Search results for: decision aiding processes

Authors: O. J. Akinsola, Yinan Zheng, Rose Anorlu, F. T. Ogunsola, Lifang Hou, Robert Leo-Murphy

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Cervical Cancer (CC) is the 2nd most common cancer among women living in low and middle-income countries, with no associated symptoms during formative periods. With the advancement and innovative medical research, there are numerous preventive measures being utilized, but the incidence of cervical cancer cannot be truncated with the application of only screening tests. The mortality associated with this invasive cervical cancer can be nipped in the bud through the important role of early-stage detection. This study research selected an array of different top features selection techniques which was aimed at developing a model that could validly diagnose the risk factors of cervical cancer. A retrospective clinic-based cohort study was conducted on 178 HIV-associated cervical cancer patients in Lagos University teaching Hospital, Nigeria (U54 data repository) in April 2022. The outcome measure was the automated prediction of the HIV-associated cervical cancer cases, while the predictor variables include: demographic information, reproductive history, birth control, sexual history, cervical cancer screening history for invasive cervical cancer. The proposed technique was assessed with R and Python programming software to produce the model by utilizing the classification algorithms for the detection and diagnosis of cervical cancer disease. Four machine learning classification algorithms used are: the machine learning model was split into training and testing dataset into ratio 80:20. The numerical features were also standardized while hyperparameter tuning was carried out on the machine learning to train and test the data. Logistic Regression (LR), Decision Tree (DT), Random Forest (RF), and K-Nearest Neighbor (KNN). Some fitting features were selected for the detection and diagnosis of cervical cancer diseases from selected characteristics in the dataset using the contribution of various selection methods for the classification cervical cancer into healthy or diseased status. The mean age of patients was 49.7±12.1 years, mean age at pregnancy was 23.3±5.5 years, mean age at first sexual experience was 19.4±3.2 years, while the mean BMI was 27.1±5.6 kg/m2. A larger percentage of the patients are Married (62.9%), while most of them have at least two sexual partners (72.5%). Age of patients (OR=1.065, p<0.001**), marital status (OR=0.375, p=0.011**), number of pregnancy live-births (OR=1.317, p=0.007**), and use of birth control pills (OR=0.291, p=0.015**) were found to be significantly associated with HIV-associated cervical cancer. On top ten 10 features (variables) considered in the analysis, RF claims the overall model performance, which include: accuracy of (72.0%), the precision of (84.6%), a recall of (84.6%) and F1-score of (74.0%) while LR has: an accuracy of (74.0%), precision of (70.0%), recall of (70.0%) and F1-score of (70.0%). The RF model identified 10 features predictive of developing cervical cancer. The age of patients was considered as the most important risk factor, followed by the number of pregnancy livebirths, marital status, and use of birth control pills, The study shows that data mining techniques could be used to identify women living with HIV at high risk of developing cervical cancer in Nigeria and other sub-Saharan African countries.

Keywords: associated cervical cancer, data mining, random forest, logistic regression

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Authors: Mbonigaba Swale

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Malaria is an infection or disease caused by parasites (Plasmodium Falciparum — causes severe Malaria, plasmodium Vivax, Plasmodium Ovale, and Plasmodium Malariae), transmitted by bites of infected anopheles (female) mosquitoes to humans. These vectors comprise of two types in Africa, particularly in Uganda, i.e. anopheles fenestus and Anopheles gambaie (‘example Anopheles arabiensis,,); feeds on man inside the house mainly at dusk, mid-night and dawn and rests indoors and makes them effective transmitters (vectors) of the disease. People in both urban and rural areas have consistently become prone to repetitive attacks of malaria, causing a lot of deaths and significantly increasing the poverty levels of the rural poor. Malaria is a national problem; it causes a lot of maternal pre-natal and antenatal disorders, anemia in pregnant mothers, low birth weights for the newly born, convulsions and epilepsy among the infants. Cumulatively, it kills about one million children every year in sub-Saharan Africa. It has been estimated to account for 25-35% of all outpatient visits, 20-45% of acute hospital admissions and 15-35% of hospital deaths. Uganda is the leading victim country, for which Rakai and Masaka districts are the most affected. So, it is not clear whether these abhorrent situations and episodes of recurrences and failure to cure from the disease are a result of poor diagnosis, prescription and dosing, treatment habits and compliance of the patients to the drugs or the ethical domain of the stake holders in relation to the main stream methodology of malaria management. The research is aimed at offering an alternative approach to manage and deal absolutely with problem by using a knowledge based software model of Artificial Intelligence (Al) that is capable of performing common-sense and cognitive reasoning so as to take decisions like the human brain would do to provide instantaneous expert solutions so as to avoid speculative simulation of the problem during differential diagnosis in the most accurate and literal inferential aspect. This system will assist physicians in many kinds of medical diagnosis, prescribing treatments and doses, and in monitoring patient responses, basing on the body weight and age group of the patient, it will be able to provide instantaneous and timely information options, alternative ways and approaches to influence decision making during case analysis. The computerized system approach, a new model in Uganda termed as “Software Aided Treatment” (SAT) will try to change the moral and ethical approach and influence conduct so as to improve the skills, experience and values (social and ethical) in the administration and management of the disease and drugs (combination therapy and generics) by both the patient and the health worker.

Keywords: knowledge based software, management, treatment, diagnosis

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Authors: Phillipa Denise Peart

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Black Asian and Minority Ethnic (BAME) people are more at risk of developing mental health disorders because they are more exposed to unfavorable social, economic, and environmental circumstances. These include housing, education, employment, community development, stigma, and discrimination. However, the majority of BAME mental health intervention studies focus on treatment with therapeutically effective drugs and use basic economic methods to evaluate their effectiveness; as a result, little is invested in the economic assessment of psychosocial interventions in BAME mental health. The UK government’s austerity programme and reduced funds for mental health services, has increased the need for the evaluation and assessment of initiatives to focus on value for money. The No Health without Mental Health policy (2011) provides practice guidance to practitioners, but there is little or no mention of the need to provide mental health initiatives targeted at BAME communities that are effective in terms of their impact and the cost-effectiveness. This, therefore, appears to contradict with and is at odds with the wider political discourse, which suggests there should be an increasing focus on health economic evaluation. As a consequence, it could be argued that whilst such policies provide direction to organisations to provide mental health services to the BAME community, by not requesting effective governance, assurance, and evaluation processes, they are merely paying lip service to address these problems and not helping advance knowledge and practice through evidence-based approaches. As a result, BAME communities suffer due to lack of efficient resources that can aid in the recovery process. This research study explores the mental health initiatives targeted at BAME communities, and analyses the techniques used when examining the cost effectiveness of mental health initiatives for BAME mental health communities. Using critical discourse analysis as an approach and method, mental health services will be selected as case studies, and their evaluations will be examined, alongside the political drivers that frame, shape, and direct their work. In doing so, it will analyse what the mental health policies initiatives are, how the initiatives are directed and demonstrate how economic models of evaluation are used in mental health programmes and how the value for money impacts and outcomes are articulated by mental health programme staff. It is anticipated that this study will further our understanding in order to provide adequate mental health resources and will deliver creative, supportive research to ensure evaluation is effective for the government to provide and maintain high quality and efficient mental health initiatives targeted at BAME communities.

Keywords: black, Asian and ethnic minority, economic models, mental health, health policy

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Authors: Dosun Shin, Assegid Kidane, Pavan Turaga

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According to the National Institute of Health, living a sedentary lifestyle leads to a number of health issues, including increased risk of cardiovascular dis-ease, type 2 diabetes, obesity, and certain types of cancers. This project brings together experts in multiple disciplines to bring product design, sensor design, algorithms, and health intervention studies to develop a product and system that helps reduce the amount of time sitting at the workplace. This paper illustrates ongoing improvements to prototypes the research team developed in initial research; including working prototypes with a software application, which were developed and demonstrated for users. Additional modifications were made to improve functionality, aesthetics, and ease of use, which will be discussed in this paper. Extending on the foundations created in the initial phase, our approach sought to further improve the product by conducting additional human factor research, studying deficiencies in competitive products, testing various materials/forms, developing working prototypes, and obtaining feedback from additional potential users. The solution consisted of an aesthetically pleasing seat cover cushion that easily attaches to common office chairs found in most workplaces, ensuring a wide variety of people can use the product. The product discreetly contains sensors that track when the user sits on their chair, sending information to a phone app that triggers reminders for users to stand up and move around after sitting for a set amount of time. This paper also presents the analyzed typical office aesthetics and selected materials, colors, and forms that complimented the working environment. Comfort and ease of use remained a high priority as the design team sought to provide a product and system that integrated into the workplace. As the research team continues to test, improve, and implement this solution for the sedentary workplace, the team seeks to create a viable product that acts as an impetus for a more active workday and lifestyle, further decreasing the proliferation of chronic disease and health issues for sedentary working people. This paper illustrates in detail the processes of engineering, product design, methodology, and testing results.

Keywords: anti-sedentary work behavior, new product development, sensor design, health intervention studies

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Authors: Saiful Islam, Deuk Jong Bae

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The purpose of this study is to examine citizen satisfaction and competitiveness of a Public Private Partnership project. The study focuses on PPP in the transport sector and investigates the New Bundang Subway Line (NBL) in South Korea as the object of a case study. Most PPP studies are dominated by the study of public and private sector interests, which are classified in to three major areas comprising of policy, finance, and management. This study will explore the user perspective by assessing customer satisfaction upon NBL cost and service quality, also the competitiveness of NBL compared to other alternative transport modes which serve the Jeongja – Gangnam trip or vice versa. The regular Bundang Subway Line, New Bundang Subway Line, bus and private vehicle are selected as the alternative transport modes. The study analysed customer satisfaction of NBL and citizen’s preference of alternative transport modes based on a survey in Bundang district, South Korea. Respondents were residents and employees who live or work in Bundang city, and were divided into the following areas Pangyo, Jeongjae – Sunae, Migeun – Ori – Jukjeon, and Imae – Yatap – Songnam. The survey was conducted in January 2015 for two weeks, and 753 responses were gathered. By applying the Hedonic Utility approach, the factors which affect the frequency of using NBL were found to be overall customer satisfaction, convenience of access, and the socio economic demographic of the individual. In addition, by applying the Analytic Hierarchy Process (AHP) method, criteria factors influencing the decision to select alternative transport modes were identified. Those factors, along with the author judgement of alternative transport modes, and their associated criteria and sub-criteria produced a priority list of user preferences regarding their alternative transport mode options. The study found that overall the regular Bundang Subway Line (BL), which was built and operated under a conventional procurement method was selected as the most preferable transport mode due to its cost competitiveness. However, on the sub-criteria level analysis, the NBL has competitiveness on service quality, particularly on journey time. By conducting a sensitivity analysis, the NBL can become the first choice of transport by increasing the NBL’s degree of weight associated with cost by 0,05. This means the NBL would need to reduce either it’s fare cost or transfer fee, or combine those two cost components to reduce the total of the current cost by 25%. In addition, the competitiveness of NBL also could be obtained by increasing NBL convenience through escalating access convenience such as constructing an additional station or providing more access modes. Although these convenience improvements would require a few extra minutes of journey time, the user found this to be acceptable. The findings and policy suggestions can contribute to the next phase of NBL development, showing that consideration should be given to the citizen’s voice. The case study results also contribute to the literature of PPP projects specifically from a user side perspective.

Keywords: public private partnership, customer satisfaction, public transport, new Bundang subway line

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Authors: D. O. Miranda, L. R. Azevedo, J. F. C. Cordeiro, A. H. Dos Santos, S. F. Lisboa, F. S. Guimarães, G. S. Bisson

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Background: The Colorectal cancer (CRC) is one of the most common cancers and the fourth leading cause of cancer death in the world. The prevalence of psychiatric-disorders among CRC patients, mainly depression, is high, resulting in impaired quality of life and side effects of primary treatment. High levels of proinflammatory cytokines at tumor microenvironment is a feature of CRC and the literature suggests that those mediators could contribute to the development of psychiatric disorders. Nevertheless, the ability of tumor-associated biological processes to affect the central nervous system (CNS) has only recently been explored in the context of symptoms of depression and is still not well understood. Therefore, the aim of the present study was to test the hypothesis that depressive-like behavior in an experimental model of CCR induced by N-methyl-N-nitro-N-nitrosoguanidine (MNNG) was correlated to proinflammatory profile in the periphery and in the brain. Methods: Colorectal carcinogenesis was induced in adult C57BL/6 mice (n=12) by administration of MNNG (5mg/kg, 0.1ml/intrarectal instillation) 2 times a week, for 2 week. Control group (n=12) received saline (0.1ml/intrarectal instillation). Eight weeks after beginning of MNNG administration animals were submitted to the forced swim test (FST) and the sucrose preference test for evaluation, respectively, of depressive- and anhedonia-like behaviors. After behavioral evaluation, the colon was collected and brain regions dissected (cortex-C, striatum-ST and hippocampus-HIP) for posterior evaluation of cytokine levels (IL-1β, IL-10, IL-17, and CX3CL1) by ELISA. Results: MNNG induced depressive-like behavior, represented by increased immobility time in the FST (Student t test, p < 0.05) and lower sucrose preference (Student t test, p < 0.05). Moreover, there were increased levels of IL-1β, IL-17 and CX3CL1 in the colonic tissue (Student t test, p < 0.05) and in the brain (IL-1 β in the ST and HIP, Student t test, p < 0.05; IL-17 and CX3CL1 in the C and HIP, p < 0.05). IL-10 levels, in contrast, were decreased in both the colon (p < 0.05) and the brain (C and HIP, p < 0.05). Conclusions: The results obtained in the present work support the notion that tumor growth induces neuroinflammation in stress-related brain regions and depressive-like behavior, which could be related to the high incidence of depression in colorectal carcinogenesis. This work have important clinical and research implications, taken into account that cytokine levels may be a marker promissory for the developing depression in CRC patients. New therapeutic strategies to assist in alleviating mental suffering in cancer patients might result from a better understanding of the role of cytokines in the pathophysiology of depression in these subjects.

Keywords: cytokines, brain, depression, colorectal cancer

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Authors: Stefan Papastefanou

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Artificial intelligence (AI) is an interdisciplinary field of computer science with the aim of creating intelligent machine behavior. Early approaches to AI have been configured to operate in very constrained environments where the behavior of the AI system was previously determined by formal rules. Knowledge was presented as a set of rules that allowed the AI system to determine the results for specific problems; as a structure of if-else rules that could be traversed to find a solution to a particular problem or question. However, such rule-based systems typically have not been able to generalize beyond the knowledge provided. All over the world and especially in IT-heavy industries such as the United States, the European Union, Singapore, and China, machine learning has developed to be an immense asset, and its applications are becoming more and more significant. It has to be examined how such products of machine learning models can and should be protected by IP law and for the purpose of this paper patent law specifically, since it is the IP law regime closest to technical inventions and computing methods in technical applications. Genetic breeding models are currently less popular than recursive neural network method and deep learning, but this approach can be more easily described by referring to the evolution of natural organisms, and with increasing computational power; the genetic breeding method as a subset of the evolutionary algorithms models is expected to be regaining popularity. The research method focuses on patentability (according to the world’s most significant patent law regimes such as China, Singapore, the European Union, and the United States) of AI inventions and machine learning. Questions of the technical nature of the problem to be solved, the inventive step as such, and the question of the state of the art and the associated obviousness of the solution arise in the current patenting processes. Most importantly, and the key focus of this paper is the problem of patenting inventions that themselves are developed through machine learning. The inventor of a patent application must be a natural person or a group of persons according to the current legal situation in most patent law regimes. In order to be considered an 'inventor', a person must actually have developed part of the inventive concept. The mere application of machine learning or an AI algorithm to a particular problem should not be construed as the algorithm that contributes to a part of the inventive concept. However, when machine learning or the AI algorithm has contributed to a part of the inventive concept, there is currently a lack of clarity regarding the ownership of artificially created inventions. Since not only all European patent law regimes but also the Chinese and Singaporean patent law approaches include identical terms, this paper ultimately offers a comparative analysis of the most relevant patent law regimes.

Keywords: algorithms, inventor, genetic breeding models, machine learning, patentability

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Authors: Shadan Dwairi

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Defining proper requirements is one of the key factors for a successful construction projects. Although there have been many attempts put forward in assist in identifying requirements, but still this area is under developed. In Buildings Information Modelling (BIM) projects. The Employer Information Requirements (EIR) is the fundamental requirements document and a necessary ingredient in achieving a successful BIM project. The provision on full and clear EIR is essential to achieving BIM Level-2. As Defined by PAS 1192-2, EIR is a “pre-tender document that sets out the information to be delivered and the standards and processes to be adopted by the supplier as part of the project delivery process”. It also notes that “EIR should be incorporated into tender documentation to enable suppliers to produce an initial BIM Execution Plan (BEP)”. The importance of effective definition of EIR lies in its contribution to a better productivity during the construction process in terms of cost and time, in addition to improving the quality of the built asset. Proper and clear information is a key aspect of the EIR, in terms of the information it contains and more importantly the information the client receives at the end of the project that will enable the effective management and operation of the asset, where typically about 60%-80% of the cost is spent. This paper reports on the research done in developing the Ontology-based tool for Employer Information Requirements (OntEIR). OntEIR has proven the ability to produce a full and complete set of EIRs, which ensures that the clients’ information needs for the final model delivered by BIM is clearly defined from the beginning of the process. It also reports on the work being done into transforming OntEIR into a smart tool for Defining Employer Information Requirements (smartEIR). smartEIR transforms the OntEIR tool into enabling it to develop custom EIR- tailored for the: Project Type, Project Requirements, and the Client Capabilities. The initial idea behind smartEIR is moving away from the notion “One EIR fits All”. smartEIR utilizes the links made in OntEIR and creating a 3D matrix that transforms it into a smart tool. The OntEIR tool is based on the OntEIR framework that utilizes both Ontology and the Decomposition of Goals to elicit and extract the complete set of requirements needed for a full and comprehensive EIR. A new ctaegorisation system for requirements is also introduced in the framework and tool, which facilitates the understanding and enhances the clarification of the requirements especially for novice clients. Findings of the evaluation of the tool that was done with experts in the industry, showed that the OntEIR tool contributes towards effective and efficient development of EIRs that provide a better understanding of the information requirements as requested by BIM, and support the production of a complete BIM Execution Plan (BEP) and a Master Information Delivery Plan (MIDP).

Keywords: building information modelling, employer information requirements, ontology, web-based, tool

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Authors: Shraddha Rane, Richard Warren, Stephen Eyre

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L-23 is a pro-inflammatory molecule that signals T cells to release cytokines such as IL-17A and IL-22. Psoriasis is driven by a dysregulated immune response, within which IL-23 is now thought to play a key role. Genome-wide association studies (GWAS) have identified a number of genetic risk loci that support the involvement of IL-23 signalling in psoriasis; in particular a robust susceptibility locus at a gene encoding a subunit of the IL-23 receptor (IL23R) (Stuart et al., 2015; Tsoi et al., 2012). The lead psoriasis-associated SNP rs9988642 is located approximately 500 bp downstream of IL23R but is in tight linkage disequilibrium (LD) with a missense SNP rs11209026 (R381Q) within IL23R (r2 = 0.85). The minor (G) allele of rs11209026 is present in approximately 7% of the population and is protective for psoriasis and several other autoimmune diseases including IBD, ankylosing spondylitis, RA and asthma. The psoriasis-associated missense SNP R381Q causes an arginine to glutamine substitution in a region of the IL23R protein between the transmembrane domain and the putative JAK2 binding site in the cytoplasmic portion. This substitution is expected to affect the receptor’s surface localisation or signalling ability, rather than IL23R expression. Recent studies have also identified a psoriatic arthritis (PsA)-specific signal at IL23R; thought to be independent from the psoriasis association (Bowes et al., 2015; Budu-Aggrey et al., 2016). The lead PsA-associated SNP rs12044149 is intronic to IL23R and is in LD with likely causal SNPs intersecting promoter and enhancer marks in memory CD8+ T cells (Budu-Aggrey et al., 2016). It is therefore likely that the PsA-specific SNPs affect IL23R function via a different mechanism compared with the psoriasis-specific SNPs. It could be hypothesised that the risk allele for PsA located within the IL23R promoter causes an increase IL23R expression, relative to the protective allele. An increased expression of IL23R might then lead to an exaggerated immune response. The independent genetic signals identified for psoriasis and PsA in this locus indicate that different mechanisms underlie these two conditions; although likely both affecting the function of IL23R. It is very important to further characterise these mechanisms in order to better understand how the IL-23 receptor and its downstream signalling is affected in both diseases. This will help to determine how psoriasis and PsA patients might differentially respond to therapies, particularly IL-23 biologics. To investigate this further we have developed an in vitro model using CD4 T cells which express either wild type IL23R and IL12Rβ1 or mutant IL23R (R381Q) and IL12Rβ1. Model expressing different isotypes of IL23R is also underway to investigate the effects on IL23R expression. We propose to further investigate the variants for Ps and PsA and characterise key intracellular processes related to the variants.

Keywords: IL23R, psoriasis, psoriatic arthritis, SNP

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Authors: Muhammad Naveed Babur, Maria Liaqat

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Background & Objective: People with disabilities especially neurological disabilities have many unmet health and rehabilitation needs, face barriers in accessing mainstream health-care services, and consequently have poor health. There are not sufficient epidemiological studies from Pakistan which assess barriers to neurorehabilitation and ways to counter it. Objectives: The objective of the study was to determine the challenges and to evaluate the barriers for neuro-rehabilitation services in developing countries. Methods: This is Exploratory sequential qualitative study based on the Panel discussion forum in International rehabilitation sciences congress and national rehabilitation conference 2017. Panel group discussion has been conducted in February 2017 with a sample size of eight professionals including Rehabilitation medicine Physician, Physical Therapist, Speech Language therapist, Occupational Therapist, Clinical Psychologist and rehabilitation nurse working in multidisciplinary/Interdisciplinary team. A comprehensive audio-videography have been developed, recorded, transcripted and documented. Data was transcribed and thematic analysis along with characteristics was drawn manually. Data verification was done with the help of two separate coders. Results: After extraction of two separate coders following results are emerged. General category themes are disease profile, demographic profile, training and education, research, barriers, governance, global funding, informal care, resources and cultural beliefs and public awareness. Barriers identified at the level are high cost, stigma, lengthy course of recovery. Hospital related barriers are lack of social support and individually tailored goal setting processes. Organizational barriers identified are lack of basic diagnostic facilities, lack of funding and human resources. Recommendations given by panelists were investment in education, capacity building, infrastructure, governance support, strategies to promote communication and realistic goals. Conclusion: It is concluded that neurorehabilitation in developing countries need attention in following categories i.e. disease profile, demographic profile, training and education, research, barriers, governance, global funding, informal care, resources and cultural beliefs and public awareness. This study also revealed barriers at the level of patient, hospital, organization. Recommendations were also given by panelists.

Keywords: disability, neurorehabilitation, telerehabilitation, disability

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Authors: Maureen Kamau, Gulnaz Mohamoud, Adelaide Lusambili, Njeri Nyanja

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Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. These multiple chronic conditions are managed with polypharmacy. Polypharmacy has numerous adverse effects including non-adherence, poor compliance to the various medications, reduced appetite, and risk of fall. Studies on polypharmacy and ageing are few and poorly understood especially in low and middle - income countries. The aim of this study was to explore the knowledge, attitudes and beliefs of older people towards polypharmacy. A qualitative study of 15 patients aged 60 years and above, taking more than five medications per day were conducted at the Aga Khan University using Semi-structured in-depth interviews. Three interviews were pilot interviews, and data analysis was performed on 12 interviews. Data were analyzed using NVIVO 12 software. A thematic qualitative analysis was carried out guided by Braun and Clarke (2006) framework. Themes identified; - knowledge of their co-morbidities and of the medication that older persons take, sources of information about medicines, and storage of the medication, experiences and attitudes of older patients towards polypharmacy both positive and negative, older peoples beliefs and their coping mechanisms with polypharmacy. The study participants had good knowledge on their multiple co-morbidities, and on the medication they took. The patients had positive attitudes towards medication as it enhanced their health and well-being, and enabled them to perform their activities of daily living. There was a strong belief among older patients that the medications were necessary for their health. All these factors enhanced compliance to the multiple medication. However, some older patients had negative attitudes due to the pill burden, side effects of the medication, and stigma associated with being ill. Cost of healthcare was a concern, with most of the patients interviewed relying on insurance to cover the cost of their medication. Older patients had accepted that the medication they were prescribed were necessary for their health, as it enabled them to complete their activities of daily living. Some concerns about the side effects of the medication arose, and brought about the need for patient education that would ensure that the patients are aware of the medications they take, and potential side effects. The effect that the COVID 19 pandemic had in the healthcare of the older patients was evident by the number of the older patients avoided coming to the hospital during the period of the pandemic. The relationship with the primary care physician and the older patients is an important one, especially in LMICs such as Kenya, as many of the older patients trusted the doctors wholeheartedly to make the best decision about their health and about their medication. Prescription review is important to avoid the use of potentially inappropriate medication.

Keywords: polypharmacy, older patients, multiple chronic conditions, Kenya, Africa, qualitative study, indepth interviews, primary care

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Authors: Meenu S. Babu, K. Jayasankara Reddy

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Depression is a serious mental health concern that leads to significant distress and dysfunction in an individual. Due to the high physical, psychological, social, and economic burden it causes, it is important to study various bio-psycho-social factors that influence the onset, course, duration, intensity of depressive symptoms. The study aims to explore relationship between autobiographical memory (AM) functions, perceived control over stressful events and depressive symptoms. AM functions and perceived control were both found to be protective factors for individuals against depression and were both modifiable to predict better behavioral and affective outcomes. An extensive review of literatur, with a systematic search on Google Scholar, JSTOR, Science Direct and Springer Journals database, was conducted for the purpose of this review paper. These were used for all the aforementioned databases. The time frame used for the search was 2010-2021. An additional search was conducted with no time bar to map the development of the theoretical concepts. The relevant studies with quantitative, qualitative, experimental, and quasi- experimental research designs were included for the review. Studies including a sample with a DSM- 5 or ICD-10 diagnosis of depressive disorders were excluded from the study to focus on the behavioral patterns in a non-clinical population. The synthesis of the findings that were obtained from the review indicates there is a significant relationship between cognitive variables of AM functions and perceived control and depressive symptoms. AM functions were found to be have significant effects on once sense of self, interpersonal relationships, decision making, self- continuity and were related to better emotion regulation and lower depressive symptoms. Not all the components of AM function were equally significant in their relationships with various depressive symptoms. While self and directive functions were more related to emotion regulation, anhedonia, motivation and hence mood and affect, the social function was related to perceived social support and social engagement. Perceived control was found to be another protective cognitive factor that provides individuals a sense of agency and control over one’s life outcomes which was found to be low in individuals with depression. This was also associated to the locus of control, competency beliefs, contingency beliefs and subjective well being in individuals and acted as protective factors against depressive symptoms. AM and perceived control over stressful events serve adaptive functions, hence it is imperative to study these variables more extensively. They can be imperative in planning and implementing therapeutic interventions to foster these cognitive protective factors to mitigate or alleviate depressive symptoms. Exploring AM as a determining factor in depressive symptoms along with perceived control over stress creates a bridge between biological and cognitive factors underlying depression and increases the scope of developing a more eclectic and effective treatment plan for individuals. As culture plays a crucial role in AM functions as well as certain aspects of control such as locus of control, it is necessary to study these variables keeping in mind the cultural context to tailor culture/community specific interventions for depression.

Keywords: autobiographical memories, autobiographical memory functions, perceived control, depressive symptoms, depression, young adults

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Authors: Shawndra Bowers, Allie Brandriet, Betsy Gilbertson

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This paper will highlight how Auburn Online’s instructional designers leveraged student and faculty data to update and improve online course design and instructional materials. When designing and revising online courses, it can be difficult for faculty to know what strategies are most likely to engage learners and improve educational outcomes in a specific discipline. It can also be difficult to identify which metrics are most useful for understanding and improving teaching, learning, and course design. At Auburn Online, the instructional designers use a suite of data based student’s performance, participation, satisfaction, and engagement, as well as faculty perceptions, to inform sound learning and design principles that guide growth-mindset consultations with faculty. The consultations allow the instructional designer, along with the faculty member, to co-create an actionable course improvement plan. Auburn Online gathers learning analytics from a variety of sources that any instructor or instructional design team may have access to at their own institutions. Participation and performance data, such as page: views, assignment submissions, and aggregate grade distributions, are collected from the learning management system. Engagement data is pulled from the video hosting platform, which includes unique viewers, views and downloads, the minutes delivered, and the average duration each video is viewed. Student satisfaction is also obtained through a short survey that is embedded at the end of each instructional module. This survey is included in each course every time it is taught. The survey data is then analyzed by an instructional designer for trends and pain points in order to identify areas that can be modified, such as course content and instructional strategies, to better support student learning. This analysis, along with the instructional designer’s recommendations, is presented in a comprehensive report to instructors in an hour-long consultation where instructional designers collaborate with the faculty member on how and when to implement improvements. Auburn Online has developed a triage strategy of priority 1 or 2 level changes that will be implemented in future course iterations. This data-informed decision-making process helps instructors focus on what will best work in their teaching environment while addressing which areas need additional attention. As a student-centered process, it has created improved learning environments for students and has been well received by faculty. It has also shown to be effective in addressing the need for improvement while removing the feeling the faculty’s teaching is being personally attacked. The process that Auburn Online uses is laid out, along with the three-tier maintenance and revision guide that will be used over a three-year implementation plan. This information can help others determine what components of the maintenance and revision plan they want to utilize, as well as guide them on how to create a similar approach. The data will be used to analyze, revise, and improve courses by providing recommendations and models of good practices through determining and disseminating best practices that demonstrate an impact on student success.

Keywords: data-driven, improvement, online courses, faculty development, analytics, course design

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Authors: Mohsen Rabbani, Trista McLaughlin, Ehsan Vahidi

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the remediation of polluted sites with heavy metals, such as rare earth elements (REEs), has been a primary concern of researchers to decontaminate the soil. Among all developed methods to address this concern, phytoremediation has been established as efficient, cost-effective, easy-to-use, and environmentally friendly way, providing a long-term solution for addressing this global concern. Furthermore, this technology has another great potential application in the metals production sector through returning metals buried in soil via metals cropping. Considering the significant metal concentration in hyper-accumulators, the utilization of bioaccumulated metals to extract metals from plant matter has been proposed as a sub-economic area called phytomining. As a recent, more advanced technology to eliminate such pollutants from the soil and produce critical metals, bioharvesting (phytomining/agromining) has been considered another compromising way to produce metals and meet the global demand for critical/target metals. The bio-ore obtained from phytomining can be safely disposed of or introduced to metal production pathways to obtain the most demanded metals, such as REEs. It is well-known that some hyperaccumulators, e.g., fern Dicranopteris linearis, can be used to absorb REE metals from the polluted soils and accumulate them in plant organs, such as leaves and stems. After soil remediation, the plant species can be harvested and introduced to the downstream steps, namely crushing/grinding, leaching, and purification processes, to extract REEs from plant matter. This novel interdisciplinary field can fill the gap between agriculture, mining, metallurgy, and the environment. Despite the advantages of agromining for the REEs production industry, key issues related to the environmental sustainability of the entire life cycle of this new concept have not been assessed yet. Hence, a comparative life cycle assessment (LCA) study was conducted to quantify the environmental footprints of REEs phytomining. The current LCA study aims to estimate and calculate environmental effects associated with phytomining by considering critical factors, such as climate change, land use, and ozone depletion. The results revealed that phytomining is an easy-to-use and environmentally sustainable approach to either eliminate REEs from polluted sites or produce REEs, offering a new source of such metals production. This LCA research provides guidelines for researchers active in developing a reliable relationship between agriculture, mining, metallurgy, and the environment to encounter soil pollution and keep the earth green and clean.

Keywords: phytoremediation, phytomining, life cycle assessment, environmental impacts, rare earth elements, hyperaccumulator

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Authors: N. Šarlija, S. Pfeifer, M. Jeger, A. Bilandžić

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Enterprise growth is generally considered as a key driver of competitiveness, employment, economic development and social inclusion. As such, it is perceived to be a highly desirable outcome of entrepreneurship for scholars and decision makers. The huge academic debate resulted in the multitude of theoretical frameworks focused on explaining growth stages, determinants and future prospects. It has been widely accepted that enterprise growth is most likely nonlinear, temporal and related to the variety of factors which reflect the individual, firm, organizational, industry or environmental determinants of growth. However, factors that affect growth are not easily captured, instruments to measure those factors are often arbitrary, causality between variables and growth is elusive, indicating that growth is not easily modeled. Furthermore, in line with heterogeneous nature of the growth phenomenon, there is a vast number of measurement constructs assessing growth which are used interchangeably. Differences among various growth measures, at conceptual as well as at operationalization level, can hinder theory development which emphasizes the need for more empirically robust studies. In line with these highlights, the main purpose of this paper is twofold. Firstly, to compare structure and performance of three growth prediction models based on the main growth measures: Revenues, employment and assets growth. Secondly, to explore the prospects of financial indicators, set as exact, visible, standardized and accessible variables, to serve as determinants of enterprise growth. Finally, to contribute to the understanding of the implications on research results and recommendations for growth caused by different growth measures. The models include a range of financial indicators as lag determinants of the enterprises’ performances during the 2008-2013, extracted from the national register of the financial statements of SMEs in Croatia. The design and testing stage of the modeling used the logistic regression procedures. Findings confirm that growth prediction models based on different measures of growth have different set of predictors. Moreover, the relationship between particular predictors and growth measure is inconsistent, namely the same predictor positively related to one growth measure may exert negative effect on a different growth measure. Overall, financial indicators alone can serve as good proxy of growth and yield adequate predictive power of the models. The paper sheds light on both methodology and conceptual framework of enterprise growth by using a range of variables which serve as a proxy for the multitude of internal and external determinants, but are unlike them, accessible, available, exact and free of perceptual nuances in building up the model. Selection of the growth measure seems to have significant impact on the implications and recommendations related to growth. Furthermore, the paper points out to potential pitfalls of measuring and predicting growth. Overall, the results and the implications of the study are relevant for advancing academic debates on growth-related methodology, and can contribute to evidence-based decisions of policy makers.

Keywords: growth measurement constructs, logistic regression, prediction of growth potential, small and medium-sized enterprises

Procedia PDF Downloads 252

Authors: Alper Tolga Kumtepe, Erdem Erdogdu, M. Recep Okur, Eda Kaypak, Ozlem Kaya, Serap Ugur, Deniz Dincer, Hakan Yildirim

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Interaction is one of the most important components of open and distance learning. According to Moore, who proposed one of the keystones on interaction types, there are three basic types of interaction: learner-teacher, learner-content, and learner-learner. From these interaction types, learner-content interaction, without doubt, can be identified as the most fundamental one on which all education is based. Efficacy, efficiency, and attraction of open and distance learning systems can be achieved by the practice of effective learner-content interaction. With the development of new technologies, interactive e-learning materials have been commonly used as a resource in open and distance learning, along with the printed books. The intellectual engagement of the learners with the content that is course materials may also affect their satisfaction for the open and distance learning practices in general. Learner satisfaction holds an important place in open and distance learning since it will eventually contribute to the achievement of learning outcomes. Using the learner-content interaction activities in course materials, Anadolu University, by its Open Education system, tries to involve learners in deep and meaningful learning practices. Especially, during the e-learning material design and production processes, identifying appropriate learner-content interaction activities within the context of learning outcomes holds a big importance. Considering the lack of studies adopting this approach, as well as its being a study on the use of e-learning materials in Open Education system, this research holds a big value in open and distance learning literature. In this respect, the present study aimed to investigate a) which learner-content interaction activities included in interactive courses are the most effective in learners’ achievement of verbal information learning outcomes and b) to what extent distance learners are satisfied with these learner-content interaction activities. For this study, the quasi-experimental research design was adopted. The 120 participants of the study were from Anadolu University Open Education Faculty students living in Eskişehir. The students were divided into 6 groups randomly. While 5 of these groups received different learner-content interaction activities as a part of the experiment, the other group served as the control group. The data were collected mainly through two instruments: pre-test and post-test. In addition to those tests, learners’ perceived learning was assessed with an item at the end of the program. The data collected from pre-test and post-test were analyzed by ANOVA, and in the light of the findings of this approximately 24-month study, suggestions for the further design of e-learning materials within the context of learner-content interaction activities will be provided at the conference. The current study is planned to be an antecedent for the following studies that will examine the effects of activities on other learning domains.

Keywords: interaction, distance education, interactivity, online courses

Procedia PDF Downloads 194

Authors: Minna Pikkarainen, Yueqiang Xu

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The integration of digital technology with existing healthcare processes has been painfully slow, a huge gap exists between the fields of strictly regulated official medical care and the quickly moving field of health and wellness technology. We claim that the promises of preventive healthcare can only be fulfilled when this gap is closed – health care and self-care becomes seamless continuum “correct information, in the correct hands, at the correct time allowing individuals and professionals to make better decisions” what we call connected health approach. Currently, the issues related to security, privacy, consumer consent and data sharing are hindering the implementation of this new paradigm of healthcare. This could be solved by following MyData principles stating that: Individuals should have the right and practical means to manage their data and privacy. MyData infrastructure enables decentralized management of personal data, improves interoperability, makes it easier for companies to comply with tightening data protection regulations, and allows individuals to change service providers without proprietary data lock-ins. This paper tackles today’s unprecedented challenges of enabling and stimulating multiple healthcare data providers and stakeholders to have more active participation in the digital health ecosystem. First, the paper systematically proposes the MyData approach for healthcare and preventive health data ecosystem. In this research, the work is targeted for health and wellness ecosystems. Each ecosystem consists of key actors, such as 1) individual (citizen or professional controlling/using the services) i.e. data subject, 2) services providing personal data (e.g. startups providing data collection apps or data collection devices), 3) health and wellness services utilizing aforementioned data and 4) services authorizing the access to this data under individual’s provided explicit consent. Second, the research extends the existing four archetypes of orchestrator-driven healthcare data business models for the healthcare industry and proposes the fifth type of healthcare data model, the MyData Blockchain Platform. This new architecture is developed by the Action Design Research approach, which is a prominent research methodology in the information system domain. The key novelty of the paper is to expand the health data value chain architecture and design from centralization and pseudo-decentralization to full decentralization, enabled by blockchain, thus the MyData blockchain platform. The study not only broadens the healthcare informatics literature but also contributes to the theoretical development of digital healthcare and blockchain research domains with a systemic approach.

Keywords: blockchain, health data, platform, action design

Procedia PDF Downloads 100

Authors: Maria Botero-Uribe, Melissa Fitzgerald, Robert Gilbert, Kim Bryceson, Jocelyn Midgley

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French fry manufacturing involves a series of processes in which structural properties of potatoes are modified to produce crispy french fries which consumers enjoy. In addition to the traditional french fry manufacturing process, the industry is applying a relatively new process called pulsed electrical field (PEF) to the whole potatoes. There is a wealth of information on the technical treatment conditions of PEF, however, there is a lack of information about its effect on the structural properties that affect texture and its synergistic interactions with the other manufacturing steps of french fry production. The effect of PEF on starch gelatinisation properties of Russet Burbank potato was measured using a Differential Scanning Calorimeter. Cation content (K+, Ca2+ and Mg2+) was determined by inductively coupled plasma optical emission spectrophotometry. Firmness, and toughness of raw and blanched potatoes were determined in an uniaxial compression test. Moisture content was determined in a vacuum oven and oil content was measured using the soxhlet system with hexane. The final texture of the french fries – crispness - was determined using a three bend point test. Triangle tests were conducted to determine if consumers were able to perceive sensory differences between French fries that were PEF treated and those without treatment. The concentration of K+, Ca2+ and Mg2+ decreased significantly in the raw potatoes after the PEF treatment. The PEF treatment significantly increased modulus of elasticity, compression strain, compression force and toughness in the raw potato. The PEF-treated raw potato were firmer and stiffer, and its structure integrity held together longer, resisted higher force before fracture and stretched further than the untreated ones. The strain stress relationship exhibited by the PEF-treated raw potato could be due to an increase in the permeability of the plasmalema and tonoplasm allowing Ca2+ and Mg2+ cations to reach the cell wall and middle lamella, and be available for cross linking with the pectin molecule. The PEF-treated raw potato exhibited a slightly higher onset gelatinisation temperatures, similar peak temperatures and lower gelatinisation ranges than the untreated raw potatoes. The final moisture content of the french fries was not significantly affected by the PEF treatment. Oil content in the PEF- treated potatoes was lower than the untreated french fries, however, not statistically significant at 5 %. The PEF treatment did not have an overall significant effect on french fry crispness (modulus of elasticity), flexure stress or strain. The triangle tests show that most consumers could not detect a difference between French fries that received a PEF treatment from those that did not.

Keywords: french fries, mechanical properties, PEF, potatoes

Procedia PDF Downloads 236

Authors: Pius A. Onobhayedo, Eugene A. Ohu

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Nigeria has one of the fastest growing mobile telecommunications industry in the world. In the absence of fixed connection access to the Internet, access to the Internet is primarily via mobile devices. It, therefore, provides a test case for how to penetrate the mobile market in an emerging economy. We also hope to contribute to a sparse literature on strategies employed in building successful data-driven mobile businesses in emerging economies. We, therefore, sought to identify and analyse the strategic approach taken in a successful locally born mobile data-driven business in Nigeria. The analysis was carried out through the framework of strategic intent and competitive advantages developed from the conception of the company to date. This study is based on an exploratory investigation of an innovative digital company based in Nigeria specializing in the mobile advertising business. The projected growth and high adoption of mobile in this African country, coinciding with the smartphone revolution triggered by the launch of iPhone in 2007 opened a new entrepreneurial horizon for the founder of the company, who reached the conclusion that ‘the future is mobile’. This dream led to the establishment of three digital businesses, designed for convergence and complementarity of medium and content. The mobile Ad subsidiary soon grew to become a truly African network with operations and campaigns across West, East and South Africa, successfully delivering campaigns in several African countries including Nigeria, Kenya, South Africa, Ghana, Uganda, Zimbabwe, and Zambia amongst others. The company recently declared a 40% year-end profit which was nine times that of the previous financial year. This study drew from an in-depth interview with the company’s founder, analysis of primary and secondary data from and about the business, as well as case studies of digital marketing campaigns. We hinge our analysis on the strategic intent concept which has been proposed to be an engine that drives the quest for sustainable strategic advantage in the global marketplace. Our goal was specifically to identify the strategic intents of the founder and how these were transformed creatively into processes that may have led to some distinct competitive advantages. Along with the strategic intents, we sought to identify the respective absorptive capacities that constituted favourable antecedents to the creation of such competitive advantages. Our recommendations and findings will be pivotal information for anybody wishing to invest in the world’s fastest technology business space - Africa.

Keywords: Africa, competitive advantage, competitive strategy, digital, mobile business, marketing, strategic intent

Procedia PDF Downloads 436

Authors: Selcen Nur Eri̇kci̇ Çeli̇k, Burcu İbaş Parlakyildiz, Gülay Zorer Gedi̇k

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Reducing the use of mechanical heating and cooling systems in buildings, which accounts for approximately 30-40% of total energy consumption in the world has a major impact in terms of energy conservation. Formations of buildings that have sustainable and low energy utilization, structural elements with mechanical systems should be evaluated with a holistic approach. In point of reduction of building energy consumption ratio, wall elements that are vertical building elements and have an area broadly (m2) have proposed as a regulation with a different system. In the study, designing surface heating and cooling energy with a hybrid type of modular wall system and the integration of building elements will be evaluated. The design of wall element; - Identification of certain standards in terms of architectural design and size, -Elaboration according to the area where the wall elements (interior walls, exterior walls) -Solution of the joints, -Obtaining the surface in terms of building compatible with both conceptual structural put emphasis on upper stages, these elements will be formed. The durability of the product to the various forces, stability and resistance are so much substantial that are used the establishment of ready-wall element section and the planning of structural design. All created ready-wall alternatives will be paid attention at some parameters; such as adapting to performance-cost by optimum level and size that can be easily processed and reached. The restrictions such as the size of the zoning regulations, building function, structural system, wheelbase that are imposed by building laws, should be evaluated. The building aims to intend to function according to a certain standardization system and construction of wall elements will be used. The scope of performance criteria determined on the wall elements, utilization (operation, maintenance) and renovation phase, alternative material options will be evaluated with interim materials located in the contents. Design, implementation and technical combination of modular wall elements in the use phase and installation details together with the integration of energy saving, heat-saving and useful effects on the environmental aspects will be discussed in detail. As a result, the ready-wall product with surface heating and cooling modules will be created and defined as hybrid wall and will be compared with the conventional system in terms of thermal comfort. After preliminary architectural evaluations, certain decisions for all architectural design processes (pre and post design) such as the implementation and performance in use, maintenance, renewal will be evaluated in the results.

Keywords: modular ready-wall element, hybrid, architectural design, thermal comfort, energy saving

Procedia PDF Downloads 254

Authors: I. Nitoi, P. Oancea, M. Raileanu, M. Crisan, L. Constantin, I. Cristea

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Hazardous organic compounds like nitroaromatics are frequently found in chemical and petroleum industries discharged effluents. Due to their bio-refractory character and high chemical stability cannot be efficiently removed by classical biological or physical-chemical treatment processes. In the past decades, semiconductor photocatalysis has been frequently applied for the advanced degradation of toxic pollutants. Among various semiconductors titania was a widely studied photocatalyst, due to its chemical inertness, low cost, photostability and nontoxicity. In order to improve optical absorption and photocatalytic activity of TiO2 many attempts have been made, one feasible approach consists of doping oxide semiconductor with metal. The degradation of dinitrobenzene (DNB) and dinitrotoluene (DNT) from aqueous solution under UVA-VIS irradiation using heavy metal (0.5% Fe, 1%Co, 1%Ni ) doped titania was investigated. The photodegradation experiments were carried out using a Heraeus laboratory scale UV-VIS reactor equipped with a medium-pressure mercury lamp which emits in the range: 320-500 nm. Solutions with (0.34-3.14) x 10-4 M pollutant content were photo-oxidized in the following working conditions: pH = 5-9; photocatalyst dose = 200 mg/L; irradiation time = 30 – 240 minutes. Prior to irradiation, the photocatalyst powder was added to the samples, and solutions were bubbled with air (50 L/hour), in the dark, for 30 min. Dopant type, pH, structure and initial pollutant concentration influence on the degradation efficiency were evaluated in order to set up the optimal working conditions which assure substrate advanced degradation. The kinetics of nitroaromatics degradation and organic nitrogen mineralization was assessed and pseudo-first order rate constants were calculated. Fe doped photocatalyst with lowest metal content (0.5 wt.%) showed a considerable better behaviour in respect to pollutant degradation than Co and Ni (1wt.%) doped titania catalysts. For the same working conditions, degradation efficiency was higher for DNT than DNB in accordance with their calculated adsobance constants (Kad), taking into account that degradation process occurs on catalyst surface following a Langmuir-Hinshalwood model. The presence of methyl group in the structure of DNT allows its degradation by oxidative and reductive pathways, while DNB is converted only by reductive route, which also explain the highest DNT degradation efficiency. For highest pollutant concentration tested (3 x 10-4 M), optimum working conditions (0.5 wt.% Fe doped –TiO2 loading of 200 mg/L, pH=7 and 240 min. irradiation time) assures advanced nitroaromatics degradation (ηDNB=89%, ηDNT=94%) and organic nitrogen mineralization (ηDNB=44%, ηDNT=47%).

Keywords: hazardous organic compounds, irradiation, nitroaromatics, photocatalysis

Procedia PDF Downloads 317

Authors: Zaman Jawahar, Anne Rouve-Khiev, Elizabeth Hoban, Joanne Williams

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Ensuring access to timely obstetric care is essential to prevent maternal deaths. Geographical barriers pose significant challenges for women accessing quality reproductive and maternal health services in rural Cambodia. This policy brief affirms the need to address the issue of transportation and cost (direct and indirect) as critical barriers to accessing reproductive and maternal health (RMH) services in four provinces in Northeast Cambodia (Kratie, Ratanak Kiri, Mondul Kiri, Stung Treng). A systemic search of the literature identified 1,116 articles, and only ten articles from low-and-middle-income countries met the inclusion criteria. The ten articles reported on transportation and cost related to accessing RMH services. In addition, research findings from Partnering to Save Lives (PSL) studies in the four provinces were included in the analysis. Thematic data analysis using the information in the ten articles and PSL research findings was conducted, and the findings are presented in this paper. The key findings are the critical barriers to accessing RMH services in the four provinces because women experience: 1) difficulties finding affordable transportation; 2) lack of available and accessible transportation; 3) greater distance and traveling time to services; 4) poor geographical terrain and; 5) higher opportunity costs. Distance and poverty pose a double burden for the women accessing RMH services making a facility-based delivery less feasible compared to home delivery. Furthermore, indirect and hidden costs associated with institutional delivery may have an impact on women’s decision to seek RMH care. Existing health financing schemes in Cambodia such as the Health Equity Fund (HEF) and the Voucher Scheme contributed to the solution but have also shown some limitations. These schemes contribute to improving access to RMH services for the poorest group, but the barrier of transportation costs remains. In conclusion, initiatives that are proven to be effective in the Cambodian context should continue or be expanded in conjunction with the HEF, and special consideration should be given to communities living in geographically remote regions and difficult to access areas. The following strategies are recommended: 1) maintain and further strengthen transportation support in the HEF scheme; 2) expand community-based initiatives such as Community Managed Health Equity Funds and Village Saving Loans Associations; 3) establish maternity waiting homes; and 4) include antenatal and postnatal care in the provision of integrated outreach services. This policy brief can be used to inform key policymakers and provide evidence that can assist them to develop strategies to increase poor women’s access to RMH services in low-income settings, taking into consideration the geographic distance and other indirect costs associated with a facility-based delivery.

Keywords: access, barriers, northeast Cambodia, reproductive and maternal health service, transportation and cost

Procedia PDF Downloads 141

Authors: Edson Pierre, Gustavo de Jesus Lopez Nunez

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The objective of this work is to analyze how physics can be taught remotely through the use of platforms and software to attract the attention of 2nd-year high school students at Colégio Cívico Militar Professor Carmelita Souza Dias and point out how remote teaching can be a teaching-learning strategy during the period of social distancing. Teaching physics has been a challenge for teachers and students, permeating common sense with the great difficulty of teaching and learning the subject. The challenge increased in 2020 and 2021 with the impact caused by the new coronavirus pandemic (Sars-Cov-2) and its variants that have affected the entire world. With these changes, a new teaching modality emerged: remote teaching. It brought new challenges and one of them was promoting distance research experiences, especially in physics teaching, since there are learning difficulties and it is often impossible for the student to relate the theory observed in class with the reality that surrounds them. Teaching physics in schools faces some difficulties, which makes it increasingly less attractive for young people to choose this profession. Bearing in mind that the study of physics is very important, as it puts students in front of concrete and real situations, situations that physical principles can respond to, helping to understand nature, nourishing and nurturing a taste for science. The use of new platforms and software, such as PhET Interactive Simulations from the University of Colorado at Boulder, is a virtual laboratory that has numerous simulations of scientific experiments, which serve to improve the understanding of the content taught practically, facilitating student learning and absorption of content, being a simple, practical and free simulation tool, attracts more attention from students, causing them to acquire greater knowledge about the subject studied, or even a quiz, bringing certain healthy competitiveness to students, generating knowledge and interest in the themes used. The present study takes the Theory of Social Representations as a theoretical reference, examining the content and process of constructing the representations of teachers, subjects of our investigation, on the evaluation of teaching and learning processes, through a methodology of qualitative. The result of this work has shown that remote teaching was really a very important strategy for the process of teaching and learning physics in the 2nd year of high school. It provided greater interaction between the teacher and the student. Therefore, the teacher also plays a fundamental role since technology is increasingly present in the educational environment, and he is the main protagonist of this process.

Keywords: physics teaching, technologies, remote learning, pandemic

Procedia PDF Downloads 66

Authors: A. Falenski, A. Kaesbohrer, M. Filter

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Introduction: Risk assessments can be performed in various ways and in different degrees of complexity. In order to assess risks associated with imported foods additional information needs to be taken into account compared to a risk assessment on regional products. The present review is an overview on currently available best practise approaches and data sources used for food import risk assessments (IRAs). Methods: A literature review has been performed. PubMed was searched for articles about food IRAs published in the years 2004 to 2014 (English and German texts only, search string “(English [la] OR German [la]) (2004:2014 [dp]) import [ti] risk”). Titles and abstracts were screened for import risks in the context of IRAs. The finally selected publications were analysed according to a predefined questionnaire extracting the following information: risk assessment guidelines followed, modelling methods used, data and software applied, existence of an analysis of uncertainty and variability. IRAs cited in these publications were also included in the analysis. Results: The PubMed search resulted in 49 publications, 17 of which contained information about import risks and risk assessments. Within these 19 cross references were identified to be of interest for the present study. These included original articles, reviews and guidelines. At least one of the guidelines of the World Organisation for Animal Health (OIE) and the Codex Alimentarius Commission were referenced in any of the IRAs, either for import of animals or for imports concerning foods, respectively. Interestingly, also a combination of both was used to assess the risk associated with the import of live animals serving as the source of food. Methods ranged from full quantitative IRAs using probabilistic models and dose-response models to qualitative IRA in which decision trees or severity tables were set up using parameter estimations based on expert opinions. Calculations were done using @Risk, R or Excel. Most heterogeneous was the type of data used, ranging from general information on imported goods (food, live animals) to pathogen prevalence in the country of origin. These data were either publicly available in databases or lists (e.g., OIE WAHID and Handystatus II, FAOSTAT, Eurostat, TRACES), accessible on a national level (e.g., herd information) or only open to a small group of people (flight passenger import data at national airport customs office). In the IRAs, an uncertainty analysis has been mentioned in some cases, but calculations have been performed only in a few cases. Conclusion: The current state-of-the-art in the assessment of risks of imported foods is characterized by a great heterogeneity in relation to general methodology and data used. Often information is gathered on a case-by-case basis and reformatted by hand in order to perform the IRA. This analysis therefore illustrates the need for a flexible, modular framework supporting the connection of existing data sources with data analysis and modelling tools. Such an infrastructure could pave the way to IRA workflows applicable ad-hoc, e.g. in case of a crisis situation.

Keywords: import risk assessment, review, tools, food import

Procedia PDF Downloads 302

Authors: Misa Nakao, Yuta Kurashina, Chikahiro Imashiro, Kenjiro Takemura

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The Research Goal: With the growing demand for regenerative medicine, an effective mass cell culture process is required. In a repetitive subculture process for proliferating cells, preparing single cell suspension which does not contain any cell aggregates is highly required because cell aggregates often raise various undesirable phenomena, e.g., apoptosis and decrease of cell proliferation. Since cell aggregates often occur in cell suspension during conventional subculture processes, this study proposes a single cell sorter driven by a resonance vibration of a cell culture substrate. The Method and the Result: The single cell sorter is simply composed of a cell culture substrate and a glass pipe vertically placed against the cell culture substrate with a certain gap corresponding to a cell diameter. The cell culture substrate is made of biocompatible stainless steel with a piezoelectric ceramic disk glued to the bottom side. Applying AC voltage to the piezoelectric ceramic disk, an out-of-plane resonance vibration with a single nodal circle of the cell culture substrate can be excited at 5.5 kHz. By doing so, acoustic radiation force is emitted, and then cell suspension containing only single cells is pumped into the pipe and collected. This single cell sorter is effective to collect single cells selectively in spite of its quite simple structure. We collected C2C12 myoblast cell suspension by the single cell sorter with the vibration amplitude of 12 µmp-p and evaluated the ratio of single cells in number against the entire cells in the suspension. Additionally, we cultured the collected cells for 72 hrs and measured the number of cells after the cultivation in order to evaluate their proliferation. As a control sample, we also collected cell suspension by conventional pipetting, and evaluated the ratio of single cells and the number of cells after the 72-hour cultivation. The ratio of single cells in the cell suspension collected by the single cell sorter was 98.2%. This ratio was 9.6% higher than that collected by conventional pipetting (statistically significant). Moreover, the number of cells cultured for 72 hrs after the collection by the single cell sorter yielded statistically more cells than that collected by pipetting, resulting in a 13.6% increase in proliferated cells. These results suggest that the cell suspension collected by the single cell sorter driven by the resonance vibration hardly contains cell aggregates whose diameter is larger than the gap between the cell culture substrate and the pipe. Consequently, the cell suspension collected by the single cell sorter maintains high cell proliferation. Conclusions: In this study, we developed a single cell sorter capable of sorting and pumping single cells by a resonance vibration of a cell culture substrate. The experimental results show the single cell sorter collects single cell suspension which hardly contains cell aggregates. Furthermore, the collected cells show higher proliferation than that of cells collected by conventional pipetting. This means the resonance vibration of the cell culture substrate can benefit us with the increase in efficiency of mass cell culture process for clinical applications.

Keywords: acoustic radiation force, cell proliferation, regenerative medicine, resonance vibration, single cell sorter

Procedia PDF Downloads 263

Authors: Nijanthan Mohan, Rolf Gross, Fabian Theis

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The conventional method used in the construction industries often resulted in significant rework since most of the decisions were taken onsite under the pressure of project deadlines and also due to the improper information flow, which results in ineffective coordination. However, today’s architecture, engineering, and construction (AEC) stakeholders demand faster and accurate deliverables, efficient buildings, and smart processes, which turns out to be a tall order. Hence, the building information modelling (BIM) concept was developed as a solution to fulfill the above-mentioned necessities. Even though BIM is successfully implemented in most of the world, it is still in the early stages in Germany, since the stakeholders are sceptical of its reliability and efficiency. Due to the huge capital requirement, the small and medium-sized construction companies are still reluctant to implement BIM workflow in their projects. The purpose of this paper is to analyse the opportunities and obstacles to implementing BIM for prefabrication. Among all other advantages of BIM, pre-fabrication is chosen for this paper because it plays a vital role in creating an impact on time as well as cost factors of a construction project. The positive impact of prefabrication can be explicitly observed by the project stakeholders and participants, which enables the breakthrough of the skepticism factor among the small scale construction companies. The analysis consists of the development of a process workflow for implementing prefabrication in building construction, followed by a practical approach, which was executed with two case studies. The first case study represents on-site prefabrication, and the second was done for off-site prefabrication. It was planned in such a way that the first case study gives a first-hand experience for the workers at the site on the BIM model so that they can make much use of the created BIM model, which is a better representation compared to the traditional 2D plan. The main aim of the first case study is to create a belief in the implementation of BIM models, which was succeeded by the execution of offshore prefabrication in the second case study. Based on the case studies, the cost and time analysis was made, and it is inferred that the implementation of BIM for prefabrication can reduce construction time, ensures minimal or no wastes, better accuracy, less problem-solving at the construction site. It is also observed that this process requires more planning time, better communication, and coordination between different disciplines such as mechanical, electrical, plumbing, architecture, etc., which was the major obstacle for successful implementation. This paper was carried out in the perspective of small and medium-sized mechanical contracting companies for the private building sector in Germany.

Keywords: building information modelling, construction wastes, pre-fabrication, small and medium sized company

Procedia PDF Downloads 113

Authors: Sylvie Michel, Sylvie Gerbaix, Marc Bidan

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The COVID-19 pandemic has been a major and global disruption that has affected all supply chains on a worldwide scale. Consequently, the question posed by this communication is to understand how - in the face of such disruptions - supply chains, including their actors, management tools, and processes, react, survive, adapt, and even improve. To do so, the concepts of resilience and antifragility applied to a supply chain have been leveraged. This article proposes to perceive resilience as a step to surpass in moving towards antifragility. The research objective is to propose an analytical framework to measure and compare resilience and antifragility, with antifragility seen as a property of a system that improves when subjected to disruptions rather than merely resisting these disruptions, as is the case with resilience. A unique case study was studied - MSF logistics (France) - using a qualitative methodology. Semi-structured interviews were conducted in person and remotely in multiple phases: during and immediately after the COVID crisis (8 interviews from March 2020 to April 2021), followed by a new round from September to November 2023. A Delphi method was employed. The interviews were analyzed using coding and a thematic framework. One of the theoretical contributions is consolidating the field of supply chain resilience research by precisely characterizing the dimensions of resilience for a humanitarian supply chain (Reorganization, Collaboration mediated by IS, Humanitarian culture). In this regard, a managerial contribution of this study is providing a guide for managers to identify the four dimensions and sub-dimensions of supply chain resilience. This enables managers to focus their decisions and actions on dimensions that will enhance resilience. Most importantly, another contribution is comparing the concepts of resilience and antifragility and proposing an analytical framework for antifragility—namely, the mechanisms on which MSF logistics relied to capitalize on uncertainties, contingencies, and shocks rather than simply enduring them. For MSF Logistics, antifragility manifested through the ability to identify opportunities hidden behind the uncertainties and shocks of COVID-19, reducing vulnerability, and fostering a culture that encourages innovation and the testing of new ideas. Logistics, particularly in the humanitarian domain, must be able to adapt to environmental disruptions. In this sense, this study identifies and characterizes the dimensions of resilience implemented by humanitarian logistics. Moreover, this research goes beyond the concept of resilience to propose an analytical framework for the concept of antifragility. The organization studied emerged stronger from the COVID-19 crisis due to the mechanisms we identified, allowing us to characterize antifragility. Finally, the results show that the information system plays a key role in antifragility.

Keywords: antifragility, humanitarian supply chain, information systems, qualitative research, resilience.

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Authors: Jianli Jiang, Bai-Chen Xie

Abstract:

The climate issue has aroused global concern. Achieving sustainable development is a good path for countries to mitigate environmental and climatic pressures, although there are many difficulties. The first step towards sustainable development is to evaluate the environmental efficiency of the energy industry with proper methods. The power sector is a major source of CO2, SO2, and NOx emissions. Evaluating the environmental efficiency (EE) of power systems is the premise to alleviate the terrible situation of energy and the environment. Data Envelopment Analysis (DEA) has been widely used in efficiency studies. However, measuring the efficiency of a system (be it a nation, region, sector, or business) is a challenging task. The classic DEA takes the decision-making units (DMUs) as independent, which neglects the interaction between DMUs. While ignoring these inter-regional links may result in a systematic bias in the efficiency analysis; for instance, the renewable power generated in a certain region may benefit the adjacent regions while the SO2 and CO2 emissions act oppositely. This study proposes a spatial network DEA (SNDEA) with a slack measure that can capture the spatial spillover effects of inputs/outputs among DMUs to measure efficiency. This approach is used to study the EE of China's power system, which consists of generation, transmission, and distribution departments, using a panel dataset from 2014 to 2020. In the empirical example, the energy and patent inputs, the undesirable CO2 output, and the renewable energy (RE) power variables are tested for a significant spatial spillover effect. Compared with the classic network DEA, the SNDEA result shows an obvious difference tested by the global Moran' I index. From a dynamic perspective, the EE of the power system experiences a visible surge from 2015, then a sharp downtrend from 2019, which keeps the same trend with the power transmission department. This phenomenon benefits from the market-oriented reform in the Chinese power grid enacted in 2015. The rapid decline in the environmental efficiency of the transmission department in 2020 was mainly due to the Covid-19 epidemic, which hinders economic development seriously. While the EE of the power generation department witnesses a declining trend overall, this is reasonable, taking the RE power into consideration. The installed capacity of RE power in 2020 is 4.40 times that in 2014, while the power generation is 3.97 times; in other words, the power generation per installed capacity shrank. In addition, the consumption cost of renewable power increases rapidly with the increase of RE power generation. These two aspects make the EE of the power generation department show a declining trend. Incorporation of the interactions among inputs/outputs into the DEA model, this paper proposes an efficiency evaluation method on the basis of the DEA framework, which sheds some light on efficiency evaluation in regional studies. Furthermore, the SNDEA model and the spatial DEA concept can be extended to other fields, such as industry, country, and so on.

Keywords: spatial network DEA, environmental efficiency, sustainable development, power system

Procedia PDF Downloads 109

Authors: Kanti Sapkota, Do Hyun Lee, Sung Soo Han

Abstract:

Nanocomposites have been widely used in various fields such as electronics, catalysis, and in chemical, biological, biomedical and optical fields. They display broad biomedical properties like antidiabetic, anticancer, antioxidant, antimicrobial and antibacterial activities. Moreover, nanomaterials have been used for wastewater treatment. Particularly, bimetallic hybrid nanocomposites exhibit unique features as compared to their monometallic components. Hybrid nanomaterials not only afford the multifunctionality endowed by their constituents but can also show synergistic properties. In addition, these hybrid nanomaterials have noteworthy catalytic and optical properties. Notably, Au−Ag based nanoparticles can be employed in sensor and catalysis due to their characteristic composition-tunable plasmonic properties. Due to their importance and usefulness, various efforts were developed for their preparation. Generally, chemical methods have been described to synthesize such bimetallic nanocomposites. In such chemical synthesis, harmful and hazardous chemicals cause environmental contamination and increase toxicity levels. Therefore, ecologically benevolent processes for the synthesis of nanomaterials are highly desirable to diminish such environmental and safety concerns. In this regard, here we disclose a simple, cost-effective, external additive free and eco-friendly method for the synthesis of Au-Ag@AgCl nanocomposites using Nephrolepis cordifolia root extract. Au-Ag@AgCl NCs were obtained by the simultaneous reduction of cationic Ag and Au into AgCl in the presence of plant extract. The particle size of 10 to 50 nm was observed with the average diameter of 30 nm. The synthesized nanocomposite was characterized by various modern characterization techniques. For example, UV−visible spectroscopy was used to determine the optical activity of the synthesized NCs, and Fourier transform infrared (FT-IR) spectroscopy was employed to investigate the functional groups present in the biomolecules that were responsible for both reducing and capping agents during the formation of nanocomposites. Similarly, powder X-ray diffraction (XRD), transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS), thermogravimetric analysis (TGA) and energy-dispersive X-ray (EDX) spectroscopy were used to determine crystallinity, size, oxidation states, thermal stability and weight loss of the synthesized nanocomposites. As a synthetic application, the synthesized nanocomposite exhibited excellent catalytic activity for the multicomponent synthesis of biologically interesting quinoline molecules via domino annulation-aromatization reaction of aniline, arylaldehyde, and phenyl acetylene derivatives. Interestingly, the nanocatalyst was efficiently recycled for five times without substantial loss of catalytic properties.

Keywords: nanoparticles, catalysis, multicomponent, quinoline

Procedia PDF Downloads 128

Authors: Peter. M. Kusen, Georg Wandrey, Christopher Probst, Dietrich Kohlheyer, Jochen Buchs, Jorg Pietruszkau

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Light as a stimulus provides the capability to develop regulation techniques for customizable gene expression. A great advantage is the extremely flexible and accurate dosing that can be performed in a non invasive and sterile manner even for high throughput technologies. Therefore, light regulation in a multiwell microbioreactor system was realized providing the opportunity to control gene expression with outstanding complexity. A light-regulated gene expression system in Saccharomyces cerevisiae was designed applying the strategy of caged compounds. These compounds are photo-labile protected and therefore biologically inactive regulator molecules which can be reactivated by irradiation with certain light conditions. The “caging” of a repressor molecule which is consumed after deprotection was essential to create a flexible expression system. Thereby, gene expression could be temporally repressed by irradiation and subsequent release of the active repressor molecule. Afterwards, the repressor molecule is consumed by the yeast cells leading to reactivation of gene expression. A yeast strain harboring a construct with the corresponding repressible promoter in combination with a fluorescent marker protein was applied in a Photo-BioLector platform which allows individual irradiation as well as online fluorescence and growth detection. This device was used to precisely control the repression duration by adjusting the amount of released repressor via different irradiation times. With the presented screening platform the regulation of complex expression procedures was achieved by combination of several repression/derepression intervals. In particular, a stepwise increase of temporally-constant expression levels was demonstrated which could be used to study concentration dependent effects on cell functions. Also linear expression rates with variable slopes could be shown representing a possible solution for challenging protein productions, whereby excessive production rates lead to misfolding or intoxication. Finally, the very flexible regulation enabled accurate control over the expression induction, although we used a repressible promoter. Summing up, the continuous online regulation of gene expression has the potential to synchronize gene expression levels to optimize metabolic flux, artificial enzyme cascades, growth rates for co cultivations and many other applications addicted to complex expression regulation. The developed light-regulated expression platform represents an innovative screening approach to find optimization potential for production processes.

Keywords: caged-compounds, gene expression regulation, optogenetics, photo-labile protecting group

Procedia PDF Downloads 327