Search results for: score variations

Authors: Nuray Baltaci, Kursat Cagiltay

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University rankings which can be seen as nouveau topic are at the center of focus and followed closely by different parties. Students are interested in university rankings in order to make informed decisions about the selection of their candidate future universities. University administrators and academicians can utilize them to see and evaluate their universities’ relative performance compared to other institutions in terms of including but not limited to academic, economic, and international outlook issues. Local institutions may use those ranking systems, as TUBITAK (The Scientific and Technological Research Council of Turkey) and YOK (Council of Higher Education) do in Turkey, to support students and give scholarships when they want to apply for undergraduate and graduate studies abroad. When it is considered that the ranking systems are concerned by this many different parties, the importance of having clear, easy to use and well-designed websites by ranking institutions will be apprehended. In this paper, a usability study for the websites of four different global university ranking institutions, namely Academic Ranking of World Universities (ARWU), Times Higher Education, QS and University Ranking by Academic Performance (URAP), was conducted. User-based approach was adopted and usability tests were conducted with 10 graduate students at Middle East Technical University in Ankara, Turkey. Before performing the formal usability tests, a pilot study had been completed to reflect the necessary changes to the settings of the study. Participants’ demographics, task completion times, paths traced to complete tasks, and their satisfaction levels on each task and website were collected. According to the analyses of the collected data, those ranking websites were compared in terms of efficiency, effectiveness and satisfaction dimensions of usability as pointed in ISO 9241-11. Results showed that none of the selected ranking websites is superior to other ones in terms of overall effectiveness and efficiency of the website. However the only remarkable result was that the highest average task completion times for two of the designed tasks belong to the Times Higher Education Rankings website. Evaluation of the user satisfaction on each task and each website produced slightly different but rather similar results. When the satisfaction levels of the participants on each task are examined, it was seen that the highest scores belong to ARWU and URAP websites. The overall satisfaction levels of the participants for each website showed that the URAP website has highest score followed by ARWU website. In addition, design problems and powerful design features of those websites reported by the participants are presented in the paper. Since the study mainly tackles about the design problems of the URAP website, the focus is on this website. Participants reported 3 main design problems about the website which are unaesthetic and unprofessional design style of the website, improper map location on ranking pages, and improper listing of the field names on field ranking page.

Keywords: university ranking, user-based approach, website usability, design

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Authors: Robert E. Kenney, Richard B. Aguilar, Efrain Antunez, Gregory Schor-Haskin, Rafael Rey, Catie Falcon, Luis Arce

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This study sought to explore the effect of Sarapin injections on chronic knee pain (CKP). Many adults suffer from CKP which is most often attributed to osteoarthritis. Current treatment regimens for CKP involve the use NSAIDS medications, injections with steroids/analgesic, platelet rich plasma injections, or orthopedic surgical interventions. Sarapin is a commercially available homeopathic aqueous extract from the pitcher plant. Studies on the use of Sarapin as a treatment for cervical, thoracic, and lumbosacral facet joint nerve blocks have been performed with mixed results. There is little available evidence on the use of Sarapin in CKP. This study examines the effect of a series of 3 weekly injections of aqueous Sarapin in 95 elderly patients with CKP in a primary care setting. Cano Health, a primary care group, identified 95 successive patients with CKP from its multimodal physiotherapy program for chronic pain. Patients underwent evaluation by a clinician, underwent diagnostic Xrays of the knees, and the treatment plan with three weekly Sarapin injections was discussed. A pain and functional limitation survey (a modified Lower Extremity Functional Scale (mLEFS)) was administered prior to initiating treatment (Entry Survey (ES)). Each patient received an intraarticular injection of 2 cc of aqueous Sarapin with 1cc 1% lidocaine during weeks 1, 2 and 3. The mLEFS was administered again at week 4, one week after the third Sarapin injection (Exit Survey (ExS)). Demographics: Mean Age 62 +/- 9.8; 73% female; 89% Hispanic/Latino; mean time between ES and ExS was 27.5 +/-8.2 days. Survey: The mLEFS was based on a published Lower Extremity Functional Scale and each patient rated their pain or functional limitation from 0 (no difficulty) to 5 (severe difficulty) for 10 questions. Answers were summed and compared. Maximum score for severe difficulty would be 50 points. Results: Mean pain/functional scores: ES was 30.3 +/-12.1 and ExS was 19.5 +/- 12.5. This represents a relative improvement of 35.7% (P<0.00001). A total of 81% (77/95) of the patients showed improvement in symptoms at week four as assessed by the mLEFS. There were 11 patients who reported an increase in their survey scores while 7 patients reported no change. When evaluating the cohort that reported improvement, the ES was 30.9 +/-11.4 and ExS was 16.3 +/-9.8 yielding a 47.2% relative improvement (P<0.00001). Injections were well tolerated, and no adverse events were reported. Conclusions: In this cohort of 95 elderly patients with CKP, treatment with 3 weekly injections of Sarapin significantly improved pain and function as assessed by a mLEFS survey. The majority (81%) of patients responded positively to therapy, 12% had worsening symptoms and 7% reported no change. The use of intraarticular injections of Sarapin for CKP was shown to be an effective modality of treatment. Sarapin’s low cost, tolerability, and ease of use make it an attractive alternative to NSAIDS, steroids, PRP or surgical intervention for this common debilitating condition.

Keywords: Sarapin, intraarticular, chronic knee pain, osteoarthritis

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Authors: Tatjana Kadifkova Panovska, Svetlana Kulevanova, Blagica Jovanova

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Biological systems possess the ability to neutralize the excess of reactive oxygen species (ROS) and to protect cells from destructive alterations. However, many pathological conditions (cardiovascular diseases, autoimmune disorders, cancer) are associated with inflammatory processes that generate an excessive amount of reactive oxygen species (ROS) that shift the balance between endogenous antioxidant systems and free oxygen radicals in favor of the latter, leading to oxidative stress. Therefore, an additional source of natural compounds with antioxidant properties that will reduce the amount of ROS in cells is much needed despite their broad utilization; many plant species remain largely unexplored. Therefore, the purpose of the present study is to investigate the antioxidant activity of twenty-five selected medicinal and aromatic plant species. The antioxidant activity of the ethanol extracts was evaluated with in vitro assays: 2,2’-diphenyl-1-pycryl-hydrazyl (DPPH), ferric reducing antioxidant power (FRAP), non-site-specific- (NSSOH) and site-specific hydroxyl radical-2-deoxy-D-ribose degradation (SSOH) assays. The Folin-Ciocalteu method and AlCl3 method were performed to determine total phenolic content (TPC) and total flavonoid content (TFC). All examined plant extracts manifested antioxidant activity to a different extent. Cinnamomum verum J.Presl bark and Ocimum basilicum L. Herba demonstrated strong radical scavenging activity and reducing power with the DPPH and FRAP assay, respectively. Additionally, significant hydroxyl scavenging potential and metal chelating properties were observed using the NSSOH and SSOH assays. Furthermore, significant variations were determined in the total polyphenolic content (TPC) and total flavonoid content (TFC), with Cinnamomum verum and Ocimum basilicum showing the highest amount of total polyphenols. The considerably strong radical scavenging activity, hydroxyl scavenging potential and reducing power for the species mentioned above suggest of a presence of highly bioactive phytochemical compounds, predominantly polyphenols. Since flavonoids are the most abundant group of polyphenols that possess a large number of available reactive OH groups in their structure, it is considered that they are the main contributors to the radical scavenging properties of the examined plant extracts. This observation is supported by the positive correlation between the radical scavenging activity and the total polyphenolic and flavonoid content obtained in the current research. The observations from the current research nominate Cinnamomum verum bark and Ocimum basilicum herba as potential sources of bioactive compounds that could be utilized as antioxidative additives in the food and pharmaceutical industries. Moreover, the present study will help the researchers as basic data for future research in exploiting the hidden potential of these important plants that have not been explored so far.

Keywords: ethanol extracts, radical scavenging activity, reducing power, total polyphenols.

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Authors: Daniel Rowe, Christopher R. Vogel, Richard H. J. Willden

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The University of Oxford’s recirculating water flume is a combined wave and current test tank with a 1 m depth, 1.1 m width, and 10 m long working section, and is capable of flow speeds up to 1 ms−1 . This study documents the hydrodynamic characteristics of the facility in preparation for experimental testing of horizontal axis tidal stream turbine models. The turbine to be tested has a rotor diameter of 0.6 m and is a modified version of one of two model-scale turbines tested in previous experimental campaigns. An Acoustic Doppler Velocimeter (ADV) was used to measure the flow at high temporal resolution at various locations throughout the flume, enabling the spatial uniformity and turbulence flow parameters to be investigated. The mean velocity profiles exhibited high levels of spatial uniformity at the design speed of the flume, 0.6 ms−1 , with variations in the three-dimensional velocity components on the order of ±1% at the 95% confidence level, along with a modest streamwise acceleration through the measurement domain, a target 5 m working section of the flume. A high degree of uniformity was also apparent for the turbulence intensity, with values ranging between 1-2% across the intended swept area of the turbine rotor. The integral scales of turbulence exhibited a far higher degree of variation throughout the water column, particularly in the streamwise and vertical scales. This behaviour is believed to be due to the high signal noise content leading to decorrelation in the sampling records. To achieve more realistic levels of vertical velocity shear in the flume, a simple procedure to practically generate target vertical shear profiles in open-channel flows is described. Here, the authors arranged a series of non-uniformly spaced parallel bars placed across the width of the flume and normal to the onset flow. By adjusting the resistance grading across the height of the working section, the downstream profiles could be modified accordingly, characterised by changes in the velocity profile power law exponent, 1/n. Considering the significant temporal variation in a tidal channel, the choice of the exponent denominator, n = 6 and n = 9, effectively provides an achievable range around the much-cited value of n = 7 observed at many tidal sites. The resulting flow profiles, which we intend to use in future turbine tests, have been characterised in detail. The results indicate non-uniform vertical shear across the survey area and reveal substantial corner flows, arising from the differential shear between the target vertical and cross-stream shear profiles throughout the measurement domain. In vertically sheared flow, the rotor-equivalent turbulence intensity ranges between 3.0-3.8% throughout the measurement domain for both bar arrangements, while the streamwise integral length scale grows from a characteristic dimension on the order of the bar width, similar to the flow downstream of a turbulence-generating grid. The experimental tests are well-defined and repeatable and serve as a reference for other researchers who wish to undertake similar investigations.

Keywords: acoustic doppler Velocimeter, experimental hydrodynamics, open-channel flow, shear profiles, tidal stream turbines

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Authors: Trevor C. Brown, David J. Miron

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Gas-solid physical adsorption methods are central to the characterization and optimization of the effective surface area, pore size and porosity for applications such as heterogeneous catalysis, and gas separation and storage. Properties such as adsorption uptake, capacity, equilibrium constants and Gibbs free energy are dependent on the composition and structure of both the gas and the adsorbent. However, challenges remain, in accurately calculating these properties from experimental data. Gas adsorption experiments involve measuring the amounts of gas adsorbed over a range of pressures under isothermal conditions. Various constant-parameter models, such as Langmuir and Brunauer-Emmett-Teller (BET) theories are used to provide information on adsorbate and adsorbent properties from the isotherm data. These models typically do not provide accurate interpretations across the full range of pressures and temperatures. The Langmuir adsorption isotherm is a simple approximation for modelling equilibrium adsorption data and has been effective in estimating surface areas and catalytic rate laws, particularly for high surface area solids. The Langmuir isotherm assumes the systematic filling of identical adsorption sites to a monolayer coverage. The BET model is based on the Langmuir isotherm and allows for the formation of multiple layers. These additional layers do not interact with the first layer and the energetics are equal to the adsorbate as a bulk liquid. This BET method is widely used to measure the specific surface area of materials. Both Langmuir and BET models assume that the affinity of the gas for all adsorption sites are identical and so the calculated adsorbent uptake at the monolayer and equilibrium constant are independent of coverage and pressure. Accurate representations of adsorption data have been achieved by extending the Langmuir and BET models to include pressure-varying uptake capacities and equilibrium constants. These parameters are determined using a novel regression technique called flexible least squares for time-varying linear regression. For isothermal adsorption the adsorption parameters are assumed to vary slowly and smoothly with increasing pressure. The flexible least squares for pressure-varying linear regression (FLS-PVLR) approach assumes two distinct types of discrepancy terms, dynamic and measurement for all parameters in the linear equation used to simulate the data. Dynamic terms account for pressure variation in successive parameter vectors, and measurement terms account for differences between observed and theoretically predicted outcomes via linear regression. The resultant pressure-varying parameters are optimized by minimizing both dynamic and measurement residual squared errors. Validation of this methodology has been achieved by simulating adsorption data for n-butane and isobutane on activated carbon at 298 K, 323 K and 348 K and for nitrogen on mesoporous alumina at 77 K with pressure-varying Langmuir and BET adsorption parameters (equilibrium constants and uptake capacities). This modeling provides information on the adsorbent (accessible surface area and micropore volume), adsorbate (molecular areas and volumes) and thermodynamic (Gibbs free energies) variations of the adsorption sites.

Keywords: Langmuir adsorption isotherm, BET adsorption isotherm, pressure-varying adsorption parameters, adsorbate and adsorbent properties and energetics

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Authors: Te Kīpa Kēpa B. Morgan, Oliver W. Mcmillan, Dylan N. Taute, Tumanako N. Fa'aui

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Epistemologies are ways of knowing. Indigenous Peoples are aware that they do not perceive and experience the world in the same way as others. So it is important when empowering Indigenous epistemologies, such as that of the New Zealand Māori, to also be able to represent a scientific understanding within the same analysis. A geothermal development assessment tool has been developed by adapting the Mauri Model Decision Making Framework. Mauri is a metric that is capable of representing the change in the life-supporting capacity of things and collections of things. The Mauri Model is a method of grouping mauri indicators as dimension averages in order to allow holistic assessment and also to conduct sensitivity analyses for the effect of worldview bias. R-shiny is the coding platform used for this Vision Mātauranga research which has created an expert decision support tool (DST) that combines a stakeholder assessment of worldview bias with an impact assessment of mauri-based indicators to determine the sustainability of proposed geothermal development. The initial intention was to develop guidelines for quantifying mātauranga Māori impacts related to geothermal resources. To do this, three typical scenarios were considered: a resource owner wishing to assess the potential for new geothermal development; another party wishing to assess the environmental and cultural impacts of the proposed development; an assessment that focuses on the holistic sustainability of the resource, including its surface features. Indicator sets and measurement thresholds were developed that are considered necessary considerations for each assessment context and these have been grouped to represent four mauri dimensions that mirror the four well-being criteria used for resource management in Aotearoa, New Zealand. Two case studies have been conducted to test the DST suitability for quantifying mātauranga Māori and other biophysical factors related to a geothermal system. This involved estimating mauri0meter values for physical features such as temperature, flow rate, frequency, colour, and developing indicators to also quantify qualitative observations about the geothermal system made by Māori. A retrospective analysis has then been conducted to verify different understandings of the geothermal system. The case studies found that the expert DST is useful for geothermal development assessment, especially where hapū (indigenous sub-tribal grouping) are conflicted regarding the benefits and disadvantages of their’ and others’ geothermal developments. These results have been supplemented with evaluations for the cumulative impacts of geothermal developments experienced by different parties using integration techniques applied to the time history curve of the expert DST worldview bias weighted plotted against the mauri0meter score. Cumulative impacts represent the change in resilience or potential of geothermal systems, which directly assists with the holistic interpretation of change from an Indigenous Peoples’ perspective.

Keywords: decision support tool, holistic geothermal assessment, indigenous knowledge, mauri model decision-making framework

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Authors: Nicola Milani, Carla Bellissimo, Davide Pogliana, Davide Panzin, Luca Garlaschelli, Giulia Facchinetti, Claudia Casson, Luca Marazzina, Andrea Sartori, Simone Rivaroli, Jeff Konin

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The patient is a 26 year-old male amateur football player from Milan, Italy; (81kg; 185cm; BMI 23.6 kg/m²). He sustained a non-contact anterior cruciate ligament tear to his right knee in June 2021. In September 2021, his right knee ligament was reconstructed using a semitendinosus graft. The injury occurred during a football match on natural grass with typical shoes on a warm day (32 degrees celsius). Playing as a defender he sustained the injury during a change of direction, where the foot was fixated on the grass. He felt pain and was unable to continue playing the match. The surgeon approved his rehabilitation to begin two weeks post-operative. The initial physiotherapist assessment determined performing two training sessions per day within the first three months. In the first three weeks, the pain was 4/10 on Numerical Rating Scale (NRS), no swelling, a range of motion was 0-110°, with difficulty fully extending his knee and minimal quadriceps activation. Crutches were discontinued at four weeks with improved walking. Active exercise, electrostimulator, physical therapy, massages, osteopathy, and passive motion were initiated. At week 6, he completed his first functional movement screen; the score was 16/21 with no pain and no swelling. At week 8, the isokinetic test showed a 23% differential deficit between the two legs in maximum strength (at 90°/s). At week 10, he improved to 15% of injury-induced deficit which suggested he was ready to start running. At week 12, the athlete sustained his first threshold test. At week 16, he performed his first return to sports movement assessment, which revealed a 10% stronger difference between the legs. At week 16, he had his second threshold test. At week 17, his first on-field test revealed a 5% differential deficit between the two legs in the hop test. At week 18, isokinetic test demonstrates that the uninjured leg was 7% stronger than the recovering leg in maximum strength (at 90°/s). At week 20, his second on-field test revealed a 2% difference in hop test; at week 21, his third isokinetic test demonstrated a difference of 5% in maximum strength (at 90°/s). At week 21, he performed his second return to sports movement assessment which revealed a 2% difference between the limbs. Since it was the end of the championship, the team asked him to partake in the playoffs; moreover the player was very motivated to participate in the playoffs also because he was the captain of the team. Together with the player and the team, we decided to let him play even though we were aware of a heightened risk of injury than what is reported in the literature because of two factors: biological recovery times and the results of the tests we performed. In the decision making process about the athlete’s recovery time, it is important to balance the information available from the literature with the desires of the patient to avoid frustration.

Keywords: ACL, football, rehabilitation, return to play

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Authors: Madina Tynybayeva, Sanya Zhumazhanova, Saltanat Kozhakhmetova, Merey Mussabayeva

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One of the leading indicators of the education quality is the level of students’ educational achievements. The processes of modernization of Kazakhstani education system have predetermined the need to improve the national system by assessing the quality of education. The results of assessment greatly contribute to addressing questions about the current state of the educational system in the country. The monitoring of students’ educational achievements (MEAS) is the systematic measurement of the quality of education for compliance with the state obligatory standard of Kazakhstan. This systematic measurement is independent of educational organizations and approved by the order of the Minister of Education and Scienceof Kazakhstan. The MEAS was conducted in the regions of Kazakhstanfor the first time in 2022 by the National Testing Centre. The measurement does not have legal consequences either for students or for educational organizations. Students’ achievements were measured in three subject areas: reading, mathematics and science literacy. MEAS was held for the first time in April this year, 105 thousand students from 1436 schools of Kazakhstan took part in the testing. The monitoring was accompanied by a survey of students, teachers, and school leaders. The goal is to identify which contextual factors affect learning outcomes. The testing was carried out in a computer format. The test tasks of MEAS are ranked according to the three levels of difficulty: basic, medium, and high. Fourth graders are asked to complete 30 closed-type tasks. The average score of the results is 21 points out of 30, which means 70% of tasks were successfully completed. The total number of test tasks for 9th grade students – 75 questions. The results of ninth graders are comparatively lower, the success rate of completing tasks is 63%. MEAS participants did not reveal a statistically significant gap in results in terms of the language of instruction, territorial status, and type of school. The trend of reducing the gap in these indicators is also noted in the framework of recent international studies conducted across the country, in particular PISA for schools in Kazakhstan. However, there is a regional gap in MOES performance. The difference in the values of the indicators of the highest and lowest scores of the regions was 11% of the success of completing tasks in the 4th grade, 14% in the 9thgrade. The results of the 4th grade students in reading, mathematics, and science literacy are: 71.5%, 70%, and 66.9%, respectively. The results of ninth-graders in reading, mathematics, and science literacy are 69.6%, 54%, and 60.8%, respectively. From the surveys, it was revealed that the educational achievements of students are considerably influenced by such factors as the subject competences of teachers, as well as the school climate and motivation of students. Thus, the results of MEAS indicate the need for an integrated approach to improving the quality of education. In particular, the combination of improving the content of curricula and textbooks, internal and external assessment of the educational achievements of students, educational programs of pedagogical specialties, and advanced training courses is required.

Keywords: assessment, secondary school, monitoring, functional literacy, kazakhstan

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Authors: Dibyendu Rakshit, Santosh K. Sarkar

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The study illustrates a comprehensive account of large-scale changes plankton community structure in relevance to water quality characteristics due to anthropogenic stresses, mainly concerned for Annual Gangasagar Festival (AGF) at the southern tip of Sagar Island of Indian Sundarban wetland for 3-year duration (2012-2014; n=36). This prograding, vulnerable and tide-dominated megadelta has been formed in the estuarine phase of the Hooghly Estuary infested by largest continuous tract of luxurious mangrove forest, enriched with high native flora and fauna. The sampling strategy was designed to characterize the changes in plankton community and water quality considering three diverse phases, namely during festival period (January) and its pre - (December) as well as post (February) events. Surface water samples were collected for estimation of different environmental variables as well as for phytoplankton and microzooplankton biodiversity measurement. The preservation and identification techniques of both biotic and abiotic parameters were carried out by standard chemical and biological methods. The intensive human activities lead to sharp ecological changes in the context of poor water quality index (WQI) due to high turbidity (14.02±2.34 NTU) coupled with low chlorophyll a (1.02±0.21 mg m-3) and dissolved oxygen (3.94±1.1 mg l-1), comparing to pre- and post-festival periods. Sharp reduction in abundance (4140 to 2997 cells l-1) and diversity (H′=2.72 to 1.33) of phytoplankton and microzooplankton tintinnids (450 to 328 ind l-1; H′=4.31 to 2.21) was very much pronounced. The small size tintinnid (average lorica length=29.4 µm; average LOD=10.5 µm) composed of Tintinnopsis minuta, T. lobiancoi, T. nucula, T. gracilis are predominant and reached some of the greatest abundances during the festival period. Results of ANOVA revealed a significant variation in different festival periods with phytoplankton (F= 1.77; p=0.006) and tintinnid abundance (F= 2.41; P=0.022). RELATE analyses revealed a significant correlation between the variations of planktonic communities with the environmental data (R= 0.107; p= 0.005). Three distinct groups were delineated from principal component analysis, in which a set of hydrological parameters acted as the causative factor(s) for maintaining diversity and distribution of the planktonic organisms. The pronounced adverse impact of anthropogenic stresses on plankton community could lead to environmental deterioration, disrupting the productivity of benthic and pelagic ecosystems as well as fishery potentialities which directly related to livelihood services. The festival can be considered as multiple drivers of changes in relevance to beach erosion, shoreline changes, pollution from discarded plastic and electronic wastes and destruction of natural habitats resulting loss of biodiversity. In addition, deterioration in water quality was also evident from immersion of idols, causing detrimental effects on aquatic biota. The authors strongly recommend for adopting integrated scientific and administrative strategies for resilience, sustainability and conservation of this megadelta.

Keywords: Gangasagar festival, phytoplankton, Sundarban megadelta, tintinnid

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Authors: Naresh Kumar, Savita Kumari, Naresh Kochhar

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The objective of the study was to assess the role of mineralogy and subsurface structure on water quality of Tosham, Malani Igneous Suite (MIS), Western Rajasthan, India. MIS is the largest (55,000 km2) A-type, anorogenic and high heat producing acid magmatism in the peninsular India and owes its origin to hot spot tectonics. Apart from agricultural and industrial wastes, geogenic activities cause fluctuations in quality parameters of water resources. Twenty water samples (20) selected from Tosham and surrounding areas were analyzed for As, Pb, B, Al, Zn, Fe, Ni using Inductive coupled plasma emission and F by Ion Chromatography. The concentration of As, Pb, B, Ni and F was above the stipulated level specified by BIS (Bureau of Indian Standards IS-10500, 2012). The concentration of As and Pb in surrounding areas of Tosham ranged from 1.2 to 4.1 mg/l and from 0.59 to 0.9 mg/l respectively which is higher than limits of 0.05mg/l (As) and 0.01 mg/l (Pb). Excess trace metal accumulation in water is toxic to humans and adversely affects the central nervous system, kidneys, gastrointestinal tract, skin and cause mental confusion. Groundwater quality is defined by nature of rock formation, mineral water reaction, physiography, soils, environment, recharge and discharge conditions of the area. Fluoride content in groundwater is due to the solubility of fluoride-bearing minerals like fluorite, cryolite, topaz, and mica, etc. Tosham is comprised of quartz mica schist, quartzite, schorl, tuff, quartz porphyry and associated granites, thus, fluoride is leached out and dissolved in groundwater. In the study area, Ni concentration ranged from 0.07 to 0.5 mg/l (permissible limit 0.02 mg/l). The primary source of nickel in drinking water is leached out nickel from ore-bearing rocks. Higher concentration of As is found in some igneous rocks specifically containing minerals as arsenopyrite (AsFeS), realgar (AsS) and orpiment (As2S3). MIS consists of granite (hypersolvus and subsolvus), rhyolite, dacite, trachyte, andesite, pyroclasts, basalt, gabbro and dolerite which increased the trace elements concentration in groundwater. Nakora, a part of MIS rocks has high concentration of trace and rare earth elements (Ni, Rb, Pb, Sr, Y, Zr, Th, U, La, Ce, Nd, Eu and Yb) which percolates the Ni and Pb to groundwater by weathering, contacts and joints/fractures in rocks. Additionally, geological setting of MIS also causes dissolution of trace elements in water resources beneath the surface. NE–SW tectonic lineament, radial pattern of dykes and volcanic vent at Nakora created a way for leaching of these elements to groundwater. Rain water quality might be altered by major minerals constituents of host Tosham rocks during its percolation through the rock fracture, joints before becoming the integral part of groundwater aquifer. The weathering process like hydration, hydrolysis and solution might be the cause of change in water chemistry of particular area. These studies suggest that geological relation of soil-water horizon with MIS rocks via mineralogical variations, structures and tectonic setting affects the water quality of the studied area.

Keywords: geochemistry, groundwater, malani igneous suite, tosham

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Authors: Liam Fassam, Pouria Liravi, Jacquie Bridgman

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Introduction: The way we travel is rapidly changing, car ownership and use are declining among young people and those residents in urban areas. Also, the increasing role and popularity of sharing economy companies like Uber highlight a movement towards consuming transportation solutions as a service [Mobility of a Service]. This research looks to bridge the knowledge gap that exists between city mobility, smart cities, sharing economy and social entrepreneurship business models. Understanding of this subject is crucial for smart city design, as access to affordable transport has been identified as a contributing factor to social isolation leading to issues around health and wellbeing. Methodology: To explore the current fit vis-a-vis transportation business models and social impact this research undertook a comparative analysis between a systematic literature review and a Delphi study. The systematic literature review was undertaken to gain an appreciation of the current academic thinking on ‘social entrepreneurship and smart city mobility’. The second phase of the research initiated a Delphi study across a group of 22 participants to review future opinion on ‘how social entrepreneurship can assist city mobility sharing models?’. The Delphi delivered an initial 220 results, which once cross-checked for duplication resulted in 130. These 130 answers were sent back to participants to score importance against a 5-point LIKERT scale, enabling a top 10 listing of areas for shared user transports in society to be gleaned. One further round (4) identified no change in the coefficient of variant thus no further rounds were required. Findings: Initial results of the literature review returned 1,021 journals using the search criteria ‘social entrepreneurship and smart city mobility’. Filtering allied to ‘peer review’, ‘date’, ‘region’ and ‘Chartered associated of business school’ ranking proffered a resultant journal list of 75. Of these, 58 focused on smart city design, 9 on social enterprise in cityscapes, 6 relating to smart city network design and 3 on social impact, with no journals purporting the need for social entrepreneurship to be allied to city mobility. The future inclusion factors from the Delphi expert panel indicated that smart cities needed to include shared economy models in their strategies. Furthermore, social isolation born by costs of infrastructure needed addressing through holistic A-political social enterprise models, and a better understanding of social benefit measurement is needed. Conclusion: In investigating the collaboration between key public transportation stakeholders, a theoretical model of social enterprise transportation models that positively impact upon the smart city needs of reduced transport poverty and social isolation was formed. As such, the research has identified how a revised business model of Mobility of a Service allied to a social entrepreneurship can deliver impactful measured social benefits associated to smart city design existent research.

Keywords: social enterprise, collaborative transportation, new models of ownership, transport social impact

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Authors: Kaori Narita, Juan de Dios Tena Horrillo, Claudio Detotto

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Decisions on replacement of leaders are of significance and high prevalence in any organization, and concerns many of its stakeholders, whether it is a leader in a political party or a CEO of a firm, as indicated by high media coverage of such events. This merits an investigation into the consequences and implications of a leadership change on the performances and behavior of organizations and their workers. Sport economics provides a fruitful field to explore these issues due to the high frequencies of managerial changes in professional sports clubs and the transparency and regularity of observations of team performance and players’ abilities. Much of the existing research on managerial change focuses on how this affects the performance of an organization. However, there is scarcely attention paid to the consequences of such events on the behavior of individuals within the organization. Changes in behavior and attitudes of a group of workers due to a managerial change could be of great interest in management science, psychology, and operational research. On the other hand, these changes cannot be observed in the final outcome of the organization, as this is affected by many other unobserved shocks, for example, the stress level of workers with the need to deal with a difficult situation. To fill this gap, this study shows the first attempt to evaluate the impact of managerial change on players’ behaviors such as attack intensity, aggressiveness, and efforts. The data used in this study is from the top tier Italian football league (“Serie A”), where an average of 13 within season replacements of head coaches were observed over the period of seasons from 2000/2001 to 2017/18. The preliminary estimation employs Pooled Ordinary Least Square (POLS) and club-season Fixed Effect (FE) in order to assess the marginal effect of having a new manager on the number of shots, corners and red/yellow cards after controlling for a home-field advantage, ex ante abilities and current positions in the league of a team and their opponent. The results from this preliminary estimation suggest that the teams do not show a significant difference in their behaviors before and after the managerial change. To build on these preliminary results, other methods, including propensity score matching and non-linear model estimates, will be used. Moreover, the study will further investigate these issues by considering other measurements of attack intensity, aggressiveness, and efforts, such as possessions, a number of fouls and the athletic performance of players, respectively. Finally, the study is going to investigate whether these results vary over the characteristics of a new head coach, for example, their age and experience as a manager and a player. Thus far, this study suggests that certain behaviours of individuals in an organisation are not immediately affected by a change in leadership. To confirm this preliminary finding and lead to a more solid conclusion, further investigation will be conducted in the aforementioned manner, and the results will be elaborated in the conference.

Keywords: behaviour, effort, manager characteristics, managerial change, sport economics

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Authors: Ionut Vintu, Stefan Laible, Ruth Schulz

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Agricultural robotics has been developing steadily over recent years, with the goal of reducing and even eliminating pesticides used in crops and to increase productivity by taking over human labor. The majority of crops are arranged in rows. The first step towards autonomous robots, capable of driving in fields and performing crop-handling tasks, is for robots to robustly detect the rows of plants. Recent work done towards autonomous driving between plant rows offers big robotic platforms equipped with various expensive sensors as a solution to this problem. These platforms need to be driven over the rows of plants. This approach lacks flexibility and scalability when it comes to the height of plants or distance between rows. This paper proposes instead an algorithm that makes use of cheaper sensors and has a higher variability. The main application is in tree nurseries. Here, plant height can range from a few centimeters to a few meters. Moreover, trees are often removed, leading to gaps within the plant rows. The core idea is to combine row detection algorithms with graph-based localization methods as they are used in SLAM. Nodes in the graph represent the estimated pose of the robot, and the edges embed constraints between these poses or between the robot and certain landmarks. This setup aims to improve individual plant detection and deal with exception handling, like row gaps, which are falsely detected as an end of rows. Four methods were developed for detecting row structures in the fields, all using a point cloud acquired with a 3D LiDAR as an input. Comparing the field coverage and number of damaged plants, the method that uses a local map around the robot proved to perform the best, with 68% covered rows and 25% damaged plants. This method is further used and combined with a graph-based localization algorithm, which uses the local map features to estimate the robot’s position inside the greater field. Testing the upgraded algorithm in a variety of simulated fields shows that the additional information obtained from localization provides a boost in performance over methods that rely purely on perception to navigate. The final algorithm achieved a row coverage of 80% and an accuracy of 27% damaged plants. Future work would focus on achieving a perfect score of 100% covered rows and 0% damaged plants. The main challenges that the algorithm needs to overcome are fields where the height of the plants is too small for the plants to be detected and fields where it is hard to distinguish between individual plants when they are overlapping. The method was also tested on a real robot in a small field with artificial plants. The tests were performed using a small robot platform equipped with wheel encoders, an IMU and an FX10 3D LiDAR. Over ten runs, the system achieved 100% coverage and 0% damaged plants. The framework built within the scope of this work can be further used to integrate data from additional sensors, with the goal of achieving even better results.

Keywords: 3D LiDAR, agricultural robots, graph-based localization, row detection

Procedia PDF Downloads 106

Authors: Qianxi Lv, Junying Liang

Abstract:

Among the various modes of interpreting, simultaneous interpreting (SI) is regarded as a ‘complex’ and ‘extreme condition’ of cognitive tasks while consecutive interpreters (CI) do not have to share processing capacity between tasks. Given that SI exerts great cognitive demand, it makes sense to posit that the output of SI may be more compromised than that of CI in the linguistic features. The bulk of the research has stressed the varying cognitive demand and processes involved in different modes of interpreting; however, related empirical research is sparse. In keeping with our interest in investigating the quantitative linguistic factors discriminating between SI and CI, the current study seeks to examine the potential lexical simplification, syntactic complexity and sequential organization mechanism with a self-made inter-model corpus of transcribed simultaneous and consecutive interpretation, translated speech and original speech texts with a total running word of 321960. The lexical features are extracted in terms of the lexical density, list head coverage, hapax legomena, and type-token ratio, as well as core vocabulary percentage. Dependency distance, an index for syntactic complexity and reflective of processing demand is employed. Frequency motif is a non-grammatically-bound sequential unit and is also used to visualize the local function distribution of interpreting the output. While SI is generally regarded as multitasking with high cognitive load, our findings evidently show that CI may impose heavier or taxing cognitive resource differently and hence yields more lexically and syntactically simplified output. In addition, the sequential features manifest that SI and CI organize the sequences from the source text in different ways into the output, to minimize the cognitive load respectively. We reasoned the results in the framework that cognitive demand is exerted both on maintaining and coordinating component of Working Memory. On the one hand, the information maintained in CI is inherently larger in volume compared to SI. On the other hand, time constraints directly influence the sentence reformulation process. The temporal pressure from the input in SI makes the interpreters only keep a small chunk of information in the focus of attention. Thus, SI interpreters usually produce the output by largely retaining the source structure so as to relieve the information from the working memory immediately after formulated in the target language. Conversely, CI interpreters receive at least a few sentences before reformulation, when they are more self-paced. CI interpreters may thus tend to retain and generate the information in a way to lessen the demand. In other words, interpreters cope with the high demand in the reformulation phase of CI by generating output with densely distributed function words, more content words of higher frequency values and fewer variations, simpler structures and more frequently used language sequences. We consequently propose a revised effort model based on the result for a better illustration of cognitive demand during both interpreting types.

Keywords: cognitive demand, corpus-based, dependency distance, frequency motif, interpreting types, lexical simplification, sequential units distribution, syntactic complexity

Procedia PDF Downloads 147

Authors: Daniela Stephanie Kuenstle

Abstract:

Complex industries such as banking or insurance experience slow growth in mobile sales. While today’s mobile applications are sophisticated and enable location based and personalized services, consumers prefer online or even face-to-face services to complete complex transactions. A possible reason for this reluctance is that the provided service within transactional mobile applications (apps) does not adequately correspond to users’ needs. Therefore, this paper examines the impact of the user context on mobile service (m-service) in m-commerce. Motivated by the potential which context-sensitive m-services hold for the future, the impact of temporal variations as a dimension of user context, on m-service design is examined. In particular, the research question asks: Does consumer urgency function as a determinant of m-service composition in transactional apps by moderating the relation between m-service type and m-service success? Thus, the aim is to explore the moderating influence of urgency on m-service types, which includes Technology Mediated Service and Technology Generated Service. While mobile applications generally comprise features of both service types, this thesis discusses whether unexpected urgency changes customer preferences for m-service types and how this consequently impacts the overall m-service success, represented by purchase intention, loyalty intention and service quality. An online experiment with a random sample of N=1311 participants was conducted. Participants were divided into four treatment groups varying in m-service types and urgency level. They were exposed to two different urgency scenarios (high/ low) and two different app versions conveying either technology mediated or technology generated service. Subsequently, participants completed a questionnaire to measure the effectiveness of the manipulation as well as the dependent variables. The research model was tested for direct and moderating effects of m-service type and urgency on m-service success. Three two-way analyses of variance confirmed the significance of main effects, but demonstrated no significant moderation of urgency on m-service types. The analysis of the gathered data did not confirm a moderating effect of urgency between m-service type and service success. Yet, the findings propose an additive effects model with the highest purchase and loyalty intention for Technology Generated Service and high urgency, while Technology Mediated Service and low urgency demonstrate the strongest effect for service quality. The results also indicate an antagonistic relation between service quality and purchase intention depending on the level of urgency. Although a confirmation of the significance of this finding is required, it suggests that only service convenience, as one dimension of mobile service quality, delivers conditional value under high urgency. This suggests a curvilinear pattern of service quality in e-commerce. Overall, the paper illustrates the complex interplay of technology, user variables, and service design. With this, it contributes to a finer-grained understanding of the relation between m-service design and situation dependency. Moreover, the importance of delivering situational value with apps depending on user context is emphasized. Finally, the present study raises the demand to continue researching the impact of situational variables on m-service design in order to develop more sophisticated m-services.

Keywords: mobile consumer behavior, mobile service design, mobile service success, self-service technology, situation dependency, user-context sensitivity

Procedia PDF Downloads 249

Authors: Raj Chandran, Saul Datwyler, Jaime Marino, Daniel West, Karla Grasso, Adam Buss, Hina Syed, Zina Al Sahouri, Jennifer Yen, Krista Caudle, Beth McQuiston

Abstract:

The Alinity i TBI test is Therapeutic Goods Administration (TGA) registered and is a panel of in vitro diagnostic chemiluminescent microparticle immunoassays for the measurement of glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) in plasma and serum. The Alinity i TBI performance was evaluated in a multi-center pivotal study to demonstrate the capability to assist in determining the need for a CT scan of the head in adult subjects (age 18+) presenting with suspected mild TBI (traumatic brain injury) with a Glasgow Coma Scale score of 13 to 15. TBI has been recognized as an important cause of death and disability and is a growing public health problem. An estimated 69 million people globally experience a TBI annually1. Blood-based biomarkers such as glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) have shown utility to predict acute traumatic intracranial injury on head CT scans after TBI. A pivotal study using prospectively collected archived (frozen) plasma specimens was conducted to establish the clinical performance of the TBI test on the Alinity i system. The specimens were originally collected in a prospective, multi-center clinical study. Testing of the specimens was performed at three clinical sites in the United States. Performance characteristics such as detection limits, imprecision, linearity, measuring interval, expected values, and interferences were established following Clinical and Laboratory Standards Institute (CLSI) guidance. Of the 1899 mild TBI subjects, 120 had positive head CT scan results; 116 of the 120 specimens had a positive TBI interpretation (Sensitivity 96.7%; 95% CI: 91.7%, 98.7%). Of the 1779 subjects with negative CT scan results, 713 had a negative TBI interpretation (Specificity 40.1%; 95% CI: 37.8, 42.4). The negative predictive value (NPV) of the test was 99.4% (713/717, 95% CI: 98.6%, 99.8%). The analytical measuring interval (AMI) extends from the limit of quantitation (LoQ) to the upper LoQ and is determined by the range that demonstrates acceptable performance for linearity, imprecision, and bias. The AMI is 6.1 to 42,000 pg/mL for GFAP and 26.3 to 25,000 pg/mL for UCH-L1. Overall, within-laboratory imprecision (20 day) ranged from 3.7 to 5.9% CV for GFAP and 3.0 to 6.0% CV for UCH-L1, when including lot and instrument variances. The Alinity i TBI clinical performance results demonstrated high sensitivity and high NPV, supporting the utility to assist in determining the need for a head CT scan in subjects presenting to the emergency department with suspected mild TBI. The GFAP and UCH-L1 assays show robust analytical performance across a broad concentration range of GFAP and UCH-L1 and may serve as a valuable tool to help evaluate TBI patients across the spectrum of mild to severe injury.

Keywords: biomarker, diagnostic, neurology, TBI

Procedia PDF Downloads 38

Authors: Petrus Louis Nolte

Abstract:

University sport in South Africa is not isolated from the complexity of globalization and professionalization of sport, as it forms an integral part of the sport development environment in South Africa. In order to align their sport programmes with global and professional requirements, several universities opted to develop elite sport programmes; recruit specialized personnel such as coaches, administrators and athletes; provide expert coaching; scientific and medical services; sports testing; fitness, technical and tactical expertise; sport psychological and rehabilitation support; academic guidance and career assistance; and student-athlete accommodation. In addition, universities provide administrative support and high-quality physical resources (training facilities) for the benefit of the overall South African sport system. Although it is not compulsory for universities to develop elite sport programmes to prepare their teams for competitions, elite competitions such as the annual Varsity Sport, University Sport South Africa (USSA) and local club competitions and leagues within university international competitions where universities not only compete but also deliver players for representative national netball teams. The aim of this study is therefore to describe the perceptions of players of the university elite netball programmes they were participating in. This study adopted a descriptive design with a quantitative approach, utilizing a self-structured questionnaire as research technique. As this research formed part of a national research project for NSA with a population of 172 national and provincial netball players, a sample of 92 university netball players from the population was selected. Content validity of the self-structured questionnaire was secured through a test-retest process, with construct validity through a member of the Statistical Consultation Services (STATCON) of the University of Johannesburg that provided feedback on the structural format of the questionnaire. Reliability was measured utilising Cronbach Alpha on p<0.005 level of significance. A reliability score of 0.87 was measured. The research was approved by the Board of Netball South Africa and ethical conduct implemented according to the processes and procedures approved by the Ethics Committees of the Faculty of Health Sciences, University of Johannesburg with clearance number REC-01-30-2019. From the results it is evident that university elite netball programmes are professional, especially with regards to the employment of knowledgeable and competent coaches and technical officials such as team managers and sport sciences staff. These professionals have access to elite training facilities, support staff, and relatively large groups of elite players, all elements of an elite programme that could enhance the national federation’s (Netball South Africa) system. Universities could serve the dual purpose of serving as university netball clubs, as well as providing elite training services and facilities as performance hubs for national players.

Keywords: elite sport programmes, university netball, player experiences, Varsity Sport netball

Procedia PDF Downloads 125

Authors: Brajesh

Abstract:

Introduction: It is generally believed that women's lack power to making decision may restrict their use of modern contraceptives practices. However, few studies have examined the different dimensions of women's empowerment and contraceptive use in Asian content. Pervasive gendered inequities and norms regarding the subordination of women give Asian men disproportionately more power than women, particularly in relation to the sex. We hypothesize that lack of sexual empowerment may pose an important barrier to reproductive health and adoption of family planning methods. Using the Demographic Health Survey, we examine the association between women’s sexual empowerment and contraceptive use in Nepal, Bangladesh and Pakistan. Objectives: To understand the trend and pattern of contraceptive choices and use among women due to sexual empowerment in selected south Asian countries. To examine the association between women’s sexual empowerment and contraceptive practices among non-pregnant married and partnered women in Nepal, Bangladesh and Pakistan. Methods: Data came from the latest round of Demographic and Health Surveys conducted between 2010-12 in and during deacde1990 -92 in Nepal, Bangladesh and Pakistan. Responses from married or cohabiting women aged 15-49 years were analyzed for six dimensions of empowerment and the current use of female-only methods or couple of methods. Bi-variate and multivariate multinomial regressions were used to identify associations between the empowerment dimensions and method use. Results: Positive associations were found between the overall empowerment score and method use in all countries (relative risk ratios, 1.1-1.3). In multivariate analysis, household economic decision-making was associated with the use of either female-only or couple methods (relative risk ratios -1. 1 for all), as was agreement on fertility preferences (RRR-1.3-1.6) and the ability to negotiate sexual activity (RRR -1. 1-1.2). In Bangladesh, women's negative attitudes toward domestic violence were correlated with the use of couple of methods (RRR -1. 1). Increasing levels of sexual empowerment were found to be associated with use of contraceptives, even after adjusting for demographic predictors of contraceptive use. This association is moderated by the wealth. Formal education, increasing wealth, and being in an unmarried partnership are associated with contraceptive use, whereas women who identify as being Muslim are less likely to use contraceptives than those who identify as being Hindus or other. These findings suggest that to achieve universal access to reproductive health services, gendered disparities in sexual empowerment, particularly among economically disadvantaged women, need to be better addressed. Conclusions: Intervention programs aimed at increasing contraceptive use may need to involve different approaches, including promoting couples' discussion of fertility preferences and family planning, improving women's self-efficacy in negotiating sexual activity and increasing their economic independence. Policies are needed to encourage the rural families to give their girls a chance of attending higher level education and professional course so that can get a better job opportunity and can economically support their family as son are expected to do.

Keywords: reproductive and child health (RCH), relative risk ratios (RRR), demographic and health survey (DHS), women’s sexual empowerment (WSE)

Procedia PDF Downloads 230

Authors: Ishan Naidu, Jessica Ryvlin, Devin Videlefsky

Abstract:

Introduction: Back pain is a leading cause of years lived with disability and economic burden, exceeding over $20 billion in healthcare costs not including indirect costs such as absence from work and caregiving. The multifactorial nature of back pain leads to treatment modalities administered by a variety of specialists, which are often disjointed. Multiple studies have found that patients receiving delayed physical therapy for lower back pain had higher medical-related costs from increased health service utilization as well as a reduced improvement in pain severity compared to early management. Uncoordinated health care delivery can exacerbate the physical and economic toll of the chronic condition, thus improvements in interdisciplinary, shared decision-making may improve outcomes. Objective: To assess whether a multidisciplinary spine clinic (MSC), consisting of orthopedic surgery, neurosurgery, pain medicine, and physiatry, alters interventional and non-interventional planning and treatment compared to a traditional unidisciplinary spine clinic (USC) including only orthopedic surgery. Methods: We conducted a retrospective cohort study with patients initially presenting for spine care to orthopedic surgeons between July 1, 2018 to June 30, 2019. Time to treatment recommendation, time to treatment and rates of treatment recommendations were assessed, including physical therapy, injections and surgery. Treatment rates were compared between MSC and USC using Pearson’s chi-square test logistic regression. Time to treatment recommendation and time to treatment were compared using log-rank test and Cox proportional hazard regression. All analyses were repeated for the propensity score (PS) matched subsample. Results: This study included 1,764 patients, with 692 at MSC and 1,072 at USC. Patients in MSC were more likely to be recommended injection when compared to USC (8.5% vs. 5.4%, p=0.01). When adjusted for confounders, the likelihood of injection recommendation remained greater in MSC than USC (Odds ratio [OR]=2.22, 95% CI: (1.39, 3.53), p=0.001). MSC was also associated with a shorter time to receiving injection recommendation versus USC (median: 21 vs. 32 days, log-rank: p<0.001; hazard ratio [HR]=1.90, 95% CI: (1.25, 2.90), p=0.003). MSC was associated with a higher likelihood of injection treatment (OR=2.27, 95% CI: (1.39, 3.73), p=0.001) and shorter lead time (HR=1.98, 95% CI: (1.27, 3.09), p=0.003). PS-matched analyses yielded similar conclusions. Conclusions: Care delivered at a multidisciplinary spine clinic was associated with a higher likelihood of recommending injection and a shorter lead time to injection administration when compared to a traditional unidisciplinary spine surgery clinic. Multidisciplinary clinics may facilitate coordinated care amongst different specialties resulting in increased utilization of less invasive treatment modalities while also improving care efficiency. The multidisciplinary clinic model is an important advancement in care delivery and communication, which can be used as a powerful method of improving patient outcomes as treatment guidelines evolve.

Keywords: coordinated care, epidural steroid injection, multi-disciplinary, non-invasive

Procedia PDF Downloads 109

Authors: Kaaryn M. Cater

Abstract:

Students with sensory processing sensitivity (SPS), Meares-Irlen Syndrome (MIS) and dyslexia can become overwhelmed and struggle to thrive in traditional tertiary learning environments. An estimated 50% of tertiary students who disclose learning related issues are dyslexic. This study explores the relationship between SPS, MIS and dyslexia. Baseline measures will be analysed to establish any correlation between these three minority methods of information processing. SPS is an innate sensitivity trait found in 15-20% of the population and has been identified in over 100 species of animals. Humans with SPS are referred to as Highly Sensitive People (HSP) and the measure of HSP is a 27 point self-test known as the Highly Sensitive Person Scale (HSPS). A 2016 study conducted by the author established base-line data for HSP students in a tertiary institution in New Zealand. The results of the study showed that all participating HSP students believed the knowledge of SPS to be life-changing and useful in managing life and study, in addition, they believed that all tutors and in-coming students should be given information on SPS. MIS is a visual processing and perception disorder that is found in approximately 10% of the population and has a variety of symptoms including visual fatigue, headaches and nausea. One way to ease some of these symptoms is through the use of colored lenses or overlays. Dyslexia is a complex phonological based information processing variation present in approximately 10% of the population. An estimated 50% of dyslexics are thought to have MIS. The study exploring possible correlations between these minority forms of information processing is due to begin in February 2017. An invitation will be extended to all first year students enrolled in degree programmes across all faculties and schools within the institution. An estimated 900 students will be eligible to participate in the study. Participants will be asked to complete a battery of on-line questionnaires including the Highly Sensitive Person Scale, the International Dyslexia Association adult self-assessment and the adapted Irlen indicator. All three scales have been used extensively in literature and have been validated among many populations. All participants whose score on any (or some) of the three questionnaires suggest a minority method of information processing will receive an invitation to meet with a learning advisor, and given access to counselling services if they choose. Meeting with a learning advisor is not mandatory, and some participants may choose not to receive help. Data will be collected using the Question Pro platform and base-line data will be analysed using correlation and regression analysis to identify relationships and predictors between SPS, MIS and dyslexia. This study forms part of a larger three year longitudinal study and participants will be required to complete questionnaires at annual intervals in subsequent years of the study until completion of (or withdrawal from) their degree. At these data collection points, participants will be questioned on any additional support received relating to their minority method(s) of information processing. Data from this study will be available by April 2017.

Keywords: dyslexia, highly sensitive person (HSP), Meares-Irlen Syndrome (MIS), minority forms of information processing, sensory processing sensitivity (SPS)

Procedia PDF Downloads 206

Authors: M. Kazou, A. Gavriil, O. Kalagkatsi, T. Paschos, E. Tsakalidou

Abstract:

Kopanisti cheese is a Greek soft Protected Designation of Origin (PDO) cheese made of raw cow, sheep or goat milk, or mixtures of them, with similar organoleptic characteristics to that of Roquefort cheese. Traditional manufacturing of Kopanisti cheese is limited in small-scale dairies, without the addition of starter cultures. Instead, an amount of over-mature Kopanisti cheese, called Mana Kopanisti, is used to initiate ripening. Therefore, the selection of proper starter cultures and the understanding of the contribution of various microbial groups to its overall quality is crucial for the production of a high-quality final product with standardized organoleptic and physicochemical characteristics. Taking the above into account, the aim of the present study was the investigation of Kopanisti cheese microbiota and its role in cheese quality. For this purpose, four different types of Kopanisti were produced in triplicates, all with pasteurized cow milk, with the addition of (A) the typical mesophilic species Lactococcus lactis and Lactobacillus paracasei used as starters in the production of soft spread cheeses, (B) strains of Lactobacillus acidipiscis and Lactobacillus rennini previously isolated from Kopanisti and Mana Kopanisti, (C) all the species from (A) and (B) as inoculum, and finally (D) the species from (A) and Mana Kopanisti. Physicochemical and microbiological analysis was performed for milk and cheese samples during ripening. Enumeration was performed for major groups of lactic acid bacteria (LAB), total mesophilic bacteria, yeasts as well as hygiene indicator microorganisms. Bacterial isolates from all the different LAB groups, apart from enterococci, alongside yeasts isolates, were initially grouped using repetitive sequence-based polymerase chain reaction (rep-PCR) and then identified at the species level using 16S rRNA gene and internal transcribed spacer (ITS) DNA region sequencing, respectively. Sensory evaluation was also performed for final cheese samples at the end of the ripening period (35 days). Based on the results of the classical microbiological analysis, the average counts of the total mesophilic bacteria and LAB, apart from enterococci, ranged between 7 and 10 log colony forming unit (CFU) g⁻¹, phychrotrophic bacteria, and yeast extract glucose chloramphenicol (YGC) isolates between 4 and 8 log CFU g⁻¹, while coliforms and enterococci up to 2 log CFU g⁻¹ throughout ripening in cheese samples A, C and D. In contrast, in cheese sample B, the average counts of the total mesophilic bacteria and LAB, apart from enterococci, phychrotrophic bacteria, and YGC isolates ranged between 0 and 10 log CFU g⁻¹ and coliforms and enterococci up to 2 log CFU g⁻¹. Although the microbial counts were not that different among samples, identification of the bacterial and yeasts isolates revealed the complex microbial community structure present in each cheese sample. Differences in the physicochemical characteristics among the cheese samples were also observed, with pH ranging from 4.3 to 5.3 and moisture from 49.6 to 58.0 % in the final cheese products. Interestingly, the sensory evaluation also revealed differences among samples, with cheese sample B ranking first based on the total score. Overall, the combination of these analyses highlighted the impact of different starter cultures on the Kopanisti microbiota as well as on the physicochemical and sensory characteristics of the final product.

Keywords: Kopanisti cheese, microbiota, classical microbiological analysis, physicochemical analysis

Procedia PDF Downloads 115

Authors: N. Uaphongsathorn, C. Worawong, S. Thaewpia

Abstract:

Background and significance: The population is aging in Thai society, the elderly dependent is at great risk of various functional, psychological, and socio-economic problems as well as less access to health care. They may require long term care at home to maximize their functional abilities and activities of daily living and to improve their quality of life during their own age. Therefore, there is a need to develop a home-based long term care to meet the long term care needs of elders dependent. Methods: The research purpose was to develop long term care model among the elderly dependent in Chaiyaphum province in Northeast region of Thailand. Action Research which is composing of planning, action, observation, and reflection phases was used. Research was carried out for 12 months in all sub-districts of 6 districts in Chaiyaphum province. Participants (N = 1,010) participating in the processes of model development were comprised of 3 groups: a) a total of 110 health care professionals, b) a total of 600 health volunteers and family caregivers and c) a total of 300 the elderly dependent with chronically medical illnesses or disabilities. Descriptive statistics and content analysis were used to analyze data. Findings: Results have shown that the most common health problems among elders dependent with physical disabilities to function independently were cardiovascular disease, dementia, and traffic injuries. The development of home-based long term care model among elders dependent in Chaiyaphum province was composed of six key steps. They are: a) initiating policies supporting formal and informal caregivers for the elder dependent in all sub-districts, b) building network and multidisciplinary team, c) developing 3-day care manager training program and 3-day care provider training program d) training case managers and care providers for the elderly dependent through team and action learning, e) assessing, planning and providing care based on care individual’s needs of the elderly dependent, and f) sharing experiences for good practice and innovation for long term care at homes in district urban and rural areas. Among all care managers and care providers, the satisfaction level for training programs was high with a mean score of 3.98 out of 5. The elders dependent and family caregivers addressed that long term care at home could contribute to improving life’s daily activities, family relationship, health status, and quality of life. Family caregivers and volunteers have feeling a sense of personal satisfaction and experiencing providing meaningful care and support for elders dependent. Conclusion: In conclusion, a home-based long term care is important to Thai elders dependent. Care managers and care providers play a large role and responsibility to provide appropriate care to meet the elders’ needs in both urban and rural areas in Thai society. Further research could be rigorously studied with a larger group of populations in similar socio-economic and cultural contexts.

Keywords: elderly people, care manager, care provider, long term care

Procedia PDF Downloads 280

Authors: Wim Hollander, Petrus Louis Nolte

Abstract:

University sport in South Africa is not isolated from the complexity of globalization and professionalization of sport, as it forms an integral part of the sports development environment in South Africa. In order to align their sports programs with global and professional requirements, several universities opted to develop elite sports programs; recruit specialized personnel such as coaches, administrators, and athletes; provide expert coaching; scientific and medical services; sports testing; fitness, technical and tactical expertise; sport psychological and rehabilitation support; academic guidance and career assistance; and student-athlete accommodation. In addition, universities provide administrative support and high-quality physical resources (training facilities) for the benefit of the overall South African sport system. Although it is not compulsory for universities to develop elite sports programs to prepare their teams for competitions, elite competitions such as the annual Varsity Sport, University Sport South Africa (USSA) and local club competitions and leagues within international university competitions where universities not only compete but also deliver players for representative national netball teams. The aim of this study is, therefore, to describe the perceptions of players of the university elite netball programs they were participating in. This study adopted a descriptive design with a quantitative approach, utilizing a self-structured questionnaire as a research technique. As this research formed part of a national research project for NSA with a population of 172 national and provincial netball players, a sample of 92 university netball players from the population was selected. Content validity of the self-structured questionnaire was secured through a test-retest process, with construct validity through a member of the Statistical Consultation Services (STATCON) of the University of Johannesburg that provided feedback on the structural format of the questionnaire. Reliability was measured utilizing Cronbach Alpha on p < 0.005 level of significance. A reliability score of 0.87 was measured. The research was approved by the Board of Netball South Africa and ethical conduct implemented according to the processes and procedures approved by the Ethics Committees of the Faculty of Health Sciences, the University of Johannesburg with clearance number REC-01-30-2019. From the results, it is evident that university elite netball programs are professional, especially with regards to the employment of knowledgeable and competent coaches and technical officials such as team managers and sport sciences staff. These professionals have access to elite training facilities, support staff, and relatively large groups of elite players, all elements of an elite program that could enhance the national federation’s (Netball South Africa) system. Universities could serve the dual purpose of serving as university netball clubs, as well as providing elite training services and facilities as performance hubs for national players.

Keywords: elite sport programmes, university netball, player experiences, varsity sport netball

Procedia PDF Downloads 145

Authors: Linara Salikhova, Elmira Nizamova, Aleksandra Katasonova, Gleb Vitkov, Olga Sarapulova.

Abstract:

While most European cities conduct research on heat-related risks, there is a research gap in the Caucasus region, particularly in Yerevan, Armenia. This study aims to test the method of establishing a correlation between urban heat islands (UHI) and urban greenery distribution for prioritization of heat-vulnerable areas for revegetation. Armenia has failed to consider measures to mitigate UHI in urban development strategies despite a 2.1°C increase in average annual temperature over the past 32 years. However, planting vegetation in the city is commonly used to deal with air pollution and can be effective in reducing UHI if it prioritizes heat-vulnerable areas. The research focuses on establishing such priorities while considering the distribution of urban greenery across the city. The lack of spatially explicit air temperature data necessitated the use of satellite images to achieve the following objectives: (1) identification of land surface temperatures (LST) and quantification of temperature variations across districts; (2) classification of massifs of land surface types using normalized difference vegetation index (NDVI); (3) correlation of land surface classes with LST. Examination of the heat-vulnerable city areas (in this study, the proportion of individuals aged 75 years and above) is based on demographic data (Census 2011). Based on satellite images (Sentinel-2) captured on June 5, 2021, NDVI calculations were conducted. The massifs of the land surface were divided into five surface classes. Due to capacity limitations, the average LST for each district was identified using one satellite image from Landsat-8 on August 15, 2021. In this research, local relief is not considered, as the study mainly focuses on the interconnection between temperatures and green massifs. The average temperature in the city is 3.8°C higher than in the surrounding non-urban areas. The temperature excess ranges from a low in Norq Marash to a high in Nubarashen. Norq Marash and Avan have the highest tree and grass coverage proportions, with 56.2% and 54.5%, respectively. In other districts, the balance of wastelands and buildings is three times higher than the grass and trees, ranging from 49.8% in Quanaqer-Zeytun to 76.6% in Nubarashen. Studies have shown that decreased tree and grass coverage within a district correlates with a higher temperature increase. The temperature excess is highest in Erebuni, Ajapnyak, and Nubarashen districts. These districts have less than 25% of their area covered with grass and trees. On the other hand, Avan and Norq Marash districts have a lower temperature difference, as more than 50% of their areas are covered with trees and grass. According to the findings, a significant proportion of the elderly population (35%) aged 75 years and above reside in the Erebuni, Ajapnyak, and Shengavit neighborhoods, which are more susceptible to heat stress with an LST higher than in other city districts. The findings suggest that the method of comparing the distribution of green massifs and LST can contribute to the prioritization of heat-vulnerable city areas for revegetation. The method can become a rationale for the formation of an urban greening program.

Keywords: heat-vulnerability, land surface temperature, urban greenery, urban heat island, vegetation

Procedia PDF Downloads 43

Authors: Zahide Tepeli Temiz, Itir Tari Comert

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Attachment patterns based on early emotional interactions between infant and primary caregiver continue to be influential in adult life, in terms of mental health and behaviors of individuals. Several studies reveal that infant-caregiver relationships have impressed the affect regulation, coping with stressful and negative situations, general satisfaction of life, and self image in adulthood, besides the attachment styles. The present study aims to examine the relationships between university students’ attachment style and their self-esteem, alexithymic features, satisfaction of life, and level of resilience. In line with this aim, the hypothesis of the prediction of attachment styles (anxious and avoidant) over life satisfaction, self-esteem, alexithymia, and psychological resilience was tested. Additionally, in this study Structural Equational Modeling was conducted to investigate the mediational role of self-esteem in the relationship between attachment styles and alexithymia, life satisfaction, and resilience. This model was examined with path analysis. The sample of the research consists of 425 university students who take education from several region of Turkey. The participants who sign the informed consent completed the Demographic Information Form, Experiences in Close Relationships-Revised, Rosenberg Self-Esteem Scale, The Satisfaction with Life Scale, Toronto Alexithymia Scale, and Resilience Scale for Adults. According to results, anxious, and avoidant dimensions of insecure attachment predicted the self-esteem score and alexithymia in positive direction. On the other hand, these dimensions of attachment predicted life satisfaction in negative direction. The results of linear regression analysis indicated that anxious and avoidant attachment styles didn’t predict the resilience. This result doesn’t support the theory and research indicating the relationship between attachment style and psychological resilience. The results of path analysis revealed the mediational role self esteem in the relation between anxious, and avoidant attachment styles and life satisfaction. In addition, SEM analysis indicated the indirect effect of attachment styles over alexithymia and resilience besides their direct effect. These findings support the hypothesis of this research relation to mediating role of self-esteem. Attachment theorists suggest that early attachment experiences, including supportive and responsive family interactions, have an effect on resilience to harmful situations in adult life, ability to identify, describe, and regulate emotions and also general satisfaction with life. Several studies examining the relationship between attachment styles and life satisfaction, alexithymia, and psychological resilience draw attention to mediational role of self-esteem. Results of this study support the theory of attachment patterns with the mediation of self-image influence the emotional, cognitive, and behavioral regulation of person throughout the adulthood. Therefore, it is thought that any intervention intended for recovery in attachment relationship will increase the self-esteem, life satisfaction, and resilience level, on the one side, decrease the alexithymic features, on the other side.

Keywords: alexithymia, anxious attachment, avoidant attachment, life satisfaction, path analysis, resilience, self-esteem, structural equation

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Authors: Juanita Wallace, Mark Jackson, Bethany Jurs

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Introduction: Exergames, VR games used as a form of exercise, are being used to reduce sedentary lifestyles in a vast number of populations. However, there is a distinct lack of research comparing the physiological response during VR exergaming to that of traditional exercises. The purpose of this study was to create a foundationary investigation establishing changes in physiological responses resulting from VR exergaming in a college aged population. Methods: In this IRB approved study, college aged students were recruited to play a virtual reality exergame (Beat Saber) on the Oculus Quest 2 (Facebook, 2021) in either a control group (CG) or training group (TG). Both groups consisted of subjects who were not habitual users of virtual reality. The CG played VR one time per week for three weeks and the TG played 150 min/week three weeks. Each group played the same nine Beat Saber songs, in a randomized order, during 30 minute sessions. Song difficulty was increased during play based on song performance. Subjects completed a pre- and posttests at which the following was collected: • Beat Saber Game Metrics: song level played, song score, number of beats completed per song and accuracy (beats completed/total beats) • Physiological Data: heart rate (max and avg.), active calories • Demographics Results: A total of 20 subjects completed the study; nine in the CG (3 males, 6 females) and 11 (5 males, 6 females) in the TG. • Beat Saber Song Metrics: The TG improved performance from a normal/hard difficulty to hard/expert. The CG stayed at the normal/hard difficulty. At the pretest there was no difference in game accuracy between groups. However, at the posttest the CG had a higher accuracy. • Physiological Data (Table 1): Average heart rates were similar between the TG and CG at both the pre- and posttest. However, the TG expended more total calories. Discussion: Due to the lack of peer reviewed literature on c exergaming using Beat Saber, the results of this study cannot be directly compared. However, the results of this study can be compared with the previously established trends for traditional exercise. In traditional exercise, an increase in training volume equates to increased efficiency at the activity. The TG should naturally increase in difficulty at a faster rate than the CG because they played 150 hours per week. Heart rate and caloric responses also increase during traditional exercise as load increases (i.e. speed or resistance). The TG reported an increase in total calories due to a higher difficulty of play. The song accuracy decreases in the TG can be explained by the increased difficulty of play. Conclusion: VR exergaming is comparable to traditional exercise for loads within the 50-70% of maximum heart rate. The ability to use VR for health could motivate individuals who do not engage in traditional exercise. In addition, individuals in health professions can and should promote VR exergaming as a viable way to increase physical activity and improve health in their clients/patients.

Keywords: virtual reality, exergaming, health, heart rate, wellness

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Authors: Samuel McLennan, Tane Moleta, Andre Brown, Marc Aurel Schnabel

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The development of Ecclesiastical buildings within New Zealand has produced some unique design characteristics that take influence from both international styles and local building methods. What this research looks at is how procedural modelling can be used to define such common characteristics and understand how they are shared and developed within different examples of a similar architectural style. This will be achieved through the creation of procedural digital reconstructions of the various timber Gothic Churches built during the 19th century in the city of Wellington, New Zealand. ‘Procedural modelling’ is a digital modelling technique that has been growing in popularity, particularly within the game and film industry, as well as other fields such as industrial design and architecture. Such a design method entails the creation of a parametric ‘ruleset’ that can be easily adjusted to produce many variations of geometry, rather than a single geometry as is typically found in traditional CAD software. Key precedents within this area of digital heritage includes work by Haegler, Müller, and Gool, Nicholas Webb and Andre Brown, and most notably Mark Burry. What these precedents all share is how the forms of the reconstructed architecture have been generated using computational rules and an understanding of the architects’ geometric reasoning. This is also true within this research as Gothic architecture makes use of only a select range of forms (such as the pointed arch) that can be accurately replicated using the same standard geometric techniques originally used by the architect. The methodology of this research involves firstly establishing a sample group of similar buildings, documenting the existing samples, researching any lost samples to find evidence such as architectural plans, photos, and written descriptions, and then culminating all the findings into a single 3D procedural asset within the software ‘Houdini’. The end result will be an adjustable digital model that contains all the architectural components of the sample group, such as the various naves, buttresses, and windows. These components can then be selected and arranged to create visualisations of the sample group. Because timber gothic churches in New Zealand share many details between designs, the created collection of architectural components can also be used to approximate similar designs not included in the sample group, such as designs found beyond the Wellington Region. This creates an initial library of architectural components that can be further expanded on to encapsulate as wide of a sample size as desired. Such a methodology greatly improves upon the efficiency and adjustability of digital modelling compared to current practices found in digital heritage reconstruction. It also gives greater accuracy to speculative design, as a lack of evidence for lost structures can be approximated using components from still existing or better-documented examples. This research will also bring attention to the cultural significance these types of buildings have within the local area, addressing the public’s general unawareness of architectural history that is identified in the Wellington based research ‘Moving Images in Digital Heritage’ by Serdar Aydin et al.

Keywords: digital forensics, digital heritage, gothic architecture, Houdini, procedural modelling

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Authors: Paola Clerici Maestosi

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Positive Energy District (PED) is a rather recent concept whose aim is to contribute to the main objectives of the Energy Union strategy. It is based on an integrated multi-sectoral approach in response to Europe's most complex challenges. PED integrates energy efficiency, renewable energy production, and energy flexibility in an integrated, multi-sectoral approach at the city level. The core idea behind Positive Energy Districts (PEDs) is to establish an urban area that can generate more energy than it consumes. Additionally, it should be flexible enough to adapt to changes in the energy market. This is crucial because a PED's goal is not just to achieve an annual surplus of net energy but also to help reduce the impact on the interconnected centralized energy networks. It achieves this by providing options to increase on-site load matching and self-consumption, employing technologies for short- and long-term energy storage, and offering energy flexibility through smart control. Thus, it seems that PEDs can encompass all types of buildings in the city environment. Given this which is the added value of having green buildings being constitutive part of PEDS? The paper will present a systematic literature review identifying the role of green building in Positive Energy District to provide answer to following questions: (RQ1) the state of the art of PEDs implementation; (RQ2) penetration of green building in Positive Energy District selected case studies. Methodological approach is based on a broad holistic study of bibliographic sources according to Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) further data will be analysed, mapped and text mining through VOSviewer. Main contribution of research is a cognitive framework on Positive Energy District in Europe and a selection of case studies where green building supported the transition to PED. The inclusion of green buildings within Positive Energy Districts (PEDs) adds significant value for several reasons. Firstly, green buildings are designed and constructed with a focus on environmental sustainability, incorporating energy-efficient technologies, materials, and design principles. As integral components of PEDs, these structures contribute directly to the district's overall ability to generate more energy than it consumes. Secondly, green buildings typically incorporate renewable energy sources, such as solar panels or wind turbines, further boosting the district's capacity for energy generation. This aligns with the PED objective of achieving a surplus of net energy. Moreover, green buildings often feature advanced systems for on-site energy management, load-matching, and self-consumption. This enhances the PED's capability to respond to variations in the energy market, making the district more agile and flexible in optimizing energy use. Additionally, the environmental considerations embedded in green buildings align with the broader sustainability goals of PEDs. By reducing the ecological footprint of individual structures, PEDs with green buildings contribute to minimizing the overall impact on centralized energy networks and promote a more sustainable urban environment. In summary, the incorporation of green buildings within PEDs not only aligns with the district's energy objectives but also enhances environmental sustainability, energy efficiency, and the overall resilience of the urban environment.

Keywords: positive energy district, renewables energy production, energy flexibility, energy efficiency

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Authors: Areej Al-Khabbaz, Swapna Goerge, Majedah Abdul-Rasoul

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Introduction: The most prevalent periodontal disease among children is gingivitis, and it usually becomes more severe in adolescence. A number of intervention studies suggested that resolution of periodontal inflammation can improve metabolic control in patients diagnosed with diabetes mellitus. Aim: to assess the effect of non-surgical periodontal therapy on glycemic control of children diagnosed with diabetes mellitus. Method: Twenty-eight children diagnosed with diabetes mellitus were recruited with established diagnosis diabetes for at least 1 year. Informed consent and child assent form were obtained from children and parents prior to enrolment. The dental examination for the participants was performed on the same week directly following their annual medical assessment. All patients had their glycosylated hemoglobin (HbA1c%) test one week prior to their annual medical and dental visit and 3 months following non-surgical periodontal therapy. All patients received a comprehensive periodontal examination The periodontal assessment included clinical attachment loss, bleeding on probing, plaque score, plaque index and gingival index. All patients were referred for non-surgical periodontal therapy, which included oral hygiene instruction and motivation followed by supra-gingival and subg-ingival scaling using ultrasonic and hand instruments. Statistical Analysis: Data were entered and analyzed using the Statistical Package for Social Science software (SPSS, Chicago, USA), version 18. Statistical analysis of clinical findings was performed to detect differences between the two groups in term of periodontal findings and HbA1c%. Binary logistic regression analysis was performed in order to examine which factors were significant in multivariate analysis after adjusting for confounding between effects. The regression model used the dependent variable ‘Improved glycemic control’, and the independent variables entered in the model were plaque index, gingival index, bleeding %, plaque Statistical significance was set at p < 0.05. Result: A total of 28 children. The mean age of the participants was 13.3±1.92 years. The study participants were divided into two groups; Compliant group (received dental scaling) and non-complaints group (received oral hygiene instructions only). No statistical difference was found between compliant and non-compliant group in age, gender distribution, oral hygiene practice and the level of diabetes control. There was a significant difference between compliant and non-compliant group in term of improvement of HBa1c before and after periodontal therapy. Mean gingival index was the only significant variable associated with improved glycemic control level. In conclusion, this study has demonstrated that non-surgical mechanical periodontal therapy can improve HbA1c% control. The result of this study confirmed that children with diabetes mellitus who are compliant to dental care and have routine professional scaling may have better metabolic control compared to diabetic children who are erratic with dental care.

Keywords: children, diabetes, metabolic control, periodontal therapy

Procedia PDF Downloads 132

Authors: Yuguang Gao, Mingtao Deng

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The integration of independently operating hospitals into a unified healthcare service system has become a strategic imperative in the pursuit of hospitals’ high-quality development. Central to the concept of group governance over such transformation, exemplified by a collaborative medical alliance, is the delineation of shared value, vision, and goals. Given the inherent disparity in capabilities among hospitals within the alliance, particularly in the treatment of different diseases characterized by Disease Related Groups (DRG) in terms of effectiveness, efficiency and resource utilization, this study aims to address the centralized decision-making of intra-hospital patient referral within the medical alliance to enhance the overall production and quality of service provided. We first introduce the notion of production utility, where a higher production utility for a hospital implies better performance in treating patients diagnosed with that specific DRG group of diseases. Then, a Discrete-Event Simulation (DES) framework is established for patient referral among hospitals, where patient flow modeling incorporates a queueing system with fixed capacities for each hospital. The simulation study begins with a two-member alliance. The pivotal strategy examined is a "whether-to-refer" decision triggered when the bed usage rate surpasses a predefined threshold for either hospital. Then, the decision encompasses referring patients to the other hospital based on DRG groups’ production utility differentials as well as bed availability. The objective is to maximize the total production utility of the alliance while minimizing patients’ average length of stay and turnover rate. Thus the parameter under scrutiny is the bed usage rate threshold, influencing the efficacy of the referral strategy. Extending the study to a three-member alliance, which could readily be generalized to multi-member alliances, we maintain the core setup while introducing an additional “which-to-refer" decision that involves referring patients with specific DRG groups to the member hospital according to their respective production utility rankings. The overarching goal remains consistent, for which the bed usage rate threshold is once again a focal point for analysis. For the two-member alliance scenario, our simulation results indicate that the optimal bed usage rate threshold hinges on the discrepancy in the number of beds between member hospitals, the distribution of DRG groups among incoming patients, and variations in production utilities across hospitals. Transitioning to the three-member alliance, we observe similar dependencies on these parameters. Additionally, it becomes evident that an imbalanced distribution of DRG diagnoses and further disparity in production utilities among member hospitals may lead to an increase in the turnover rate. In general, it was found that the intra-hospital referral mechanism enhances the overall production utility of the medical alliance compared to individual hospitals without partnership. Patients’ average length of stay is also reduced, showcasing the positive impact of the collaborative approach. However, the turnover rate exhibits variability based on parameter setups, particularly when patients are redirected within the alliance. In conclusion, the re-structuring of diagnostic disease groups within the medical alliance proves instrumental in improving overall healthcare service outcomes, providing a compelling rationale for the government's promotion of patient referrals within collaborative medical alliances.

Keywords: collaborative medical alliance, disease related group, patient referral, simulation

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