Search results for: dynamical heterogeneity

Authors: Dipali Dhawan

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Cancerous epithelial cells are confined to a primary site by the continued expression of adhesion molecules and the intact basal lamina. However, as the cancer progresses some cells are believed to undergo an epithelial-mesenchymal transition (EMT) event, leading to increased motility, invasion and, ultimately, metastasis of the cells from the primary tumour to secondary sites within the body. These disseminated cancer cells need the ability to self-renew, as stem cells do, in order to establish and maintain a heterogeneous metastatic tumour mass. Identification of the specific subpopulation of cancer stem cells amenable to the process of metastasis is highly desirable. In this study, we have isolated and characterized cancer stem cells from luminal and basal breast cancer cell lines (MDA-MB-231, MDA-MB-453, MDA-MB-468, MCF7 and T47D) on the basis of cell surface markers CD44 and CD24; as well as Side Populations (SP) using Hoechst 33342 dye efflux. The isolated populations were analysed for epithelial and mesenchymal markers like E-cadherin, N-cadherin, Sfrp1 and Vimentin by Western blotting and Immunocytochemistry. MDA-MB-231 cell lines contain a major population of CD44+CD24- cells whereas MCF7, T47D and MDA-MB-231 cell lines show a side population. We observed higher expression of N-cadherin in MCF-7 SP cells as compared to MCF-7NSP (Non-side population) cells suggesting that the SP cells are mesenchymal like cells and hence express increased N-cadherin with stem cell-like properties. There was an expression of Sfrp1 in the MCF7- NSP cells as compared to no expression in MCF7-SP cells, which suggests that the Wnt pathway is expressed in the MCF7-SP cells. The mesenchymal marker Vimentin was expressed only in MDA-MB-231 cells. Hence, understanding the breast cancer heterogeneity would enable a better understanding of the disease progression and therapeutic targeting.

Keywords: cancer stem cells, epithelial to mesenchymal transition, biomarkers, breast cancer

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Authors: Viktor Müller, Ulman Lindenberger

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Neurophysiological evidence suggests that the physiological states of the system are characterized by specific network structures and network topology dynamics, demonstrating a robust interplay between network topology and function. It is also evident that interpersonal action coordination or social interaction (e.g., playing music in duets or groups) requires strong intra- and interbrain synchronization resulting in a specific hyper brain network activity across two or more brains to support such coordination or interaction. Such complex hyper brain networks can be described as multiplex or multilayer networks that have a specific multidimensional or multilayer network organization characteristic for superordinate systems and their constituents. The aim of the study was to describe multilayer hyper brain networks and synchronization patterns of guitarists playing guitar in a quartet by using electroencephalography (EEG) hyper scanning (simultaneous EEG recording from multiple brains) and following time-frequency decomposition and multilayer network construction, where within-frequency coupling (WFC) represents communication within different layers, and cross-frequency coupling (CFC) depicts communication between these layers. Results indicate that communication or coupling dynamics, both within and between the layers across the brains of the guitarists, play an essential role in action coordination and are particularly enhanced during periods of high demands on musical coordination. Moreover, multilayer hyper brain network topology and dynamical structure of guitar sounds showed specific guitar-guitar, brain-brain, and guitar-brain causal associations, indicating multilevel dynamics with upward and downward causation, contributing to the superordinate system dynamics and hyper brain functioning. It is concluded that the neuronal dynamics during interpersonal interaction are brain-wide and frequency-specific with the fine-tuned balance between WFC and CFC and can best be described in terms of multilayer multi-brain networks with specific network topology and connectivity strengths. Further sophisticated research is needed to deepen our understanding of these highly interesting and complex phenomena.

Keywords: EEG hyper scanning, intra- and interbrain coupling, multilayer hyper brain networks, social interaction, within- and cross-frequency coupling

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Authors: Saeed Pourhassan, Nastaran Maghbouli

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Statement of the problem: The relationship between obesity and cardiovascular diseases has been studied widely(1). The distribution of fat tissue gained attention in relation to cardiovascular risk factors during lang-time research (2). American College of Cardiology/American Heart Association (ACC/AHA) is widely and the most reliable tool to be used as a cardiovascular risk (CVR) assessment tool(3). This study aimed to determine which anthropometric index is better in discrimination of high CVR patients from low risks using ACC/AHA score in addition to finding the best index as a CVR predictor among both genders in different races and countries. Methodology & theoretical orientation: The literature in PubMed, Scopus, Embase, Web of Science, and Google Scholar were searched by two independent investigators using the keywords "anthropometric indices," "cardiovascular risk," and "obesity." The search strategy was limited to studies published prior to Jan 2022 as full-texts in the English language. Studies using ACC/AHA risk assessment tool as CVR and those consisted at least 2 anthropometric indices (ancient ones and novel ones) are included. Study characteristics and data were extracted. The relative risks were pooled with the use of the random-effect model. Analysis was repeated in subgroups. Findings: Pooled relative risk for 7 studies with 16,348 participants were 1.56 (1.35-1.72) for BMI, 1.67(1.36-1.83) for WC [waist circumference], 1.72 (1.54-1.89) for WHR [waist-to-hip ratio], 1.60 (1.44-1.78) for WHtR [waist-to-height ratio], 1.61 (1.37-1.82) for ABSI [A body shape index] and 1.63 (1.32-1.89) for CI [Conicity index]. Considering gender, WC among females and WHR among men gained the highest RR. The heterogeneity of studies was moderate (α²: 56%), which was not decreased by subgroup analysis. Some indices such as VAI and LAP were evaluated just in one study. Conclusion & significance: This meta-analysis showed WHR could predict CVR better in comparison to BMI or WHtR. Some new indices like CI and ABSI are less accurate than WHR and WC. Among women, WC seems to be a better choice to predict cardiovascular disease risk.

Keywords: obesity, cardiovascular disease, risk assessment, anthropometric indices

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Authors: Silpita Paul, Susanta Sadhukhan, Biswanath Maity, Madhusudan Das

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Neural tube defects (NTDs) are one of the most common forms of birth defect and affect ~300,000 new born worldwide each year. The prevalence is higher in Northern India (11 per 1000 birth) compare to southern India (5 per 1000 birth). NTDs are one of the common birth defects related with low blood folate and Hcy concentration. Though the mechanism is still unknown, but it is now established that, NTDs in human are polygenic in nature and follow the heterogeneous trait. In spite of its heterogeneity, polymorphism in few genes affects significantly the trait of NTDs. Polymorphisms in the genes FOLH1 and MTHFR plays important role in NTDs. In this study, the polymorphisms of these genes were screened by bi-directional sequencing from 30 mothers with NTD babies as case. The result revealed that 26.67% patients had bi-allelic FOLH1 polymorphism. The polymorphism has been identified as p.Y60H and frequent to cause NTDs. The study of MTHFR gene showed 2 different SNPs rs1801131 (at exon 4) and rs1801131 (at exon 7). The study showed 6.67% patients of both mono- and bi-allelic MTHFR-rs1801131 polymorphism and 6.67% patients of bi-allelic MTHFR-rs1801131 polymorphism. These polymorphisms has been responsible for p.A222V and p.E429A change respectively and frequently involved in NTD formation. Those polymorphisms affect mainly the absorption of dietary folate from intestine and the formation of 5-methylenetetrahydrofolate (5 MTHF) from 5,10-methylenetetrahydrofolate (5,10- MTHF), which is the functional folate form in our system. Though the study is not complete yet, but these polymorphisms play crucial roles in the formation of NTDs in other world population. Based on the result till date, it can be concluded that they also play significant role in our population too as in control samples we have not found any changes.

Keywords: neural tube defects, polymorphism, FOLH1, MTHFR

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Authors: Ekaterina Zubkova, Irina Beloglazova, Iurii Stafeev, Konsyantin Dergilev, Yelena Parfyonova, Mikhail Menshikov

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Mesenchymal stromal cells from adipose tissue (MSC) currently are widely used in regenerative medicine to restore the function of damaged tissues, but that is significantly hampered by their heterogeneity. One of the modern approaches to overcoming this obstacle is the polarization of cell subpopulations into a specific phenotype under the influence of cytokines and other factors that activate receptors and signal transmission to cells. We polarized MSC with factors affecting the inflammatory signaling and functional properties of cells, followed by verification of their expression profile and ability to affect the polarization of macrophages. RT-PCR evaluation showed that cells treated with LPS, interleukin-17, tumor necrosis factor α (TNF α), primarily express pro-inflammatory factors and cytokines, and after treatment with polyninosin polycytidic acid and interleukin-4 (IL4) anti-inflammatory factors and some proinflammatory factors. MSC polarized with pro-inflammatory cytokines showed a more robust pro-angiogenic effect in fibrin gel bead 3D angiogenesis assay. Further, we evaluated the possibility of paracrine effects of MSCs on the polarization of intact macrophages. Polarization efficiency was assesed by expression of M1/M2 phenotype markers CD80 and CD206. We showed that conditioned media from MSC preincubated in the presence of IL-4 cause an increase in CD206 expression similar to that observed in M2 macrophages. Conditioned media from MSC polarized in the presence of LPS or TNF-α increased the expression of CD80 antigen in macrophages, similar to that observed in M1 macrophages. In other cases, a pronounced paracrine effect of MSC on the polarization of macrophages was not detected. Thus, our study showed that the polarization of MSC along the pro-inflammatory or anti-inflammatory pathway allows us to obtain cell subpopulations that have a multidirectional modulating effect on the polarization of macrophages. (RFBR grants 20-015-00405 and 18-015-00398.)

Keywords: angiogenesis, cytokines, mesenchymal, polarization, inflammation

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Authors: Anum Javed

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This study identifies the dynamical image of human body that continues its metamorphosis in the virtual field of reality. It calls attention to the ways where humans start co-evolving with other life forms; technology in particular and are striving to establish a realm outside the physical framework of matter. The problem exceeds the area of technological ethics by explicably and explanatorily entering the space of literary texts and criticism. Textual analysis of Geek Love (1989) by Katherine Dunn is adjoined with posthumanist perspectives of Pramod K. Nayar to beget psycho-somatic changes in man’s nature of being. It uncovers the meaning people give to their experiences in this budding social and cultural phenomena of material representation tied up with personal practices and technological innovations. It also observes an ethical, physical and psychological reassessment of man within the context of technological evolutions. The study indicates the elements that have rendered morphological freedom and new materialism in man’s consciousness. Moreover this work is inquisitive of what it means to be a human in this time of accelerating change where surgeries, implants, extensions, cloning and robotics have shaped a new sense of being. It attempts to go beyond individual’s body image and explores how objectifying media and culture have influenced people’s judgement of others on new material grounds. It further argues a decentring of the glorified image of man as an independent entity because of his energetic partnership with intelligent machines and external agents. The history of the future progress of technology is also mentioned. The methodology adopted is posthumanist techno-ethical textual analysis. This work necessitates a negotiating relationship between man and technology in order to achieve harmonic and balanced interconnected existence. The study concludes by recommending a call for an ethical set of codes to be cultivated for the techno-human habituation. Posthumanism ushers a strong need of adopting new ethics within the terminology of neo-materialist humanism.

Keywords: corporeality, dematerialism, human ethos, posthumanism

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Authors: Vaibhav Pandey, K. Chattopadhyay, N. C. Santhi Srinivas, Vakil Singh

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Aluminium alloy 7075 consist of different intermetallic precipitate particles MgZn2, CuAl2, which result in heterogeneity of micro structure and influence the corrosion properties of the alloy. Artificial ageing was found to enhance the strength properties, but highly susceptible to stress-corrosion cracking. Various conventional surface modification techniques are developed for improving corrosion properties of aluminum alloys. This led to development of novel surface mechanical attrition treatment (SMAT) technique the so called ultrasonic shot peening which gives nano-grain structure at surface. In the present investigation the influence of surface mechanical attrition treatment on corrosion behavior of aluminum alloy 7075 was studied in 3.5wt% NaCl solution. Two different size of 1 mm and 3 mm steel balls are used as peening media and SMAT was carried out for different time intervals 5, 15 and 30 minutes. Surface nano-grains/nano-crystallization was observed after SMAT. The formation of nano-grain structure was observed for larger size balls with time of treatment and consequent increase in micro strain. As-SMATed sample with 1 mm balls exhibits better corrosion resistance as compared to that of un-SMATed sample. The enhancement in corrosion resistance may be due to formation of surface nano-grain structure which reduced the electron release rate. In contrast the samples treated with 3 mm balls showed very poor corrosion resistance. A decrease in corrosion resistance was observed with increase in the time of peening. The decrease in corrosion resistance in the shotpeened samples with larger diameter balls may due to increase in microstrain and defect density.

Keywords: aluminum alloy 7075, corrosion, SMAT, ultrasonic shot peening, surface nano-grains

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Authors: Christina Hagen, Pragathi Kamale Gurmurthy, Thorsten M. Buzug

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CFD simulations are performed in the upper airway of a patient suffering from obstructive sleep apnea (OSA) that is a sleep related breathing disorder characterized by repetitive partial or complete closures of the upper airways. The simulations are aimed at getting a better understanding of the pathophysiological flow patterns in an OSA patient. The simulation is compared to medical data of a sleep endoscopic examination under sedation. A digital model consisting of surface triangles of the upper airway is extracted from the MR images by a region growing segmentation process and is followed by a careful manual refinement. The computational domain includes the nasal cavity with the nostrils as the inlet areas and the pharyngeal volume with an outlet underneath the larynx. At the nostrils a flat inflow velocity profile is prescribed by choosing the velocity such that a volume flow rate of 150 ml/s is reached. Behind the larynx at the outlet a pressure of -10 Pa is prescribed. The stationary incompressible Navier-Stokes equations are numerically solved using finite elements. A grid convergence study has been performed. The results show an amplification of the maximal velocity of about 2.5 times the inlet velocity at a constriction of the pharyngeal volume in the area of the tongue. It is the same region that also shows the highest pressure drop from about 5 Pa. This is in agreement with the sleep endoscopic examinations of the same patient under sedation showing complete contractions in the area of the tongue. CFD simulations can become a useful tool in the diagnosis and therapy of obstructive sleep apnea by giving insight into the patient’s individual fluid dynamical situation in the upper airways giving a better understanding of the disease where experimental measurements are not feasible. Within this study, it could been shown on one hand that constriction areas within the upper airway lead to a significant pressure drop and on the other hand a good agreement of the area of pressure drop and the area of contraction could be shown.

Keywords: biomedical engineering, obstructive sleep apnea, pharynx, upper airways

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Authors: Manmeet Kaur, Madhu Vij

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The Board of Directors in a firm performs the primary role of an internal control mechanism. This Study seeks to understand the relationship between internal governance and performance of banks in India. The research paper investigates the effect of board structure (proportion of nonexecutive directors, gender diversity, board size and meetings per year) on the firm performance. This paper evaluates the impact of corporate governance mechanisms on bank’s financial performance using panel data for 28 listed banks in National Stock Exchange of India for the period of 2008-2014. Returns on Asset, Return on Equity, Tobin’s Q and Net Interest Margin were used as the financial performance indicators. To estimate the relationship among governance and bank performance initially the Study uses Pooled Ordinary Least Square (OLS) Estimation and Generalized Least Square (GLS) Estimation. Then a well-developed panel Generalized Method of Moments (GMM) Estimator is developed to investigate the dynamic nature of performance and governance relationship. The Study empirically confirms that two-step system GMM approach controls the problem of unobserved heterogeneity and endogeneity as compared to the OLS and GLS approach. The result suggests that banks with small board, boards with female members, and boards that meet more frequently tend to be more efficient and subsequently have a positive impact on performance of banks. The study offers insights to policy makers interested in enhancing the quality of governance of banks in India. Also, the findings suggest that board structure plays a vital role in the improvement of corporate governance mechanism for financial institutions. There is a need to have efficient boards in banks to improve the overall health of the financial institutions and the economic development of the country.

Keywords: board of directors, corporate governance, GMM estimation, Indian banking

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Authors: Christine Ysabelle G. Roman, Pauline Torres

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Background: Hypertrophic cardiomyopathy is a disease of marked heterogeneity. It is a genetically determined heart disease characterized by significant myocardium hypertrophy that results in diastolic dysfunction, left ventricular outflow tract obstruction, and an increased risk of arrhythmias. The primary treatment in patients with such conditions is negative inotropic drugs, such as beta-blockers, calcium channel antagonists, and disopyramide. However, for those who remain symptomatic and need septal reduction therapy, surgical septal myectomy or alcohol septal ablation are options. Case Summary: A 19 – year old female presented in the authors’ institution with easy fatigability. The consult was done a year prior, and 2D echocardiography was requested which showed concentric left ventricular hypertrophy, asymmetrically hypertrophied interventricular septum (IVS) with the largest diameter of 3.3cm & subaortic dynamic obstruction with a maximum gradient of 47 mmHg. A repeat echo a year later showed asymmetric septal hypertrophy (IVS measuring at 3cm) with the systolic anterior motion of anterior mitral valve leaflet and left ventricular outflow tract obstruction (peak gradient of 50mmHg). The patient then underwent alcohol septal ablation and was discharged stable after four days of admission. Conclusion: Hypertrophic obstructive cardiomyopathy, a cardiovascular genetic disease, results in various patterns of left ventricular hypertrophy and abnormality of mitral valve apparatus. The patient is managed medically initially. However, despite optimal drug therapy and significant left ventricular outflow tract obstruction, significant heart failure symptoms or syncope require invasive treatment.

Keywords: hypertrophic obstructive cardiomyopathy, left ventricular outflow tract obstruction, alcohol septal ablation, alcohol

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Authors: Emily C. Shepard, Caroline Sweeney, Jessica Grimm, Sophie Jacobs, Lauren Thompson, Lisa L. Weyandt

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Adolescence is a critical phase of development in which individuals are prone to more risky behavior while also facing potentially life-changing decisions. The balance of increased behavioral risk and responsibility indicates the importance of executive functioning ability. In recent years, executive function training has emerged as a technique to enhance this cognitive ability. The aim of the present systematic review was to discuss the reported efficacy of executive functioning training techniques among adolescents. After reviewing 3110 articles, a total of 24 articles were identified which examined the role of executive functioning training techniques among adolescents (age 10-19). Articles retrieved demonstrated points of comparison across psychiatric and medical diagnosis, location of training, and stage of adolescence. Typically developing samples, as well as those with attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), conduct disorder, and physical health concerns were found, allowing for the comparison of the efficacy of techniques considering physical and psychological heterogeneity. Among typically developing adolescents, executive functioning training yielded nonsignificant or low effect size improvements in executive functioning, and in some cases executive functioning ability was decreased following the training. In special populations, including those with ADHD, (ASD), conduct disorder, and physical health concerns significant differences and larger effect sizes in executive functioning were seen following treatment, particularly among individuals with ADHD. Future research is needed to identify the long-term efficacy of these treatments, as well as their generalizability to real-world conditions.

Keywords: adolescence, attention-deficit hyperactivity disorder, executive function, executive function training, traumatic brain injury

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Authors: Asrat M.Belachew, Tiago Pereira, Institute of Mathematics, Computer Sciences, Avenida Trabalhador São Carlense, 400, São Carlos, 13566-590, Brazil

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Infectious diseases are among the most prominent threats to human beings. They cause morbidity and mortality to an individual and collapse the social, economic, and political systems of the whole world collectively. Mathematical models are fundamental tools and provide a comprehensive understanding of how infectious diseases spread and designing the control strategy to mitigate infectious diseases from the host population. Modeling the spread of infectious diseases using a compartmental model of inhomogeneous populations is good in terms of complexity. However, in the real world, there is a situation that accounts for heterogeneity, such as ages, locations, and contact patterns of the population which are ignored in a homogeneous setting. In this work, we study how classical an SEIR infectious disease spreading of the compartmental model can be extended by incorporating the mobility of population between heterogeneous cities during an outbreak of infectious disease. We have formulated an SEIR multi-cities epidemic spreading model using a system of 4k ordinary differential equations to describe the disease transmission dynamics in k-cities during the day and night. We have shownthat the model is epidemiologically (i.e., variables have biological interpretation) and mathematically (i.e., a unique bounded solution exists all the time) well-posed. We constructed the next-generation matrix (NGM) for the model and calculated the basic reproduction number R0for SEIR-epidemic spreading model with cities mobility. R0of the disease depends on the spectral radius mobility operator, and it is a threshold between asymptotic stability of the disease-free equilibrium and disease persistence. Using the eigenvalue perturbation theorem, we showed that sending a fraction of the population between cities decreases the reproduction number of diseases in interconnected cities. As a result, disease transmissiondecreases in the population.

Keywords: SEIR-model, mathematical model, city mobility, epidemic spreading

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Authors: George N. Prodromidis, Frank A. Coutelieris

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Biogas can be currently considered as an alternative option for electricity production, mainly due to its high energy content (hydrocarbon-rich source), its renewable status and its relatively low utilization cost. Solid Oxide Fuel Cell (SOFC) stacks convert fuel’s chemical energy to electricity with high efficiencies and reveal significant advantages on fuel flexibility combined with lower emissions rate, especially when utilize biogas. Electricity production by biogas constitutes a composite problem which incorporates an extensive parametric analysis on numerous dynamic variables. The main scope of the presented study is to propose a detailed thermodynamic model on the optimization of SOFC-based power plants’ operation based on fundamental thermodynamics, energy and exergy balances. This model named THERMAS (THERmodynamic MAthematical Simulation model) incorporates each individual process, during electricity production, mathematically simulated for different case studies that represent real life operational conditions. Also, THERMAS offers the opportunity to choose a great variety of different values for each operational parameter individually, thus allowing for studies within unexplored and experimentally impossible operational ranges. Finally, THERMAS innovatively incorporates a specific criterion concluded by the extensive energy analysis to identify the most optimal scenario per simulated system in exergy terms. Therefore, several dynamical parameters as well as several biogas mixture compositions have been taken into account, to cover all the possible incidents. Towards the optimization process in terms of an innovative OPF (OPtimization Factor), presented here, this research study reveals that systems supplied by low methane fuels can be comparable to these supplied by pure methane. To conclude, such an innovative simulation model indicates a perspective on the optimal design of a SOFC stack based system, in the direction of the commercialization of systems utilizing biogas.

Keywords: biogas, exergy, efficiency, optimization

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Authors: Ragi Poyyara, Vijaya Patnana, Mohammed Alam

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When acid is pumped into damaged reservoirs for damage removal/stimulation, distorted inflow of acid into the formation occurs caused by acid preferentially traveling into highly permeable regions over low permeable regions, or (in general) into the path of least resistance. This can lead to poor zonal coverage and hence warrants diversion to carry out an effective placement of acid. Diversion is desirably a reversible technique of temporarily reducing the permeability of high perm zones, thereby forcing the acid into lower perm zones. The uniqueness of each reservoir can pose several challenges to engineers attempting to devise optimum and effective diversion strategies. Diversion techniques include mechanical placement and/or chemical diversion of treatment fluids, further sub-classified into ball sealers, bridge plugs, packers, particulate diverters, viscous gels, crosslinked gels, relative permeability modifiers (RPMs), foams, and/or the use of placement techniques, such as coiled tubing (CT) and the maximum pressure difference and injection rate (MAPDIR) methodology. It is not always realized that the effectiveness of diverters greatly depends on reservoir properties, such as formation type, temperature, reservoir permeability, heterogeneity, and physical well characteristics (e.g., completion type, well deviation, length of treatment interval, multiple intervals, etc.). This paper reviews the mechanisms by which each variety of diverter functions and discusses the effect of various reservoir properties on the efficiency of diversion techniques. Guidelines are recommended to help enhance productivity from zones of interest by choosing the best methods of diversion while pumping an optimized amount of treatment fluid. The success of an overall acid treatment often depends on the effectiveness of the diverting agents.

Keywords: diversion, reservoir, zonal coverage, carbonate, sandstone

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Authors: Leng Jian-Wei, Wang Lai-Jun, Li Ye

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In order to measure and analyze the transportation situation within the counties of Shaanxi province over a certain period of time and to promote the province's future transportation planning and development, this paper proposes a reasonable layout plan and compares model rationality. The study uses entropy weight method to measure the transportation advantages of 107 counties in Shaanxi province from three dimensions: road network density, trunk line influence and location advantage in 2013 and 2021, and applies spatial autocorrelation analysis method to analyze the spatial layout and development trend of county-level transportation, and conducts ordinary least square (OLS)regression on transportation impact factors and other influencing factors. The paper also compares the regression fitting degree of the Geographically weighted regression(GWR) model and the OLS model. The results show that spatially, the transportation advantages of Shaanxi province generally show a decreasing trend from the Weihe Plain to the surrounding areas and mainly exhibit high-high clustering phenomenon. Temporally, transportation advantages show an overall upward trend, and the phenomenon of spatial imbalance gradually decreases. People's travel demands have changed to some extent, and the demand for rapid transportation has increased overall. The GWR model regression fitting degree of transportation advantages is 0.74, which is higher than the OLS regression model's fitting degree of 0.64. Based on the evolution of transportation advantages, it is predicted that this trend will continue for a period of time in the future. To improve the transportation advantages of Shaanxi province increasing the layout of rapid transportation can effectively enhance the transportation advantages of Shaanxi province. When analyzing spatial heterogeneity, geographic factors should be considered to establish a more reliable model

Keywords: traffic dominance, GWR model, spatial autocorrelation analysis, temporal and spatial evolution

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Authors: Ravinder Kaur

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Introduction Global cerebrovascular reactivity (CVR) mapping is a promising clinical assessment for stress-testing the brain using physiological challenges, such as CO₂, to elicit changes in perfusion. It enables real-time assessment of cerebrovascular integrity and health. Conventional imaging approaches solely use steady-state parameters, like cerebral blood flow (CBF), to evaluate the integrity of the resting parenchyma and can erroneously show a healthy brain at rest, despite the underlying pathogenesis in the presence of cerebrovascular disease. Conversely, coupling CO₂ inhalation with phase-contrast MRI neuroimaging interrogates the capacity of the vasculature to respond to changes under stress. It shows promise in providing prognostic value as a novel health marker to measure neurovascular function in disease and to detect early brain vasculature dysfunction. Objective This exploratory study was established to:(a) quantify the CBF response to CO₂ in hypocapnia and hypercapnia,(b) evaluate disparities in CVR between internal carotid (ICA) and vertebral artery (VA), and (c) assess sex-specific variation in CVR. Methodology Phase-contrast MRI was employed to measure the cerebrovascular reactivity to CO₂ (±10 mmHg). The respiratory interventions were presented using the prospectively end-tidal targeting RespirActTM Gen3 system. Post-processing and statistical analysis were conducted. Results In 9 young, healthy subjects, the CBF increased from hypocapnia to hypercapnia in all vessels (4.21±0.76 to 7.20±1.83 mL/sec in ICA, 1.36±0.55 to 2.33±1.31 mL/sec in VA, p < 0.05). The CVR was quantitatively higher in ICA than VA (slope of linear regression: 0.23 vs. 0.07 mL/sec/mmHg, p < 0.05). No statistically significant effect was observed in CVR between male and female (0.25 vs 0.20 mL/sec/mmHg in ICA, 0.09 vs 0.11 mL/sec/mmHg in VA, p > 0.05). Conclusions The principal finding in this investigation validated the modulation of CBF by CO₂. Moreover, it has indicated that regional heterogeneity in hemodynamic response exists in the brain. This study provides scope to standardize the quantification of CVR prior to its clinical translation.

Keywords: cerebrovascular disease, neuroimaging, phase contrast MRI, cerebrovascular reactivity, carbon dioxide

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Authors: Zyrah Lou R. Samar, Genecarlo Liwanag

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Type 2 Diabetes Mellitus is the more prevalent type, caused by a combination of insulin resistance and inadequate insulin response to hyperglycemia1. Aside from pharmacologic interventions, medical nutrition therapy is an integral part of the management of patients with Type 2 Diabetes Mellitus. Whey protein, which is one of the best protein sources, has been investigated for its applicability in improving glycemic control in patients with Type 2 Diabetes Mellitus. This systematic review and meta-analysis was conducted to measure the magnitude of the effect of whey protein on glycemic control in type 2 diabetes mellitus. The aim of this review is to evaluate the efficacy and safety of whey protein in patients with type 2 diabetes mellitus. Methods: A systematic electronic search for studies in the PubMed and Cochrane Collaboration database was done. Included in this review were randomized controlled trials of whey protein enrolling patients with type 2 diabetes mellitus. Three reviewers independently searched, assessed, and extracted data from the individual studies. Results: A systematic literature search on online databases such as Cochrane Central Registry, PubMed, and Herdin Plus was conducted in April to September 2021 to identify eligible studies. The search yielded 21 randomized controlled trials after removing duplicates. Only 5 articles were included after reviewing the full text, which met the criteria for selection. Conclusion: Whey protein supplementation significantly reduced fasting blood glucose. However, it did not reduce post-prandial blood glucose, HbA1c level, and weight when compared with the placebo. There has been a considerate heterogeneity across all studies, which may have contributed/confounded its effects. A larger sample size and better inclusion, and a more specific study may be included in the future reviews.

Keywords: whey protein, diabetes, nutrition, fasting blood sugar, postprandial glucose, HbA1c, weight reduction

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Authors: Zainab Abbas Soharwardi, Chunli Su, Harold Wilson Tumwitike Mapoma, Syed Zahid Aziz, Mahmut Ince

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This study investigated the spatial variations of groundwater chemistry used by communities in Lahore city with emphasis on arsenic (As) and fluoride (F) levels. A total of 472 tubewell samples were collected from 7 towns and analyzed for physical and chemical parameters, including pH, turbidity, electrical conductivity (EC), total dissolved solids (TDS), total hardness, HCO3, Ca2+, Mg2+, Na+, K+, SO42-, Cl-, NO3-, NO2-, F- and As. There were significant spatial variations observed for total hardness, TDS, HCO3, NO3 and As. In general, the south-east of the city displayed higher TH and HCO3 while the north-east showed significantly higher As concentrations attributed to the heterogeneity of the aquifer and industrial activities. In most cases, As was higher than WHO limit value. Indiscriminate disposal of domestic and commercial wastewater into River Ravi is the cause of elevated NO3 observed in the north-west compared to other places in the area. Investigation of the groundwater type revealed facies in the order: Ca-Mg-HCO3-SO4 > Mg-Ca-HCO3-SO4 > Ca-Mg-HCO3-SO4-Cl > Mg-Ca-HCO3-SO4 > Ca-HCO3-SO4 > Ca-Mg-SO4-HCO3. The plausible mineralization control mechanism seems to be that of carbonate weathering, although silicate weathering is probable. Moreover, PHREEQC model results showed that the groundwater was under saturated with respect to evaporites (anhydrite, fluorite, gypsum and halite) while generally equilibrium to saturated with respect to aragonite, calcite and dolomite. The Hierarchical Cluster Analysis (HCA) showed that pH significantly affected As, F, NO3 and NO2 while HCO3 contributing most to the observed TDS values in Lahore. It is concluded that inherent mineral dissolution/ precipitation, pH, oxic conditions, anthropogenic activities, atmospheric transport/ wet deposition, microbial activities and surface soil characteristics play their significant roles in elevating both As and F in the city's groundwater.

Keywords: Lahore, arsenic, fluoride, groundwater

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Authors: Nikolaos Petropoulos, Elena Blokhina, Andrii Sokolov, Andrii Semenov, Panagiotis Giounanlis, Xutong Wu, Dmytro Mishagli, Eugene Koskin, Robert Bogdan Staszewski, Dirk Leipold

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We investigate entanglement and quantum information scrambling (QIS) by the example of a many-body Extended and spinless effective Fermi-Hubbard Model (EFHM and e-FHM, respectively) that describes a special type of quantum dot array provided by Equal1 labs silicon-based quantum computer. The concept of QIS is used in the framework of quantum information processing by quantum circuits and quantum channels. In general, QIS is manifest as the de-localization of quantum information over the entire quantum system; more compactly, information about the input cannot be obtained by local measurements of the output of the quantum system. In our work, we will first make an introduction to the concept of quantum information scrambling and its connection with the 4-point out-of-time-order (OTO) correlators. In order to have a quantitative measure of QIS we use the tripartite mutual information, in similar lines to previous works, that measures the mutual information between 4 different spacetime partitions of the system and study the Transverse Field Ising (TFI) model; this is used to quantify the dynamical spreading of quantum entanglement and information in the system. Then, we investigate scrambling in the quantum many-body Extended Hubbard Model with external magnetic field Bz and spin-spin coupling J for both uniform and thermal quantum channel inputs and show that it scrambles for specific external tuning parameters (e.g., tunneling amplitudes, on-site potentials, magnetic field). In addition, we compare different Hilbert space sizes (different number of qubits) and show the qualitative and quantitative differences in quantum scrambling as we increase the number of quantum degrees of freedom in the system. Moreover, we find a "scrambling phase transition" for a threshold temperature in the thermal case, that is, the temperature of the model that the channel starts to scramble quantum information. Finally, we make comparisons to the TFI model and highlight the key physical differences between the two systems and mention some future directions of research.

Keywords: condensed matter physics, quantum computing, quantum information theory, quantum physics

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Authors: Tahani Hallek, Dhaou Akrout, Riadh Ahmadi, Mabrouk Montacer

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The present work is an organic geochemical study of the Fahdene Formation outcrops at the Mahjouba region belonging to the Eastern part of the Kalaat Senan structure in northwestern Tunisia (the Kef-Tedjerouine area). The analytical study of the organic content of the samples collected, allowed us to point out that the Formation in question is characterized by an average to good oil potential. This fossilized organic matter has a mixed origin (type II and III), as indicated by the relatively high values of hydrogen index. This origin is confirmed by the C29 Steranes abundance and also by tricyclic terpanes C19/(C19+C23) and tetracyclic terpanes C24/(C24+C23) ratios, that suggest a marine environment of deposit with high plants contribution. We have demonstrated that the heterogeneity of organic matter between the marine aspect, confirmed by the presence of foraminifera, and the continental contribution, is the result of an episodic anomaly in relation to the sequential stratigraphy. Given that the study area is defined as an outer platform forming a transition zone between a stable continental domain to the south and a deep basin to the north, we have explained the continental contribution by successive forced regressions, having blocked the albian transgression, allowing the installation of the lowstand system tracts. This aspect is represented by the incised valleys filling, in direct contact with the pelagic and deep sea facies. Consequently, the Fahdene Formation, in the Kef-Tedjerouine area, consists of transgressive system tracts (TST) brutally truncated by extras of continental progradation; resulting in a mixed influence deposition having retained a heterogeneous organic material.

Keywords: molecular geochemistry, biomarkers, forced regression, deposit environment, mixed origin, Northern Tunisia

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Authors: Atena Sadat Hosseini, Mohammadhossein Habibi

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Acute myeloid leukemia (AML) is the most typically diagnosed leukemia. In older adults, AML imposes a dismal outcome. AML originates with a dominant mutation, then adds collaborative, transformative mutations leading to myeloid transformation and clinical/biological heterogeneity. Several chemotherapeutic drugs are used for this cancer. These drugs are naturally associated with several side effects, and finding a more accurate molecular mechanism of these drugs can have a significant impact on the selection and better candidate of drugs for treatment. In this study, we evaluated bortezomibin myeloma cells using bioinformatics analysis and evaluation of RNA-Seq data. Then investigated the molecular pathways proteins- proteins interactions associated with this chemotherapy drug. A total of 658upregulated genes and 548 downregulated genes were sorted.AUF1 (hnRNP D0) binds and destabilizes mRNA, degradation of GLI2 by the proteasome, the role of GTSE1 in G2/M progression after G2 checkpoint, TCF dependent signaling in response to WNT demonstrated in upregulated genes. Besides insulin resistance, AKT phosphorylates targets in the nucleus, cytosine methylation, Longevity regulating pathway, and Signal Transduction of S1P Receptor were related to low expression genes. With respect to this results, HIST2H2AA3, RP11-96O20.4, ZED9, PRDX1, and DOK2, according to node degrees and betweenness elements candidates from upregulated genes. in the opposite side, PYURF, NRSN1, FGF23, UPK3BL, and STAG3 were a prominent role in downregulated genes. Sum up, Using in silico analysis in the present study, we conducted a precise study ofbortezomib molecular mechanisms in myeloma cells. so that we could take further evaluation to discovermolecular cancer therapy. Naturally, more additional experimental and clinical procedures are needed in this survey.

Keywords: myeloma cells, acute myeloid leukemia, bioinformatics analysis, bortezomib

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Authors: Shidratul Moontaha Suha

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Violence is organized and utilized differently in various communities across the globe. The capacity to employ violence in numerous societies is largely limited to the apparatus of the state, like law enforcement officers, and in a small share of contexts, it is controlled within the state institutions as per the rule of law. Contrastingly, in many other societies, a broad array of players, mainly organized criminal gangs, are using violence on a substantial scale to agitate against social ills or attain personal interests. The present paper examined the role of social injustice in driving children living off and on the streets of Dhaka, Bangladesh, into joining organized criminal gangs and committing crimes. The study entailed a comprehensive review of existing literature with theoretical analyses based on three theories: the Marxist’s theory of capitalism and class struggle, the Weberian model of social stratification theory, and the social disorganization theory. The analysis revealed that, in Dhaka, Bangladesh, criminal gangs emerged from social disorganization of communities characterized by absolute poverty, residential mobility, and population heterogeneity, which promote deviance among the youth, and subsequently, led to the rise of organized gangs and delinquency. Although the latter was formed as a response to class struggle, they have been employed by the state and police as the tools of exploitation and oppression to rule the working class. The criminal gangs exploit the vulnerability of street children by using them as sources of cheap labor to peddle drugs, extort, or kill specific individuals who are against their ideals. In retrospect, the street children receive individual, group, and social protection. Therefore, social class struggle plays a central role in the proliferation of organized criminal gangs and the engagement of street children in criminal activities in Dhaka, Bangladesh.

Keywords: cheap labor, organized crimes, poverty, social stratification, social children

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Authors: M. A. Rashed, A. S. Mansour, H. Faris, W. Afify

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The calcarenites carbonate rocks of the Quaternary ridges, which extend along the northwestern Mediterranean coastal plain of Egypt, represent an excellent model for the transformation of loose sediments to real sedimentary rocks by the different stages of meteoric diagenesis. The depositional and diagenetic fabrics of the rocks, in addition to the strata orientation, highly affect their ultimate compressive strength and other geotechnical properties. There is a marked increase in the compressive strength (UCS) from the first to the fourth ridge rock samples. The lowest values are related to the loose packing, weakly cemented aragonitic ooid sediments with high porosity, besides the irregularly distributed of cement, which result in decreasing the ability of these rocks to withstand crushing under direct pressure. The high (UCS) values are attributed to the low porosity, the presence of micritic cement, the reduction in grain size and the occurrence of micritization and calcretization processes. The strata orientation has a notable effect on the measured (UCS). The lowest values have been recorded for the samples cored in the inclined direction; whereas the highest values have been noticed in most samples cored in the vertical and parallel directions to bedding plane. In case of the inclined direction, the bedding planes were oriented close to the plane of maximum shear stress. The lowest and highest anisotropy values have been recorded for the first and the third ridges rock samples, respectively, which may attributed to the relatively homogeneity and well sorted grain-stone of the first ridge rock samples, and relatively heterogeneity in grain and pore size distribution and degree of cementation of the third ridge rock samples, besides, the abundance of shell fragments with intra-particle pore spaces, which may produce lines of weakness within the rock.

Keywords: compressive strength, anisotropy, calcarenites, Egypt

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Authors: A. Camões, M. Ferreira Dias, M. Amorim

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In recent years, the social economy is increasingly seen as a viable means to address social problems. Social enterprises, as well as public projects and initiatives targeted to meet social purposes, offer organizational models that assume heterogeneity, flexibility and adaptability to the ‘real world and real problems’. Despite the growing popularity of social initiatives, decision makers still face a paucity in what concerns the available models and tools to adequately assess its sustainability, and its impacts, notably the nature of its contribution to economic growth. This study was carried out at the local level, by analyzing the social impact initiatives and projects promoted by the Municipality of Albergaria-a-Velha (Câmara Municipal de Albergaria-a-Velha -CMA), a municipality of 25,000 inhabitants in the central region of Portugal. This work focuses on the challenges related to the qualifications and employability of citizens, which stands out as one of the key concerns in the Portuguese economy, particularly expressive in the context of small-scale cities and inland territories. The study offers a characterization of the Municipality, its socio-economic structure and challenges, followed by an exploratory analysis of multiple sourced data, collected from the CMA's documental sources as well as from privileged informants. The purpose is to conduct detailed analysis of the CMA's social projects, aimed at characterizing its potential impact for the model of qualifications and employability of the citizens of the Municipality. The study encompasses a discussion of the socio-economic profile of the municipality, notably its asymmetries, the analysis of the social projects and initiatives, as well as of data derived from inquiry actors involved in the implementation of the social projects and its beneficiaries. Finally, the results obtained with the Better Life Index will be included. This study makes it possible to ascertain if what is implicit in the literature goes to the encounter of what one experiences in reality.

Keywords: measurement, municipalities, social economy, social impact

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Authors: Cristina Cirone, Katrina Cirone, Monali S. Malvankar-Mehta

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Purpose: An increased risk of visual impairment has been observed in individuals lacking a balanced diet. The purpose of this paper is to characterize the relationship between plant-based diets and specific ocular outcomes among adults. Design: Systematic review and meta-analysis. Methods: This systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. The databases MEDLINE, EMBASE, Cochrane, and PubMed, were systematically searched up until May 27, 2021. Of the 503 articles independently screened by two reviewers, 21 were included in this review. Quality assessment and data extraction were performed by both reviewers. Meta-analysis was conducted using STATA 15.0. Fixed-effect and random-effect models were computed based on heterogeneity. Results: A total of 503 studies were identified which then underwent duplicate removal and a title and abstract screen. The remaining 61 studies underwent a full-text screen, 21 progressed to data extraction and fifteen were included in the quantitative analysis. Meta-analysis indicated that regular consumption of fish (OR = 0.70; CI: [0.62-0.79]) and skim milk, poultry, and non-meat animal products (OR = 0.70; CI: [0.61-0.79]) is positively correlated with a reduced risk of visual impairment (age-related macular degeneration, age-related maculopathy, cataract development, and central geographic atrophy) among adults. Consumption of red meat [OR = 1.41; CI: [1.07-1.86]) is associated with an increased risk of visual impairment. Conclusion: Overall, a pescatarian diet is associated with the most favorable visual outcomes among adults, while the consumption of red meat appears to negatively impact vision. Results suggest a need for more local and government-led interventions promoting a healthy and balanced diet.

Keywords: plant-based diet, pescatarian diet, visual impairment, systematic review, meta-analysis

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Authors: Carmen Maria Hernandez-Nicolas, Juan Francisco Martín-Ugedo, Antonio Mínguez-Vera

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This paper analyses the influence of gender of the mayors of Spanish local governments on different budget items using a sample of 8,243 town councils between 2002 and 2010 period and 64,361 observations. The system Generalized Method of Moments (GMM) technique was employed to examine this panel data. This powerful methodology allows controlling for the endogenity of the variables and the heterogeneity of the sample. Unlike previous works focused on the study of gender influence on firm decisions, the present work analyzes the influence of the gender of the major in the council’s decisions. Specifically, we examine the differences in financial liabilities, security, protection and social promotion expenses and income items relating to public management. In addition, the study focuses on the Spanish context, which is characterized by the presence of decentralization of public responsibility to a greater extent than in neighboring countries, feeding the debate on the operational efficiency of local government increased with an open debate on the importance of gender in public management. The results show that female mayors tend to have lower expenses in general without significant differences in incomes obtained for men and women majors. We also find that female majors incur fewer financial liabilities, one of the most important problems in the Spanish public sector. However, despite of cutting in the public sector, these councils have higher expenditure on security, protection and social promotion. According to these evidences, the presence of women in politics may serve to improve the councils’ economic situation and it is not only necessary for social justice but for economics efficiency. Besides, in councils with more inhabitants, women mayors are more common, but women who served for a very long time are less common.

Keywords: councils, gender, local budgets, public management, women mayors

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Authors: Vahid Ebrahimipour

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Word representation and context meaning of text-based documents play an essential role in knowledge modeling. Business procedures written in natural language are meant to store technical and engineering information, management decision and operation experience during the production system life cycle. Context meaning representation is highly dependent upon word sense, lexical relativity, and sematic features of the argument. This paper proposes a method for lexical semantic analysis and context meaning representation of maintenance activity in a mass production system. Our approach constructs a straightforward lexical semantic approach to analyze facilitates semantic and syntactic features of context structure of maintenance report to facilitate translation, interpretation, and conversion of human-readable interpretation into computer-readable representation and understandable with less heterogeneity and ambiguity. The methodology will enable users to obtain a representation format that maximizes shareability and accessibility for multi-purpose usage. It provides a contextualized structure to obtain a generic context model that can be utilized during the system life cycle. At first, it employs a co-occurrence-based clustering framework to recognize a group of highly frequent contextual features that correspond to a maintenance report text. Then the keywords are identified for syntactic and semantic extraction analysis. The analysis exercises causality-driven logic of keywords’ senses to divulge the structural and meaning dependency relationships between the words in a context. The output is a word contextualized representation of maintenance activity accommodating computer-based representation and inference using OWL/RDF.

Keywords: lexical semantic analysis, metadata modeling, contextual meaning extraction, ontology modeling, knowledge representation

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Authors: Seungho Shin, Keunwoo Choi, Ali Akbar, Sukkee Um

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In this study, the nanoscale transport properties and catalyst utilization of vertically aligned carbon nanotube (VACNT) catalyst layers are computationally predicted by the three-dimensional lattice Boltzmann simulation based on the quasi-random nanostructural model in pursuance of fuel cell catalyst performance improvement. A series of catalyst layers are randomly generated with statistical significance at the 95% confidence level to reflect the heterogeneity of the catalyst layer nanostructures. The nanoscale gas transport phenomena inside the catalyst layers are simulated by the D3Q19 (i.e., three-dimensional, 19 velocities) lattice Boltzmann method, and the corresponding mass transport characteristics are mathematically modeled in terms of structural properties. Considering the nanoscale reactant transport phenomena, a transport-based effective catalyst utilization factor is defined and statistically analyzed to determine the structure-transport influence on catalyst utilization. The tortuosity of the reactant mass transport path of VACNT catalyst layers is directly calculated from the streaklines. Subsequently, the corresponding effective mass diffusion coefficient is statistically predicted by applying the pre-estimated tortuosity factors to the Knudsen diffusion coefficient in the VACNT catalyst layers. The statistical estimation results clearly indicate that the morphological structures of VACNT catalyst layers reduce the tortuosity of reactant mass transport path when compared to conventional catalyst layer and significantly improve consequential effective mass diffusion coefficient of VACNT catalyst layer. Furthermore, catalyst utilization of the VACNT catalyst layer is substantially improved by enhanced mass diffusion and electric current paths despite the relatively poor interconnections of the ion transport paths.

Keywords: Lattice Boltzmann method, nano transport phenomena, polymer electrolyte fuel cells, vertically aligned carbon nanotube

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Authors: Adefarati Oloruntoba, Yongmin Zhang, Hongliang Xiao

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An annular fluidized bed (AFB) is gaining extensive application in the process industry due to its efficient gas-solids contacting. But a direct evaluation of its reaction performance is still lacking. In this paper, comparative 3D Euler–Lagrange multiphase-particle-in-cell (MP-PIC) computations are performed to assess the reaction performance of AFB relative to a bubbling fluidized bed (BFB) in an FCC regeneration process. By using the energy-minimization multi-scale (EMMS) drag model with a suitable heterogeneity index, the MP-PIC simulation predicts the typical fountain region in AFB and solids holdup of BFB, which is consistent with an experiment. Coke combustion rate, flue gas and temperature profile are utilized as the performance indicators, while related bed hydrodynamics are explored to account for the different performance under varying superficial gas velocities (0.5 m/s, 0.6 m/s, and 0.7 m/s). Simulation results indicate that the burning rates of coke and its species are relatively the same in both beds, albeit marginal increase in BFB. Similarly, the shape and evolution time of flue gas (CO, CO₂, H₂O and O₂) curves are indistinguishable but match the coke combustion rates. However, AFB has high proclivity to high temperature-gradient as higher gas and solids temperatures are predicted in the freeboard. Moreover, for both beds, the effect of superficial gas velocity is only conspicuous on the temperature but negligible on combustion efficiency and effluent gas emissions due to constant gas volumetric flow rate and bed loading criteria. Cross-flow of solids from the annulus to the spout region as well as the high primary gas in the AFB directly assume the underlying mechanisms for its unique gas-solids hydrodynamics (pressure, solids holdup, velocity, mass flux) and local spatial homogeneity, which in turn influence the reactor performance. Overall, the study portrays AFB as a cheap alternative reactor to BFB for catalyst regeneration.

Keywords: annular fluidized bed, bubbling fluidized bed, coke combustion, flue gas, fountaining, CFD, MP-PIC, hydrodynamics, FCC regeneration

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Authors: Camila Plaza, Stefan Felder

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In October 2014, the TARMED reform was implemented in Switzerland. In an effort to even out the financial standing of general practitioners (including pediatricians) relative to that of specialists in the outpatient sector, the reform tackled two aspects: on the one hand, GPs would be able to bill an additional 9 CHF per patient, once per consult per day. This is referred to as the surcharge position. As a second measure, it reduced the fees for certain technical services targeted to specialists (e.g., imaging, surgical technical procedures, etc.). Given the fee-for-service reimbursement system in Switzerland, we predict that physicians reacted to the economic incentives of the reform by increasing the consults per patient and decreasing the average amount of time per consult. Within this framework, our treatment group is formed by GPs and our control group by those specialists who were not affected by the reform. Using monthly insurance claims panel data aggregated at the physician praxis level (provided by SASIS AG), for the period of January 2013-December 2015, we run difference in difference panel data models with physician and time fixed effects in order to test for the causal effects of the reform. We account for seasonality, and control for physician characteristics such as age, gender, specialty, and physician experience. Furthermore, we run the models on subgroups of physicians within our sample so as to account for heterogeneity and treatment intensities. Preliminary results support our hypothesis. We find evidence of an increase in consults per patients and a decrease in time per consult. Robustness checks do not significantly alter the results for our outcome variable of consults per patient. However, we do find a smaller effect of the reform for time per consult. Thus, the results of this paper could provide policymakers a better understanding of physician behavior and their sensitivity to financial incentives of reforms (both past and future) under the current reimbursement system.

Keywords: difference in differences, financial incentives, health reform, physician behavior

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