Search results for: critical care transition program

Authors: A. Mostaani, M. P. Pereira, B. F. Rolfe

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The increasing application of Advanced High Strength Steel (AHSS) in the automotive industry to fulfill crash requirements has introduced higher levels of wear in stamping dies and parts. Therefore, understanding wear behaviour in sheet metal forming is of great importance as it can help to reduce the high costs currently associated with tool wear. At the contact between the die and the sheet, the tips of hard tool asperities interact with the softer sheet material. Understanding the deformation that occurs during this interaction is important for our overall understanding of the wear mechanisms. For these reasons, the scratching of a perfectly plastic material by a rigid indenter has been widely examined in the literature; with finite element modelling (FEM) used in recent years to further understand the behaviour. The ‘wear mode diagram’ has been commonly used to classify the deformation regime of the soft work-piece during scratching, into three modes: ploughing, wedge formation, and cutting. This diagram, which is based on 2D slip line theory and upper bound method for perfectly plastic work-piece and rigid indenter, relates different wear modes to attack angle and interfacial strength. This diagram has been the basis for many wear studies and wear models to date. Additionally, it has been concluded that galling is most likely to occur during the wedge formation mode. However, there has been little analysis in the literature of how the material behaviour and deformation conditions associated with metal forming processes influence the wear behaviour. Therefore, the first aim of this work is first to use a commercial FEM package (Abaqus/Explicit) to build a 3D model to capture wear modes during scratching with indenters with different attack angles and different interfacial strengths. The second goal is to utilise the developed model to understand how wear modes might change in the presence of bulk deformation of the work-piece material as a result of the metal forming operation. Finally, the effect of the work-piece material properties, including strain hardening, will be examined to understand how these influence the wear modes and wear behaviour. The results show that both strain hardening and substrate deformation can change the critical attack angle at which the wedge formation regime is activated.

Keywords: finite element, pile-up, scratch test, wear mode

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Authors: A. P. Pashkov

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The number of environmental factors that adversely affect children's health is growing every year; their combination in each territory is different. The contribution of socio-economic factors to the health status of the younger generation is increasing. It is the child’s body that is most sensitive to changes in environmental conditions, responding to this with a deterioration in health. Over the past years, scientists have determined the influence of environmental factors and the incidence of children. Currently, there is a tendency to study regional characteristics of the interaction of a combination of environmental factors with the child's body. The aim of the work was to identify trends in the primary non-infectious morbidity of the children of the Altai Territory as a unique region that combines territories with different levels of environmental quality indicators, as well as to assess the effect of atmospheric air, drinking water and socio-economic indicators on the incidence of children in the region. An unfavorable tendency has been revealed in the region for incidence of such nosological groups as neoplasms, including malignant ones, diseases of the endocrine system, including obesity and thyroid disease, diseases of the circulatory system, digestive diseases, diseases of the genitourinary system, congenital anomalies, and respiratory diseases. Between some groups of diseases revealed a pattern of geographical distribution during mapping and a significant correlation. Some nosologies have a relationship with socio-economic indicators for an integrated assessment: circulatory system diseases, respiratory diseases (direct connection), endocrine system diseases, eating disorders, and metabolic disorders (feedback). The analysis of associations of the incidence of children with average annual concentrations of substances that pollute the air and drinking water showed the existence of reliable correlation in areas of critical and intense degree of environmental quality. This fact confirms that the population living in contaminated areas is subject to the negative influence of environmental factors, which immediately affects the health status of children. The results obtained indicate the need for a detailed assessment of the influence of environmental factors on the incidence of children in the regional aspect, the formation of a database, and the development of automated programs that can predict the incidence in each specific territory. This will increase the effectiveness, including economic of preventive measures.

Keywords: incidence of children, regional features, socio-economic factors, environmental factors

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Authors: Bilge Ozel

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Cities are high-complex living organisms and are subjects to continuous transformations produced by the stress that derives from changing conditions. Today the metropolises are seen like “development engines” of the countries and accordingly they become the centre of better living conditions that encourages demographic growth which constitutes the main reason of the changes. Indeed, the potential for economic advancement of the cities directly represents the economic status of their countries. The term of “resilience”, which sees the changes as natural processes and represents the flexibility and adaptability of the systems in the face of changing conditions, becomes a key concept for the development of urban transformation policies. The term of “resilience” derives from the Latin word ‘resilire’, which means ‘bounce’, ‘jump back’, refers to the ability of a system to withstand shocks and still maintain the basic characteristics. A resilient system does not only survive the potential risks and threats but also takes advantage of the positive outcomes of the perturbations and ensures adaptation to the new external conditions. When this understanding is taken into the urban context - or rather “urban resilience” - it delineates the capacity of cities to anticipate upcoming shocks and changes without undergoing major alterations in its functional, physical, socio-economic systems. Undoubtedly, the issue of coordinating the urban systems in a “resilient” form is a multidisciplinary and complex process as the cities are multi-layered and dynamic structures. The concept of “urban transformation” is first launched in Europe just after World War II. It has been applied through different methods such as renovation, revitalization, improvement and gentrification. These methods have been in continuous advancement by acquiring new meanings and trends over years. With the effects of neoliberal policies in the 1980s, the concept of urban transformation has been associated with economic objectives. Subsequently this understanding has been improved over time and had new orientations such as providing more social justice and environmental sustainability. The aim of this research is to identify the most applied urban transformation methods in Turkey and its main reasons of being selected. Moreover, investigating the lacking and limiting points of the urban transformation policies in the context of “urban resilience” in a comparative way with European interventions. The emblematic examples, which symbolize the breaking points of the recent evolution of urban transformation concepts in Europe and Turkey, are chosen and reviewed in a critical way.

Keywords: resilience, urban dynamics, urban resilience, urban transformation

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Authors: Danny Barash

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Riboswitches are RNA genetic control elements that were originally discovered in bacteria and provide a unique mechanism of gene regulation. They work without the participation of proteins and are believed to represent ancient regulatory systems in the evolutionary timescale. One of the biggest challenges in riboswitch research is that many are found in prokaryotes but only a small percentage of known riboswitches have been found in certain eukaryotic organisms. The few examples of eukaryotic riboswitches were identified using sequence-based bioinformatics search methods that include some slight structural considerations. These pattern-matching methods were the first ones to be applied for the purpose of riboswitch detection and they can also be programmed very efficiently using a data structure called affix arrays, making them suitable for genome-wide searches of riboswitch patterns. However, they are limited by their ability to detect harder to find riboswitches that deviate from the known patterns. Several methods have been developed since then to tackle this problem. The most commonly used by practitioners is Infernal that relies on Hidden Markov Models (HMMs) and Covariance Models (CMs). Profile Hidden Markov Models were also carried out in the pHMM Riboswitch Scanner web application, independently from Infernal. Other computational approaches that have been developed include RMDetect by the use of 3D structural modules and RNAbor that utilizes Boltzmann probability of structural neighbors. We have tried to incorporate more sophisticated secondary structure considerations based on RNA folding prediction using several strategies. The first idea was to utilize window-based methods in conjunction with folding predictions by energy minimization. The moving window approach is heavily geared towards secondary structure consideration relative to sequence that is treated as a constraint. However, the method cannot be used genome-wide due to its high cost because each folding prediction by energy minimization in the moving window is computationally expensive, enabling to scan only at the vicinity of genes of interest. The second idea was to remedy the inefficiency of the previous approach by constructing a pipeline that consists of inverse RNA folding considering RNA secondary structure, followed by a BLAST search that is sequence-based and highly efficient. This approach, which relies on inverse RNA folding in general and our own in-house fragment-based inverse RNA folding program called RNAfbinv in particular, shows capability to find attractive candidates that are missed by Infernal and other standard methods being used for riboswitch detection. We demonstrate attractive candidates found by both the moving-window approach and the inverse RNA folding approach performed together with BLAST. We conclude that structure-based methods like the two strategies outlined above hold considerable promise in detecting riboswitches and other conserved RNAs of functional importance in a variety of organisms.

Keywords: riboswitches, RNA folding prediction, RNA structure, structure-based methods

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Authors: Mustafa M. Donma, Orkide Donma

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Metabolisms of macrominerals, those of calcium, phosphorus and magnesium, are closely associated with the metabolism of vitamin D. Particularly magnesium, the second most abundant intracellular cation, is related to biochemical and metabolic processes in the body, such as those of carbohydrates, proteins and lipids. The status of each mineral was investigated in obesity to some extent. Their products and ratios may possibly give much more detailed information about the matter. The aim of this study is to investigate possible relations between each macromineral and some obesity-related parameters. This study was performed on 235 children, whose ages were between 06-18 years. Aside from anthropometric measurements, hematological analyses were performed. TANITA body composition monitor using bioelectrical impedance analysis technology was used to establish some obesity-related parameters including basal metabolic rate (BMR), total fat, mineral and muscle masses. World Health Organization body mass index (BMI) percentiles for age and sex were used to constitute the groups. The values above 99^th percentile were defined as morbid obesity. Those between 95^th and 99^th percentiles were included into the obese group. The overweight group comprised of children whose percentiles were between 95 and 85. Children between the 85^th and 15^th percentiles were defined as normal. Metabolic syndrome (MetS) components (waist circumference, fasting blood glucose, triacylglycerol, high density lipoprotein cholesterol, systolic pressure, diastolic pressure) were determined. High performance liquid chromatography was used to determine Vitamin D status by measuring 25-hydroxy cholecalciferol (25-hydroxy vitamin D₃, 25(OH)D). Vitamin D values above 30.0 ng/ml were accepted as sufficient. SPSS statistical package program was used for the evaluation of data. The statistical significance degree was accepted as p < 0.05. The important points were the correlations found between vitamin D and magnesium as well as phosphorus (p < 0.05) that existed in the group with normal BMI values. These correlations were lost in the other groups. The ratio of phosphorus to magnesium was even much more highly correlated with vitamin D (p < 0.001). The negative correlation between magnesium and total fat mass (p < 0.01) was confined to the MetS group showing the inverse relationship between magnesium levels and obesity degree. In this group, calcium*magnesium product exhibited the highest correlation with total fat mass (p < 0.001) among all groups. Only in the MetS group was a negative correlation found between BMR and calcium*magnesium product (p < 0.05). In conclusion, magnesium is located at the center of attraction concerning its relationships with vitamin D, fat mass and MetS. The ratios and products derived from macrominerals including magnesium have pointed out stronger associations other than each element alone. Final considerations have shown that unique correlations of magnesium as well as calcium*magnesium product with total fat mass have drawn attention particularly in the MetS group, possibly due to the derangements in some basic elements of carbohydrate as well as lipid metabolism.

Keywords: macrominerals, metabolic syndrome, pediatric obesity, vitamin D

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Authors: Wilfred Emmannuel Dzasu, Sani Usman Kunya, Inuwa Yusuf Mohammed, Moses Jonathan Gambo

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The research aimed at investigating and identifying the strategies for enhancing access to microfinance for housing provision in the informal sector of North East Nigeria, with a focus on addressing the critical issue of housing poverty and lack of access to affordable housing finance among low-income households in the informal sector. The study employed an exploratory sequential mixed method design, combining both qualitative and quantitative data collection and analysis techniques. In the qualitative phase, 12 participants from microfinance institutions (MFIs) in four selected states (Adamawa, Bauchi, Gombe, and Taraba) were interviewed. The interviews were conducted using an interview guide with open-ended questions and were recorded with the consent of the respondents. In the quantitative phase, a survey strategy was adopted to collect data from 500 questionnaires distributed to informal sector workers (ISWs) in the study area. A total of 350 questionnaires were returned, representing a 70.0% response rate. The most preferred strategy for improving access to housing microfinance among ISWs is aggressive awareness of housing financing options by MFIs, with a mean score of 4.213; the most important strategy for improving access to housing microfinance among MFIs is close monitoring and adequate supervision of housing loan beneficiaries by MFIs, with a mean score of 4.675. The study identified several government-related strategies that are necessary for enhancing access to housing microfinance, including the provision of grants and subsidized intervention funds for housing, improvement in infrastructures to aid housing developments, and adequate measures for checking inflation/price fluctuation of building materials. The study also identified several MFI-related strategies that are necessary for enhancing access to housing microfinance, including deliberate expansion in the capital bases of MFIs, adequate training and capacity development of MFIs staff on relevant skills in housing micro-financing, and introduction of loan products that suit the incremental building needs of informal sector workers. Overall, the study highlights the need for a combination of government-related and MFI-related strategies to enhance access to microfinance for housing provision in the informal sector of North East Nigeria.

Keywords: finanace, microfinance, housing, North East Nigeria

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Authors: Umut Tuğlu Karslı

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While, port function had a major role during the antiquity and medieval times, it has started to lose its significance in 19th century. In many port cities, while heavy industrial functions and ports have been moved out of the former port districts, the resulting derelict spaces have been transformed to new waterfront quarters to accommodate commercial, tourism, cultural, residential and public uses. Primary aim of these operations is to revitalize abandoned spaces of historical potential and re-establish a relationship between the city and the coast. Karakoy Port, field of this study, located in the Bosphorus, was surrounded by the city centre in time due to the transformation of urban functions, and as a result it has lost its former significance. While Karakoy has 24 hours lively residential and commercial uses in old times; in early 1980s, became a district of mechanical, plumbing and electronic parts suppliers during the day and a place for homeless at night. Today, activities for revitalization of this region continue in two forms and scales. First of these activities is the "planned transformation projects," which also includes the most important one “Galataport project”, and the second one is "spontaneous transformation," which consists of individual interventions. Galataport project that based on the idea of arranging the area specifically for tourists was prepared in 2005 and became a topic of tremendous public debate. On the other hand, the "spontaneous transformation" that is observed in the Karakoy District starts in 2004 with the foundation of “Istanbul Modern Museum”. Istanbul Modern, the first contemporary arts museum of the city, allowed the cultural integration of old naval warehouses of the port to the daily life. Following this adaptive reuse intervention, the district started to accommodate numerous art galleries, studios, café-workshops and design stores. In this context, this paper briefly examines revitalization studies in obsolete port regions, analyzes the planned and ongoing socio-spatial transformations in the specific case of Karakoy under the subjects of "planned transformation projects" and "spontaneous transformation", and realizes a critical review of the sustainability of the proposals on how to reinstate the district in the active life of Istanbul.

Keywords: port cities, socio-spatial transformation, urban regeneration, urban revitalization

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Authors: Sandra Maria Cerqueira Da Silva

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The construction of the material world involves a series of social power relations. These relations, in a way, can dictate, shape, judge and drive the profiles of so-called ‘ideal’ individuals. Gender relations, as power relations, are defined based on hierarchies, obediences and inequalities, and male domination seems, with few exceptions, to be rooted in every society around the world. The profile of the Brazilian woman, beyond patriarchal and market determinations, is strongly subjected to media products. Women are, numerically, the majority in Brazilian society. The social indicators point to slight advances in terms of years of study and professional qualification, as well as access to the job market; yet, differences in opportunity and conditions — often explained though the ‘unquestionable’ cultural rancidness argument — still hinder women’s ability to reach and keep job positions. These unequalities are also visible in everyday interactions and in gender relations, and they become greater once race is added to the analysis. For a black woman, her racial origins may play a part in determining the construction of her gender roles. In these terms, there is need to investigate the racial character of the sexual differences within a larger social proccess of naturalization and justification of cultural hierarchies. Thus, the goal of this study is to identify and discuss the media-built image of black women in Brazil. Furthermore, it is necessary to seek views different than those of the ruling classes. The study uses a qualitative approach based on the feminist standpoint, which intends to hold women’s experiences as central. The body of the research — images taken from the Internet — was treated through critical content analysis. The results show that in Brazil the profile of black women, beyond the machist and sexist generalizations, objectifies them or sees them as servants, always at the disposal of non-blacks. It is necessary to overcome the history of this nation, always considering the contribution of these women to the growth and development of places and societies. This can be done through the acknowledgement and highlighting of the few black women who were able to overcome the many barriers in their path and reach leadership position in the country. There are still many important challenges in the way of finding affirmative policies and reaching a more equal society in terms of gender and race; a serious and firm political commitment seems sine qua non.

Keywords: black woman, feminist standpoint, markings, objectification

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Authors: Iman Jabbar

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Within the scope of professionalism and in order to compete with the modern world, teachers, are expected to develop their teaching skills and activities in addition to their professional knowledge. At the college level, the teacher should be able to face classroom challenges through his engagement with the learning situation to understand the students and their needs. In our field of TESOL, the role of the English teacher is no longer restricted to teaching English texts, but rather he should endeavor to enhance the students’ skills such as communication and critical analysis. Within the literature of professionalism, there are certain strategies and tools that an English teacher should adopt to develop his competence and performance. Reflective practice, which is an exploratory process, is one of these strategies. Another strategy contributing to classroom development is motivation. It is crucial in students’ learning as it affects the quality of learning English in the classroom in addition to determining success or failure as well as language achievement. This is a qualitative study grounded on interpretive perspectives of teachers and students regarding the process of professional development. This study aims at (a) understanding how teachers at the college level conceptualize reflective practice and motivation inside EFL classroom, and (b) exploring the methods and strategies that they implement to practice reflection and motivation. This study and is based on two questions: 1. How do EFL teachers perceive and view reflection and motivation in relation to their teaching and professional development? 2. How can reflective practice and motivation be developed into practical strategies and actions in EFL teachers’ professional context? The study is organized into two parts, theoretical and practical. The theoretical part reviews the literature on the concept of reflective practice and motivation in relation to professional development through providing certain definitions, theoretical models, and strategies. The practical part draws on the theoretical one, however; it is the core of the study since it deals with two issues. It involves the research design, methodology, and methods of data collection, sampling, and data analysis. It ends up with an overall discussion of findings and the researcher's reflections on the investigated topic. In terms of significance, the study is intended to contribute to the field of TESOL at the academic level through the selection of the topic and investigating it from theoretical and practical perspectives. Professional development is the path that leads to enhancing the quality of teaching English as a foreign or second language in a way that suits the modern trends of globalization and advanced technology.

Keywords: professional development, motivation, reflection, learning

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Authors: Seval Kula-Kartal

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Developing students’ reading comprehension skills is an aim that is difficult to accomplish and requires to follow long-term and systematic teaching and assessment processes. In these processes, teachers need tools to provide guidance to them on what reading comprehension is and which comprehension skills they should develop. Due to a lack of clear and evidence-based frameworks defining reading comprehension skills, especially in Turkiye, teachers and students mostly follow various processes in the classrooms without having an idea about what their comprehension goals are and what those goals mean. Since teachers and students do not have a clear view of comprehension targets, strengths, and weaknesses in students’ comprehension skills, the formative feedback processes cannot be managed in an effective way. It is believed that detecting and defining influential comprehension skills may provide guidance both to teachers and students during the feedback process. Therefore, in the current study, some of the reading comprehension frameworks that define comprehension skills operationally were examined. The aim of the study is to develop a simple and clear framework that can be used by teachers and students during their teaching, learning, assessment, and feedback processes. The current study is qualitative research in which documents related to reading comprehension skills were analyzed. Therefore, the study group consisted of recourses and frameworks which made big contributions to theoretical and operational definitions of reading comprehension. A content analysis was conducted on the resources included in the study group. To determine the validity of the themes and sub-categories revealed as the result of content analysis, three educational assessment experts were asked to examine the content analysis results. The Fleiss’ Cappa coefficient revealed that there is consistency among themes and categories defined by three different experts. The content analysis of the reading comprehension frameworks revealed that comprehension skills could be examined under four different themes. The first and second themes focus on understanding information given explicitly or implicitly within a text. The third theme includes skills used by the readers to make connections between their personal knowledge and the information given in the text. Lastly, the fourth theme focus on skills used by readers to examine the text with a critical view. The results suggested that fundamental reading comprehension skills can be examined under four themes. Teachers are recommended to use these themes in their reading comprehension teaching and assessment processes. Acknowledgment: This research is supported by Pamukkale University Scientific Research Unit within the project, whose title is Developing A Reading Comprehension Rubric.

Keywords: reading comprehension, assessing reading comprehension, comprehension taxonomies, educational assessment

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Authors: Meifang Chen

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Background: As China increased its engagement in global health affairs and research, global Health (GH) emerged as a new discipline in China after 2010. Duke Kunshan University (DKU), as a member of the Chinese Consortium of Universities for Global Health, is the first university that experiments “Western-style” liberal arts and sciences (LAS) education pedagogy in GH undergraduate and postgraduate programs in China since 2014. The COVID-19 pandemic has brought significant disruption to education across the world. At the peak of the pandemic, 45 countries in the Europe and Central Asia regions closed their schools, affecting 185 million students. DKU, as many other universities and schools, was unprepared for this sudden abruptness and were forced to build emergency remote learning systems almost immediately. This qualitative study aims to gain a deeper understanding of 1) how Chinese students and parents embrace GH training in the liberal arts and sciences education context, and 2) how the COVID pandemic influences the students’ learning experience as well as affects students and parents’ perceptions of GH-related study and career development in China. Methods: students and parents at DKU were invited and recruited for open-ended, semi-structured interviews during Sept 2021-Mar 2022. Open coding procedures and thematic content analysis were conducted using Nvivo 12 software. Results: A total of 18 students and 36 parents were interviewed. Both students and parents were fond of delivering GH education using the liberal arts and sciences pedagogy. Strengths of LAS included focusing on whole person development, allowing personal enrichment, tailoring curriculum to individual’s interest, providing well-rounded knowledge through interdisciplinary learning, and increasing self-study capacity and adaptability. Limitations of LAS included less time to dive deep into disciplines. There was a significant improvement in independence, creativity, problem solving, and team coordinating capabilities among the students. The impact of the COVID pandemic on GH learning experience included less domestic and abroad fieldwork opportunities, less in-person interactions (especially with foreign students and faculty), less timely support, less lab experience, and coordination challenges due to time-zone difference. The COVID pandemic increased the public’s awareness of the importance of GH and acceptance of GH as a career path. More job and postgraduate program opportunities were expected in near future. However, some parents expressed concerns about GH-related employment opportunities in China. Conclusion: The application of the liberal arts and science education pedagogy in GH training were well-received by the Chinese students and parents. Although global pandemic like COVID disrupted GH learning in many ways, most Chinese students and parents held optimistic attitudes toward GH study and career development.

Keywords: COVID, global health, liberal arts and sciences pedagogy, China

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Authors: Frank Dorrian, Aniket Adhikari

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The placenta accreta spectrum (PAS), which includes placenta accreta, increta, and percreta, is characterized by the abnormal implantation of placental chorionic villi beyond the decidua basalis. Key risk factors include placenta previa, prior cesarean sections, advanced maternal age, uterine surgeries, multiparity, pelvic radiation, and in vitro fertilization (IVF). The incidence of PAS has increased tenfold over the past 50 years, largely due to rising cesarean rates. PAS is associated with significant peripartum and postpartum hemorrhage. Magnetic resonance imaging (MRI) and ultrasound assist in the evaluation of PAS, enabling a multidisciplinary approach to mitigate morbidity and mortality. This study retrospectively analyzed PAS cases at Royal Prince Alfred Hospital, Sydney, Australia. Using the SAR-ESUR joint consensus statement, seven imaging signs were reassessed for their sensitivity and specificity in predicting PAS, with histopathological correlation. The standardized MRI protocols for PAS at the institution were also reviewed. Data were collected from the picture archiving and communication system (PACS) records from 2010 to July 2024, focusing on cases where MR imaging and confirmed histopathology or operative notes were available. This single-center, observational study provides insights into the reliability of MRI for PAS detection and the optimization of imaging protocols for accurate diagnosis. The findings demonstrate that intraplacental dark bands serve as highly sensitive markers for diagnosing PAS, achieving sensitivities of 88.9%, 85.7%, and 100% for placenta accreta, increta, and percreta, respectively, with a combined specificity of 42.9%. Sensitivity for abnormal vascularization was lower (33.3%, 28.6%, and 50%), with a specificity of 57.1%. The placenta bulge exhibited sensitivities of 55.5%, 57.1%, and 100%, with a specificity of 57.1%. Loss of the T2 hypointense interface had sensitivities of 66.6%, 85.7%, and 100%, with 42.9% specificity. Myometrial thinning showed high sensitivity across PAS conditions (88.9%, 71.4%, and 100%) and a specificity of 57.1%. Bladder wall thinning was sensitive only for placenta percreta (50%) but had a specificity of 100%. Focal exophytic mass displayed variable sensitivity (22.9%, 42.9%, and 100%) with a specificity of 85.7%. These results highlight the diagnostic variability among markers, with intraplacental dark bands and myometrial thinning being useful in detecting abnormal placentation, though they lack high specificity. The literature and the results of our study highlight that while no single feature can definitively diagnose PAS, the presence of multiple features -especially when combined with elevated clinical risk- significantly increases the likelihood of an underlying PAS. A thorough understanding of the range of MRI findings associated with PAS, along with awareness of the clinical significance of each sign, helps the radiologist more accurately diagnose the condition and assist in surgical planning, ultimately improving patient care.

Keywords: placenta, accreta, spectrum, MRI

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Authors: Xiaoyu Sun

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In recent years, the rapid development of Artificial Intelligence (AI) has extensively promoted medicine, pharmaceutical, and other related fields. The medical research and development of artificial intelligence by scientific and commercial organizations are on the fast track. The ethics review is one of the critical procedures of registration to get the products approved and launched. However, the SOPs for ethics review is not enough to guide the healthy and rapid development of artificial intelligence in healthcare in China. Ethical Review Measures for Biomedical Research Involving Human Beings was enacted by the National Health Commission of the People's Republic of China (NHC) on December 1st, 2016. However, from a legislative design perspective, it was neither updated timely nor in line with the trends of AI international development. Therefore, it was great that NHC published a consultation paper on the updated version on March 16th, 2021. Based on the most updated laws and regulations in the States and EU, and in-depth-interviewed 11 subject matter experts in China, including lawmakers, regulators, and key members of ethics review committees, heads of Regulatory Affairs in SaMD industry, and data scientists, several suggestions were proposed on top of the updated version. Although the new version indicated that the Ethics Review Committees need to be created by National, Provincial and individual institute levels, the review authorities of different levels were not clarified. The suggestion is that the precise scope of review authorities for each level should be identified based on Risk Analysis and Management Model, such as the complicated leading technology, gene editing, should be reviewed by National Ethics Review Committees, it will be the job of individual institute Ethics Review Committees to review and approve the clinical study with less risk such as an innovative cream to treat acne. Furthermore, to standardize the research and development of artificial intelligence in healthcare in the age of AI, more clear guidance should be given to data security in the layers of data, algorithm, and application in the process of ethics review. In addition, transparency and responsibility, as two of six principles in the Rome Call for AI Ethics, could be further strengthened in the updated version. It is the shared goal among all countries to manage well and develop AI to benefit human beings. Learned from the other countries who have more learning and experience, China could be one of the most advanced countries in artificial intelligence in healthcare.

Keywords: biomedical research involving human beings, data security, ethics committees, ethical review, medical artificial intelligence

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Authors: A. S. Ibrahim Mamane, S. Giljean, M.-J. Pac, G. L’Hostis

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Fiber reinforced composite laminates are particularly subject to residual stresses due to their heterogeneity and the complex chemical, mechanical and thermal mechanisms that occur during their processing. Residual stresses are now well known to cause damage accumulation, shape instability, and behavior disturbance in composite parts. Many works exist in the literature on techniques for minimizing residual stresses in thermosetting and thermoplastic composites mainly. To study in-depth the influence of processing mechanisms on the formation of residual stresses and to minimize them by establishing a reliable correlation, it is essential to be able to measure very precisely the profile of residual stresses in the composite. Residual stresses are important data to consider when sizing composite parts and predicting their behavior. The incremental hole drilling is very effective in measuring the gradient of residual stresses in composite laminates. This method is semi-destructive and consists of drilling incrementally a hole through the thickness of the material and measuring relaxation strains around the hole for each increment using three strain gauges. These strains are then converted into residual stresses using a matrix of coefficients. These coefficients, called calibration coefficients, depending on the diameter of the hole and the dimensions of the gauges used. The reliability of the incremental hole drilling depends on the accuracy with which the calibration coefficients are determined. These coefficients are calculated using a finite element model. The samples’ features and the experimental conditions must be considered in the simulation. Any mismatch can lead to inadequate calibration coefficients, thus introducing errors on residual stresses. Several calibration coefficient correction methods exist for isotropic material, but there is a lack of information on this subject concerning composite laminates. In this work, a Python program was developed to automatically generate the adequate finite element model. This model allowed us to perform a parametric study to assess the influence of experimental errors on the calibration coefficients. The results highlighted the sensitivity of the calibration coefficients to the considered errors and gave an order of magnitude of the precisions required on the experimental device to have reliable measurements. On the basis of these results, improvements were proposed on the experimental device. Furthermore, a numerical method was proposed to correct the calibration coefficients for different types of materials, including thick composite parts for which the analytical approach is too complex. This method consists of taking into account the experimental errors in the simulation. Accurate measurement of the experimental errors (such as eccentricity of the hole, angular deviation of the gauges from their theoretical position, or errors on increment depth) is therefore necessary. The aim is to determine more precisely the residual stresses and to expand the validity domain of the incremental hole drilling technique.

Keywords: fiber reinforced composites, finite element simulation, incremental hole drilling method, numerical correction of the calibration coefficients, residual stresses

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Authors: Md Monirul Islam, Shahaduz Zaman, Mosarraf H. Sarker

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Context: Medical waste management (MWM) is a critical sector in Bangladesh due to its impact on human health and the environment. There is a need to assess the current policies and identify the role of policy actors in the policy formulation and implementation process. Research Aim: The study aimed to evaluate the role of policy actors in the medical waste management policy-making process in Bangladesh, identify policy gaps, and provide actionable recommendations for improvement. Methodology: The study adopted a qualitative research method and conducted key informant interviews. The data collected were analyzed using the thematic coding approach through Atlas.ti software. Findings: The study found that policies are formulated at higher administrative levels and implemented in a top-down approach. Higher-level institutions predominantly contribute to policy development, while lower-level institutions focus on implementation. However, due to negligence, ignorance, and lack of coordination, medical waste management receives insufficient attention from the actors. The study recommends the need for immediate strategies, a comprehensive action plan, regular policy updates, and inter-ministerial meetings to enhance medical waste management practices and interventions. Theoretical Importance: The research contributes to evaluating the role of policy actors in medical waste management policymaking and implementation in Bangladesh. It identifies policy gaps and provides actionable recommendations for improvement. Data Collection: The study used key informant interviews as the data collection method. Thirty-six participants were interviewed, including influential policymakers and representatives of various administrative spheres. Analysis Procedures: The data collected was analyzed using the inductive thematic analysis approach. Question Addressed: The study aimed to assess the role of policy actors in medical waste management policymaking and implementation in Bangladesh. Conclusion: In conclusion, the study provides insights into the current medical waste management policy in Bangladesh, the role of policy actors in policy formulation and implementation, and the need for improved strategies and policy updates. The findings of this study can guide future policy-making efforts to enhance medical waste management practices and interventions in Bangladesh.

Keywords: key informant, medical waste management, policy maker, qualitative study

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Authors: Milena Trojanowska

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Disability is a phenomenon for which meanings and definitions have evolved over the decades. This became the trigger to start a project to answer the question of what disability constitutes in the course of an incurable chronic disease. The chosen research group are people living with multiple sclerosis.The contextual phase of the research was participant observation at the Polish Multiple Sclerosis Society, the largest NGO in Poland supporting people living with MS and their relatives. The research techniques used in the project are (in order of implementation): group interviews with people living with MS and their relatives, narrative interviews, asynchronous technique, participant observation during events organised for people living with MS and their relatives.The researcher is currently conducting follow-up interviews, as inaccuracies in the respondents' narratives were identified during the data analysis. Interviews and supplementary research techniques were used over the four years of the research, and the researcher also benefited from experience gained from 12 years of working with NGOs (diaries, notes). The research was carried out in Poland with the participation of people living in this country only.The research has been based on grounded theory methodology in a constructivist perspectivedeveloped by Kathy Charmaz. The goal was to follow the idea that research must be reliable, original, and useful. The aim was to construct an interpretive theory that assumes temporality and the processualityof social life. TheAtlas.ti software was used to collect research material and analyse it. It is a program from the CAQDAS(Computer-Assisted Qualitative Data Analysis Software) group.Several key factors influencing the construction of a disability identity by people living with multiple sclerosis was identified:-course of interaction with significant relatives,- the expectation of identification with disability (expressed by close relatives),- economic profitability (pension, allowances),- institutional advantages (e.g. parking card),- independence and autonomy (not equated with physical condition, but access to adapted infrastructure and resources to support daily functioning),- the way a person with MS construes the meaning of disability,- physical and mental state,- medical diagnosis of illness.In addition, it has been shown that making an assumption about the experience of disability in the course of MS is a form of cognitive reductionism leading to further phenomenon such as: the expectation of the person with MS to construct a social identity as a person with a disability (e.g. giving up work), the occurrence of institutional inequalities. It can also be a determinant of the choice of a life strategy that limits social and individual functioning, even if this necessity is not influenced by the person's physical or psychological condition.The results of the research are important for the development of knowledge about the phenomenon of disability. It indicates the contextuality and complexity of the disability phenomenon, which in the light of the research is a set of different phenomenon of heterogeneous nature and multifaceted causality. This knowledge can also be useful for institutions and organisations in the non-governmental sector supporting people with disabilities and people living with multiple sclerosis.

Keywords: disability, multiple sclerosis, grounded theory, poland

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Authors: M. Shahin Alam, Satoru Takahashi, Mariko Itoh, Miyuki Komura, Mayuko Suzuki, Natthanan Sangsriratanakul, Kazuaki Takehara

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Cleaning and disinfection are key components of routine biosecurity in livestock farming and food processing industry. The usage of suitable disinfectants and their proper concentration are important factors for a successful biosecurity program. Disinfectants have optimum bactericidal and virucidal efficacies at temperatures above 20°C, but very few studies on application and effectiveness of disinfectants at low temperatures have been done. In the present study, the bactericidal efficacies of food additive grade calcium hydroxide (FdCa(OH)), quaternary ammonium compound (QAC) and their mixture, were investigated under different conditions, including time, organic materials (fetal bovine serum: FBS) and temperature, either in suspension or in carrier test. Salmonella Infantis and Escherichia coli, which are the most prevalent gram negative bacteria in commercial poultry housing and food processing industry, were used in this study. Initially, we evaluated these disinfectants at two different temperatures (4°C and room temperature (RT) (25°C ± 2°C)) and 7 contact times (0, 5 and 30 sec, 1, 3, 20 and 30 min), with suspension tests either in the presence or absence of 5% FBS. Secondly, we investigated the bactericidal efficacies of these disinfectants by carrier tests (rubber, stainless steel and plastic) at same temperatures and 4 contact times (30 sec, 1, 3, and 5 min). Then, we compared the bactericidal efficacies of each disinfectant within their mixtures, as follows. When QAC was diluted with redistilled water (dW2) at 1: 500 (QACx500) to obtain the final concentration of didecyl-dimethylammonium chloride (DDAC) of 200 ppm, it could inactivate Salmonella Infantis within 5 sec at RT either with or without 5% FBS in suspension test; however, at 4°C it required 30 min in presence of 5% FBS. FdCa(OH)2 solution alone could inactivate bacteria within 1 min both at RT and 4°C even with 5% FBS. While FdCa(OH)2 powder was added at final concentration 0.2% to QACx500 (Mix500), the mixture could inactivate bacteria within 30 sec and 5 sec, respectively, with or without 5% FBS at 4°C. The findings from the suspension test indicated that low temperature inhibited the bactericidal efficacy of QAC, whereas Mix500 was effective, regardless of short contact time and low temperature, even with 5% FBS. In the carrier test, single disinfectant required bit more time to inactivate bacteria on rubber and plastic surfaces than on stainless steel. However, Mix500 could inactivate S. Infantis on rubber, stainless steel and plastic surfaces within 30 sec and 1 min, respectively, at RT and 4°C; but, for E. coli, it required only 30 sec at both temperatures. So, synergistic effects were observed on different carriers at both temperatures. For a successful enhancement of biosecurity during winter, the disinfectants should be selected that could have short contact times with optimum efficacy against the target pathogen. The present study findings help farmers to make proper strategies for application of disinfectants in their livestock farming and food processing industry.

Keywords: carrier, food additive grade calcium hydroxide (FdCa(OH)₂), quaternary ammonium compound, synergistic effects

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Authors: John Zanetich

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Due to their positive associations with student learning and retention, certain undergraduate opportunities are designated ‘high-impact.’ High-Impact Practices (HIPs) such as, learning communities, community based projects, research, internships, study abroad and culminating senior experience, share several traits bin common: they demand considerable time and effort, learning occurs outside of the classroom, and they require meaningful interactions between faculty and students, they encourage collaboration with diverse others, and they provide frequent and substantive feedback. As a result of experiential learning in these practices, participation in these practices can be life changing. High impact learning helps individuals locate tacit knowledge, and build mental models that support the accumulation of knowledge. On-going learning from experience and knowledge conversion provides the individual with a way to implicitly organize knowledge and share knowledge over a lifetime. Knowledge conversion is a knowledge management component which focuses on the explication of the tacit knowledge that exists in the minds of students and that knowledge which is embedded in the process and relationships of the classroom educational experience. Knowledge conversion is required when working with tacit knowledge and the demand for a learner to align deeply held beliefs with the cognitive dissonance created by new information. Knowledge conversion and tacit knowledge result from the fact that an individual's way of knowing, that is, their core belief structure, is considered generalized and tacit instead of explicit and specific. As a phenomenon, tacit knowledge is not readily available to the learner for explicit description unless evoked by an external source. The development of knowledge–related capabilities such as Aggressive Development of Tacit Knowledge (ADTK) can be used in experiential educational programs to enhance knowledge, foster behavioral change, improve decision making, and overall performance. ADTK allows the student in HIPs to use their existing knowledge in a way that allows them to evaluate and make any necessary modifications to their core construct of reality in order to amalgamate new information. Based on the Lewin/Schein Change Theory, the learner will reach for tacit knowledge as a stabilizing mechanism when they are challenged by new information that puts them slightly off balance. As in word association drills, the important concept is the first thought. The reactionary outpouring to an experience is the programmed or tacit memory and knowledge of their core belief structure. ADTK is a way to help teachers design their own methods and activities to unfreeze, create new learning, and then refreeze the core constructs upon which future learning in a subject area is built. This paper will explore the use of ADTK as a technique for knowledge conversion in the classroom in general and in HIP programs specifically. It will focus on knowledge conversion in curriculum development and propose the use of one-time educational experiences, multi-session experiences and sequential program experiences focusing on tacit knowledge in educational programs.

Keywords: tacit knowledge, knowledge management, college programs, experiential learning

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Authors: M. A. Hafiz, P. T. Matevenga

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Micro-level machining of metals is a developing field which has shown to be a prospective approach to produce features on the parts in the range of a few to a few hundred microns with acceptable machining quality. It is known that the mechanics (i.e. the material removal mechanism) of micro-machining and conventional machining have significant differences due to the scaling effects associated with tool-geometry, tool material and work piece material characteristics. Shape memory alloys (SMAs) are those metal alloys which display two exceptional properties, pseudoelasticity and the shape memory effect (SME). Nickel-titanium (NiTi) alloys are one of those unique metal alloys. NiTi alloys are known to be difficult-to-cut materials specifically by using conventional machining techniques due to their explicit properties. Their high ductility, high amount of strain hardening, and unusual stress–strain behaviour are the main properties accountable for their poor machinability in terms of tool wear and work piece quality. The motivation of this research work was to address the challenges and issues of micro-machining combining with those of machining of NiTi alloy which can affect the desired performance level of machining outputs. To explore the significance of range of cutting conditions on surface roughness and tool wear, machining tests were conducted on NiTi. Influence of different cutting conditions and cutting tools on surface and sub-surface deformation in work piece was investigated. Design of experiments strategy (L9 Array) was applied to determine the key process variables. The dominant cutting parameters were determined by analysis of variance. These findings showed that feed rate was the dominant factor on surface roughness whereas depth of cut found to be dominant factor as far as tool wear was concerned. The lowest surface roughness was achieved at the feed rate of equal to the cutting edge radius where as the lowest flank wear was observed at lowest depth of cut. Repeated machining trials have yet to be carried out in order to observe the tool life, sub-surface deformation and strain induced hardening which are also expecting to be amongst the critical issues in micro machining of NiTi. The machining performance using different cutting fluids and strategies have yet to be studied.

Keywords: nickel titanium, micro-machining, surface roughness, machinability

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Authors: Akmez Nabeerasool, Michaelis Massaros, Nigel Brown, David Sanderson, David Parocki, Charlotte Thompson, Mike Lodge, Mikael Khan

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The provision of clean and safe drinking water is of paramount importance and is a basic human need. Water scarcity coupled with tightening of regulations and the inability of current treatment technologies to deal with emerging contaminants and Pharmaceuticals and personal care products means that alternative treatment technologies that are viable and cost effective are required in order to meet demand and regulations for clean water supplies. Logistically, the application of water treatment in rural areas presents unique challenges due to the decentralisation of abstraction points arising from low population density and the resultant lack of infrastructure as well as the need to treat water at the site of use. This makes it costly to centralise treatment facilities and hence provide potable water direct to the consumer. Furthermore, across the UK there are segments of the population that rely on a private water supply which means that the owner or user(s) of these supplies, which can serve one household to hundreds, are responsible for the maintenance. The treatment of these private water supply falls on the private owners, and it is imperative that a chemical free technological solution that can operate unattended and does not produce any waste is employed. Arvia’s patented advanced oxidation technology combines the advantages of adsorption and electrochemical regeneration within a single unit; the Organics Destruction Cell (ODC). The ODC uniquely uses a combination of adsorption and electrochemical regeneration to destroy organics. Key to this innovative process is an alternative approach to adsorption. The conventional approach is to use high capacity adsorbents (e.g. activated carbons with high porosities and surface areas) that are excellent adsorbents, but require complex and costly regeneration. Arvia’s technology uses a patent protected adsorbent, Nyex™, which is a non-porous, highly conductive, graphite based adsorbent material that enables it to act as both the adsorbent and as a 3D electrode. Adsorbed organics are oxidised and the surface of the Nyex™ is regenerated in-situ for further adsorption without interruption or replacement. Treated water flows from the bottom of the cell where it can either be re-used or safely discharged. Arvia™ Technology Ltd. has trialled the application of its tertiary water treatment technology in treating reservoir water abstracted near Glasgow, Scotland, with promising results. Several other pilot plants have also been successfully deployed at various locations in the UK showing the suitability and effectiveness of the technology in removing recalcitrant organics (including pharmaceuticals, steroids and hormones), COD and colour.

Keywords: Arvia™ process, adsorption, water treatment, electrochemical oxidation

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Authors: Daphney Nozizwe Conco, Jonathan Levin, Boitumelo Komane, Sharon Fonn

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Background: South Africa is globally renowned for its reproductive rights framework. Despite the progressive abortion legislation, evidence points to limited access to safe abortion due to stigma, provider opposition, and lack of trained providers. Consequently, women resort to informal abortion providers and later present with incomplete abortion (ICA) at public hospitals. 20 years after the passing of the Choice for Termination of Pregnancy Act (CTOPA), we hypothesized that the incidence of ICA and abortion-related morbidity would change, influenced by access to safe abortion care and the availability of medication abortion. The aim was to generate data that could be compared with the results of similar studies conducted in 1994 and 2000. Objectives: The research objectives were to determine the number of women who presented with ICA to public hospitals, to describe their characteristics, to categorize medical complications according to severity, and to describe treatment provided to them at South African public hospitals. Methods: This is a cross-sectional retrospective medical record review study. A stratified random sample of public hospitals was selected. Data was extracted from the medical records of women who presented with incomplete abortions to sampled public hospitals in 2018. Data was captured directly into a REDCap database. To estimate the national prevalence of incomplete abortions, we used population estimates for 2018 comprising 17,199,227 women aged 12-49 years and 1,200,436 live births. Results: We found 913 medical records of women who presented with ICA to the 52 sampled hospitals. The women’s mean age of 27 years, and most had a previous pregnancy. These results were similar in the three studies (2018, 2000, and 1994). A greater proportion of women admitted with a gestation between 0-12 weeks seem to be on the increase, 60.5% in 1994, 67.1% in 2000, and 73.9% in 2024. We found an ICA incidence of 362 (269-455) per 100 000 women aged 12­49 years, which was the same as the 2000 incidence of 362 (282­441) but lower than the incidence of 375 (299­451) in 1994. Signs of infection decreased over time: 79.5% in 1994, 90.1% in 2000, and 92.5% in 2018 had no signs of infection. Similarly, 95.6% in 1994, 97.1% in 2000 and 99.1% in 2018 recorded no organ failure. Conclusion: A trend of lower infection rates was observed, suggesting that women are getting safer abortions, possibly from informal providers. However, the lack of change in ICA incidence indicates that the implementation of CTOPA has failed. It is safe to conclude that the legislation has made no significant impact on women’s health and rights. The implications of such failure are profound, as South Africa has not effectively implemented the act, which has important consequences for women’s health and rights.

Keywords: incomplete abortion, abortion-related morbidity, safe-abortion, South Africa public health, sexual and reproductive health rights, women’s health

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Authors: Giovana Vesentini, Fernanda Piculo, Gabriela Marini, Debora Damasceno, Angelica Barbosa, Selma Martheus, Marilza Rudge

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Problem statement: Skeletal muscle is highly adaptable, muscle fiber composition and size can respond to a variety of stimuli, such physiologic, as pregnancy, and metabolic abnormalities, as Diabetes mellitus. This study aimed to analyze the effects of pregnancy-associated diabetes on the rectus abdominis muscle (RA), and to compare this changes in rats and women. Methods: Female Wistar rats were maintained under controlled conditions and distributed in Pregnant (P) and Long-term mild pregnant diabetic (LTMd) (n=3 r/group). Diabetes in rats was induced by streptozotocin (100mg/Kg, sc) on the first day of life, for a hyperglycemic state between 120-300 mg/dL in adult life. Female rats were mated overnight, at day 21 of pregnancy were anesthetized, and killed for the harvesting of maternal RA. Pregnant women who attended the Diabetes Prenatal Care Clinic of Botucatu Medical School were distributed in Pregnant non-diabetic (Pnd) and Gestational Diabetic (GDM) (n=3 w/group). The diagnosis of GDM was established according to ADA’s criteria (2016). The harvesting of RA was during the cesarean section. Transversal cross-sections of the RA of both women and rats were analyzed by transmission electron microscopy. All procedures were approved by the Ethics Committee on Animal Experiments of the Botucatu Medical School (Protocol Number 1003/2013) and by the Botucatu Medical School Ethical Committee for Human Research in Medical Sciences (CAAE: 41570815.0.0000.5411). Results: The photomicrographs of the RA of rats revealed disorganized Z lines, thinning sarcomeres, and a usual quantity of intermyofibrillar mitochondria in the P group. The LTMd group showed swollen sarcoplasmic reticulum, dilated T tubes and areas with sarcomere disruption. The ultrastructural analysis of Pnd non-diabetic women in the RA showed well-organized myofibrils forming intact sarcomeres, organized Z lines and a normal distribution of intermyofibrillar mitochondria. The GDM group revealed increase in intermyofibrillar mitochondria, areas with sarcomere disruption and increased lipid droplets. Conclusion: Pregnancy and diabetes induce adaptations in the ultrastructure of the rectus abdominis muscle for both women and rats, changing the architectural design of these tissues. However, in rats these changes are more severe maybe because, besides the high blood glucose levels, the quadrupedal animal may suffer an excessive mechanical tension during pregnancy by gravity. Probably, these findings may suggest that these alterations are a risk factor that contributes to the development of muscle dysfunction in women with GDM and may motivate treatment strategies in these patients.

Keywords: gestational diabetes, muscle dysfunction, pregnancy, rectus abdominis

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Authors: Jithin S. Kumar, Ramesh Kannan Kandasami

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Geomaterials are generally porous in nature due to the presence of discrete particles and interconnected voids. The porosity present in these geomaterials play a critical role in many engineering applications such as CO2 sequestration, well bore strengthening, enhanced oil and hydrocarbon recovery, hydraulic fracturing, and subsurface waste storage. These applications involves solid-fluid interactions, which govern the changes in the porosity which in turn affect the permeability and stiffness of the medium. Injecting fluid into the geomaterials results in permeation which exhibits small or negligible deformation of the soil skeleton followed by cavity expansion/ fingering/ fracturing (different forms of instabilities) due to the large deformation especially when the flow rate is greater than the ability of the medium to permeate the fluid. The complexity of this problem increases as the geomaterial behaves like a solid and fluid under certain conditions. Thus it is important to understand this multiphysics problem where in addition to the permeation, the elastic-plastic deformation of the soil skeleton plays a vital role during fluid injection. The phenomenon of permeation and cavity expansion in porous medium has been studied independently through extensive experimental and analytical/ numerical models. The analytical models generally use Darcy's/ diffusion equations to capture the fluid flow during permeation while elastic-plastic (Mohr-Coulomb and Modified Cam-Clay) models were used to predict the solid deformations. Hitherto, the research generally focused on modelling cavity expansion without considering the effect of injected fluid coming into the medium. Very few studies have considered the effect of injected fluid on the deformation of soil skeleton. However, the porosity changes during the fluid injection and coupled elastic-plastic deformation are not clearly understood. In this study, the phenomenon of permeation and instabilities such as cavity and finger/ fracture formation will be quantified extensively by performing experiments using a novel experimental setup in addition to utilizing image processing techniques. This experimental study will describe the fluid flow and soil deformation characteristics under different boundary conditions. Further, a well refined coupled semi-analytical model will be developed to capture the physics involved in quantifying the deformation behaviour of geomaterial during fluid injection.

Keywords: solid-fluid interaction, permeation, poroelasticity, plasticity, continuum model

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Authors: Abdulaziz Alakeel, Roaa Alamri, Abdulrahman Alomair, Mohammed Fouda

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Introduction: Ibrutinib is a selective, potent, and irreversible small-molecule inhibitor of Bruton's tyrosine kinase (BTK). It forms a covalent bond with a cysteine residue (CYS-481) at the active site of Btk, leading to inhibition of Btk enzymatic activity. The drug is indicated to treat certain type of cancers such as mantle cell lymphoma (MCL), chronic lymphocytic leukaemia and Waldenström's macroglobulinaemia (WM). Cardiac failure is a condition referred to inability of heart muscle to pump adequate blood to human body organs. There are multiple types of cardiac failure including left and right-sided heart failure, systolic and diastolic heart failures. The aim of this review is to evaluate the risk of cardiac failure associated with the use of ibrutinib and to suggest regulatory recommendations if required. Methodology: Signal Detection team at the National Pharmacovigilance Center (NPC) of Saudi Food and Drug Authority (SFDA) performed a comprehensive signal review using its national database as well as the World Health Organization (WHO) database (VigiBase), to retrieve related information for assessing the causality between cardiac failure and ibrutinib. We used the WHO- Uppsala Monitoring Centre (UMC) criteria as standard for assessing the causality of the reported cases. Results: Case Review: The number of resulted cases for the combined drug/adverse drug reaction are 212 global ICSRs as of July 2020. The reviewers have selected and assessed the causality for the well-documented ICSRs with completeness scores of 0.9 and above (35 ICSRs); the value 1.0 presents the highest score for best-written ICSRs. Among the reviewed cases, more than half of them provides supportive association (four probable and 15 possible cases). Data Mining: The disproportionality of the observed and the expected reporting rate for drug/adverse drug reaction pair is estimated using information component (IC), a tool developed by WHO-UMC to measure the reporting ratio. Positive IC reflects higher statistical association while negative values indicates less statistical association, considering the null value equal to zero. The results of (IC=1.5) revealed a positive statistical association for the drug/ADR combination, which means “Ibrutinib” with “Cardiac Failure” have been observed more than expected when compared to other medications available in WHO database. Conclusion: Health regulators and health care professionals must be aware for the potential risk of cardiac failure associated with ibrutinib and the monitoring of any signs or symptoms in treated patients is essential. The weighted cumulative evidences identified from causality assessment of the reported cases and data mining are sufficient to support a causal association between ibrutinib and cardiac failure.

Keywords: cardiac failure, drug safety, ibrutinib, pharmacovigilance, signal detection

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Authors: Henry Venter, Murali Thyloth, Alceu Casseb

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Historically, mental and substance use disorders were not a global health priority. Since the 1993 World Development Report, the importance of the contribution of mental health and substance abuse on the relative global burden associated with disease morbidity has been recognized with 300 million people worldwide suffering from depression alone. This led to an international effort to improve the mental health of populations around the world. Despite these efforts some countries remain at the top of the list of countries with the highest rate of mental illness. Important research questions were asked: Would there be commonalities regarding mental health between these countries; would there be common factors leading to the high prevalence of mental illness; and how prepared are these countries with mental health delivery? Findings from this research can aid organizations and institutions preparing mental health service providers to focus training and preparation to address specific needs revealed by the study. Methods: Researchers decided to compare three distinctly different countries at the top of the list of countries with the highest rate of mental illness, the USA, India and Brazil, situated on three different continents with different economies and lifestyles. Data were collected using archival research methodology, reviewing records and findings of international and national health and mental health studies to subtract and compare data and findings. Results: The findings indicated that India is the most depressed country in the world, followed by the USA (and China) with Brazil in Latin America with the greatest number of depressed individuals. By 2020 roughly 20% of India, acountry of over one billion citizens, will suffer from some form of mental illnees, yet there are less than 4,000 experts available. In the USA 164.8 million people were substance abusers and an estimate of 47.6 million adults, 18 or older, had any mental illness in 2018. That means that about one in five adults in the USA experiences some form of mental illness each year, but only 41% of those affected received mental health care or services in the past year. Brazil has the greatest number of depressed individuals, in Latin America. Adults living in Sao Paulo megacity has prevalence of mental disorders at greater levels than similar surveys conducted in other areas of the world with more than one million adults with serious impairment levels. Discussion: The results show that, despite the vast socioeconomic differences between the three countries, there are correlations regarding mental health prevalence and difficulty to provide adequate services including a lack of awareness of how serious mental illness is, stigma for seeking mental illness, with comorbidity a common phenomenon, and a lack of partnership between different levels of service providers, which weakens mental health service delivery. The findings also indicate that mental health training institutions have a monumental task to prepare personnel to address the future mental health needs in each of the countries compared, which will constitute the next phase of the research.

Keywords: mental health epidemiology, mental health disorder, mental health prevalence, mental health treatment

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Authors: Aline V. Arroteia, Gustavo G. Do Amaral, Simone Z. Kikuti, Norberto C. S. Moura, Silvio B. Melhado

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Despite the significant advances made by the construction industry in recent years, the crystalized absence of integration between the design and construction phases is still an evident and costly problem in building construction. Globally, the construction industry has sought to adopt collaborative practices through new technologies to mitigate impacts of this fragmented process and to optimize its production. In this new technological business environment, professionals are required to develop new methodologies based on the notion of collaboration and integration of information throughout the building lifecycle. This scenario also represents the industry’s reality in developing nations, and the increasing need for overall efficiency has demanded new educational alternatives at the undergraduate and post-graduate levels. In countries like Brazil, it is the common understanding that Architecture, Engineering and Building Construction educational programs are being required to review the traditional design pedagogical processes to promote a comprehensive notion about integration and simultaneity between the phases of the project. In this context, the coherent inclusion of computation design to all segments of the educational programs of construction related professionals represents a significant research topic that, in fact, can affect the industry practice. Thus, the main objective of the present study was to comparatively measure the effectiveness of the Building Information Modeling courses offered by the University of Sao Paulo, the most important academic institution in Brazil, at the Schools of Architecture and Civil Engineering and the courses offered in well recognized BIM research institutions, such as the School of Design in the College of Architecture of the Georgia Institute of Technology, USA, to evaluate the dissemination of BIM knowledge amongst students in post graduate level. The qualitative research methodology was developed based on the analysis of the program and activities proposed by two BIM courses offered in each of the above-mentioned institutions, which were used as case studies. The data collection instruments were a student questionnaire, semi-structured interviews, participatory evaluation and pedagogical practices. The found results have detected a broad heterogeneity of the students regarding their professional experience, hours dedicated to training, and especially in relation to their general knowledge of BIM technology and its applications. The research observed that BIM is mostly understood as an operational tool and not as methodological project development approach, relevant to the whole building life cycle. The present research offers in its conclusion an assessment about the importance of the incorporation of BIM, with efficiency and in its totality, as a teaching method in undergraduate and graduate courses in the Brazilian architecture, engineering and building construction schools.

Keywords: building information modeling (BIM), BIM education, BIM process, design teaching

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Authors: Stephen L. Green, Alexander N. Gorban, Ivan Y. Tyukin

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Within the past decade, using Convolutional Neural Networks (CNN)’s to create Deep Learning systems capable of translating Sign Language into text has been a breakthrough in breaking the communication barrier for deaf-mute people. Conventional research on this subject has been concerned with training the network to recognize the fingerspelling gestures of a given language and produce their corresponding alphanumerics. One of the problems with the current developing technology is that images are scarce, with little variations in the gestures being presented to the recognition program, often skewed towards single skin tones and hand sizes that makes a percentage of the population’s fingerspelling harder to detect. Along with this, current gesture detection programs are only trained on one finger spelling language despite there being one hundred and forty-two known variants so far. All of this presents a limitation for traditional exploitation for the state of current technologies such as CNN’s, due to their large number of required parameters. This work aims to present a technology that aims to resolve this issue by combining a pretrained legacy AI system for a generic object recognition task with a corrector method to uptrain the legacy network. This is a computationally efficient procedure that does not require large volumes of data even when covering a broad range of sign languages such as American Sign Language, British Sign Language and Chinese Sign Language (Pinyin). Implementing recent results on method concentration, namely the stochastic separation theorem, an AI system is supposed as an operate mapping an input present in the set of images u ∈ U to an output that exists in a set of predicted class labels q ∈ Q of the alphanumeric that q represents and the language it comes from. These inputs and outputs, along with the interval variables z ∈ Z represent the system’s current state which implies a mapping that assigns an element x ∈ ℝⁿ to the triple (u, z, q). As all xi are i.i.d vectors drawn from a product mean distribution, over a period of time the AI generates a large set of measurements xi called S that are grouped into two categories: the correct predictions M and the incorrect predictions Y. Once the network has made its predictions, a corrector can then be applied through centering S and Y by subtracting their means. The data is then regularized by applying the Kaiser rule to the resulting eigenmatrix and then whitened before being split into pairwise, positively correlated clusters. Each of these clusters produces a unique hyperplane and if any element x falls outside the region bounded by these lines then it is reported as an error. As a result of this methodology, a self-correcting recognition process is created that can identify fingerspelling from a variety of sign language and successfully identify the corresponding alphanumeric and what language the gesture originates from which no other neural network has been able to replicate.

Keywords: convolutional neural networks, deep learning, shallow correctors, sign language

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Authors: Zan Chen, D. Kwok

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The SkillsFuture Singapore’s mission to develop a responsive and forward-looking Training and Adult Education (TAE) and workforce development system is undergirded by how successful TAE providers are in their business performance and strategies that strengthen their operational efficiency and processes. Therefore, understanding the factors that drive the business performance of TAE providers is critical to the success of SkillsFuture Singapore’s initiatives. This study aims to investigate how business strategy, work autonomy, work intensity and professional development support impact the business performance of private TAE providers. Specifically, the three research questions are: (1) Are there significant relationships between the above-mentioned four factors and TAE providers’ business performance?; (2) Are there significant differences on the four factors between low and high TAE providers’ business performance groups?; and (3) To what extent and in what manner do the four factors predict TAE providers’ business performance? This was part of the first national study on organizations and professionals working in the Training and Adult Education (TAE) sector. Data from 265 private TAE providers where respondents were Chief Executive Officers representatives from the Senior Management were analyzed. The results showed that business strategy (the extent that the organization leads the way in terms of developing new products and services; uses up-to-date learning technologies; customizes its products and services to the client’s needs), work autonomy (the extent that the staff personally have an influence on how hard they work; deciding what tasks they are to do; deciding how they are to do the tasks, and deciding the quality standards to which they work) and professional development support (both monetary and non-monetary support and incentives) had positive and significant relationships with business performance. However, no significant relationship is found between work intensity and business performance. A business strategy, work autonomy and professional development support were significantly higher in the high business performance group compared to the low-performance group among the TAE providers. Results of hierarchical regression analyses controlling for the size of the TAE providers showed significant impacts of business strategy, work autonomy and professional development support on TAE providers’ business performance. Overall, the model accounted for 27% of the variance in TAE providers’ business performance. This study provides policymakers with insights into improving existing policies, designing new initiatives and implementing targeting interventions to support TAE providers. The findings also have implications on how the TAE providers could better formulate their organizational strategies and business models. Finally, limitations of study, along with directions for future research will be discussed in the paper.

Keywords: adult education, business performance, business strategy, training, work autonomy

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Authors: Ian Kingsbury

Abstract:

The rapid expansion of charter schools (public schools that receive government but do not face the same regulations as traditional public schools) over the preceding two decades has raised concerns over the potential for graft and fraud. These concerns are largely justified: Incidents of financial crime and mismanagement are not unheard of, and the charter sector has become a darling of hedge fund managers. In response, several states have strengthened their charter school regulatory regimes. Imposing regulations and attempting to increase accountability seem like sensible measures, and perhaps they are necessary. However, increased regulation may come at the cost of imposing barriers to entry. Specifically, increased regulation often entails evidence for a high likelihood of fiscal solvency. That should theoretically entail access to capital in the short-term, which may systematically preclude Black or Hispanic applicants from opening charter schools. Moreover, increased regulation necessarily entails more red tape. The institutional wherewithal and the number of hours required to complete an application to open a charter school might favor those who have partnered with an education service provider, specifically a charter management organization (CMO) or education management organization (EMO). These potential barriers to entry pose a significant policy concern. Just as policymakers hope to increase the share of minority teachers and principals, they should sensibly care whether individuals who open charter schools look like the students in that school. Moreover, they might be concerned if successful applications in states with stringent regulations are overwhelmingly affiliated with education service providers. One of the original missions of charter schools was to serve as a laboratory of innovation. Approving only those applications affiliated with education service providers (and in effect establishing a parallel network of schools rather than a diverse marketplace of schools) undermines that mission. Data and methods: The analysis examines more than 2,000 charter school applications from 15 states. It compares the outcomes of applications from states with a strong regulatory environment (those with high scores) from NACSA-the National Association of Charter School Authorizers- to applications from states with a weak regulatory environment (those with a low NACSA score). If the hypothesis is correct, applicants not affiliated with an ESP are more likely to be rejected in high-regulation states compared to those affiliated with an ESP, and minority candidates not affiliated with an education service provider (ESP) are particularly likely to be rejected. Initial returns indicate that the hypothesis holds. More applications in low NASCA-scoring Arizona come from individuals not associated with an ESP, and those individuals are as likely to be accepted as those affiliated with an ESP. On the other hand, applicants in high-NACSA scoring Indiana and Ohio are more than 20 percentage points more likely to be accepted if they are affiliated with an ESP, and the effect is particularly pronounced for minority candidates. These findings should spur policymakers to consider the drawbacks of charter school accountability and consider accountability regimes that do not impose barriers to entry.

Keywords: accountability, barriers to entry, charter schools, choice

Procedia PDF Downloads 159

Authors: Marwa Abida, Florian Gehring, Jamel Mars, Alexandre Vivet, Fakhreddine Dammak, Mohamed Haddar

Abstract:

The demand for bio-based materials in semi-structural and structural applications is constantly growing to conform to new environmental policies. Among them, Plant Fiber Reinforced Composites (PFRC) are attractive for the scientific community as well as the industrial world. Due to their relatively low densities and low environmental impact, vegetal fibers appear to be suitable as reinforcing materials for polymers. However, the major issue of plant fibers and PFRC in general is their hydrophilic behavior (high affinity to water molecules). Indeed, when absorbed, water causes fiber swelling and a loss of mechanical properties. Thus, the environmental loadings (moisture, temperature, UV) can strongly affect their mechanical properties and therefore play a critical role in the service life of PFRC. In order to analyze the influence of conditioning at relative humidity on the behavior of flax fiber reinforced composites, a preliminary study on flax fabrics has been conducted. The conditioning of the fabrics in different humid atmospheres made it possible to study the influence of the water content on the hygro-mechanical behavior of flax reinforcement through mechanical tensile tests. This work shows that increasing the relative humidity of the atmosphere induces an increase of the water content in the samples. It also brings up the significant influence of water content on the stiffness and elongation at break of the fabric, while no significant change of the breaking load is detected. Non-linear decrease of flax fabric rigidity and increase of its elongation at maximal force with the increase of water content are observed. It is concluded that water molecules act as a softening agent on flax fabrics. Two kinds of typical tensile curves are identified. Most of the tensile curves of samples show one unique linear region where the behavior appears to be linear prior to the first yarn failure. For some samples in which water content is between 2.7 % and 3.7 % (regardless the conditioning atmosphere), the emergence of a two-linear region behavior is pointed out. This phenomenon could be explained by local heterogeneities of water content which could induce premature local plasticity in some regions of the flax fabric sample behavior.

Keywords: hygro-mechanical behavior, hygroscopy, flax fabric, relative humidity, mechanical properties

Procedia PDF Downloads 188