Search results for: John. R. J. French

Authors: Suha Hassen

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This research aims to untangle the complexity of conducting face-to-face interviews with 80 ex-Islamic State fighters, encompassing three groups: local Iraqis, Arabs from the Middle East, and international fighters from around the globe. Each interview lasted approximately two hours and was conducted in both Arabic and English, focusing on the motivations behind joining the Islamic State and the pathways and mechanisms facilitating their involvement. The phenomenon of individuals joining violent Islamist extremist and jihadist organizations is multifaceted, drawing substantial attention within terrorism and security studies. Organizations such as the Islamic State, Hezbollah, Hamas, and Al-Qaeda pose formidable threats to international peace and stability, employing various terrorist tactics for radicalization and recruitment. However, significant gaps remain in current studies, including a lack of firsthand accounts, an inadequate understanding of original narratives (religious and linguistic) due to abstraction and misinterpretation of motivations, and a lack of Arab women's perspectives from the region. This study addresses these gaps by exploring the cultural, religious, and historical complexities that shape the narratives of ex-ISIS fighters. The paper will showcase three distinct cases: one French prisoner, one Moroccan fighter, and a local Iraqi, illustrating the diverse motivations and experiences that contribute to joining and leaving extremist groups. The findings provide valuable insights into the nuanced dynamics of radicalization, emphasizing the need for gender-sensitive approaches in counter-terrorism strategies and deradicalization programs. Importantly, this research has practical implications for counter-narrative policies and early-stage prevention of radicalization. By understanding the narratives used by ex-fighters, policymakers can develop targeted counter-narratives that disrupt recruitment efforts. Additionally, insights into the mechanisms of radicalization can inform early intervention programs, helping to identify and support at-risk individuals before they become entrenched in extremist ideologies. Ultimately, this research enhances our understanding of the individual experiences of ex-ISIS fighters and calls for a reevaluation of the narratives surrounding women’s roles in extremism and recovery.

Keywords: Arab women in extremism, counter-narrative policy, ex-ISIS fighters in Iraq, radicalization

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Authors: John Hardy

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The early twenty-first century national security environment has been characterized by political coercion. Despite an abundance of political commentary on the various forms of non-state coercion leveraged against the state, there is a lack of literature which distinguishes between the mechanisms and the mediums of coercion. Frequently non-state movements seeking to coerce the state are labelled by their tactics, not their strategies. Terrorists, insurgencies and social movements are largely defined by the ways in which they seek to influence the state, rather than by their political aims. This study examines the strategies of coercion used by non-state actors against states. This approach includes terrorist groups, insurgencies, and social movements who seek to coerce state politics. Not all non-state actors seek political coercion, so not all examples of different group types are considered. This approach also excludes political coercion by states, focusing on the non-state actor as the primary unit of analysis. The study applies a general theory of political coercion, which is defined as attempts to change the policies or action of a polity against its will, to the strategies employed by terrorist groups, insurgencies, and social movements. This distinguishes non-state actors’ strategic objectives from their actions and motives, which are variables that are often used to differentiate between types of non-state actors and the labels commonly used to describe them. It also allows for a comparative analysis of theoretical perspectives from the disciplines of terrorism, insurgency and counterinsurgency, and social movements. The study finds that there is a significant degree of overlap in the way that different disciplines conceptualize the mechanism of political coercion by non-state actors. Studies of terrorism and counterterrorism focus more on the notions of cost tolerance and collective punishment, while studies of insurgency focus on a contest of legitimacy between actors, and social movement theory tend to link political objectives, social capital, and a mechanism of influence to leverage against the state. Each discipline has a particular vernacular for the mechanism of coercion, which is often linked to the means of coercion, but they converge on three core theoretical components of compelling a polity to change its policies or actions: exceeding resistance to change, using political or violent punishments, and withholding legitimacy or consent from a government.

Keywords: counter terrorism, homeland security, insurgency, political coercion, social movement theory, terrorism

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Authors: Mariateresa Torchia, Helene Cristini, Hannele Kauppinen

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Leadership plays a vital role in organizations. Leaders provide directions and facilitate the processes that enable organizations to achieve their goals and objectives. However, while productivity and financial objectives are often given the greatest emphasis, leaders also have the responsibility for instituting standards of ethical conduct and moral values that guide the behavior of employees. Leaders’ behaviors such as support, empowerment and a high-quality relationship with their employees might not only prevent stress, but also improve employees’ stress coping meanwhile contributing to their affective well-being. Stemming from Girard’s Mimetic Theory, this study aims at understanding how leaders can foster well-being in organizations. To do so, we explore which is the role leaders play in conflict management, resentment management and negative emotions dissipation. Furthermore, we examine whether and to what extent religiosity impacts the way in which leaders operate in relation to employees’ well-being. Indeed, given that organizational values are crucial to ethical behavior and firms’ values may be steeled by a deep sense of spirituality and religious identification, there is a need to take a closer look at the role religion and spirituality play in influencing the way leaders impact employees’ well-being. Thus, religion might work as an overarching logic that provides a set of principles guiding leaders’ everyday practices and relations with employees. We answer our research questions using a qualitative approach. We interviewed 27 Christian leaders (members of the Christian Entrepreneurs and Leaders Association – EDC, a non-profit organization created in 1926 including 3,000 French Christian Leaders & Entrepreneurs). Our results show that well-being can have a different meaning in relation to the type of companies, size, culture, country of analysis. Moreover the values and believes of leaders influence the way they see and foster well-being among employees. Furthermore, leaders can have both a positive or negative impact on well-being. Indeed on the one side, they could increase well-being in the company while on the other hand, they could be the source of resentment and conflicts among employees. Finally, we observed that Christian leaders possess characteristics that are sometimes missing in leaders (humility, inability to compare with others, attempt to be coherent with their values and beliefs, interest in the common good instead of the personal interest, having tougher dilemmas, collectively undertaking the firm). Moreover the Christian leader believes that the common good should come before personal interest. In other words, to them, not only short –termed profit shouldn’t guide strategical decisions but also leaders should feel responsible for their employees’ well-being. Last but not least, the study is not an apologia of Christian, yet it discusses the implications of these values through the light of Girard’s mimetic theory for both theory and practice.

Keywords: Christian leaders, employees well-being, leadership, mimetic theory

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Authors: Manuela S. Tolentino, John G. Nepomuceno

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The purpose of this investigation was to assess the implementation of inclusive education (IE) in 6 elementary and 5 secondary public schools in the City Schools Division of Dasmarinas. Participants in this study were 11 school heads, 73 teachers, 22 parents and 22 students (regular and with special needs) who were selected using purposive sampling. A 30-item questionnaire was used to gather data on the extent of the implementation of IE in the division while focus group discussion (FGD) was used to gather insights on what facilitate and hinder the implementation of the IE program. This study assessed the following variables: school culture and environment, inclusive education policy implementation, and curriculum design and practices. Data were analyzed using frequency count, mean and ranking. Results revealed that participants have similar assessment on the extent of the implementation of IE. School heads rated school culture and environment as highest in terms of implementation while teachers and pupils chose curriculum design and practices. On the other hand, parents felt that inclusive education policies are implemented best. School culture and environment are given high ratings. Participants perceived that the IE program in the division is making everyone feel welcome regardless of age, sex, social status, physical, mental and emotional state; students with or without disability are equally valued, and students help each. However, some aspects of the IE program implementation are given low ratings namely: partnership between staff, parents and caregivers, school’s effort to minimize discriminatory practice, and stakeholders sharing the philosophy of inclusion. As regards education policy implementation, indicators with the highest ranks were school’s effort to admit students from the locality especially students with special needs, and the implementation of the child protection policy and anti-bullying policy. The results of the FGD revealed that both school heads and teachers possessed the welcoming gesture to accommodate students with special needs. This can be linked to the increasing enrolment of SNE in the division. However, limitations of the teachers’ knowledge on handling learners, facilities and collaboration among stakeholders hinder the implementation of IE program. Based on the findings, inclusion program framework was developed for program enhancement. This will be the basis for the improvement of the program’s efficiency, the relationship between stakeholders, and formulation of solutions.

Keywords: inclusion, inclusive education, framework, special education

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Authors: Erick R. Bandala, Kebret Kebede, Nicole Johnson, Rebecca Murray, Destiny Green, John Mejia, Polioptro Martinez-Austria

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Summertemperature data from Clark County was collected and used to estimate two different heat-related indexes: the heat index (HI) and excess heat factor (EHF). These two indexes were used jointly with data of health-related deaths in Clark County to assess the effect of extreme heat on the exposed population. The trends of the heat indexes were then analyzed for the 2007-2016 decadeandthe correlation between heat wave episodes and the number of heat-related deaths in the area was estimated. The HI showed that this value has increased significantly in June, July, and August over the last ten years. The same trend was found for the EHF, which showed a clear increase in the severity and number of these events per year. The number of heat wave episodes increased from 1.4 per year during the 1980-2016 period to 1.66 per yearduring the 2007-2016 period. However, a different trend was found for heat-wave-event duration, which decreasedfrom an average of 20.4 days during the trans-decadal period (1980-2016) to 18.1 days during the most recent decade(2007-2016). The number of heat-related deaths was also found to increase from 2007 to 2016, with 2016 with the highest number of heat-related deaths. Both HI and the number of deaths showeda normal-like distribution for June, July, and August, with the peak values reached in late July and early August. The average maximum HI values better correlated with the number of deaths registered in Clark County than the EHF, probably because HI uses the maximum temperature and humidity in its estimation,whereas EHF uses the average medium temperature. However, it is worth testing the EHF of the study zone because it was reported to fit properly in the case of heat-related morbidity. For the overall period, 437 heat-related deaths were registered in Clark County, with 20% of the deaths occurring in June, 52% occurring in July, 18% occurring in August,and the remaining 10% occurring in the other months of the year. The most vulnerable subpopulation was people over 50 years old, for which 76% of the heat-related deaths were registered.Most of the cases were associated with heart disease preconditions. The second most vulnerable subpopulation was young adults (20-50), which accounted for 23% of the heat-related deaths. These deathswere associated with alcoholic/illegal drug intoxication.

Keywords: heat, health, hazards, workforce

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Authors: Franco Ferrucci, Driss Stitou, Pascal Ortega, Franck Lucas

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The energy situation in tropical insular regions, as found in the French Polynesian islands, presents a number of challenges, such as high dependence on imported fuel, high transport costs from the mainland and weak electricity grids. Alternatively, these regions have a variety of renewable energy resources, which favor the exploitation of smart microgrids and energy storage technologies. With regards to the electrical energy demand, the high temperatures in these regions during the entire year implies that a large proportion of consumption is used for cooling buildings, even during the evening hours. In this context, this paper presents an air conditioning system driven by photovoltaic (PV) electricity that combines a refrigeration system and a thermochemical storage process. Thermochemical processes are able to store energy in the form of chemical potential with virtually no losses, and this energy can be used to produce cooling during the evening hours without the need to run a compressor (thus no electricity is required). Such storage processes implement thermochemical reactors in which a reversible chemical reaction between a solid compound and a gas takes place. The solid/gas pair used in this study is BaCl2 reacting with ammonia (NH3), which is also the coolant fluid in the refrigeration circuit. In the proposed system, the PV-driven electric compressor is used during the daytime either to run the refrigeration circuit when a cooling demand occurs or to decompose the ammonia-charged salt and remove the gas from thermochemical reactor when no cooling is needed. During the evening, when there is no electricity from solar source, the system changes its configuration and the reactor reabsorbs the ammonia gas from the evaporator and produces the cooling effect. In comparison to classical PV-driven air conditioning units equipped with electrochemical batteries (e.g. Pb, Li-ion), the proposed system has the advantage of having a novel storage technology with a much longer charge/discharge life cycle, and no self-discharge. It also allows a continuous operation of the electric compressor during the daytime, thus avoiding the problems associated with the on-off cycling. This work focuses on the system concept and on the efficiency study of its main components. It also compares the thermochemical with electrochemical storage as well as with other forms of thermal storage, such as latent (ice) and sensible heat (chilled water). The preliminary results show that the system seems to be a promising alternative to simultaneously fulfill cooling and energy storage needs in tropical insular regions.

Keywords: microgrid, solar air-conditioning, solid/gas sorption, thermochemical storage, tropical and insular regions

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Authors: Nikhil John Kollannur, Dali Naidu Arnepalli

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Most of the surface related phenomena in the case of fine-grained soil are attributed to their unique surface charge properties and specific surface area. The temporal variations in soil behavior, to some extent, can be credited to the changes in these properties. Among the multitude of factors that affect the charge and surface area of clay minerals, the inherent system chemistry occupies the cardinal position. The impact is more profound when the chemistry change is manifested in terms of the system pH. pH plays a significant role by modifying the edge charges of clay minerals and facilitating mineral dissolution. Hence there is a need to address the variations in physical and charge properties of fine-grained soils treated over a range of acidic as well as alkaline conditions. In the present study, three soils (two soils commercially procured and one natural soil) exhibiting distinct mineralogical compositions are subjected to different pH environment over a range of 2 to 13. The soil-solutions prepared at a definite liquid to solid ratio are adjusted to the required pH value by adding measured quantities of 0.1M HCl/0.1M NaOH. The studies are conducted over a range of interaction time, varying from 1 to 96 hours. The treated soils are then analyzed for their physical properties in terms of specific surface area and particle size characteristics. Further, modifications in surface morphology are evaluated from scanning electron microscope (SEM) imaging. Changes in the surface charge properties are assessed in terms of zeta potential measurements. Studies show significant variations in total surface area, probably because of the dissolution of clay minerals. This observation is further substantiated by the morphological analysis with SEM imaging. The zeta potential measurements on soils indicate noticeable variation upon pH treatment, which is partially ascribed to the modifications in the pH-dependant edge charges and partially due to the clay mineral dissolution. The results provide valuable insight into the role of pH in a clay-electrolyte system upon surface related phenomena such as species adsorption, fabric modification etc.

Keywords: acid and alkali treatment, mineral dissolution , specific surface area, zeta potential

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Authors: Amos Olajide Oluyege, Akpanobong Akpan Ekong, Emmanuel Uchechukwu Opara, Sunday Adeniyi Adedutan, Joseph Adeola Fuwape, Olawale John Olukunle

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This study was carried out to evaluate the influence of wood species and wood plastic ratio on the physical and mechanical properties of wood plastic composites (WPCs) produced from polyethylene terephthalate (PET) plastic bottle wastes and sawdust from three hardwood species, namely, Terminalia superba, Gmelina arborea, and Ceiba pentandra. The experimental WPCs were prepared from sawdust particle size classes of ≤ 0.5, 0.5 – 1.0, and 1.0 – 2.0 mm at wood/plastic ratios of 40:60, 50:50 and 60:40 (percentage by weight). The WPCs for each study variable combination were prepared in 3 replicates and laid out in a randomized complete block design (RCBD). The physical properties investigated water absorption (WA), linear expansion (LE) and thickness swelling (TS) while the mechanical properties evaluated were Modulus of Elasticity (MOE) and Modulus of Rupture (MOR). The mean values for WA, LE and TS ranged from 1.07 to 34.04, 0.11 to 1.76 and 0.11 to 4.05 %, respectively. The mean values of the three physical properties increased with decrease in wood plastic ratio. Wood plastic ratio of 40:60 at each particle size class generally resulted in the lowest values while wood plastic ratio of 60:40 had the highest values for each of the three species. For each of the physical properties, T. superba had the least mean values followed by G. arborea, while the highest values were observed C. pentandra. The mean values for MOE and MOR ranged from 458.17 to 1875.67 and 2.64 to 18.39 N/mm2, respectively. The mean values of the two mechanical properties decreased with increase in wood plastic ratio. Wood plastic ratio of 40:60 at each wood particle size class generally had the highest values while wood plastic ratio of 60:40 had the least values for each of the three species. For each of the mechanical properties, C. pentandra had the highest mean values followed by G. arborea, while the least values were observed T. superba. There were improvements in both the physical and mechanical properties due to decrease in sawdust particle size class with the particle size class of ≤ 0.5 mm giving the best result. The results of the Analysis of variance revealed significant (P < 0.05) effects of the three study variables – wood species, sawdust particle size class and wood/plastic ratio on all the physical and mechanical properties of the WPCs. It can be concluded from the results of this study that wood plastic composites from sawdust particle size ≤ 0.5 and PET plastic bottle wastes with acceptable physical and mechanical properties are better produced using 40:60 wood/plastic ratio, and that at this ratio, all the three species are suitable for the production of wood plastic composites.

Keywords: polyethylene terephthalate plastic bottle wastes, wood plastic composite, physical properties, mechanical properties

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Authors: Abigail Kusi Amponsah, Evans Frimpong Kyei, John Bright Agyemang, Hanson Boakye, Joana Kyei-Dompim, Collins Kwadwo Ahoto, Evans Oduro

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Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children’s pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children’s pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children’s pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n =24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses’ inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children’s pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children’s pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain management

Keywords: Nursing-Related Barriers, Children, Pain Management, Ghana

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Authors: Jonathan Ogwal, Louis H. Kamulegeya, John M. Bwanika, Davis Musinguzi

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Introduction: Community retail Pharmacy drug distribution points (CRPDDP) were implemented in the Lango sub-region as part of the Ministry of Health’s response to improving access and adherence to antiretroviral treatment (ART). Clients received their ART refills from nearby local pharmacies; as such, the need for continuous engagement through mobile phone appointment reminders and health messages. We share learnings from the implementation of mobile text reminders and voice call follow-ups among ART clients attending the CRPDDP program in northern Uganda. Methods: A retrospective data review of electronic medical records from four pharmacies allocated for CRPDDP in the Lira and Apac districts of the Lango sub-region in Northern Uganda was done from February to August 2022. The process involved collecting phone contacts of eligible clients from the health facility appointment register and uploading them onto a messaging platform customized by Rapid-pro, an open-source software. Client information, including code name, phone number, next appointment date, and the allocated pharmacy for ART refill, was collected and kept confidential. Contacts received appointment reminder messages and other messages on positive living as an ART client. Routine voice call follow-ups were done to ascertain the picking of ART from the refill pharmacy. Findings: In total, 1,354 clients were reached from the four allocated pharmacies found in urban centers. 972 clients received short message service (SMS) appointment reminders, and 382 were followed up through voice calls. The majority (75%) of the clients returned for refills on the appointed date, 20% returned within four days after the appointment date, and the remaining 5% needed follow-up where they reported that they were not in the district by the appointment date due to other engagements. Conclusion: The use of mobile text reminders and voice call follow-ups improves the attendance of community retail pharmacy refills.

Keywords: antiretroviral treatment, community retail drug distribution points, mobile text reminders, voice call follow-up

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Authors: Mette Pedersen

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This paper outlines the criteria that assessment specialists use when they design the 'Persuasive Essay' task for the four Advanced Placement World Language and Culture Exams (AP French, German, Italian, and Spanish). The 'Persuasive Essay' is a free-response, source-based, standardized measure of presentational writing. Each 'Persuasive Essay' item consists of three sources (an article, a chart, and an audio) and a prompt, which is a statement of the topic phrased as an interrogative sentence. Due to its richness of source materials and due to the amount of time that test takers are given to prepare for and write their responses (a total of 55 minutes), the 'Persuasive Essay' is the free-response task on the AP World Language and Culture Exams that goes to the greatest lengths to unleash the test takers' proficiency potential. The author focuses on the work that goes into designing the 'Persuasive Essay' task, outlining best practices for the selection of topics and sources, the interplay that needs to be present among the sources and the thinking behind the articulation of prompts for the 'Persuasive Essay' task. Using released 'Persuasive Essay' items from the AP World Language and Culture Exams and accompanying data on test taker performance, the author shows how different passages, and features of passages, have succeeded (and sometimes not succeeded) in eliciting writing proficiency among test takers over time. Data from approximately 215.000 test takers per year from 2014 to 2017 and approximately 35.000 test takers per year from 2012 to 2013 form the basis of this analysis. The conclusion of the study is that test taker performance improves significantly when the sources that test takers are presented with express directly opposing viewpoints. Test taker performance also improves when the interrogative prompt that the test takers respond to is phrased as a yes/no question. Finally, an analysis of linguistic difficulty and complexity levels of the printed sources reveals that test taker performance does not decrease when the complexity level of the article of the 'Persuasive Essay' increases. This last text complexity analysis is performed with the help of the 'ETS TextEvaluator' tool and the 'Complexity Scale for Information Texts (Scale)', two tools, which, in combination, provide a rubric and a fully-automated technology for evaluating nonfiction and informational texts in English translation.

Keywords: advanced placement world language and culture exams, designing presentational writing assessments, large-scale standardized assessments of written language proficiency, source-based language testing

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Authors: John Acord, Ankita Batla, Kiran Khepar, Maude Schmidt, Charlotte Allen, Russ Bradford

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Objectives: Despite the availability oftreatment options, Parkinson’s disease (PD) continues to impact heavily on a patient’s quality of life (QoL), as many symptoms that bother the patient remain unexplored and untreated in clinical settings. The aims of this research were to understand the burden of PDsymptoms from a patient perspective, particularly those which are the most persistent and debilitating, and to determine if current treatments and treatment algorithms adequately focus on their resolution. Methods: A13-question, online, patient-reported survey was created based on the MDS-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS)and symptoms listed on Parkinson’s Disease Patient Advocacy Groups websites, and then validated by 10 Parkinson’s patients. In the survey, patients were asked to choose both their most common and their most bothersome symptoms, whether they had received treatment for those and, if so, had it been effective in resolving those symptoms. Results: The most bothersome symptoms reported by the 111 participants who completed the survey were sleep problems (61%), feeling tired (56%), slowness of movements (54%), and pain in some parts of the body (49%). However, while 86% of patients reported receiving dopamine or dopamine like drugs to treat their PD, far fewer reported receiving targeted therapies for additional symptoms. For example, of the patients who reported having sleep problems, only 33% received some form of treatment for this symptom. This was also true for feeling tired (30% received treatment for this symptom), slowness of movements (62% received treatment for this symptom), and pain in some parts of the body (61% received treatment for this symptom). Additionally, 65% of patients reported that the symptoms they experienced were not adequately controlled by the treatments they received, and 9% reported that their current treatments had no effect on their symptoms whatsoever. Conclusion: The survey outcomes highlight that the majority of patients involved in the study received treatment focused on their disease, however, symptom-based treatments were less well represented. Consequently, patient-reported symptoms such as sleep problems and feeling tired tended to receive more fragmented intervention than ‘classical’ PD symptoms, such as slowness of movement, even though they were reported as being amongst the most bothersome symptoms for patients. This research highlights the need to explore symptom burden from the patient’s perspective and offer Customised treatment/support for both motor and non-motor symptoms maximize patients’ quality of life.

Keywords: survey, patient reported symptom burden, unmet needs, parkinson's disease

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Authors: Scarlet Tabot Enanga Longsti

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Community-Based Health Insurance (CBHI) schemes have been proposed as a possible means to achieve affordable health care in low-and lower-middle-income countries. The existing evidence provides mixed results on the impact of CBHI schemes on healthcare utilisation and out -of-pocket payments (OOPP) for healthcare. Over 900 CBHI schemes have been implemented in underdeveloped countries, and these schemes have undergone different modifications over the years. Prior reviews have suggested that different designs of CBHI schemes may result in different outcomes. Objectives: This review sought to determine the interventions that affect the impact of CBHI schemes on OOPP and health service utilisation. Interventions in this study referred to any action or modification in the design of a CBHI scheme that affected the impact of the scheme on OOPP and/or healthcare utilization. Methods: Any CBHI study that was done in a lower middle-income country, that used an experimental design, that included OOPP or health care utilisation as outcome variables, and that was published in either English or French was included in this study. Studies were searched for in MEDLINE, Embase, CINAHL, EconLit, IBSS, Web of Science, Cochrane Library, and Global Index Medicus from July to August 2023. Bias was assessed using Joanna Brigs Institute tools for quality assessment for randomized control trials and quasi experimental studies. A narrative synthesis was done. Results: 12 studies were included in the review, with a total of 69 villages, 13,653 households, and 62,786 participants. Average premium collection was 4.8 USD/year. Most CBHI schemes had flat rates. The study revealed that a range of interventions impact OOPP and health care utilisation. Five categories of interventions were identified. The intervention with the highest impact on OOPP and utilisation was “Audit visits”. Next in line came external funds, training scheme workers, and engaging community leaders and village heads to advertise the scheme. Free healthcare led to a significant increase in utilisation of health services, a significant reduction in Catastrophic health expenditure, but an insignificant effect on OOPP among insured compared with uninsured. Conclusions: Community-Based Health Insurance could pave the way for Universal Health Care in low and middle-income countries. However, this can only be possible if careful thought is given to how schemes are designed. Due to the heterogeneity of studies and results on CBHI schemes, there is need for further research for more effective designs to be developed.

Keywords: community based health insurance, developing countries, health service utilisation, out of pocket payment

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Authors: Yves Alain Ach, Sandra Rmadi Said

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An extensive review of literature in relation to brands has shown that little research has focused on the nature and determinants of the information disclosed by companies with respect to the brands they own and use. The objective of this paper is to address this issue. More specifically, the aim is to characterize the nature of the information disclosed by companies in terms of estimating the value of brands and to identify the determinants of that information according to the company’s characteristics most frequently tested by previous studies on the disclosure of information on intangible capital, by studying the practices of a sample of 37 French companies. Our findings suggest that companies prefer to communicate accounting, economic and strategic information in relation to their brands instead of providing financial information. The analysis of the determinants of the information disclosed on brands leads to the conclusion that the groups which operate internationally and have chosen a category 1 auditing firm to communicate more information to investors in their annual report. Our study points out that the sector is not an explanatory variable for voluntary brand disclosure, unlike previous studies on intangible capital. Our study is distinguished by the study of an element that has been little studied in the financial literature, namely the determinants of brand-related information. With regard to the effect of size on brand-related information disclosure, our research does not confirm this link. Many authors point out that large companies tend to publish more voluntary information in order to respond to stakeholder pressure. Our study also establishes that the relationship between brand information supply and performance is insignificant. This relationship is already controversial by previous research, and it shows that higher profitability motivates managers to provide more information, as this strengthens investor confidence and may increase managers' compensation. Our main contribution focuses on the nature of the inherent characteristics of the companies that disclose the most information about brands. Our results show the absence of a link between size and industry on the one hand and the supply of brand information on the other, contrary to previous research. Our analysis highlights three types of information disclosed about brands: accounting, economics and strategy. We, therefore, question the reasons that may lead companies to voluntarily communicate mainly accounting, economic and strategic information in relation to our study from one year to the next and not to communicate detailed information that would allow them to reconstitute the financial value of their brands. Our results can be useful for companies and investors. Our results highlight, to our surprise, the lack of financial information that would allow investors to understand a better valuation of brands. We believe that additional information is needed to improve the quality of accounting and financial information related to brands. The additional information provided in the special report that we recommend could be called a "report on intangible assets”.

Keywords: brand related information, brand value, information disclosure, determinants

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Authors: Suehyun Cho, Darrell Harrington, Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Alex Kiselyov, Michael Shpigelmacher

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Bionaut Labs, LLC is developing a minimally invasive robotic microdevice designed to treat non-communicating hydrocephalus in both adult and pediatric patients. The device utilizes biocompatible microsurgical particles (Bionaut™) that are specifically designed to safely and reliably perform accurate fenestration(s) in the 3rd ventricle, aqueduct of Sylvius, and/or trapped intraventricular cysts of the brain in order to re-establish normal cerebrospinal fluid flow dynamics and thereby balance and/or normalize intra/intercompartmental pressure. The Bionaut™ is navigated to the target via CSF or brain tissue in a minimally invasive fashion with precise control using real-time imaging. Upon reaching the pre-defined anatomical target, the external driver allows for directing the specific microsurgical action defined to achieve the surgical goal. Notable features of the proposed protocol are i) Bionaut™ access to the intraventricular target follows a clinically validated endoscopy trajectory which may not be feasible via ‘traditional’ rigid endoscopy: ii) the treatment is microsurgical, there are no foreign materials left behind post-procedure; iii) Bionaut™ is an untethered device that is navigated through the subarachnoid and intraventricular compartments of the brain, following pre-designated non-linear trajectories as determined by the safest anatomical and physiological path; iv) Overall protocol involves minimally invasive delivery and post-operational retrieval of the surgical Bionaut™. The approach is expected to be suitable to treat pediatric patients 0-12 months old as well as adult patients with obstructive hydrocephalus who fail traditional shunts or are eligible for endoscopy. Current progress, including platform optimization, Bionaut™ control, and real-time imaging and in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of ovine models, will be discussed.

Keywords: Bionaut™, cerebrospinal fluid, CSF, fenestration, hydrocephalus, micro-robot, microsurgery

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Authors: John Michael Weber

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The following research results spanned six months and 175 people addicted to some form of substance, from alcohol to heroin. One question was asked, and the answers were amazing and consistent. The following work is the detailed results of this writer’s answer to his own question and the 175 that followed. A constant pattern took shape throughout the bio-psycho-social assessments, these addicts had “first memories,” the memories were vivid and took place between the ages of three to six years old, to a person those first memories were traumatic. This writer’s personal search into his childhood was not to find an excuse for the way he became, but to explain the reason for becoming an addict. To treat addiction, these memories that have caused Post Traumatic Stress Disorder (PTSD), must be recognized as the catalyst that sparked a predisposition. Cognitive Behavioral Therapy (CBT), integrated with treatment specifically focused on PTSD, gives the addict a better chance at recovery sans relapse. This paper seeks to give the findings of first memories of the addicts assessed and provide the best treatment plan for such an addict, considering, the childhood trauma in congruence with treatment of the Substance Use Disorder (SUD). The question posed was concerning what their first life memory wa It is the hope of this author to take the knowledge that trauma is one of the main catalysts for addiction, will allow therapists to provide better treatment and reduce relapse from abstinence from drugs and alcohol. This research led this author to believe that if treatment of childhood trauma is not a priority, the twelve steps of Alcoholics Anonymous, specifically steps 4 and 5, will not be thoroughly addressed and odds for relapse increase. With this knowledge, parents can be educated on childhood trauma and the effect it has on their children. Parents could be mindful of the fact that the things they perceive as traumatic, do not match what a child, in the developmental years, absorbs as traumatic. It is this author’s belief that what has become the status quo in treatment facilities has not been working for a long time. It is for that reason this author believes things need to change. Relapse has been woven into the fabric of standard operating procedure and that, in this authors view, is not necessary. Childhood Trauma is not being addressed early in recovery and that creates an environment of inevitable relapse. This paper will explore how to break away from the status -quo and rethink the current “evidencebased treatments.” To begin breaking away from status-quo, this ends the Abstract, with hopes an interest has been peaked to read on.

Keywords: childood, trauma, treatment, addiction, change

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Authors: Seema Paul, John Mango Magero, Prosun Bhattacharya, Zahra Kalantari, Steve W. Lyon

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The purpose of this review paper is to develop an understanding of lake hydrodynamics and the potential climate impact on the Lake Victoria (LV) catchment scale. This paper briefly discusses the main problems of lake hydrodynamics and its’ solutions that are related to quality assessment and climate effect. An empirical methodology in modeling and mapping have considered for understanding lake hydrodynamic and visualizing the long-term observational daily, monthly, and yearly mean dataset results by using geographical information system (GIS) and Comsol techniques. Data were obtained for the whole lake and five different meteorological stations, and several geoprocessing tools with spatial analysis are considered to produce results. The linear regression analyses were developed to build climate scenarios and a linear trend on lake rainfall data for a long period. A potential evapotranspiration rate has been described by the MODIS and the Thornthwaite method. The rainfall effect on lake water level observed by Partial Differential Equations (PDE), and water quality has manifested by a few nutrients parameters. The study revealed monthly and yearly rainfall varies with monthly and yearly maximum and minimum temperatures, and the rainfall is high during cool years and the temperature is high associated with below and average rainfall patterns. Rising temperatures are likely to accelerate evapotranspiration rates and more evapotranspiration is likely to lead to more rainfall, drought is more correlated with temperature and cloud is more correlated with rainfall. There is a trend in lake rainfall and long-time rainfall on the lake water surface has affected the lake level. The onshore and offshore have been concentrated by initial literature nutrients data. The study recommended that further studies should consider fully lake bathymetry development with flow analysis and its’ water balance, hydro-meteorological processes, solute transport, wind hydrodynamics, pollution and eutrophication these are crucial for lake water quality, climate impact assessment, and water sustainability.

Keywords: climograph, climate scenarios, evapotranspiration, linear trend flow, rainfall event on LV, concentration

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Authors: Daniel John Avutia

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Solar Photovoltaic (PV) development is reliant on the sunlight hours available in a particular region to generate electricity. A potential area is assessed through its inherent solar radiation intensity measured in watts per square meter. Solar energy development involves the feasibility, design, construction, operation and maintenance of the relevant infrastructure, but this paper will focus on the design and construction aspects. Africa and Australasia have the longest sunlight hours per day and the highest solar radiation per square meter, 7 sunlight hours/day and 5 kWh/day respectively. Solar PV support configurations consist of fixed-tilt support and tracker system structures, the differentiation being that the latter was introduced to improve the power generation efficiency of the former due to the sun tracking movement capabilities. The installation of Solar PV foundations involves rammed piles, drilling/grout piles and shallow raft reinforced concrete structures. This paper presents a case study of 2 solar PV projects in Africa and Australia, discussing the foundation design consideration and associated construction cost implications of the selected foundations systems. Solar PV foundations represent up to one fifth of the civil works costs in a project. Therefore, the selection of the most structurally sound and feasible foundation for the prevailing ground conditions is critical towards solar PV development. The design wind speed measured by anemometers govern the pile embedment depth for rammed and drill/grout foundation systems. The lateral pile deflection and vertical pull out resistance of piles increase proportionally with the embedment depth for uniform pile geometry and geology. The pile driving rate may also be used to anticipate the lateral resistance and skin friction restraining the pile. Rammed pile foundations are the most structurally suitable due to the pile skin friction and ease of installation in various geological conditions. The competitiveness of solar PV projects within the renewable energy mix is governed by lowering capital expenditure, improving power generation efficiency and power storage technological advances. The power generation reliability and efficiency are areas for further research within the renewable energy niche.

Keywords: design, foundations, piles, solar

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Authors: John K. Avor, Choong-Koo Chang

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The transfer of electrical loads at power generation stations from Standby Auxiliary Transformer (SAT) to Unit Auxiliary Transformer (UAT) and vice versa is through a fast bus transfer scheme. Fast bus transfer is a time-critical application where the transfer process depends on various parameters, thus transfer schemes apply advance algorithms to ensure power supply reliability and continuity. In a nuclear power generation station, supply continuity is essential, especially for critical class 1E electrical loads. Bus transfers must, therefore, be executed accurately within 4 to 10 cycles in order to achieve safety system requirements. However, the main problem is that there are instances where transfer schemes scrambled due to inaccurate interpretation of key parameters; and consequently, have failed to transfer several critical loads from UAT to the SAT during main generator trip event. Although several techniques have been adopted to develop robust transfer schemes, a combination of Artificial Neural Network and Fuzzy Systems (Neuro-Fuzzy) has not been extensively used. In this paper, we apply the concept of Neuro-Fuzzy to determine plant operating mode and dynamic prediction of the appropriate bus transfer algorithm to be selected based on the first cycle of voltage information. The performance of Sequential Fast Transfer and Residual Bus Transfer schemes was evaluated through simulation and integration of the Neuro-Fuzzy system. The objective for adopting Neuro-Fuzzy approach in the bus transfer scheme is to utilize the signal validation capabilities of artificial neural network, specifically the back-propagation algorithm which is very accurate in learning completely new systems. This research presents a combined effect of artificial neural network and fuzzy systems to accurately interpret key bus transfer parameters such as magnitude of the residual voltage, decay time, and the associated phase angle of the residual voltage in order to determine the possibility of high speed bus transfer for a particular bus and the corresponding transfer algorithm. This demonstrates potential for general applicability to improve reliability of the auxiliary power distribution system. The performance of the scheme is implemented on APR1400 nuclear power plant auxiliary system.

Keywords: auxiliary power system, bus transfer scheme, fuzzy logic, neural networks, reliability

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Authors: John McDowall, Lucy Lightfoot

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Stigma constitutes a significant barrier to the recovery and social integration of individuals affected by mental illness. Although there is some debate in the literature regarding the definition and utility of stigma as a concept, it is widely accepted that it comprises three components: stereotypical beliefs, prejudicial reactions, and discrimination. Stereotypical beliefs describe the cognitive knowledge-based component of stigma, referring to beliefs (often negative) about members of a group that is based on cultural and societal norms (e.g. ‘People with anxiety are just weak’). Prejudice refers to the affective/evaluative component of stigma and describes the endorsement of negative stereotypes and the resulting negative emotional reactions (e.g. ‘People with anxiety are just weak, and they frustrate me’). Discrimination refers to the behavioural component of stigma, which is arguably the most problematic, as it exerts a direct effect on the stigmatized person and may lead people to behave in a hostile or avoidant way towards them (i.e. refusal to hire them). Research exploring anti-stigma initiatives focus primarily on an educational approach, with the view that accurate information will replace misconceptions and decrease stigma. Many approaches take a biogenetic stance, emphasising brain and biochemical deficits - the idea being that ‘mental illness is an illness like any other.' While this approach tends to effectively reduce blame, it has also demonstrated negative effects such as increasing prognostic pessimism, the desire for social distance and perceptions of stereotypes. In the present study 144 participants were split into three groups and read one of three vignettes presenting causal explanations for Generalised Anxiety Disorder (GAD): One explanation emphasized biogenetic factors as being important in the etiology of GAD, another emphasised psychosocial factors (e.g. aversive life events, poverty, etc.), and a third stressed the adaptive features of the disorder from an evolutionary viewpoint. A variety of measures tapping the various components of stigma were administered following the vignettes. No difference in stigma measures as a function of causal explanation was found. People who had contact with mental illness in the past were significantly less stigmatising across a wide range of measures, but this did not interact with the type of causal explanation.

Keywords: generalised anxiety disorder, discrimination, prejudice, stigma

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Authors: Zeenat Rupawalla, Nicole Robinson, Susanne Schmidt, Sijie Li, Selina Carruthers, Elodie Buisset, John Roles, Ben Hankamer, Juliane Wolf

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Agriculture has radically changed the global biogeochemical cycle of nitrogen (N). Fossil fuel-enabled synthetic N-fertiliser is a foundation of modern agriculture but applied to soil crops only use about half of it. To address N-pollution from cropping and the large carbon and energy footprint of N-fertiliser synthesis, new technologies delivering enhanced energy efficiency, decarbonisation, and a circular nutrient economy are needed. We characterised algae fertiliser (AF) as an alternative to synthetic N-fertiliser (SF) using empirical and modelling approaches. We cultivated microalgae in nutrient solution and modelled up-scaled production in nutrient-rich wastewater. Over four weeks, AF released 63.5% of N as ammonium and nitrate, and 25% of phosphorous (P) as phosphate to the growth substrate, while SF released 100% N and 20% P. To maximise crop N-use and minimise N-leaching, we explored AF and SF dose-response-curves with spinach in glasshouse conditions. AF-grown spinach produced 36% less biomass than SF-grown plants due to AF’s slower and linear N-release, while SF resulted in 5-times higher N-leaching loss than AF. Optimised blends of AF and SF boosted crop yield and minimised N-loss due to greater synchrony of N-release and crop uptake. Additional benefits of AF included greener leaves, lower leaf nitrate concentration, and higher microbial diversity and water holding capacity in the growth substrate. Life-cycle-analysis showed that replacing the most effective SF dosage with AF lowered the carbon footprint of fertiliser production from 2.02 g CO₂ (C-producing) to -4.62 g CO₂ (C-sequestering), with a further 12% reduction when AF is produced on wastewater. Embodied energy was lowest for AF-SF blends and could be reduced by 32% when cultivating algae on wastewater. We conclude that (i) microalgae offer a sustainable alternative to synthetic N-fertiliser in spinach production and potentially other crop systems, and (ii) microalgae biofertilisers support the circular nutrient economy and several sustainable development goals.

Keywords: bioeconomy, decarbonisation, energy footprint, microalgae

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Authors: Jami Wang, Brian Kao, Davin Agustines

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COVID-19 highlighted the active discrimination against the Asian American population easily seen through media, social tension, and increased crimes against the specific population. It is well known that long-term racism can also have a large impact on both emotional and psychological well-being. However, the healthcare disparity during this time also revealed how the Asian American community lacked the research data, political support, and medical infrastructure for this particular population. During a time when Asian American fear for safety with decreasing mental health, telepsychiatry is particularly promising. COVID-19 demonstrated how well psychiatry could integrate with telemedicine, with psychiatry being the second most utilized telemedicine visits. However, the Asian American community did not utilize the telepsychiatry resources as much as other groups. Because of this, we wanted to understand why the patient population who was affected the most by COVID-19 mentally did not seek out care. To do this, we decided to study the top top telepsychiatry platforms. The current top telepsychiatry companies in the United States include Teladoc and BetterHelp. In the Teladoc mental health sector, they only had 4 available languages (English, Spanish, French, and Danis,) with none of them being an Asian language. In a similar manner, Teladoc’s top competitor in the telepsychiatry space, BetterHelp, only listed a total of 3 Asian languages, including Mandarin, Japanese, and Malaysian. However, this is still a short list considering they have over 20 languages available. The shortage of available physicians that speak multiple languages is concerning, as it could be difficult for the Asian American community to relate with. There are limited mental health resources that cater to their likely cultural needs, further exacerbating the structural racism and institutional barriers to appropriate care. It is important to note that these companies do provide interpreters to comply with the nondiscrimination and language assistance federal law. However, interactions with an interpreter are not only more time-consuming but also less personal than talking directly with a physician. Psychiatry is the field that emphasizes interpersonal relationships. The trust between a physician and the patient is critical in developing patient rapport to guide in better understanding the clinical picture and treating the patient appropriately. The language barrier creates an additional barrier between the physician and patient. Because Asian Americans are one of the largest growing patient population bases, these telehealth companies have much to gain by catering to the Asian American market. Without providing adequate access to bilingual and bicultural physicians, the current system will only further exacerbate the growing disparity. The healthcare community and telehealth companies need to recognize that the Asian American population is a severely underserved population in mental health and has much to gain from telepsychiatry. The lack of language is one of many reasons why there is a disparity for Asian Americans in the mental health space.

Keywords: telemedicine, psychiatry, Asian American, disparity

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Authors: Hsiu-Ling Hsu, En-Minh (John) Lan

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Pronunciation has received more and more language researchers’ and teachers’ attention because it is important for effective or even successful communication. How to consistently and correctly orally produce verbal morphology, such as English regular past tense inflection, has been a big challenge and troublesome for FL learners. The research aims to explore EFL (English as a foreign language) learners’ developmental trajectory of the inflectional morphology, that is, what mediating processes and strategies EFL learners use, to attain native-like prosodic structure of inflectional morphemes (e.g., –ed and –s suffixes) by comparing the differences among EFL learners at different English levels. This research adopted a self-repair analysis and Prosodic Transfer Hypothesis with three developmental stages as a theoretical framework. To answer the research questions, we conducted two experiments, grammatical tense test written production (Experiment 1) and read-aloud oral production (Experiment 2), and recruited 30 participants who were divided into three groups, low-, middle-, and advanced EFL learners. Experiment 1 was conducted to ensure that participants had learned the knowledge of forming the English regular past tense rules and Experiment 2 was carried out to compare the data across FL English learner groups at different English levels. The EFL learners’ self-repair data showed at least four interesting findings. First, low achievers were more sensitive to the plural suffix -s than the past tense suffix -ed. Middle achievers exhibited a greater responsiveness to the past tense suffix, while high achievers demonstrated equal sensitivity to both suffixes. Additionally, two strategies used by EFL English learners to produce verbs and nouns with inflectional morphemes were to delete internal syllable and to divide a four-syllable verb (e.g., ‘graduated’) into two prosodic structures (e.g., ‘gradu’ and ‘ated’ or ‘gradua’ and ‘ted’). Third, true vowel epenthesis was found only in the low EFL achievers. Moreover fortition (native-like sound) was observed in the low and middle EFL achievers. These findings and self-repair data disclosed mediating processes between the developmental stages and provided insight on how Taiwan EFL learners attained the adjunction prosodic structures of inflectional Morphemes in English.

Keywords: inflectional morphology, prosodic structure, developmental trajectory, strategies and mediating processes, English as a foreign language

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Authors: Mike Yaw Osei-Atweneboana, John Asiedu Larbi, Edward Jenner Tettevi

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Background: The lymphatic filariasis (LF) control programme has been on-going in Ghana since 2000. This community-wide approach involves the use of ivermectin (IVM) and albendazole (ALB). Soil-transmitted helminth (STH) infections control is augmented within this programme; however, in areas where LF is not prevalent, albendazole alone is administered to school children. The purpose of this study was therefore, to determine the efficacy of albendazole against soils transmitted helminths and the impact of mass drug administration of albendazole and ivermectin on the health status of children of school going age and pregnant women. Material/Methods: This was a twelve months longitudinal study. A total of 412 subjects including school children (between the ages of 2-17 years) and pregnant women were randomly selected from four endemic communities in Kpandai district of the Northern region. Coprological assessment for parasites was based on the Kato–Katz technique in both dry and rainy seasons at baseline, 21 days and 3 months post-treatment. Single-dose albendazole treatment was administered to all patients at baseline. Preserved samples are currently under molecular studies to identify possible single nucleotide polymorphism (SNP) within the beta tubulin gene which is associated with benzimidazole resistance. Results: Of all the parasites found (hookworm, Trichuris trichiura, Hymenolepis nana, and Taenia sp.); hookworm was the most prevalent. In the dry season, the overall STHs prevalence at pre-treatment was 29%, while 9% and 13% prevalence was recorded at 21 days, and three months after treatment respectively. However, in the rainy season, the overall STHs prevalence was 8%, while 4% and 12% was recorded at 21 days and three months respectively after ALB treatment. In general, ALB treatment resulted in an overall hookworm egg count reduction rate of 89% in the dry season and 93% in the rainy season, while the T. trichiura egg count reduction rate was 100% in both seasons. Conclusions: STH infections still remains a significant public health burden in Ghana. Hookworm infection seems to respond poorly or sub-optimally to ALB, raising concerns of possible emergence of resistance which may lead to a major setback for the control and elimination of STH infections, especially hookworm infections.

Keywords: hookworm, sub-optimal response, albendazole, trichuriasis, soil-transmitted helminths

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Authors: Aiman Mazhar Qureshi, Ahmed Rachid

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Extreme heat events are emerging human environmental health concerns in dense urban areas due to anthropogenic activities. High spatial and temporal resolution heat maps are important for urban heat adaptation and mitigation, helping to indicate hotspots that are required for the attention of city planners. The Heat Vulnerability Index (HVI) is the important approach used by decision-makers and urban planners to identify heat-vulnerable communities and areas that require heat stress mitigation strategies. Amiens is a medium-sized French city, where the average temperature has been increasing since the year 2000 by +1°C. Extreme heat events are recorded in the month of July for the last three consecutive years, 2018, 2019 and 2020. Poor air quality, especially ground-level ozone, has been observed mainly during the same hot period. In this study, we evaluated the HVI in Amiens during extreme heat days recorded last three years (2018,2019,2020). The Principal Component Analysis (PCA) technique is used for fine-scale vulnerability mapping. The main data we considered for this study to develop the HVI model are (a) socio-economic and demographic data; (b) Air pollution; (c) Land use and cover; (d) Elderly heat-illness; (e) socially vulnerable; (f) Remote sensing data (Land surface temperature (LST), mean elevation, NDVI and NDWI). The output maps identified the hot zones through comprehensive GIS analysis. The resultant map shows that high HVI exists in three typical areas: (1) where the population density is quite high and the vegetation cover is small (2) the artificial surfaces (built-in areas) (3) industrial zones that release thermal energy and ground-level ozone while those with low HVI are located in natural landscapes such as rivers and grasslands. The study also illustrates the system theory with a causal diagram after data analysis where anthropogenic activities and air pollution appear in correspondence with extreme heat events in the city. Our suggested index can be a useful tool to guide urban planners and municipalities, decision-makers and public health professionals in targeting areas at high risk of extreme heat and air pollution for future interventions adaptation and mitigation measures.

Keywords: heat vulnerability index, heat mapping, heat health-illness, remote sensing, urban heat mitigation

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Authors: Philip Friedlander, John Rutledge, Jason Suh

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Inhibition of programmed death-1 (PD-1) or its ligand PD-L1 confers therapeutic efficacy in a wide range of solid tumor malignancies. Primary or acquired resistance can develop through activation of immunosuppressive immune cells such as tumor-associated macrophages. The renin angiotensin system (RAS) systemically regulates fluid and sodium hemodynamics, but components are expressed on and regulate the activity of immune cells, particularly of myeloid lineage. We hypothesized that inhibition of RAS would improve the efficacy of PD-1/PD-L-1 treatment. A retrospective analysis was performed through a chart review of patients with solid metastatic malignancies treated with a PD-1/PD-L1 inhibitor between 1/2013 and 6/2019 at Valley Hospital, a community hospital in New Jersey, USA. Efficacy was determined by medical oncologist documentation of clinical benefit in visit notes and by the duration of time on immunotherapy treatment. The primary endpoint was the determination of efficacy differences in patients treated with an inhibitor of RAS ( ace inhibitor, ACEi, or angiotensin blocker, ARB) compared to patients not treated with these inhibitors. To control for broader antihypertensive effects, efficacy as a function of treatment with beta blockers was assessed. 173 patients treated with PD-1/PD-L-1 inhibitors were identified of whom 52 were also treated with an ACEi or ARB. Chi-square testing revealed a statistically significant relationship between being on an ACEi or ARB and efficacy to PD-1/PD-L-1 therapy (p=0.001). No statistically significant relationship was seen between patients taking or not taking beta blocker antihypertensives (p= 0.33). Kaplan-Meier analysis showed statistically significant improvement in the duration of therapy favoring patients concomitantly treated with ACEi or ARB compared to patients not exposed to antihypertensives and to those treated with beta blockers. Logistic regression analysis revealed that age, gender, and cancer type did not have significant effects on the odds of experiencing clinical benefit (p=0.74, p=0.75, and p=0.81, respectively). We conclude that retrospective analysis of the treatment of patients with solid metastatic tumors with anti-PD-1/PD-L1 in a community setting demonstrates greater clinical benefit in the context of concomitant ACEi or ARB inhibition, irrespective of gender or age. This data supports the development of prospective assessment through randomized clinical trials.

Keywords: angiotensin, cancer, immunotherapy, PD-1, efficacy

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Authors: Jaime Leavitt, Katy Haralampides

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Numerical modelling has been used to investigate the long-term impact of a large dam on downstream wetland areas, specifically in terms of changing sediment dynamics in the system. The Mactaquac Generating Station (MQGS) is a 672MW run-of-the-river hydroelectric facility, commissioned in 1968 on the mainstem of the Wolastoq|Saint John River in New Brunswick, Canada. New Brunswick Power owns and operates the dam and has been working closely with the Canadian Rivers Institute at UNB Fredericton on a multi-year, multi-disciplinary project investigating the impact the dam has on its surrounding environment. With focus on the downstream river, this research discusses the initialization, set-up, calibration, and preliminary results of a 2-D hydrodynamic model using the Delft3d Flexible Mesh Suite (successor of the Delft3d 4 Suite). The flexible mesh allows the model grid to be structured in the main channel and unstructured in the floodplains and other downstream regions with complex geometry. The combination of grid types improves computational time and output. As the movement of water governs the movement of sediment, the calibrated and validated hydrodynamic model was applied to sediment transport simulations, particularly of the fine suspended sediments. Several provincially significant Protected Natural Areas and federally significant National Wildlife Areas are located 60km downstream of the MQGS. These broad, low-lying floodplains and wetlands are known as the Grand Lake Meadows Complex (GLM Complex). There is added pressure to investigate the impacts of river regulation on these protected regions that rely heavily on natural river processes like sediment transport and flooding. It is hypothesized that the fine suspended sediment would naturally travel to the floodplains for nutrient deposition and replenishment, particularly during the freshet and large storms. The purpose of this research is to investigate the impacts of river regulation on downstream environments and use the model as a tool for informed decision making to protect and maintain biologically productive wetlands and floodplains.

Keywords: hydrodynamic modelling, national wildlife area, protected natural area, sediment transport.

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Authors: Sylvain Perrin, Thomas Saillour

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The Grande-Motte port and seafront development project on the French Mediterranean coastline entailed evaluating wave impact loads (pressures and forces) on the new beach seawall and comparing the resulting scour potential at the base of the existing and new seawall. A physical model was built at ARTELIA’s hydraulics laboratory in Grenoble (France) to provide insight into the evolution of scouring overtime at the front of the wall, quasi-static and impulsive wave force intensity and distribution on the wall, and water and sand overtopping discharges over the wall. The beach was constituted of fine sand and approximately 50 m wide above mean sea level (MSL). Seabed slopes were in the range of 0.5% offshore to 1.5% closer to the beach. A smooth concrete structure will replace the existing concrete seawall with an elevated curved crown wall. Prior the start of breaking (at -7 m MSL contour), storm-driven maximum spectral significant wave heights of 2.8 m and 3.2 m were estimated for the benchmark historical storm event dated of 1997 and the 50-year return period storms respectively, resulting in 1 m high waves at the beach. For the wave load assessment, a tensor scale measured wave forces and moments and five piezo / piezo-resistive pressure sensors were placed on the wall. Light-weight sediment physical model and pressure and force measurements were performed with scale 1:18. The polyvinyl chloride light-weight particles used to model the prototype silty sand had a density of approximately 1 400 kg/m3 and a median diameter (d50) of 0.3 mm. Quantitative assessments of the seabed evolution were made using a measuring rod and also a laser scan survey. Testing demonstrated the occurrence of numerous impulsive wave impacts on the reflector (22%), induced not by direct wave breaking but mostly by wave run-up slamming on the top curved part of the wall. Wave forces of up to 264 kilonewtons and impulsive pressure spikes of up to 127 kilonewtons were measured. Maximum scour of -0.9 m was measured for the new seawall versus -0.6 m for the existing seawall, which is imputable to increased wave reflection (coefficient was 25.7 - 30.4% vs 23.4 - 28.6%). This paper presents a methodology for the setup and operation of a physical model in order to assess the hydrodynamic and morphodynamic processes at a beach seawall during storms events. It discusses the pros and cons of such methodology versus others, notably regarding structures peculiarities and model effects.

Keywords: beach, impacts, scour, seawall, waves

Procedia PDF Downloads 153

Authors: Anne C. Richer-De-Forges, Dominique Arrouays, Songchao Chen, Mercedes Roman Dobarco

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Most of the digital soil mapping (DSM) products rely on machine learning (ML) prediction models and/or the use or pedotransfer functions (PTF) in which calibration data come from soil analyses performed in labs. However, many other observations (often qualitative, nominal, or ordinal) could be used as proxies of lab measurements or as input data for ML of PTF predictions. DSM and ML are briefly described with some examples taken from the literature. Then, we explore the potential of an ordinal qualitative variable, i.e., the hand-feel soil texture (HFST) estimating the mineral particle distribution (PSD): % of clay (0-2µm), silt (2-50µm) and sand (50-2000µm) in 15 classes. The PSD can also be measured by lab measurements (LAST) to determine the exact proportion of these particle-sizes. However, due to cost constraints, HFST are much more numerous and spatially dense than LAST. Soil texture (ST) is a very important soil parameter to map as it is controlling many of the soil properties and functions. Therefore, comes an essential question: is it possible to use HFST as a proxy of LAST for calibration and/or validation of DSM predictions of ST? To answer this question, the first step is to compare HFST with LAST on a representative set where both information are available. This comparison was made on ca 17,400 samples representative of a French region (34,000 km2). The accuracy of HFST was assessed, and each HFST class was characterized by a probability distribution function (PDF) of its LAST values. This enables to randomly replace HFST observations by LAST values while respecting the PDF previously calculated and results in a very large increase of observations available for the calibration or validation of PTF and ML predictions. Some preliminary results are shown. First, the comparison between HFST classes and LAST analyses showed that accuracies could be considered very good when compared to other studies. The causes of some inconsistencies were explored and most of them were well explained by other soil characteristics. Then we show some examples applying these relationships and the increase of data to several issues related to DSM. The first issue is: do the PDF functions that were established enable to use HSFT class observations to improve the LAST soil texture prediction? For this objective, we replaced all HFST for topsoil by values from the PDF 100 time replicates). Results were promising for the PTF we tested (a PTF predicting soil water holding capacity). For the question related to the ML prediction of LAST soil texture on the region, we did the same kind of replacement, but we implemented a 10-fold cross-validation using points where we had LAST values. We obtained only preliminary results but they were rather promising. Then we show another example illustrating the potential of using HFST as validation data. As in numerous countries, the HFST observations are very numerous; these promising results pave the way to an important improvement of DSM products in all the countries of the world.

Keywords: digital soil mapping, improvement of digital soil mapping predictions, potential of using hand-feel soil texture, soil texture prediction

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Authors: Evelyn Marie Richmond, Andrew McBride, Chris Johnston, John Marley

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Background: Good quality patient information resources for orthognathic treatment help to reinforce information delivered during the initial consultation and help patients make informed decisions about their care. The Consultant Orthodontists and a Dental Core Trainee noted limited patient engagement with the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources and that the existing BOS patient information leaflet (PIL) could be customised and developed to meet local requirements. Aim: The quality improvement project (QIP) aimed to improve patients' understanding of orthognathic treatment by ensuring at least 90% of patients had read the new in-house patient information leaflet (PIL) and a minimum of 50% of patients had accessed the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources before attending the joint orthognathic multidisciplinary clinic by June 2023. Methods: The QIP was undertaken in the orthodontic department of the School of Dentistry, Belfast. Data was collected prospectively during a 6-month period from January 2023 to June 2023 over 3 Plan, Do, Study, Act (PDSA) cycles. Suitable patients were identified at consultant orthodontic new patient clinics. Following initial consultation for orthognathic treatment, patients were contacted to complete a patient questionnaire. Design: The change ideas were a poster with a QR code directing patients to the BOS 'Your Jaw Surgery' website in consultation areas and a new in-house PIL with a QR code directing patients to the BOS 'Your Jaw Surgery' website. Results: In PDSA cycle 1, 86.7% of patients were verbally directed to the BOS 'Your Jaw Surgery' website, and 53.3% accessed the online resources after their initial consultation. Although 100% of patients reported reading the existing PIL, only 64.3% felt it discussed the risks of orthognathic treatment in sufficient detail. By PDSA cycle 3, 100% of patients reported being directed to the BOS 'Your Jaw Surgery' website, however, only 58.3% engaged with the website. 100% of patients who read the new PIL felt that it discussed the risks of orthognathic treatment in sufficient detail. Conclusion: The slight improvement in access to the BOS 'Your Jaw Surgery' website shows that patients do not necessarily choose to access information online despite its availability. The uptake of the new PIL was greater than reported patient engagement with the BOS 'Your Jaw Surgery' website, which indicates patients still value written information despite the availability of online resources.

Keywords: orthognathic surgery, patient information resources, quality improvement project, risks

Procedia PDF Downloads 60