Search results for: academic learning integration

Authors: Sonia David, Uma Warrier

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Background: Film therapy is the use of commercial or non-commercial films to enhance healing for therapeutic purposes. Objectives: The mixed-method study aims to evaluate the effect of film-based counseling on body image dissatisfaction among adolescents to precisely ascertain the cause of the alteration in body image dissatisfaction due to the said intervention. Method: The one group pre-test post-test research design study using inferential statistics and thematic analysis is based on a pre-test post-test design conducted on 44 school-going adolescents between 13 and 17. The Body Shape Questionnaire (BSQ- 34) was used as a pre-test and post-test measure. The film-based counseling intervention model was used through individual counseling sessions. The analysis involved paired sample t-test used to examine the data quantitatively, and thematic analysis was used to evaluate qualitative data. Findings: The results indicated that there is a significant difference between the pre-test and post-test means. Since t(44)= 9.042 is significant at a 99% confidence level, it is ascertained that film-based counseling intervention reduces body image dissatisfaction. The five distinct themes from the thematic analysis are “acceptance, awareness, empowered to change, empathy, and reflective.” Novelty: The paper originally contributes to the repertoire of research on film therapy as a successful counseling intervention for addressing the challenges of body image dissatisfaction. This study also opens avenues for considering alteration of teaching pedagogy to include video-based learning in various subjects.

Keywords: body image dissatisfaction, adolescents, film-based counselling, film therapy, acceptance and commitment therapy

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Authors: Anisa Suraya Ab Razak, Izza Hayat

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Introduction: The diagnosis and management of severe hyponatremia in neuropsychiatric patients present a significant challenge to physicians. Several factors contribute, including diagnostic shadowing and attributing abnormal behavior to intellectual disability or psychiatric conditions. Hyponatraemia is the commonest electrolyte abnormality in the inpatient population, ranging from mild/asymptomatic, moderate to severe levels with life-threatening symptoms such as seizures, coma and death. There are several documented fatal case reports in the literature of severe hyponatremia secondary to psychogenic polydipsia, often diagnosed only in autopsy. This paper presents a case study of acute severe hyponatremia in a neuropsychiatric patient with early diagnosis and admission to intensive care. Case study: A 21-year old Caucasian male with known epilepsy and learning disability was admitted from residential living with generalized tonic-clonic self-terminating seizures after refusing medications for several weeks. Evidence of superficial head injury was detected on physical examination. His laboratory data demonstrated mild hyponatremia (125 mmol/L). Computed tomography imaging of his brain demonstrated no acute bleed or space-occupying lesion. He exhibited abnormal behavior - restlessness, drinking water from bathroom taps, inability to engage, paranoia, and hypersexuality. No collateral history was available to establish his baseline behavior. He was loaded with intravenous sodium valproate and leveritircaetam. Three hours later, he developed vomiting and a generalized tonic-clonic seizure lasting forty seconds. He remained drowsy for several hours and regained minimal recovery of consciousness. A repeat set of blood tests demonstrated profound hyponatremia (117 mmol/L). Outcomes: He was referred to intensive care for peripheral intravenous infusion of 2.7% sodium chloride solution with two-hourly laboratory monitoring of sodium concentration. Laboratory monitoring identified dangerously rapid correction of serum sodium concentration, and hypertonic saline was switched to a 5% dextrose solution to reduce the risk of acute large-volume fluid shifts from the cerebral intracellular compartment to the extracellular compartment. He underwent urethral catheterization and produced 8 liters of urine over 24 hours. Serum sodium concentration remained stable after 24 hours of correction fluids. His GCS recovered to baseline after 48 hours with improvement in behavior -he engaged with healthcare professionals, understood the importance of taking medications, admitted to illicit drug use and drinking massive amounts of water. He was transferred from high-dependency care to ward level and was initiated on multiple trials of anti-epileptics before achieving seizure-free days two weeks after resolution of acute hyponatremia. Conclusion: Psychogenic polydipsia is often found in young patients with intellectual disability or psychiatric disorders. Patients drink large volumes of water daily ranging from ten to forty liters, resulting in acute severe hyponatremia with mortality rates as high as 20%. Poor outcomes are due to challenges faced by physicians in making an early diagnosis and treating acute hyponatremia safely. A low index of suspicion of water intoxication is required in this population, including patients with known epilepsy. Monitoring urine output proved to be clinically effective in aiding diagnosis. Early referral and admission to intensive care should be considered for safe correction of sodium concentration while minimizing risk of fatal complications e.g. central pontine myelinolysis.

Keywords: epilepsy, psychogenic polydipsia, seizure, severe hyponatremia

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Authors: M. Bukowski, K. Kreissl

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Social and environmental pressures in our times bear threats that often cross-border in scale, such as climate change, poverty-driven migration, demographic change as well as socio-economic developments. One of the hot topics is prevailing in many societies across Europe and worldwide, concerns 'affordable housing' and poverty-driven international and domestic migration (including displacements through gentrification processes), focusing here on the urban and regional context. The right to adequate housing and shelter is one of the recognized in the Universal Declaration of Human rights and International Covenant on Economic, Social and Cultural Rights, and as such considered as a human right of the second generation. The decreasing supply of affordable housing, especially in urban areas, has reached dimensions that have led to an increasing 'housing crisis'. This crisis, which has even reached middle-income homes, has an even more devastating impact on low income and poor households raising poverty levels. Therefore, the understanding of the connection between housing and poverty is vital to integrate and support the different stakeholders in order to tackle poverty. When it comes to issues of inequalities and poverty within the SDG framework, multi-faceted stakeholders with different claims, distribution of resources and interactions with other development goals (spill-over and trade-offs) account for a highly complex context. To contribute to a sustainable and fair society and hence to support the UN Sustainable Development Goals, the University of Salzburg participates in the Austrian-wide universities' network 'UniNEtZ'. Our joint target is to develop an options report for the Austrian Government regarding the seventeen SDGs, so far hosted by 18 Austrian universities. In this vein, the University of Salzburg; i.e., the Centre for Ethics and Poverty Research, the departments of Geography and Geology and the Department of Sociology and Political Science are focusing on the SDG 1 (No Poverty) and SDG 10 (Reduced Inequalities). Our target and research focus is to assess and evaluate the status of SDG 1 and 10 in Austria, to find possible solutions and to support stakeholders' integration. We aim at generating and deducing appropriate options as scientific support, from interdisciplinary research studies to 'Sustainability Developing Goals and their Targets' in action. For this reason, and to deal with the complexity of the Agenda 2030, we have developed a special Model for Inequalities and Poverty Assessment (IPAM). Through the example of 'affordable housing' we provide insight into the situation focusing on sustainable outcomes, including ethical and justice perceptions. The IPAM has proven to be a helpful tool in detecting the different imponderables on the Agenda 2030, assessing the situation, showing gaps and options for ethical SDG actions combining different SDG targets. Supported by expert and expert group interviews, this assessment allows different stakeholders to overview a complex and dynamic SDG challenge (here housing) which is necessary to be involved in an action finding process.

Keywords: affordable housing, inequality, poverty, sustainable development goals

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Authors: Jamunarani Appalasamy, Tha Kyi Kyi, Quek Kia Fatt, Joyce Pauline Joseph, Anuar Zaini M. Zain

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Background: The Health Belief Theory had always been associated with chronic disease management. Various health behaviour concepts and perception branching from this Health Belief Theory had involved with medication understanding, use, and self-efficacy which directly link to medication adherence. In a previous quantitative and qualitative study, stroke patients in Malaysia were found to be strongly believing information obtained by various sources such as the internet and social communication. This action leads to lower perception of their stroke preventative medication benefit which in long-term creates non-adherence. Hence, this study intends to pilot an intervention which uses audio-visual concept incorporated with mHealth service to enhance learning and self-reflection among stroke patients to manage their disease. Methods/Design: Twenty patients will be allocated to a proposed intervention whereas another twenty patients are allocated to the usual treatment. The intervention involves a series of developed audio-visual videos sent via mobile phone which later await for responses and feedback from the receiver (patient) via SMS or recorded calls. The primary outcome would be the medication understanding, use and self-efficacy measured over two months pre and post intervention. Secondary outcome is measured from changes of blood parameters and other self-reported questionnaires. Discussion: This study shall also assess uptake/attrition, feasibility, and acceptability of this intervention. Trial Registration: NMRR-15-851-24737 (IIR)

Keywords: health belief, medication understanding, medication use, self-efficacy

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Authors: Zhu Weimin, Allegorico Carmine, Ruggiero Gionata

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During decades of Baker Hughes (BH) iCenter experience, it is demonstrated that in addition to conventional insights on equipment steady operation conditions, insights on transient conditions can add significant and exclusive value for anomaly detection, downtime saving, and predictive maintenance. Our work shows examples from the BH iCenter experience to introduce the advantages and features of using transient condition analytics: (i) Operation under critical engine conditions: e.g., high level or high change rate of temperature, pressure, flow, vibration, etc., that would not be reachable in normal operation, (ii) Management of dedicated sub-systems or components, many of which are often bottlenecks for reliability and maintenance, (iii) Indirect detection of anomalies in the absence of instrumentation, (iv) Repetitive sequences: if data is properly processed, the engineering features of transients provide not only anomaly detection but also problem characterization and prognostic indicators for predictive maintenance, (v) Engine variables accounting for fatigue analysis. iCenter has been developing and deploying a series of analytics based on transient conditions. They are contributing to exclusive value adding in the following areas: (i) Reliability improvement, (ii) Startup reliability improvement, (iii) Predictive maintenance, (iv) Repair/overhaul cost down. Illustrative examples for each of the above areas are presented in our study, focusing on challenges and adopted techniques ranging from purely statistical approaches to the implementation of machine learning algorithms. The obtained results demonstrate how the value is obtained using transient condition analytics in the BH iCenter experience.

Keywords: analytics, diagnostics, monitoring, turbomachinery

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Authors: Jaci Marie Mastrandrea, Rosario Haro

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Background: The National Comprehensive Cancer Network (NCCN) recommends that healthcare institutions have established processes for integrating palliative care (PC) into cancer treatment and that all cancer patients be screened for PC needs upon initial diagnosis as well as throughout the entire continuum of care (National Comprehensive Cancer Network, 2021). Early PC screening and intervention is directly associated with improved patient outcomes. The Sky Lakes Cancer Treatment Center (SLCTC) is an institution that has access to PC services yet does not have protocols in place for identifying patients with palliative needs or a standardized referral process. The aim of this quality improvement project was to improve early access to PC services by establishing a standardized screening and referral process for outpatient oncology patients. Method: The sample population included all adult patients with an oncology diagnosis who presented to the SLCTC for treatment during the project timeline. The “Palliative and Supportive Needs Assessment'' (PSNA) screening tool was developed from validated, evidence-based PC referral criteria. The tool was initially implemented using paper forms, and data was collected over a period of eight weeks. Patients were screened by nurses on the SLCTC oncology treatment team. Nurses responsible for screening patients received an educational inservice prior to implementation. Patients with a PSNA score of three or higher received an educational handout on the topic of PC and education about PC and symptom management. A score of five or higher indicates that PC referral is strongly recommended, and the patient’s EHR is flagged for the oncology provider to review orders for PC referral. The PSNA tool was approved by Sky Lakes administration for full integration into Epic-Beacon. The project lead collaborated with the Sky Lakes’ information systems team and representatives from Epic on the tool’s aesthetic and functionality within the Epic system. SLCTC nurses and physicians were educated on how to document the PSNA within Epic and where to view results. Results: Prior to the implementation of the PSNA screening tool, the SLCTC had zero referrals to PC in the past year, excluding referrals to hospice. Data was collected from the completed screening assessments of 100 patients under active treatment at the SLCTC. Seventy-three percent of patients met criteria for PC referral with a score greater than or equal to three. Of those patients who met referral criteria, 53.4% (39 patients) were referred for a palliative and supportive care consultation. Patients that were not referred to PC upon meeting criteria were flagged in EPIC for re-screening within one to three months. Patients with lung cancer, chronic hematologic malignancies, breast cancer, and gastrointestinal malignancy most frequently met the criteria for PC referral and scored highest overall on the scale of 0-12. Conclusion: The implementation of a standardized PC screening tool at the SLCTC significantly increased awareness of PC needs among cancer patients in the outpatient setting. Additionally, data derived from this quality improvement project supports the national recommendation for PC to be an integral component of cancer treatment across the entire continuum of care.

Keywords: oncology, palliative and supportive care, symptom management, outpatient oncology, palliative screening tool

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Authors: Kavitha Puthanveedu, Kasi Sekar, Preeti Jacob, Kavita Jangam

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In India, The Juvenile Justice (Care and Protection of Children) Act, 2015, the law related to children alleged and found to be in conflict with law, proposes to address to the rehabilitation of children in conflict with law by catering to the basic rights by providing care and protection, development, treatment, and social re-integration. A major concern in addressing the issues of children in conflict with law in Kerala the southernmost state in India identified were: 1. Lack of psychological assessment for children in conflict with law, 2. Poor psychosocial intervention for children in conflict with law on bail, 3. Lack of psychosocial intervention or proper care and protection of CCL residing at observation and special home, 4. Lack convergence with systems related with mental health care. Aim: To develop individual care plan for children in conflict with law. Methodology: NIMHANS a premier Institute of Mental Health and Neurosciences, collaborated with Social Justice Department, Govt. of Kerala to address this issue by developing a participatory methodology to implement psychosocial care in the existing services by integrating the activities through multidisciplinary and multisectoral approach as per the Sec. 18 of JJAct 2015. Developing individual care plan: Key informant interviews, focus group discussion with multiple stakeholders consisting of legal officers, police, child protection officials, counselors, and home staff were conducted. Case studies were conducted among children in conflict with law. A checklist on 80 psychosocial problems among children in conflict with law was prepared with eight major issues identified through the quantitative process such as family and parental characteristic, family interactions and relationships, stressful life event, social and environmental factors, child’s individual characteristics, education, child labour and high-risk behavior. Standardised scales were used to identify the anxiety, caseness, suicidality and substance use among the children. This provided a background data understand the psychosocial problems experienced by children in conflict with law. In the second stage, a detailed plan of action was developed involving multiple stakeholders that include Special juvenile police unit, DCPO, JJB, and NGOs. The individual care plan was reviewed by a panel of 4 experts working in the area of children, followed by the review by multiple stakeholders in juvenile justice system such as Magistrates, JJB members, legal cum probation officers, district child protection officers, social workers and counselors. Necessary changes were made in the individual care plan in each stage which was pilot tested with 45 children for a period of one month and standardized for administering among children in conflict with law. Result: The individual care plan developed through scientific process was standardized and currently administered among children in conflict with law in the state of Kerala in the 3 districts that will be further implemented in other 14 districts. The program was successful in developing a systematic approach for the psychosocial intervention of children in conflict with law that can be a forerunner for other states in India.

Keywords: psychosocial care, individual care plan, multidisciplinary, multisectoral

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Authors: Anastasios Papathanasiou, George Liontos, Athanasios Katsouras, Vasiliki Liagkou, Euripides Glavas

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Email remains a crucial communication tool due to its efficiency, accessibility and cost-effectiveness, enabling rapid information exchange across global networks. However, the global adoption of email has also made it a prime target for cyber threats, including phishing, malware and Business Email Compromise (BEC) attacks, which exploit its integral role in personal and professional realms in order to perform fraud and data breaches. To combat these threats, this research advocates for a multi-layered defense strategy incorporating advanced technological tools such as anti-spam and anti-malware software, machine learning algorithms and authentication protocols. Moreover, we developed an artificial intelligence model specifically designed to analyze email headers and assess their security status. This AI-driven model examines various components of email headers, such as "From" addresses, ‘Received’ paths and the integrity of SPF, DKIM and DMARC records. Upon analysis, it generates comprehensive reports that indicate whether an email is likely to be malicious or benign. This capability empowers users to identify potentially dangerous emails promptly, enhancing their ability to avoid phishing attacks, malware infections and other cyber threats.

Keywords: email security, artificial intelligence, header analysis, threat detection, phishing, DMARC, DKIM, SPF, ai model

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Authors: Kothuri Sriraman, Mattupalli Komal Teja

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In this paper, a novel algorithm is proposed for the recognition of hulls in a hand written images that might be irregular or digit or character shape. Identification of objects and internal objects is quite difficult to extract, when the structure of the image is having bulk of clusters. The estimation results are easily obtained while going through identifying the sub-regional objects by using the SASK algorithm. Focusing mainly to recognize the number of internal objects exist in a given image, so as it is shadow-free and error-free. The hard clustering and density clustering process of obtained image rough set is used to recognize the differentiated internal objects, if any. In order to find out the internal hull regions it involves three steps pre-processing, Boundary Extraction and finally, apply the Hull Detection system. By detecting the sub-regional hulls it can increase the machine learning capability in detection of characters and it can also be extend in order to get the hull recognition even in irregular shape objects like wise black holes in the space exploration with their intensities. Layered hulls are those having the structured layers inside while it is useful in the Military Services and Traffic to identify the number of vehicles or persons. This proposed SASK algorithm is helpful in making of that kind of identifying the regions and can useful in undergo for the decision process (to clear the traffic, to identify the number of persons in the opponent’s in the war).

Keywords: chain code, Hull regions, Hough transform, Hull recognition, Layered Outline Extraction, SASK algorithm

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Authors: Jianhong Xiang, Rui Sun, Linyu Wang

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In recent years, due to the continuous improvement of deep learning theory, Convolutional Neural Network (CNN) has played a great superior performance in the research of Hyperspectral Image (HSI) classification. Since HSI has rich spatial-spectral information, only utilizing a single dimensional or single size convolutional kernel will limit the detailed feature information received by CNN, which limits the classification accuracy of HSI. In this paper, we design a multi-scale CNN with MLP based on residual and attention modules (INRAM-3DCNN) for the HSI classification task. We propose to use multiple 3D convolutional kernels to extract the packet feature information and fully learn the spatial-spectral features of HSI while designing residual 3D convolutional branches to avoid the decline of classification accuracy due to network degradation. Secondly, we also design the 2D Inception module with a joint channel attention mechanism to quickly extract key spatial feature information at different scales of HSI and reduce the complexity of the 3D model. Due to the high parallel processing capability and nonlinear global action of the Multilayer Perceptron (MLP), we use it in combination with the previous CNN structure for the final classification process. The experimental results on two HSI datasets show that the proposed INRAM-3DCNN method has superior classification performance and can perform the classification task excellently.

Keywords: INRAM-3DCNN, residual, channel attention, hyperspectral image classification

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Authors: Hui Zhang, Ye Tian, Fang Ye, Ziming Guo

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Communication signal modulation recognition technology is one of the key technologies in the field of modern information warfare. At present, communication signal automatic modulation recognition methods are mainly divided into two major categories. One is the maximum likelihood hypothesis testing method based on decision theory, the other is a statistical pattern recognition method based on feature extraction. Now, the most commonly used is a statistical pattern recognition method, which includes feature extraction and classifier design. With the increasingly complex electromagnetic environment of communications, how to effectively extract the features of various signals at low signal-to-noise ratio (SNR) is a hot topic for scholars in various countries. To solve this problem, this paper proposes a feature extraction algorithm for the communication signal based on the improved Holder cloud feature. And the extreme learning machine (ELM) is used which aims at the problem of the real-time in the modern warfare to classify the extracted features. The algorithm extracts the digital features of the improved cloud model without deterministic information in a low SNR environment, and uses the improved cloud model to obtain more stable Holder cloud features and the performance of the algorithm is improved. This algorithm addresses the problem that a simple feature extraction algorithm based on Holder coefficient feature is difficult to recognize at low SNR, and it also has a better recognition accuracy. The results of simulations show that the approach in this paper still has a good classification result at low SNR, even when the SNR is -15dB, the recognition accuracy still reaches 76%.

Keywords: communication signal, feature extraction, Holder coefficient, improved cloud model

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Authors: Nina Leila Mussa

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Background: The devastating effects of the war on Syria’s educational infrastructure has been widely reported, with millions of children denied access. However, among those who resettled in Lebanon, the impact of receiving educational assistance on their abilities to pass the English entrance exam is not well described. The aim of this study was to identify predictors of success among Syrian refugees receiving English language courses in a Lebanese university. Methods: The database of Syrian refugee girls matriculated in English courses at the American University of Beirut (AUB) was reviewed. The study period was 7/2018-09/2020. Variables compared included: family size and income, welfare status, parents’ education, English proficiency, access to the internet, and need for external help with homework. Results: For the study period, there were 28 girls enrolled. The average family size was 6 (range 4-9), with eight having completed primary, 14 secondary education, and 6 graduated high school. Eighteen were single-income families. After 12 weeks of English courses, 16 passed the Test of English as Foreign Language (TOEFL) from the first attempt, and 12 failed. Out of the 12, 8 received external help, and 6 passed on the second attempt, which brings the total number of successful passing to 22. Conclusion: Despite the tragedy of war, girls receiving assistance in learning English in Lebanon are able to pass the basic language test. Investment in enhancing those educational experiences will be determinantal in achieving widespread progress among those at-risk children.

Keywords: refugee girls, TOEFL, education, success

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Authors: Sujeet Kumar

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Education has greater importance particularly in terms of increasing human capital and economic competitiveness. It plays a crucial role in terms of cognitive and skill development. Its plays a vital role in process of socialization, fostering social justice, and enhancing social cohesion. Policy related to education has been always a priority for developed countries, which is later adopted by developing countries also. The government of India has also brought change in education polices in line with recognizing change at national and supranational level. However, quality education is still not become an open door for every child in India and several reports are produced year to year about level of school education in India. This paper is concerned with schooling in India. Particularly, it focuses on two government and two private schools in Bihar, but reference has made to schools in Delhi especially around slum communities. The paper presents brief historical context and an overview of current school systems in India. Later, it focuses on analysis of current development in policy in reference with field observation, which is anchored around choice, diversity, market – orientation and gap between different groups of pupils. There is greater degree of difference observed at private and government school levels in terms of quality of teachers, method of teaching and overall environment of learning. The paper concludes that the recent policy development in education particularly Sarva Siksha Abhiyaan (SAA) and Right to Education Act (2009) has required renovating new approach to bridge the gap through broader consultation at grassroots and participatory approach with different stakeholders.

Keywords: education, public policy, participatory approach

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Authors: Rana Alaa El-Deen Ahmed, M. Elemam Shehab, Shereen Morsy, Nermeen Mekawie

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With the growing popularity and acceptance of e-commerce platforms, users face an ever increasing burden in actually choosing the right product from the large number of online offers. Thus, techniques for personalization and shopping guides are needed by users. For a pleasant and successful shopping experience, users need to know easily which products to buy with high confidence. Since selling a wide variety of products has become easier due to the popularity of online stores, online retailers are able to sell more products than a physical store. The disadvantage is that the customers might not find products they need. In this research the customer will be able to find the products he is searching for, because recommender systems are used in some ecommerce web sites. Recommender system learns from the information about customers and products and provides appropriate personalized recommendations to customers to find the needed product. In this paper eleven classification algorithms are comparatively tested to find the best classifier fit for consumer online shopping attitudes and behavior in the experimented dataset. The WEKA knowledge analysis tool, which is an open source data mining workbench software used in comparing conventional classifiers to get the best classifier was used in this research. In this research by using the data mining tool (WEKA) with the experimented classifiers the results show that decision table and filtered classifier gives the highest accuracy and the lowest accuracy classification via clustering and simple cart.

Keywords: classification, data mining, machine learning, online shopping, WEKA

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Authors: Virender Singh, Mathew Rees, Simon Hampton, Sivaram Annadurai

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Plant identification is a challenging task that aims to identify the family, genus, and species according to plant morphological features. Automated deep learning-based computer vision algorithms are widely used for identifying plants and can help users narrow down the possibilities. However, numerous morphological similarities between and within species render correct classification difficult. In this paper, we tested custom convolution neural network (CNN) and vision transformer (ViT) based models using the PyTorch framework to classify plants. We used a large dataset of 88,000 provided by the Royal Horticultural Society (RHS) and a smaller dataset of 16,000 images from the PlantClef 2015 dataset for classifying plants at genus and species levels, respectively. Our results show that for classifying plants at the genus level, ViT models perform better compared to CNN-based models ResNet50 and ResNet-RS-420 and other state-of-the-art CNN-based models suggested in previous studies on a similar dataset. ViT model achieved top accuracy of 83.3% for classifying plants at the genus level. For classifying plants at the species level, ViT models perform better compared to CNN-based models ResNet50 and ResNet-RS-420, with a top accuracy of 92.5%. We show that the correct set of augmentation techniques plays an important role in classification success. In conclusion, these results could help end users, professionals and the general public alike in identifying plants quicker and with improved accuracy.

Keywords: plant identification, CNN, image processing, vision transformer, classification

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Authors: Muhammad Zafarullah Khan, Sumeera Abbasi

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The Farmers Field School (FFS) learning approach aims to improve knowledge of the farmers through integrated crop management and provide leadership in their decision making process. The study was conducted to assess the impact of FFS on vegetables production before and after FFS intervention in four villages of district Peshawar in cropping season 2012, by interviewing 80 FFS respondents, twenty from each selected village. It was observed from the study results that all the respondents were satisfied from the impact of FFS and they informed an increased in production in vegetables. It was further observed that after the implementation of FFS the sowing seed rate of tomato and cucumber were decreased from 0.185kg/kanal to 0.100 kg/ kanal and 0.120kg/kanal to 0.010kg/kanal where as the production of tomato and cucumber were increased from 8158.75kgs/kanal to 10302. 5kgs/kanal and 3230kgs/kanal to 5340kgs/kanal, respectively. The cost of agriculture inputs per kanal including seed cost, crop management, Farm Yard Manure, and weedicides in case of tomato were reduced by Rs.28, Rs. 3170, Rs.658and Rs 205 whereas in cucumber reduced by Rs.35, Rs.570, Rs 80 and Rs.430 respectively. Only fertilizers cost was increased by Rs. 2200 in case of tomato and Rs 465 in case of cucumber. Overall the cost was reduced to Rs 545 in tomato and Rs 490 in cucumber production.FFS provided a healthy vegetables and also reduced input cost by adopting integrated crop management. Therefore the promotion of FFS is needed to be planned for farmers to reduce cost of production, so that the more farmers should be benefited.

Keywords: impact, farmer field schools, vegetable production, Peshawar Khyber Pakhtunkhwa

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Authors: Jameela Ali, Hamid A. Jalab, Loay E. George, Abdul Rahim Ahmad, Azizah Suliman, Karim Al-Jashamy

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Red blood cells (RBC) are the most common types of blood cells and are the most intensively studied in cell biology. The lack of RBCs is a condition in which the amount of hemoglobin level is lower than normal and is referred to as “anemia”. Abnormalities in RBCs will affect the exchange of oxygen. This paper presents a comparative study for various techniques for classifying the RBCs as normal, or abnormal (anemic) using WEKA. WEKA is an open source consists of different machine learning algorithms for data mining applications. The algorithm tested are Radial Basis Function neural network, Support vector machine, and K-Nearest Neighbors algorithm. Two sets of combined features were utilized for classification of blood cells images. The first set, exclusively consist of geometrical features, was used to identify whether the tested blood cell has a spherical shape or non-spherical cells. While the second set, consist mainly of textural features was used to recognize the types of the spherical cells. We have provided an evaluation based on applying these classification methods to our RBCs image dataset which were obtained from Serdang Hospital-alaysia, and measuring the accuracy of test results. The best achieved classification rates are 97%, 98%, and 79% for Support vector machines, Radial Basis Function neural network, and K-Nearest Neighbors algorithm respectively.

Keywords: K-nearest neighbors algorithm, radial basis function neural network, red blood cells, support vector machine

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Authors: Derjew Ayele Ejigu, Houde Song, Xiaojing Liu

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This work presents the particle swarm optimization trained neural network (PSO-NN) supervisory proportional integral derivative (PID) control method to monitor the pressurized water reactor (PWR) core power for safe operation. The proposed control approach is implemented on the transfer function of the PWR core, which is computed from the state-space model. The PWR core state-space model is designed from the neutronics, thermal-hydraulics, and reactivity models using perturbation around the equilibrium value. The proposed control approach computes the control rod speed to maneuver the core power to track the reference in a closed-loop scheme. The particle swarm optimization (PSO) algorithm is used to train the neural network (NN) and to tune the PID simultaneously. The controller performance is examined using integral absolute error, integral time absolute error, integral square error, and integral time square error functions, and the stability of the system is analyzed by using the Bode diagram. The simulation results indicated that the controller shows satisfactory performance to control and track the load power effectively and smoothly as compared to the PSO-PID control technique. This study will give benefit to design a supervisory controller for nuclear engineering research fields for control application.

Keywords: machine learning, neural network, pressurized water reactor, supervisory controller

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Authors: Arunima Verma, Padmabati Mondal

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Serotonin-receptor binding plays a key role in several neurological and biological processes, including mood, sleep, hunger, cognition, learning, and memory. In this article, we performed molecular dynamics simulation to examine the key residues that play an essential role in the binding of serotonin to the G-protein-coupled 5-HT₁ᴮ receptor (5-HT₁ᴮ R) via electrostatic interactions. An end-point free energy calculation method (MM-PBSA) determines the stability of the 5-HT1B R due to serotonin binding. The single-point mutation of the polar or charged amino acid residues (Asp129, Thr134) on the binding sites and the calculation of binding free energy validate the importance of these residues in the stability of the serotonin-receptor complex. Principal component analysis indicates the serotonin-bound 5-HT1BR is more stabilized than the apo-receptor in terms of dynamical changes. The difference dynamic cross-correlations map shows the correlation between the transmembrane and mini-Go, which indicates signal transduction happening between mini-Go and the receptor. Allosteric communication reveals the key nodes for signal transduction in 5-HT1BR. These results provide useful insights into the signal transduction pathways and mutagenesis study to regulate the functionality of the complex. The developed protocols can be applied to study local non-covalent interactions and long-range allosteric communications in any protein-ligand system for computer-aided drug design.

Keywords: allostery, CADD, MD simulations, MM-PBSA

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Authors: Kyu Jin Kim, Byung Kwan Oh, Hyo Seon Park

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The seismic responses-based structural health monitoring system has been performed to prevent seismic damage. Structural seismic damage of building is caused by the instantaneous stress concentration which is related with dynamic characteristic of earthquake. Meanwhile, seismic response analysis to estimate the dynamic responses of building demands significantly high computational cost. To prevent the failure of structural members from the characteristic of the earthquake and the significantly high computational cost for seismic response analysis, this paper presents an artificial neural network (ANN) based prediction model for dynamic responses of building considering specific time length. Through the measured dynamic responses, input and output node of the ANN are formed by the length of specific time, and adopted for the training. In the model, evolutionary radial basis function neural network (ERBFNN), that radial basis function network (RBFN) is integrated with evolutionary optimization algorithm to find variables in RBF, is implemented. The effectiveness of the proposed model is verified through an analytical study applying responses from dynamic analysis for multi-degree of freedom system to training data in ERBFNN.

Keywords: structural health monitoring, dynamic response, artificial neural network, radial basis function network, genetic algorithm

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Authors: Sandra Hartl, Meena Chavan

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This paper presents the outcome of a four year Ph.D. research on cross-cultural conflict management in transnational business relationships. An important and complex problem about managing conflicts that arise across cultures in business relationships is investigated, and conflict resolution strategies are identified. This paper particularly focuses on transnational relationships within a Chinese, German and Middle Eastern framework. Unlike many papers on this issue which have been built on experiments with international MBA students, this research provides real-life cases of cross-cultural conflicts which are not easy to capture. Its uniqueness is underpinned as the real case data was gathered by interviewing top executives at management positions in large multinational corporations through a qualitative case study method approach. This paper makes a valuable contribution to the theory of cross-cultural conflicts, and despite the sensitivity, this research primarily presents real-time business data about breaches of contracts between two counterparties engaged in transnational operating organizations. The overarching aim of this research is to identify the degree of significance for the cultural factors and the communication factors embedded in cross-cultural business conflicts. It questions from a cultural perspective what factors lead to the conflicts in each of the cases, what the causes are and the role of culture in identifying effective strategies for resolving international disputes in an increasingly globalized business world. The results of 20 face to face interviews are outlined, which were conducted, recorded, transcribed and then analyzed using the NVIVO qualitative data analysis system. The outcomes make evident that the factors leading to conflicts are broadly organized under seven themes, which are communication, cultural difference, environmental issues, work structures, knowledge and skills, cultural anxiety and personal characteristics. When evaluating the causes of the conflict it is to notice that these are rather multidimensional. Irrespective of the conflict types (relationship or task-based conflict or due to individual personal differences), relationships are almost always an element of all conflicts. Cultural differences, which are a critical factor for conflicts, result from different cultures placing different levels of importance on relationships. Communication issues which are another cause of conflict also reflect different relationships styles favored by different cultures. In identifying effective strategies for solving cross-cultural business conflicts this research identifies that solutions need to consider the national cultures (country specific characteristics), organizational cultures and individual culture, of the persons engaged in the conflict and how these are interlinked to each other. Outcomes identify practical dispute resolution strategies to resolve cross-cultural business conflicts in reference to communication, empathy and training to improve cultural understanding and cultural competence, through the use of mediation. To conclude, the findings of this research will not only add value to academic knowledge of cross-cultural conflict management across transnational businesses but will also add value to numerous cross-border business relationships worldwide. Above all it identifies the influence of cultures and communication and cross-cultural competence in reducing cross-cultural business conflicts in transnational business.

Keywords: business conflict, conflict management, cross-cultural communication, dispute resolution

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Authors: Qaisara Parveen, M. Imran Yousuf

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The purpose of this study was to find the effectiveness of the use of advance organizer model for enhancing meta-cognition of students in the subject of science. It was hypothesized that the students of experimental group taught through advance organizer model would show the better cognition than the students of control group taught through traditional teaching. The population of the study consisted of all secondary school students studying in government high school located in Rawalpindi. The sample of the study consisted of 50 students of 9th class of humanities group. The sample was selected on the basis of their pretest scores through matching, and the groups were randomly assigned for the treatment. The experimental group was taught through advance organizer model while the control group was taught through traditional teaching. The self-developed achievement test was used for the purpose of pretest and posttest. After collecting the pre-test score and post-test score, the data was analyzed and interpreted by use of descriptive statistics as mean and standard deviation and inferential statistics t-test. The findings indicate that students taught using advance organizers had a higher level of meta-cognition as compared to control group. Further, meta cognition level of boys was found higher than that of girls students. This study also revealed the fact that though the students at different meta-cognition level approached learning situations in a different manner, Advance organizer model is far superior to Traditional method of teaching.

Keywords: descriptive, experimental, humanities, meta-cognition, statistics, science

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Authors: Ewa M. Laskowska, Jorn Vatn

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Industry 4.0 focuses on digital optimization of industrial processes. The idea is to use extracted data in order to build a decision support model enabling use of those data for real time decision making. In terms of predictive maintenance, the desired decision support tool would be a model enabling prognostics of system's health based on the current condition of considered equipment. Within area of system prognostics and health management, a commonly used health indicator is Remaining Useful Lifetime (RUL) of a system. Because the RUL is a random variable, it has to be estimated based on available health indicators. Health indicators can be of different types and come from different sources. They can be process variables, equipment performance variables, data related to number of experienced failures, etc. The aim of this study is the analysis of performance variables of emergency shutdown valves (ESV) used in oil and gas industry. ESV is inspected periodically, and at each inspection torque and time of valve operation are registered. The data will be analyzed by means of machine learning or statistical analysis. The purpose is to investigate whether the available data could be used as a health indicator for a prognostic purpose. The second objective is to examine what is the most efficient way to incorporate the data into predictive model. The idea is to check whether the data can be applied in form of explanatory variables in Markov process or whether other stochastic processes would be a more convenient to build an RUL model based on the information coming from registered data.

Keywords: emergency shutdown valves, health indicator, prognostics, remaining useful lifetime, RUL

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Authors: Çağrı Bekir Baysal, Göktuğ Burak Çalık

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Armored vehicles may have different traction layouts as a result of terrain capabilities and mobility needs. Two main categories of layouts can be separated as wheeled and tracked. Tracked vehicles have superior off-road capabilities but what they gain on terrain performance they lose on mobility front. Wheeled vehicles on the other hand do not have as good terrain capabilities as tracked vehicles but they have superior mobility capabilities such as top speed, range and agility with respect to tracked vehicles. Conventional armored vehicles employ a diesel ICE as main power source. In these vehicles ICE is mechanically connected to the powertrain. This determines the ICE rpm as a result of speed and torque requested by the driver. ICE efficiency changes drastically with torque and speed required and conventional vehicles suffer in terms of fuel consumption because of this. Hybrid electric vehicles employ at least one electric motor in order to improve fuel efficiency. There are different types of hybrid vehicles but main types are Series Hybrid, Parallel Hybrid and Series-Parallel Hybrid. These vehicles introduce an electric motor for traction and also can have a generator electric motor for range extending purposes. Having an electric motor as the traction power source brings the flexibility of either using the ICE as an alternative traction source while it is in efficient range or completely separating the ICE from traction and using it solely considering efficiency. Hybrid configurations have additional advantages for armored vehicles in addition to fuel efficiency. Heat signature, silent operation and prolonged stationary missions can be possible with the help of the high-power battery pack that will be present in the vehicle for hybrid drivetrain. Because of the reasons explained, hybrid armored vehicles are becoming a target area for military and also for vehicle suppliers. In order to have a better idea and starting point when starting a hybrid armored vehicle design, hybrid drivetrain configuration has to be selected after performing a trade-off study. This study has to include vehicle mobility simulations, integration level, vehicle level and performance level criteria. In this study different hybrid traction configurations possible for an 8x8 vehicle is compared using above mentioned criteria set. In order to compare hybrid traction configurations ease of application, cost, weight advantage, reliability, maintainability, redundancy and performance criteria have been used. Performance criteria points have been defined with the help of vehicle simulations and tests. Results of these simulations and tests also help determining required tractive power for an armored vehicle including conditions like trench and obstacle crossing, gradient climb. With the method explained in this study, each configuration is assigned a point for each criterion. This way, correct configuration can be selected objectively for every application. Also, key aspects of armored vehicles, mine protection and ballistic protection will be considered for hybrid configurations. Results are expected to vary for different types of vehicles but it is observed that having longitudinal differential locking capability improves mobility and having high motor count increases complexity in general.

Keywords: armored vehicles, electric drivetrain, electric mobility, hybrid vehicles

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Authors: Benyapa Thitimapong

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Teenage pregnancy and adolescent mothers have become a matter of increasing concern in Thailand. Since adolescent mothers have been a big problem for two main consequences; health outcomes and socio-economic impacts. Adolescent mothers often endure poor living conditions; limited financial resources while also experience high stress, family instability, and limited educational opportunities. These disadvantages are negative and have long-term effects on adolescent mothers, their families, and the community. The majority of pregnant students and adolescent mothers dropped out of school after becoming pregnant, and some of them return to study again after they gave birth. This research aimed to explain the meaning of adolescent mothers who had undergone with childrearing and studying simultaneously after childbirth. A phenomenological qualitative approach was undertaken to investigate this study. The participants were 20 adolescent mothers each of whom became a mother and a student concurrently within less than 2 years after giving birth to a healthy baby and had also undergone the experience of childrearing and studying in non-formal education. In-depth interview was carried out for data collection, and the data were analyzed using content analysis method. ‘Learning to move forward’ was the meaning of adolescent mothers who experienced with childrearing and studying simultaneously. Their expressions were classified into two categories 1) having more responsibility, and 2) conceding and going on. The result of this study can be used as evidence for health care providers, especially nurses to facilitate and support pregnant adolescents and adolescent mothers to continue their education. Also, it can be used to guide policy to promote in all educational system to enable these groups to remain in school for their life-long success in the future.

Keywords: adolescent mothers, childrearing, studying, teenage pregnancy

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Authors: Laura Alvarez-Alonso, Francisco Garcia-Carro, Jorge Loredo

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Population growth and industrial development imply an increase in the energy demands and the problems caused by emissions of greenhouse effect gases, which has inspired the search for clean sources of energy. Hydrogen (H₂) is expected to play a key role in the world’s energy future by replacing fossil fuels. The properties of H₂ make it a green fuel that does not generate pollutants and supplies sufficient energy for power generation, transportation, and other applications. Supercritical Water Gasification (SCWG) represents an attractive alternative for the recovery of energy from wastes. SCWG allows conversion of a wide range of raw materials into a fuel gas with a high content of hydrogen and light hydrocarbons through their treatment at conditions higher than those that define the critical point of water (temperature of 374°C and pressure of 221 bar). Methane used as a transport fuel is another important gasification product. The number of different uses of gas and energy forms that can be produced depending on the kind of material gasified and type of technology used to process it, shows the flexibility of SCWG. This feature allows it to be integrated with several industrial processes, as well as power generation systems or waste-to-energy production systems. The final aim of this work is to study which conditions and equipment are the most efficient and advantageous to explore the possibilities to obtain streams rich in H₂ from oily wastes, which represent a major problem both for the environment and human health throughout the world. In this paper, the relative complexity of technology needed for feasible gasification process cycles is discussed with particular reference to the different feedstocks that can be used as raw material, different reactors, and energy recovery systems. For this purpose, a review of the current status of SCWG technologies has been carried out, by means of different classifications based on key features as the feed treated or the type of reactor and other apparatus. This analysis allows to improve the technology efficiency through the study of model calculations and its comparison with experimental data, the establishment of kinetics for chemical reactions, the analysis of how the main reaction parameters affect the yield and composition of products, or the determination of the most common problems and risks that can occur. The results of this work show that SCWG is a promising method for the production of both hydrogen and methane. The most significant choices of design are the reactor type and process cycle, which can be conveniently adopted according to waste characteristics. Regarding the future of the technology, the design of SCWG plants is still to be optimized to include energy recovery systems in order to reduce costs of equipment and operation derived from the high temperature and pressure conditions that are necessary to convert water to the SC state, as well as to find solutions to remove corrosion and clogging of components of the reactor.

Keywords: hydrogen production, organic wastes, supercritical water gasification, system integration, waste-to-energy

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Authors: M. Ciminello, I. Dimino, S. Ameduri, A. Concilio

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Improving aircraft's efficiency is one of the key elements of Aeronautics. Modern aircraft possess many advanced functions, such as good transportation capability, high Mach number, high flight altitude, and increasing rate of climb. However, no aircraft has a possibility to reach all of this optimized performance in a single airframe configuration. The aircraft aerodynamic efficiency varies considerably depending on the specific mission and on environmental conditions within which the aircraft must operate. Structures that morph their shape in response to their surroundings may at first seem like the stuff of science fiction, but take a look at nature and lots of examples of plants and animals that adapt to their environment would arise. In order to ensure both the controllable and the static robustness of such complex structural systems, a monitoring network is aimed at verifying the effectiveness of the given control commands together with the elastic response. In order to achieve this kind of information, the use of FBG sensors network is, in this project, proposed. The sensor network is able to measure morphing structures shape which may show large, global displacements due to non-standard architectures and materials adopted. Chord -wise variations may allow setting and chasing the best layout as a function of the particular and transforming reference state, always targeting best aerodynamic performance. The reason why an optical sensor solution has been selected is that while keeping a few of the contraindication of the classical systems (like cabling, continuous deployment, and so on), fibre optic sensors may lead to a dramatic reduction of the wires mass and weight thanks to an extreme multiplexing capability. Furthermore, the use of the ‘light’ as ‘information carrier’, permits dealing with nimbler, non-shielded wires, and avoids any kind of interference with the on-board instrumentation. The FBG-based transducers, herein presented, aim at monitoring the actual shape of adaptive trailing edge. Compared to conventional systems, these transducers allow more fail-safe measurements, by taking advantage of a supporting structure, hosting FBG, whose properties may be tailored depending on the architectural requirements and structural constraints, acting as strain modulator. The direct strain may, in fact, be difficult because of the large deformations occurring in morphing elements. A modulation transducer is then necessary to keep the measured strain inside the allowed range. In this application, chord-wise transducer device is a cantilevered beam sliding trough the spars and copying the camber line of the ATE ribs. FBG sensors array position are dimensioned and integrated along the path. A theoretical model describing the system behavior is implemented. To validate the design, experiments are then carried out with the purpose of estimating the functions between rib rotation and measured strain.

Keywords: fiber optic sensor, morphing structures, strain sensor, shape reconstruction

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Authors: Jessie Rapoza, Petr Moroshkin, Jimmy Xu

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Chirality is omnipresent, in nature, in life, and in the field of physics. One intriguing example is the homochirality that has remained a great secret of life. Another is the pairs of mirror-image molecules – enantiomers. They are identical in atomic composition and therefore indistinguishable in the scalar physical properties. Yet, they can be either therapeutic or toxic, depending on their chirality. Recent studies suggest a potential link between abnormal levels of certain D-amino acids and some serious health impairments, including schizophrenia, amyotrophic lateral sclerosis, and potentially cancer. Although indistinguishable in their scalar properties, the chirality of a molecule reveals itself in interaction with the surrounding of a certain chirality, or more generally, a broken mirror-symmetry. In this work, we report on a system for chiral molecule detection, in which the mirror-symmetry is doubly broken, first by asymmetric structuring a nanopatterned plasmonic surface than by the incidence of circularly polarized light (CPL). In this system, the incident circularly-polarized light induces a surface plasmon polariton (SPP) wave, propagating along the asymmetric plasmonic surface. This SPP field itself is chiral, evanescently bound to a near-field zone on the surface (~10nm thick), but with an amplitude greatly intensified (by up to 104) over that of the incident light. It hence probes just the molecules on the surface instead of those in the volume. In coupling to molecules along its path on the surface, the chiral SPP wave favors one chirality over the other, allowing for chirality detection via the change in an optical rectification current measured at the edges of the sample. The asymmetrically structured surface converts the high-frequency electron plasmonic-oscillations in the SPP wave into a net DC drift current that can be measured at the edge of the sample via the mechanism of optical rectification. The measured results validate these design concepts and principles. The observed optical rectification current exhibits a clear differentiation between a pair of enantiomers. Experiments were performed by focusing a 1064nm CW laser light at the sample - a gold grating microchip submerged in an approximately 1.82M solution of either L-arabinose or D-arabinose and water. A measurement of the current output was then recorded under both rights and left circularly polarized lights. Measurements were recorded at various angles of incidence to optimize the coupling between the spin-momentums of the incident light and that of the SPP, that is, spin-momentum locking. In order to suppress the background, the values of the photocurrent for the right CPL are subtracted from those for the left CPL. Comparison between the two arabinose enantiomers reveals a preferential signal response of one enantiomer to left CPL and the other enantiomer to right CPL. In sum, this work reports on the first experimental evidence of the feasibility of chiral molecule detection via optical rectification in a metal meta-grating. This nanoscale interfaced electrical detection technology is advantageous over other detection methods due to its size, cost, ease of use, and integration ability with read-out electronic circuits for data processing and interpretation.

Keywords: Chirality, detection, molecule, spin

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Authors: Sarah Reker, Christiane H. Kellner

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From the perspective of people with disabilities, inequalities can also emerge from spatial segregation, the lack of social contacts or limited economic resources. In order to reduce or even eliminate these disadvantages and increase general well-being, community-based participation as well as decentralisation efforts within exclusively residential homes is essential. Therefore, the new research project “Index for participation development and quality of life for persons with disabilities”(TeLe-Index, 2014-2016), which is anchored at the Technische Universität München in Munich and at a large residential complex and service provider for persons with disabilities in the outskirts of Munich aims to assist the development of community-based living environments. People with disabilities should be able to participate in social life beyond the confines of the institution. Since a diverse society is a society in which different individual needs and wishes can emerge and be catered to, the ultimate goal of the project is to create an environment for all citizens–regardless of disability, age or ethnic background–that accommodates their daily activities and requirements. The UN-Convention on the Rights of Persons with Disabilities, which Germany also ratified, postulates the necessity of user-centered design, especially when it comes to evaluating the individual needs and wishes of all citizens. Therefore, a multidimensional approach is required. Based on this insight, the structure of the town-like center will be remodeled to open up the community to all people. This strategy should lead to more equal opportunities and open the way for a much more diverse community. Therefore, macro-level research questions were inspired by quality of life theory and were formulated as follows for different dimensions: •The user dimension: what needs and necessities can we identify? Are needs person-related? Are there any options to choose from? What type of quality of life can we identify? The economic dimension: what resources (both material and staff-related) are available in the region? (How) are they used? What costs (can) arise and what effects do they entail? •The environment dimension: what “environmental factors” such as access (mobility and absence of barriers) prove beneficial or impedimental? In this context, we have provided academic supervision and support for three projects (the construction of a new school, inclusive housing for children and teenagers with disabilities and the professionalization of employees with person-centered thinking). Since we cannot present all the issues of the umbrella-project within the conference framework, we will be focusing on one project more in-depth, namely “Outpatient Housing Options for Children and Teenagers with Disabilities”. The insights we have obtained until now will enable us to present the intermediary results of our evaluation. The most central questions pertaining to this part of the research were the following: •How have the existing network relations been designed? •What meaning (or significance) does the existing service offers and structures have for the everyday life of an external residential group? These issues underpinned the environmental analyses as well as the qualitative guided interviews and qualitative network analyses we carried out.

Keywords: decentralisation, environmental analyses, outpatient housing options for children and teenagers with disabilities, qualitative network analyses

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Authors: Alaa Abdellatif, Gabrièle Breda

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Background. Advanced therapy medicinal products (ATMPs) are innovative therapies that mainly target orphan diseases and high unmet medical needs. ATMP includes gene therapy medicinal products (GTMP), somatic cell therapy medicinal products (CTMP), and tissue-engineered therapies (TEP). Since legislation opened the way in 2007, 25 ATMPs have been approved in the EU, which is about the same amount as the U.S. Food and Drug Administration. However, not all of the ATMPs that have been approved have successfully reached the market and retained their approval. Objectives. We aim to understand all the factors limiting the market access to very promising therapies in a systemic approach, to be able to overcome these problems, in the future, with scientific, regulatory and commercial innovations. Further to recent reviews that focus either on specific countries, products, or dimensions, we will address all the challenges faced by ATMP development today. Methodology. We used mixed methods and a multi-level approach for data collection. First, we performed an updated academic literature review on ATMP development and their scientific and market access challenges (papers published between 2018 and April 2023). Second, we analyzed industry feedback from cell and gene therapy webinars and white papers published by providers and pharmaceutical industries. Finally, we established a comparative analysis of the regulatory guidelines published by EMA and the FDA for ATMP approval. Results: The main challenges in bringing these therapies to market are the high development costs. Developing ATMPs is expensive due to the need for specialized manufacturing processes. Furthermore, the regulatory pathways for ATMPs are often complex and can vary between countries, making it challenging to obtain approval and ensure compliance with different regulations. As a result of the high costs associated with ATMPs, challenges in obtaining reimbursement from healthcare payers lead to limited patient access to these treatments. ATMPs are often developed for orphan diseases, which means that the patient population is limited for clinical trials which can make it challenging to demonstrate their safety and efficacy. In addition, the complex manufacturing processes required for ATMPs can make it challenging to scale up production to meet demand, which can limit their availability and increase costs. Finally, ATMPs face safety and efficacy challenges: dangerous adverse events of these therapies like toxicity related to the use of viral vectors or cell therapy, starting material and donor-related aspects. Conclusion. As a result of our mixed method analysis, we found that ATMPs face a number of challenges in their development, regulatory approval, and commercialization and that addressing these challenges requires collaboration between industry, regulators, healthcare providers, and patient groups. This first analysis will help us to address, for each challenge, proper and innovative solution(s) in order to increase the number of ATMPs approved and reach the patients

Keywords: advanced therapy medicinal products (ATMPs), product development, market access, innovation

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