine pollutant residues (MPR) composed of mixed plastics, organic matter, paper, and textiles. Using diatomaceous earth (DE) catalysis and aqueous-phase (AQ) recirculation, the effects on product yield, composition, and energy recovery were examined. Under optimized conditions (380 °C, 80 min, 10 wt% DE, RR = 6 mL g -1 ), a maximum bio crude yield of 51.6% with an HHV of 40.3 MJ kg -1 was achieved. Elemental, molecular, and thermal analyses (CHNS, GC–MS, FTIR, TGA) indicated improved hydrocarbon content and reduced oxygenation in the DE + AQ configuration. Net energy ratio (NER) calculations showed that the process can achieve energy-positive operation under conditions of elevated AQ recirculation temperature, highlighting the importance of heat integration. While these results demonstrate effective conversion of heterogeneous marine residues into energy-dense products, broader sustainability claims require further assessment of emissions, wastewater toxicity, and scale-up feasibility. The study provides experimentally grounded insights into HTL as a potential component of coastal waste valorization strategies.

Background Defining socio-demographic factors, clinical presentations and underlying diseases associated with COVID-19 severity could be helpful in its management. This study aimed to further clarify the determinants and clinical risk factors of the disease severity in patients infected with COVID-19. Methods A multi-centre descriptive study on all patients who have been diagnosed with COVID-19 in the province of Tehran from March 2020 up to Dec 2020 was conducted. Data on socio-demographic characteristics, clinical presentations, comorbidities, and the health outcomes of 205,654 patients were examined. Characteristics of the study population were described. To assess the association of study variables with the disease severity, the Chi-Squared test and Multiple Logistic Regression model were applied. Results The mean age of the study population was 52.8 years and 93,612 (45.5%) were women. About half of the patients have presented with low levels of blood oxygen saturation. The ICU admission rate was 17.8% and the overall mortality rate was 10.0%. Older age, male sex, comorbidities including hypertension, cancer, chronic respiratory diseases other than asthma, chronic liver diseases, chronic kidney diseases, chronic neurological disorders, and HIV/AIDS infection were risk markers of poor health outcome. Clinical presentations related with worse prognosis included fever, difficulty breathing, impaired consciousness, and cutaneous manifestations. Conclusion These results might alert physicians to pay attention to determinants and risk factors associated with poor prognosis in patients with COVID-19. In addition, our findings aid decision makers to emphasise on vulnerable groups in the public health strategies that aim at preventing the spread of the disease and its mortalities.

The consumption of oxygen in ice-covered lakes is analyzed and related to biological oxygen demand and sediment oxygen demand. An approach for computing dissolved oxygen concentration is suggested assuming horizontally mixed waters and negligable vertical dispersion. It is found that the depletion of dissolved oxygen is mainly due to the transfer of oxygen at the water/sediment interface. The morphology of a lake is very important for how fast the dissolved oxygen concentration is reduced during winter.