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Background Cardiovascular diseases (CVD) are the main cause of mortality in low- and middle-income countries like Nepal. Different risk factors usually cluster and interact multiplicatively to increase the risk of developing acute cardiovascular events; however, information related to clustering of CVD risk factors is scarce in Nepal. Therefore, we aimed to determine the prevalence of CVD risk factors with a focus on their clustering pattern in a rural Nepalese population. Methods A community-based cross-sectional study was conducted among residents aged 40 to 80 years in Lamjung District of Nepal in 2014. A clustered sampling technique was used in steps. At first, four out of 18 wards were chosen at random. Then, one person per household was selected randomly ( n  = 388). WHO STEPS questionnaires (version 2.2) were used to collect data. Chi-square and independent t-test were used to test significance at the level of p  < 0.05. Results A total 345 samples with complete data were analyzed. Smoking [24.1% (95% CI: 19.5–28.6)], harmful use of alcohol [10.7% (7.4–13.9)], insufficient intake of fruit and vegetable [72% (67.1–76.6)], low physical activity [10.1% (6.9–13.2)], overweight and obesity [59.4% (54.2–64.5)], hypertension [42.9% (37.6–48.1)], diabetes [16.2% (14.0–18.3)], and dyslipidemia [56.0% (53.0–58.7)] were common risk factors among the study population. Overall, 98.2% had at least one risk factor, while 2.0% exhibited six risk factors. Overall, more than a half (63.4%) of participants had at least three risk factors (male: 69.4%, female: 58.5%). Age [OR: 2.3 (95% CI: 1.13–4.72)] and caste/ethnicity [2.0 (95% CI: 1.28–3.43)] were significantly associated with clustering of at least three risk factors. Conclusions Cardiovascular risk factors and their clustering were common in the rural population of Nepal. Therefore, comprehensive interventions against all risk factors should be immediately planned and implemented to reduce the future burden of CVD in the rural population of Nepal.

The degradation of solar photovoltaic (PV) modules is caused by a number of factors that have an impact on their effectiveness, performance, and lifetime. One of the reasons contributing to the decline in solar PV performance is the aging issue. This study comprehensively examines the effects and difficulties associated with aging and degradation in solar PV applications. In light of this, this article examines and analyzes many aging factors, including temperature, humidity, dust, discoloration, cracks, and delamination. Additionally, the effects of aging factors on solar PV performance, including the lifetime, efficiency, material degradation, overheating, and mismatching, are critically investigated. Furthermore, the main drawbacks, issues, and challenges associated with solar PV aging are addressed to identify any unfulfilled research needs. Finally, this paper provides new directions for future research, best practices, and recommendations to overcome aging issues and achieve the sustainable management and operation of solar energy systems. For PV engineers, manufacturers, and industrialists, this review’s critical analysis, evaluation, and future research directions will be useful in paving the way for conducting additional research and development on aging issues to increase the lifespan and efficiency of solar PV.

Background Low level of physical activity (PA) has become an important public health problem even in low-income countries. The objectives of this study were to measure PA levels, determine the prevalence of low PA and identify socio-demographic factors associated with it in Bangladeshi adults. Methods Data from 792 (urban, 395; rural, 397) Bangladeshi adults (25–64 years) were included in this population-based cross-sectional study conducted in 2011. Global Physical Activity Questionnaire version 2 (GPAQ-2) was used to measure PA. The metabolic equivalent task (MET) in minutes per week was calculated to determine total PA. Participants were categorized into low, moderate and high PA groups. Logistic regression was used to assess socio-demographic factors associated with low level of PA. Results Median MET-minute of total PA per week was almost double in the rural area (1720) than the urban area (960). The overall prevalence of low PA was 50.3% (95% CI: 46.8–53.8), urban 59.5% (54.7–64.3) and rural 41.9% (37.0–46.8). Women in general were more inactive (women 63.1% [58.3–67.9], men 39.3% [34.6–44.0]). The main contributions to total PA were from work (urban 40.0%, rural 77.0%) and active commute (57.0%, 21.0%). Leisure-time PA represented a very small proportion (<3.0%). Multiple logistic regressions found a significant association of urban residence (OR = 2.2; 95% CI: 1.5–3.2), women (2.1; 1.4–3.9), oldest age group 55–64 years (15.6; 7.5–32.2) compared to youngest age group 25–34 years, graduation or further education (8.6; 4.1–17.7), and higher socio-economic class (2.4; 1.4–4.2) compared to poor with insufficient PA. Conclusions This study identifies low PA in a rural and urban population in Bangladesh and that further large-scale population studies are warranted.

Organic and pharmaceutical pollution of water is a serious problem, particularly when it comes to drinking and groundwater. Although some evaluations indicate that these pollutants are unlikely to be at current exposure levels, they are often detected in aquatic systems and can be harmful to human health. Organic contaminants include hazardous micropollutants, aromatic phenols, pesticides, etc. Pharmaceutical contaminants are sulfamethoxazole, diclofenac, doxycycline, amoxicillin, trimethoprim, ciprofloxacin, norfloxacin, lipid regulators, nonsteroidal anti-inflammatory drugs (NSAIDs), hormones, antidepressants, etc. Hydrogel adsorbents’ distinct structural, chemical, and environmentally benign qualities make them a potential and successful option for environmental remediation, especially in wastewater treatment. In the search for clean water resources, they are an important instrument because of their reusability and capacity to be customized for certain contaminants, such as organic and pharmaceutical pollutants. This review focusses on the present state, adsorption sites and surfaces, different adsorption mechanisms, and the prospects and scope of improvement of effective hydrogels for eliminating dangerous aqueous organic and pharmaceutical contaminants. It offers a thorough summary of the area, highlighting its facets and potential paths forward.

Energy generation from renewable sources is a global trend due to the carbon emissions generated by fossil fuels, which cause serious harm to the ecosystem. As per the long-term goals of the ASEAN countries, the Malaysian government established a target of 31% renewable energy generation by 2025 to facilitate ongoing carbon emission reductions. To reach the goal, a large-scale solar auction is one of the most impactful initiatives among the four potential strategies taken by the government. To assist the Malaysian government’s large-scale solar policy as detailed in the national renewable energy roadmap, this article investigated the techno-economic and feasibility aspects of a 10 MW floating solar PV system at UMP Lake. The PVsyst 7.3 software was used to develop and compute energy production and loss estimation. The plant is anticipated to produce 17,960 MWh of energy annually at a levelized cost of energy of USD 0.052/kWh. The facility requires USD 8.94 million in capital costs that would be recovered within a payback period of 9.5 years from the date of operation. The plant is expected to reduce carbon emissions by 11,135.2 tons annually. The proposed facility would ensure optimal usage of UMP Lake and contribute to the Malaysian government’s efforts toward sustainable growth.

Purpose Nigeria is a country with very low health insurance coverage, with only 3 per cent of its population in the public and private sector covered by conventional health insurance. This made it possible for the exploration of alternative methods of insurance in Muslim dominated northwestern Nigeria. Thus, this paper aims to extend the theory of planned behavior to understand the role of awareness in the acceptance of Islamic health insurance (takaful) among microenterprises in northwestern Nigeria. Design/methodology/approach The methodology used was a purely quantitative survey with data collected from seven states that form the northwestern Nigeria. Findings The findings revealed that attitude, social influence and perceived behavioral control have a significant direct influence on takaful acceptance intention among microenterprises in northwestern Nigeria, while awareness does not. It was also discovered that awareness of takaful moderates the influences of social influence and perceived behavioral control on takaful acceptance intention, but it failed to moderate the influence of attitude on takaful acceptance intention in the same context. Research limitations/implications The implication is that despite the acceptance intention more awareness is required to enlarge the takaful market in the region. The study contributes to the theories of reasoned action and planned behavior through the integration of awareness as a moderator. Originality/value The work is pioneering, extent literature in the area of takaful failed in investigating the role of awareness as a moderating variables in Nigeria where much awareness of the concept is desirable.

The mismatch in current-voltage (I-V) characteristics of photovoltaic (PV) modules causes significant power loss in a large PV array, which is known as mismatch power loss (MML). The PV array output power generation can be improved by minimizing MML using different techniques. This paper investigates the performance of different module arrangement techniques to minimize MML both for long series string (LSS) and long parallel branch (LPB) in series-parallel (SP) array configurations at uniform irradiance condition. To investigate the significance of MML LSS-SP configuration with dimensions: 1 × 40, 2 × 20, 4 × 10, 5 × 8 and LPB-SP configuration with dimensions: 40 × 1, 20 × 2, 10 × 4, 8 × 5 were used. A comparative analysis is made to find the effectiveness of MML reduction techniques on PV arrays with three different power ratings. Simulation results show that the PV modules arrangement obtained by the genetic algorithm (GA) and current based arrangement (Im) performed better than the arrangements obtained by all other techniques in terms of PV array output power and MML minimization. The performance of the proposed technique was analyzed for both LSS-SP and LPB-SP array configurations in 400 W, 3400 W, and 9880 W arrays. To substantiate the simulation results experiment was performed using a 400 W PV array in outdoor weather condition and obtained similar results. It was also observed that the percentage of recoverable energy (%RE) obtained by arranging the modules using the GA method was higher than Im based method for both LSS-SP and LPB-SP array configurations. A maximum %RE of 4.159 % was recorded for a 5 × 8 LSS-SP array configuration by applying the GA based MML reduction method.

Introduction : Ulcerative colitis (UC) is a chronic inflammatory disease that primarily affects the colon. Tumor necrosis factor-α inhibitors (like adalimumab) are effective agents for UC. However, loss of response may occur. Proactive therapeutic drug monitoring involves measuring drug levels at regular intervals in patients in remission to maintain therapeutic concentrations and potentially prevent loss of response. Aim : This study aims to evaluate adalimumab trough level (TL), the development of anti-drug antibodies (ADAs), and their relationships with clinical and laboratory variables in Iraqi patients with ulcerative colitis receiving adalimumab therapy. Patients and methods : The present study was cross-sectional and conducted from April 2024 to November 2024. It included 44 UC patients allocated into 2 groups: group 1 (patients with TL within or above the therapeutic range) and group 2 (patients with TL below the therapeutic range). Results : Out of 44 patients, 23 patients reached target TL, while 21 patients did not. Based on the TL, developments of ADAs, and clinical state of patients, recommendations were made to escalate the dose for 13 patients, switch therapy for 16 patients, de-escalate the dose for 10 patients, and continue therapy for 5 patients. Additionally, it was found that neutrophil count, erythrocyte sedimentation rate, and C-reactive protein were higher, and hemoglobin and packed cell volume were lower in patients who did not reach the target adalimumab TL ( p <0.05). Conclusions : Therapeutic drug monitoring for adalimumab can be an important tool for optimizing UC treatment and explaining the potential causes of non-responsiveness to this medicine.

In the landscape of transportation electrification, the incorporation of plug-in electric vehicles (PEVs) into distribution systems has emerged as a crucial focal point of research in recent years. With the decline of fossil fuels, the automotive industry is swiftly transitioning from traditional vehicles to electric ones, with PEVs at the forefront of this shift. This transition is accompanied by various strategies aimed at promoting the widespread adoption of electric vehicles across different countries and regions. Forecasts indicate a rapid increase in the number of electric vehicles (EVs) on the roads, excluding two/three wheelers, reaching into the millions in the foreseeable future. However, this surge in EVs brings forth a significant concern: the potential strain on electrical grids. Without proper management, the uncontrolled influx of EVs could result in a sharp rise in load profiles, especially if free charging policies are implemented. Charging behaviors vary widely, from residential setups to public charging stations, each presenting its own set of challenges. While residential charging may seem individually modest, its cumulative impact can overload distribution systems. On the other hand, fast charging at public stations leads to a rapid escalation of power demand, exacerbating the overall load across multiple plug-in points. These trends indicate a substantial increase in electricity demand, potentially reaching thousands of terawatt-hours in the near future. As a result, distribution systems worldwide are facing the imminent threat of congestion due to this exponential growth in EVs. Managing this congestion poses a significant challenge for distribution system operators, who must navigate this landscape while ensuring the integrity of the network. This article undertakes a thorough literature review, exploring various strategies for congestion management in the context of PEV integration. By synthesizing a wealth of research, this review provides researchers with invaluable insights into the key challenges and diverse techniques associated with PEV integration. As transportation electrification continues to reshape our world, this article serves as a comprehensive guide for understanding and addressing the complexities of managing congestion in distribution systems amidst the proliferation of EVs.

This paper describes an effective operating strategy for electric vehicles (EVs) in a hybrid facility that leverages renewable energy sources. The method is to enhance the profit of the wind–thermal–EV hybrid plant while maintaining the grid frequency (fPG) and energy level of the EV battery storage system. In a renewable-associated power network, renewable energy producers must submit power supply proposals to the system operator at least one day before operations begin. The market managers then combine the power plans for the next several days based on bids from both power providers and distributors. However, due to the unpredictable nature of renewable resources, the electrical system cannot exactly adhere to the predefined power supply criteria. When true and estimated renewable power generation diverges, the electrical system may experience an excess or shortage of electricity. If there is a disparity between true and estimated wind power (TWP, EWP), the EV plant operates to minimize this variation. This lowers the costs associated with the discrepancy between actual and projected wind speeds (TWS, EWS). The proposed method effectively reduces the uncertainty associated with wind generation while being economically feasible, which is especially important in a deregulated power market. This study proposes four separate energy levels for an EV battery storage system (EEV,max, EEV,opt, EEV,low, and EEV,min) to increase system profit and revenue, which is unique to this work. The optimum operating of these EV battery energy levels is determined by the present electric grid frequency and the condition of TWP and EWP. The proposed approach is tested on a modified IEEE 30 bus system and compared to an existing strategy to demonstrate its effectiveness and superiority. The entire work was completed using the optimization technique called sequential quadratic programming (SQP).