Search results for: integrated care delivery

Authors: Peter Iyobosa Asemota

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This study on solid waste management practices addressed aspects of environmental and health impacts resulting from poor management of solid waste. The study was occasioned by the observed rate and volume of illegal and indiscriminate dumping of solid waste materials especially in informal settlements. The main focus of this study was to establish the impact of waste management practices on human health and the environment. The study, therefore, presents a critical analysis of the state of solid waste management in the study area and the implications for human health and the environment. The study was carried out in Kayamandi informal settlement within Stellenbosch municipality. The sustainable management of solid waste is very important in order to minimize the environmental and public health risks associated with improper solid waste management. There is no denying the fact that the problems of waste management will become critical as time goes on because of improper and inefficient waste management practices. Towns and cities exhibit the burdens of waste management which is a characteristics feature of most African cities. The study critically assess the implementation of waste management practices by the residents of the informal settlement; identify the factors affecting management issues in the operation of solid waste management system by the municipality; identify factors militating against the implementation of waste management policies and legislation. Furthermore, a waste assessment study was carried out to assess the generation; composition of the waste stream and also determine the attitudes and behavior of the residents with regard to waste management practices. Findings from the study revealed that Kayamandi is not different from other informal settlements with regards to waste management. People are of the opinion that solid waste management is the sole responsibility of municipal authorities and as such, the government should be responsible for bearing the cost of solid waste management.

Keywords: environment, waste, waste composition, waste stream, policy, waste categories, sanitary landfill, waste collection, integrated solid waste management

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Authors: Shima Nikanjam, Badiossadat Hassanpour, Adi Irfan Che Ani

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The design process in architecture education is based upon the Learning-by-Doing method, which leads students to understand how to design by practicing rather than studying. First-year design studios, as starting educational stage, provide integrated knowledge and skills of design for newly jointed architecture students. Within the basic design studio environment, students are guided to transfer their abstract thoughts into visual concrete decisions under the supervision of design educators for the first time. Therefore, introductory design studios have predominant impacts on students’ operational thinking and designing. Architectural design thinking is quite different from students’ educational backgrounds and learning habits. This educational challenge at basic design studios creates a severe need to study the reality of design education at foundation year and define appropriate educational methods with convenient project types with the intention of enhancing architecture education quality. Material for this study has been gathered through long-term direct observation at a first year second semester design studio at the faculty of architecture at EMU (known as FARC 102), fall and spring academic semester 2014-15. Distribution of a questionnaire among case study students and interviews with third and fourth design studio students who passed through the same methods of education in the past 2 years and conducting interviews with instructors are other methodologies used in this research. The results of this study reveal a risk of a mismatch between the implemented teaching method, project type and scale in this particular level and students’ learning styles. Although the existence of such risk due to varieties in students’ profiles could be expected to some extent, recommendations can support educators to reach maximum compatibility.

Keywords: architecture education, basic design studio, educational method, forms creation skill

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Authors: Emad Mohammed Sani

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Women encounter exclusion and discrimination in varying degrees, particularly those who marry as minors. The detrimental custom of getting married young is still prevalent worldwide and affects millions of people. It has been less common over time, although it is still widespread in underdeveloped nations. Oromia Regional State is the region in Ethiopia with the highest proportion of child brides. This study aimed at evaluating the effects of early marriage on its survivors’ life conditions – specifically, empowerment and household decision-making – in Eastern Hararghe Zone of Oromia Region. This study employed community-based cross-sectional study design. It adopted mixed method approach – survey, in-depth interview and focus group discussion (FGD) – to collect, analyses and interpret data on early marriage and its effects on household decision-making processes. Narratives and analytical descriptions were integrated to substantiate and/or explain observed quantitative results, or generate contextual themes. According to this study, married women who were married at or after the age of eighteen participated more in household decision-making than child brides. Child brides were more likely to be victims of violence and other types of spousal abuse in their marriages. These changes are mostly caused by an individual's age at first marriage. Delaying marriage had a large positive impact on women's empowerment at the household level, and age at first marriage had a considerable negative impact. In order to advance women's welfare and emancipation, we advise more research to concentrate on the relationship between the home and the social-structural forms that appear at the individual and communal levels.

Keywords: child-bride, early marriage, women, ethiopia

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Authors: Tsung Chieh Ma, I-Ling Chen

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Disclosing family origins to adoptees is an important topic in the adoption process. Adoption agencies usually educate adoptive parents on how to disclose to adoptees, but many adoptive parents worry that the disclosure will affect the parent–child relationship. Thus, how adoptees would like to receive the disclosure and whether they subjectively feel that the parent–child relationship is affected are both topics worthy of further discussion. This research takes a qualitative approach and connects with adoption agencies to interview six adoptees who are now adults. The purpose of the interviews is to learn about their experience receiving disclosures and their subjective feelings after learning of their family origins. The aim is to reveal the changes disclosure brought to the parent–child relationship and whether common concerns are raised due to the adoptive status. We also want to know about factors that affect their identification with their adopted status so that we can consequently give advice to other adoptive families. in this study finds that adoptees see disclosure as a process rather than an isolated event. The majority want to be told their family origin as early and proactively as possible and expect to learn the reasons they were given up for adoption and taken in as adoptees. The disclosure does not necessarily influence the parent–child relationship, and adoptees care more about the positive experiences they had with adoptive parents in their childhood. Moreover, adopted children seek contact with their original family mostly to understand why they were given up for adoption. The effects of disclosure depend on how the adoptive parents or other significant people in the lives of adoptees interpret the identity of the adoptees. That is, their response and attitude toward the identity have a lasting impact on the adoptees. The study suggests that early disclosure gives adoptees a chance to internalize the experience in the process and find self-identification.

Keywords: adoption, adoptees, disclosure of family origins, parent–child relationship, self-identity

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Authors: Iveta Eimontaite, Sarah R. Fletcher, Michele Surico, Alfio Minissale, Fabio F. Abba

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Industry 4.0 offers possibilities for increased production volumes and greater efficiency whilst at the same time presenting new opportunities and challenges for the human workforce. Exoskeletons have been used in healthcare and are now starting to be adopted in manufacturing. The potential benefits of reducing fatigue and physical strain are attractive prospects of the technology for industry; however, the novelty of exoskeletons and surrounding ethical issues raise concerns amongst the stakeholders. The current case study investigated the introduction of an upper body exoskeleton designed to support posture but not increase physical strength in a factory over three time points: before the exoskeleton was introduced, and one and two months post-introduction once operators had experienced working with it. The main focus was to evaluate changes in operators' workload, situation awareness, technology self-efficacy, and physical discomfort following the introduction of the exoskeleton. After using the exoskeleton over two months, operators reported a decrease in temporal demand and an increase in performance of the NASA TLX instrument. Furthermore, over the second month, operators' self-reported technology self-efficacy scores increased, but at the same time, their situation awareness decreased. Interestingly, operators' physical discomfort after using the exoskeleton for two months increased from not uncomfortable to quite uncomfortable in the shoulder, arm, and middle back regions. The results suggest that self-perceived task efficiency improved; however, increased discomfort and decreased situation awareness scores indicate that two months might not be long enough for the exoskeleton to be integrated into operators’ mental body schema. The paper will discuss further implications and suggestions for exoskeleton introduction to manufacturing environments.

Keywords: exoskeleton, manufacturing, mental workload, physical discomfort, situation awareness, technology self-efficacy

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Authors: F. Sarkinfada, Dabo N. Tukur, Abbas A. Muaz, Adamu A. Yahuza

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Appropriate Quality Assurance (QA) of parasite-based diagnosis of malaria to justify Artemisinin-based Combination Therapy (ACT) is essential for Malaria Programmes. In Low and Middle Income Countries (LMIC), resource constrain appears to be a major challenge in implementing the conventional QA system. We designed and implemented a modified LQAS model for QA of malaria parasite (MP) microscopy and RDT in a State Specialist Hospital (SSH) and a University Health Clinic (UHC) in Kano, Nigeria. The capacities of both facilities for MP microscopy and RDT were assessed before implementing a modified LQAS over a period of 3 months. Quality indicators comprising the qualities of blood film and staining, MP positivity rates, concordance rates, error rates (in terms of false positives and false negatives), sensitivity and specificity were monitored and evaluated. Seventy one percent (71%) of the basic requirements for malaria microscopy was available in both facilities, with the absence of certifies microscopists, SOPs and Quality Assurance mechanisms. A daily average of 16 to 32 blood samples were tested with a blood film staining quality of >70% recorded in both facilities. Using microscopy, the MP positivity rates were 50.46% and 19.44% in SSH and UHS respectively, while the MP positivity rates were 45.83% and 22.78% in SSH and UHS when RDT was used. Higher concordance rates of 88.90% and 93.98% were recorded in SSH and UHC respectively using microscopy, while lower rates of 74.07% and 80.58% in SSH and UHC were recorded when RDT was used. In both facilities, error rates were higher when RDT was used than with microscopy. Sensitivity and specificity were higher when microscopy was used (95% and 84% in SSH; 94% in UHC) than when RDT was used (72% and 76% in SSH; 78% and 81% in UHC). It could be feasible to implement an integrated QA model for MP microscopy and RDT using modified LQAS in Malaria Control Programmes in Low and Middle Income Countries that might have resource constrain for parasite-base diagnosis of malaria to justify ACT treatment.

Keywords: malaria, microscopy, quality assurance, RDT

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Authors: Abeer Ahmed Abdelhamed

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Introduction: Postoperative pulmonary complications (PPCs) are the most common complications observed and managed after abdominal or cardiothoracic surgery. Hypoxemia, atelectasis, pleural effusion, or diaphragmatic dysfunction, are often a source of morbidity in cardiac surgery patients, and are more common in patients receiving unilateral or bilateral internal mammary artery (IMT) grafts than patients receiving saphenous vein (SV) grafts alone. Purpose: The aim of this work was to investigate the effect of Threshold load inspiratory muscle training on pulmonary gas exchange and maximum inspiratory pressure (MIP) in patient undergoing coronary revascularization. Subject: Thirty three male patients eligible for coronary revascularization were selected to participate in the study. Method: They were divided into two groups(17 patients in the intervention group and 16 patients in the control group), the interventional group received inspiratory muscle training at 30% of their maximum inspiratory pressure throughout the hospitalization period in addition to routine post operative care. Result: The results of this study showed a significant improvement on maximum inspiratory pressure(MIP), Arterial-alveolar pressure gradient (A-a gradient) and oxygen saturation in the intervention group. Conclusion: Inspiratory muscle training using threshold mode significantly improves maximum inspiratory pressure, pulmonary gas exchange tested by alveolar-arterial gradient and oxygen saturation in Patients undergoing coronary revascularization.

Keywords: coronary revascularization, inspiratory muscle training, maximum inspiratory pressure, pulmonary gas exchange

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Authors: Amin AminiKhafri, James M. Dawson-Edwards, Ryan M. Simpson, Simaan M. AbouRizk

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Earned value management (EVM) has been introduced as an integrated method to combine schedule, budget, and work breakdown structure (WBS). EVM provides various indices to demonstrate project performance including the cost performance index (CPI). CPI is also used to forecast final project cost at completion based on the cost performance during the project execution. Knowing the final project cost during execution can initiate corrective actions, which can enhance project outputs. CPI, however, is not constant during the project, and calculating the final project cost using a variable index is an inaccurate and challenging task for practitioners. Since CPI is based on the cumulative progress values and because of the learning curve effect, CPI variation dampens and stabilizes as project progress. Although various definitions for the CPI stability have been proposed in literature, many scholars have agreed upon the definition that considers a project as stable if the CPI at 20% completion varies less than 0.1 from the final CPI. While 20% completion point is recognized as the stability point for military development projects, construction projects stability have not been studied. In the current study, an empirical study was first conducted using construction project data to determine the stability point for construction projects. Early findings have demonstrated that a majority of construction projects stabilize towards completion (i.e., after 70% completion point). To investigate the effect of CPI stability on cost forecast accuracy, the correlation between CPI stability and project cost at completion forecast accuracy was also investigated. It was determined that as projects progress closer towards completion, variation of the CPI decreases and final project cost forecast accuracy increases. Most projects were found to have 90% accuracy in the final cost forecast at 70% completion point, which is inlined with findings from the CPI stability findings. It can be concluded that early stabilization of the project CPI results in more accurate cost at completion forecasts.

Keywords: cost performance index, earned value management, empirical study, final project cost

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Authors: Rasha Ahmadi

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Glioblastoma is one of the most frequent brain malignancies, having a high mortality rate and limited survival in individuals with this malignancy. Despite different treatments and surgery, recurrence of glioblastoma cancer stem cells may arise as a subsequent tumor. For this reason, it is crucial to research the markers associated with glioblastoma stem cells and specifically their microenvironment. In this study, using bioinformatics analysis, we analyzed and nominated genes in the microenvironment pathways of glioblastoma stem cells. In this study, an appropriate database was selected for analysis by referring to the GEO database. This dataset comprised gene expression patterns in stem cells derived from glioblastoma patients. Gene clusters were divided as high and low expression. Enrichment databases such as Enrichr, STRING, and GEPIA were utilized to analyze the data appropriately. Finally, we extracted the potential genes 2700 high-expression and 1100 low-expression genes are implicated in the metabolic pathways of glioblastoma cancer progression. Cellular senescence, MAPK, TNF, hypoxia, zimosterol biosynthesis, and phosphatidylinositol metabolism pathways were substantially expressed and the metabolic pathways were downregulated. After assessing the association between protein networks, MSMP, SOX2, FGD4 ,and CNTNAP3 genes with high expression and DMKN and SBSN genes with low were selected. All of these genes were observed in the survival curve, with a survival of fewer than 10 percent over around 15 months. hsa-mir-192-5p, hsa-mir-129-5p, hsa-mir-215-5p, hsa-mir-335-5p, and hsa-mir-340-5p played key function in glioblastoma cancer stem cells microenviroments. We introduced critical genes through integrated and regular bioinformatics studies by assessing the amount of gene expression profile data that can play an important role in targeting genes involved in the energy and microenvironment of glioblastoma cancer stem cells. Have. This study indicated that hsa-mir-192-5p, and hsa-mir-129-5p are appropriate candidates for this.

Keywords: Glioblastoma, Cancer Stem Cells, Biomarker Discovery, Gene Expression Profiles, Bioinformatics Analysis, Tumor Microenvironment

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Authors: Sara Rute Monteiro Silva Sousa

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Since the second half of the 20th century, environmental problems began to generate deep concern around the world. The harmful effects of human's irresponsible actions are increasingly evident, profoundly affecting biodiversity and even human health. Given the seriousness of this human footprint, governments, organizations, and civil society must all be more proactive and adopt more effective measures to solve environmental problems and promote sustainable development. This can be achieved through different tools, namely through a more efficient education that enables current and future generations to meet their needs in an integrated approach to the economic, social, and environmental dimensions of sustainable development. In this context, schools play a key role, being responsible for educating today's students and tomorrow's leaders, decision makers, intellectuals, managers, politicians, employers, and parents. Aware of this crucial role of education and schools, the Foundation for Environmental Education created the Eco-Schools program in 1992, ensuring that schools develop a whole-school approach to environmental and sus-tainable education. This research aims to increase knowledge and information about the efficiency of the Eco-Schools program as a promoter of more sustainable schools and communities. This research study analyses a specific case of a Portuguese higher education institution in the area of management, accounting, and administration. A description, reflection, and discussion are made on some of the main measures implemented in the last academic year of 2021/22 within the scope of the Eco-Schools program, concluding that, despite some implementation difficulties, the program was successfully developed, involving the participation of students, teachers, staff, and outside school community members, being awarded with the Green Flag as a recognition of its key contribution to a more sustainable society.

Keywords: sustainable development, environmental education, eco-schools program, higher education institutions, portugal

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Authors: Jamie R. Chua, Christina Irene D. Mejia, Regina P. Berba

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Disseminated tuberculosis is an infectious disease caused by Mycobacterium tuberculosis involving two or more non-contiguous sites identified through bacteriologic confirmation or clinical diagnosis. Over the five year period included in the study, the UP-PGH TB DOTS clinic had total of 3,967 referrals, and the prevalence of disseminated tuberculosis is 1% (68/3967). The mean age was 33.9 years (range 19-64 years) with a male: female ratio of 1:1. 67% (52 patients) had no predisposing comorbid illness or immune disorder. The most common presenting symptoms were abdominal pain (19%), back pain (13%), abdominal enlargement (11%) and mass (10.2%). Anemia, leukocytosis, hypoalbuminemia, and high-normal serum calcium were common biochemical and hematologic findings. Around 36% (25) of patients were diagnosed clinically with disseminated tuberculosis despite lacking bacteriologic evidence of multi-organ involvement. The lungs (86%) is still the most commonly involved site, followed by intestinal (22%), vertebral/Pott’s (27%), and pelvic/genital (19%). The mean time from presentation to initiation of therapy was 22 days (SD 32.7). Only 18 patients (29.3%) were properly recorded to have been referred to local TB DOTs facilities. Of the 68 patients, only 16% (11 patients) continued follow-up at PGH, and all had documented treatment completion. Treatment outcomes of the remaining were unknown. Due to the variety of involved sites, a high index of suspicion is required. Knowledge on clinical features, common radiographic findings, and histopathologic characteristics of disseminated TB is important as bacteriologic evidence of infection is not always apparent.

Keywords: disseminated tuberculosis, Mycobacterium tuberculosis, miliary tuberculosis, tuberculosis

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Authors: Selman Cagman

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A detailed analysis is made within an organized industrial zone (OIZ) that has 1165 production facilities such as manufacturing of furniture, fabricated metal products (machinery and equipment), food products, plastic and rubber products, machinery and equipment, non-metallic mineral products, electrical equipment, textile products, and manufacture of wood and cork products. In this OIZ, a field study is done by choosing some facilities that can represent the whole OIZ sectoral distribution. In this manner, there are 207 facilities included to the site visit, and there is a 17 questioned survey carried out with each of them to assess their inputs, outputs, and waste amounts during manufacturing processes. The survey result identify that MDF/Particleboard and chipboard particles, textile, food, foam rubber, sludge (treatment sludge, phosphate-paint sludge, etc.), plastic, paper and packaging, scrap metal (aluminum shavings, steel shavings, iron scrap, profile scrap, etc.), slag (coal slag), ceramic fracture, ash from the fluidized bed are the wastes come from these facilities. As a result, there are 5 industrial symbiosis projects established with this study. One of the projects is a 2.840 kW capacity Integrated Biomass Based Waste Incineration-Energy Production Facility running on 35.000 tons/year of MDF particles and chipboard waste. Another project is a biogas plant with 225 tons/year whey, 100 tons/year of sesame husk, 40 tons/year of burnt wafer dough, and 2.000 tons/year biscuit waste. These two plants investment costs and operational costs are given in detail. The payback time of the 2.840 kW plant is almost 4 years and the biogas plant is around 6 years.

Keywords: industrial symbiosis, energy, biogas, waste to incineration

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Authors: Souhir Chelly, Asma Ben Cheikh, Hela Ghali, Salwa Khefacha, Lamine Dhidah, Mohamed Ben Rejeb, Houyem Said Latiri

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The hospital risk management department is firstly involved in the methodological analysis of grade zero sterilization incidents. The system is based on a subsequent analysis process in compliance with the ongoing requirements of the Haute Autorité de santé (HAS) for a reactive approach to risk, allowing to identify failures and start the appropriate preventive and corrective measures. The use of the association of litigation and risk management (ALARM) method makes easier the grade zero analysis and brings to light the team or institutional, organizational, temporal, individual factors representative of undesirable effects. Two main factors come out again from this analysis, pre-disinfection step of the emergency block unsupervised instrumentalist intern was poorly done since she did not remove the battery from micro air motor. At the sterilization unit, the worker who was not supervised by the nurse did the conditioning of the motor without having checked it if it still contained the battery. The main cause is that the management of human resources was inadequate at both levels, the instrumental trainee in the block who was not supervised by his supervisor and the worker of the sterilization unit who was not supervised by the responsible nurse. There is a lack of research help, advice, and collaboration. The difficulties encountered during this type of analysis are multiple. The first is based on its necessary acceptance by the various actors of care involved, which should not perceive it as a tool leading to individual punishment, but rather as a means to improve their practices.

Keywords: ALARM (Association of Litigation and Risk Management Method), incident, risk management, sterilization

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Authors: Karim Hajjar, Luis Lillo, Diego Martinez, Manuel Hermosilla, Nicholas Risko

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Objectives: This study examines the relationship between universal health coverage (UCH) and the burden of emergency diseases at a global level. Methods: Data on Disability-Adjusted Life Years (DALYs) from emergency conditions were extracted from the Institute for Health Metrics and Evaluation (IHME) database for the years 2015 and 2019. Data on UHC, measured using two variables, 1) coverage of essential health services and 2) proportion of population spending more than 10% of household income on out-of-pocket health care expenditure, was extracted from the World Bank Database for years preceding our outcome of interest. Linear regression was performed, analyzing the effect of the UHC variables on the DALYs of emergency diseases, controlling for other variables. Results: A total of 133 countries were included. 44.4% of the analyzed countries had coverage of essential health services index of at least 70/100, and 35.3% had at least 10% of their population spend greater than 10% of their household income on healthcare. For every point increase in the coverage of essential health services index, there was a 13-point reduction in DALYs of emergency medical diseases (95% CI -16, -11). Conversely, for every percent decrease in the population with large household expenditure on healthcare, there was a 0.48 increase in DALYs of emergency medical diseases (95% CI -5.6, 4.7). Conclusions: After adjusting for multiple variables, an increase in coverage of essential health services was significantly associated with improvement in DALYs for emergency conditions. There was, however, no association between catastrophic health expenditure and DALYs.

Keywords: emergency medicine, universal healthcare, global health, health economics

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Authors: Lingju Wu, Hao Hua

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This paper presents a digital fashion production methodology and workflow based on fused deposition modeling additive manufacturing technology, as demonstrated through a 3D printed fashion show held at Southeast University in Nanjing, China. Unlike traditional fashion, 3D printed fashion allows for the creation of complex geometric shapes and unique structural designs, facilitating diverse reconfiguration and sustainable production of textile fabrics. The proposed methodology includes two components: morphogenesis and the 3D printing process. The morphogenesis part comprises digital design methods such as mesh deformation, structural reorganization, particle flow stretching, sheet partitioning, and spreading methods. The 3D printing process section includes three types of methods: sculptural objects, multi-material composite fabric, and self-forming composite fabrics. This paper focuses on multi-material composite fabrics and self-forming composite fabrics, both of which involve weaving fabrics with 3D-printed material sandwiches. Multi-material composite fabrics create specially tailored fabric from the original properties of the printing path and multiple materials, while self-forming fabrics apply pre-stress to the flat fabric and then print the sandwich, allowing the fabric's own elasticity to interact with the printed components and shape into a 3D state. The digital design method and workflow enable the integration of abstract sensual aesthetics and rational thinking, showcasing a digital aesthetic that challenges conventional handicraft workshops. Overall, this paper provides a comprehensive framework for the production of 3D-printed fashion, from concept to final product.

Keywords: digital fashion, composite fabric, self-forming structure, additive manufacturing, generating design

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Authors: Tanja Salary

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This study uncovers a gap in the research and adds to the body of knowledge regarding medication errors in a juvenile justice facility. The study includes an introduction to data collected about medication errors in a juvenile justice facility and explores contributing factors that relate to those errors. The data represent electronic incident records of the medication errors that were documented from the years 2011 through 2019. In addition, this study reviews both current and historical research of empirical data about patient safety standards and quality care comparing traditional healthcare facilities to juvenile justice residential facilities. The theoretical/conceptual framework for the research study pertains to Bandura and Adams’s (1977) framework of self-efficacy theory of behavioral change and Mark Friedman’s results-based accountability theory (2005). Despite the lack of evidence in previous studies about addressing medication errors in juvenile justice facilities, this presenter will relay information that adds to the body of knowledge to note the importance of how assessing the potential relationship between medication errors. Implications for more research include recommendations for more education and training regarding increased communication among juvenile justice staff, including nurses, who administer medications to juveniles to ensure adherence to patient safety standards. There are several opportunities for future research concerning other characteristics about factors that may affect medication administration errors within the residential juvenile justice facility.

Keywords: juvenile justice, medication errors, psychotropic medications, behavioral health, juveniles, incarcerated youth, recidivism, patient safety

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Authors: Mario Isaza-Ruget, Claudia C. Colmenares-Mejia, Nancy Yomayusa, Camilo A. González, Andres Cely, Jossie Murcia

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Quantification of risks associated with complications development from chronic kidney disease (CKD) through accurate survival models can help with patient management. A retrospective cohort that included patients diagnosed with CKD from a primary care program and followed up between 2013 and 2018 was carried out. Time-dependent and static covariates associated with demographic, clinical, and laboratory factors were included. Deep Learning (DL) survival analyzes were developed for three CKD outcomes: CKD stage progression, >25% decrease in Estimated Glomerular Filtration Rate (eGFR), and Renal Replacement Therapy (RRT). Models were evaluated and compared with Random Survival Forest (RSF) based on concordance index (C-index) metric. 2.143 patients were included. Two models were developed for each outcome, Deep Neural Network (DNN) model reported C-index=0.9867 for CKD stage progression; C-index=0.9905 for reduction in eGFR; C-index=0.9867 for RRT. Regarding the RSF model, C-index=0.6650 was reached for CKD stage progression; decreased eGFR C-index=0.6759; RRT C-index=0.8926. DNN models applied in survival analysis context with considerations of longitudinal covariates at the start of follow-up can predict renal stage progression, a significant decrease in eGFR and RRT. The success of these survival models lies in the appropriate definition of survival times and the analysis of covariates, especially those that vary over time.

Keywords: artificial intelligence, chronic kidney disease, deep neural networks, survival analysis

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Authors: Mohammed-Hareef Asunramu, Sana Hashemi, Raja Ohri, Luc Worthington, Nadia Zaman, Junkai Zhu

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Background: The 2012 Health and Social Care Act committed to a ‘parity of esteem between mental and physical health services. Although this investment, aimed to both increase the quality of services and ensure the retention of mental health staff, questions remained regarding its ability to prevent mental health problems. One possible solution is a focus on the social determinants of health which have been shown to impact mental health. Aim: To examine the relationship between the index of multiple deprivations (IMD) and the prevalence of common mental health disorders (CMD) for CCGs in NHS England between 2019 and 2020. Design and setting: Cross-sectional analysis of 189 CCGs in NHS England. Methods: A multivariate linear regression model was utilized with CMD as outcome variable and IMD, age and ethnicity as explanatory variables. Datasets were obtained from Public Health England and the latest UK Census. Results: CCG IMD was found to have a significantly positive relationship with CMD. For every 1-point increase in IMD, CMD increases by 0.25%. Ethnicity had a significantly positive relationship with CMD. For every 1% increase in the population that identifies as BME, there is a 0.03% increase in CMD. Age had a significantly negative relationship with CMD. For every 1% increase in the population aged 60+, there is a 0.11% decrease in CMD. Conclusion: This study demonstrates that addressing mental health issues may require a multi-pronged approach. Beyond budget increases, it is essential to prioritize health equity, with careful considerations towards ethnic minorities and different age brackets.

Keywords: deprivation, health inequality, mental health, social determinants

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Authors: Sophio Kobauri, David Tugushi, Vladimir P. Torchilin, Ramaz Katsarava

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Hydrophobic / hydrophilically modified functional polymers are of high interest in modern biomedicine due to their ability to solubilize water-insoluble / poorly soluble (hydrophobic) drugs. Among the many approaches that are being developed in this direction, one of the most effective methods is the use of polymeric micelles (PMs) (micelles formed by amphiphilic block-copolymers) for solubilization of hydrophobic biologicals. For therapeutic purposes, PMs are required to be stable and biodegradable, although quite a few amphiphilic block-copolymers are described capable of forming stable micelles with good solubilization properties. For obtaining micelle-forming block-copolymers, polyethylene glycol (PEG) derivatives are desirable to use as hydrophilic shell because it represents the most popular biocompatible hydrophilic block and various hydrophobic blocks (polymers) can be attached to it. Although the construction of the hydrophobic core, due to the complex requirements and micelles structure development, is the very actual and the main problem for nanobioengineers. Considering the above, our research goal was obtaining biodegradable micelles for the solubilization of hydrophobic drugs and biologicals. For this purpose, we used biodegradable polymers– pseudo-proteins (PPs)(synthesized with naturally occurring amino acids and other non-toxic building blocks, such as fatty diols and dicarboxylic acids) as hydrophobic core since these polymers showed reasonable biodegradation rates and excellent biocompatibility. In the present study, we used the hydrophobic amino acid – L-phenylalanine (MW 4000-8000Da) instead of L-leucine. Amino-PEG (MW 2000Da) was used as hydrophilic fragments for constructing the suitable micelles. The molecular weight of PP (the hydrophobic core of micelle) was regulated by variation of used monomers ratios. Micelles were obtained by dissolving of synthesized amphiphilic polymer in water. The micelle-forming property was tested using dynamic light scattering (Malvern zetasizer NanoZSZEN3600). The study showed that obtaining amphiphilic block-copolymer form stable neutral micelles 100 ± 7 nm in size at 10mg/mL concentration, which is considered as an optimal range for pharmaceutical micelles. The obtained preliminary data allow us to conclude that the obtained micelles are suitable for the delivery of poorly water-soluble drugs and biologicals.

Keywords: amino acid – L-phenylalanine, pseudo-proteins, amphiphilic block-copolymers, biodegradable micelles

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Authors: Abdulrahman Alajlan

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While the sun serves as a robust energy source, the frigid conditions of outer space present promising prospects for nocturnal power generation due to its continuous accessibility during nighttime hours. This investigation illustrates a proficient methodology facilitating uninterrupted energy capture throughout the day. This method involves the utilization of water-based heat storage systems and radiative thermal emitters implemented across thermometric devices. Remarkably, this approach permits an enhancement of nighttime power generation that exceeds the level of 1 Wm-2, which is unattainable by alternative methodologies. Outdoor experiments conducted at the King Abdulaziz City for Science and Technology (KACST) have demonstrated unparalleled performance, surpassing prior experimental benchmarks by nearly an order of magnitude. Furthermore, the developed device exhibits the capacity to concurrently supply power to multiple light-emitting diodes, thereby showcasing practical applications for nighttime power generation. This research unveils opportunities for the creation of scalable and efficient 24-hour power generation systems based on thermoelectric devices. Central findings from this study encompass the realization of continuous 24-hour power generation from clean and sustainable energy sources. Theoretical analyses indicate the potential for nighttime power generation reaching up to 1 Wm-2, while experimental results have reached nighttime power generation at a density of 0.5 Wm-2. Additionally, the efficiency of multiple light-emitting diodes (LEDs) has been evaluated when powered by the nighttime output of the integrated thermoelectric generator (TEG). Therefore, this methodology exhibits promise for practical applications, particularly in lighting, marking a pivotal advancement in the utilization of renewable energy for both on-grid and off-grid scenarios.

Keywords: nighttime power generation, thermoelectric devices, radiative cooling, thermal management

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Authors: Claudia Martínez-Araneda, Mariella Gutiérrez, Pedro Gómez, Diego Maldonado, Alejandra Segura, Christian Vidal-Castro

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The purpose of this document is to showcase the preliminary work in developing an EduChatbot-type tool and measuring the effects of its use aimed at providing effective feedback to students in programming courses. This bot, hereinafter referred to as tutorBot+, was constructed based on chatGPT and is tasked with assisting and delivering timely positive feedback to students in the field of computer science at the Universidad Católica de Concepción. The proposed working method consists of four stages: (1) Immersion in the domain of Large Language Models (LLMs), (2) Development of the tutorBot+ prototype and integration, (3) Experiment design, and (4) Intervention. The first stage involves a literature review on the use of artificial intelligence in education and the evaluation of intelligent tutors, as well as research on types of feedback for learning and the domain of chatGPT. The second stage encompasses the development of tutorBot+, and the final stage involves a quasi-experimental study with students from the Programming and Database labs, where the learning outcome involves the development of computational thinking skills, enabling the use and measurement of the tool's effects. The preliminary results of this work are promising, as a functional chatBot prototype has been developed in both conversational and non-conversational versions integrated into an open-source online judge and programming contest platform system. There is also an exploration of the possibility of generating a custom model based on a pre-trained one tailored to the domain of programming. This includes the integration of the created tool and the design of the experiment to measure its utility.

Keywords: assessment, chatGPT, learning strategies, LLMs, timely feedback

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Authors: Samson Viulu, Hugo Hebala, Duddley Kopu

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Constituency Development Fund (CDF) is a controversial fund that has existed in the Solomon Islands since the early 90s to date. It is largely controversial because it is directly handled by members of parliament (MPs) of the Solomon Islands legislation chamber. It is commonly described as a political slash fund because only voters of MPs benefit from it to retain loyalty. The CDF was established by a legislative act in 2013; however, it does not have any subsidiary regulations to it, therefore, very weak governance. CDF is purposely to establish development projects in the rural areas of the Solomon Islands to spur economic growth. Although almost USD500M was spent in CDF in the last decade, there has been no growth in the economy of the Solomon Islands; rather, a regress. Solomon Islands has now formulated a first home-grown policy aimed at guiding the overall development of the fifty constituencies, improving delivery mechanisms of the CDF, and strengthening its governance through the regulation of the CDF Act 2013. The Solomon Islands Constituency Development Policy is the first for the country since gaining independence in 1978 and gives strong emphasis on a cross-sectoral approach through effective partnerships and collaborations and decentralizing government services to the isolated rural areas of the country. The new policy is driving the efforts of the political government to decentralize government services to isolated rural communities to encourage the participation of rural dwellers in economic activities. The decentralization will see the establishment of constituency offices within all constituencies and the piloting of townships in constituencies that have met the statutory requirements of the state. It also encourages constituencies to become development agents of the national government than being mere political boundaries. The decentralization will go in line with the establishment of the Solomon Islands Special Economic Zones (SEZ), where investors will be given special privileges and exemptions from government taxes and permits to attract tangible development to occur in rural constituencies. The design and formulation of the new development policy are supported by the UNDP office in the Solomon Islands. The new policy is promoting a reorientation on the allocation of resources more toward the productive and resource sectors, making access to finance easier for entrepreneurs and encouraging growth in rural entrepreneurship in the fields of agriculture, fisheries, down streaming, and tourism across the Solomon Islands. This new policy approach will greatly assist the country to graduate from the least developed countries status in a few years’ time.

Keywords: decentralization, constituency development fund, Solomon Islands constituency development policy, partnership, entrepreneurship

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Authors: Frida C. Jaime Franco, C. Paulina Navarro Núñez, R. Jacob Sánchez Nájera

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The importance of developing multi-language abilities in our global society is noteworthy. However, the necessity, interest, and consciousness of the significance that the development of another language represents, apart from the mother tongue, is not always the same in all contexts as it is in multicultural communities, especially in rural higher education institutions immersed in small communities. Leading opportunities for digital interaction among learners from Mexico and abroad partners represents scaffolding towards, not only language skills development but also intercultural communicative competences (ICC). This study leads us to consider what should be the best approach to work while applying a program of ICC integrated into the practice of EFL. While analyzing the roots of the language, it is possible to obtain the main objective of learning another language, to communicate with a functional purpose, as well as attaching social practices to the learning process, giving a result of functionality and significance to the target language. Hence, the collateral impact that collaborative learning leads to, aims to contribute to a better global understanding as well as a means of self and other cultural awareness through intercultural communication. While communicating through the target language by online collaboration among students in platforms of long-distance communication, language is used as a tool of interaction to broaden students’ perspectives reaching a substantial improvement with the help of their differences. This process should consider the application of the target language in the inquiry of sociocultural information, expecting the learners to integrate communicative skills to handle cultural differentiation at the same time they apply the knowledge of their target language in a real scenario of communication, despite being through virtual resources.

Keywords: collaborative learning, communicative approach, culture, interaction, interculturalism, target language, virtual partnership

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Authors: Cheng Fang Wang, Fu Li Gao, Jian Ying Zhou

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The '1+4' integration pilot area in the border area of Guangzhou-Foshan is an important platform for Guangzhou-Foshan strategic cooperation, as well as a typical semi-urbanized area with mixed urban and rural landscapes, of which the Baiyun-Nanhai pilot area is one of them. Baiyun district and Nanhai district are only separated by the Pearl River. In this paper, the three dimensions, which include production, living, and ecology, have been put forward, as well as cross-regional multi-agency negotiation mechanism has been discussed. Taking 'Baiyun-Nanhai' pilot area as a case study, POI (Point of Interest) data to analyze the distribution characteristics of 'production-living-ecological space' from the spatial dimension has been introduced in this paper, as well as the land-use change of 'production-living-ecological space' in western region of Baiyun district in 2007 and 2017 from the temporal dimension has been analyzed. Based on the above analysis, the integration development strategy and rethinking of cross-administrative region based on 'production-living-ecological integration' mechanism have been discussed later. It will explore the mechanism of industrial collaborative innovation, infrastructure co-construction, and ecological co-protection in semi-urban areas across borders. And it is expected to provide a reference for the integrated construction of the Guangdong-Hong Kong-Macao Greater Bay Area.

Keywords: semi-urbanization, production-living-ecological integration, multi-agency negotiation, Guangzhou-Foshan integration, synergetic development

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Authors: Abdolhamid Anazadehsayed, Jamal Naser

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An integrated computational fluid dynamics model is developed for a combined simulation of Plateau borders, films, and transitional areas between the film and the Plateau borders to reduce the simplifications and shortcomings of available models for foam drainage in micro-scale. Additionally, the counter-flow related to the Marangoni effect in the transitional area is investigated. The results of this combined model show the contribution of the films, the exterior Plateau borders, and Marangoni flow in the drainage process more accurately since the inter-influence of foam's elements is included in this study. The exterior Plateau borders flow rate can be four times larger than the interior ones. The exterior bubbles can be more prominent in the drainage process in cases where the number of the exterior Plateau borders increases due to the geometry of container. The ratio of the Marangoni counter-flow to the Plateau border flow increases drastically with an increase in the mobility of air-liquid interface. However, the exterior bubbles follow the same trend with much less intensity since typically, the flow is less dependent on the interface of air-liquid in the exterior bubbles. Moreover, the Marangoni counter-flow in a near-wall transition area is less important than an internal one. The influence of air-liquid interface mobility on the average velocity of interior foams is attained with more accuracy with more realistic boundary condition. Then it has been compared with other numerical and analytical results. The contribution of films in the drainage is significant for the mobile foams as the velocity of flow in the film has the same order of magnitude as the velocity in the Plateau border. Nevertheless, for foams with rigid interfaces, film's contribution in foam drainage is insignificant, particularly for the films near the wall of the container.

Keywords: foam, plateau border, film, Marangoni, CFD, bubble

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Authors: Huanhuan Qiang, Sijia Jin

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Population aging has become a global trend, and China has entered an aging society, implementing an active aging system focused on home and community-based care. However, most urban communities where elderly people live face issues such as monotonous planning, unappealing landscapes, and inadequate aging infrastructure, which do not meet the requirements for active aging. Intergenerational friendliness and mutual assistance are key components in China's active aging policy framework. Therefore, residential development should prioritize enhancing intergenerational friendliness. Residential and public spaces are central to community life and well-being, offering new and challenging venues to improve relationships among residents of different ages. They are crucial for developing intergenerational communities with diverse generations and non-blood relationships. This paper takes the Maigaoqiao community in Nanjing, China, as a case study, examining intergenerational interactions in public spaces. Based on Maslow's hierarchy of needs and using time geography analysis, it identifies the spatiotemporal behavior characteristics of intergenerational groups in outdoor activities. Then construct an intergenerational-friendly evaluation system and an IPA quadrant model for public spaces in residential areas. Lastly, it explores optimization strategies for public spaces to promote intergenerational friendly interactions, focusing on five aspects: accessibility, safety, functionality, a sense of belonging, and interactivity.

Keywords: intergenerational friendliness, demand theory, spatiotemporal behavior, IPA analysis, existing residential public space

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Authors: Wei Wang, Yannick Liu, Lu Zhen, H. Wang

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Maritime transport plays an important role in global economic development but also inevitably faces increasing pressures from all sides, such as ship operating cost reduction and environmental protection. An ideal innovation to address these pressures is electric ships. The electric ship is in the early stage. Considering the special characteristics of electric ships, i.e., travel range limit, to guarantee the efficient operation of electric ships, the service network needs to be re-designed carefully. This research designs a cost-efficient and environmentally friendly service network for electric ships, including the location of charging stations, charging plan, route planning, ship scheduling, and ship deployment. The problem is formulated as a mixed-integer linear programming model with the objective of minimizing total cost comprised of charging cost, the construction cost of charging stations, and fixed cost of ships. A case study using data of the shipping network along the Yangtze River is conducted to evaluate the performance of the model. Two operating scenarios are used: an electric ship scenario where all the transportation tasks are fulfilled by electric ships and a conventional ship scenario where all the transportation tasks are fulfilled by fuel oil ships. Results unveil that the total cost of using electric ships is only 42.8% of using conventional ships. Using electric ships can reduce 80% SOx, 93.47% NOx, 89.47% PM, and 42.62% CO2, but will consume 2.78% more time to fulfill all the transportation tasks. Extensive sensitivity analyses are also conducted for key operating factors, including battery capacity, charging speed, volume capacity, and a service time limit of transportation task. Implications from the results are as follows: 1) it is necessary to equip the ship with a large capacity battery when the number of charging stations is low; 2) battery capacity will influence the number of ships deployed on each route; 3) increasing battery capacity will make the electric ship more cost-effective; 4) charging speed does not affect charging amount and location of charging station, but will influence the schedule of ships on each route; 5) there exists an optimal volume capacity, at which all costs and total delivery time are lowest; 6) service time limit will influence ship schedule and ship cost.

Keywords: cost reduction, electric ship, environmental protection, sustainable shipping

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Authors: Parul Suraia, Harshit Sosan Lakra

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Indigenous communities represent some of the most marginalized populations globally, with India labeled as tribals, experiencing particularly pronounced marginalization and a concerning decline in their numbers. These communities often inhabit geographically challenging regions characterized by low population densities, posing significant challenges to providing essential infrastructure services. Jharkhand, a Schedule 5 state, is infamous for its low-level health status due to disparities in access to health care. The primary objective of this study is to investigate the spatial inequalities in healthcare accessibility among tribal populations within the state and pinpoint critical areas requiring immediate attention. Health indicators were selected based on the tribal perspective and association of Sustainable Goal 3 (Good Health and Wellbeing) with other SDGs. Focused group discussions in which tribal people and tribal experts were done in order to finalize the indicators. Employing Principal Component Analysis, two essential indices were constructed: the Tribal Health Index (THI) and the Tribal Health Intervention Index (THII). Index values were calculated based on the district-wise secondary data for Jharkhand. The bivariate spatial association technique, Moran’s I was used to assess the spatial pattern of the variables to determine if there is any clustering (positive spatial autocorrelation) or dispersion (negative spatial autocorrelation) of values across Jharkhand. The results helped in facilitating targeting policy interventions in deprived areas of Jharkhand.

Keywords: tribal health, health spatial disparities, health status, Jharkhand

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Authors: Udomporn Pangnakorn, Sombat Chuenchooklin

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Effect of the biopesticide from entomopathogenic nematode (Steinernema thailandensis n. sp.), bacteria ISR (Pseudomonas fluorescens), wood vinegar and fermented organic substances from plants: (neem Azadirachta indica + citronella grass Cymbopogon nardus Rendle + bitter bush Chromolaena odorata L.) were tested on culantro (Eryngium foetidum L.). The biopesticide was carried out for reduction infestation of the major insects pest (whitefly Bemisia tabaci (Gennadius)). The experimental plots were located at farmers’ farm in Tumbol Takhian Luean, Nakhon Sawan Province, Thailand. This study was undertaken during the drought season (lately November to May). The populations of whitefly were observed and recorded every hour up to 3 hours with insect net and yellow sticky traps after the treatments were applied. The results showed that bacteria ISR was the highest effectiveness for control whitefly infestation on culantro, the whitefly numbers on insect net were 12.5, 10.0, and 7.5 after spraying in 1hr, 2hr, and 3hr, respectively. While the whitefly on yellow sticky traps showed 15.0, 10.0, and 10.0 after spraying in 1hr, 2hr, and 3hr, respectively. Furthermore, overall the experiments showed that treatment of bacteria ISR found the average whitefly numbers only 8.06 and 11.0 on insect net and sticky tap respectively, followed by treatment of nematode found the average whitefly with 9.87 and 11.43 on the insect net and sticky tap, respectively. Therefore, the application of biopesticide from entomopathogenic nematodes, bacteria ISR, organic substances from plants and wood vinegar combined with natural enemies is the alternative method of Integrated Pest Management (IPM) for against infestation of whitefly.

Keywords: whitefly (Bemisia tabaci Gennadius), culantro (Eryngium foetidum L.), entomopathogenic nematode (Steinernema thailandensis n. sp.), bacteria ISR (Pseudomonas fluorescens), wood vinegar, fermented organic substances

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Authors: Donna-Marie Phyllis Lanton

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Sarcopenia is a well-known geriatric syndrome characterized by the progressive and generalized loss of muscle quantity or quality. The incidence of sarcopenia increases with age and is associated with adverse outcomes such as the increased risk of falls, cognitive impairment, loss of independence, diminished quality of life, increased health costs, need for care in a skilled nursing facility, and increased mortality. Physical activity, including resistance training, is the most prevalent recommendation for treating and preventing sarcopenia. Residents (N = 23) of a skilled nursing facility in East Orlando, Florida, participated in a 90-day strength training program designed using the PARIHS framework to improve measures of muscle mass, muscle strength, physical performance, and quality of life. Residents engaged in both resistance and balance exercises for 1 hour two times a week. Baseline data were collected and compared to data at Days 30, 60, and 90. T tests indicated significant gains on all measures from baseline to 90 days: muscle mass increased by 1.2 (t[22] = 2.85, p = .009), grip strength increased by 4.02 (t[22] = 8.15, p < .001), balance increased by 2.13 (t[22] = 18.64, p < .001), gait speed increased by 1.83 (t[22] = 17.84, p < .001), chair speed increased 1.87 (t[22] = 16.36, p < .001), and quality of life score increased by 17.5 (t[22] = 19.26, p < .001). For residents with sarcopenia in skilled nursing facilities, a 90-day strength training program with resistance and balance exercises may provide an option for decreasing the incidence of sarcopenia among that population

Keywords: muscle mass, muscle strength, older adults, PARIHS framework

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