Solar energy utilization techniques, policies, potentials, progresses, challenges and recommendations in asean countries

Sustainable development goals not only contributes towards a clean environment but also towards better climatic conditions. Within Asia next to China and India, the Association of Southeast Asian Nations (ASEAN) are the actively developing countries in terms of economy and technologies. On the verge of achieving development, the ASEAN countries highly depend on fossil fuels for their energy needs. The ASEAN countries have taken visionary steps towards increasing the renewable energy mix with the conventional grid without hampering the ongoing development; this study presents the solar energy utilization policies, potential, progresses, and challenges adopted in ASEAN countries; furthermore, in these nations there is a huge potential of solar energy being located near the equator, therefore, they should focus on both solar to electrical and solar to thermal energy applications; however, in order to meet the peak demand and ensure the reliability of renewable energy like solar power, the development of advanced energy storage systems could be the key areas, and concrete efforts are required. Therefore, this article is a spotlight on government policies and goals focusing on energy potential, major progress in terms of energy storage and challenges in implementation of renewable energy systems in ASEAN countries; furthermore the recommended highlights on policies to accelerate the exploitation of renewable energy usage among the people are also discussed in detail, besides, the insights on reduction of carbon footprints over the next decade through incorporation of advanced energy storage systems. The issues discussed in this article will be helpful for exploring the desired energy storage systems and energy policies to be followed, which will eventually attract the stakeholders for small and medium-scale entrepreneurs for the development of renewable energy business in the region, if implemented on the ground

Post buckling mechanics and strength of cold-formed steel columns exhibiting Local-Distortional interaction mode failure

This paper reports the numerical investigation conducted to study the influence of Local-Distortional (L-D) interaction mode buckling on post buckling strength erosion in fixed ended lipped channel cold formed steel columns. This investigation comprises of 81 column sections with various geometries and yield stresses that are carefully chosen to cover wide range of strength related parametric ratios like (i) distortional to local critical buckling stress ratio (0.91≤FCRD/FCRL≤4.05) (ii) non dimensional local slenderness ratio (0.88≤λL≤3.54) (iii) non-dimensional distortional slenderness ratio (0.68≤λD≤3.23) and (iv) yield to non-critical buckling stress ratio (0.45 to 10.4). The numerical investigation is carried out by conducting linear and non-linear shell finite element analysis (SFEA) using ABAQUS software. The non-linear SFEA includes both geometry and material non-linearity. The numerical results obtained are deeply analysed to understand the post buckling mechanics, failure modes and ultimate strength that are influenced by L-D interaction with respect to strength related parametric ratios. The ultimate strength data obtained from numerical analysis are compared with (i) the experimental tests data concerning L-D interaction mode buckling reported by other researchers (ii) column strength predicted by Direct Strength Method (DSM) column strength curves for local and distortional buckling specified in AISI S-100 (iii) strength predicted by available DSM based approaches that includes L-D interaction mode failure. The role of flange width to web depth ratio on post buckling strength erosion is reported. Then the paper concludes with merits and limitations of codified DSM and available DSM based approaches on accurate failure strength prediction

Attitudes towards psychiatry amongst medical and nursing students in Singapore

10.1186/s12909-019-1518-xBMC Medical Education1919

Physicians' guideline adherence is associated with long-term heart failure mortality in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry

Background: Physicians' adherence to guideline-recommended therapy is associated with short-term clinical outcomes in heart failure (HF) with reduced ejection fraction (HFrEF). However, its impact on longer-term outcomes is poorly documented. Here, we present results from the 18-month follow-up of the QUALIFY registry. Methods and results: Data at 18 months were available for 6118 ambulatory HFrEF patients from this international prospective observational survey. Adherence was measured as a continuous variable, ranging from 0 to 1, and was assessed for five classes of recommended HF medications and dosages. Most deaths were cardiovascular (CV) (228/394) and HF-related (191/394) and the same was true for unplanned hospitalizations (1175 CV and 861 HF-related hospitalizations, out of a total of 1541). According to univariable analysis, CV and HF deaths were significantly associated with physician adherence to guidelines. In multivariable analysis, HF death was associated with adherence level [subdistribution hazard ratio (SHR) 0.93, 95% confidence interval (CI) 0.87–0.99 per 0.1 unit adherence level increase; P = 0.034] as was composite of HF hospitalization or CV death (SHR 0.97, 95% CI 0.94–0.99 per 0.1 unit adherence level increase; P = 0.043), whereas unplanned all-cause, CV or HF hospitalizations were not (all-cause: SHR 0.99, 95% CI 0.9–1.02; CV: SHR 0.98, 95% CI 0.96–1.01; and HF: SHR 0.99, 95% CI 0.96–1.02 per 0.1 unit change in adherence score; P = 0.52, P = 0.2, and P = 0.4, respectively). Conclusion: These results suggest that physicians' adherence to guideline-recommended HF therapies is associated with improved outcomes in HFrEF. Practical strategies should be established to improve physicians' adherence to guidelines. © 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiolog

Mortality from esophagectomy for esophageal cancer across low, middle, and high-income countries: An international cohort study.

BACKGROUND No evidence currently exists characterising global outcomes following major cancer surgery, including esophageal cancer. Therefore, this study aimed to characterise impact of high income countries (HIC) versus low and middle income countries (LMIC) on the outcomes following esophagectomy for esophageal cancer. METHOD This international multi-center prospective study across 137 hospitals in 41 countries included patients who underwent an esophagectomy for esophageal cancer, with 90-day follow-up. The main explanatory variable was country income, defined according to the World Bank Data classification. The primary outcome was 90-day postoperative mortality, and secondary outcomes were composite leaks (anastomotic leak or conduit necrosis) and major complications (Clavien-Dindo Grade III - V). Multivariable generalized estimating equation models were used to produce adjusted odds ratios (ORs) and 95% confidence intervals (CI). RESULTS Between April 2018 to December 2018, 2247 patients were included. Patients from HIC were more significantly older, with higher ASA grade, and more advanced tumors. Patients from LMIC had almost three-fold increase in 90-day mortality, compared to HIC (9.4% vs 3.7%, p < 0.001). On adjusted analysis, LMIC were independently associated with higher 90-day mortality (OR: 2.31, CI: 1.17-4.55, p = 0.015). However, LMIC were not independently associated with higher rates of anastomotic leaks (OR: 1.06, CI: 0.57-1.99, p = 0.9) or major complications (OR: 0.85, CI: 0.54-1.32, p = 0.5), compared to HIC. CONCLUSION Resections in LMIC were independently associated with higher 90-day postoperative mortality, likely reflecting a failure to rescue of these patients following esophagectomy, despite similar composite anastomotic leaks and major complication rates to HIC. These findings warrant further research, to identify potential issues and solutions to improve global outcomes following esophagectomy for cancer