General Services Administration

We report 850 °C operation of ultrawide bandgap (UWBG) Al-rich Al<sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">0.68</sub>Ga<sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">0.32</sub>N channel high electron mobility transistors (HEMTs) at atmospheric pressure in nitrogen ambient. Temperature dependent DC electrical characteristics were measured in situ up to 850 °C, after exposure to 850 °C for 60 minutes, and at 25 °C after high temperature testing. At 850 °C (time, t = 0 min), all HEMTs tested maintained an on/off ratio greater than 10<sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">4</sup> (maximum of 4.6×10<sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">4</sup>). The threshold voltage demonstrated excellent stability with less than ±10% deviation. After returning to 25 °C, the devices showed negligible degradation. In fact, the off-state gate current decreased and on/off ratio slightly increased. The robustness of these UWBG AlGaN transistors at temperatures up to 850 °C demonstrates their viability for extreme environment applications.

Pressure injuries remain a significant and largely preventable cause of morbidity among hospitalized patients. Accurate and complete risk assessment using validated tools such as the Braden Scale is fundamental to effective prevention; however, documentation practices are often inconsistent, particularly in resource-limited settings. To evaluate the completeness of Braden Scale documentation in the Internal Medicine Department at Dongola Specialized Hospital and to assess the impact of a targeted quality-improvement intervention through a closed-loop clinical audit. A prospective closed-loop clinical audit was conducted over two cycles, each reviewing 51 patient records. Baseline documentation practices (Cycle 1) were assessed against predefined standards derived from international pressure-injury prevention guidelines. Following a structured two-month intervention comprising staff education, reinforcement of documentation expectations, and introduction of a standardized Braden documentation form, a second audit cycle (Cycle 2) was performed using identical criteria. Documentation completeness was analyzed using descriptive statistics, and differences between cycles were assessed using chi-square tests. At baseline, none of the Braden subscale scores, total scores, risk levels, or preventive actions were documented. Following the intervention, documentation of all six Braden subscales improved to near-universal completion (96.4-100%). Documentation of total Braden score, risk level, and preventive actions increased to 89.1%, 83.6%, and 89.1%, respectively (all p < 0.001). Significant improvements were also observed in consultant identification and bed number documentation. Conversely, completion rates for certain demographic fields, particularly hospital number and admission date, declined in Cycle 2. This audit demonstrates that targeted education and standardized documentation tools can lead to substantial and statistically significant improvements in Braden Scale documentation. While clinical risk assessment practices improved markedly, persistent gaps in administrative documentation highlight the need for sustained monitoring and system-level reinforcement. Closed-loop clinical audits represent an effective strategy for strengthening pressure-injury risk assessment practices in hospital settings.

Managing a large portfolio of buildings involves decisions on reuse, retrofit, renovation, rehabilitation, and new construction, influenced by trade-offs between performance metrics such as cost, time, and operational flexibility over the building's life cycle. Traditional life cycle assessment tools for evaluating these metrics can be labor- and compute-intensive, requiring extensive data and modeling for each building. Metamodels (or surrogate models) using machine learning have been explored as faster alternatives, but training these models has been hindered by the limited availability of comprehensive data on key life cycle metrics. Recent advancements in machine learning, particularly deep learning techniques like zero-shot and few-shot learning, allow models to learn from sparse or limited data. We propose a machine learning-based metamodel that leverages these techniques for rapid estimation of key building life cycle metrics. This presentation will cover the model architecture, data collection, training, and validation processes, along with an ongoing case study applied to a large portfolio of buildings. We will discuss the model's performance in terms of accuracy, compute time, limitations, and its potential for expanding to additional life cycle metrics. This data-driven approach offers a promising direction for the rapid evaluation of large building portfolios.

Key populations (KP), including men who have sex with men, people who inject drugs, sex workers, transgender people and people in closed settings, are disproportionately affected by HIV and face structural and legal barriers to care. While community-led responses are central to reaching KP, services are often disease-specific and disconnected from national primary healthcare (PHC) systems. PHC, defined by WHO as a whole-of-society approach to delivering integrated and person-centred services, is rarely designed to meet the broader health needs of KP, who also experience high burdens of non-communicable diseases, mental health conditions and violence. This paper describes three service delivery models, supported by PEPFAR, that integrate HIV and PHC services for KP in Vietnam, Nigeria and Eswatini. The three models are community-led, client-centred, and tailored to KP health and social needs. Each integrates HIV services-including testing, antiretroviral therapy, viral load monitoring, pre-exposure prophylaxis (PrEP) and advanced HIV disease management-alongside broader PHC services such as mental healthcare, sexual and reproductive health, non-communicable disease screening and tuberculosis services. All models include structural and community-based interventions such as gender-based violence support, stigma reduction, peer navigation and economic empowerment. These services are delivered in safe, trusted spaces by multidisciplinary teams including peer and clinical providers. While the models demonstrate alignment with PHC principles (accessibility, cultural competence, continuity and community empowerment), challenges remain related to integration within national health systems, financing and provider training. Recent U.S. global health policy shifts, including reductions in funding for KP-specific programming and limited PrEP access, pose additional threats to programme sustainability and client trust. Integrated models of HIV and PHC for KP can improve access, engagement and health outcomes across a range of services. They represent promising approaches for addressing intersecting health and structural needs, particularly in settings where stigma and criminalization persist. Sustained progress will require inclusion of KP in PHC policies and planning, protection of community-led services and domestic financing strategies that ensure continuity in the face of shifting donor priorities.

No single constraint can explain the stagnant agricultural productivity growth in sub-Saharan Africa. Most interventions that relax individual barriers to productivity have delivered disappointing results. We evaluate an at-scale program that targets several productivity constraints with a bundled intervention, using a randomized controlled trial in western Kenya. Program participation increases maize yields by 26%, total maize output by 24%, and profits by 18%. While we cannot directly test whether the program’s success is due to its bundled nature, we find patterns in the data that are consistent with this hypothesis.

This field study worked in hospitals and health centers to activate infection control standards in health facilities, and the importance of applying them to workers in health facilities even after health centers obtained the accreditation certificate for quality standards in health facilities (CPAHI). The questionnaire was created and sent electronically via social media, where 700 social questionnaires were distributed to people aged (23-58 years), men and women in the city Of Riyadh, and responses from 450 people were obtained via Google Drive.it is concluded the rate Of application Of infection control standards is high.

تعد التمارين التصحيحية من أهم ما يصحح أخطاء الأداء الفني لتطوير السباحين ولما لها من تأثير على البدء (بدء الاركاض) في رياضة السباحة لذلك ارتأى الباحث الى تطوير بدء الاركاض في السباحة عن طريق اكتشاف الأخطاء وتصحيحها للسباحين. وتكمن مشكلة البحث في عدم استخدام التمارين التصحيحية الخاصة والتي لها علاقة في الأداء الفني. ويهدف البحث إلى الكشف عن قيم بعض المتغيرات البايوكينماتيكية في الأداء الفني لبدء الاركاض في السباحة. والكشف عن الأخطاء الفنية ووضع تمارين تصحيحية لهذه الاخطاء والتي تعطى من على منصة البدء مضافا اليها مجموعة من التمارين التعزيزية من اجل رفع مستوى السباحين في البدء. واستخدم الباحث المنهج التجريبي لملاءمته لطبيعة مشكلة البحث مستخدماً التصميم التجريبي المسمى بتصميم المجموعة الواحدة ذات الاختبارين القبلي والبعدي. وتكونت عينة البحث من (5) سباحين من منتخب محافظة نينوى في السباحة. واستخدم الباحث القياس، والملاحظة العلمية التقنية، والتحليل الكينيماتيكي، وسائل لجمع البيانات للحصول على متغيرات البحث. واعتمد الباحث على الحقيبة الإحصائية (SPSS) لاستخراج الوسائل الاحصائية (الوسط الحسابي، والانحراف المعياري، واختبار (T) للعينات المرتبطة). واستنتج الباحث ان تمارين التصحيحية المستخدمة اثرت تأثيراً إيجابيا في متغيرات المسافة المتجهة بين القدمين لوضع الاستعداد والمسافة الافقية والمسافة العمودية والمسافة المحصلة من اعلى ارتفاع يصله السباح في الهواء الى نقطة دخول الماء في متغيرات الحركة كاملة لعينة البحث.

This paper presents an in-depth contextualized tutorial on Agricultural IoT (Agri-IoT), covering the fundamental concepts, assessment of routing architectures and protocols, and performance optimization techniques via systematic survey and synthesis of related literature. The negative impacts of climate change and the increasing global population on food security and unemployment threats have motivated the adoption of the wireless sensor network (WSN)-based Agri-IoT as an indispensable underlying technology in precision agriculture and greenhouses to improve food production capacities and quality. However, most related Agri-IoT testbed solutions have failed to achieve their performance expectations due to the lack of an in-depth and contextualized reference tutorial that provides a holistic overview of communication technologies, routing architectures, and performance optimization modalities based on users’ expectations. Thus, although IoT applications are founded on a common idea, each use case (e.g., Agri-IoT) varies based on specific performance and users expectations as well as its technological, architectural, and deployment requirements. Likewise, the agricultural setting is a unique and hostile area where conventional IoT technologies do not apply, hence the need for this tutorial. Consequently, this tutorial addresses these via the following contributions: (1) a systematic overview of the fundamental concepts, technologies, and architectural standards of WSN-based Agri-IoT, (2) an evaluation of the technical design requirements of a robust, location-independent, and affordable Agri-IoT, (3) a comprehensive survey of the benchmarking fault tolerance techniques, communication standards, routing and medium access control (MAC) protocols, and WSN-based Agri-IoT testbed solutions, and (4) an in-depth case study on how to design a self-healing, energy-efficient, affordable, adaptive, stable, autonomous, and cluster-based WSN-specific Agri-IoT from a proposed taxonomy of multi-objective optimization (MOO) metrics that can guarantee an optimized network performance. Furthermore, this tutorial established new taxonomies of faults, architectural layers, and MOO metrics for cluster-based Agri-IoT (CA-IoT) networks and a 3-tier objective framework with remedial measures for designing an efficient associated supervisory protocol for cluster-based Agri-IoT networks.

Policy makers have sought to discourage concurrent prescribing of opioids and benzodiazepines (coprescribing) because it is associated with overdose. Email alerts sent by pharmacists may reduce coprescribing, but this intervention lacks randomized evidence. To investigate whether pharmacist emails to practitioners caring for patients who recently received opioids and benzodiazepines reduce coprescribing of these medications. Randomized clinical trial (intention to treat) conducted in 2019-2021 of patients and their practitioners (prescribers and primary care managers) in the National Capital Region of the Military Health System. Participants were 2237 patients who were recently coprescribed opioids and benzodiazepines. These patients had 789 practitioners eligible for emails. Patients were randomized to email alerts to their practitioners or as-usual care. Clinical pharmacists sent the email alert. Messages were standardized and designed to facilitate coordination between practitioners, increase awareness of guidelines, and provide action steps and resources. The primary outcomes were patients' days received of opioids, benzodiazepines, and concurrent opioids and benzodiazepines during the 90 days following enrollment evaluated using 1-sided hypothesis tests. Secondary outcomes included total prescribing of opioids and benzodiazepines by patients' practitioners, including to patients outside the study, to test for broader outcomes on their prescribing. Of 2237 patients, 1187 were assigned to treatment and 1050 to control; 1275 (57%) were women. Patients received a mean (SD) of 31 (44) days of opioids and 33 (34) days of benzodiazepines in the 90 days before enrollment. There were no detected differences in the primary end points, including patients' receipt of opioids (adjusted difference, 1.1 days; 95% CI, -∞ to 3.0; P = .81), benzodiazepines (adjusted difference, -0.6 days; 95% CI, -∞ to 1.4; P = .30), and opioids and benzodiazepines together (adjusted difference, -0.1 days; 95% CI, -∞ to 0.7; P = .41). Of 789 practitioners, 429 were considered the treatment group, 325 were considered controls, and 35 were excluded. There were no detected differences in practitioners' total prescribing of opioids, benzodiazepines, or both drug classes together. In this randomized clinical trial of pharmacist emails to practitioners, email alerts failed to detectably reduce coprescribing, highlighting the value of alternative approaches. Combining randomization with quality improvement activities may help stakeholders seeking evidence-based interventions to encourage guideline-concordant care. ClinicalTrials.gov Identifier: NCT03887247.