Search results for: milan criteria

Authors: Ahmad Idris, Armaya`u Suleiman Labo, Ado Yusuf Abdulfatah, Murtala Umar

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Super pave is the short form of Superior Performing Asphalt Pavement and represents a basis for specifying component materials, asphalt mixture design and analysis, and pavement performance prediction. This new technology is the result of long research projects conducted by the strategic Highway Research program (SHRP) of the Federal Highway Administration. This research was aimed at examining the suitability of Aggregates found in Kano for used in super pave design method. Aggregates samples were collected from different sources in Kano Nigeria and their Engineering properties, as they relate to the SUPERPAVE design requirements were determined. The average result of Coarse Aggregate Angularity in Kano was found to be 87% and 86% of one fractured face and two or more fractured faces respectively with a standard of 80% and 85% respectively. Fine Aggregate Angularity average result was found to be 47% with a requirement of 45% minimum. A flat and elongated particle which was found to be 10% has a maximum criterion of 10%. Sand equivalent was found to be 51% with the criteria of 45% minimum. Strength tests were also carried out, and the results reflect the requirements of the standards. The tests include Impact value test, Aggregate crushing value and Aggregate Abrasion tests and the results are 27.5%, 26.7% and 13% respectively with a maximum criteria of 30%. Specific gravity was also carried out and the result was found to have an average value of 2.52 with a criterion of 2.6 to 2.9 and Water absorption was found to be 1.41% with maximum criteria of 0.6%. From the study, the result of the tests indicated that the aggregates properties have met the requirements of Super pave design method based on the specifications of ASTMD 5821, ASTM D 4791, AASHTO T176, AASHTO T33 and BS815.

Keywords: aggregates, construction, road design, super pave

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Authors: Samia Alblwi, Amani Ayad

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Mutation testing is the art of generating syntactic variations of a base program and checking whether a candidate test suite can identify all the mutants that are not semantically equivalent to the base: this technique is widely used by researchers to select quality test suites. One of the main obstacles to the widespread use of mutation testing is cost: even small pro-grams (a few dozen lines of code) can give rise to a large number of mutants (up to hundreds): this has created an incentive to seek to reduce the number of mutants while preserving their collective effectiveness. Two criteria have been used to reduce the size of mutant sets: equiva-lence, which aims to partition the set of mutants into equivalence classes modulo semantic equivalence, and selecting one representative per class; subsumption, which aims to define a partial ordering among mutants that ranks mutants by effectiveness and seeks to select maximal elements in this ordering. In this paper we analyze these two policies using analytical and em-pirical criteria.

Keywords: mutation testing, mutant sets, mutant equivalence, mutant subsumption, mutant set minimization

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Authors: Mohd Taufiq bin Azmy, Yahaya Hassan, Shubashini Gnanasan, Loganathan Fahrni

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Inappropriate prescribing in older patients has been associated with resource utilization and adverse drug events (ADE) such as hospitalization, morbidity and mortality. Globally, there is a lack of published data on ADE induced by inappropriate prescribing. Our study is specific to an older population and is aimed at identifying risk factors for ADE and to develop a model that will link ADE to inappropriate prescribing. The design of the study was prospective whereby computerized medical records of 302 hospitalized elderly aged 65 years and above in 3 public hospitals in Malaysia (Hospital Serdang, Hospital Selayang and Hospital Sungai Buloh) were studied over a 7 month period from September 2013 until March 2014. Potentially inappropriate medications and potential prescribing omissions were determined using the published and validated START-STOPP criteria. Patients who had at least one inappropriate medication were included in Phase II of the study where ADE were identified by local expert consensus panel based on the published and validated Naranjo ADR probability scale. The panel also assessed whether ADE were causal or contributory to current hospitalization. The association between inappropriate prescribing and ADE (hospitalization, mortality and adverse drug reactions) was determined by identifying whether or not the former was causal or contributory to the latter. Rate of ADE avoidability was also determined. Our findings revealed that the prevalence of potential inappropriate prescribing was 58.6%. A total of ADEs were detected in 31 of 105 patients (29.5%) when STOPP criteria were used to identify potentially inappropriate medication; All of the 31 ADE (100%) were considered causal or contributory to admission. Of the 31 ADEs, 28 (90.3%) were considered avoidable or potentially avoidable. After adjusting for age, sex, comorbidity, dementia, baseline activities of daily living function, and number of medications, the likelihood of a serious avoidable ADE increased significantly when a potentially inappropriate medication was prescribed (odds ratio, 11.18; 95% confidence interval [CI], 5.014 - 24.93; p < .001). The medications identified by STOPP criteria, are significantly associated with avoidable ADE in older people that cause or contribute to urgent hospitalization but contributed less towards morbidity and mortality. Findings of the study underscore the importance of preventing inappropriate prescribing.

Keywords: adverse drug events, appropriate prescribing, health services research

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Authors: Kanita Beširević

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Open-source software development activities highly rely on Internet gathering communities volunteering in software development projects. Additionally, the libraries and cultural institutions share their metadata in the form of linked metadata to enable dissemination and enrichment. The open-source software provides free alternatives to traditional software solutions. The article aims to investigate the ever-increasing options for the digital library open source software adoption. The software available is presented and compared to other software solutions as well as to their previous versions. The top three open-source digital library software solutions are presented and compared. The comparison criteria are adopted from the UNESCO study by Bankier, J., & Gleason, K. Institutional Repository Software Comparison comprising of twelve criteria to appraise software, namely: infrastructure, front-end design, content discovery, publication tools, interoperability, and preservation. This article adopts a descriptive methodology based on data and information collected through selected software websites and the literature review.

Keywords: open source software, digital library, DSpace, Fedora, Greenstone

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Authors: Aleksandra Aleksandrovna Filimonova, Lev Sergeevich Kazarinov, Tatyana Aleksandrovna Barbasova

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A method of effective planning and control of industrial facility energy consumption is offered. The method allows to optimally arrange the management and full control of complex production facilities in accordance with the criteria of minimal technical and economic losses at the forecasting control. The method is based on the optimal construction of the power efficiency characteristics with the prescribed accuracy. The problem of optimal designing of the forecasting model is solved on the basis of three criteria: maximizing the weighted sum of the points of forecasting with the prescribed accuracy; the solving of the problem by the standard principles at the incomplete statistic data on the basis of minimization of the regularized function; minimizing the technical and economic losses due to the forecasting errors.

Keywords: energy consumption, energy efficiency, energy management system, forecasting model, power efficiency characteristics

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Authors: Victoria Y. Garnova, Vladimir G. Merzlikin, Sergey V. Khudyakov, Aleksandr A. Gajour, Andrei P. Garnov

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This paper refers to the analysis of the characteristics of industrial and lifestyle facilities heat- energy objects as a part of the thermal envelope of Earth's surface for inclusion in any database of economic forecasting. The idealized model of the Earth's surface is discussed. This model gives the opportunity to obtain the energy equivalent for each element of terrain and world ocean. Energy efficiency criterion of comfortable human existence is introduced. Dynamics of changes of this criterion offers the possibility to simulate the possible technogenic catastrophes with a spontaneous industrial development of the certain Earth areas. Calculated model with the confirmed forecast of the Gulf Stream freezing in the Polar Regions in 2011 due to the heat-energy balance disturbance for the oceanic subsurface oil polluted layer is given. Two opposing trends of human development under the limited and unlimited amount of heat-energy resources are analyzed.

Keywords: Earth's surface, heat-energy consumption, energy criteria, technogenic catastrophes

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Authors: Fatemeh Zare, Kaveh Bazrafkan, Alireza Bolhari

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Quality of life is one of the most recent issues in today's architectural world. It has numerous criteria and has diverse aspects in different nation's cultures. Social sustainability, on the other hand, is frequently a positive attitude which is manifested by integration of human beings and equity of access to fundamental amenities; for instance, transportation, hygienic systems, equal education facilities, etc. This paper demonstrates that achieving desired quality of life is through assurance of sustainable society. Choosing a sustainable approach in every day's life becomes a practical manner and solution for human life. By assuming that an architect is someone who designs people's life by his/her projects, scrutinizing the relationship between quality of life and architectural buildings would reveal hidden criteria through Datascapes technique. This would be enriched when considering this relationship with everyone's basic needs in the society. One the most impressive needs are the particular demands of physically challenged people which are directly examined and discussed.

Keywords: sustainable design, social sustainability, disabled people, datascapes technique

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Authors: Elvan Ender, Murat Zencirkıran

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One of the most important criteria that increase the success of design in landscape architecture is the visual effect. The characteristics that affect visual appearance in plant design vary depending on the phenological periods of the plants. In plants, although different effects are observed in different periods of the year, this effect is felt most prominently in flowering periods. For this reason, knowing the flowering time, duration and flower characteristics should be considered as a factor increasing the success of plant design. In this study, flower characteristics of natural woody plants with attractive flowers have been examined. Because of the variability of these characteristics of plants in the region, consideration of these criteria in the planting design processes in the region may increase the success of the design. At the same time, when species selection is made considering the obtained data, visuality and sustainability of natural species can be possible in Bursa city with planting design.

Keywords: Bursa, flower characteristics, natural plants, planting design

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Authors: Muhammad Irfan

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The UN General Assembly has advocated improving energy efficiency by SDG criteria to promote global economic growth. Pakistan is confronted with financial obstacles when it comes to acquiring energy efficiency because of the COVID-19 pandemic, economic and political instability, budgetary strains, and poor financial circumstances. The study examines how cutting-edge financing approaches like FinTech, financial inclusion, and green financing affect Pakistan's energy consumption. It finds noteworthy outcomes. The study's results have demonstrated the important impact of these funding methods on energy conservation. The best and most helpful finance tool for energy efficiency is green financing; yet, because of differences in characteristics, workings, and financial institutions, FinTech, and financial inclusion play a smaller role in Pakistan. The researchers propose that to achieve energy efficiency, FinTech activities and funding criteria such as green bonds should be reviewed. It also advised authorities to create energy system-friendly regulations for green finance in Pakistan.

Keywords: green finance, FinTech, financial inclusion, energy efficiency, Pakistan

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Authors: Asma Ben Yaghlane, Mohamed Naceur Azaiez

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In this paper, we briefly introduce the concept of Poisson attacks in the case of defense/attack strategies where attacks are assumed to be continuous. We suggest a game model in which the attacker will combine both criteria of a sufficient confidence level of a successful attack and a reasonably small size of the estimation error in order to launch an attack. Here, estimation error arises from assessing the system failure upon attack using aggregate data at the system level. The corresponding error is referred to as aggregation error. On the other hand, the defender will attempt to deter attack by making one or both criteria inapplicable. The defender will build his/her strategy by both strengthening the targeted system and increasing the size of error. We will formulate the defender problem based on appropriate optimization models. The attacker will opt for a Bayesian updating in assessing the impact on the improvement made by the defender. Then, the attacker will evaluate the feasibility of the attack before making the decision of whether or not to launch it. We will provide illustrations to better explain the process.

Keywords: attacker, defender, game theory, information

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Authors: Malek Makki

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The main purpose of this research study is to assist non-profit organizations (NPOs) to better segment a group of least developing countries and to optimally target the most needier areas, so that the provided aids make positive and lasting differences. We applied international marketing and strategy approaches to segment a sub-group of candidates among a group of 151 countries identified by the UN-G77 list, and furthermore, we point out the areas of priorities. We use reliable and well known criteria on the basis of economics, geography, demography and behavioral. These criteria can be objectively estimated and updated so that a follow-up can be performed to measure the outcomes of any program. We selected 12 socio-economic criteria that complement each other: GDP per capita, GDP growth, industry value added, export per capita, fragile state index, corruption perceived index, environment protection index, ease of doing business index, global competitiveness index, Internet use, public spending on education, and employment rate. A weight was attributed to each variable to highlight the relative importance of each criterion within the country. Care was taken to collect the most recent available data from trusted well-known international organizations (IMF, WB, WEF, and WTO). Construct of equivalence was carried out to compare the same variables across countries. The combination of all these weighted estimated criteria provides us with a global index that represents the level of development per country. An absolute index that combines wars and risks was introduced to exclude or include a country on the basis of conflicts and a collapsing state. The final step applied to the included countries consists of a benchmarking method to select the segment of countries and the percentile of each criterion. The results of this study allowed us to exclude 16 countries for risks and security. We also excluded four countries because they lack reliable and complete data. The other countries were classified per percentile thru their global index, and we identified the needier and the areas where aids are highly required to help any NPO to prioritize the area of implementation. This new concept is based on defined, actionable, accessible and accurate variables by which NPO can implement their program and it can be extended to profit companies to perform their corporate social responsibility acts.

Keywords: developing countries, international marketing, non-profit organization, segmentation

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Authors: Aleksandr A. Gajour, Vladimir G. Merzlikin, Vladimir I. Veselov

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This paper refers to the analysis of the characteristics of industrial and lifestyle facilities heat- energy objects as a part of the thermal envelope of Earth's surface for inclusion in any database of economic forecasting. The idealized model of the Earth's surface is discussed. This model gives the opportunity to obtain the energy equivalent for each element of terrain and world ocean. Energy efficiency criterion of comfortable human existence is introduced. Dynamics of changes of this criterion offers the possibility to simulate the possible technogenic catastrophes with the spontaneous industrial development of the certain Earth areas. Calculated model with the confirmed forecast of the Gulf Stream freezing in the polar regions in 2011 due to the heat-energy balance disturbance for the oceanic subsurface oil polluted layer is given. Two opposing trends of human development under limited and unlimited amount of heat-energy resources are analyzed.

Keywords: Earth's surface, heat-energy consumption, energy criteria, technogenic catastrophes

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Authors: Gelareh Ghaderi

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the overall objective of this study is to develop two alternative plans of spatial and infrastructural development for the Netwerkstad Twente (Twente region) until 2040 and to assess the impacts of those two alternative plans. This region is located on the eastern border of the Netherlands, and it comprises of five municipalities. Based on the strengths and opportunities of the five municipalities of the Netwerkstad Twente, and in order develop the region internationally, strengthen the job market and retain skilled and knowledgeable young population, two alternative visions have been developed; environmental oriented vision, and economical oriented vision. Environmental oriented vision is based mostly on preserving beautiful landscapes. Twente would be recognized as an educational center, driven by green technologies and environment-friendly economy. Market-oriented vision is based on attracting and developing different economic activities in the region based on visions of the five cities of Netwerkstad Twente, in order to improve the competitiveness of the region in national and international scale. On the basis of the two developed visions and strategies for achieving the visions, land use and infrastructural development are modeled and assessed. Based on the SWOT analysis, criteria were formulated and employed in modeling the two contrasting land use visions by the year 2040. Land use modeling consists of determination of future land use demand, assessment of suitability land (Suitability analysis), and allocation of land uses on suitable land. Suitability analysis aims to determine the available supply of land for future development as well as assessing their suitability for specific type of land uses on the basis of the formulated set of criteria. Suitability analysis was operated using CommunityViz, a Planning Support System application for spatially explicit land suitability and allocation. Netwerkstad Twente has highly developed transportation infrastructure, consists of highways network, national road network, regional road network, street network, local road network, railway network and bike-path network. Based on the assumptions of speed limitations on different types of roads provided, infrastructure accessibility level of predicted land use parcels by four different transport modes is investigated. For evaluation of the two development scenarios, the Multi-criteria Evaluation (MCE) method is used. The first step was to determine criteria used for evaluation of each vision. All factors were categorized as economical, ecological and social. Results of Multi-criteria Evaluation show that Environmental oriented cities scenario has higher overall score. Environment-oriented scenario has impressive scores in relation to economical and ecological factors. This is due to the fact that a large percentage of housing tends towards compact housing. Twente region has immense potential, and the success of this project will define the Eastern part of The Netherlands and create a real competitive local economy with innovations and attractive environment as its backbone.

Keywords: economical oriented vision, environmental oriented vision, infrastructure, land use, multi criteria assesment, vision

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Authors: Patrick Mapulanga, Chisomo Petros Ganya

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Purpose: This study aimed to investigate the integration of Simulation-Based Education (SBE) into nursing and midwifery curricula in resource-constrained countries using Malawi as a case study. The purpose of this study is to assess the extent to which SBE is mentioned in curricula and explore the associated content, assessment criteria, and guidelines. Methodology: The research methodology involved a desk study of nursing and midwifery curricula in Malawi. A comprehensive review was conducted to identify references to SBE by examining documents such as official curriculum guides, syllabi, and educational policies. The focus is on understanding the prevalence of SBE without delving into the specific content or assessment details. Findings: The findings revealed that SBE is indeed mentioned in the nursing and midwifery curricula in Malawi; however, there is a notable absence of detailed content and assessment criteria. While acknowledgement of SBE is a positive step, the lack of specific guidelines poses a challenge to its effective implementation and assessment within the educational framework. Conclusion: The study concludes that although the recognition of SBE in Malawian nursing and midwifery curricula signifies a potential openness to innovative learning strategies, the absence of detailed content and assessment criteria raises concerns about the practical application of SBE. Addressing this gap is crucial for harnessing the full transformative potential of SBE in resource-constrained environments. Areas for Further Research: Future research endeavours should focus on a more in-depth exploration of the content and assessment criteria related to SBE in nursing and midwifery curricula. Investigating faculty perspectives and students’ experiences with SBE could provide valuable insights into the challenges and opportunities associated with its implementation. Study Limitations and Implications: The study's limitations include reliance on desk-based analysis, which limits the depth of understanding regarding SBE implementation. Despite this constraint, the implications of the findings underscore the need for curriculum developers, educators, and policymakers to collaboratively address the gaps in SBE integration and ensure a comprehensive and effective learning experience for nursing and midwifery students in resource-constrained countries.

Keywords: simulation based education, transformative learning, nursing and midwifery, curricula, Malawi

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Authors: Luís Marques, João Rocha, Andreia Fernandes, Maria Moura, Cláudia Caseiro, Filipa Figueiredo, João Nunes

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The implementation of circularity strategies other than recycling, such as reducing the amount of raw material, as well as reusing or sharing existing products, remains marginal. The European Commission announced that the transition towards a more circular economy could lead to the net creation of about 700,000 jobs in Europe by 2030, through additional labour demand from recycling plants, repair services and other circular activities. Efforts to create new circular business models in accordance with completely circular processes, as opposed to linear ones, have increased considerably in recent years. In order to create a societal Circular Economy transition model, it is necessary to include innovative solutions, where startups play a key role. Early-stage startups based on new business models according to circular processes often face difficulties in creating enough impact. The StartUp Zero Program designs a model and approach to increase the flow of startups in the Circular Economy field, focusing on a systemic decision analysis and multi-generational approach, considering Multi-Criteria Decision Analysis to support a decision-making tool, which is also supported by the use of a combination of an Analytical Hierarchy Process and Multi-Attribute Value Theory methods. We define principles, criteria and indicators for evaluating startup prerogatives, quantifying the evaluation process in a unique result. Additionally, this entrepreneurship program spanning 16 months involved more than 2400 young people, from ages 14 to 23, in more than 200 interaction activities.

Keywords: circular economy, entrepreneurship, startups;, multi-criteria decision analysis

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Authors: Irina Canco, Amela Malaj

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It is evident that there exists a relationship between supply chain management and business performance. Surveys have showed that in many cases the manager's beliefs and expectations on supply chain management do not match the reality of the business. In this context, the study of supply chain issues is of particular importance and interest considering specifically the current period. The economic problems of this period, are present in Albania as well. The complexity of the supply chain focuses on order fulfilment. Therefore, in this paper, attention will be paid to the impact of supply chain management on business performance. The objective of the paper is to find a relationship between the good supply chain management and business performance. This research is based on the results of surveys referring to the experience of successful businesses on issues related to sustainable supply chain management and its synchronization with the provision of products and services required by the final customers. This study clearly evidenced the impact of the speed of meeting customer requirements on AMAZONA performance. This was also confirmed mathematically through one of the decision criteria in conditions of uncertainty—Laplace criterion.

Keywords: supply chain management, AMAZONA, business performance, Laplace criteria

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Authors: Yah-Ling Hung

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eHealth is undoubtedly emerging as a promising vehicle to provide information for individual self-care management. However, the accessing ability, reading strategies and navigating behavior between higher literacy users and lower literacy users are significantly different. Yet, ways to tailor audiences’ health literacy and develop appropriate eHealth to feed their need become a big challenge. The purpose of this study is to compare the educational effectiveness of eHealth to deliver health knowledge between higher literacy users and lower literacy users, thus establishing useful design strategies of eHealth for users with different level of health literacy. The study was implemented in four stages, the first of which developed a website as the testing media to introduce health care knowledge relating to children’s allergy. Secondly, a reliability and validity test was conducted to make sure that all of the questions in the questionnaire were good indicators. Thirdly, a pre-post knowledge test was conducted with 66 participants, 33 users with higher literacy and 33 users with lower literacy respectively. Finally, a usability evaluation survey was undertaken to explore the criteria used by users with different levels of health literacy to evaluate eHealth. The results demonstrated that the eHealth Intervention in both groups had a positive outcome. There was no significant difference between the effectiveness of eHealth intervention between users with higher literacy and users with lower literacy. However, the average mean of lower literacy group was marginally higher than the average mean of higher literacy group. The findings also showed that the criteria used to evaluate eHealth could be analyzed in terms of the quality of information, appearance, appeal and interaction, but the users with lower literacy have different evaluation criteria from those with higher literacy. This is an interdisciplinary research which proposes the sequential key steps that incorporate the planning, developing and accessing issues that need to be considered when designing eHealth for patients with varying degrees of health literacy.

Keywords: eHealth, health intervention, health literacy, usability evaluation

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Authors: Marzouk Benali, Jawad Jeaidi, Behrang Mansoornejad, Olumoye Ajao, Banafsheh Gilani, Nima Ghavidel Mehr

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Canadian forest industry is seeking to identify and implement transformational strategies for enhanced financial performance through the emerging bioeconomy or more specifically through the concept of the biorefinery. For example, processing forest residues or surplus of biomass available on the mill sites for the production of biofuels, biochemicals and/or biomaterials is one of the attractive strategies along with traditional wood and paper products and cogenerated energy. There are many possible process-product biorefinery pathways, each associated with specific product portfolios with different levels of risk. Thus, it is not obvious which unique strategy forest industry should select and implement. Therefore, there is a need for analytical and design tools that enable evaluating biorefinery strategies based on a set of criteria considering a perspective of sustainability over the short and long terms, while selecting the existing core products as well as selecting the new product portfolio. In addition, it is critical to assess the manufacturing flexibility to internalize the risk from market price volatility of each targeted bio-based product in the product portfolio, prior to invest heavily in any biorefinery strategy. The proposed paper will focus on introducing a systematic methodology for designing integrated biorefineries using process systems engineering tools as well as a multi-criteria decision making framework to put forward the most effective biorefinery strategies that fulfill the needs of the forest industry. Topics to be covered will include market analysis, techno-economic assessment, cost accounting, energy integration analysis, life cycle assessment and supply chain analysis. This will be followed by describing the vision as well as the key features and functionalities of the I-BIOREF software platform, developed by CanmetENERGY of Natural Resources Canada. Two industrial case studies will be presented to support the robustness and flexibility of I-BIOREF software platform: i) An integrated Canadian Kraft pulp mill with lignin recovery process (namely, LignoBoost™); ii) A standalone biorefinery based on ethanol-organosolv process.

Keywords: biorefinery strategies, bioproducts, co-production, multi-criteria decision making, tool

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Authors: Fatemeh Rezaei, Mohammad H. Yarmohammadian, Masoud Ferdosi, Abbas Haghshnas

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Background: Failure Modes and Effect Analysis is now having known as the main methods of risk assessment and the accreditation requirements for many organizations. The Risk Priority Number (RPN) approach is generally preferred, especially for its easiness of use. Indeed it does not require statistical data, but it is based on subjective evaluations given by the experts about the Occurrence (O i), the Severity (Si) and the Detectability (D i) of each cause of failure. Methods: This study is a quantitative – qualitative research. In terms of qualitative dimension, method of focus groups with inductive approach is used. To evaluate the results of the qualitative study, quantitative assessment was conducted to calculate RPN score. Results; We have studied patient’s journey process in surgery ward and the most important phase of the process determined Transport of the patient from the holding area to the operating room. Failures of the phase with the highest priority determined by defining inclusion criteria included severity (clinical effect, claim consequence, waste of time and financial loss), occurrence (time- unit occurrence and degree of exposure to risk) and preventability (degree of preventability and defensive barriers) and quantifying risks priority criteria in the context of RPN index. Ability of improved RPN reassess by root cause (RCA) analysis showed some variations. Conclusions: Finally, It could be concluded that understandable criteria should have been developed according to personnel specialized language and communication field. Therefore, participation of both technical and clinical groups is necessary to modify and apply these models.

Keywords: failure mode, effects analysis, risk priority number(RPN), health system, risk assessment

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Authors: B. J. Mahen, N. E. Lloyd-Gale, S. Johnson, W. P. Rakowicz, M. J. Harris, A. D. Miller

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Background: Migraine is a leading cause of disability in the world. Calcitonin gene-related peptide (CGRP) receptor antagonists offer an approach to migraine prophylaxis by inhibiting the inflammatory and vasodilatory effects of CGRP. In recent years, NICE licensed the use of three CGRP-receptor antagonists: Fremanezumab, Galcanezumab, and Erenumab. Here, we present the outcomes of CGRP-antagonist treatment in a cohort of patients who suffer from episodic or chronic migraine and have failed at least three oral prophylactic therapies. Methods: We offered CGRP antagonists to 86 patients who met the NICE criteria to start therapy. We recorded the number of headache days per month (HDPM) at 0 weeks, 3 months, and 12 months. Of those, 26 patients were switched to an alternative treatment due to poor response or side effects. Of the 112 total cases, 9 cases did not sufficiently maintain their headache diary, and 5 cases were not followed up at 3 months. We have therefore included 98 sets of data in our analysis. Results: Fremanezumab achieved a reduction in HDPM by 51.7% at 3 months (p<0.0001), with 63.7% of patients meeting NICE criteria to continue therapy. Patients trialed on Galcanezumab attained a reduction in HDPM by 47.0% (p=0.0019), with 51.6% of patients meeting NICE criteria to continue therapy. Erenumab, however, only achieved a reduction in HDPM by 17.0% (p=0.29), and this was not statistically significant. Furthermore, 34.4%, 9.7%, and 4.9% of patients taking Fremanezumab, Galcanezumab, and Erenumab, respectively, continued therapy beyond 12 months. Of those who attempted drug holidays following 12 months of treatment, migraine symptoms relapsed in 100% of cases. Conclusion: We observed a significant improvement in HDPM amongst episodic and chronic migraine patients following treatment with Fremanezumab or Galcanezumab.

Keywords: migraine, CGRP, fremanezumab, galcanezumab, erenumab

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Authors: Ellen Bautista, Rebecca M. Flueckiger, Easter Dasmarinas, Rajeev Colaco, Fulbert Alec R. Gillego, Alma M. Lozada, Cristina Bisson

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Lactational Amenorrhea Method (LAM) for family planning is at least 98% effective at preventing pregnancy when all criteria are met; (1) the mother is exclusively or nearly exclusively breastfeeding, (2) the mother is amenorrheic (not menstruating), and (3) the baby is six months old or younger. LAM is particularly suited for women interested in family planning accepted by religious authorities. As a majority catholic nation, LAM is a common and accepted form of family planning in the Philippines. The USAID funded, LuzonHealth project conducted a prospective evaluation in Legazpi City to inform the enhancement of guidelines aimed at increasing LAM compliance and encouraging a second form of contraceptive once LAM protection expires. LAM compliance, reasons for non-compliance, family planning referral and uptake of secondary modern family planning methods were tracked over a nine-month period among 521 postpartum women. The evaluation found that at three months postpartum, 97% of women either met LAM criteria or had shifted to a non-LAM modern family planning method. In month six 87% of women no longer met LAM criteria and of these only 35% had shifted to an alternative modern family planning method. This means that at six-months postpartum 65% of the women in this evaluation were not protected against pregnancy through modern family planning methods. By postpartum month nine, 70% of the women had been referred to family planning counseling, yet of those referred only 34% reported using modern family planning methods. This evaluation clearly indicates scale-up of non-LAM modern family planning does not sufficiently complement the scale-down of LAM compliance. There is a need to increase client knowledge and understanding of LAM as a temporary family planning method with a strong focus on preparing to shift to another form of modern family planning once LAM protection expires. Additionally, there is great need to restructure the referral mechanism to ensure efficacy and quality of care.

Keywords: Philippines, family planning, lactational amenorrhea method, contraceptives

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Authors: Milan Paudel, Fook Fah Yap, Anil K. Bastola

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The difficulties in riding small wheel bicycles and their lesser stability have been perceived for a long time. Although small wheel bicycles are designed using the similar approach and guidelines that have worked well for big wheel bicycles, the performance of the big wheelers and the smaller wheelers are markedly different. Since both the big wheelers and small wheelers have same fundamental geometry, most blame the small wheel for this discrepancy in the performance. This paper reviews existing guidelines for bicycle design, especially the front steering geometry for the bicycle, and provides a systematic and quantitative analysis of different wheel sized bicycles. A validated mathematical model has been used as a tool to assess the dynamic performance of the bicycles in term of their self-stability. The results obtained were found to corroborate the subjective perception of cyclists for small wheel bicycles. The current approach for small wheel bicycle design requires higher speed to be self-stable. However, it was found that increasing the headtube angle and selecting a proper trail could improve the dynamic performance of small wheel bicycles. A range of parameters for front steering geometry has been identified for small wheel bicycles that have comparable stability as big wheel bicycles. Interestingly, most of the identified geometries are found to be beyond the ISO recommended range and seem to counter the current approach of small wheel bicycle design. Therefore, it was successfully shown that the guidelines for big wheelers do not translate directly to small wheelers, but careful selection of the front geometry could make small wheel bicycles as stable as big wheel bicycles.

Keywords: big wheel bicycle, design approach, ISO requirements, small wheel bicycle, stability and performance

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Authors: Gianni Jacucci

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Epistemology traditionally finds its place within human research philosophies and methodologies. Artificial intelligence methods pose challenges, particularly given the unresolved relationship between AI and pivotal concepts in social arenas such as hermeneutics and accountability. We begin by examining the essential criteria governing scientific rigor in the human sciences. We revisit the three foundational philosophies underpinning qualitative research methods: empiricism, hermeneutics, and phenomenology. We elucidate the distinct attributes, merits, and vulnerabilities inherent in the methodologies they inspire. The integration of AI, e.g., deep learning algorithms, sparks an interest in evaluating these criteria against the diverse forms of AI architectures. For instance, Interpreted AI could be viewed as a hermeneutic approach, relying on a priori interpretations, while straight AI may be perceived as a descriptive phenomenological approach, processing original and uncontaminated data. This paper serves as groundwork for such explorations, offering preliminary reflections to lay the foundation and outline the initial landscape.

Keywords: artificial intelligence, deep learning, epistemology, qualitative research, methodology, hermeneutics, accountability

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Authors: Sayuri Inoue, Naohiro Nakamura, Tsubasa Hamada

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The seismic design method of buildings is classified into two types: static design and dynamic design. The static design is a design method that exerts static force as seismic force and is a relatively simple design method created based on the experience of seismic motion in the past 100 years. At present, static design is used for most of the Japanese buildings. Dynamic design mainly refers to the time history response analysis. It is a comparatively difficult design method that input the earthquake motion assumed in the building model and examine the response. Currently, it is only used for skyscrapers and specific buildings. In the present design standard in Japan, it is good to use either the design method of the static design and the dynamic design in the medium and high-rise buildings. However, when actually designing middle and high-rise buildings by two kinds of design methods, the relatively simple static design method satisfies the criteria, but in the case of a little difficult dynamic design method, the criterion isn't often satisfied. This is because the dynamic design method was built with the intention of designing super high-rise buildings. In short, higher safety is required as compared with general buildings, and criteria become stricter. The authors consider applying the dynamic design method to general buildings designed by the static design method so far. The reason is that application of the dynamic design method is reasonable for buildings that are out of the conventional standard structural form such as emphasizing design. For the purpose, it is important to compare the design results when the criteria of both design methods are arranged side by side. In this study, we performed time history response analysis to medium-rise buildings that were actually designed with allowable stress method. Quantitative comparison between static design and dynamic design was conducted, and characteristics of both design methods were examined.

Keywords: buildings, seismic design, allowable stress design, time history response analysis, Japanese seismic code

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Authors: Osman Turkoglu, Alvin Estilo, Ritu Gupta, Liliam Pineda-Salgado, Rajesh Pandey

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Background: Hepatotoxicity can be linked to a variety of clinical symptoms and histopathological signs, posing a great challenge in the surveillance of suspected drug-induced liver injury (DILI) cases in the safety database. Additionally, the majority of such cases are rare, idiosyncratic, highly unpredictable, and tend to demonstrate unique individual susceptibility; these qualities, in turn, lend to a pharmacovigilance monitoring process that is often tedious and time-consuming. Objective: Develop a multifactorial algorithm to assist pharmacovigilance physicians in identifying high-risk hepatotoxicity cases associated with DILI from the sponsor’s safety database (Argus). Methods: Multifactorial selection criteria were established using Structured Query Language (SQL) and the TIBCO Spotfire® visualization tool, via a combination of word fragments, wildcard strings, and mathematical constructs, based on Hy’s law criteria and pattern of injury (R-value). These criteria excluded non-eligible cases from monthly line listings mined from the Argus safety database. The capabilities and limitations of these criteria were verified by comparing a manual review of all monthly cases with system-generated monthly listings over six months. Results: On an average, over a period of six months, the algorithm accurately identified 92% of DILI cases meeting established criteria. The automated process easily compared liver enzyme elevations with baseline values, reducing the screening time to under 15 minutes as opposed to multiple hours exhausted using a cognitively laborious, manual process. Limitations of the algorithm include its inability to identify cases associated with non-standard laboratory tests, naming conventions, and/or incomplete/incorrectly entered laboratory values. Conclusions: The newly developed multifactorial algorithm proved to be extremely useful in detecting potential DILI cases, while heightening the vigilance of the drug safety department. Additionally, the application of this algorithm may be useful in identifying a potential signal for DILI in drugs not yet known to cause liver injury (e.g., drugs in the initial phases of development). This algorithm also carries the potential for universal application, due to its product-agnostic data and keyword mining features. Plans for the tool include improving it into a fully automated application, thereby completely eliminating a manual screening process.

Keywords: automation, drug-induced liver injury, pharmacovigilance, post-marketing

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Authors: Yong Bum Shin

Abstract:

This case focuses on Weighted additive difference, Conjunctive, Disjunctive, and Elimination by aspects methodologies in consumer decision-making models and the Simple additive weighting (SAW) approach in the multi-criteria decision-making (MCDM) area. Most decision-making models illustrate that the rank reversal phenomenon is unpreventable. This paper presents that rank reversal occurs in popular managerial methods such as Weighted Additive Difference (WAD), Conjunctive Method, Disjunctive Method, Elimination by Aspects (EBA) and MCDM methods as well as such as the Simple Additive Weighting (SAW) and finally Unified Commensurate Multiple (UCM) models which successfully addresses these rank reversal problems in most popular MCDM methods in decision-making area.

Keywords: multiple criteria decision making, rank inconsistency, unified commensurate multiple, analytic hierarchy process

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Authors: Deliou Adel, Saadalah Younes, Belkaid Khmissi, Dehbi Meriem

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Composite materials, in the most common sense of the term, are a set of synthetic materials designed and used mainly for structural applications; the mechanical function is dominant. The mechanical behaviors of the composite, as well as the degradation mechanisms leading to its rupture, depend on the nature of the constituents and on the architecture of the fiber preform. The profile is required because it guides the engineer in designing structures with precise properties in relation to the needs. This work is about studying the mechanical behavior of unidirectional composite laminates according to different failure criteria. Varying strength parameter values make it possible to compare the ultimate mechanical characteristics obtained by the criteria of Tsai-Hill, Fisher and maximum stress. The laminate is subjected to uniaxial tensile membrane forces. Estimates of their ultimate strengths and the plotting of the failure envelope constitute the principal axis of this study. Using the theory of maximum stress, we can determine the various modes of damage of the composite. The different components of the deformation are presented for different orientations of fibers.

Keywords: unidirectional kevlar/epoxy composite, failure criterion, membrane stress, deformations, failure envelope

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Authors: Nasser Almonawer

Abstract:

Timely reaction to an evolving global business environment and volatile market conditions necessitates system and process flexibility, which in turn demands agile and adaptable architecture and a steady infusion of affordable new technologies. On the contrary, a large number of organizations utilize systems characterized by inflexible and obsolete legacy architectures. To effectively respond to the dynamic contemporary business environments, such architectures must be migrated to robust and modular open architectures. To this end, this paper proposes an integrated decision support system for a seamless migration to open systems. The proposed decision support system (DSS) integrates three well-established quantitative and qualitative decision-making models—namely, the Delphi method, Analytic Hierarchy Process (AHP) and Goal Programming (GP) to (1) assess risks and establish evaluation criteria; (2) formulate migration strategy and rank candidate systems; and (3) allocate resources among the selected systems.

Keywords: decision support systems, open systems architecture, analytic hierarchy process (AHP), goal programming (GP), delphi method

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Authors: Elena Bellini, Daniele Mugnaini, Michele Boschetto

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People with an Autistic Spectrum Disorder and an Intellectual Disability who need to attend a Hospital Emergency Waiting Room frequently present high levels of discomfort and challenging behaviors due to stress-related hyperarousal, sensory sensitivity, novelty-anxiety, communication and self-regulation difficulties. Increased agitation and acting out also disturb the diagnostic and therapeutic processes, and the emergency room climate. Architectural design disciplines aimed at reducing distress in hospitals or creating autism-friendly environments are called for to find effective answers to this particular need. A growing number of researchers are considering the physical environment as an important point of intervention for people with autism. It has been shown that providing the right setting can help enhance confidence and self-esteem and can have a profound impact on their health and wellbeing. Environmental psychology has evaluated the perceived quality of care, looking at the design of hospital rooms, paths and circulation, waiting rooms, services and devices. Furthermore, many studies have investigated the influence of the hospital environment on patients, in terms of stress-reduction and therapeutic intervention’ speed, but also on health professionals and their work. Several services around the world are organizing autism-friendly hospital environments which involve the architecture and the specific staff training. In Italy, the association Spes contra spem has promoted and published, in 2013, the ‘Chart of disabled people in the hospital’. It stipulates that disabled people should have equal rights to accessible and high-quality care. There are a few Italian examples of therapeutic programmes for autistic people as the Dama project in Milan and the recent experience of Children and Autism Foundation in Pordenone. Careggi’s Emergency Waiting Room in Florence has been built to satisfy this challenge. This project of research comes from a collaboration between the technical staff of Careggi Hospital, the Center for autism PAMAPI and some architects expert in the sensory environment. The methodology of focus group involved architects, psychologists and professionals through a transdisciplinary research, centered on the links between the spatial characteristics and clinical state of people with ASD. The relationship between architectural space and quality of life is studied to pay maximum attention to users’ needs and to support the medical staff in their work by a specific program of training. The result of this research is a sum of criteria used to design the emergency waiting room, that will be illustrated. A protected room, with a clear space design, maximizes comprehension and predictability. The multisensory environment is thought to help sensory integration and relaxation. Visual communication through Ipad allows an anticipated understanding of medical procedures, and a specific technological system supports requests, choices and self-determination in order to fit sensory stimulation to personal preferences, especially for hypo and hypersensitive people. All these characteristics should ensure a better regulation of the arousal, less behavior problems, improving treatment accessibility, safety, and effectiveness. First results about patient-satisfaction levels will be presented.

Keywords: accessibility of care, autism-friendly architecture, personalized therapeutic process, sensory environment

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Authors: M. A. C. S. Sampath Fernando, James M. Curran, Renate Meyer

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Model assessment, in the Bayesian context, involves evaluation of the goodness-of-fit and the comparison of several alternative candidate models for predictive accuracy and improvements. In posterior predictive checks, the data simulated under the fitted model is compared with the actual data. Predictive model accuracy is estimated using information criteria such as the Akaike information criterion (AIC), the Bayesian information criterion (BIC), the Deviance information criterion (DIC), and the Watanabe-Akaike information criterion (WAIC). The goal of an information criterion is to obtain an unbiased measure of out-of-sample prediction error. Since posterior checks use the data twice; once for model estimation and once for testing, a bias correction which penalises the model complexity is incorporated in these criteria. Cross-validation (CV) is another method used for examining out-of-sample prediction accuracy. Leave-one-out cross-validation (LOO-CV) is the most computationally expensive variant among the other CV methods, as it fits as many models as the number of observations. Importance sampling (IS), truncated importance sampling (TIS) and Pareto-smoothed importance sampling (PSIS) are generally used as approximations to the exact LOO-CV and utilise the existing MCMC results avoiding expensive computational issues. The reciprocals of the predictive densities calculated over posterior draws for each observation are treated as the raw importance weights. These are in turn used to calculate the approximate LOO-CV of the observation as a weighted average of posterior densities. In IS-LOO, the raw weights are directly used. In contrast, the larger weights are replaced by their modified truncated weights in calculating TIS-LOO and PSIS-LOO. Although, information criteria and LOO-CV are unable to reflect the goodness-of-fit in absolute sense, the differences can be used to measure the relative performance of the models of interest. However, the use of these measures is only valid under specific circumstances. This study has developed 11 models using normal, log-normal, gamma, and student’s t distributions to improve the PCR stutter prediction with forensic data. These models are comprised of four with profile-wide variances, four with locus specific variances, and three which are two-component mixture models. The mean stutter ratio in each model is modeled as a locus specific simple linear regression against a feature of the alleles under study known as the longest uninterrupted sequence (LUS). The use of AIC, BIC, DIC, and WAIC in model comparison has some practical limitations. Even though, IS-LOO, TIS-LOO, and PSIS-LOO are considered to be approximations of the exact LOO-CV, the study observed some drastic deviations in the results. However, there are some interesting relationships among the logarithms of pointwise predictive densities (lppd) calculated under WAIC and the LOO approximation methods. The estimated overall lppd is a relative measure that reflects the overall goodness-of-fit of the model. Parallel log-likelihood profiles for the models conditional on equal posterior variances in lppds were observed. This study illustrates the limitations of the information criteria in practical model comparison problems. In addition, the relationships among LOO-CV approximation methods and WAIC with their limitations are discussed. Finally, useful recommendations that may help in practical model comparisons with these methods are provided.

Keywords: cross-validation, importance sampling, information criteria, predictive accuracy

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