Search results for: Arba Minch general hospital
Commenced in January 2007
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Edition: International
Paper Count: 6906

Search results for: Arba Minch general hospital

1356 Business Intelligence Dashboard Solutions for Improving Decision Making Process: A Focus on Prostate Cancer

Authors: Mona Isazad Mashinchi, Davood Roshan Sangachin, Francis J. Sullivan, Dietrich Rebholz-Schuhmann

Abstract:

Background: Decision-making processes are nowadays driven by data, data analytics and Business Intelligence (BI). BI as a software platform can provide a wide variety of capabilities such as organization memory, information integration, insight creation and presentation capabilities. Visualizing data through dashboards is one of the BI solutions (for a variety of areas) which helps managers in the decision making processes to expose the most informative information at a glance. In the healthcare domain to date, dashboard presentations are more frequently used to track performance related metrics and less frequently used to monitor those quality parameters which relate directly to patient outcomes. Providing effective and timely care for patients and improving the health outcome are highly dependent on presenting and visualizing data and information. Objective: In this research, the focus is on the presentation capabilities of BI to design a dashboard for prostate cancer (PC) data that allows better decision making for the patients, the hospital and the healthcare system related to a cancer dataset. The aim of this research is to customize a retrospective PC dataset in a dashboard interface to give a better understanding of data in the categories (risk factors, treatment approaches, disease control and side effects) which matter most to patients as well as other stakeholders. By presenting the outcome in the dashboard we address one of the major targets of a value-based health care (VBHC) delivery model which is measuring the value and presenting the outcome to different actors in HC industry (such as patients and doctors) for a better decision making. Method: For visualizing the stored data to users, three interactive dashboards based on the PC dataset have been developed (using the Tableau Software) to provide better views to the risk factors, treatment approaches, and side effects. Results: Many benefits derived from interactive graphs and tables in dashboards which helped to easily visualize and see the patients at risk, better understanding the relationship between patient's status after treatment and their initial status before treatment, or to choose better decision about treatments with fewer side effects regarding patient status and etc. Conclusions: Building a well-designed and informative dashboard is related to three important factors including; the users, goals and the data types. Dashboard's hierarchies, drilling, and graphical features can guide doctors to better navigate through information. The features of the interactive PC dashboard not only let doctors ask specific questions and filter the results based on the key performance indicators (KPI) such as: Gleason Grade, Patient's Age and Status, but may also help patients to better understand different treatment outcomes, such as side effects during the time, and have an active role in their treatment decisions. Currently, we are extending the results to the real-time interactive dashboard that users (either patients and doctors) can easily explore the data by choosing preferred attribute and data to make better near real-time decisions.

Keywords: business intelligence, dashboard, decision making, healthcare, prostate cancer, value-based healthcare

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1355 Impact of Expressive Writing on Creativity

Authors: Małgorzata Osowiecka

Abstract:

Negative emotions are rather seen as creativity inhibitor. On the other hand, it is worth noting that negative emotions may be good for our functioning. Negative emotions enhance cognitive resources and improve evaluative processes. Moreover maintaining a negative emotional state allow for cognitive reinterpretation of the emotional stimuli, what is good for our creativity, especially cognitive flexibility. Writing a diary or writing about difficult emotional experiences in general can be the way to not only improve psychical health, but also – enhance creative behaviors. Thanks to translating difficult emotions to the verbal level and giving them ‘a name’ or ‘a label’, we can get easier access to both emotional content of an experience and to the semantic content, without the need of speaking out loud. Expressive writing improves academic results and the efficiency of working memory. The classical method of writing about emotions consists in a long-term process of describing negative experiences. Present research demonstrate the efficiency of this process over a shorter period of time - one writing session, on school children sample. Participants performed writing task. Writing task had two different topics: emotions connected with their negative emotions (expressive writing) and content not connected with negative emotional state (writing about one’s typical day). Creativity was measured by Guilford’s Alternative Uses Task. Results have shown that writing about negative emotions results in the higher level of divergent thinking in all three parameters: fluency, flexibility and originality. After the writing task mood of expressive writing participants remained negative more than the mood of the controls. Taking an expressive action after a difficult emotional experience can support functioning, which can be observed in enhancement of divergent thinking. Writing about emotions connected with negative experience makes one more creative, than writing about something unrelated with difficult emotional moments. Research has shown that young people should not demonize negative emotions. Sometimes, properly applied, negative emotions can be the basis of creation. Preparation was supported by a The Young Scientist University grant titled ‘Dynamics of emotions in the creative process’ from The Polish Ministry of Science and Higher Education.

Keywords: creativity, divergent thinking, emotions, expressive writing

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1354 Effect of Access to Finance on Innovation and Productivity of SMEs in Nigeria: Evidence from the World Bank Enterprise Survey

Authors: Abidemi C. Adegboye, Samuel Iweriebor

Abstract:

The primary link between financial institutions and economic performance is the provision of resources by these institutions to businesses in order to drive enterprise expansion, sustainability, and development. In this study, the role of access to finance in driving innovations and productivity in Nigerian SMEs is investigated using the World Bank Enterprise Survey (ES) dataset. Innovation is defined based on the ES analysis using five compositions including product, method, organisational, use of foreign-licensed technology, and spending on R&D. The study considers finance in terms of source in meeting investment needs and in terms of access. Moreover, finance access is categorized as external and internal to a firm with each having different implications. The research methodology adopted a survey analysis based on the 2014 World Bank Enterprise Survey of 19 states in Nigeria. The survey comprised over 10,000 manufacturing and services firms, both at the small scale and medium scale levels. The logit estimation technique is used to estimate the relationships in the study. The results from the empirical analysis show that in general, access to finance drives SME innovation in Nigeria. In particular, ease of accessing bank loans and credit is shown to be the strongest positive force in driving all types of innovation among SMEs in Nigeria. In the same vein, the type of finance source for investment matters in terms of how it affects innovation: it is shown that both internal and external sources improve investment in product, process, and organisational innovation, but only external financing has effect on R&D spending and use of foreign licensed technology. Overall spending on R&D is only driven by access to external finance by the SMEs. For productivity, the results show that while structure of financing investment improves productivity, increased access to finance may actually lead to productivity decline among SMEs in Nigeria. There is a need for the financial system to evolve structures to increase fund availability to SMEs in Nigeria, especially for the purpose of innovation investment.

Keywords: access to finance, financing investment, innovation, productivity, SMEs

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1353 Multi-Elemental Analysis Using Inductively Coupled Plasma Mass Spectrometry for the Geographical Origin Discrimination of Greek Giant Beans “Gigantes Elefantes”

Authors: Eleni C. Mazarakioti, Anastasios Zotos, Anna-Akrivi Thomatou, Efthimios Kokkotos, Achilleas Kontogeorgos, Athanasios Ladavos, Angelos Patakas

Abstract:

“Gigantes Elefantes” is a particularly dynamic crop of giant beans cultivated in western Macedonia (Greece). This variety of large beans growing in this area and specifically in the regions of Prespes and Kastoria is a protected designation of origin (PDO) species with high nutritional quality. Mislabeling of geographical origin and blending with unidentified samples are common fraudulent practices in Greek food market with financial and possible health consequences. In the last decades, multi-elemental composition analysis has been used in identifying the geographical origin of foods and agricultural products. In an attempt to discriminate the authenticity of Greek beans, multi-elemental analysis (Ag, Al, As, B, Ba, Be, Ca, Cd, Co, Cr, Cs, Cu, Fe, Ga, Ge, K, Li, Mg, Mn, Mo, Na, Nb, Ni, P, Pb, Rb, Re, Se, Sr, Ta, Ti, Tl, U, V, W, Zn, Zr) was performed by inductively coupled plasma mass spectrometry (ICP-MS) on 320 samples of beans, originated from Greece (Prespes and Kastoria), China and Poland. All samples were collected during the autumn of 2021. The obtained data were analysed by principal component analysis (PCA), an unsupervised statistical method, which allows for to reduce of the dimensionality of the enormous datasets. Statistical analysis revealed a clear separation of beans that had been cultivated in Greece compared with those from China and Poland. An adequate discrimination of geographical origin between bean samples originating from the two Greece regions, Prespes and Kastoria, was also evident. Our results suggest that multi-elemental analysis combined with the appropriate multivariate statistical method could be a useful tool for bean’s geographical authentication. Acknowledgment: This research has been financed by the Public Investment Programme/General Secretariat for Research and Innovation, under the call “YPOERGO 3, code 2018SE01300000: project title: ‘Elaboration and implementation of methodology for authenticity and geographical origin assessment of agricultural products.

Keywords: geographical origin, authenticity, multi-elemental analysis, beans, ICP-MS, PCA

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1352 Restorative Justice to the Victims of Terrorism in the Criminal Justice System of India

Authors: Sumanta Meher, Gaurav Shukla

Abstract:

The torments of the victims of terrorism have not only confined to loss of life and limp but also includes the physiological trauma to the innocent victims. The physical wounds may heal, but the trauma remains in the mind and heart of the victims and their loved ones; however, one should not deny that these terrorist activities affect to a major extent to their livelihood. To protect their human rights and restore the shattered lives of the victims of terrorism all the Nations beyond their differences have to show solidarity and frame a comprehensive restorative policy with an effective implementing mechanism. The General Assembly of United Nations, through its several resolutions, has appealed Nations to show solidarity and also committed to helping the Members State to frame the law and policy to support the victims of terrorism. To achieve the objectives of the resolutions adopted by the United Nations, the Indian legislators in 2008 amended the Code of Criminal Procedure, 1973 and incorporated Section 357A to provide financial assistance to the victims of terrorism. In India, the contemporary developments in the victims’ oriented studies have increased the dimension of the traditional criminal justice systems to protect the rights of the victims. In this regard, the paper has ascertained the Indian legal framework in respect to the restorative justice to the victims of terrorism and also addressed the question as to whether the statutory provisions and enforcement mechanisms are efficient enough to protect the human rights of the victims of terrorism. For that purpose, the paper has analyzed the International instruments and the reports with regard to the compensation to the victims of terrorist attacks, with that, the article also evaluates the initiatives of United Nations to help Members State to frame the law and policies to support the victims of terrorism. The study also made an attempt to critically analyze the legal provisions of compensation and rehabilitation of the victims of terrorist attacks in India and whether they are in alignment with the International standards. While concluding, the paper has made an endeavor for a robust legal framework towards the restorative justice for the victims of terrorism in India.

Keywords: victims of terrorism, restorative justice, human rights, criminal justice system of India

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1351 Genotypic Characterization of Gram-Positive Bacteria Isolated on Ornamental Animals Feed

Authors: C. Miranda, R. Soares, S. Cunha, L. Ferreira, G. Igrejas, P. Poeta

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Different animal species, including ornamental animals, are reported as potential reservoirs of antibiotic resistance genes. Consequently, these resistances can be disseminated in the environment and transferred to humans. Moreover, multidrug-resistant bacteria reduce the efficacy of antibiotics, as the case of vancomycin-resistant enterococci. Enterococcus faecalis and E. faecium are described as the main nosocomial pathogens. In this line, the aim of this study was to characterize resistance and virulence genes of enterococci species isolated from samples of food supplied to ornamental animals during 2020. The 29 enterococci isolates (10 E. faecalis and 19 E. faecium) were tested for the presence of the resistance genes for the following antibiotics: erythromicyn (ermA, ermB and ermC), tetracycline (tetL, tetM, tetK and tetO), quinupristin/dalfopristin (vatD and vatE), gentamicin (aac(6’)-aph(2’’)-Ia), chloramphenicol (catA), streptomycin (ant(6)-Ia) and vancomycin (vanA and vanB). The same isolates were also tested for 10 virulence factors genes (esp, ace, gelE, agg, fsr, cpd, cylA, cylB, cylM and cylLL). The resistance and virulence genes were performed by PCR, using specific primers and conditions. Negative and positive controls were used in all PCR assays. The most prevalent resistance genes detected in both enterococci species were ermB (n=15, 52%), ermC (n=7, 24%), tetK (n=8, 28%) and vatE (n=4, 14%). Resistance genes for vancomycin were found in ten (34%) E. faecalis and ten (34%) E. faecium isolates. Only E. faecium isolates showed the presence of ermA (n=2, 7%), tetL (n=13, 45%) and ant(6)-Ia gene (n=4, 14%). A total of nine (31%) enterococci isolates were classified as multidrug-resistant bacteria (3 E. faecalis and 6 E. faecium). In three E. faecalis and one E. faecium were not detected resistance genes. The virulence genes detected in both species were agg (n=6, 21%) and cylLL (n=11, 38%). In general, each isolate showed only one of these virulence genes. Five E. faecalis and eleven E. faecium isolates were negative for all analyzed virulence genes. These preliminary results showed the presence of multidrug-resistant enterococci in food supplied to ornamental animals, in particular vancomycin-resistant enterococci. This genotypic characterization reinforces the relevance to public health in the control of antibiotic-resistant bacteria.

Keywords: antibiotic resistance, enterococci, feed, ornamental animals

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1350 [Keynote Talk]: Discovering Liouville-Type Problems for p-Energy Minimizing Maps in Closed Half-Ellipsoids by Calculus Variation Method

Authors: Lina Wu, Jia Liu, Ye Li

Abstract:

The goal of this project is to investigate constant properties (called the Liouville-type Problem) for a p-stable map as a local or global minimum of a p-energy functional where the domain is a Euclidean space and the target space is a closed half-ellipsoid. The First and Second Variation Formulas for a p-energy functional has been applied in the Calculus Variation Method as computation techniques. Stokes’ Theorem, Cauchy-Schwarz Inequality, Hardy-Sobolev type Inequalities, and the Bochner Formula as estimation techniques have been used to estimate the lower bound and the upper bound of the derived p-Harmonic Stability Inequality. One challenging point in this project is to construct a family of variation maps such that the images of variation maps must be guaranteed in a closed half-ellipsoid. The other challenging point is to find a contradiction between the lower bound and the upper bound in an analysis of p-Harmonic Stability Inequality when a p-energy minimizing map is not constant. Therefore, the possibility of a non-constant p-energy minimizing map has been ruled out and the constant property for a p-energy minimizing map has been obtained. Our research finding is to explore the constant property for a p-stable map from a Euclidean space into a closed half-ellipsoid in a certain range of p. The certain range of p is determined by the dimension values of a Euclidean space (the domain) and an ellipsoid (the target space). The certain range of p is also bounded by the curvature values on an ellipsoid (that is, the ratio of the longest axis to the shortest axis). Regarding Liouville-type results for a p-stable map, our research finding on an ellipsoid is a generalization of mathematicians’ results on a sphere. Our result is also an extension of mathematicians’ Liouville-type results from a special ellipsoid with only one parameter to any ellipsoid with (n+1) parameters in the general setting.

Keywords: Bochner formula, Calculus Stokes' Theorem, Cauchy-Schwarz Inequality, first and second variation formulas, Liouville-type problem, p-harmonic map

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1349 Label Survey in Romania: A Study on How Consumers Use Food Labeling

Authors: Gabriela Iordachescu, Mariana Cretu Stuparu, Mirela Praisler, Camelia Busila, Doina Voinescu, Camelia Vizireanu

Abstract:

The aim of the study was to evaluate the consumers’ degree of confidence in food labeling, how they use and understand the label and respectively food labeling elements. The label is a bridge between producers, suppliers, and consumers. It has to offer enough information in terms of public health and food safety, statement of ingredients, nutritional information, warnings and advisory statements, producing date and shelf-life, instructions for storage and preparation (if required). The survey was conducted on 500 consumers group in Romania, aged 15+, males and females, from urban and rural areas and with different graduation levels. The questionnaire was distributed face to face and online. It had single or multiple choices questions and label images for the efficiency and best understanding of the question. The law 1169/2011 applied to food products from 13 of December 2016 improved and adapted the requirements for labeling in a clear manner. The questions were divided on following topics: interest and general trust in labeling, use and understanding of label elements, understanding of the ingredient list and safety information, nutrition information, advisory statements, serving sizes, best before/use by meanings, intelligent labeling, and demographic data. Three choice selection exercises were also included. In this case, the consumers had to choose between two similar products and evaluate which label element is most important in product choice. The data were analysed using MINITAB 17 and PCA analysis. Most of the respondents trust the food label, taking into account some elements especially when they buy the first time the product. They usually check the sugar content and type of sugar, saturated fat and use the mandatory label elements and nutrition information panel. Also, the consumers pay attention to advisory statements, especially if one of the items is relevant to them or the family. Intelligent labeling is a challenging option. In addition, the paper underlines that the consumer is more careful and selective with the food consumption and the label is the main helper for these.

Keywords: consumers, food safety information, labeling, labeling nutritional information

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1348 An Exploration of Gender Differences in Academic Writing in Science

Authors: Gayani Ranawake, Kate Wilson

Abstract:

Underrepresentation of women in academia, particularly in science, has been discussed by many scholars for decades. The causes of this underrepresentation are debated to this day. Publication is an important aspect of success in academia, and publication and citation rates are significant metrics in performance review, promotion, and employment. It has been established that men’s and women’s language use in general, both spoken and written, is different. However, no one, to our knowledge, has looked at whether men’s and women’s writing in science is different. If there are significant differences in the writing of men and women, then these differences may affect women’s ability to succeed in science. This study is part of a larger project to explore whether differences can be recognized in the academic science writing of men and women. Mono authored articles from high ranking physics, biology and psychology journals by men and women authors were compared in terms of readability statistics. In particular, the abstract and introduction sections were compared, as these are the first sections encountered by a reviewer, and so may have an important effect on their impression of the work. The Flesch Reading Ease, the percentage of passive sentences and the Flesch-Kincaid Reading Grade Level were calculated for each section of each article, along with counts of numbers of sentences, words per sentence and sentences per paragraph. Significance of differences was tested using the Behrens statistic. It was found that for both physics and biology papers there were no significant differences in the complexity or verbosity of the writing of men and women authors. However, there was a significant difference between the two disciplines, with physics articles being generally more readable (higher readability score) while also more passive (higher number of passive sentences). In contrast, the psychology articles showed a difference between men and women authors which may be significant. The average readability for introductions in women’s articles was 28 which was higher than for men’s articles, which was 19 (higher values indicate more readable). Women’s articles in psychology also had a greater proportion of passive sentences. It can be concluded that, at least in the more traditional sciences, men and women have adopted similar ways of writing, and that disciplinary differences are greater than gender differences. This may not be the case in psychology, which many consider to be more closely aligned with the humanities. Whether the lack of differences is because women have adapted to a masculine way of writing, or whether the genre itself is gender neutral needs further investigation.

Keywords: academic writing, gender differences, readability, science

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1347 Evaluation of a Higher Diploma in Mental Health Nursing Using Qualitative and Quantitative Methods: Effects on Student Behavior, Attitude and Perception

Authors: T. Frawley, G. O'Kelly

Abstract:

The UCD School of Nursing, Midwifery and Health Systems Higher Diploma in Mental Health (HDMH) nursing programme commenced in January 2017. Forty students successfully completed the programme. Programme evaluation was conducted from the outset. Research ethics approval was granted by the UCD Human Research Ethics Committee – Sciences in November 2016 (LS-E-16-163). Plan for Sustainability: Each iteration of the programme continues to be evaluated and adjusted accordingly. Aims: The ultimate purpose of the HDMH programme is to prepare registered nurses (registered children’s nurse (RCN), registered nurse in intellectual disability (RNID) and registered general nurse (RGN)) to function as effective registered psychiatric nurses in all settings which provide care and treatment for people experiencing mental health difficulties. Curriculum evaluation is essential to ensure that the programme achieves its purpose, that aims and expected outcomes are met and that required changes are highlighted for the programme’s continuing positive development. Methods: Both quantitative and qualitative methods were used in the evaluation. A series of questionnaires were used (the majority pre and post programme) to determine student perceptions of the programme, behaviour and attitudinal change from commencement to completion. These included the student assessment of learning gains (SALG); mental health knowledge schedule (MAKS); mental health clinician attitudes scale (MICA); reported and intended behaviour scale (RIBS); and community attitudes towards the mentally ill (CAMI). In addition, student and staff focus groups were conducted. Evaluation methods also incorporated module feedback. Outcome/Results: The evaluation highlighted a very positive response in relation to the achievement of programme outcomes and preparation for future work as registered psychiatric nursing. Some areas were highlighted for further development, which have been taken cognisance of in the 2019 iteration of the programme.

Keywords: learning gains, mental health, nursing, stigma

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1346 Ecocentric Principles for the Change of the Anthropocentric Design Within the Other Species Related Fields

Authors: Armando Cuspinera

Abstract:

Humans are nature itself, being with non-human species part of the same ecosystem, but the praxis reflects that not all relations are the same. In fields of design such as Biomimicry, Biodesign, and Biophilic design exist different approaches towards nature, nevertheless, anthropocentric principles such as domination, objectivization, or exploitation are defined in the same as ecocentric principles of inherent importance in life itself. Anthropocentrism has showed humanity with pollution of the earth, water, air, and the destruction of whole ecosystems from monocultures and rampant production of useless objects that life cannot outstand this unaware rhythm of life focused only for the human benefits. Even if by nature the biosphere is resilient, studies showed in the Paris Agreement explain that humanity will perish in an unconscious way of praxis. This is why is important to develop a differentiation between anthropocentric and ecocentricprinciples in the praxis of design, in order to enhance respect, valorization, and positive affectivity towards other life forms is necessary to analyze what principles are reproduced from each practice of design. It is only from the study of immaterial dimensions of design such as symbolism, epistemology, and ontology that the relation towards nature can be redesigned, and in order to do so, it must be studies from the dimensions of ontological design what principles –anthropocentric or ecocentric- through what the objects enhance or focus the perception humans have to its surrounding. The things we design also design us is the principle of ontological design, and in order to develop a way of ecological design in which is possible to consider other species as users, designers or collaborators is important to extend the studies and relation to other living forms from a transdisciplinary perspective of techniques, knowledge, practice, and disciplines in general. Materials, technologies, and any kind of knowledge have the principle of a tool: is not good nor bad, but is in the way of using it the possibilities that exist within them. The collaboration of disciplines and fields of study gives the opportunity to connect principles from other cultures such as Deep Ecology and Environmental Humanities in the development of methodologies of design that study nature, integrates their strategies to our own species, and considers life of other species as important as human life, and is only form the studies of ontological design that material and immaterial dimensions can be analyzed and imbued with structures that already exist in other fields.

Keywords: design, antropocentrism, ecocentrism, ontological design

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1345 Child Marriages in Africa: Using a Rights-Based Approach to Protect the Girl-Child in Nigeria

Authors: Foluke Abimbola

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The United Nations Convention on the rights of the child has been signed and ratified by several countries due to the concern about various abuses and crimes committed against children both locally and internationally. It is a shame that in view of the peculiar hardships being experienced by children today, the natural right to childhood has to be protected by a vast array of laws and international conventions. 194 countries have so far acceded to and ratified the convention on the Rights of a Child while some countries such as Nigeria have enacted the convention as a domestic law, yet child abuse is still rampant not only in Nigeria but all over the world. In Nigeria, the Child Rights Act was passed into law in 2003, with its provisions similar to the United Nations Convention on the Rights of a Child. Despite the age of marriage provided in the Nigerian Child’s Rights Act 2003, many communities still practice child marriages to the detriment of the girl-child. Cases where these children have to withdraw from school as a result of these unripe marriages abound. Unfortunately, the Constitution of the Federal Republic of Nigeria 1999 appears to indirectly support early marriages for girls in section 29 (4) where it states that a woman who is married is deemed to be of full age whereas ‘full age’ as a general term in the Constitution is from 18 years old and above. Section 29 (4) may thus be interpreted to mean that a girl of 12 years old, if married, is deemed to be of ‘full-age.’ In view of these discrepancies which continue to justify this unwholesome practice, this paper shall proffer solutions to this unlawful act and make recommendations to existing institutions, using a rights-based approach, on how to prevent and/or substantially reduce this practice. A comparative analysis with other African countries will be adopted in order to conduct a research for effective policies that may be implemented for the protection of these girls. Thus, this paper will further examine the issue of child marriage which is still quite rampant in African countries particularly in Nigeria which also affects the girl-child’s right to an education. Such children are in need of special protection and this paper will recommend ways in which state institutions, particularly in Nigeria, may be able to introduce policies to curb incidences of child marriage and child sexual abuse while proffering strategies for the prevention of these crimes.

Keywords: child abuse, child marriages, child rights, constitutions, child rights, the girl-child

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1344 Media Framing and Democratization Under Multi-Party System: A Case Study of the 2023 Malaysian Six-State Elections

Authors: Chew Zhao Hong

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Since the transition of power in 2018, the Malaysian political landscape has experienced substantial shifts and complexities. The decline of the longstanding ruling party, United Malays National Organization (UMNO), following the party rotation, has given rise to splinter parties such as the Indigenous Unity Party (Bersatu), along with the enduring presence of the Pan-Malaysian Islamic Party (PAS) in the northern region of the Malay Peninsula. However, the "Sheraton Move" in 2020 led to the fall of the Pakatan Harapan government and the emergence of Perikatan Nasional, signifying the ascent of a third political force. The 2022 general elections marked Malaysia's entry into a hung parliament, culminating in an intricate negotiation that resulted in a coalition government formed by Pakatan Harapan, Barisan Nasional, and the Sarawak parties alliance (GPS), collectively governing the Malaysian federal administration. During the 2023 state elections, Pakatan Harapan and Barisan Nasional formed an unprecedented alliance, yet the media framing benefited Perikatan Nasional, even securing substantial support from UMNO's traditional constituencies. In the era of converging new media, Malaysia’s democratization faces new challenges: first, political leaders leveraging media to cultivate unfiltered personas risk inducing populism; second, under the influence of agenda-setting and two-step flow theories, media contributes to polarization; lastly, Malaysia's multi-party system is no longer effectively moderate extreme ideologies into the political center. This study examines the role of media framing and its impact on the democratization process within Malaysia's consociational democracy under a multi-party system and analyzes media discourse before and after the 2023 Malaysian state elections to explore how different parties shape public opinion and political discourse, and how political messages may be amplified or distorted in the process.

Keywords: multi-party system, democratization, elections, political polarization, Malaysia, media framing

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1343 A Damage-Plasticity Concrete Model for Damage Modeling of Reinforced Concrete Structures

Authors: Thanh N. Do

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This paper addresses the modeling of two critical behaviors of concrete material in reinforced concrete components: (1) the increase in strength and ductility due to confining stresses from surrounding transverse steel reinforcements, and (2) the progressive deterioration in strength and stiffness due to high strain and/or cyclic loading. To improve the state-of-the-art, the author presents a new 3D constitutive model of concrete material based on plasticity and continuum damage mechanics theory to simulate both the confinement effect and the strength deterioration in reinforced concrete components. The model defines a yield function of the stress invariants and a compressive damage threshold based on the level of confining stresses to automatically capture the increase in strength and ductility when subjected to high compressive stresses. The model introduces two damage variables to describe the strength and stiffness deterioration under tensile and compressive stress states. The damage formulation characterizes well the degrading behavior of concrete material, including the nonsymmetric strength softening in tension and compression, as well as the progressive strength and stiffness degradation under primary and follower load cycles. The proposed damage model is implemented in a general purpose finite element analysis program allowing an extensive set of numerical simulations to assess its ability to capture the confinement effect and the degradation of the load-carrying capacity and stiffness of structural elements. It is validated against a collection of experimental data of the hysteretic behavior of reinforced concrete columns and shear walls under different load histories. These correlation studies demonstrate the ability of the model to describe vastly different hysteretic behaviors with a relatively consistent set of parameters. The model shows excellent consistency in response determination with very good accuracy. Its numerical robustness and computational efficiency are also very good and will be further assessed with large-scale simulations of structural systems.

Keywords: concrete, damage-plasticity, shear wall, confinement

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1342 Analyzing Competition in Public Construction Projects

Authors: Khaled Hesham Hyari, Amjad Almani

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Construction projects in the public sector are commonly awarded through competitive bidding. In the last decade, the Construction projects environment in the Middle East went through many changes. These changes have been caused by different factors including the economic crisis, delays in monthly payments, international competition and reduced number of projects. These factors had a great impact on the bidding behaviors of contractors and their pricing strategies. This paper examines the competition characteristics in public construction projects through an analysis of bidding results of contractors in public construction projects over a period of 6 years (2006-2011) in Jordan. The analyzed projects include all categories of projects such as infrastructure, buildings, transportation and engineering services (design and supervision contracts). Data for the projects were obtained from the General Tender’s Directorate in Jordan and includes 462 projects. The analysis performed in this projects includes, studying the bid spread in all projects as it is an indication of the level of competition in the analyzed bids. The analysis studied the factors that affect bid spread such as number of bidders, Value of the project, Project category and years. It also studying the “Signal to Noise Ratio” in all projects as it is an indication of the accuracy of cost estimating performed by competing bidders and bidder´s evaluation of project risks. The analysis performed includes the relationship between signal to noise ratio and different parameters such as project category, number of bidders and changes over years. Moreover, the analysis includes determining the bidder´s aggressiveness in bidding as it is an indication of competition level in such projects. This was performed by determining the pack price which can be considered as the true value of the project and comparing it with the lowest bid submitted for each project to determine the level of aggressiveness in submitted bids. The analysis performed in this project should prove to be useful to owners in understanding bidding behaviors of contractors and pointing out areas that needs improvement in preparing bidding documents. Also the project should be useful to contractors in understanding the competitive bidding environment and should help them to improve their bidding strategies to maximize the success rate in obtaining contracts.

Keywords: construction projects, competitive bidding, public construction, competition

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1341 Demographic Variations of Multiple Sclerosis Patients between Britain and Kuwait

Authors: Ali Fuad Ashour

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Introduction: Multiple sclerosis (MS) is a chronic, progressive and degenerative disease that affects the central nervous system (CNS). MS has been described to result in the debilitating symptom of the disease. It is reported to have a negative impact on the patient’s mental activities, brings a lower quality of life, leads to unemployment, causes distress and psychological disorders, generates low levels of motivation and self-esteem, and result in disability and neurological impairment. The aim of this study was to compare the effects of MS on patients from Britain and Kuwait. Methodology: A questionnaire was distributed to 200 individuals with MS (100 Kuwaiti and 100 British). The questionnaire consists of three parts; 1. General demographics, 2. Disease-specific data (symptoms, severity levels, relapse frequency, and support system), and 3. Attitudes towards physical exercise. Results: A response rate of 62% from the British sample and 50% from the Kuwaiti sample was achieved. 84% of the sample (n=52) were 41 years old or over. The duration of the disease was less than 10 years in 43.4% of British and 68% of Kuwaiti respondents. The majority of British respondents (56.5%) reported the disease severity to be moderate, while the majority of Kuwaitis was mild (72%). The annual relapse rates in Kuwait were relatively low, with 82% of the Kuwaiti sample had one relapse per year, compared to the 64.5% of British. The most common symptoms reported by British respondents were balance (75.8%), fatigue (74.2%), and weakness (71%), and by Kuwaiti respondents were fatigue (86%), balance (76%), and weakness (66%). The help and support for MS were by far more diverse for the British than Kuwaiti respondents. Discussion: The results unveiled marked differences between two groups of British and Kuwaiti MS patients in terms of patients’ age and disease duration, and severity. The overwhelming majority of Kuwaiti patients are young individuals who have been with the disease for a relatively short period of time, and their MS in most cases was mild. On the other hand, British patients were relatively older, many have been with the disease for a long period of time, and their average MS condition was more serious than that of their Kuwaiti counterparts. The main support in Kuwait comes from the neurologist, who primarily prescribe medications and advise patients to try to be active. The Kuwaiti respondents thought that lack of encouragement was the main reason for them not to engage in social activities.

Keywords: multiple sclerosis, Kuwait, exercise, demographic

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1340 The Constitutional Rights of a Child to a Clean and Healthy Environment: A Case Study in the Vaal Triangle Region

Authors: Christiena Van Der Bank, Marjone Van Der Bank, Ronelle Prinsloo

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The constitutional right to a healthy environment and the constitutional duty imposed on the state actively to protect the environment fulfill the specific duties to prevent pollution and ecological degradation and to promote conservation. The aim of this paper is to draw attention to the relationship between child rights and the environment. The focus is to analyse government’s responses as mandated with section 24 of the Bill of Rights for ensuring the right to a clean and healthy environment. The principle of sustainability of the environment encompasses the notion of equity and the harm to the environment affects the present as well as future generations. Section 24 obliges the state to ensure that the legacy of future generations is protected, an obligation that has been said to be part of the common law. The environment is an elusive and wide concept that can mean different things to different people depending on the context in which it is used for example clean drinking water or safe food. An extensive interpretation of the term environment would include almost everything that may positively or negatively influence the quality of human life. The analysis will include assessing policy measures, legislation, budgetary measures and other measures taken by the government in order to progressively meet its constitutional obligation. The opportunity of the child to grow up in a healthy and safe environment is extremely unjustly distributed. Without a realignment of political, legal and economic conditions this situation will not fundamentally change. South Africa as a developing country that needs to meet the demand of social transformation and economic growth whilst at the same time expediting its ability to compete in global markets, the country will inevitably embark on developmental programmes as a measure for sustainable development. The courts would have to inquire into the reasonableness of those measures. Environmental threats to children’s rights must be identified, taking into account children’s specific needs and vulnerabilities, their dependence and marginalisation. Obligations of states and violations of rights must be made more visible to the general public.

Keywords: environment, children rights, pollution, healthy, violation

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1339 Teacher Agency in Media Literacy: A Qualitative Study of Bolivian Teachers and Their Room to Manoeuvre

Authors: Daniela Lamaison Sepulveda

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Critical media literacy teaches people to think analytically about the information they receive through the media. It is heavily influenced by Paulo Freire’s critical pedagogy and the necessity of becoming conscious of one’s reality in order to transform it. This qualitative research examines the case of Bolivia, which experienced dramatic political change after the first indigenous president, Evo Morales, was elected in 2006. In 2010, the government passed an education reform — the Avelino Siñani Elizardo Pérez (ASEP) —that draws heavily on decolonial thought and the Freirean notion of critical consciousness. The extent to which these theories were implemented in practice is evaluated in context of a media literacy project, run by an NGO, that trains secondary school teachers from public schools across Bolivia through yearly workshops ranging from producing media to identifying fake news. This context is examined against the backdrop of the highly contested general elections in October 2019. While there is plenty of literature that outlines the benefits of teaching media literacy in the classroom and different ways to apply it, little research has been done analysing implementation at an institutional level and how to best enable teachers who are motivated to teach the subject. Through semi-structured interviews, document analysis and naturalistic observations, this study aims to identify the struggles faced by teachers who are dedicated to teaching critical media literacy in their classrooms and how they navigate educational spaces while being subject to a demanding national curriculum that supposedly also seeks to promote critical thinking. The interplay between the aspirations of teachers and NGOs in contrast to the top-down discourse and policy of governmental institutions provides for a very enlightening case. By exploring these institutional, cultural, sociopolitical and economic barriers the teachers face, this research attempts to contribute to the debate in media literacy theories concerned with implementing the practice in schools.

Keywords: media literacy, critical pedagogy, teacher agency, misinformation, education reform, Bolivia

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1338 Euthanasia with Reference to Defective Newborns: An Analysis

Authors: Nibedita Priyadarsini

Abstract:

It is said that Ethics has a wide range of application which mainly deals with human life and human behavior. All ethical decisions are ultimately concerned with life and death. Both life and death must be considered dignified. Medical ethics with its different topics mostly deals with life and death concepts among which euthanasia is one. Various types of debates continue over Euthanasia long since. The question of putting an end to someone’s life has aroused controversial in legal sphere as well as in moral sphere. To permit or not to permit has remained an enigma the world over. Modern medicine is in the stage of transcending limits that cannot be set aside. The morality of allowing people to die without treatment has become more important as methods of treatment have become more sophisticated. Allowing someone to die states an essential recognition that there is some point in any terminal illness when further curative treatment has no purpose and the patient in such situation should allow dying a natural death in comfort, peace, and dignity, without any interference from medical science and technology. But taking a human life is in general sense is illogical in itself. It can be said that when we kill someone, we cause the death; whereas if we merely let someone die, then we will not be responsible for anyone’s death. This point is often made in connection with the euthanasia cases and which is often debatable. Euthanasia in the pediatric age group involves some important issues that are different from those of adult issues. The main distinction that occurs is that the infants and newborns and young children are not able to decide about their future as the adult does. In certain cases, where the child born with some serious deformities with no hope of recovery, in that cases doctor decide not to perform surgery in order to remove the blockage, and let the baby die. Our aim in this paper is to examine, whether it is ethically justified to withhold or to apply euthanasia on the part of the defective infant. What to do with severely defective infants from earliest time if got to know that they are not going to survive at all? Here, it will deal mostly with the ethics in deciding the relevant ethical concerns in the practice of euthanasia with the defective newborns issues. Some cases in relation to disabled infants and newborn baby will be taken in order to show what to do in a critical condition, that the patient and family members undergoes and under which condition those could be eradicated, if not all but some. The final choice must be with the benefit of the patient.

Keywords: ethics, medical ethics, euthanasia, defective newborns

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1337 Evaluation of Flow Alteration under Climate Change Scenarios for Disaster Risk Management in Lower Mekong Basin: A Case Study in Prek Thnot River in Cambodia

Authors: Vathanachannbo Veth, Ilan Ich, Sophea Rom Phy, Ty Sok, Layheang Song, Sophal Try, Chantha Oeurng

Abstract:

Climate change is one of the major global challenges inducing disaster risks and threatening livelihoods and communities through adverse impacts on food and water security, ecosystems, and services. Prek Thnot River Basin of Cambodia is one of the largest tributaries in the Lower Mekong that has been exposed to hazards and disasters, particularly floods and is said to be the effect of climate change. Therefore, the assessment of precipitation and streamflow changes under the effect of climate change was proposed in this river basin using Soil Water Assessment Tool (SWAT) model and different flow indices under baseline (1997 to 2011) and climate change scenarios (RCP2.6 and RCP8.5 with three General Circulation Models (GCMs): GFDL, GISS, and IPSL) in two time-horizons: near future (the 2030s: 2021 to 2040) and medium future (2060s: 2051 to 2070). Both intensity and frequency indices compared with the historical extreme rainfall indices significantly change in the GFDL under the RCP8.5 for both 2030s and 2060s. The average rate change of Rx1day, Rx10day, SDII, and R20mm in the 2030s and 2060s of both RCP2.6 and RCP8.5 was found to increase in GFDL and decrease in both GISS and IPSL. The mean percentage change of the flow analyzed in the IHA tool (Group1) indicated that the flow in the Prek Thnot River increased in GFDL for both RCP2.6 and RCP8.5 in both 2030s and 2060s, oppositely in GISS, the flow decreases. Moreover, the IPSL affected the flow by increasing in five months (January, February, October, November, and December), and in the other seven months, the flow decreased accordingly. This study provides water resources managers and policymakers with a wide range of precipitation and water flow projections within the Prek Thnot River Basin in the context of plausible climate change scenarios.

Keywords: IHA, climate change, disaster risk, Prek Thnot River Basin, Cambodia

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1336 Effectiveness of an Attachment-Based Intervention on Child Cognitive Development: Preliminary Analyses of a 12-Month Follow-Up

Authors: Claire Baudry, Jessica Pearson, Laura-Emilie Savage, George Tarbulsy

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Introduction: Over the last decade, researchers have implemented attachment-based interventions to promote parental interactive sensitivity and child development among vulnerable families. In the context of the present study, these interventions have been shown to be effective to enhance cognitive development when child outcome was measured shortly after the intervention. Objectives: The goal of the study was to investigate the effects of an attachment-based intervention on child cognitive development one year post-intervention. Methods: Thirty-five mother-child dyads referred by Child Protective Services in the province of Québec, Canada, were included in this study: 21 dyads who received 6 to 8 intervention sessions and 14 dyads not exposed to the intervention and matched for the following variables: duration of child protective services, reason for involvement with child protection, age, sex and family status. Child cognitive development was measured using the WPPSI-IV, 12 months after the end of the intervention when the average age of children was 54 months old. Findings: An independent-samples t-test was conducted to compare the scores obtained on the WPPSI-IV for the two groups. In general, no differences were observed between the two groups. There was a significant difference on the fluid reasoning scale between children exposed to the intervention (M = 95,13, SD = 16,67) and children not exposed (M = 81, SD = 9,90). T (23) = -2,657; p= .014 (IC :-25.13;3.12). This difference was found only for children aged between 48 and 92 months old. Other results did not show any significant difference between the two groups (Global IQ or subscales). Conclusions: This first set of analyses suggest that relatively little effects of attachment-based intervention remain on the level of cognitive functioning 12-months post-intervention. It is possible that the significant findings concerning fluid reasoning may be pertinent in that fluid reasoning is linked to the capacity to analyse, to solve problems, and remember information, which may be important for promoting school readiness. As the study is completed and as more information is gained from other assessments of cognitive and socioemotional outcome, a clearer picture of the potential moderate-term impact of attachment-based intervention will emerge.

Keywords: attachment-based intervention, child development, child protective services, cognitive development

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1335 Evaluating the Challenges of Large Scale Urban Redevelopment Projects for Central Government Employee Housing in Delhi

Authors: Parul Kapoor, Dheeraj Bhardwaj

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Delhi and other Indian cities accommodate thousands of Central Government employees in housing complexes called ‘General Pool Residential Accommodation’ (GPRA), located in prime parcels of the city. These residential colonies are now undergoing redevelopment at a massive scale, significantly impacting the ecology of the surrounding areas. Essentially, these colonies were low-rise, low-density planned developments with a dense tree cover and minimal parking requirements. But with increasing urbanisation and spike in parking demand, the proposed built form is an aggregate of high-rise gated complexes, redefining the skyline of the city which is a huge departure from the mediocre setup of Low-rise Walk-up apartments. The complexity of these developments is further aggravated by the need for parking which necessitates cutting huge number of trees to accommodate multiple layers of parking beneath the structures thus sidelining the authentic character of these areas which is laden with a dense tree cover. The aftermath of this whole process is the generation of a huge carbon footprint on the surrounding areas, which is unaccounted for, in the planning and design practice. These developments are currently planned as mix-use compounds with large commercial built-up spaces which have additional parking requirements over and above the residential parking. Also, they are perceived as gated complexes and not as neighborhood units, thus project isolated images of high-rise, dense systems with little context to the surroundings. The paper would analyze case studies of GPRA Redevelopment projects in Delhi, and the lack of relevant development control regulations which have led to abnormalities and complications in the entire redevelopment process. It would also suggest policy guidelines which can establish comprehensive codes for effective planning of these settlements.

Keywords: gated complexes, GPRA Redevelopment projects, increased densities, huge carbon footprint, mixed-use development

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1334 Fault-Tolerant Control Study and Classification: Case Study of a Hydraulic-Press Model Simulated in Real-Time

Authors: Jorge Rodriguez-Guerra, Carlos Calleja, Aron Pujana, Iker Elorza, Ana Maria Macarulla

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Society demands more reliable manufacturing processes capable of producing high quality products in shorter production cycles. New control algorithms have been studied to satisfy this paradigm, in which Fault-Tolerant Control (FTC) plays a significant role. It is suitable to detect, isolate and adapt a system when a harmful or faulty situation appears. In this paper, a general overview about FTC characteristics are exposed; highlighting the properties a system must ensure to be considered faultless. In addition, a research to identify which are the main FTC techniques and a classification based on their characteristics is presented in two main groups: Active Fault-Tolerant Controllers (AFTCs) and Passive Fault-Tolerant Controllers (PFTCs). AFTC encompasses the techniques capable of re-configuring the process control algorithm after the fault has been detected, while PFTC comprehends the algorithms robust enough to bypass the fault without further modifications. The mentioned re-configuration requires two stages, one focused on detection, isolation and identification of the fault source and the other one in charge of re-designing the control algorithm by two approaches: fault accommodation and control re-design. From the algorithms studied, one has been selected and applied to a case study based on an industrial hydraulic-press. The developed model has been embedded under a real-time validation platform, which allows testing the FTC algorithms and analyse how the system will respond when a fault arises in similar conditions as a machine will have on factory. One AFTC approach has been picked up as the methodology the system will follow in the fault recovery process. In a first instance, the fault will be detected, isolated and identified by means of a neural network. In a second instance, the control algorithm will be re-configured to overcome the fault and continue working without human interaction.

Keywords: fault-tolerant control, electro-hydraulic actuator, fault detection and isolation, control re-design, real-time

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1333 Creating Legitimate Expectations in International Energy Investments: Role of the Stability Provisions

Authors: Rahmi Kopar

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Legitimate expectations principle is considered one of the most dominant elements of the Fair and Equitable Treatment Standard which is today’s most relied upon treaty standard. Since its utilization by arbitral tribunals is relatively new, the contours of the legitimate expectations concept under investment treaty law have not been precisely defined yet. There are various fragmented views arising both from arbitral tribunals and scholarly writings with respect to its limits and use even though the principle is ‘firmly rooted in arbitral practice.’ International energy investments, due to their characteristics, are more prone to certain types of risks, especially the political risks. Thus, there are several mechanisms to protect an energy investment against those risks. Stabilisation is one of these investment protection methods. Stability provisions can be found under domestic legislations, as a contractual clause, or as a separate legal stability agreement. This paper will start by examining the roots of the contentious concept of legitimate expectations with reference to its application in domestic legal systems from where the doctrine under investment treaty law context was transplanted. Then the paper will turn to the investment treaty law and analyse the main contours of the doctrine as understood and applied by arbitral tribunals. 'What gives rise to the investor’s legitimate expectations?' question is answered mainly by three categories of sources: the general legal framework prevalent in a host state, the representations made by the officials or organs of a host state, and the contractual commitments. However, there is no unanimity among the arbitral tribunals and the scholars with respect to the form these sources should take. At this point, the study will discuss the sources of a stability provision and the effect of these stability provisions found in various legal sources in creating a legitimate expectation for the investor. The main questions to be discussed in this paper are as follows: a) Do the stability provisions found under different legal sources create a legitimate expectation on the investor side? b) If yes, what levels of legitimate expectations do they create? These questions will be answered mainly by reference to investment treaty jurisprudence.

Keywords: fair and equitable treatment standard, international energy investments, investment protection, legitimate expectations, stabilization

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1332 Factors Influencing Public Attitudes Towards Mental Illness in the Togolese Population

Authors: Myriam Roy

Abstract:

The perspectives of the Togolese public towards mental illness were assessed, looking at religious affiliation, personal knowledge of someone with a mental illness, and education level as influencers. The goal was to observe which factors influenced most strongly the general public’s attitudes towards mental illness. The Togolese population was surveyed within the context of mental health awareness workshops and involved college and university students, rural community members, and company employees. Taylor and Dear’s Community Attitudes towards the Mentally Ill (CAMI) questionnaire was used to assess these influencers and includes four dimensions of community attitudes towards mental illness: authoritarianism, benevolence, social restrictiveness, and community mental health ideology (CMHI). Demographic questions were also included, tailored to the various realities of the Togolese population. These questions looked, among others, at religious, ethnical (region of origin within Togo), and educational background. It was found that religious affiliation and personal knowledge did not correlate significantly with changes in the four dimensions of the CAMI scale. It suggests that public perspectives towards mental illness might not be as associated with these variables as was previously thought. The dimensions, however, did correlate with themselves as was expected. Authoritarianism was associated positively with social restrictiveness, benevolence was associated negatively with social restrictiveness and positively with CMHI, and CMHI was associated negatively with social restrictiveness, indicating the CAMI did not suffer from reliability and validity issues when used with this population. Interestingly, level of education significantly impacted authoritarianism level, with higher education associated with a decrease in authoritarianism. This finding would support the notion that education is likely to provide access to a wide array of information as well as interaction with people from various backgrounds and situations. Providing increased awareness regarding mental health and illness in schools could be beneficial to favor the impact that education appears to have on public perspectives towards mental illness in Togo. Future studies could assess which mental health interventions in schools would be the most useful in Togo.

Keywords: CAMI questionnaire, cross-cultural psychology, stigma towards mental illness, West African psychology

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1331 Machine Learning Framework: Competitive Intelligence and Key Drivers Identification of Market Share Trends among Healthcare Facilities

Authors: Anudeep Appe, Bhanu Poluparthi, Lakshmi Kasivajjula, Udai Mv, Sobha Bagadi, Punya Modi, Aditya Singh, Hemanth Gunupudi, Spenser Troiano, Jeff Paul, Justin Stovall, Justin Yamamoto

Abstract:

The necessity of data-driven decisions in healthcare strategy formulation is rapidly increasing. A reliable framework which helps identify factors impacting a healthcare provider facility or a hospital (from here on termed as facility) market share is of key importance. This pilot study aims at developing a data-driven machine learning-regression framework which aids strategists in formulating key decisions to improve the facility’s market share which in turn impacts in improving the quality of healthcare services. The US (United States) healthcare business is chosen for the study, and the data spanning 60 key facilities in Washington State and about 3 years of historical data is considered. In the current analysis, market share is termed as the ratio of the facility’s encounters to the total encounters among the group of potential competitor facilities. The current study proposes a two-pronged approach of competitor identification and regression approach to evaluate and predict market share, respectively. Leveraged model agnostic technique, SHAP, to quantify the relative importance of features impacting the market share. Typical techniques in literature to quantify the degree of competitiveness among facilities use an empirical method to calculate a competitive factor to interpret the severity of competition. The proposed method identifies a pool of competitors, develops Directed Acyclic Graphs (DAGs) and feature level word vectors, and evaluates the key connected components at the facility level. This technique is robust since its data-driven, which minimizes the bias from empirical techniques. The DAGs factor in partial correlations at various segregations and key demographics of facilities along with a placeholder to factor in various business rules (for ex. quantifying the patient exchanges, provider references, and sister facilities). Identified are the multiple groups of competitors among facilities. Leveraging the competitors' identified developed and fine-tuned Random Forest Regression model to predict the market share. To identify key drivers of market share at an overall level, permutation feature importance of the attributes was calculated. For relative quantification of features at a facility level, incorporated SHAP (SHapley Additive exPlanations), a model agnostic explainer. This helped to identify and rank the attributes at each facility which impacts the market share. This approach proposes an amalgamation of the two popular and efficient modeling practices, viz., machine learning with graphs and tree-based regression techniques to reduce the bias. With these, we helped to drive strategic business decisions.

Keywords: competition, DAGs, facility, healthcare, machine learning, market share, random forest, SHAP

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1330 Long-Term Health and Quality of Life Outcomes Following War-Related Traumatic Lower-Limb Amputation; A Study on Community Re-Integrated Army Veterans in Sri Lanka

Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana

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Background: Civil war in Sri Lanka ended a decade ago, leaving thousands of army veterans permanently disabled following lower-limb amputations. Quantifying long-term functional health and psychological wellbeing will inform the development of tailored home-based rehabilitation intervention. Objectives: To assess the long-term health and quality of life of Sri Lankan soldiers with traumatic lower-limb amputation.Methods and Materials: A comparative cross-sectional study was conducted in five districts of Sri Lanka. Using stratified random sample technique, two groups of 85 participants were selected; group 1, community re-integrated male army veterans with unilateral lower-limb amputation, and group 2, age and sex matched normal healthy individuals. Long-term health and quality of life (QoL) outcomes were assessed and compared between the two groups using self-administered Short-Form Health Survey-36 questionnaire (SF-36) previously validated for use in Sri Lanka. Results: Group 1 were active prosthetic users who had undergone amputation > ten years ago (Mean±SD: 21.7±5.9). The most prevalent comorbidities for group 1 and 2 were hypertension and diabetes (22.4% and 30.6% and 9.4% and 9.8%, respectively). In group 1, injury-associated long-term health outcomes included knee osteoarthritis (18.8%), knee pain (20.0%), and back pain (69.4%). Scores of physical health and psychological wellbeing were 53.1 (IQR 64.4- 43.8) and 63.5 (IQR 73.3- 51.4) for each group, respectively. Scores revealed the highest QoL related to social functioning (75 (IQR 87.5- 62.5)) and the poorest aspects of QoL related to general health (40 (IQR 50- 35)). Prevalence of comorbidities was significantly higher, and QoL outcomes were significantly lower among soldiers compared to normal healthy individuals (p<0.05).Conclusion: Higher prevalence of comorbidities, poor physical health, and lower QoL outcomes were more prevalent in soldiers with lower-limb amputation when compared to healthy counterparts.

Keywords: community-based, disability, health outcomes, quality of life, soldiers

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1329 Rapid Identification of Thermophilic Campylobacter Species from Retail Poultry Meat Using Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry

Authors: Graziella Ziino, Filippo Giarratana, Stefania Maria Marotta, Alessandro Giuffrida, Antonio Panebianco

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In Europe, North America and Japan, campylobacteriosis is one of the leading food-borne bacterial illnesses, often related to the consumption of poultry meats and/or by-products. The aim of this study was the evaluation of Campylobacter contamination of poultry meats marketed in Sicily (Italy) using both traditional methods and Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS). MALDI-TOF MS is considered a promising rapid (less than 1 hour) identification method for food borne pathogens bacteria. One hundred chicken and turkey meat preparations (no. 68 hamburgers, no. 21 raw sausages, no. 4 meatballs and no. 7 meat rolls) were taken from different butcher’s shops and large scale retailers and submitted to detection/enumeration of Campylobacter spp. according to EN ISO 10272-1:2006 and EN ISO 10272-2:2006. Campylobacter spp. was detected with general low counts in 44 samples (44%), of which 30 from large scale retailers and 14 from butcher’s shops. Chicken meats were significantly more contaminated than turkey meats. Among the preparations, Campylobacter spp. was found in 85.71% of meat rolls, 50% of meatballs, 44.12% of hamburgers and 28.57% of raw sausages. A total of 100 strains, 2-3 from each positive samples, were isolated for the identification by phenotypic, biomolecular and MALDI-TOF MS methods. C. jejuni was the predominant strains (63%), followed by C. coli (33%) and C. lari (4%). MALDI-TOF MS correctly identified 98% of the strains at the species level, only 1% of the tested strains were not identified. In the last 1%, a mixture of two different species was mixed in the same sample and MALDI-TOF MS correctly identified at least one of the strains. Considering the importance of rapid identification of pathogens in the food matrix, this method is highly recommended for the identification of suspected colonies of Campylobacteria.

Keywords: campylobacter spp., Food Microbiology, matrix-assisted laser desorption ionization-time of flight mass spectrometry, rapid microbial identification

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1328 Assessing Impacts of Climate Variability and Change on Water Productivity and Nutrient Use Efficiency of Maize in the Semi-arid Central Rift Valley of Ethiopia

Authors: Fitih Ademe, Kibebew Kibret, Sheleme Beyene, Mezgebu Getnet, Gashaw Meteke

Abstract:

Changes in precipitation, temperature and atmospheric CO2 concentration are expected to alter agricultural productivity patterns worldwide. The interactive effects of soil moisture and nutrient availability are the two key edaphic factors that determine crop yield and are sensitive to climatic changes. The study assessed the potential impacts of climate change on maize yield and corresponding water productivity and nutrient use efficiency under climate change scenarios for the Central Rift Valley of Ethiopia by mid (2041-2070) and end century (2071-2100). Projected impacts were evaluated using climate scenarios generated from four General Circulation Models (GCMs) dynamically downscaled by the Swedish RCA4 Regional Climate Model (RCM) in combination with two Representative Concentration Pathways (RCP 4.5 and RCP8.5). Decision Support System for Agro-technology Transfer cropping system model (DSSAT-CSM) was used to simulate yield, water and nutrient use for the study periods. Results indicate that rainfed maize yield might decrease on average by 16.5 and 23% by the 2050s and 2080s, respectively, due to climate change. Water productivity is expected to decline on average by 2.2 and 12% in the CRV by mid and end centuries with respect to the baseline. Nutrient uptake and corresponding nutrient use efficiency (NUE) might also be negatively affected by climate change. Phosphorus uptake probably will decrease in the CRV on average by 14.5 to 18% by 2050s, while N uptake may not change significantly at Melkassa. Nitrogen and P use efficiency indicators showed decreases in the range between 8.5 to 10.5% and between 9.3 to 10.5%, respectively, by 2050s relative to the baseline average. The simulation results further indicated that a combination of increased water availability and optimum nutrient application might increase both water productivity and nutrient use efficiency in the changed climate, which can ensure modest production in the future. Potential options that can improve water availability and nutrient uptake should be identified for the study locations using a crop modeling approach.

Keywords: crop model, climate change scenario, nutrient uptake, nutrient use efficiency, water productivity

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1327 The Comparison between bFGF and Small Molecules in Derivation of Chicken Primordial Germ Cells and Embryonic Germ Cells

Authors: Maryam Farzaneh, Seyyedeh Nafiseh Hassani, Hossein Baharvand

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Objective: Chicken gonadal tissue has a two population such primordial germ cells (PGCs) and stromal cells (somatic cells). PGCs and embryonic germ cells (EGCs) that is a pluripotent type of PGCs in long-term culture are suitable sources for the production of chicken pluripotent stem cell lines, transgenic birds, vaccine and recombinant protein production. In general, the effect of growth factors such bFGF and mouse LIF on derivation of PGCs in vitro are important and in this study we could see the unique effect of small molecules such PD032 and SB43 as a chemical, in comparison to growth factors. Materials and Methods: After incubation of fertilized chicken egg up to 6 days and isolation of primary gonadal tissues and culture of mixed cells like PGCs and stromal cells. PGCs proliferate in the present of fetal calf serum (FCS) and small molecules and in another group bFGF, that these factors are important for PGCs culture and derivation. Somatic cells produce a multilayer feeder under the PGCs in primary culture and PGCs make a small cluster under these cells. Results: In present of small molecules and high volume of FCS (15%), the present of EGCs as a pluripotent stem cells were clear four weeks, that they had a positive immune-staining and periodic acid-Schiff staining (PAS), but in present of growth factors like bFGF without any chemicals, the present of PGCs were clear but after 7 until 10 days, there were disappear. Conclusion: Until now we have seen many researches about derivation and maintenance of chicken PGCs, in the hope of understanding the mechanisms that occur during germline development and production of a therapeutic product by transgenic birds. There are still many unknowns in this area and this project will try to have efficient conditions for identification of suitable culture medium for long-term culture of PGCs in vitro without serum and feeder cells.

Keywords: chicken gonadal primordial germ cells, pluripotent stem cells, growth factors, small molecules, transgenic birds

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