Search results for: US index options

Authors: Lobna Ahmed Galal

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Modal integration has given minimal consideration in cities of developing countries, as well as the declining dominance of public transport, and predominance of informal transport, the modal share of informal taxis in greater Cairo has increased from 6% in 1987 to 37% in 2001 and this has since risen even higher, informal and non-motorized modes of transport acting as a gap filler by feeding other modes of transport, not by design or choice, but often by lack of accessible and affordable public transport. Yet non-motorized transport is peripheral, with minimal priority in urban planning and investments, lacking of strong polices to support non-motorized transport, for authorities development is associated with technology and motorized transport, and promotion of non-motorized transport may be considered corresponding to development, as well as social stigma against non-motorized transport, as it is seen a travel mode for the poor. Cairo as a city of a developing country, has poor quality infrastructure for non-motorized transport, suffering from absence of dedicated corridors, and when existing they are often encroached for commercial purposes, widening traffic lanes at the expense of sidewalks, absence of footpaths, or being overcrowded, poor lighting, making walking unsafe and yet, lack of financial supply to such facilities as it is often considered beyond city capabilities. This paper will deal with the objective measuring of the built environment relating to walking, in some neighborhoods of new cities around Cairo, In addition to comparing the results of the objective measures of the built environment with the level of self-reported survey. The first paper's objective is to show how the index ‘walkability of community neighborhoods’ works in the contexts in neighborhoods of new cities around Cairo. The procedure of objective measuring is of a high potential to be carried out by using GIS.

Keywords: assessing, built environment, Cairo, walkability

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Authors: Keiko Naito, Y. Nakashima, S. Yamauchi, Y. Kunitani, Y. Ishigami, K. Numata, M. Mizobe, Y. Homma, J. Takahashi, T. Inoue, T. Shiga, H. Funakoshi

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Background: A presence of severe acidemia, defined as pH < 7.2, is common during endotracheal intubation for critically ill patients in the emergency department (ED). Severe acidemia is widely recognized as a predisposing factor for intubation failure. However, it is unclear that acidemic condition itself actually makes endotracheal intubation more difficult. We aimed to evaluate if a presence of severe acidemia before intubation is associated with the lower first attempt intubation success rate in the ED. Methods: This is a retrospective observational cohort study in the ED of an urban hospital in Japan. The collected data included patient demographics, such as age, sex, and body mass index, presence of one or more factors of modified LEMON criteria for predicting difficult intubation, reasons for intubation, blood gas levels, airway equipment, intubation by emergency physician or not, and the use of the rapid sequence intubation technique. Those with any of the following were excluded from the analysis: (1) no blood gas drawn before intubation, (2) cardiopulmonary arrest, and (3) under 18 years of age. The primary outcome was the first attempt intubation success rates between a severe acidemic patients (SA) group and a non-severe acidemic patients (NA) group. Logistic regression analysis was used to test the first attempt success rates for intubations between those two groups. Results: Over 5 years, a total of 486 intubations were performed; 105 in the SA group and 381 in the NA group. The univariate analysis showed that the first attempt intubation success rate was lower in the SA group than in the NA group (71.4% vs 83.5%, p < 0.01). The multivariate logistic regression analysis identified that severe acidemia was significantly associated with the first attempt intubation failure (OR 1.9, 95% CI 1.03-3.68, p = 0.04). Conclusions: A presence of severe acidemia before endotracheal intubation lowers the first attempt intubation success rate in the ED.

Keywords: acidemia, airway management, endotracheal intubation, first-attempt intubation success rate

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Authors: Wong Kean Hin, Kumarason A. L. V. Rasiah

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A building provides shelter and protection for an individual to live, work, sleep, procreate or engage in leisurely activities comfortably. Currently, a very popular term related to building was often stated by many parties, which is sustainability. A sustainable building is environmental friendly, healthy to the occupants, as well as efficient in electricity and water. This particular research is important to any parties that are involved in the construction industry. This research will provide the awareness and acceptability of Malaysian public towards sustainable residential building. It will also provide the developers about which sustainable features that the people usually want so that the developers can build a sustainable housing that suits the needs of people. Then, propose solutions to solve the difficulties of implementing sustainability in Malaysian housing industry. Qualitative and quantitative research methods were used throughout the process of data collection. The quantitative research method was distribution of questionnaires to 100 Malaysian public and 50 individuals that worked in developer companies. Then, the qualitative method was an interview session with experienced personnel in Malaysian construction industry. From the data collected, there is increasingly Malaysian public and developers are aware about the existence of sustainability. Moreover, the public is willing to invest on sustainable residential building with minimum additional cost. However, there is a mismatch in between sustainable elements provided by developers and the public needs. Some recommendations to improve the progression of sustainability had been proposed in this study, which include laws enforcement, cooperation between the both government sector with private sector, and private sector with private sector, and learn from modern countries. These information will be helpful and useful for the future of sustainability development in Malaysia.

Keywords: acceptability, awareness, Malaysian housing industry, sustainable elements, green building index

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Authors: Alexis D'Agostino, Amanda Pomeroy

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Background: Resource availability is essential to effective implementation of national nutrition policies. To this end, the SPRING Project has collected and analyzed budget data from government ministries in Uganda, international donors, and other nutrition implementers to provide data for the first time on what funding is actually allocated to implement nutrition activities named in the national nutrition plan. Methodology: USAID’s SPRING Project used the Uganda Nutrition Action Plan (UNAP) as the starting point for budget analysis. Thorough desk reviews of public budgets from government, donors, and NGOs were mapped to activities named in the UNAP and validated by key informants (KIs) across the stakeholder groups. By relying on nationally-recognized and locally-created documents, SPRING provided a familiar basis for discussions to increase credibility and local ownership of findings. Among other things, the KIs validated the amount, source, and type (specific or sensitive) of funding. When only high-level budget data were available, KIs provided rough estimates of the percentage of allocations that were actually nutrition-relevant, allowing creation of confidence intervals around some funding estimates. Results: After validating data and narrowing in on estimates of funding to nutrition-relevant programming, researchers applied a formula to estimate overall nutrition allocations. In line with guidance by the SUN Movement and its three-step process, nutrition-specific funding was counted at 100% of its allocation amount, while nutrition sensitive funding was counted at 25%. The vast majority of nutrition funding in Uganda is off-budget, with over 90 percent of all nutrition funding is provided outside of the government system. Overall allocations are split nearly evenly between nutrition-specific and –sensitive activities. In FY 2013/14, the two-year study’s baseline year, on- and off-budget funding for nutrition was estimated to be around 60 million USD. While the 60 million USD allocations compare favorably to the 66 million USD estimate of the cost of the UNAP, not all activities are sufficiently funded. Those activities with a focus on behavior change were the most underfunded. In addition, accompanying qualitative research suggested that donor funding for nutrition activities may shift government funding into other areas of work, making it difficult to estimate the sustainability of current nutrition investments.Conclusions: Beyond providing figures, these estimates can be used together with the qualitative results of the study to explain how and why these amounts were allocated for particular activities and not others, examine the negotiation process that occurred, and suggest options for improving the flow of finances to UNAP activities for the remainder of the policy tenure. By the end of the PBN study, several years of nutrition budget estimates will be available to compare changes in funding over time. Halfway through SPRING’s work, there is evidence that country stakeholders have begun to feel ownership over the ultimate findings and some ministries are requesting increased technical assistance in nutrition budgeting. Ultimately, these data can be used within organization to advocate for more and improved nutrition funding and to improve targeting of nutrition allocations.

Keywords: budget, nutrition, financing, scale-up

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Authors: Sibele A. F. Leite, Bernno S. Leite, José Vicente H. D´Angelo, Ana Teresa P. Dell’Isola, Julio CéSar Souza

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The generation of bioenergy is one of the oldest and simplest biomass applications and is one of the safest options for minimizing emissions of greenhouse gasses and replace the use of fossil fuels. In addition, the increasing development of technologies for energy biomass conversion parallel to the advancement of research in biotechnology and engineering has enabled new opportunities for exploitation of biomass. Agricultural residues offer great potential for energy use, and Brazil is in a prominent position in the production and export of agricultural products such as banana and rice. Despite the economic importance of the growth prospects of these activities and the increasing of the agricultural waste, they are rarely explored for energy and production of new materials. Brazil products almost 10.5 million tons/year of rice husk and 26.8 million tons/year of banana stem. Thereby, the aim of this study was to analysis the potential of biomass residues for energy production and applications in new materials. Rice husk (specify the type) and banana stem (specify the type) were characterized by physicochemical analyses using the following parameters: organic carbon, nitrogen (NTK), proximate analyses, FT-IR spectroscopy, thermogravimetric analyses (TG), calorific values and silica content. Rice husk and banana stem presented attractive superior calorific (from 11.5 to 13.7MJ/kg), and they may be compared to vegetal coal (21.25 MJ/kg). These results are due to the high organic matter content. According to the proximate analysis, biomass has high carbon content (fixed and volatile) and low moisture and ash content. In addition, data obtained by Walkley–Black method point out that most of the carbon present in the rice husk (50.5 wt%) and in banana stalk (35.5 wt%) should be understood as organic carbon (readily oxidizable). Organic matter was also detected by Kjeldahl method which gives the values of nitrogen (especially on the organic form) for both residues: 3.8 and 4.7 g/kg of rice husk and banana stem respectively. TG and DSC analyses support the previous results, as they can provide information about the thermal stability of the samples allowing a correlation between thermal behavior and chemical composition. According to the thermogravimetric curves, there were two main stages of mass-losses. The first and smaller one occurred below 100 °C, which was suitable for water losses and the second event occurred between 200 and 500 °C which indicates decomposition of the organic matter. At this broad peak, the main loss was between 250-350 °C, and it is because of sugar decomposition (components readily oxidizable). Above 350 °C, mass loss of the biomass may be associated with lignin decomposition. Spectroscopic characterization just provided qualitative information about the organic matter, but spectra have shown absorption bands around 1030 cm-1 which may be identified as species containing silicon. This result is expected for the rice husk and deserves further investigation to the stalk of banana, as it can bring a different perspective for this biomass residue.

Keywords: rice husk, banana stem, bioenergy, renewable feedstock

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Authors: Mukesh Khadka, Alexander Paz, Hanns de la Fuente-Mella

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Typically, pavement performance models are developed in two steps: (i) pavement segments with similar characteristics are grouped together to form a cluster, and (ii) the corresponding performance models are developed using statistical techniques. A challenge is to select the characteristics that define clusters and the segments associated with them. If inappropriate characteristics are used, clusters may include homogeneous segments with different performance behavior or heterogeneous segments with similar performance behavior. Prediction accuracy of performance models can be improved by grouping the pavement segments into more uniform clusters by including both characteristics and a performance measure. This grouping is not always possible due to limited information. It is impractical to include all the potential significant factors because some of them are potentially unobserved or difficult to measure. Historical performance of pavement segments could be used as a proxy to incorporate the effect of the missing potential significant factors in clustering process. The current state-of-the-art proposes Clusterwise Linear Regression (CLR) to determine the pavement clusters and the associated performance models simultaneously. CLR incorporates the effect of significant factors as well as a performance measure. In this study, a mathematical program was formulated for CLR models including multiple explanatory variables. Pavement data collected recently over the entire state of Nevada were used. International Roughness Index (IRI) was used as a pavement performance measure because it serves as a unified standard that is widely accepted for evaluating pavement performance, especially in terms of riding quality. Results illustrate the advantage of the using CLR. Previous studies have used CLR along with experimental data. This study uses actual field data collected across a variety of environmental, traffic, design, and construction and maintenance conditions.

Keywords: clusterwise regression, pavement management system, performance model, optimization

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Authors: Goutom K. Pall

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At the very heart of the power system, power transmission (PT) acts as an essential link between power generation and distribution. Timely completion of PT infrastructures is therefore crucial to support the development of power system as a whole. Yet despite the importance, studies on PT infrastructure development projects are embryonic and, hence, PT projects undergoing widespread delays worldwide. These delay factors are idiosyncratic and identifying the critical delay factors is essential if the PT industry professionals are to complete their projects efficiently and within the expected timeframes. This study identifies and categorizes 46 causes of PT project delay under ten major groups using six sector expert’s recommendations studied by a preliminary questionnaire survey. Based on the experts’ strong recommendations, two new groups are introduced in the final questionnaire survey: sector specific factors (SSF) and general factors (GF). SSF pertain to delay factors applicable only to the PT projects, while GF represents less biased samples with shared responsibilities of all project parties involved in a project. The study then uses 112 data samples from the contractors to rank the delay factors using relative importance index (RII). The results reveal that SSF, GF and external factors are the most critical groups, while the highest ranked delay factors include the right of way (RoW) problems of transmission lines (TL), delay in payments, frequent changes in TL routes, poor communication and coordination among the project parties and accessibility to TL tower locations. Finally, recommendations are made to minimize the identified delay. The findings are expected to be of substantial benefit to professionals in minimizing time overrun in PT projects implementation, as well as power generation, power distribution, and non-power linear construction projects worldwide.

Keywords: delay, project delay, power transmission projects, time-overruns

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Authors: Rahim Sarvar, Bahram Azadbakht, Samira Safaee

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The leading goal of all planning is to attain sustainable development, regional balance, suitable distribution of activities, and maximum use of environmental capabilities in the process of development of regions. Intensive concentration of population and activities in one or some limited geographical locality is of main characteristics of most developing countries, especially Iran. Not considering the long-term programs and relying on temporary and superficial plans by people in charge of decision-making to attain their own objectives causes obstacles, resulting in unbalance development. The basic reason for these problems is to establish the development planning while economic aspects are merely considered and any attentions are not paid to social and regional feedbacks, what have been ending up to social and economic inequality, unbalanced distribution of development among the regions as well. In addition to study of special planning and structure of the county of Malekan, this research tries to achieve some other aims, i.e. recognition and introduction of approaches in order to utilize resources optimally, to distribute the population, activities, and facilities in optimum fashion, and to investigate and identify the spatial development potentials of the County. Based on documentary, descriptive, analytical, and field studies, this research employs maps to analyze the data, investigates the variables, and applies SPSS, Auto CAD, and Arc View software. The results show that the natural factors have a significant influence on spatial layout of settlements; distribution of facilities and functions are not equal among the rural districts of the county; and there is a spatial equivalence in the region area between population and number of settlements.

Keywords: development, entropy index, Malekan City, planning, regional equilibrium

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Authors: Ibrahim Mamat, Wan Mohd Zaifurin Wan Nawang

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Malaysia's poverty eradication program is a long-term plan that was initially implemented by the government after the riots of the races on May 13, 1969. The incident broke out due to the huge economic gap between the majority of Malaysians,Malays and non-Malays minorities. As a result of the event, the government drafted the New Economic Policy(NEP) in 1970 to reduce the differences in economic status among races in Malaysia. At the end of this policy period (NEP) in 1990, the incidence of poverty in Malaysia was around 6.5 per cent. The incidence of poverty in Malaysia continued to decline to 0.6 per cent (2014) through some other policy after the NEP. The decline in poverty has been the result of the government's efforts to implement the New Economic Policy (1970-1990), National Development Policy (1991-2000), NationalVision Policy (2001-2010), and National Transformation Policy (2011-2020).This article also explains the meaning, concepts and measurements of poverty in order to identify the Poverty Level and measure the Poverty Index using various dimensions. This explanation is very important for a country like Malaysia who has some people living below the poverty line. In such a context, an effective poverty eradication policy can benefit the poor.Consequently, this article examines the continuing involvement of the government and non-governmental organizations through the empowerment program of the hardcore poor to change their lifestyle and culture as well as the vicious circle of poverty is indispensable to ensure that poverty eradication programs are in line with current economic and social changes. In addition, the involvement of non-governmental organizations and the State Islamic Religious Council to provide assistance to the poor is appropriate as the institution has its own distinctive interpretation of poverty to determine the type of assistance, criteria and so on to enable the rights of the poor to be ensured and protected.

Keywords: economic policy, poor, poverty eradication, poverty program

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Authors: Mohamed El-Khateeb

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Encompassing inventory, warehousing, and transportation management, logistics is a crucial predictor of firm performance. This has been extensively proven by extant literature in business and operations management. Logistics is also a fundamental determinant of a country's ability to access international markets. Available studies in international and transport economics have shown that limited transport infrastructure and underperforming transport services can severely affect international competitiveness. However, the evidence lacks the overall impact of logistics performance-encompassing all inventory, warehousing, and transport components- on global trade. In order to fill this knowledge gap, the paper uses a gravitational trade model with 155 countries from all geographical regions between 2007 and 2018. Data on logistics performance is obtained from the World Bank's Logistics Performance Index (LPI). First, the relationship between logistics performance and a country’s total trade is estimated, followed by a breakdown by the economic sector. Then, the analysis is disaggregated according to the level of technological intensity of traded goods. Finally, after evaluating the intensive margin of trade, the relevance of logistics infrastructure and services for the extensive trade margin is assessed. Results suggest that: (i) improvements in both logistics infrastructure and services are associated with export growth; (ii) manufactured goods can significantly benefit from these improvements, especially when both exporting and importing countries increase their logistics performance; (iii) the quality of logistics infrastructure and services becomes more important as traded goods are technology-intensive; and (iv) improving the exporting country's logistics performance is essential in the intensive margin of trade while enhancing the importing country's logistics performance is more relevant in the extensive margin.

Keywords: low-cost, recycling, reuse, solid waste, wastewater treatment

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Authors: Ilona Buchem, Carolin Gellner

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The call for the support of senior learners in the development of digital literacy has become prevalent in recent years, especially in view of the aging societies paired with advances in digitalization in all spheres of life, including e-health. The goal has been to create opportunities for learning that incorporate the use of context in a reflective and dialogical way. Contextual learning has focused on developing skills through the application of authentic problems. While major research efforts in supporting senior learners in developing digital literacy have been invested so far in e-learning, focusing on knowledge acquisition and cognitive tasks, little research exists in reflective mentoring and coaching with the help of pedagogical agents and addressing the contextual dimensions of learning. This paper describes an approach to creating opportunities for senior learners to improve their digital literacy in the authentic context of the electronic health record (EHR) with the support of an intelligent virtual learning coach. The paper focuses on the design of the virtual coach as part of an e-learning system, which was developed in the EPA-Coach project founded by the German Ministry of Education and Research. The paper starts with the theoretical underpinnings of contextual learning and the related design considerations for a virtual learning coach based on previous studies. Since previous research in the area was mostly designed to cater to the needs of younger audiences, the results had to be adapted to the specific needs of senior learners. Next, the paper outlines the stages in the design of the virtual coach, which included the adaptation of the design requirements, the iterative development of the prototypes, the results of the two evaluation studies and how these results were used to improve the design of the virtual coach. The paper then presents the four prototypes of a senior-friendly virtual learning coach, which were designed to represent different preferences related to the visual appearance, the communication and social interaction styles, and the pedagogical roles. The first evaluation of the virtual coach design was an exploratory, qualitative study, which was carried out in October 2020 with eight seniors aged 64 to 78 and included a range of questions about the preferences of senior learners related to the visual design, gender, age, communication and role. Based on the results of the first evaluation, the design was adapted to the preferences of the senior learners and the new versions of prototypes were created to represent two male and two female options of the virtual coach. The second evaluation followed a quantitative approach with an online questionnaire and was conducted in May 2021 with 41 seniors aged 66 to 93 years. Following three research questions, the survey asked about (1) the intention to use, (2) the perceived characteristics, and (3) the preferred communication/interaction style of the virtual coach, i. e. task-oriented, relationship-oriented, or a mix. This paper follows with the discussion of the results of the design process and ends with conclusions and next steps in the development of the virtual coach including recommendations for further research.

Keywords: virtual learning coach, virtual mentor, pedagogical agent, senior learners, digital literacy, electronic health records

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Authors: Emad A. Mohammed

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The concept of hydraulic flow units (HFU) has been used for decades in the petroleum industry to improve the prediction of permeability. This concept is strongly related to the flow zone indicator (FZI) which is a function of the reservoir rock quality index (RQI). Both indices are based on reservoir porosity and permeability of core samples. It is assumed that core samples with similar FZI values belong to the same HFU. Thus, after dividing the porosity-permeability data based on the HFU, transformations can be done in order to estimate the permeability from the porosity. The conventional practice is to use the power law transformation using conventional HFU where percentage of error is considerably high. In this paper, neural network technique is employed as a soft computing transformation method to predict permeability instead of power law method to avoid higher percentage of error. This technique is based on HFU identification where Amaefule et al. (1993) method is utilized. In this regard, Kozeny and Carman (K–C) model, and modified K–C model by Hasan and Hossain (2011) are employed. A comparison is made between the two transformation techniques for the two porosity-permeability models. Results show that the modified K-C model helps in getting better results with lower percentage of error in predicting permeability. The results also show that the use of artificial intelligence techniques give more accurate prediction than power law method. This study was conducted on a heterogeneous complex carbonate reservoir in Oman. Data were collected from seven wells to obtain the permeability correlations for the whole field. The findings of this study will help in getting better estimation of permeability of a complex reservoir.

Keywords: permeability, hydraulic flow units, artificial intelligence, correlation

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Authors: Basant H. El-Refay, Nabeel T. Faiad

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Background: The high prevalence of obesity in Egypt has a great impact on the health care system, economic and social situation. Evidence suggests that even a moderate amount of weight loss can be useful. Aim of the study: To analyze the effects of lower body positive pressure supported treadmill training, conducted with hypocaloric diet, on body composition of obese children. Methods: Thirty children aged between 8 and 14 years, were randomly assigned into two groups: intervention group (15 children) and control group (15 children). All of them were evaluated using body composition analysis through bioelectric impedance. The following parameters were measured before and after the intervention: body mass, body fat mass, muscle mass, body mass index (BMI), percentage of body fat and basal metabolic rate (BMR). The study group exercised with antigravity treadmill three times a week during 2 months, and participated in a hypocaloric diet program. The control group participated in a hypocaloric diet program only. Results: Both groups showed significant reduction in body mass, body fat mass and BMI. Only study group showed significant reduction in percentage of body fat (p = 0.0.043). Changes in muscle mass and BMR didn't reach statistical significance in both groups. No significant differences were observed between groups except for muscle mass (p = 0.049) and BMR (p = 0.042) favoring study group. Conclusion: Both programs proved effective in the reduction of obesity indicators, but lower body positive pressure supported treadmill training was more effective in improving muscle mass and BMR.

Keywords: children, hypocaloric diet, lower body positive pressure supported treadmill, obesity

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Authors: Muhammad Faisal, Zai-Jin You, Muhammad Naeem

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Concerns about the environment, public health, and the economy are raised by the fact that the world produces around 6 trillion cigarettes annually. Arguably the most pervasive forms of environmental litter, this dangerous trash must be eliminated. The researchers wanted to get an idea of how much pollution is seeping out of cigarette butts in metropolitan areas by studying their distribution and concentration. In order to accomplish this goal, the cigarette butt pollution indicator was applied in 29 different areas. The locations were monitored monthly for a full calendar year. The conditions for conducting the investigation of the venues were the same on both weekends and during the weekdays. By averaging the metal leakage ratio in various climates and the average weight of cigarette butts, we were able to estimate the total amount of heavy metal leakage. The findings revealed that the annual average value of the index for the areas that were investigated ranged from 1.38 to 10.4. According to these numbers, just 27.5% of the areas had a low pollution rating, while 43.5% had a major pollution status or worse. Weekends witnessed the largest fall (31% on average) in all locations' indices, while spring and summer saw the largest increase (26% on average) compared to autumn and winter. It was calculated that the average amount of heavy metals such as Cr, Cu, Cd, Zn, and Pb that seep into the environment from discarded cigarette butts in commercial, residential, and park areas, respectively, is 0.25 µg/m2, 0.078 µg/m2, and 0.18 µg/m2. Butt from cigarettes is one of the most prevalent forms of litter in the area that was examined. This litter is the origin of a wide variety of contaminants, including heavy metals. This toxic garbage poses a significant risk to the city.

Keywords: heavy metal, hazardous waste, waste management, litter

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Authors: Terentes Printzios Dimitrios, Loanna Gourgouli, Vlachopoulos Charalambos

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Aims: Atrial fibrillation (AF) remains one of the major causes of stroke, heart failure, sudden death and cardiovascular morbidity. Ablation techniques are becoming more appealing after the latest results of randomized trials showing the overall clinical benefit. On the other hand, imaging techniques and the frontier application of 3D printing are emerging as a valuable ally for cardiac procedures. However, no randomized trial has directly assessed the impact of preprocedural imaging and especially 3D printing guidance for AF ablation. The present study is designed to investigate for the first time the effect of 3D printing of the heart on the safety and effectiveness of the ablation procedure. Methods and design: The 3D-GALA trial is a randomized, open-label, controlled, multicentre clinical trial of 2 parallel groups designed to enroll a total of 100 patients undergoing ablation using cryo-balloon for paroxysmal and persistent AF. Patients will be randomized with a patient allocation ratio of 1: 1 to preprocedural MRI scan of the heart and 3D printing of left atrium and pulmonary veins and cryoablation versus standard cryoablation without imaging. Patients will be followed up to 6 months after the index procedure. The primary outcome measure is the reduction of radiation dose and contrast amount during pulmonary veins isolation. Secondary endpoints will include the percentage of atrial fibrillation relapse at 24h-Holter electrocardiogram monitoring at 6 months after initial treatment. Discussion: To our knowledge, the 3D-GALA trial will be the first study to provide evidence about the clinical impact of preprocedural imaging and 3D printing before cryoablation.

Keywords: atrial fibrillation, cardiac MRI, cryoablation, 3-d printing

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Authors: S. P. Pradhan, Amulya Ratna Roul

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A number of landslides are occurring during the rainy season along Rayagada-Koraput Railway track for past three years. The track was constructed about 20 years ago. However, the protection measures are not able to control the recurring slope failures now. It leads to a loss to Indian Railway and its passengers ultimately leading to wastage of time and money. The slopes along Rayagada-Koraput track include both rock and soil slopes. The rock types include mainly Khondalite and Charnockite whereas soil slopes are mainly composed of laterite ranging from less weathered to highly weathered laterite. The field studies were carried out in one of the critical slope. Field study was followed by the kinematic analysis to assess the type of failure. Slake Durability test, Uniaxial Compression test, specific gravity test and triaxial test were done on rock samples to calculate and assess properties such as weathering index, unconfined compressive strength, density, cohesion, and friction angle. Following all the laboratory tests, rock mass rating was calculated. Further, from Kinematic analysis and Rock Mass Ratingbasic, Slope Mass Rating was proposed for each slope. The properties obtained were used to do the slope stability simulations using finite element method based modelling. After all the results, suitable protection measures, to prevent the loss due to slope failure, were suggested using the relation between Slope Mass Rating and protection measures.

Keywords: landslides, slope stability, rock mass rating, slope mass rating, numerical simulation

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Authors: Behnaz Farahani, Razieh Sotoudeh, Ali Vahdani, Hamed Abdi

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Individual differences in eating behavior can cause underweight or overweight and obesity. Thus influencing factors on children’s eating behavior such as mothers’ feeding practices are needed to be more investigated. The goals of this survey are to evaluate the association of (i) parental pressure and children’s food avoidant tendency, (ii) parental restriction and children’s food approach tendency, (iii) modeling of healthy eating in front of children and their children’s eating behavior. 760 mothers of children aged 7-10 from schools in Isfahan were asked to complete questionnaires including Child Feeding Questionnaire, Children’s Eating Behavior Questionnaire, Modeling Questionnaire, and self-administered demographic questionnaire in which mothers reported their children’s height and weight as well. Of those mothers, 745 completed the questionnaires for the children’s index (mean age: 8.513±1.112) during the 2011-2012 school year. The results of this quantitative, descriptive, cross-sectional analysis indicated that “parental restriction” was positively associated with child food responsiveness (P,0.000) and food enjoyment (P,0.000) and surprisingly, it was positively associated with Food Fussiness(0.000) .Parental pressure to eat was positively associated with child satiety responsiveness (P,0.000), slowness (P,0.000), and fussiness (P,0.00) and negatively associated with Food responsiveness(p,0.000)and Enjoyment of food (p,0.002), modeling of healthy eating were positively associated with Enjoyment of food / q (p,0.000) and negatively with food fussiness (P,0.000). The results of this survey will improve interventions and maternal guidance on their feeding practices and their association with children’s eating behavior and weight.

Keywords: feeding practices, eating behavior, pressure to eat, restriction, modeling, satiety responsiveness, slowness in eating, food fussiness, food responsiveness, enjoyment of food

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Authors: D. Mowla, N. Rasti, P. Keshavarz

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Reduction of fossil fuels sources, increasing of pollution gases emission, and global warming effects increase the demand of renewable fuels. One of the main candidates of alternative fuels is biodiesel. Biodiesel limits greenhouse gas effects due to the closed CO₂ cycle. Biodiesel has more biodegradability, lower combustion emissions such as CO, SO_x, HC, PM and lower toxicity than petro diesel. However, biodiesel has high production cost due to high price of plant oils as raw material. So, the utilization of waste cooking oils (WCOs) as feedstock, due to their low price and disposal problems reduce biodiesel production cost. In this study, production of biodiesel by transesterification of methanol and WCO using modified sodic potassic (SP) clinoptilolite zeolite and sodic potassic calcic (SPC) clinoptilolite zeolite as heterogeneous catalysts have been investigated. These natural clinoptilolite zeolites were modified by KOH solution to increase the site activity. The optimum biodiesel yields for SP clinoptilolite and SPC clinoptilolite were 95.8% and 94.8%, respectively. Produced biodiesel were analyzed and compared with petro diesel and ASTM limits. The properties of produced biodiesel confirm well with ASTM limits. The density, kinematic viscosity, cetane index, flash point, cloud point, and pour point of produced biodiesel were all higher than petro diesel but its acid value was lower than petro diesel. Finally, the reusability and regeneration of catalysts were investigated. The results indicated that the spent zeolites cannot be reused directly for the transesterification, but they can be regenerated easily and can obtain high activity.

Keywords: biodiesel, renewable fuel, transesterification, waste cooking oil

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Authors: Dinara F. Gaynutdinova, Vladimir Ya Modorsky, Nikolay A. Shevelev

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The problem under research is that of unpredictable modes occurring in two-stage centrifugal hydraulic pump as a result of hydraulic processes caused by vibrations of structural components. Numerical, analytical and experimental approaches are considered. A hypothesis was developed that the problem of unpredictable pressure decrease at the second stage of centrifugal pumps is caused by cavitation effects occurring upon vibration. The problem has been studied experimentally and theoretically as of today. The theoretical study was conducted numerically and analytically. Hydroelastic processes in dynamic “liquid – deformed structure” system were numerically modelled and analysed. Using ANSYS CFX program engineering analysis complex and computing capacity of a supercomputer the cavitation parameters were established to depend on vibration parameters. An influence domain of amplitudes and vibration frequencies on concentration of cavitation bubbles was formulated. The obtained numerical solution was verified using CFM program package developed in PNRPU. The package is based on a differential equation system in hyperbolic and elliptic partial derivatives. The system is solved by using one of finite-difference method options – the particle-in-cell method. The method defines the problem solution algorithm. The obtained numerical solution was verified analytically by model problem calculations with the use of known analytical solutions of in-pipe piston movement and cantilever rod end face impact. An infrastructure consisting of an experimental fast hydro-dynamic processes research installation and a supercomputer connected by a high-speed network, was created to verify the obtained numerical solutions. Physical experiments included measurement, record, processing and analysis of data for fast processes research by using National Instrument signals measurement system and Lab View software. The model chamber end face oscillated during physical experiments and, thus, loaded the hydraulic volume. The loading frequency varied from 0 to 5 kHz. The length of the operating chamber varied from 0.4 to 1.0 m. Additional loads weighed from 2 to 10 kg. The liquid column varied from 0.4 to 1 m high. Liquid pressure history was registered. The experiment showed dependence of forced system oscillation amplitude on loading frequency at various values: operating chamber geometrical dimensions, liquid column height and structure weight. Maximum pressure oscillation (in the basic variant) amplitudes were discovered at loading frequencies of approximately 1,5 kHz. These results match the analytical and numerical solutions in ANSYS and CFM.

Keywords: computing experiment, hydroelasticity, physical experiment, vibration

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Authors: Hassnen M. Jafer, W. Atherton, F. Ruddock

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This paper represents the results of experimental work to investigate the suitability of a waste material (WM) for soft soil stabilisation. In addition, the effect of particle size distribution (PSD) of the waste material on its performance as a soil stabiliser was investigated. The WM used in this study is produced from the incineration processes in domestic energy power plant and it is available in two different grades of fineness (coarse waste material (CWM) and fine waste material (FWM)). An intermediate plasticity silty clayey soil with medium organic matter content has been used in this study. The suitability of the CWM and FWM to improve the physical and engineering properties of the selected soil was evaluated dependant on the results obtained from the consistency limits, compaction characteristics (optimum moisture content (OMC) and maximum dry density (MDD)); along with the unconfined compressive strength test (UCS). Different percentages of CWM were added to the soft soil (3, 6, 9, 12 and 15%) to produce various admixtures. Then the UCS test was carried out on specimens under different curing periods (zero, 7, 14, and 28 days) to find the optimum percentage of CWM. The optimum and other two percentages (either side of the optimum content) were used for FWM to evaluate the effect of the fineness of the WM on UCS of the stabilised soil. Results indicated that both types of the WM used in this study improved the physical properties of the soft soil where the index of plasticity (IP) was decreased significantly. IP was decreased from 21 to 13.64 and 13.10 with 12% of CWM and 15% of FWM respectively. The results of the unconfined compressive strength test indicated that 12% of CWM was the optimum and this percentage developed the UCS value from 202kPa to 500kPa for 28 days cured samples, which is equal, approximately 2.5 times the UCS value for untreated soil. Moreover, this percentage provided 1.4 times the value of UCS for stabilized soil-CWA by using FWM which recorded just under 700kPa after 28 days curing.

Keywords: soft soil stabilisation, waste materials, fineness, unconfined compressive strength

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Authors: Haftay Abraha Tadesse

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Background: Staphylococcus is a genus of worldwide distributed bacteria correlated to several infectious of different sites in humans and animals. They are among the most important causes of infection that are associated with the consumption of contaminated food. Objective: The objective of this study was to determine the isolates, antimicrobial susceptibility patterns and Public Health Significance of Staphylococcus aureus in raw meat from butchery and abattoir houses of Mekelle, Northern Ethiopia. Methodology: A cross-sectional study was conducted from April to October 2019. Socio-demographic data and Public Health Significance were collected using a predesigned questionnaire. The raw meat samples were collected aseptically in the butchery and abattoir houses and transported using an ice box to Mekelle University, College of Veterinary Sciences, for isolating and identification of Staphylococcus aureus. Antimicrobial susceptibility tests were determined by the disc diffusion method. Data obtained were cleaned and entered into STATA 22.0 and a logistic regression model with odds ratio was calculated to assess the association of risk factors with bacterial contamination. A P-value < 0.05 was considered statistically significant. Results: In the present study, 88 out of 250 (35.2%) were found to be contaminated with Staphylococcus aureus. Among the raw meat specimens, the positivity rate of Staphylococcus aureus was 37.6% (n=47) and (32.8% (n=41), butchery and abattoir houses, respectively. Among the associated risks, factories not using gloves reduces risk was found to (AOR=0.222; 95% CI: 0.104-0.473), Strict Separation b/n clean & dirty (AOR= 1.37; 95% CI: 0.66-2.86) and poor habit of hand washing (AOR=1.08; 95%CI: 0.35 3.35) was found to be statistically significant and have associated with Staphylococcus aureus contamination. All isolates of thirty-seven of Staphylococcus aureus were checked and displayed (100%) sensitive to doxycycline, trimethoprim, gentamicin, sulphamethoxazole, amikacin, CN, Co trimoxazole and nitrofurantoi. Whereas the showed resistance to cefotaxime (100%), ampicillin (87.5%), Penicillin (75%), B (75%), and nalidixic acid (50%) from butchery houses. On the other hand, all isolates of Staphylococcus aureus isolate 100% (n= 10) showed sensitive chloramphenicol, gentamicin and nitrofurantoin, whereas they showed 100% resistance of Penicillin, B, AMX, ceftriaxone, ampicillin and cefotaxime from abattoirs houses. The overall multi-drug resistance pattern for Staphylococcus aureus was 90% and 100% of butchery and abattoir houses, respectively. Conclusion: 35.3% Staphylococcus aureus isolated were recovered from the raw meat samples collected from the butchery and abattoirs houses. More has to be done in the development of hand washing behavior and availability of safe water in the butchery houses to reduce the burden of bacterial contamination. The results of the present finding highlight the need to implement protective measures against the levels of food contamination and alternative drug options. The development of antimicrobial resistance is nearly always a result of repeated therapeutic and/or indiscriminate use of them. Regular antimicrobial sensitivity testing helps to select effective antibiotics and to reduce the problems of drug resistance development towards commonly used antibiotics.

Keywords: abattoir house, AMR, butchery house, S. aureus

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Authors: Rodrigo Calili, Anna Carolina Sermarini, João Henrique Azevedo, Vanessa Cardoso de Albuquerque, Felipe Gonçalves, Gilberto Jannuzzi

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The diffusion of Distributed Energy Resources (DER) has caused structural changes in the relationship between consumers and electrical systems. The Photovoltaic Distributed Generation (PVDG), in particular, is an essential strategy for achieving the 2030 Agenda goals, especially SDG 7 and SDG 13. However, it is observed that most projects involving this technology in Brazil are restricted to the wealthiest classes of society, not yet reaching the low-income population, aligned with theories of energy justice. Considering the research for energy equality, one of the policies adopted by governments is the social electricity tariff (SET), which provides discounts on energy tariffs/bills. However, just granting this benefit may not be effective, and it is possible to merge it with DER technologies, such as the PVDG. Thus, this work aims to evaluate the economic viability of the policy to replace the social electricity tariff (the current policy aimed at the low-income population in Brazil) by PVDG projects. To this end, a proprietary methodology was developed that included: mapping the stakeholders, identifying critical variables, simulating policy options, and carrying out an analysis in the Brazilian context. The simulation answered two key questions: in which municipalities low-income consumers would have lower bills with PVDG compared to SET; which consumers in a given city would have increased subsidies, which are now provided for solar energy in Brazil and for the social tariff. An economic model was created for verifying the feasibility of the proposed policy in each municipality in the country, considering geographic issues (tariff of a particular distribution utility, radiation from a specific location, etc.). To validate these results, four sensitivity analyzes were performed: variation of the simultaneity factor between generation and consumption, variation of the tariff readjustment rate, zeroing CAPEX, and exemption from state tax. The behind-the-meter modality of generation proved to be more promising than the construction of a shared plant. However, although the behind-the-meter modality presents better results than the shared plant, there is a greater complexity in adopting this modality due to issues related to the infrastructure of the most vulnerable communities (e.g., precarious electrical networks, need to reinforce roofs). Considering the shared power plant modality, many opportunities are still envisaged since the risk of investing in such a policy can be mitigated. Furthermore, this modality can be an alternative due to the mitigation of the risk of default, as it allows greater control of users and facilitates the process of operation and maintenance. Finally, it was also found, that in some regions of Brazil, the continuity of the SET presents more economic benefits than its replacement by PVDG. However, the proposed policy offers many opportunities. For future works, the model may include other parameters, such as cost with low-income populations’ engagement, and business risk. In addition, other renewable sources of distributed generation can be studied for this purpose.

Keywords: low income, subsidy policy, distributed energy resources, energy justice

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Authors: Alexandros Pournaras, Anastasia Papadopoulou, Serafim Kontos, Anastasios Karakostas

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The air quality of modern cities is an important concern, as poor air quality contributes to human health and environmental issues. Reliable air quality forecasting has, thus, gained scientific and governmental attention as an essential tool that enables authorities to take proactive measures for public safety. In this study, the potential of Machine Learning (ML) models to forecast PM2.5 at local scale is investigated in the city of Thessaloniki, the second largest city in Greece, which has been struggling with the persistent issue of air pollution. ML models, with proven ability to address timeseries forecasting, are employed to predict the PM2.5 concentrations and the respective Air Quality Index 5-days ahead by learning from daily historical air quality and meteorological data from 2014 to 2016 and gathered from two stations with different land use characteristics in the urban fabric of Thessaloniki. The performance of the ML models on PM2.5 concentrations is evaluated with common statistical methods, such as R squared (r²) and Root Mean Squared Error (RMSE), utilizing a portion of the stations’ measurements as test set. A multi-categorical evaluation is utilized for the assessment of their performance on respective AQIs. Several conclusions were made from the experiments conducted. Experimenting on MLs’ configuration revealed a moderate effect of various parameters and training schemas on the model’s predictions. Their performance of all these models were found to produce satisfactory results on PM2.5 concentrations. In addition, their application on untrained stations showed that these models can perform well, indicating a generalized behavior. Moreover, their performance on AQI was even better, showing that the MLs can be used as predictors for AQI, which is the direct information provided to the general public.

Keywords: Air Quality, AQ Forecasting, AQI, Machine Learning, PM2.5

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Authors: Gorazd Karer

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When performing a diagnostic procedure or surgery in general anesthesia (GA), a proper introduction and dosing of anesthetic agents are one of the main tasks of the anesthesiologist. However, depth of anesthesia (DoA) also seems to be a suitable process for closed-loop control implementation. To implement such a system, one must be able to acquire the relevant signals online and in real-time, as well as stream the calculated control signal to the infusion pump. However, during a procedure, patient monitors and infusion pumps are purposely unable to connect to an external (possibly medically unapproved) device for safety reasons, thus preventing closed-loop control. The paper proposes a conceptual solution to the aforementioned problem. First, it presents some important aspects of contemporary clinical practice. Next, it introduces the closed-loop-control-system structure and the relevant information flow. Focusing on transferring the data from the patient to the computer, it presents a non-invasive image-based system for signal acquisition from a patient monitor for online depth-of-anesthesia assessment. Furthermore, it introduces a UDP-based communication method that can be used for transmitting the calculated anesthetic inflow to the infusion pump. The proposed system is independent of a medical device manufacturer and is implemented in Matlab-Simulink, which can be conveniently used for DoA control implementation. The proposed scheme has been tested in a simulated GA setting and is ready to be evaluated in an operating theatre. However, the proposed system is only a step towards a proper closed-loop control system for DoA, which could routinely be used in clinical practice.

Keywords: closed-loop control, depth of anesthesia (DoA), modeling, optical signal acquisition, patient state index (PSi), UDP communication protocol

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Authors: Saulutė Juzelėnienė, Skirmantė Šarkauskienė

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In this paper, it is aimed to analyse the multimodal representations of the concepts of LOVE and PASSION in Lithuanian graphic novel “Gertrūda”, by Gerda Jord. The research is based on the earlier findings by Forceville (2005), Eerden (2009) as well as insights made by Shihara and Matsunaka (2009) and Kövecses (2000). The domains of target and source of LOVE and PASSION metaphors in comics are expressed by verbal and non-verbal cues. The analysis of non-verbal cues adopts the concepts of rune and indexes. A pictorial rune is a graphic representation of an object that does not exist in reality in comics, such as lines, dashes, text "balloons", and pictorial index – a graphically represented object of reality, a real symptom expressing a certain emotion, such as a wide smile, furrowed eyebrows, etc. Indexes are often hyperbolized in comics. The research revealed that most frequent source domains are CLOSINESS/UNITY, NATURAL/ PHYSICAL FORCE, VALUABLE OBJECT, PRESSURE. The target is the emotion of LOVE/PASSION which belongs to a more abstract domain of psychological experience. In this kind of metaphor, the picture can be interpreted as representing the emotion of happiness. Data are taken from Lithuanian comic books and Internet sites, where comics have been presented. The data and the analysis we are providing in this article aims to reveal that there are pictorial metaphors that manifest conceptual metaphors that are also expressed verbally and that methodological framework constructed for the analysis in the papers by Forceville at all is applicable to other emotions and culture specific pictorial manifestations.

Keywords: multimodal metaphor, conceptual metaphor, comics, graphic novel, concept of love/passion

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Authors: Alonso-Cañadas J., Galán-Valdivieso F., Saraite-Sariene L., García-Tabuyo M., Alonso-Morales N.

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Green Public Procurement (GPP) has recently gained attention in the academic and policy arenas since climate change has shown the need to be addressed by both private companies and public entities. Such growing interest motivates this article, aiming to explore the most influential journals, publishers, categories, and topics, as well as the recent trends and future research lines in GPP. Based on the Web of Science database, 578 articles from 2004 to February 2022 devoted to GPP are analyzed using Bibliometrix, an R-tool to perform bibliometric analysis, and Google’s Big Query and Data Studio. This article introduces a variety of findings. First, the most influential journals by far are “Journal of Cleaner Production” and “Sustainability,” differing in that the latter is open access while the former publishes via traditional subscription. This result also occurs regarding the main publishers (Elsevier and MDPI). These features lead us to split the sample into open-access journals and traditional journals to deepen into the similarities and differences between them, confirming that traditional journals exhibit a higher degree of influence in the literature than their open-access counterparts in terms of the number of documents, number of citations and impact (according to the H index). Second, this research also highlights the recent emergence of green-related terms (sustainable, environment) and, parallelly, the increase in categorizing GPP papers in “green” WoS categories, particularly since 2019. Finally, a number of related topics are emerging and will lead the research, such as food security, infrastructures, and implementation barriers of GPP.

Keywords: bibliometric analysis, green public procurement, open access, traditional journals

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Authors: Yingxiao Ye, Christopher Doehring, Angelos Georghiou, Hugh Robinson, Phebe Vayanos

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Human development is a threat to biodiversity, and conservation organizations (COs) are purchasing land to protect areas for biodiversity preservation. However, COs have limited budgets and thus face hard prioritization decisions that are confounded by uncertainty in future human land use. This research proposes a data-driven sequential planning model to help COs choose land parcels that minimize the uncertain human impact on biodiversity. The proposed model is robust to uncertain development, and the sequential decision-making process is adaptive, allowing land purchase decisions to adapt to human land use as it unfolds. The cellular automata model is leveraged to simulate land use development based on climate data, land characteristics, and development threat index from NASA Socioeconomic Data and Applications Center. This simulation is used to model uncertainty in the problem. This research leverages state-of-the-art techniques in the robust optimization literature to propose a computationally tractable reformulation of the model, which can be solved routinely by off-the-shelf solvers like Gurobi or CPLEX. Numerical results based on real data from the Jaguar in Central and South America show that the proposed method reduces conservation loss by 19.46% on average compared to standard approaches such as MARXAN used in practice for biodiversity conservation. Our method may better help guide the decision process in land acquisition and thereby allow conservation organizations to maximize the impact of limited resources.

Keywords: data-driven robust optimization, biodiversity conservation, uncertainty simulation, adaptive sequential planning

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Authors: Hira Jabbar

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Education is vital for inclusive growth of an economy and a critical contributor for investment in human capital. Like other developing countries, Pakistan is facing enormous challenges regarding the provision of public facilities, improper infrastructure planning, accelerating rate of population and poor accessibility. The influence of the rapid advancement and innovations in GIS and RS techniques have proved to be a useful tool for better planning and decision making to encounter these challenges. Therefore present study incorporates GIS and RS techniques to investigate the spatial distribution of school facilities, identifies settlements with served and unserved population, finds potential areas for new schools based on population and develops an accessibility index to evaluate the higher accessibility for schools. For this purpose high-resolution worldview imagery was used to develop road network, settlements and school facilities and to generate school accessibility for each level. Landsat 8 imagery was utilized to extract built-up area by applying pre and post-processing models and Landscan 2015 was used to analyze population statistics. Service area analysis was performed using network analyst extension in ArcGIS 10.3v and results were evaluated for served and underserved areas and population. An accessibility tool was used to evaluate a set of potential destinations to determine which is the most accessible with the given population distribution. Findings of the study may contribute to facilitating the town planners and education authorities for understanding the existing patterns of school facilities. It is concluded that GIS and remote sensing can be effectively used in urban transport and facility planning.

Keywords: accessibility, geographic information system, landscan, worldview

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Authors: Amirah Azzeri, Fatiha H. Shabaruddin, Scott A. McDonald, Rosmawati Mohamed, Maznah Dahlui

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Objective: A scaled-up treatment cascade with direct-acting antiviral (DAA) therapy is necessary to achieve global WHO targets for hepatitis C virus (HCV) elimination in Malaysia. Recently, limited access to Sofosbuvir/Daclatasvir (SOF/DAC) is available through compulsory licensing, with future access to Sofosbuvir/Velpatasvir (SOF/VEL) expected through voluntary licensing due to recent agreements. SOF/VEL has superior clinical outcomes, particularly for cirrhotic stages, but has higher drug acquisition costs compared to SOF/DAC. It has been proposed that a stratified treatment cascade might be the most cost-efficient approach for Malaysia whereby all HCV patients are treated with SOF/DAC except for patients with cirrhosis who are treated with SOF/VEL. This study aimed to conduct a five-year budget impact analysis from the provider perspective of the proposed stratified treatment cascade for HCV treatment in Malaysia. Method: A disease progression model that was developed based on model-predicted HCV epidemiology data in Malaysia was used for the analysis, where all HCV patients in scenario A were treated with SOF/DAC for all disease stages while in scenario B, SOF/DAC was used only for non-cirrhotic patients and SOF/VEL was used for the cirrhotic patients. The model projections estimated the annual numbers of patients in care and the numbers of patients to be initiated on DAA treatment nationally. Healthcare costs associated with DAA therapy and disease stage monitoring was included to estimate the downstream cost implications. For scenario B, the estimated treatment uptake of SOF/VEL for cirrhotic patients were 25%, 50%, 75%, 100% and 100% for 2018, 2019, 2020, 2021 and 2022 respectively. Healthcare costs were estimated based on standard clinical pathways for DAA treatment described in recent guidelines. All costs were reported in US dollars (conversion rate US$1=RM4.09, the price year 2018). Scenario analysis was conducted for 5% and 10% reduction of SOF/VEL acquisition cost anticipated from the competitive market pricing of generic DAA in Malaysia. Results: The stratified treatment cascade with SOF/VEL in Scenario B was found to be cost-saving compared to Scenario A. A substantial portion of the cost reduction was due to the costs associated with DAA therapy which resulted in USD 40 thousand (year 1) to USD 443 thousand (year 5) savings annually, with cumulative savings of USD 1.1 million after 5 years. Cost reductions for disease stage monitoring were seen in year three onwards which resulted in cumulative savings of USD 1.1 thousand. Scenario analysis estimated cumulative savings of USD 1.24 to USD 1.35 million when the acquisition cost of SOF/VEL was reduced. Conclusion: A stratified treatment cascade with SOF/VEL was expected to be cost-saving and can results in a budget impact reduction in overall healthcare expenditure in Malaysia compared to treatment with SOF/DAC. The better clinical efficacy with SOF/VEL is expected to halt patients’ HCV disease progression and may reduce downstream costs of treating advanced disease stages. The findings of this analysis may be useful to inform healthcare policies for HCV treatment in Malaysia.

Keywords: Malaysia, direct acting antiviral, compulsory licensing, voluntary licensing

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Authors: Chen-Yu Chen, Ping-Hsueh We, Wei-Mon Yan

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Over the past few centuries, human requirements for energy have been met by burning fossil fuels. However, exploiting this resource has led to global warming and innumerable environmental issues. Thus, finding alternative solutions to the growing demands for energy has recently been driving the development of low-carbon and even zero-carbon energy sources. Wind power and solar energy are good options but they have the problem of unstable power output due to unpredictable weather conditions. To overcome this problem, a reliable and efficient energy storage sub-system is required in future distributed-power systems. Among all kinds of energy storage technologies, the fuel cell system with hydrogen storage is a promising option because it is suitable for large-scale and long-term energy storage. The high-temperature proton exchange membrane fuel cell (HT-PEMFC) with metallic bipolar plates is a promising fuel cell system because an HT-PEMFC can tolerate a higher CO concentration and the utilization of metallic bipolar plates can reduce the cost of the fuel cell stack. However, the operating life of metallic bipolar plates is a critical issue because of the corrosion phenomenon. As a result, in this work, we try to apply different coating layer on the metal surface and to investigate the protection performance of the coating layers. The tested bipolar plates include uncoated SS304 bipolar plates, titanium nitride (TiN) coated SS304 bipolar plates and chromium nitride (CrN) coated SS304 bipolar plates. The results show that the TiN coated SS304 bipolar plate has the lowest contact resistance and through-plane resistance and has the best cell performance and operating life among all tested bipolar plates. The long-term in-situ fuel cell tests show that the HT-PEMFC with TiN coated SS304 bipolar plates has the lowest performance decay rate. The second lowest is CrN coated SS304 bipolar plate. The uncoated SS304 bipolar plate has the worst performance decay rate. The performance decay rates with TiN coated SS304, CrN coated SS304 and uncoated SS304 bipolar plates are 5.324×10⁻³ % h⁻¹, 4.513×10⁻² % h⁻¹ and 7.870×10⁻² % h⁻¹, respectively. In addition, the EIS results indicate that the uncoated SS304 bipolar plate has the highest growth rate of ohmic resistance. However, the ohmic resistance with the TiN coated SS304 bipolar plates only increases slightly with time. The growth rate of ohmic resistances with TiN coated SS304, CrN coated SS304 and SS304 bipolar plates are 2.85×10⁻³ h⁻¹, 3.56×10⁻³ h⁻¹, and 4.33×10⁻³ h⁻¹, respectively. On the other hand, the charge transfer resistances with these three bipolar plates all increase with time, but the growth rates are all similar. In addition, the effective catalyst surface areas with all bipolar plates do not change significantly with time. Thus, it is inferred that the major reason for the performance degradation is the elevated ohmic resistance with time, which is associated with the corrosion and oxidation phenomena on the surface of the stainless steel bipolar plates.

Keywords: coating layer, high-temperature proton exchange membrane fuel cell, metallic bipolar plate, performance degradation

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