Search results for: mobile standards

Authors: Umamaheswari Shanmugam, Silvia Ronchi, Radu Vornicu

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that are able to use the large amount and variety of data generated during healthcare services every day. As we read the news, over 500 machine learning or other artificial intelligence medical devices have now received FDA clearance or approval, the first ones even preceding the year 2000. One of the big advantages of these new technologies is the ability to get experience and knowledge from real-world use and to continuously improve their performance. Healthcare systems and institutions can have a great benefit because the use of advanced technologies improves the same time efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and also to protect patients’ safety. The evolution and the continuous improvement of software used in healthcare must take into consideration the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device approval, but they are necessary to ensure performance, quality, and safety, and at the same time, they can be a business opportunity if the manufacturer is able to define in advance the appropriate regulatory strategy. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems.

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Authors: Kayne Uriel K. Rodrigo, Jerriane Hillary Heart S. Marcial, Samuel C. Brillo

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Rice leaf diseases significantly impact yield production in rice-dependent countries, affecting their agricultural sectors. As part of precision agriculture, early and accurate detection of these diseases is crucial for effective mitigation practices and minimizing crop losses. Hence, this study proposes an enhancement to the Convolutional Neural Network (CNN), a widely-used method for Rice Leaf Disease Image Classification, by incorporating MobileViTV2—a recently advanced architecture that combines CNN and Vision Transformer models while maintaining fewer parameters, making it suitable for broader deployment on edge devices. Our methodology utilizes a publicly available rice disease image dataset from Kaggle, which was validated by a university structural biologist following the guidelines provided by the Philippine Rice Institute (PhilRice). Modifications to the dataset include renaming certain disease categories and augmenting the rice leaf image data through rotation, scaling, and flipping. The enhanced dataset was then used to train the MobileViTV2 model using the Timm library. The results of our approach are as follows: the model achieved notable performance, with 98% accuracy in both training and validation, 6% training and validation loss, and a Receiver Operating Characteristic (ROC) curve ranging from 95% to 100% for each label. Additionally, the F1 score was 97%. These metrics demonstrate a significant improvement compared to a conventional CNN-based approach, which, in a previous 2022 study, achieved only 78% accuracy after using 5 convolutional layers and 2 dense layers. Thus, it can be concluded that MobileViTV2, with its fewer parameters, outperforms traditional CNN models, particularly when applied to Rice Leaf Disease Image Identification. For future work, we recommend extending this model to include datasets validated by international rice experts and broadening the scope to accommodate biotic factors such as rice pest classification, as well as abiotic stressors such as climate, soil quality, and geographic information, which could improve the accuracy of disease prediction.

Keywords: convolutional neural network, MobileViTV2, rice leaf disease, precision agriculture, image classification, vision transformer

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Authors: Jemima C. A. Sumboh

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Given the urgency and consensus for countries to move towards Universal Health Coverage (UHC), health financing systems need to be accurately and consistently monitored to provide valuable data to inform policy and practice. Most of the indicators for monitoring UHC, particularly catastrophe and impoverishment, are established based on the impact of out-of-pocket health payments (OOPHP) on households’ living standards, collected through varied household surveys. These surveys, however, vary substantially in survey methods such as the length of the recall period or the number of items included in the survey questionnaire or the farming of questions, potentially influencing the level of OOPHP. Using different survey instruments can provide inaccurate, inconsistent, erroneous and misleading estimates of UHC, subsequently influencing wrong policy decisions. Using data from a household budget survey conducted by the Navrongo Health Research Center in Ghana from May 2017 to December 2018, this study intends to explore the potential implications of using surveys with varied levels of disaggregation of OOPHP data on estimates of financial risk protection. The household budget survey, structured around food and non-food expenditure, compared three OOPHP measuring instruments: Version I (existing questions used to measure OOPHP in household budget surveys), Version II (new questions developed through benchmarking the existing Classification of the Individual Consumption by Purpose (COICOP) OOPHP questions in household surveys) and Version III (existing questions used to measure OOPHP in health surveys integrated into household budget surveys- for this, the demographic and health surveillance (DHS) health survey was used). Version I, II and III contained 11, 44, and 56 health items, respectively. However, the choice of recall periods was held constant across versions. The sample size for Version I, II and III were 930, 1032 and 1068 households, respectively. Financial risk protection will be measured based on the catastrophic and impoverishment methodologies using STATA 15 and Adept Software for each version. It is expected that findings from this study will present valuable contributions to the repository of knowledge on standardizing survey instruments to obtain estimates of financial risk protection that are valid and consistent.

Keywords: Ghana, household budget surveys, measuring financial risk protection, out-of-pocket health payments, survey instruments, universal health coverage

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Authors: Muteeb Ulhaq, Rizwan Latif, Sayed Adnan Qasim, Imran Shafi

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Diesel engines are most efficient and reliable in terms of efficiency, reliability and adaptability. Most of the research and development up till now have been directed towards High-Speed Diesel Engine, for Commercial use. In these engines objective is to optimize maximum acceleration by reducing exhaust emission to meet international standards. In high torque low-speed engines the requirement is altogether different. These types of Engines are mostly used in Maritime Industry, Agriculture industry, Static Engines Compressors Engines etc. Unfortunately due to lack of research and development, these engines have low efficiency and high soot emissions and one of the most effective way to overcome these issues is by efficient combustion in an engine cylinder, the fuel spray atomization process plays a vital role in defining mixture formation, fuel consumption, combustion efficiency and soot emissions. Therefore, a comprehensive understanding of the fuel spray characteristics and atomization process is of a great importance. In this research, we will examine the effects of primary breakup modeling on the spray characteristics under diesel engine conditions. KH-ACT model is applied to cater the effect of aerodynamics in an engine cylinder and also cavitations and turbulence generated inside the injector. It is a modified form of most commonly used KH model, which considers only the aerodynamically induced breakup based on the Kelvin–Helmholtz instability. Our model is extensively evaluated by performing 3-D time-dependent simulations on Open FOAM, which is an open source flow solver. Spray characteristics like Spray Penetration, Liquid length, Spray cone angle and Souter mean diameter (SMD) were validated by comparing the results of Open Foam and Matlab. Including the effects of cavitation and turbulence enhances primary breakup, leading to smaller droplet sizes, decrease in liquid penetration, and increase in the radial dispersion of spray. All these properties favor early evaporation of fuel which enhances Engine efficiency.

Keywords: Kelvin–Helmholtz instability, open foam, primary breakup, souter mean diameter, turbulence

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Authors: William E. Bauta, Jennifer Rebeles, Reggie Jacob

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Porphyrins are noteworthy in biomedical science for their cancer tissue accumulation and photophysical properties. The preferential accumulation of some porphyrins in cancerous tissue has been known for many years. This, combined with their characteristic photophysical and photochemical properties, including their strong fluorescence and their ability to generate reactive oxygen species in vivo upon laser irradiation, has led to much research into the application of porphyrins as cancer diagnostic and therapeutic agents. Porphyrins have been used as dyes to detect cancer cells both in vivo and, less commonly, in vitro. In one example, human sputum samples from lung cancer patients and patients without the disease were dissociated and stained with the porphyrin TCPP (5,10,15,20-tetrakis-(4-carboxyphenyl)-porphine). Cells were analyzed by flow cytometry. Cancer samples were identified by their higher TCPP fluorescence intensity relative to the no-cancer controls. However, quantitative analysis of fluorescence in cell suspensions stained with multiple fluorophores requires particles stained with each of the individual fluorophores as controls. Fluorescent control particles must be compatible in size with flow cytometer fluidics and have favorable hydrodynamic properties in suspension. They must also display fluorescence comparable to the cells of interest and be stable upon storage amine-functionalized spherical polystyrene beads in the 5 to 20-micron diameter range that was reacted with TCPP and EDC in aqueous pH six buffer overnight to form amide bonds. Beads were isolated by centrifugation and tested by flow cytometry. The 10-micron amine-functionalized beads displayed the best combination of fluorescence intensity and hydrodynamic properties, such as lack of clumping and remaining in suspension during the experiment. These beads were further optimized by varying the stoichiometry of EDC and TCPP relative to the amine. The reaction was accompanied by the formation of a TCPP-related particulate, which was removed, after bead centrifugation, using a microfiltration process. The resultant TCPP-functionalized beads were compatible with flow cytometry conditions and displayed a fluorescence comparable to that of stained cells, which allowed their use as fluorescence standards. The beads were stable in refrigerated storage in the dark for more than eight months. This work demonstrates the first preparation of porphyrin-functionalized flow cytometry control beads.

Keywords: tetraaryl porphyrin, polystyrene beads, flow cytometry, peptide coupling

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Authors: Farzana Esmailkassam, Usakorn Kunanuvat, Zahraa Mohammed Ali

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Objective: The key barrier in Clozapine treatment of treatment-resistant schizophrenia (TRS) includes frequent bloods draws to monitor neutropenia, the main drug side effect. WBC and ANC monitoring must occur throughout treatment. Accurate WBC and ANC counts are necessary for clinical decisions to halt, modify or continue clozapine treatment. The CSAN Pronto point-of-care (POC) analyzer generates white blood cells (WBC) and absolute neutrophils (ANC) through image analysis of capillary blood. POC monitoring offers significant advantages over central laboratory testing. This study evaluated the performance of the CSAN Pronto against the Beckman DxH900 Hematology laboratory analyzer. Methods: Forty venous samples (EDTA whole blood) with varying concentrations of WBC and ANC as established on the DxH900 analyzer were tested in duplicates on three CSAN Pronto analyzers. Additionally, both venous and capillary samples were concomitantly collected from 20 volunteers and assessed on the CSAN Pronto and the DxH900 analyzer. The analytical performance including precision using liquid quality controls (QCs) as well as patient samples near the medical decision points, and linearity using a mix of high and low patient samples to create five concentrations was also evaluated. Results: In the precision study for QCs and whole blood, WBC and ANC showed CV inside the limits established according to manufacturer and laboratory acceptability standards. WBC and ANC were found to be linear across the measurement range with a correlation of 0.99. WBC and ANC from all analyzers correlated well in venous samples on the DxH900 across the tested sample ranges with a correlation of > 0.95. Mean bias in ANC obtained on the CSAN pronto versus the DxH900 was 0.07× 109 cells/L (95% L.O.A -0.25 to 0.49) for concentrations <4.0 × 109 cells/L, which includes decision-making cut-offs for continuing clozapine treatment. Mean bias in WBC obtained on the CSAN pronto versus the DxH900 was 0.34× 109 cells/L (95% L.O.A -0.13 to 0.72) for concentrations <5.0 × 109 cells/L. The mean bias was higher (-11% for ANC, 5% for WBC) at higher concentrations. The correlations between capillary and venous samples showed more variability with mean bias of 0.20 × 109 cells/L for the ANC. Conclusions: The CSAN pronto showed acceptable performance in WBC and ANC measurements from venous and capillary samples and was approved for clinical use. This testing will facilitate treatment decisions and improve clozapine uptake and compliance.

Keywords: absolute neutrophil counts, clozapine, point of care, white blood cells

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Authors: Ahmed Elaksher, Islam Omar

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For many years, Mars surface has been a mystery for scientists. Lately with the help of geospatial data and photogrammetric procedures researchers were able to capture some insights about this planet. Two of the most imperative data sources to explore Mars are the The High Resolution Imaging Science Experiment (HiRISE) and the Mars Orbiter Laser Altimeter (MOLA). HiRISE is one of six science instruments carried by the Mars Reconnaissance Orbiter, launched August 12, 2005, and managed by NASA. The MOLA sensor is a laser altimeter carried by the Mars Global Surveyor (MGS) and launched on November 7, 1996. In this project, we used MOLA-based DEMs to orthorectify HiRISE optical images for generating a more accurate and trustful surface of Mars. The MOLA data was interpolated using the kriging interpolation technique. Corresponding tie points were digitized from both datasets. These points were employed in co-registering both datasets using GIS analysis tools. In this project, we employed three different 3D to 2D transformation models. These are the parallel projection (3D affine) transformation model; the extended parallel projection transformation model; the Direct Linear Transformation (DLT) model. A set of tie-points was digitized from both datasets. These points were split into two sets: Ground Control Points (GCPs), used to evaluate the transformation parameters using least squares adjustment techniques, and check points (ChkPs) to evaluate the computed transformation parameters. Results were evaluated using the RMSEs between the precise horizontal coordinates of the digitized check points and those estimated through the transformation models using the computed transformation parameters. For each set of GCPs, three different configurations of GCPs and check points were tested, and average RMSEs are reported. It was found that for the 2D transformation models, average RMSEs were in the range of five meters. Increasing the number of GCPs from six to ten points improve the accuracy of the results with about two and half meters. Further increasing the number of GCPs didn’t improve the results significantly. Using the 3D to 2D transformation parameters provided three to two meters accuracy. Best results were reported using the DLT transformation model. However, increasing the number of GCPS didn’t have substantial effect. The results support the use of the DLT model as it provides the required accuracy for ASPRS large scale mapping standards. However, well distributed sets of GCPs is a key to provide such accuracy. The model is simple to apply and doesn’t need substantial computations.

Keywords: mars, photogrammetry, MOLA, HiRISE

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Authors: Jhiamluka Zservando Solano Velasquez, Raul Palma, Alejandro Calderon, Servio Paguada, Erick Marin, Kellyn Funes, Hana Sandoval, Oscar Hernandez

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Background: Screening cardiac conditions in primary care in developing countries can be challenging, and Honduras is not the exception. One of the main limitations is the underfunding of the Healthcare System in general, causing conventional ECG acquisition to become a secondary priority. Objective: Development of a low-cost ECG to improve screening of arrhythmias in primary care and communication with a specialist in secondary and tertiary care. Methods: Design a portable, pocket-size low-cost 3 lead ECG (Handy EKG). The device is autonomous and has Wi-Fi/Bluetooth connectivity options. A mobile app was designed which can access online servers with machine learning, a subset of artificial intelligence to learn from the data and aid clinicians in their interpretation of readings. Additionally, the device would use the online servers to transfer patient’s data and readings to a specialist in secondary and tertiary care. 50 randomized patients volunteer to participate to test the device. The patients had no previous cardiac-related conditions, and readings were taken. One reading was performed with the conventional ECG and 3 readings with the Handy EKG using different lead positions. This project was possible thanks to the funding provided by the National Autonomous University of Honduras. Results: Preliminary results show that the Handy EKG performs readings of the cardiac activity similar to those of a conventional electrocardiograph in lead I, II, and III depending on the position of the leads at a lower cost. The wave and segment duration, amplitude, and morphology of the readings were similar to the conventional ECG, and interpretation was possible to conclude whether there was an arrhythmia or not. Two cases of prolonged PR segment were found in both ECG device readings. Conclusion: Using a Frugal innovation approach can allow lower income countries to develop innovative medical devices such as the Handy EKG to fulfill unmet needs at lower prices without compromising effectiveness, safety, and quality. The Handy EKG provides a solution for primary care screening at a much lower cost and allows for convenient storage of the readings in online servers where clinical data of patients can then be accessed remotely by Cardiology specialists.

Keywords: low-cost hardware, portable electrocardiograph, prototype, remote healthcare

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Authors: Joachim F. Sartor

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According to German guidelines, external natural catchments are greater sub-catchments without significant portions of impervious areas, which possess a surface drainage system and empty in a sewer network. Basically, such catchments should be disconnected from sewer networks, particularly from combined systems. If this is not possible due to local conditions, their flow hydrographs have to be considered at the design of sewer systems, because the impact may be significant. Since there is a lack of sufficient measurements of storm-runoff events for such catchments and hence verified simulation methods to analyze their design flows, German standards give only general advices and demands special considerations in such cases. Compared to urban sub-catchments, external natural catchments exhibit greatly different flow characteristics. With increasing area size their hydrological behavior approximates that of rural catchments, e.g. sub-surface flow may prevail and lag times are comparable long. There are few observed peak flow values and simple (mostly empirical) approaches that are offered by literature for Central Europe. Most of them are at least helpful to crosscheck results that are achieved by simulation lacking calibration. Using storm-runoff data from five monitored rural watersheds in the west of Germany with catchment areas between 0.33 and 1.07 km2 , the author investigated by multiple event simulation three different approaches to determine the rainfall excess. These are the modified SCS variable run-off coefficient methods by Lutz and Zaiß as well as the soil moisture model by Ostrowski. Selection criteria for storm events from continuous precipitation data were taken from recommendations of M 165 and the runoff concentration method (parallel cascades of linear reservoirs) from a DWA working report to which the author had contributed. In general, the two run-off coefficient methods showed results that are of sufficient accuracy for most practical purposes. The soil moisture model showed no significant better results, at least not to such a degree that it would justify the additional data collection that its parameter determination requires. Particularly typical convective summer events after long dry periods, that are often decisive for sewer networks (not so much for rivers), showed discrepancies between simulated and measured flow hydrographs.

Keywords: external natural catchments, sewer network design, storm-runoff modelling, urban drainage

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Authors: Ariadne Katsouras, Andrea Chareunsy

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The number of large hydroelectric dams in the world has increased from almost 6,000 in the 1950s to over 45,000 in 2000. Dams are often built to increase the economic development of a country. This can occur in several ways. Large dams take many years to build so the construction process employs many people for a long time and that increased production and income can flow on into other sectors of the economy. Additionally, the provision of electricity can help raise people’s living standards and if the electricity is sold to another country then the money can be used to provide other public goods for the residents of the country that own the dam. Dams are also built to control flooding and provide irrigation water. Most dams are of these types. This paper will give an overview of the environmental and economic theories of the impact of dams in different regions of the world. There is a difference in the degree of environmental and economic impacts due to the varying climates and varying social and political factors of the regions. Production of greenhouse gases from the dam’s reservoir, for instance, tends to be higher in tropical areas as opposed to Nordic environments. However, there are also common impacts due to construction of the dam itself, such as, flooding of land for the creation of the reservoir and displacement of local populations. Economically, the local population tends to benefit least from the construction of the dam. Additionally, if a foreign company owns the dam or the government subsidises the cost of electricity to businesses, then the funds from electricity production do not benefit the residents of the country the dam is built in. So, in the end, the dams can benefit a country economically, but the varying factors related to its construction and how these are dealt with, determine the level of benefit, if any, of the dam. Some of the theories or practices used to evaluate the potential value of a dam include cost-benefit analysis, environmental impacts assessments and regressions. Systems analysis is also a useful method. While these theories have value, there are also possible shortcomings. Cost-benefit analysis converts all the costs and benefits to dollar values, which can be problematic. Environmental impact assessments, likewise, can be incomplete, especially if the assessment does not include feedback effects, that is, they only consider the initial impact. Finally, regression analysis is dependent on the available data and again would not necessarily include feedbacks. Systems analysis is a method that can allow more complex modelling of the environment and the economic system. It would allow a clearer picture to emerge of the impacts and can include a long time frame.

Keywords: comparison, economics, environment, hydroelectric dams

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Authors: Maria Antonieta Erna Castillo Holly

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During the last decade, data analysis, strategic decision making, and the use of artificial intelligence (AI) tools in Latin American agriculture have been a challenge. In some countries, the availability, quality, and reliability of historical data, in addition to the current data recording methodology in the field, makes it difficult to use information systems, complete data analysis, and their support for making the right strategic decisions. This is something essential in Agriculture 4.0. where the increase in the global demand for fresh agricultural products of tropical origin, during all the seasons of the year requires a change in the production model and greater agility in the responses to the consumer market demands of quality, quantity, traceability, and sustainability –that means extensive data-. Having quality information available and updated in real-time on what, how much, how, when, where, at what cost, and the compliance with production quality standards represents the greatest challenge for sustainable and profitable agriculture in the region. The objective of this work is to present a methodological proposal for the collection of georeferenced data from the protected agriculture sector, specifically in production units (UP) with tall structures (Greenhouses), initially for Venezuela, taking the state of Mérida as the geographical framework, and horticultural products as target crops. The document presents some background information and explains the methodology and tools used in the 3 phases of the work: diagnosis, data collection, and analysis. As a result, an evaluation of the process is carried out, relevant data and dashboards are displayed, and the first satellite maps integrated with layers of information in a geographic information system are presented. Finally, some improvement proposals and tentatively recommended applications are added to the process, understanding that their objective is to provide better qualified and traceable georeferenced data for subsequent analysis of the information and more agile and accurate strategic decision making. One of the main points of this study is the lack of quality data treatment in the Latin America area and especially in the Caribbean basin, being one of the most important points how to manage the lack of complete official data. The methodology has been tested with horticultural products, but it can be extended to other tropical crops.

Keywords: greenhouses, protected agriculture, data analysis, geographic information systems, Venezuela

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Authors: Alireza Nikbakht Shahbazi, Emadeddin Shirali

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Since optimization issues of water resources are complicated due to the variety of decision making criteria and objective functions, it is sometimes impossible to resolve them through regular optimization methods or, it is time or money consuming. Therefore, the use of modern tools and methods is inevitable in resolving such problems. An accurate and essential utilization policy has to be determined in order to use natural resources such as water reservoirs optimally. Water reservoir programming studies aim to determine the final cultivated land area based on predefined agricultural models and water requirements. Dam utilization rule curve is also provided in such studies. The basic information applied in water reservoir programming studies generally include meteorological, hydrological, agricultural and water reservoir related data, and the geometric characteristics of the reservoir. The system of Dez dam water resources was simulated applying the basic information in order to determine the capability of its reservoir to provide the objectives of the performed plan. As a meta-exploratory method, genetic algorithm was applied in order to provide utilization rule curves (intersecting the reservoir volume). MATLAB software was used in order to resolve the foresaid model. Rule curves were firstly obtained through genetic algorithm. Then the significance of using rule curves and the decrease in decision making variables in the system was determined through system simulation and comparing the results with optimization results (Standard Operating Procedure). One of the most essential issues in optimization of a complicated water resource system is the increasing number of variables. Therefore a lot of time is required to find an optimum answer and in some cases, no desirable result is obtained. In this research, intersecting the reservoir volume has been applied as a modern model in order to reduce the number of variables. Water reservoir programming studies has been performed based on basic information, general hypotheses and standards and applying monthly simulation technique for a statistical period of 30 years. Results indicated that application of rule curve prevents the extreme shortages and decrease the monthly shortages.

Keywords: optimization, rule curve, genetic algorithm method, Dez dam reservoir

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Authors: Sourabh Jain, S. S. Jain

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Intelligent transportation system (ITS) is the application of technologies for developing a user–friendly transportation system to extend the safety and efficiency of urban transportation systems in developing countries. These systems involve vehicles, drivers, passengers, road operators, managers of transport services; all interacting with each other and the surroundings to boost the security and capacity of road systems. The goal of urban corridor management using ITS in road transport is to achieve improvements in mobility, safety, and the productivity of the transportation system within the available facilities through the integrated application of advanced monitoring, communications, computer, display, and control process technologies, both in the vehicle and on the road. Intelligent transportation system is a product of the revolution in information and communications technologies that is the hallmark of the digital age. The basic ITS technology is oriented on three main directions: communications, information, integration. Information acquisition (collection), processing, integration, and sorting are the basic activities of ITS. In the paper, attempts have been made to present the endeavor that was made to interpret and evaluate the performance of the 27.4 Km long study corridor having eight intersections and four flyovers. The corridor consisting of six lanes as well as eight lanes divided road network. Two categories of data have been collected such as traffic data (traffic volume, spot speed, delay) and road characteristics data (no. of lanes, lane width, bus stops, mid-block sections, intersections, flyovers). The instruments used for collecting the data were video camera, stop watch, radar gun, and mobile GPS (GPS tracker lite). From the analysis, the performance interpretations incorporated were the identification of peak and off-peak hours, congestion and level of service (LOS) at midblock sections and delay followed by plotting the speed contours. The paper proposed the urban corridor management strategies based on sensors integrated into both vehicles and on the roads that those have to be efficiently executable, cost-effective, and familiar to road users. It will be useful to reduce congestion, fuel consumption, and pollution so as to provide comfort, safety, and efficiency to the users.

Keywords: ITS strategies, congestion, planning, mobility, safety

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Authors: Eftychia Kessopoulou, Styliani Xanthopoulou, Ypatia Theodorakioglou, George Tsiotras, Katerina Gotzamani

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Public sector managers frequently herald that implementing best practices as a set of standards, may lead to superior organizational performance. However, recent research questions the objectification of best practices, highlighting: a) the inability of public sector organizations to develop innovative administrative practices, as well as b) the adoption of stereotypical renowned practices inculcated in the public sector by international governance bodies. The process through which organizations construe what a best practice is, still remains a black box that is yet to be investigated, given the trend of continuous changes in public sector performance, as well as the burgeoning interest of sharing popular administrative practices put forward by international bodies. This study aims to describe and understand how organizational best practices are constructed by public sector performance management teams, like benchmarkers, during the benchmarking-mediated performance improvement process and what mechanisms enable this construction. A critical realist action research methodology is employed, starting from a description of various approaches on best practice nature when a benchmarking-mediated performance improvement initiative, such as the Common Assessment Framework, is applied. Firstly, we observed the benchmarker’s management process of best practices in a public organization, so as to map their theories-in-use. As a second step we contextualized best administrative practices by reflecting the different perspectives emerged from the previous stage on the design and implementation of an interview protocol. We used this protocol to conduct 30 semi-structured interviews with “best practice” process owners, in order to examine their experiences and performance needs. Previous research on best practices has shown that needs and intentions of benchmarkers cannot be detached from the causal mechanisms of the various contexts in which they work. Such causal mechanisms can be found in: a) process owner capabilities, b) the structural context of the organization, and c) state regulations. Therefore, we developed an interview protocol theoretically informed in the first part to spot causal mechanisms suggested by previous research studies and supplemented it with questions regarding the provision of best practice support from the government. Findings of this work include: a) a causal account of the nature of best administrative practices in the Greek public sector that shed light on explaining their management, b) a description of the various contexts affecting best practice conceptualization, and c) a description of how their interplay changed the organization’s best practice management.

Keywords: benchmarking, action research, critical realism, best practices, public sector

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Authors: Camila Hurtado, Maria A. Morales, Diego Torres, L.H. Reyes, Alejandro Maranon, Alicia Porras

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This work presents the physical and chemical characterization of beer brand fibers and the properties of novel composite materials made of these fibers and polylactic acid (PLA). Treated and untreated fibers were physically characterized in terms of their moisture content (ASTM D1348), density, and particle size (ASAE S319.2). A chemical analysis following TAPPI standards was performed to determine ash, extractives, lignin, and cellulose content on fibers. Thermal stability was determined by TGA analysis, and an FTIR was carried out to check the influence of the alkali treatment in fiber composition. An alkali treatment with NaOH (5%) of fibers was performed for 90 min, with the objective to improve the interfacial adhesion with polymeric matrix in composites. Composite materials based on either treated or untreated beer brand fibers and polylactic acid (PLA) were developed characterized in tension (ASTM D638), bending (ASTM D790) and impact (ASTM D256). Before composites manufacturing, PLA and brand beer fibers (10 wt.%) were mixed in a twin extruder with a temperature profile between 155°C and 180°C. Coupons were manufactured by compression molding (110 bar) at 190°C. Physical characterization showed that alkali treatment does not affect the moisture content (6.9%) and the density (0.48 g/cm³ for untreated fiber and 0.46 g/cm³ for the treated one). Chemical and FTIR analysis showed a slight decrease in ash and extractives. Also, a decrease of 47% and 50% for lignin and hemicellulose content was observed, coupled with an increase of 71% for cellulose content. Fiber thermal stability was improved with the alkali treatment at about 10°C. Tensile strength of composites was found to be between 42 and 44 MPa with no significant statistical difference between coupons with either treated or untreated fibers. However, compared to neat PLA, composites with beer bran fibers present a decrease in tensile strength of 27%. Young modulus increases by 10% with treated fiber, compared to neat PLA. Flexural strength decreases in coupons with treated fiber (67.7 MPa), while flexural modulus increases (3.2 GPa) compared to neat PLA (83.3 MPa and 2.8 GPa, respectively). Izod impact test results showed an improvement of 99.4% in coupons with treated fibers - compared with neat PLA.

Keywords: beer bran, characterization, green composite, polylactic acid, surface treatment

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Authors: Huda Arshadlamphon

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Advancing frontiers of technology and industry is moving rapidly fast influenced by the economic and political phenomena. One vital phenomenon,which has had consolidated the world to a one single village, is Globalization. In response, architecture and the built-environment have faced numerous changes, adjustments, and developments. Tall-buildings, as a product of globalization, represent prestigious icons, symbols, and landmarks for highly economics and advanced countries. Despite the fact, this trend has been encountering several design challenges incorporating architectural identity, traditions, and characteristics that enhance the built-environments' sociocultural values and traditions. The necessity of these values and traditionsform self-solitarily, leading to visual and spatial creativity, independency, and individuality. In other words, they maintain the inherited identity and avoid replications in all means and aspects. This paper, firstly, defines globalization phenomenon, architectural identity, and the concerns of sociocultural values in relation to the traditional characteristics of the built-environment. Secondly, through three case-studies of tall-buildings located in Jeddah city, Saudi Arabia, the Queen's Building, the National Commercial Bank Building (NCB), and the Islamic Development Bank Building; design strategies and methodologies in acclimating architectural identity and characteristics in tall-buildings are discussed. The case-studies highlight buildings' sites and surroundings, concepts and inspirations, design elements, architectural forms and compositions, characteristics, issues, barriers, and trammels facing the designs' decisions, representation of facades, and selection of materials and colors. Furthermore, the research will elucidate briefs of the dominant factors that shape the architectural identity of Jeddah city. In conclusion, the study manifests four tall-buildings' design standards guideline in preserving and developing architectural identity in Jeddah city; the scale of urban and natural environment, the scale of architectural design elements, the integration of visual images, and the creation of spatial scenes and scenarios. The prosed guideline will encourage the development of architectural identity aligned with zeitgeist demands and requirements, supports the contemporary architectural movement toward tall-buildings, and shoresself-solitarily in representing sociocultural values and traditions of the built-environment.

Keywords: architectural identity, built-environment, globalization, sociocultural values and traditions, tall-buildings

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Authors: Sendy Ghirardi, Pau Rausell Köster

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The European Commission increasingly pushes cultural policies towards social outcomes and local and regional authorities also call for culture-driven strategies for local development and prosperity and therefore, the measurement of cultural participation becomes increasingly more significant for evidence-based policy-making processes. Cultural participation involves various kinds of social and economic spillovers that combine social and economic objectives of value creation, including social sustainability and respect for human values. Traditionally, from the economic perspective, cultural consumption is measured by the value of financial transactions in purchasing, subscribing to, or renting cultural equipment and content, addressing the market value of cultural products and services. The main sources of data are the household spending survey and merchandise trade survey, among others. However, what characterizes the cultural consumption is that it is linked with the hedonistic and affective dimension rather than the utilitarian one. In fact, nowadays, more and more attention is being paid to the social and psychological dimensions of culture. The aim of this work is to present a comprehensive approach to measure the impacts of cultural participation and cultural users’ behaviour, combining both socio-psychological and economic approaches. The model combines contingent evaluation techniques with the individual characteristic and perception analysis of the cultural experiences to evaluate the cognitive, aesthetic, emotive and social impacts of cultural participation. To investigate the comprehensive approach to measure the impact of the cultural events on individuals, the research has been designed on the basis of prior theoretical development. A deep literature methodology has been done to develop the theoretical model applied to the web platform to measure the impacts of cultural experience on individuals. The developed framework aims to become a democratic tool for evaluating the services that cultural or policy institutions can adopt through the use of an interacting platform that produces big data benefiting academia, cultural management and policies. The Au Culture is a prototype based on an application that can be used on mobile phones or any other digital platform. The development of the AU Culture Platform has been funded by the Valencian Innovation Agency (Government of the Region of Valencia) and it is part of the Horizon 2020 project MESOC.

Keywords: comprehensive approach, cultural participation, economic dimension, socio-psychological dimension

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Authors: E. Happ, Zs. Ivancsone Horvath

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With the development of the information technology, IT, sector, all industry of the world has a new path, dealing with digitalisation. Tourism is the most rapidly increasing industry in the world. Without digitalisation, tourism operators would not be competitive enough with foreign destinations or other experience-based service providers. Digitalisation is also necessary to enable organizations, which are interested in tourism to meet the growing expectations of consumers. With the help of digitalisation, tourism providers can also obtain information about tourists, changes in consumer behaviour, and the use of online services. The degree of digitalisation in tourism is different for different services. The research is based on a questionnaire survey conducted in 2018 in Hungary. The sample with more than 500 respondents was processed by the SPSS program, using a variety of analysis methods. The following two variables were observed from more aspects: frequency of travel and the importance of services related to online travel. With the help of these variables, a cluster analysis was performed among the participants. The sample can be divided into two groups using K-mean cluster analysis. Cluster ‘1’ is a positive group; they can be called the “most digital tourists.” They agree in most things, with low standard deviation, and for them, digitalisation is a starting point. To the members of Cluster ‘2’, digitalisation is important, too. The results show what is important (accommodation, information gathering) to them, but also what they are not interested in at all within the digital world (e.g., car rental or online sharing). Interestingly, there is no third negative cluster. This result (that there is no result) proves that tourism uses digitalisation, and the question is only the extent of the use of online tools and methods. With the help of the designed consumer groups, the characteristics of digital tourism segments can be identified. The help of different variables characterised these groups. One of them is the frequency of travel, where there is a significant correlation between travel frequency and cluster membership. The shift is clear towards Cluster ‘1’, which means, those who find services related to online travel more important, are more likely to travel as well. By learning more about digital tourists’ consumer behaviour, the results of this research can help the providers in what kind of marketing tools could be used to influence the consumer choices of the different consumer groups created using digital devices, furthermore how to conduct more detailed and effective marketing activities. The main finding of the research was that most of the people have digital tools which are important to be able to participate in e-tourism. Of these, mobile devices are increasingly preferred. That means the challenge for service providers is no longer the digital presence but having optimised application for different devices.

Keywords: cluster analysis, digital tourism, marketing tool, tourist behaviour

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Authors: Xilu Liu, Ameen Farooq

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Beijing has several compact residential housing settings in many of its urban districts. The study in this paper reveals that urban compactness, as predictor of density, may carry an altogether different meaning in the developing world when compared to the U.S for achieving objectives of urban sustainability. Recent urban design studies in the U.S are debating for compact and mixed-use higher density housing to achieve sustainable and energy efficient living environments. While the concept of urban compactness is widely accepted as an approach in modern architectural and urban design fields, this belief may not directly carry well into all areas within cities of developing countries. Beijing’s technology-driven economy, with its historic and rich cultural heritage and a highly speculated real-estate market, extends its urban boundaries into multiple compact urban settings of varying scales and densities. The accelerated pace of migration from the countryside for better opportunities has led to unsustainable and uncontrolled buildups in order to meet the growing population demand within and outside of the urban center. This unwarranted compactness in certain urban zones has produced an unhealthy physical density with serious environmental and ecological challenging basic living conditions. In addition, crowding, traffic congestion, pollution and limited housing surrounding this compactness is a threat to public health. Several residential blocks in close proximity to each other were found quite compacted, or ill-planned, with residential sites due to lack of proper planning in Beijing. Most of them at first sight appear to be compact and dense but further analytical studies revealed that what appear to be dense actually are not as dense as to make a good case that could serve as the corner stone of sustainability and energy efficiency. This study considered several factors including floor area ratio (FAR), ground coverage (GSI), open space ratio (OSR) as indicators in analyzing urban compactness as a predictor of density. The findings suggest that these measures, influencing the density of residential sites under study, were much smaller in density than expected given their compact adjacencies. Further analysis revealed that several residential housing appear to support the notion of density in its compact layout but are actually compacted due to unregulated planning marred by lack of proper urban design standards, policies and guidelines specific to their urban context and condition.

Keywords: Beijing, density, sustainability, urban compactness

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Authors: Fauzanah Fauzan El Muhammady

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In the recent years, the Indonesian government has made tremendous efforts to improve the quality of Indonesia’s Islamic Higher Education Institutions (IHEIs) through the implementation of the institutional transformation policy. This policy has encouraged some IHEIs, such as Islamic Collages and Islamic Institutes to shift their institution from college to Institute or from Institute to university. As one of the requirements, the IHEIs should provide non-religious curriculum and integrate it with the religious curriculum (as the core curriculum of IHEIs). As results, since the 2000s, some Islamic Collages and Islamic Institutes have successfully developed the non-religious curriculum and achieved institutional transformation. However, after 15 years, the impact of the institutional transformation to the IHEIs is still debatable. The institutional transformation policy can be questioned as to whether the goal of status transformation has truly brought significant improvement to the quality of IHEIs. Therefore, based on the situation above, this study aims to explore how far the institutional transformation has effectively brought significant impact to the quality improvement of IHEIs. This study has used literature review method to investigate the current development of the institutional transformation in Indonesia’s IHEIs context. This is a part of literature review development to support the process of doctoral research. Based on the literature review, some studies found that the institutional transformation has led pro and cons to the academic community, society, and local government. Some agreed the institutional transformation has effectively facilitated non-religious curriculum development and it has significantly improved the number of prospective students and the student admitted at Islamic Universities. Meanwhile, others argue the development of non-religious curriculum will gradually eliminate the existence of the religious curriculum itself. On the other hand, the government suggests that the institutional transformation should be based on the quality standards. As a result, recently, the government has taken an initiative to restrict the institutional transformation (moratorium) in order to ensure the quality control of the institutional transformation application and to control the increasing number of the institutional transformation demands. This study provided the current issues that related to the contemporary of the institutional transformation in IHEIs context to disclosure how far both IHEIs and government overcome the quality issues of the institutional transformation development. The study results are expected can be used to advocate government, policymakers, and academic leaders in 1) reviewing the sustainability impact of the institutional transformation to the quality improvement of higher education institutions; 2) and finding effective solutions for the continuity of the institutional transformation in the future, particularly in the IHEIs context.

Keywords: curriculum, higher education, institutional transformation, quality

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Authors: Rui Lin, Jimmy Xiangji Huang, Gary Spraakman

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This forthcoming systematic review will underscore the imperative of leveraging technology to mitigate social isolation in older adults, particularly in the context of unprecedented global challenges such as the COVID-19 pandemic. With the continual evolution of technology, it becomes crucial to scrutinize the efficacy of interventions and discern how they can alleviate social isolation and augment social well-being among the elderly. This review will strive to clarify the best methods for older adults to utilize cost-effective and user-friendly technology and will investigate how the adaptation and execution of such interventions can be fine-tuned to maximize their positive outcomes. The study will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to filter pertinent studies. We foresee conducting an analysis of articles and executing a narrative analysis to discover themes and indicators related to quality of life and, technology use and well-being. The review will examine how involving older adults at the community level, applying top practices from community-based participatory research, can establish efficient strategies to implement technology-based interventions designed to diminish social isolation and boost digital use self-efficacy. Applications based on mobile technology and virtual platforms are set to assume a crucial role not only in enhancing connections within families but also in connecting older adults to vital healthcare resources, fostering both physical and mental well-being. The review will investigate how technological devices and platforms can address the cognitive, visual, and auditory requirements of older adults, thus strengthening their confidence and proficiency in digital use—a crucial factor during enforced social distancing or self-isolation periods during pandemics. This review will endeavor to provide insights into the multifaceted benefits of technology for older adults, focusing on how tailored technological interventions can be a beacon of social and mental wellness in times of social restrictions. It will contribute to the growing body of knowledge on the intersection of technology and elderly well-being, offering nuanced understandings and practical implications for developing user-centric, effective, and inclusive technological solutions for older populations.

Keywords: older adults, health service delivery, digital health, social isolation, social well-being

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Authors: Zan Chen, D. Kwok

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The SkillsFuture Singapore’s mission to develop a responsive and forward-looking Training and Adult Education (TAE) and workforce development system is undergirded by how successful TAE providers are in their business performance and strategies that strengthen their operational efficiency and processes. Therefore, understanding the factors that drive the business performance of TAE providers is critical to the success of SkillsFuture Singapore’s initiatives. This study aims to investigate how business strategy, work autonomy, work intensity and professional development support impact the business performance of private TAE providers. Specifically, the three research questions are: (1) Are there significant relationships between the above-mentioned four factors and TAE providers’ business performance?; (2) Are there significant differences on the four factors between low and high TAE providers’ business performance groups?; and (3) To what extent and in what manner do the four factors predict TAE providers’ business performance? This was part of the first national study on organizations and professionals working in the Training and Adult Education (TAE) sector. Data from 265 private TAE providers where respondents were Chief Executive Officers representatives from the Senior Management were analyzed. The results showed that business strategy (the extent that the organization leads the way in terms of developing new products and services; uses up-to-date learning technologies; customizes its products and services to the client’s needs), work autonomy (the extent that the staff personally have an influence on how hard they work; deciding what tasks they are to do; deciding how they are to do the tasks, and deciding the quality standards to which they work) and professional development support (both monetary and non-monetary support and incentives) had positive and significant relationships with business performance. However, no significant relationship is found between work intensity and business performance. A business strategy, work autonomy and professional development support were significantly higher in the high business performance group compared to the low-performance group among the TAE providers. Results of hierarchical regression analyses controlling for the size of the TAE providers showed significant impacts of business strategy, work autonomy and professional development support on TAE providers’ business performance. Overall, the model accounted for 27% of the variance in TAE providers’ business performance. This study provides policymakers with insights into improving existing policies, designing new initiatives and implementing targeting interventions to support TAE providers. The findings also have implications on how the TAE providers could better formulate their organizational strategies and business models. Finally, limitations of study, along with directions for future research will be discussed in the paper.

Keywords: adult education, business performance, business strategy, training, work autonomy

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Authors: Joanna Wozniak-Holecka, Sylwia Jaruga-Sekowska

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There are 45 statutory spa and treatment areas in Poland, and the demand for spa and treatment services increases year by year. Within each type of spa treatment facilities, nutritional education services are provided. During spa treatment, the patient learns the principles of rational nutrition and applied diet therapy. It should help him develop proper eating habits, which will also follow at home. However, the nutrition education system of spa resort patients should be considered as very imperfect and requiring a definite systemic correction. It has, at the same time, a wide human and infrastructure base, which guarantees to obtain positive reinforcement in the scope of undertaken activities and management. Unfortunately, this advantage is not fully used. The aim of the project was to assess the quality of implemented nutritional education and to assess the diet of patients in spa treatment entities from a nationwide perspective. The material for the study was data obtained as part of an in-depth interview conducted among nutrition department managers (25 interviews) and a survey addressed to patients (600 questionnaires) of a selected group of spa resorts from across the country about the implementation of nutritional education in institutions. Also, decade menus for the basic diet, easily digestible diet and diet with limitation of easily digestible carbohydrates (a total of 1,120 menus) were obtained for the study. Almost 2/3 of respondents (73.2%) were overweight or obese, but only 32.8% decided on an easily digestible or low-energy diet during the treatment. Most of the surveyed patients rated the nutrition in spa resorts as satisfactory. Classes on nutrition education were carried out mainly by a dietitian (65% of meetings), the other educators were doctors and nurses. The meetings (95%) were of a group nature and lasted only 30 minutes on average. The subjects of the classes concerned the principles of proper nutrition and composition of meals, a nutrition pyramid and a diet adapted to a given disease. The assessed menus did not meet the nutrition standards and, therefore, did not provide patients with the correct quality of nutrition. The norm of protein, fat, vitamin A, B12, phosphorus, iron and sodium was exceeded, while vitamin D, folic acid, magnesium and zinc were not enough than recommended. The study allowed to conclude that there is a large discrepancy between the recommendations presented during the nutrition education classes and the quality of diet implemented in the examined institutions. The project may contribute to the development of effective educational tools in nutrition, especially about a specific group of chronically ill patients.

Keywords: diet, management, nutritional education, spa resort

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Authors: Jeannette Anniés, Panagiotis Michalis, Chrysoula Papathanasiou, Selby Knudsen

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RiskPACC project aims to bring together researchers, practitioners, and first responders from nine European countries following a co-creation approach aiming to develop customised solutions to meet the needs of end-users. The co-creation workshops target to enhance the communication pathways between local civil protection authorities (CPAs) and citizens, in an effort to close the risk perception-action gap (RPAG). The participants in the workshops include a variety of stakeholders, as well as citizens, fostering the dialogue between the groups and supporting citizen participation in disaster risk management (DRM). The co-creation methodology in place implements co-design elements due to the integration of four ICT tools. Such ICT tools include web-based and mobile application technical solutions in different development stages, ranging from formulation and validation of concepts to pilot demonstrations. In total, seven different case studies are foreseen in RiskPACC. The workflow of the workshops is designed to be adaptive to every of the seven case study countries and their cultures’ particular needs. This work aims to provide an overview of the the preparation and the conduction of the workshops in which researchers and practitioners focused on mapping these different needs from the end users. The latter included first responders but also volunteers and citizens who actively participated in the co-creation workshops. The strategies to improve communication between CPAs and citizens themselves differ in the countries, and the modules of the co-creation methodology are adapted in response to such differences. Moreover, the project partners experienced how the structure of such workshops is perceived differently in the seven case studies. Therefore, the co-creation methodology itself is a design method underlying several iterations, which are eventually shaped by cross-cultural collaboration. For example, some case studies applied other modules according to the participatory group recruited. The participants were technical experts, teachers, citizens, first responders, or volunteers, among others. This work aspires to present the divergent approaches of the seven case studies implementing the co-creation methodology proposed, in response to different perceptions of the modules. An analysis of the adaptations and implications will also be provided to assess where the case studies’ objective of improving disaster resilience has been obtained.

Keywords: citizen participation, co-creation, disaster resilience, risk perception, ICT tools

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Authors: Mercedes Del Rio Merino, Jaime Santacruz Astorqui, Paola Villoria Saez, Carmen Viñas Arrebola

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The lack of treatment of the waste from construction and demolition waste (CDW) is a problem that must be solved immediately. It is estimated that in the world not to use CDW generates an increase in the use of new materials close to 20% of the total value of the materials used. The problem is even greater in case these wastes are considered hazardous because the final deposition of them may also generate significant contamination. Therefore, the possibility of including CDW in the manufacturing of building materials, represents an interesting alternative to ensure their use and to reduce their possible risk. In this context and in the last years, many researches are being carried out in order to analyze the viability of using CDW as a substitute for the traditional raw material of high environmental impact. Even though it is true, much remains to be done, because these works generally characterize materials but not specific applications that allow the agents of the construction to have the guarantees required by the projects. Therefore, it is necessary the involvement of all the actors included in the life cycle of these new construction materials, and also to promote its use for, for example, definition of standards, tax advantages or market intervention is necessary. This paper presents the main findings reached in "Waste to resources (W2R)" project since it began in October 2014. The main goal of the project is to develop new materials, elements and construction systems, manufactured from CDW, to be used in improving the energy efficiency of buildings. Other objectives of the project are: to quantify the CDW generated in the energy rehabilitation works, specifically wastes from the building envelope; and to study the traceability of CDW generated and promote CDW reuse and recycle in order to get close to the life cycle of buildings, generating zero waste and reducing the ecological footprint of the construction sector. This paper determines the most important aspects to consider during the design of new constructive solutions, which improve the energy efficiency of buildings and what materials made with CDW would be the most suitable for that. Also, a survey to select best practices for reducing "close to zero waste" in refurbishment was done. Finally, several pilot rehabilitation works conform the parameters analyzed in the project were selected, in order to apply the results and thus compare the theoretical with reality. Acknowledgements: This research was supported by the Spanish State Secretariat for Research, Development and Innovation of the Ministry of Economy and Competitiveness under "Waste 2 Resources" Project (BIA2013-43061-R).

Keywords: building waste, construction and demolition waste, recycling, resources

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Authors: Ilaria Barletta, Mahesh Mani, Björn Johansson

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The concept of sustainability encompasses economic, environmental, social and institutional considerations. Sustainable manufacturing (SM) is, therefore, a multi-faceted concept. It broadly implies the development and implementation of technologies, projects and initiatives that are concerned with the life cycle of products and services, and are able to bring positive impacts to the environment, company stakeholders and profitability. Because of this, achieving SM-related goals requires a holistic, life-cycle-thinking approach from manufacturing companies. Further, such an approach must rely on a logic of continuous improvement and ease of implementation in order to be effective. Currently, there exists in the academic literature no comprehensively structured frameworks that support manufacturing companies in the identification of the issues and the capabilities that can either hinder or foster sustainability. This scarcity of support extends to difficulties in obtaining quantifiable measurements in order to objectively evaluate solutions and programs and identify improvement areas within SM for standards conformance. To bridge this gap, this paper proposes the concept of a framework for assessing and continuously improving the sustainability of manufacturing companies. The framework addresses strategies and projects for SM and operates in three sequential phases: analysis of the issues, design of solutions and continuous improvement. A set of interviews, observations and questionnaires are the research methods to be used for the implementation of the framework. Different decision-support methods - either already-existing or novel ones - can be 'plugged into' each of the phases. These methods can assess anything from business capabilities to process maturity. In particular, the authors are working on the development of a sustainable manufacturing maturity model (SMMM) as decision support within the phase of 'continuous improvement'. The SMMM, inspired by previous maturity models, is made up of four maturity levels stemming from 'non-existing' to 'thriving'. Aggregate findings from the use of the framework should ultimately reveal to managers and CEOs the roadmap for achieving SM goals and identify the maturity of their companies’ processes and capabilities. Two cases from two manufacturing companies in Australia are currently being employed to develop and test the framework. The use of this framework will bring two main benefits: enable visual, intuitive internal sustainability benchmarking and raise awareness of improvement areas that lead companies towards an increasingly developed SM.

Keywords: life cycle management, continuous improvement, maturity model, sustainable manufacturing

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Authors: Pranee Suecharoen, Ratchadaporn Soontornpas, Jaturat Kanpittaya

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Background: Contrast media has an important role for disease diagnosis through detection of pathologies. Contrast media can, however, cause adverse reactions after administration of its agents. Although non-ionic contrast media are commonly used, the incidence of adverse events is relatively low. The most common reactions found (10.5%) were mild and manageable and/or preventable. Pharmacists can play an important role in evaluating adverse reactions, including awareness of the specific preparation and the type of adverse reaction. As most common types of adverse reactions are idiosyncratic or pseudo-allergic reactions, common standards need to be established to prevent and control adverse reactions promptly and effectively. Objective: To measure the effect of using tools for symptom evaluation in order to reduce the severity, or prevent the occurrence, of adverse reactions from contrast media. Methods: Retrospective review descriptive research with data collected on adverse reactions assessment and Naranjo’s algorithm between June 2015 and May 2016. Results: 158 patients (10.53%) had adverse reactions. Of the 1,500 participants with an adverse event evaluation, 137 (9.13%) had a mild adverse reaction, including hives, nausea, vomiting, dizziness, and headache. These types of symptoms can be treated (i.e., with antihistamines, anti-emetics) and the patient recovers completely within one day. The group with moderate adverse reactions, numbering 18 cases (1.2%), had hypertension or hypotension, and shortness of breath. Severe adverse reactions numbered 3 cases (0.2%) and included swelling of the larynx, cardiac arrest, and loss of consciousness, requiring immediate treatment. No other complications under close medical supervision were recorded (i.e., corticosteroids use, epinephrine, dopamine, atropine, or life-saving devices). Using the guideline, therapies are divided into general and specific and are performed according to the severity, risk factors and ingestion of contrast media agents. Patients who have high-risk factors were screened and treated (i.e., prophylactic premedication) for prevention of severe adverse reactions, especially those with renal failure. Thus, awareness for the need for prescreening of different risk factors is necessary for early recognition and prompt treatment. Conclusion: Studying adverse reactions can be used to develop a model for reducing the level of severity and setting a guideline for a standardized, multidisciplinary approach to adverse reactions.

Keywords: role of pharmacist, management of adverse reactions, guideline for contrast media, non-ionic contrast media

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Authors: Gizem Kodak, Alper Unal, Birsen Koldemir, Tayfun Acarer

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Turkish Straits System which consists of Istanbul Strait (Bosphorus), Canakkale Strait (Dardanelles) and the Marmara Sea has a strategical location on international maritime as it is a unique waterway between the Mediterranean Sea, Black Sea and the Aegean Sea. Thus, this area has great importance since it is the only waterway between Black Sea countries and the rest of the World. Turkish Straits System has dangerous environmental factors hosts more vessel every day through developing World trade and this situation results in expanding accident risks day by day. Today, a lot of precautions have been taken to ensure safe navigation and to prevent maritime accidents, and international standards are followed to avoid maritime accidents. Despite this, the environmental factors that affect this area, trigger the maritime accidents and threaten the vessels with new accidents risks in different months with different hazards. This descriptive study consists of temporal and spatial analyses of environmental factors causing maritime accidents. This study also aims at contributing to safety navigation including monthly and regionally characteristics of variables. In this context, two different data sets are created consisting of environmental factors and accidents. This descriptive study on the accidents between 2001 and 2017 the mentioned region also studies the months and places of the accidents with environmental factor variables. Environmental factor variables are categorized as dynamic and static factors. Dynamic factors are appointed as meteorological and oceanographical while static factors are appointed as geological factors that threaten safety navigation with geometrical restricts. The variables that form dynamic factors are approached meteorological as wind direction, wind speed, wave altitude and visibility. The circulations and properties of the water mass on the system are studied as oceanographical properties. At the end of the study, the efficient meteorological and oceanographical parameters on the region are presented monthly and regionally. By this way, we acquired the monthly, seasonal and regional distributions of the accidents. Upon the analyses that are done; The Turkish Straits System that connects the Black Sea countries with the other countries and which is one of the most important parts of the world trade; is analyzed on temporal and spatial dimensions on the reasons of the accidents and have been presented as environmental factor dynamics causing maritime accidents.

Keywords: descriptive study, environmental factors, maritime accidents, statistics

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Authors: Joshi Rajiv, Shah Priyank, Thavkar Amit, Rohira Poonam, Mehta Suyog

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Topical formulation containing minoxidil and finasteride helps hair growth in the treatment of male androgenetic alopecia. The objective of this study is to compare the irritation potential of three conventional formulations of minoxidil 5% + finasteride 0.1% topical solution of in human patch test. The study was a single centre, double blind, non-randomized controlled study in 53 healthy adult Indian subjects. Occlusive patch test for 24 hours was performed with three formulations of minoxidil 5% + finasteride 0.1% topical solution. Products tested included aqueous based minoxidil 5% + finasteride 0.1% (AnasureTM-F, Sun Pharma, India – Brand A), lipid based minoxidil 5% + finasteride 0.1% (Brand B) and aqueous based minoxidil 5% + finasteride 0.1% (Brand C). Isotonic saline 0.9% and 1% w/w sodium lauryl sulphate were included as negative control and positive control respectively. Patches were applied and removed after 24 hours. The skin reaction was assessed and clinically scored 24 hours after the removal of the patches under constant artificial daylight source using the Draize scale (0-4 points scale for erythema/dryness//wrinkles and for oedema). Follow-up was scheduled after one week to confirm recovery for any reaction. A combined mean score up to 2.0/8.0 indicates a product is “non-irritant” and a score between 2.0/8.0 and 4.0/8.0 indicates “mildly irritant” and a score above 4.0/8.0 indicates “irritant”. The procedure of the patch test followed the principles outlined by the Bureau of Indian Standards (BIS) (IS 4011:2018; Methods of Test for safety evaluation of Cosmetics-3rd revision). Fifty three subjects with mean age 31.9 years (25 males and 28 females) participated in the study. The combined mean score ± standard deviation were: 0.06 ± 0.23 (Brand A), 0.81 ± 0.59 (Brand B), 0.38 ± 0.49 (Brand C), 2.92 ± 0.47 (positive control) and 0.0 ± 0.0 (Negative control). This means the score of Brand A (Sun Pharma product) was significantly lower than that of Brand B (p=0.001) and that of Brand C (p=0.001). The combined mean erythema score ± standard deviation were: 0.06 ± 0.23 (Brand A), 0.81 ± 0.59 (Brand B), 0.38 ± 0.49 (Brand C), 2.09 ± 0.4 (Positive control) and 0.0 ± 0.0 (Negative control). The mean erythema score of Brand A was significantly lower than Brand B (p=0.001) and that of Brand C (p=0.001). Any reaction observed at 24hours after patch removal subsided in a week. All the three topical formulations of minoxidil 5% + finasteride 0.1% were non-irritant. Brand A of minoxidil 5% + finasteride 0.1% (Sun Pharma) was found to be the least irritant than Brand B and Brand C based on the combined mean score and mean erythema score in the human patch test as per the BIS, IS 4011:2018

Keywords: erythema, finasteride, irritation, minoxidil, patch test

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Authors: Sule Pallavi, Shah Priyank, Thavkar Amit, Rohira Poonam, Mehta Suyog

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Introduction: Minoxidil has been used topically for a long time to assist hair growth in the management of male androgenetic alopecia. The aim of this study was a comparative assessment of the irritation potential of three commercial formulations of minoxidil 2% topical solution in a human patch test. Methodology: The study was a non-randomized, double-blind, controlled, single-center study of 56 healthy adult Indian subjects. A 24-hour occlusive patch test was conducted with three formulations of minoxidil 2% topical solution. Products tested were aqueous-based minoxidil 2% (AnasureTM 2%, Sun Pharma, India – Brand A), alcohol-based minoxidil 2% (Brand B) and aqueous-based minoxidil 2% (Brand C). Isotonic saline 0.9% and 1% w/w sodium lauryl sulphate as a negative and positive control, respectively, were included. Patches were applied on the back, followed by removal after 24 hours. The Draize scale (0-4 points scale for erythema/dryness/wrinkles and for oedema) was used to evaluate and clinically score the skin reaction under constant artificial daylight 24 hours after the removal of the patches. The patch test was based on the principles outlined by Bureau of Indian Standards (BIS) (IS 4011:2018; Methods of Test for safety evaluation of Cosmetics-3rd revision). A mean combined score up to 2.0/8.0 indicates that a product is “non-irritant,” and a score between 2.0/8.0 and 4.0/8.0 indicates “mildly irritant” and a score above 4.0/8.0 indicates “irritant”. In case of any skin reaction that was observed, a follow-up was planned after one week to confirm recovery. Results: The 56 subjects who participated in the study had a mean age of 28.7 years (28 males and 28 females). The combined mean score ± standard deviation was: 0.09 ± 0.29 (Brand A), 0.29± 0.53 (Brand B), 0.30 ± 0.46 (Brand C), 3.25 ± 0.77 (positive control) and 0.02 ± 0.13 (negative control). This mean score of Brand A (Sun Pharma) was significantly lower than that of Brand B (p=0.016) and that of Brand C (p=0.004). The mean erythema score ± standard deviation was: 0.09 ± 0.29 (Brand A), 0.27 ± 0.49 (Brand B), 0.30 ± 0.46 (Brand C), 2.5 ± 0.66 (positive control) and 0.02 ± 0.13 (negative control). The mean erythema score of Brand A (Sun Pharma) was significantly lower than that of Brand B (p=0.019) and that of Brand C (p=0.004). Reactions that were observed 24 hours after patch removal subsided in a week’s time. Conclusion: Based on the human patch test as per the BIS, IS 4011:2018, all the three topical formulations of minoxidil 2% were found to be non-irritant. Brand A of 2% minoxidil (Sun Pharma) was found to be the least irritant than Brand B and Brand C based on the combined mean score and mean erythema score.

Keywords: erythema, irritation, minoxidil, patch test

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