Search Results (9,546)

Objective: This study aimed to develop a performance evaluation index system for a district-level public hospital in Chongqing, China, based on Diagnosis-Related Groups (DRGs), to provide a benchmark for performance assessment in similar hospitals. The system was constructed using a literature analysis, the Delphi method, and the Analytic Hierarchy Process (AHP) to identify and weight relevant indicators. Results: The evaluation system consists of three primary indicators and eighteen secondary indicators. Key secondary indicators include the Case Mix Index (CMI), cost consumption index, low-risk group mortality rate, the proportion of patients with three- or four-level surgeries at discharge, and the proportion of medical service revenue to medical income. In 2020, significant improvements were observed in several indicators, such as a decrease in the low-risk group mortality rate to 0% and increases in the proportion of patients with three- or four-level surgeries and CMI by nearly 10% and 13%, respectively. Conclusions: This study successfully developed a comprehensive and scientifically sound performance evaluation index system for a district-level public hospital in Chongqing. The system has proven effective in objectively assessing inpatient medical care performance and providing valuable guidance for improving healthcare services in similar settings. Full article

Food security is crucial for social stability and economic development. Ensuring food security in the arid region of Northwest China presents unique challenges due to limited water and soil resources. This study addresses these challenges by integrating a comprehensive water and soil resource matching assessment with grain production forecasting. Based on data from 2000 to 2020, this research projects the food security status to 2035 using the GM(1,1) model, incorporating a comprehensive index of soil and water resource matching and regression analysis to inform production forecasts. Key assumptions include continued historical trends in population growth, urbanization, and dietary shifts towards an increased animal protein consumption. The findings revealed a consistent upward trend in grain production from 2000 to 2020, with an average annual growth rate of 3.5%. Corn and wheat emerged as the dominant grain crops. Certain provinces demonstrated comparative advantages for specific crops like rice and wheat. The most significant finding is that despite the projected growth in the total grain output by 2035 compared to 2020, the regional grain self-sufficiency rate is projected to range from 79.6% to 84.1%, falling below critical food security benchmarks set by the FAO and China. This projected shortfall carries significant implications, underscoring a serious challenge to regional food security and highlighting the region’s increasing vulnerability to external food supply fluctuations. The findings strongly signal that current trends are insufficient and necessitate urgent and proactive policy interventions. To address this, practical policy recommendations include promoting water-saving technologies, enhancing regional cooperation, and strategically utilizing the international grain trade to ensure regional food security. Full article

Background: Low-glycemic index (GI) carbohydrates like isomaltulose (ISO) are known to enhance incretin release and to improve postprandial glucose control at the following meal (an effect known as second meal effect, or SME), which is particularly beneficial for individuals with metabolic syndrome (MetS). This study aimed to assess the most effective preprandial interval of ISO- or saccharose (SUC) snacks (1 h vs. 3 h preload) to enhance prandial incretin responses to a subsequent meal. Methods: In a randomized crossover design, 15 participants with MetS completed four experimental conditions on four non-consecutive days, combining two preload types (ISO or SUC) and two preload timings (Intervention A: 3 h preload; Intervention B: 1 h preload). Specifically, the four conditions were (1) ISO + Intervention A, (2) SUC + Intervention A, (3) ISO + Intervention B, and (4) SUC + Intervention B. The order of conditions was randomized and separated by a 3–7-day washout period to minimize carryover effects. On each study day, participants consumed two mixed meal tests (MMT-1 and MMT-2) with a standardized preload (50 g ISO or SUC) administered either 3 h or 1 h prior to MMT-2. Blood samples were collected over 9 h at 15 predefined time points for analysis of glucose, insulin, C-peptide, and incretin hormones (GLP-1, GIP, and PYY). Results: The unique digestion profile of ISO resulted in a blunted glucose ascent rate (ΔG/Δt: 0.28 vs. 0.53 mmol/L/min for SUC, p < 0.01), paralleled by synonyms PYY elevation over 540 min monitoring, compared with SUC. ISO also led to higher and more sustained GLP-1 and PYY levels, while SUC induced a stronger GIP response. Notably, the timing of ISO consumption significantly influenced PYY secretion, with the 3 h preload showing enhanced PYY responses and a more favorable SME compared to the 1 h preload. Conclusions: ISO, particularly when consumed 3 h before a meal (vs. 1 h), offers significant advantages over SUC by elevating PYY levels, blunting the glucose ascent rate, and sustaining GLP-1 release. This synergy enhances the second meal effect, suggesting ISO’s potential for managing postprandial glycemic excursions in MetS. Full article

In the context of achieving low-carbon goals, building low-carbon energy systems is a crucial development direction and implementation pathway. Renewable energy is favored because of its clean characteristics, but the access may have an impact on the power grid. Microgrid technology provides an effective solution to this problem. Uncertainty exists in single microgrids, so multiple microgrids are introduced to improve system stability and robustness. Electric carbon trading and profit redistribution among multiple microgrids have been challenges. To promote energy commensurability among microgrids, expand the types of energy interactions, and improve the utilization rate of renewable energy, this paper proposes a cooperative operation optimization model of multi-microgrids based on the green certificate and carbon trading mechanism to promote local energy consumption and a low carbon economy. First, this paper introduces a carbon capture system (CCS) and power-to-gas (P2G) device in the microgrid and constructs a cogeneration operation model coupled with a power-to-gas carbon capture system. On this basis, a low-carbon operation model for multi-energy microgrids is proposed by combining the local carbon trading market, the stepped carbon trading mechanism, and the green certificate trading mechanism. Secondly, this paper establishes a cooperative game model for multiple microgrid electricity carbon trading based on the Nash negotiation theory after constructing the single microgrid model. Finally, the ADMM method and the asymmetric energy mapping contribution function are used for the solution. The case study uses a typical 24 h period as an example for the calculation. Case study analysis shows that, compared with the independent operation mode of microgrids, the total benefits of the entire system increased by 38,296.1 yuan and carbon emissions were reduced by 30,535 kg through the coordinated operation of electricity–carbon coupling. The arithmetic example verifies that the method proposed in this paper can effectively improve the economic benefits of each microgrid and reduce carbon emissions. Full article

The tolerance of the fall armyworm (Spodoptera frugiperda) to plant-derived secondary compounds gradually increases with instars. Therefore, even if plant-based additives are applied at early stages, such as the second or third instar, they may have a differential impact on the ecofriendly control of S. frugiperda. In this study, S. frugiperda larvae were exposed to vanillic acid or sinapic acid at the second and third instar, and physiological and growth parameters were measured. The results showed that the effects of vanillic acid treatment on S. frugiperda were similar at the different instars. They can significantly affect the larval carboxylesterase, glutathione S-transferase, and mixed-function oxidase activities. By reducing larval food intake, food conversion, and utilization efficiency while increasing the food consumption rate, it inhibits weight accumulation. This leads to a significant extension of the development of both the larval and pupal stages, and the adult longevity was reduced. Treatment with sinapic acid at the second instar extended the negative effects on the pupal duration of S. frugiperda when compared to treatment at the third instar, but did not affect adult longevity. Therefore, vanillic acid treatment at the second or third instar stage, can play an important role in the ecofriendly control process of S. frugiperda. The results of this study are of great significance for integrated pest management. Full article

An Analog-to-Digital Converter (ADC) is an indispensable part of image sensor systems. This paper presents a silicon-based 13-bit 100 kS/s two-step single-slope analog-to-digital converter (TS-SS ADC) for infrared image sensors with a frame rate of 100 Hz. For the charge leakage and offset voltage issues inherent in conventional TS-SS ADC, a four-terminal comparator was employed to resolve the fine ramp voltage offset caused by charge redistribution in storage and parasitic capacitors. In addition, a current-steering digital-to-analog converter (DAC) was adopted to calibrate the voltage reference of the dynamic comparator and mitigate differential nonlinearity (DNL)/integral nonlinearity (INL). To eliminate quantization dead zones, a 1-bit redundancy was incorporated into the fine quantization circuit. Finally, the quantization scheme consisted of 7-bit coarse quantization followed by 7-bit fine quantization. The ADC was implemented using an SMIC 55 nm processSemiconductor Manufacturing International Corporation, Shanghai, China. The post-simulation results show that when the power supply is 3.3 V, the ADC achieves a quantization range of 1.3 V–3 V. Operating at a 100 kS/s sampling rate, the proposed ADC exhibits an effective number of bits (ENOBs) of 11.86, a spurious-free dynamic range (SFDR) of 97.45 dB, and a signal-to-noise-and-distortion ratio (SNDR) of 73.13 dB. The power consumption of the ADC was 22.18 mW. Full article

Direct electrification and hydrogen utilization represent two key pathways for decarbonizing the glass industry, with their effectiveness subject to adequate furnace design and renewable energy availability. This study presents a techno-economic assessment for optimal solar energy integration in a representative 300 t/d oxyfuel container glass furnace with a specific energy consumption of 4.35 GJ/t. A mixed-integer linear programming formulation is developed to evaluate specific melting costs, carbon emissions, and renewable energy self-consumption and self-production rates across three scenarios: direct solar coupling, battery storage, and a hydrogen-based infrastructure. Battery storage achieves the greatest reductions in specific melting costs and emissions, whereas hydrogen integration minimizes electricity export to the grid. By incorporating capital investment considerations, the study quantifies the cost premiums and capacity requirements under varying decarbonization targets. A combination of 30 MW of solar plant and 9 MW of electric boosting enables the realization of around 30% carbon reduction while increasing total costs by 25%. Deeper decarbonization targets require more advanced systems, with batteries emerging as a cost-effective solution. These findings offer critical insights into the economic and environmental trade-offs, as well as the technical constraints associated with renewable energy adoption in the glass industry, providing a foundation for strategic energy and decarbonization planning. Full article

Indoor horticulture requires a substantial quantity of electricity to meet crops extended photoperiodic requirements for optimal photosynthetic rate. Simultaneously, global electricity costs have grown dramatically in recent years, endangering the sustainability and profitability of indoor vertical farms and/or modern greenhouses that use artificial lighting systems to accelerate crop development and growth. This study investigates the growth rate and physiological development of cherry tomato plants cultivated in a pilot indoor vertical farm at the Agricultural University of Athens’ Laboratory of Farm Structures (AUA) under continuous and disruptive lighting. The leaf physiological traits from multiple photoperiodic stress treatments were analyzed and utilized to estimate the plant’s tolerance rate under varied illumination conditions. Four different photoperiodic treatments were examined and compared, firstly plants grew under 14 h of continuous light (C-14L10D/control), secondly plants grew under a normalized photoperiod of 14 h with intermittent light intervals of 10 min of light followed by 50 min of dark (NI-14L10D/stress), the third treatment where plants grew under 14 h of a load-shifted energy demand response intermittent lighting schedule (LSI-14L10D/stress) and finally plants grew under 13 h photoperiod following of a load-shifted energy demand response intermittent lighting schedule (LSI-13L11D/stress). Plants were subjected also under two different light spectra for all the treatments, specifically WHITE and Blue/Red/Far-red light composition. The aim was to develop flexible, energy-efficient lighting protocols that maintain crop productivity while reducing electricity consumption in indoor settings. Results indicated that short periods of disruptive light did not negatively impact physiological responses, and plants exhibited tolerance to abiotic stress induced by intermittent lighting. Post-harvest data indicated that intermittent lighting regimes maintained or enhanced growth compared to continuous lighting, with spectral composition further influencing productivity. Plants under LSI-14L10D and B/R/FR spectra produced up to 93 g fresh fruit per plant and 30.4 g dry mass, while consuming up to 16 kWh less energy than continuous lighting—highlighting the potential of flexible lighting strategies for improved energy-use efficiency. Full article

The endoscopic capsule is a miniaturized device used for medical diagnosis, which is less invasive compared to traditional gastrointestinal endoscopy and can reduce patient discomfort. However, it faces challenges in communication transmission, such as high power consumption, serious signal interference, and low data transmission rate. To address these issues, this paper proposes an optimized modulation scheme that is low-cost, low-power, and robust in harsh environments, aiming to improve its transmission rate. The scheme is analyzed in terms of the in-body channel. The analysis and discussion for the scheme in wireless body area networks (WBANs) are divided into three aspects: bit error rate (BER) performance, energy efficiency (EE), and spectrum efficiency (SE), and complexity. These correspond to the following issues: transmission rate, communication quality, and low power consumption. The results demonstrate that the optimized scheme is more suitable for improving the communication performance of endoscopic capsules. Full article

Triphenyl phosphate (TPhP) is a widely used organophosphate flame retardant and plasticizer, raising concerns over its health impacts. This study examined the effects of embryonic TPhP exposure on axial skeletal development and metabolism in medaka (Oryzias latipes), a vertebrate fish model relevant to human bone biology. Medaka embryos were exposed to 1 µM TPhP and assessed through early larval stages. TPhP impaired vertebral ossification, causing shortened centra and reduced cartilage in the caudal complex, alongside disrupted distribution of osteoblast-lineage cells. Key osteogenic genes were significantly downregulated at 14 days post fertilization, and transcriptomic analysis revealed altered mitochondrial pathways linked to skeletal disorders. Functionally, TPhP-exposed larvae showed reduced caudal fin regeneration and decreased metabolic rate and oxygen consumption, consistent with mitochondrial dysfunction. These findings indicate that TPhP disrupts bone development and metabolism by affecting osteoblast differentiation and mitochondrial regulation, highlighting the value of small fish models for studying environmental toxicants and bone metabolic disease risk. Full article

Background/Objectives: Understanding the impact of dietary habits in terms of obesity, health outcomes, and functional decline is critical in Europe’s growing elderly population. This study analyzed trends in Mediterranean diet (MD) adherence, obesity prevalence, and grip strength among middle-aged and elderly Europeans using data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Methods: Data from four SHARE waves (2015–2022) across 28 countries were analyzed. Dietary patterns were assessed through food frequency questionnaires classifying participants as MD-adherent or non-adherent where adherent implies daily consumption of fruits and vegetables and occasional (3–6 times/week) intake of eggs, beans, legumes, meat, fish, or poultry (an unvalidated definition of the MD pattern). Handgrip strength, a biomarker of functional capacity, was categorized into low, medium, and high groups. Body mass index (BMI), self-perceived health (SPHUS), chronic disease prevalence, and CASP-12 scores (control, autonomy, self-realization, and pleasure evaluated on the 12-item version) were also evaluated. Statistical analyses included descriptive methods, logistic regressions, and multiple imputations to address missing data. Results: A significant majority (74–77%) consumed fruits and vegetables daily, which is consistent with MD principles; however, the high daily intake of dairy products (>50%) indicates limited adherence to the MD, which advocates for moderate consumption of dairy products. Logistic regression indicated that individuals with two or more chronic diseases were more likely to follow the MD (odds ratio [OR] = 1.21, confidence interval [CI] = 1.11–1.32), as were those individuals who rated their SPHUS as very good/excellent ([OR] = 1.42, [CI] = 1.20–1.69). Medium and high maximal handgrip were also strongly and consistently associated with higher odds of MD adherence (Medium: [OR] = 1.44, [CI] = 1.18–1.74; High: [OR] = 1.27, [CI] = 1.10–1.48). Conclusions: The findings suggest that middle-aged and older adults are more likely to adhere to the MD dietary pattern if they have more than two chronic diseases, are physically active, and have a medium or high handgrip. Although an unvalidated definition of the MD dietary pattern was used, the results highlight the importance of implementing targeted dietary strategies for middle-aged and elderly adults. Full article

Food loss and waste from the European Union’s dairy supply chain, particularly in the management of fresh milk, imposes significant environmental burdens. This study demonstrates that implementing Radio Frequency Identification (RFID)-enabled digital decision-support tools can substantially reduce these impacts across the region. A cradle-to-grave life cycle assessment (LCA) was used to quantify both the additional environmental burdens from RFID (tag production, usage, and disposal) and the avoided burdens due to reduced milk losses in the farm, processing, and distribution stages. Within the EU’s fresh milk supply chain, the implementation of digital tools could result in annual net reductions of up to 80,000 tonnes of CO₂-equivalent greenhouse gas emissions, 81,083 tonnes of PM_2.5-equivalent particulate matter, 84,326 tonnes of land use–related carbon deficit, and 80,000 cubic meters of freshwater-equivalent consumption. Spatial analysis indicates that regions with historically high spoilage rates, particularly in Southern and Eastern Europe, see the greatest benefits from RFID enabled digital-decision support tools. These environmental savings are most pronounced during the peak months of milk production. Overall, the study demonstrates that despite the environmental footprint of RFID systems, their integration into the EU’S dairy supply chain enhances transparency, reduces waste, and improves resource efficiency—supporting their strategic value. Full article

(1) Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by liver damage similar to alcoholic fatty liver disease, including triglyceride infiltration of hepatocytes, regardless of alcohol consumption. It leads to progressive liver damage, such as loss of liver function, cirrhosis, and liver cancer, and the response rate of drugs under clinical research is less than 50%. There is an urgent need for biomarkers to evaluate the efficacy of these drugs. (2) Methods: MASLD was induced in mice using a High-Fat diet (HF), Western diet (WD), and Methionine/Choline-Deficient diet (MCD) for 20 weeks (4 weeks for MCD). Liver tissue biopsies were performed, and the treatment effects of saponin and non-saponin feeds were evaluated. Fat accumulation and hepatic inflammation were measured, and mRNA sequencing analysis was conducted. The therapeutic effects were validated using patient-derived liver organoids. (3) Results: The NAFLD Activity Score (NAS) significantly increased in all MASLD models compared with controls. Saponin treatment decreased NAS in the HF and WD groups but not in the MCD group. RNA sequencing and PCA analysis showed that the HF saponin response samples were similar to normal controls. DAVID analysis revealed significant changes in lipid, triglyceride, and fatty acid metabolic processes. qRT-PCR confirmed decreased fibrosis markers in the HF saponin response group, and GSEA analysis showed reduced HAMP1 gene expression. (4) Conclusions: Among the diets, red ginseng was most effective in the HF diet, with significant effects in the saponin-treated group. The therapeutic efficacy was better when HAMP1 expression was increased. Therefore, we propose HAMP1 as a potential exploratory biomarker to assess the saponin response in a preclinical setting. In addition, the reduction of inflammation and hepatic iron accumulation suggests that saponins may exert antioxidant effects through modulation of oxidative stress. Full article

Groundwater is one of the main water sources for consumption, domestic use, agriculture, and tourism in coastal communities. However, high total dissolved solids (TDS) levels in the water (700–2000 mg L⁻¹ TDS) and electrical conductivity (3000–5000 µS cm⁻¹) threaten the health and economic growth opportunities for residents. This research aims to evaluate the performance of a laboratory-scale electrodialysis system as a technology for desalinating brackish water. For this purpose, water samples were collected from real groundwater sources. Batch experiments were conducted with varying operational parameters, such as voltage (2–10 V), feed volume (100–1600 mL), recovery rate (50–80%), and cros-flow velocity (1.3–5.1 cm s⁻¹) to determine the electrodialysis system setup that meets the requirements for drinking water in terms of TDS and energy efficiency. A total specific energy consumption of 1.65 kWh m⁻³, including pumping energy, was achieved at a laboratory scale. The conditions were as follows: flow velocity of 5.14 cm s⁻¹, applied voltage of 6 V, feed volume of 1.6 L, and a water recovery of 66%. Furthermore, increasing the flow velocity and the applied voltage enhanced the desalination kinetics and salt removal. Additionally, the system presented opportunities for scalability. This research aims to evaluate a sustainable membrane-based treatment technology for meeting the growing demand for water resources in coastal communities, particularly in developing countries in South America. Full article

The use of microwaves (MWs) has been proposed as an energy-efficient method for reducing checking. Along with understanding moisture distribution, it is essential to consider structural characteristics to explain how MWs reduce checking. The influence of MWs on these characteristics depends on the food matrix’s dielectric and viscoelastic properties, which vary significantly between fresh and pre-baked dough. This study investigates the effects of MW treatment applied before (MW-O) or after conventional oven baking (O-MW) on low-fat biscuits that are prone to checking. Color (CIELab), thickness, moisture content and distribution, checking rate, texture, sensory properties, energy consumption and baking time were analyzed. The findings suggest that MWs reduce checking rate by eliminating internal moisture differences, while also changing structural properties, as evidenced by increased thickness and hardness. MW-O eliminated checking (control samples showed 100%) but negatively affected color, texture (increased hardness and breaking work), and sensory quality. The O-MW checking rate (3.41%) was slightly higher than in MW-O, probably due to the resulting different structural properties (less thickness, less hardness and breaking work). O-MW biscuits were the most preferred by consumers (54.76% ranked them first), with color and texture close to the control samples. MW-O reduced total energy consumption by 16.39% and baking time by 25.00%. For producers, these improvements could compensate for the lower biscuit quality. O-MW did not affect energy consumption but reduced baking time by 14.38%. The productivity improvement, along with the reduction in checking and the satisfactory sensory quality, indicates that O-MW could be beneficial for the bakery sector. Full article