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Authors: Babar Rasheed, Saad Ghafoor

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Introduction: Idea campaigns are commonly held across organizations for generating employee engagement. The contribution is specifically designed to identify and solve prevalent issues. It is argued that numerous organizations fail to achieve their desired goals despite arranging for such campaigns and investing heavily in them. There are however practices that organizations use to achieve higher degree of effectiveness, and these practices may be up for exploration by research to make them usable for the other organizations. Purpose: The aim of this research is to surface the idea management practices of a leading electric company with global operations. The study involves a large sized, multi site organization that is attributed to have added challenges in terms of managing ideas from employees, in comparison to smaller organizations. The study aims to highlight the factors that are looked at as the idea management team strategies for the campaign, sets terms and rewards for it, makes follow up with the employees and lastly, evaluate and award ideas. Methodology: The study is conducted in a leading electric appliance corporation that has a large number of employees and is based in numerous regions of the world. A total of 7 interviews are carried out involving the chief innovation officer, innovation manager and members of idea management and evaluation teams. The interviews are carried out either on Skype or in-person based on the availability of the interviewee. Findings: While this being a working paper and while the study is under way, it is anticipated that valuable information is being achieved about specific details on how idea management systems are governed and how idea campaigns are carried out. The findings may be particularly useful for innovation consultants as resources they can use to promote idea campaigning. The usefulness of the best practices highlighted as a result is, in any case, the most valuable output of this study.

Keywords: employee engagement, motivation, idea campaigns, large organizations, best practices, employees input, organizational output

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Authors: Adelson G. Guillarte, M. D., Noel J. Belonguel, Jarungchai Anton S. Vatanagul

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Patients with malignant middle cerebral infarction (MCA) (with massive brain swelling and herniation) were reported to have a mortality rate of 80% even with the appropriate conservative medical therapy. European Trials (DECIMAL, DESTINY I, and II, HAMLET) showed significant improvement in mortality and functional outcome with hemicraniectomy. No known published local studies in the region, thus a local study is vital. This is a single center, retrospective, descriptive, cross-sectional, chart review study which includes ≥18 year-old patients with malignant MCA infarction, who underwent hemicraniectomy, and those who were given conservative medical therapy alone, from January 2008 to December 2012 at Perpetual Succour Hospital. Excluded were patients whose charts are with insufficient data, prior MCA stroke, with concomitant intracerebral hemorrhage and with other serious medical conditions or terminal illnesses. Minimum of 32 populations were needed. Data were presented in mean, standard deviation, frequency and percentage distribution. Man n Whitney U test and Chi Square test were used. P-values lesser than 0.05 alpha were considered statistically significant. A total of 672 stroke patients were admitted. 34 patients pass the inclusion criteria. 9 underwent hemicraniectomy and 25 were treated by conservative medical therapy alone. Although not statistically significant (64% vs 33%, p=0.112) there were more patients noted improved in the conservative treatment group. Meanwhile, the Hemicraniectomy group have increased percentage of mortality (67%) (p=0.112). There was a decreasing trend in the average NIHSS score in both groups from admission to post-op 7 days (p=0.198, p=0.78). A bigger multicenter prospective study is recommended to control inherent biases and limitations of a retrospective and smaller study.

Keywords: cerebral infarct, hemicraniectomy, ischemic stroke, malignant middle cerebral artery (MCA) infarct

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Authors: Ashkan Asgari, Korous Khoshbakht, Saeid Soufizadeh

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Various factors including land lots can affect biodiversity indices in Agricultural systems. Field study conducted to evaluate factors affecting crop diversity in Sarpolzahab in 2012. Required data were collected through direct observation of farms and filling questionnaires. Total numbers of 140 questionnaires were filled, SAS Software was used to analyse data and Ecological Methodology Program was applied to calculate Shannon-Winner index, subsequently. Results of study indicated that average number of land lots for each farmer was 2.78 and various from 2.2 in Rikhak Olia Village to 4.31 in Golam Kaboud Olia Village which shows small size of land lots due to separating larger lots by children of deceased farmers. The correlation between number of land lots and species biodiversity (0.308**) was significant and Shannon-Winner index was (0.262**). Therefore, according to the mentioned results one can assume that increase in number of land lots results in improving of the target index. Multiple land lots allow farmers to cultivate various crops which results in increasing biodiversity of crops in agro ecosystem. Subsequently, this increase will facilitate economic sustainability of the farmers and distribution of work force in the region throughout the year. The correlation of seasonal workers with biodiversity of crop species (0.256**) and Shannon-Winner (0.286**) was statistically significant and increasing number of seasonal work forces had resulted in improving crop biodiversity and decreasing dominant species or single crop farming systems. Vegetable farms which have a significant diversity, require a significant number of work forces which describes correlation between number of workers and diversity of species.

Keywords: agricultural systems, biodiversity indices, Shannon-Winner index, sustainability, rural

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Authors: Elizabeth Owusu Asiamah

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The Ghanaian news media play a crucial role in shaping people's thinking patterns through the nature of the coverage they give to issues, events and personalities. Since the media do not work in a vacuum but within a broader spectrum, which is society, whatever stories they cover and the nature of frames used to narrate such stories go a long way to influence how citizens perceive issues in the country. Consequently, the National Media Commission and the National Communications Authority were instituted to monitor and direct the activities of the media to ensure professionalism that prioritizes society's interest over commercial interest. As the two media regulators go about their routine task of monitoring the operations of the media, they receive coverage from various media outlets (newspapers, radio, television and online). Some people believe that the kind of approach the regulators adopt depends on the nature of coverage the media give them in their reportage. This situation demands an investigation into how the media, regulated by these regulatory bodies, are representing the regulators in the public's eye and the issues arising from such coverage. Extant literature indicates that studies on media framing have centered on politics, environmental issues, public health issues, conflict and wars, etc. However, there appear to be no studies on media framing of media regulators, especially in the Ghanaian context. Since online newspapers have assumed more mainstream positions in the Ghanaian media and have attracted more audiences in recent times, this study investigates the nature of coverage given to media regulators by four purposively sampled online newspapers in Ghana. 96 news articles are extracted from the websites of the Daily Graphic, Ghanaian Times, Daily Guide and Chronicle newspapers within a five-year period to identify the prominence given to stories about the two media regulators and the frames used to narrate stories about them. Data collected are thematically analyzed through the lens of agenda-setting and media-framing theories. The findings of the study revealed that the two regulators were not given much coverage by way of frequency; however, much prominence was given to them in terms of enhancements such as images. The study further disclosed that most of the news articles framed the regulators as weak and incompetent, which is likely to affect how the public also views the regulators. The study concludes that since frames around the supportive nature of the regulators to issues of the media were not hammered by the online newspapers, the public will not perceive the regulators as playing their roles effectively. Thus, a need for more positive frames to be used to narrate stories about the National Media Commission and the National Communication Authority to promote a cordial relationship between the two institutions and a good image to the public.

Keywords: agenda setting, media framing, media regulators, online newspapers

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Authors: Jared R. Chapman

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This study introduces a type of motivational information system called an educational engagement information system (EEIS). An EEIS draws on principles of behavioral economics, motivation theory, and learning cognition theory to design information systems that help students want to improve their performance. This study compares academic outcomes for course sections taught by part- and full-time instructors both with and without an EEIS. Without an EEIS, students in the part-time instructor's course sections demonstrated significantly higher failure rates (a 143.8% increase) and dropout rates (a 110.4% increase) with significantly fewer students scoring a B- or higher (39.8% decrease) when compared to students in the course sections taught by a full-time instructor. It is concerning that students in the part-time instructor’s course without an EEIS had significantly lower academic outcomes, suggesting less understanding of the course content. This could impact retention and continuation in a major. With an EEIS, when comparing part- and full-time instructors, there was no significant difference in failure and dropout rates or in the number of students scoring a B- or higher in the course. In fact, with an EEIS, the failure and dropout rates were statistically identical for part- and full-time instructor courses. When using an EEIS (compared with not using an EEIS), the part-time instructor showed a 62.1% decrease in failures, a 61.4% decrease in dropouts, and a 41.7% increase in the number of students scoring a B- or higher in the course. We are unaware of other interventions that yield such large improvements in academic performance. This suggests that using an EEIS such as Delphinium may compensate for part-time instructors’ limitations of expertise, time, or rewards that can have a negative impact on students’ academic outcomes. The EEIS had only a minimal impact on failure rates (7.7% decrease) and dropout rates (18.8% decrease) for the full-time instructor. This suggests there is a ceiling effect for the improvements that an EEIS can make in student performance. This may be because experienced instructors are already doing the kinds of things that an EEIS does, such as motivating students, tracking grades, and providing feedback about progress. Additionally, full-time instructors have more time to dedicate to students outside of class than part-time instructors and more rewards for doing so. Using adjunct and other types of part-time instructors will likely remain a prevalent practice in higher education management courses. Given that using part-time instructors can have a negative impact on student graduation and persistence in a field of study, it is important to identify ways we can augment part-time instructors’ performance. We demonstrated that when part-time instructors use an EEIS, it can result in significantly lower students’ failure and dropout rates and an increase in the rate of students earning a B- or above; and bring their students’ performance to parity with the performance of students taught by a full-time instructor.

Keywords: gamification, engagement, motivation, academic outcomes

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Authors: Zehra Gencel Efe, Fatma Susam Ozsayın, Satı Tas

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Background and Aim: It is not possible to teach all the knowledge related to operating room nursing in the nursing education process. Certified courses are organized by the Ministry of Health to compensate the lack of postgraduate training and the theoretical and practical training needs of working nurses. In this study; It is aimed to investigate the participants’ opinions and recommendations attending the certified course of operating room nursing that organized in İKCU AtaturkTraining and Research Hospital. Method: Two operating room nursing courses were organized in 2016. The 1st Operating Room Nursing Certified Course Program was organized between March 07, 2016 and April 6, 2016and the 2nd Operating Room Nursing Certified Course Program was organized between 07 November 2016 - 06 December 2016 at the İKCU Ataturk Training and Research Hospital. The first program was accepted for 29 participants, the second program was accepted for 30 participants. In the collection of the data, the 'Operating Room Nursing Certified Training Program Evaluation Form', 'Operating Room Nursing Certified Training Program Theoretical Training Evaluation Form' were used. Three point Likert-type scale is used for responses in the 'Operating Room Nursing Certified Training Program Evaluation Form’ (1=verygood, 2=good, 3=poor). Data is collected in five areas related to training program, operation room practice, communication, responsibility, experiences of learning. Four point Likert-type scale is used for responses in the 'Operating Room Nursing Certified Training Program Theoretical Training Evaluation Form' (1=verysatisfied, 2=quitesatisfied, 3=satisfied, 4=dissatisfied). Data is collected in two areas include presentation and content. Data were analyzed with SPSS 16 program. Findings and Conclusion: It was found that 93,22% of participants were female in addition, 62,7% had bachelor degree. It was seen that 33,87% of the work group had 1-5 years of experience in their field. It was found that; 88% of trainees participating in the first group to the operating room nursing-certified course program stated the training program was very good, 12% of them stated the training program was good. Nobody was signed the ‘poor’ choice. 81% of the trainees who participated in the 2nd group to the operating room nursing-certified course program stated the training program was very good, 19% of them stated the training program was good. Nobody was signed the ‘poor’ choice. It was found that there was no meaningful difference between the achievement ratios of the trainees and the learning status of the trainees when compared with the t test in the groups with success level of the operating room nursing certified course program according to the learning status of the participants (p ˃ 0,05). The trainees noted that the course was satisfied with theoretical and practical steps but the support services (lunch, coffee breaks etc.) were in adequate.

Keywords: certified courses, nursing certified courses, operating room nursing, training program

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Authors: Santosh Sharma

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Background: Drug abuse, needle sharing, and risky sexual behaviour are often compounded to increase the risk of HIV transmission. Injecting Drug Users are at the duel risk of needle sharing and risky sexual Behaviour, becoming more vulnerable to STI and HIV. Thus, studying the interface of injecting drug use and risky sexual behaviour is important to curb the pace of HIV epidemic among IDUs. The aim of this study is to determine the factor associated with HIV among injecting drug users in three states of India. Materials and methods: This paper analyzes covariates of multiplicity of risk behavior among injecting drug users. Findings are based on data from Integrated Behavioral and Biological Assessment (IBBA) round 2, 2010. IBBA collects the information of IDUs from the six districts. IDUs were selected on the criteria of those who were 18 years or older, who injected addictive substances/drugs for non-medical purposes at least once in past six month. A total of 1,979 in round 2 were interviewed in the IBBA. The study employs quantitative techniques using standard statistical tools to achieve the above objectives. All results presented in this paper are unweighted univariate measures. Results: Among IDUs, average duration of injecting drugs is 5.2 years. Mean duration between first drug use to first injecting drugs among younger IDUs, belongs to 18-24 years is 2.6 years Needle cleaning practices is common with above two-fifths reporting its every time cleaning. Needle sharing is quite prevalent especially among younger IDUs. Further, IDUs practicing needle sharing exhibit pervasive multi-partner behavior. Condom use with commercial partners is almost 81 %, whereas with intimate partner it is 39 %. Coexistence of needle sharing and unprotected sex enhances STI prevalence (6.8 %), which is further pronounced among divorced/separated/widowed (9.4 %). Conclusion: Working towards risk reduction for IDUs must deal with multiplicity of risk. Interventions should deal with covariates of risk, addressing youth, and risky sexual behavior.

Keywords: IDUs, HIV, STI, behaviour

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Authors: Eszter Kulcsar, Agnes Takacs, Gabriella B. Kiss, Peter Prakfalvi

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The Karancs Mountain is part of the Miocene Inner Carpathian Volcanic Belt and is located in N-NE Hungary, along the Hungarian-Slovakian border. The 14 Ma old andesitic-dacitic units are surrounded by Oligocene sedimentary units (sandstone, siltstone). The host rocks of the mineralisation are siliceous and/or argillaceous volcanic units, quartz veins, hydrothermal breccia, and strongly silicified vuggy rocks, found in the various altered volcanic units. The hydrothermal breccia consists of highly silicified vuggy quartz clasts in quartz matrix. The hydrothermal alteration of the host units shows structural control at the deeper levels. The main ore minerals are galena, pyrite, marcasite, sphalerite, hematite, magnetite, arsenopyrite, anglesite and argentite The mineralisation was first mentioned in 1944 and the first exploration took place between 1961 and 1962 in the area. The first ore geological studies were performed between 1984-1985. The exploration programme was limited only to surface sampling; no drilling programme was performed. Petrographical and preliminary fluid inclusion studies were performed on calcite samples from a galena-bearing vein. Despite the early discovery of the mineralisation, no detailed description is available, thus its size, characteristics, and origin have remained unknown. The aim of this study is to examine the mineralisation, describe the characteristics in detail and to test the possible gold content of the various quartz veins and breccias. Finally, we also investigate the potential relation of the hydrothermal mineralisation to the surrounding similar mineralisations with similar ages (e.g. W-Mátra Mountains in Hungary, Banska Bystrica, Banska Stiavnica in Slovakia) in order to place the mineralisation within the volcanic-hydrothermal evolution of the Miocene Inner Carpathian Belt. As first steps, the study includes field mapping, traditional petrological and ore microscopy; X-ray diffraction analysis; SEM-EDS and EMPA studies on ore minerals, to obtain mineral chemical information. Fluid inclusion petrography and microthermometry and micro-Raman-spectroscopy studies are also planned on quartz-hosted inclusions to investigate the physical and chemical properties of the ore-forming fluid.

Keywords: epithermal, Karancs Mountain, Hungary, Miocene Inner Carpathian volcanic belt, polimetallic ore deposit

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Authors: Arzyana Sunkar, Yanto Santosa, Intan Purnamasari, Yohanna Dalimunthe

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A variety of negative allegations have criticized the Indonesian oil palm plantations as being environmentally unfriendly. One of the important allegations thus must be verified is that expansion of Indonesian oil palm plantation has increased the deforestation rate of primary tropical forest. In relation to this, a research was conducted to study the origin or history of the status and land use of 8 private oil palm plantations (with a total of 46,372.38 ha) located in Riau Province. Several methods were employed: (1) conducting analysis of overlay maps between oil palm plantation studied with the 1986 Forest Map Governance Agreement (TGHK) and the 1994 and 2014 Riau Provincial Spatial Plans(RTRWP); (2) studying the Cultivation Right on Land (HGU) documents including the Forestry Ministerial Decree on the release of forest area and (3) interpretation of lands at imagery of bands 542, covering 3 years before and after the oil palm industries operated. In addition, field cross-checked, and interviews were conducted with National Land Agency, Plantation and Forestry Office and community figures. The results indicated that as much as 1.95% of the oil palm plantations under study were converted from production forest, 30.34% from limited production forest and 67.70% from area for other usage /conversion production forest. One year prior to the establishment of the plantations, the land cover types comprised of rubber plantations (49.96%), secondary forest (35.99%), bare land (10.17%), shrubs (3.03%) and mixed dryland farming-shrubs (0.84%), whereas the land use types comprised of 35.99% forest concession areas, 14.04% migrants dryland farms, and 49.96% Cultivation Right on Land of other companies. These results indicated that most of the private oil palm plantations under study, resulted from the conversion of production forests and the previous land use were not primary forest but rubber plantations and secondary forests.

Keywords: land cover types, land use history, primary forest, private oil palm plantations

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Authors: F. Saccucci

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Gamification has now started to take root in the post-secondary classroom. Educators have learned much about gamification to date but there is still a great deal to learn. One definition of gamification is the ability to engage post-secondary students with games that are fun and correlate to class room curriculum. There is no shortage of literature illustrating the advantages of gamification in the class room. This study is an extension of similar thought as well as an extension of a previous study where in class testing proved with the used of paired T-test that gamification did significantly improve the students’ understanding of subject material. Gamification itself in the class room can range from high end computer simulated software to paper based games of which both have advantages and disadvantages. This analysis used a paper based game to highlight certain qualitative advantages of gamification. The paper based game in this analysis was inexpensive, required low preparation time for the faculty member and consumed approximately 20 minutes of class room time. Data for the study was collected through in class student feedback surveys and narrative from the faculty member moderating the game. Students were randomly selected into groups of four. Qualitative advantages identified in this analysis included: 1. Students had a chance to meet, connect and know other students. 2. Students enjoyed the gamification process given there was a sense of fun and competition. 3. The post assessment that followed the simulation game was not part of their grade calculation therefore it was an opportunity to participate in a low risk activity whereby students could subsequently self-assess their understanding of the subject material. 4. In the view of the student, content knowledge did increase after the gamification process. These qualitative advantages identified in this analysis contribute to the argument that there should be an attempt to use gamification in today’s post-secondary class room. The analysis also highlighted that eighty (80) percent of the respondents believe twenty minutes devoted to the gamification process was appropriate, however twenty (20) percentage of respondents believed that rather than scheduling a gamification process and its post quiz in the last week, a review for the final exam may have been more useful. An additional study to this hopes to determine if the scheduling of the gamification had any correlation to a percentage of the students not wanting to be engaged in the process. As well, the additional study hopes to determine at what incremental level of time invested in class room gamification produce no material incremental benefits to the student as well as determine if any correlation exist between respondents preferring not to have it at the end of the semester to students not believing the gamification process added to the increase of their curricular knowledge.

Keywords: gamification, inexpensive, non-quantitative advantages, post-secondary

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Authors: Ranojoy Dutta

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HVAC equipment capacity has a direct impact on occupant comfort and energy consumption of a building. Glazing gains, especially in buildings with high window area, can be a significant contributor to the total peak load on the HVAC system, leading to over-sized systems that mostly operate at poor part load efficiency. In addition, radiant temperature, which largely drives occupant comfort in glazed perimeter zones, is often not effectively controlled despite the HVAC being designed to meet the air temperature set-point. This is due to short wave solar radiation transmitted through windows, that is not sensed by the thermostat until much later when the thermal mass in the room releases the absorbed solar heat to the indoor air. The implication of this phenomenon is increased cooling energy despite poor occupant comfort. EC glazing can significantly eliminate direct solar transmission through windows, reducing both the space cooling loads for the building and improving comfort for occupants near glazing. This paper will review the exact mechanism of how EC glazing would reduce the peak load under design day conditions, leading to reduced cooling capacity vs regular high-performance glazing. Since glazing heat transfer only affects the sensible load, system sizing will be evaluated both with and without the availability of a DOAS to isolate the downsizing potential of the primary cooling equipment when outdoor air is conditioned separately. Given the dynamic nature of glazing gains due to the sun’s movement, effective peak load mitigation with EC requires an automated control system that can predict solar movement and radiation levels so that the right tint state with the appropriate SHGC is utilized at any given time for a given façade orientation. Such an automated EC product will be evaluated for a prototype commercial office model situated in four distinct climate zones.

Keywords: electrochromic glazing, peak sizing, thermal comfort, glazing load

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Authors: Anne-Marie Dionne

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Teacher reading aloud to students is a practice that is well established in preschool and primary classrooms. Many benefits of this pedagogical activity have been highlighted in multiple studies. However, it has also been shown that teachers are not keen on choosing informational texts for their read aloud, as their selections for this venue are mainly fictional stories, mostly written in a unique narrative story-like structure. Considering that students soon have to read complex informational texts by themselves as they go from one grade to another, there is cause for concern because those who do not benefit from an early exposure to informational texts could be lacking knowledge of informational text structures that they will encounter regularly in their reading. Exposing students to informational texts could be done in different ways in classrooms. However, since read aloud appears to be such a common and efficient practice in preschool and primary grades, it is important to examine more deeply the factors taken into account by teachers when they are selecting their readings for this important teaching activity. Moreover, it seems critical to know why teachers are not inclined to choose more often informational texts when they are reading aloud to their pupils. A group of 22 preschool or primary grade teachers participated in this study. The data collection was done by a survey and an individual semi-structured interview. The survey was conducted in order to get quantitative data on the read-aloud practices of teachers. As for the interviews, they were organized around three categories of questions (exploratory, analytical, opinion) regarding the process of selecting the texts for the read-aloud sessions. A statistical analysis was conducted on the data obtained by the survey. As for the interviews, they were subjected to a content analysis aiming to classify the information collected in predetermined categories such as the reasons given to favor fictional texts over informative texts, the reasons given for avoiding informative texts for reading aloud, the perceptions of the challenges that the informative texts could bring when they are read aloud to students, and the perceived advantages that they would present if they were chosen more often for this activity. Results are showing variable factors that are guiding the teachers when they are making their selection of the texts to be read aloud. As for example, some of them are choosing solely fictional texts because of their convictions that these are more interesting for their students. They also perceive that the informational texts are not good choices because they are not suitable for pleasure reading. In that matter, results are pointing to some interesting elements. Many teachers perceive that read aloud of fictional or informational texts have different goals: fictional texts are read for pleasure and informational texts are read mostly for academic purposes. These results bring out the urgency for teachers to become aware of the numerous benefits that the reading aloud of each type of texts could bring to their students, especially the informational texts. The possible consequences of teachers’ perceptions will be discussed further in our presentation.

Keywords: fictional texts, informational texts, preschool or primary grade teachers, reading aloud

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Authors: Vacharee Svamivastu

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This research investigates the application of geometrical relationship to the ancient religious assembly hall (Vihara) housing a reclining Buddha statue of Thailand's Kamphaeng Phet Historical Park. The study utilizes the archaeological and wooden roof structure remains of the Vihara as the prima facie evidence, supplemented with evidence from other active archaeological sites with architectural kinship as well as Buddhist ideology. At present, the wooden roofs of the Vihara fell prey to the elements and there remain only the base, columns and enclosing walls. Unlike typical Viharas whose floor plan are of rectangular shape, the floor plan of the Vihara housing the reclining Buddha is of square configuration of 25x25m. Further observation has revealed the utilization of large laterite boulders as the principal construction material of the assembly hall (Vihara) columns. The laterite columns are of square shape (1x1m) and various heights (H), ranging from 3.50m to 5.50m. The erection of the Vihara required a total of 36 laterite columns. The pattern of columns arrangement is of two rows of inner columns, two rows of outer columns and two rows of verandah columns. The space between pairs of the verandah columns was stacked with laterite blocks of varying sizes to form the Vihara walls with small openings for ventilation. Upon applying the geometrical relationship-grid system to the Vihara, the results reveal that the placement of the columns was deliberately and masterfully undertaken such that the center of the square-shaped Vihara is conspicuously spacious so as to accommodate the sacred reclining Buddha statue. The elegance of the Vihara demonstrates the ingenious application of geometrical relationship to transforming a space into a structure (i.e. Vihara) of architectural and religious significance.

Keywords: geometrical relationship, the religious assembly hall, Vihara, Kamphaeng Phet School of Master Builder

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Authors: Maiya Smith, Tyler Thorne

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Background: The Pacific faces multiple healthcare crises, including high rates of noncommunicable diseases, infectious disease outbreaks, and susceptibility to natural disasters. These issues are expected to worsen in the coming decades, increasing the burden on an already understaffed healthcare system. Telehealth is not new to the Pacific, but improvements in technology and accessibility have increased its utility and have already proven to reduce costs and increase access to care in remote areas. Telehealth includes distance learning; a form of education that can help alleviate many healthcare issues by providing continuing education to healthcare professionals and upskilling staff, while decreasing costs. This study examined distance learning programs at the Ministry of Health in the Pacific nation of Palau and identified key elements to their successful distance learning programs. Methods: Staff at the Belau National Hospital in Koror, Palau as well as private practitioners were interviewed to assess distance learning programs utilized. This included physicians, IT personnel, public health members, and department managers of allied health. In total, 36 people were interviewed. Standardized questions and surveys were conducted in person throughout the month of July 2019. Results: Two examples of successful distance learning programs were identified. Looking at the factors that made these programs successful, as well as consulting with staff who undertook other distance learning programs, four factors for success were determined: having a cohort, having a facilitator, dedicated study time off from work, and motivation. Discussion: In countries as geographically isolated as the Pacific, with poor access to specialists and resources, telehealth has the potential to radically change how healthcare is delivered. Palau shares similar resources and issues as other countries in the Pacific and the lessons learned from their successful programs can be adapted to help other Pacific nations develop their own distance learning programs.

Keywords: distance learning, Pacific, Palau, telehealth

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Authors: Nicole V. Shifrin

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Scheduling flexibility is becoming an increasingly available option for employees struggling to balance their work and life responsibilities, allowing employees to coordinate work schedules with their additional roles. The goal of such opportunities is to help employees manage the demands they face across domains of life by allowing employees to work from home, design their own work hours, take time off when necessary, along with various other scheduling accommodations. Organizations are also turning to utilizing scheduling flexibility to facilitate employee health and wellbeing through the reduction of stress and maximization of efficiency. The purpose of the present study is to investigate the effects of scheduling flexibility on employee health-related behaviors and outcomes through a synthesis of research. The current meta-analytic review of 19 samples within 16 studies with a total sample size of 20,707 employees examines the relationship between the degree of scheduling flexibility available to employees and the resulting health outcomes and exercise habits. The results demonstrate that reduced scheduling flexibility is associated with poorer health status, suggesting that schedule inflexibility can hinder employees’ ability to maintain and support their health. These findings hold practical implications for developing work schedules to promote employee health and health-related behaviors, such as eating well and exercising. Additionally, there was a positive association between increased scheduling flexibility and engagement in exercise, suggesting that employees with more flexible schedules exercise more frequently than those with less flexible schedules. A potential explanation for the resulting relationship is that flexible schedules leave employees more time due to shorter work days, shorter or eliminated commutes, etc. with which they can use to engage in healthy behaviors. These findings stress the importance of promoting job designs that facilitate employee engagement in healthy behaviors, which directly impact their overall health status. Implications for practice are discussed as well as future directions in examining the link between job design and employee health and well-being.

Keywords: exercise, health, meta-analysis, job design, scheduling flexibility

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Authors: Ekele T. Ochedi, Ahmad H. Taki, Birgit Painter

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The effect of the sun and its path on thermal comfort and energy consumption in residential buildings in tropical climates constitute a serious concern for designers, building owners, and users. Passive design approaches based on the sun and its path have been identified as a means of reducing energy consumption as well as enhancing thermal comfort in buildings worldwide. Hence, a thorough understanding regarding the sun path is key to achieving this. This is necessary due to energy need, poor energy supply, and distribution, energy poverty, and over-dependence on electric generators for power supply in Nigeria. These challenges call for a change in the approach to energy-related issues, especially in terms of buildings. The aim of this study is to explore the influence of building orientation, glazing and the use of shading devices on residential buildings in Nigeria. This is intended to provide data that will guide designers in the design of energy-efficient residential buildings. The paper used EnergyPlus to analyze a typical semi-detached residential building in Lokoja, Nigeria using hourly weather data for a period of 10 years. Building performance was studied as well as possible improvement regarding different orientations, glazing types and shading devices. The simulation results show some reductions in energy consumption in response to changes in building orientation, types of glazing and the use of shading devices. The results indicate 29.45% reduction in solar gains and 1.90% in annual operative temperature using natural ventilation only. This shows a huge potential to reduce energy consumption and improve people’s well-being through the use of proper building orientation, glazing and appropriate shading devices on building envelope. The study concludes that for a significant reduction in total energy consumption by residential buildings, the design should focus on multiple design options rather than concentrating on one or few building elements. Moreover, the investigation confirms that energy performance modeling can be used by building designers to take advantage of the sun and to evaluate various design options.

Keywords: energy consumption, energy-efficient buildings, glazing, thermal comfort, shading devices, solar gains

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Authors: Amira Mabrouk

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This paper deals with the acceptability of urban toll in Tunisia. The price-based regulation, i.e. urban toll, is the outcome of a political process hampered by three-fold objectives: effectiveness, equity and social acceptability. This produces both economic interest groups and functions that are of incongruent preferences. The plausibility of this speculation goes hand in hand with the fact that these economic interest groups are also taxpayers who undeniably perceive urban toll as an additional charge. This wariness is coupled with an inquiry about the conditions of usage, the redistribution of the collected tax revenue and the idea of the leviathan state completes the picture. In a nutshell, if researches related to road congestion proliferate, no de facto legitimacy can be pleaded. Nonetheless, the theory on urban tolls engenders economists’ questioning of ways to reduce negative external effects linked to it. Only then does the urban toll appear to bear an answer to these issues. Undeniably, the urban toll suggests inherent conflicts due to the apparent no-payment principal of a public asset as well as to the social perception of the new measure as a mere additional charge. However, when the main concern is effectiveness is its broad sense and the social well-being, the main factors that determine the acceptability of such a tariff measure along with the type of incentives should be the object of a thorough, in-depth analysis. Before adopting this economic role, one has to recognize the factors that intervene in the acceptability of a congestion toll which brought about a copious number of articles and reports that lacked mostly solid theoretical content. It is noticeable that nowadays uncertainties float over the exact nature of the acceptability process. Accepting a congestion tariff could differ from one era to another, from one region to another and from one population to another, etc. Notably, this article, within a convenient time frame, attempts at bringing into focus a link between the social acceptability of the urban congestion toll and the value of time through a survey method barely employed in Tunisia, that of stated preference method. How can the urban toll, as a tax, be defined, justified and made acceptable? How can an equitable and effective tariff of congestion toll be reached? How can the costs of this urban toll be covered? In what way can we make the redistribution of the urban toll revenue visible and economically equitable? How can the redistribution of the revenue of urban toll compensate the disadvantaged while introducing such a tariff measure? This paper will offer answers to these research questions and it follows the line of contribution of JULES DUPUIT in 1844.

Keywords: congestion charge, social perception, acceptability, stated preferences

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Authors: Geeta, Richa, M. L. Sharma

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Himachal Pradesh, a hilly State of India located in the Western Himalayas, with varied altitudinal gradients and climatic conditions, is a repository of plant diversity and the traditional knowledge associated with plants. The State is inhabited by various tribal communities who usually depend upon local plants for curing various ailments. Utilization of plant resources in their day-to-day life has been an age old practice of the people inhabiting this State. The present study pertains to the tribal district Kinnaur of Himachal Pradesh, located between 77°45’ and 79°00’35” east longitudes and between 31°05’50” and 32°05’15” north altitudes. Being a remote area with only very basic medical facilities, local people mostly use traditional herbal medicines for primary healthcare needs. Traditional healers called “Amji” are usually very secretive in revealing their medicinal knowledge to novice and pass on their knowledge to next generation orally. As a result, no written records of healing herbs are available. The aim of present study was to collect and consolidate the ethno-medicinal knowledge of local people of the district about the use of plants for treating gastrointestinal ailments. The ethnobotanical information was collected from the local practitioners, herbal healers and elderly people having rich knowledge about the medicinal herbs through semi-structured questionnaire and key informant discussions. A total 46 plant species belonging to 40 genera and 24 families have been identified which are used as cure for gastrointestinal ailments. Among the parts used for gastointestinal ailments, aerial parts (14%) were followed by the whole plant (13%), root (8%), leaves (6%), flower (5%), fruit and seed (3%) and tuber (1%). These plant species could be prioritized for conservation and subject to further studies related to phytochemical screening for their authenticity. Most of the medicinal plants of the region are collected from the wild and are often harvested for trade. Sustainable harvesting and domestication of the highly traded species from the study area is needed.

Keywords: Amji, gastrointestinal, Kinnaur, medicinal plants, traditional knowledge

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Authors: Tebikew Yeneabat, Tefera Belachew, Muluneh Haile

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Background: Exclusive breast-feeding (EBF) is the practice of feeding only breast milk (including expressed breast milk) during the first six months and no other liquids and solid foods except medications. The time to cessation of exclusive breast-feeding, however, is different in different countries depending on different factors. Studies showed the risk of diarrhea morbidity and mortality is higher among none exclusive breast-feeding infants, common during starting other foods. However, there is no study that evaluated the time to cessation of exclusive breast-feeding in the study area. The aim of this study was to show time to cessation of EBF and its predictors among mothers of index infants less than twelve months old. Methods: We conducted a community-based cross-sectional study from February 13 to March 3, 2012 using both quantitative and qualitative methods. This study included a total of 592 mothers of index infant using multi-stage sampling method. Data were collected by using interviewer administered structured questionnaire. Bivariate and multivariate Cox regression analyses were performed. Results: Cessation of exclusive breast-feeding occurred in 392 (69.63%) cases. Among these, 224 (57.1%) happened before six months, while 145 (37.0%) and 23 (5.9%) occurred at six months and after six months of age of the index infant respectively. The median time for infants to stay on exclusive breast-feeding was 6.36 months in rural and 5.13 months in urban, and this difference was statistically significant on a Log rank (Cox-mantel) test. Maternal and paternal occupation, place of residence, postnatal counseling on exclusive breast-feeding, mode of delivery, and birth order of the index infant were significant predictors of cessation of exclusive breast-feeding. Conclusion: Providing postnatal care counseling on EBF, routine follow-up and support of those mothers having infants stressing for working mothers can bring about implementation of national strategy on infant and young child feeding.

Keywords: exclusive breastfeeding, cessation, median duration, Ankesha Guagusa Woreda

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Authors: Taddese Alemu Zerfu, Melaku Umeta Deressa, Kaleab Baye

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Background: Maternal and child under-nutrition is the underlying cause of 3•5 million annual deaths, globally. Anemia during pregnancy is among the leading nutritional disorders with serious short and long term consequences to both the mother and fetus. Objective: Examine the effect of dietary diversity on maternal anemia, nutritional status and key pregnancy outcomes of pregnancy. Methods: A prospective cohort study design, involving a total of 432 eligible pregnant women, in their second antenatal care visit was conducted between August 2014 to March, 2015. The individual dietary diversity status of mothers was used as the exposure variable to select, enroll and follow the mothers. All mothers were enrolled during second antenatal care visit and followed until delivery. Epi-data, SPSS and STATA software are used to enter and analyze the data. Chi-square test, independent 't'-test, and GLM are used to calculate risk, association and differences between key variables at P < 0.05. Results: Study participants did not differ in many of the basic characteristics (p < 0.05). The incidence of maternal anemia increased significantly from 28.6% to 32.1% between baseline and term. Pregnant mothers with inadequate dietary diversity groups had more (56% at baseline and 68% at term) risk of anemia than the comparison (adequate) groups, (RR, 1.56 and 1.68; 95% CI, 1.24 - 1.83 and 1.39 - 2.04). The overall incidence of still birth, low birth weight and pre-term birth was 4.5%, 9.1% and 13.6%, respectively. The variation of these outcomes was significant across study groups (P < 0.05). Conclusion and recommendations: Dietary diversity status of pregnant mothers has significant effect on the incidence of anemia and key pregnancy outcomes in resource limited settings, like rural Ethiopia. Therefore, apart from the ongoing routine IFA supplementation, special emphasis should be given to dietary diversity of mothers to improve related outcomes of pregnancy and maternal health.

Keywords: anemia, birth weight, dietary diversity, pregnancy, pregnancy outcome

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Authors: M. A. Okezue, K. L. Clase, S. R. Byrn

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The requirement for maintaining data integrity in laboratory operations is critical for regulatory compliance. Automation of procedures reduces incidence of human errors. Quality control laboratories located in low-income economies may face some barriers in attempts to automate their processes. Since data from quality control tests on pharmaceutical products are used in making regulatory decisions, it is important that laboratory reports are accurate and reliable. Zinc Sulphate (ZnSO₄) tablets is used in treatment of diarrhea in pediatric population, and as an adjunct therapy for COVID-19 regimen. Unfortunately, zinc content in these formulations is determined titrimetrically; a manual analytical procedure. The assay for ZnSO4 tablets involves time-consuming steps that contain mathematical formulae prone to calculation errors. To achieve consistency, save costs, and improve data integrity, validated spreadsheets were developed to simplify the two critical steps in the analysis of ZnSO4 tablets: standardization of 0.1M Sodium Edetate (EDTA) solution, and the complexometric titration assay procedure. The assay method in the United States Pharmacopoeia was used to create a process flow for ZnSO₄ tablets. For each step in the process, different formulae were input into two spreadsheets to automate calculations. Further checks were created within the automated system to ensure validity of replicate analysis in titrimetric procedures. Validations were conducted using five data sets of manually computed assay results. The acceptance criteria set for the protocol were met. Significant p-values (p < 0.05, α = 0.05, at 95% Confidence Interval) were obtained from students’ t-test evaluation of the mean values for manual-calculated and spreadsheet results at all levels of the analysis flow. Right-first-time analysis and principles of data integrity were enhanced by use of the validated spreadsheet calculators in titrimetric evaluations of ZnSO₄ tablets. Human errors were minimized in calculations when procedures were automated in quality control laboratories. The assay procedure for the formulation was achieved in a time-efficient manner with greater level of accuracy. This project is expected to promote cost savings for laboratory business models.

Keywords: data integrity, spreadsheets, titrimetry, validation, zinc sulphate tablets

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Authors: Xharavina V., Gallopeni F., Ahmeti K.

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Stuttered speech is filled with intermittent sound prolongations and/or rapid part word repetitions. Oftentimes, these aberrant acoustic behaviors are associated with intermittent physical tension and struggle behaviors such as head jerks, arm jerks, finger tapping, excessive eye-blinks, etc. Additionally, the jarring nature of acoustic and physical manifestations that often accompanies moderate-severe stuttering may induce negative emotional responses in listeners, which alters communication between the person who stutters and their listeners. However, researches for the influence of negative emotions in the communication and for physical reaction are limited. Therefore, to compare psycho-physiological responses of fluent adults, while listening the speech of adults who speak fluency and adults who stutter, are necessary. This study comprises the experimental method, with total of 104 participants (average age-20 years old, SD=2.1), divided into 3 groups. All participants self-reported no impairments in speech, language, or hearing. Exploring the responses of the participants, there were used two records speeches; a voice who speaks fluently and the voice who stutters. Heartbeats and the pulse were measured by the digital blood pressure monitor called 'Tensoval', as a physiological response to the fluent and stuttering sample. Meanwhile, the emotional responses of participants were measured by the self-reporting questionnaire (Steenbarger, 2001). Results showed an increase in heartbeats during the stuttering speech compared with the fluent sample (p < 0.5). The listeners also self-reported themselves as more alive, unhappy, nervous, repulsive, sad, tense, distracted and upset when listening the stuttering words versus the words of the fluent adult (where it was reported to experience positive emotions). These data support the notions that speech with stuttering can bring a psycho-physical reaction to the listeners. Speech pathologists should be aware that listeners show intolerable physiological reactions to stuttering that remain visible over time.

Keywords: emotional, physiological, stuttering, fluent speech

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Authors: Muñiz-Lino Marcos Agustín, Vazquez Borbolla Jessica, Licéaga-Escalera Carlos

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The ectomesenchymal tissues involved in tooth development and their remnants are the origin of different odontogenic lesions, including tumors and cysts of the jaws, with a wide range of clinical behaviors. Dentigerous cyst (DC) represents approximately 20% of all cases of odontogenic cysts, and it has been demonstrated that it can develop benign and malignant odontogenic tumors. DC is characterized by bone destruction of the area surrounding the crown of a tooth which has not erupted and it contain is liquid. The treatment of odontogenic tumors and cysts usually are partial or total removal of the jaw, causing important secondary co-morbidities. However, molecules implicated in DC pathogenesis as well in its development to odontogenic tumors remains unknown. A cellular model may be useful to study these molecules, but that model has not been established yet. Here, we reported the establishment of a cell culture derived from a dentigerous cyst. This cell line was named DeCy-1. In spite of its ectomesenchymal morphology, DeCy-1 cells express epithelial markers such as cytokeratins 5, 6, and 8. Furthermore, these cells express the ODAM protein, which is present in odontogenesis and in dental follicle, indicating that DeCy-1 cells derived from odontogenic epithelium. Analysis by electron microscopy of this cell line showed that it has a high vesicular activity, suggesting that DeCy-1 could secrete molecules that may be involved in DC pathogenesis. Thus, secreted proteins were analyzed by PAGE-SDS, where we observed approximately 11 bands. In addition, the capacity of these secretions to degrade proteins was analyzed by gelatin substrate zymography. A degradation band of about 62 kDa was found in these assays. Western blot assays suggested that the matrix metalloproteinase 2 (MMP-2) is responsible of this protease activity. Thus, our results indicate that the establishment of a cell line derived from DC is a useful in vitro model to study the biology of this odontogenic lesion and its participation in the development of odontogenic tumors.

Keywords: dentigerous cyst, MMP20, cancer, cell culture

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Authors: Carri Welsby, Jessie Gunson, Pen Roe

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Currently, there is limited research examining health care professionals (HCPs) views on long-acting reversible contraception (LARC) advice and prescription, particularly outside of the general practice (GP) setting. The aim of this study is to systematically review existing evidence around the barriers and enablers of oral contraception (OC) in comparison to LARC, as perceived by HCPs in non-GP settings. Five electronic databases were searched in April 2018 using terms related to LARC, OC, HCPs, and views, but not terms related to GPs. Studies were excluded if they concerned emergency oral contraception, male contraceptives, contraceptive use in conjunction with a health condition(s), developing countries, GPs and GP settings, were non-English or was not published before 2013. A total of six studies were included for systematic reviewing. Five key areas emerged, under which themes were categorised, including (1) understanding HCP attitudes and counselling practices towards contraceptive methods; (2) assessment of HCP attitudes and beliefs about contraceptive methods; (3) misconceptions and concerns towards contraceptive methods; and (4) influences on views, attitudes, and beliefs of contraceptive methods. Limited education and training of HCPs exists around LARC provision, particularly compared to OC. The most common misconception inhibiting HCPs contraceptive information delivery to women was the belief that LARC was inappropriate for nulliparous women. In turn, by not providing the correct information on a variety of contraceptive methods, HCP counselling practices were disempowering for women and restricted them from accessing reproductive justice. Educating HCPs to be able to provide accurate and factual information to women on all contraception is vital to encourage a woman-centered approach during contraceptive counselling and promote informed choices by women.

Keywords: advice, contraceptives, health care professionals, long acting reversible contraception, oral contraception, reproductive justice

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Authors: Paulina Ojeda, Damaris Estrella, Hector Rubio

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Insomnia is a disorder characterized by difficulty falling asleep, staying asleep or both. It negatively affects the life quality of people, it hinders the concentration, attention, memory, motor skills, among other abilities that complicate work or learning. Some studies show that women are more susceptible to insomnia. Medicine curricula usually involve a great deal of theoretical and memory content, especially in the early years of the course. The way to accredit a university course is to demonstrate the level of competence or acquired knowledge. In Mexico the most widely used form of measurement is written exams, with numerical scales results. The prevalence of sleep disorders in university students is usually high, so it is important to know if insomnia has an effect on school performance in men and women. A cross-sectional study was designed that included a probabilistic sample of 118 regular students from the School of Medicine of the Autonomous University of Yucatan, Mexico. All on legally age. The project was authorized by the School of Medicine and all the ethical implications of the case were monitored. Participants completed anonymously the following questionnaires: Pittsburgh Sleep Quality Index, Insomnia Severity Index, AUDIT test, epidemiological and clinical data. Academic performance was assessed by the average number of official grades earned on written exams, as well as the number of approved or non-approved courses. These data were obtained officially through the corresponding school authorities. Students with at least one unapproved course or average less than 70 were considered to be poor performers. With all courses approved and average between 70-79 as regular performance and with an average of 80 or higher as a good performance. Statistical analysis: t-Student, difference of proportions and ANOVA. 65 men with a mean age of 19.15 ± 1.60 years and 53 women of 18.98 ± 1.23 years, were included. 96% of the women and 78.46% of the men sleep in the family home. 16.98% of women and 18.46% of men consume tobacco. Most students consume caffeinated beverages. 3.7% of the women and 10.76% of the men complete criteria of harmful consumption of alcohol. 98.11% of the women and 90.76% of the men are perceived with poor sleep quality. Insomnia was present in 73% of women and 66% of men. Women had higher levels of moderate insomnia (p=0.02) compared to men and only one woman had severe insomnia. 50.94% of the women and 44.61% of the men had poor academic performance. 18.86% of women and 27% of men performed well. Only in the group of women we found a significant association between poor performance with mild (p= 0.0035) and moderate (p=0.031) insomnia. The medical students reported poor sleep quality and insomnia. In women, levels of insomnia were associated with poor academic performance.

Keywords: scholar-average, sex, sleep, university

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Authors: Briony Gray, Glenn Simpson, Hajira Dambha-Miller, Andrew Farmer

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Multimorbidity may be strongly affected by a variety of conditions, factors, and variables requiring higher demands on health and social care services, infrastructure, and expenses. Holding one or more conditions increases one’s risk for development of future conditions; with patients over 65 years old at highest risk. Psychosocial factors such as anxiety and depression are rising exponentially globally, which has been amplified by the COVID19 pandemic. These are highly correlated and predict poorer outcomes when held in coexistence and increase the likelihood of comorbid physical health conditions. While possible future reform of social and healthcare systems may help to alleviate some of these mounting pressures, there remains an urgent need to better understand the potential role health behaviours and psychosocial conditions - such as anxiety and depression – may have on aging populations. Using the UK healthcare scene as a lens for analysis, this study uses big data collected in the UK Longitudinal Study of Aging (ELSA) to examine the role of anxiety and depression in ageing populations (65yrs+). Using logistic regression modelling, results identify the 10 most significant variables correlated with both anxiety and depression from data categorised into the areas of health behaviour, psychosocial, socioeconomic, and life satisfaction (each demonstrated through literature review to be of significance). These are compared with wider global research findings with the aim of better understanding the areas in which social and healthcare reform can support multimorbidity interventions, making suggestions for improved patient-centred care. Scope of future research is outlined, which includes analysis of 59 total multimorbidity variables from the ELSA dataset, going beyond anxiety and depression.

Keywords: multimorbidity, health behaviours, patient centred care, psychosocial factors

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Authors: D. A. S. Gamage, B. F. A. Basnayake, W. A. J. M. De Costa

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Agriculture plays an important and strategic role in the performance of Sri Lankan national economy. Rice is the staple food of Sri Lankans thus; rice cultivation is the major agricultural activity of the country. In Sri Lanka, out of the total rice production, a considerable amount of rice straw and rice husk goes wasted. Hence, there is a great potential of production of quality compost and rice husk charcoal. The concept of making rice straw compost and rice husk charcoal is practicable in Sri Lanka, where more than 40% of the farmers are engaged in rice cultivation. The application of inorganic nitrogen fertilizer has become a burden to the country. Rice husk charcoal as a coating material to retain N fertilizer is a suitable solution to gradually release nitrogenous compounds. Objective of this study was to produce rice husk charcoal coated urea as a slow releasing fertilizer with rice straw compost and to compare the leaching losses of nitrogen, phosphorus and potassium using leaching columns. Leaching column studies were prepared using 1.2 m tall PVC pipes with a diameter of 15 cm and a sampling port was attached to the bottom end of the column-cap. Leachates (100 ml/leaching column) were obtained from two sets of (each set has four leaching columns) leaching columns. The sampling was done once a week for 3 month period. Rice husk charcoal coated urea can potentially be used as a slow releasing nitrogen fertilizer which reduces leaching losses of urea. It also helps reduce the phosphate and potassium leaching. The cyclic effect of phosphate release is an important finding which could be the central issue in defining microbial behavior in soils. The fluctuations of phosphate may have cyclic effects of 28 days. In addition, rice straw compost and rice husk charcoal coating is less costly and contribute to mitigate pollution of water bodies by inorganic fertilizers.

Keywords: leaching, mitigate, rice husk charcoal, slow releasing fertilizer

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Authors: Gayani K. Nandasiri, Tilak Dias, William Hurley

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Venous disease of human lower limb could range from minor asymptomatic incompetence of venous valves to chronic venous ulceration. The sheer prevalence of varicose veins and its associated significant costs of treating late complications such as chronic ulcers contribute to a higher burden on health care resources. In most of western countries with developed health care systems, treatment costs associated with Venous disease accounts for a considerable portion of their total health care budget, and it has become a high-cost burden to National Health Service (NHS), UK. The established gold standard of treatment for the venous disease is the graduated compression, where the pressure at the ankle being highest and decreasing towards the knee and thigh. Currently, medical practitioners use two main methods to treat venous disease; i.e. compression bandaging and compression stockings. Both these systems have their own disadvantages which lead to the current programme of research. The aim of the present study is to revolutionize the compression therapy by using a novel active compression system to deliver a controllable and more accurate pressure profiles using a series of inflatable mini bladders. Two types of commercially available silicones were tested for the application. The mini bladders were designed with a special fabrication procedure to provide required pressure profiles, and a series of experiments were conducted to characterise the mini bladders. The inflation/deflation heights of these mini bladders were investigated experimentally and using a finite element model (FEM), and the experimental data were compared to the results obtained from FEM simulations, which showed 70-80% agreement. Finally, the mini bladders were tested for its pressure transmittance characteristics, and the results showed a 70-80% of inlet air pressure transmitted onto the treated surface.

Keywords: finite element analysis, graduated compression, inflatable bladders, venous disease

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Authors: Choonoh Lee, Seyeon Park, Dongyun Kang, Jaehyeong Choi, Soojee Kim, Younggeun Kim

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Market Kurly is the first South Korean online grocery retailer that guarantees same-day, overnight shipping. More than 1.6 million customers place an average of 4.7 million orders and add 3 to 14 products into a cart per month. The company has sold almost 30,000 kinds of various products in the past 6 months, including food items, cosmetics, kitchenware, toys for kids/pets, and even flowers. The company is operating and expanding multiple dry, cold, and frozen fulfillment centers in order to store and ship these products. Due to the scale and complexity of the fulfillment, pick-pack-ship processes are planned and operated in batches, and thus, the planning that decides the batch of the customers’ orders is a critical factor in overall productivity. This paper introduces a metaheuristic optimization method that reduces the complexity of batch processing in a fulfillment center. The method is an iterative genetic algorithm with heuristic creation and evolution strategies; it aims to group similar orders into pick-pack-ship batches to minimize the total number of distinct products. With a well-designed approach to create initial genes, the method produces streamlined plans, up to 13.5% less complex than the actual plans carried out in the company’s fulfillment centers in the previous months. Furthermore, our digital-twin simulations show that the optimized plans can reduce 3% of operation time for packing, which is the most complex and time-consuming task in the process. The optimization method implements a multithreading design on the Spring framework to support the company’s warehouse management systems in near real-time, finding a solution for 4,000 orders within 5 to 7 seconds on an AWS c5.2xlarge instance.

Keywords: fulfillment planning, genetic algorithm, online grocery retail, optimization

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Authors: S. Fadda, M. Fiori, C. Matzuzzi

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Mineralized formations in the bottom sediments of a Miocene transgression have been discovered in Sardinia. The mineral assemblage consists of copper sulphides and oxidates suggesting fluctuations of redox conditions in neutral to high-pH restricted shallow-water coastal basins. Azurite/malachite has been observed as authigenic and occurs as loose spheroidal crystalline particles associated with the transitional-littoral horizon forming the bottom of the marine transgression. Many field observations are consistent with a supergenic circulation of metals involving terrestrial groundwater-seawater mixing. Both clastic materials and metals come from Tertiary volcanic edifices while the main precipitating anions, carbonates, and sulphides species are of both continental and marine origin. Formation of Cu carbonates as a supergene secondary 'oxide' assemblage, does not agree with field evidences, petrographic observations along with textural evidences in the host-rock types. Samples were collected along the sedimentary sequence for different analyses: the majority of elements were determined by X-ray fluorescence and plasma-atomic emission spectroscopy. Mineral identification was obtained by X-ray diffractometry and scanning electron microprobe. Thin sections of the samples were examined in microscopy while porosity measurements were made using a mercury intrusion porosimeter. Cu-carbonates deposited at a temperature below 100 C° which is consistent with the clay minerals in the matrix of the host rock dominated by illite and montmorillonite. Azurite nodules grew during the early diagenetic stage through reaction of cupriferous solutions with CO₂ imported from the overlying groundwater and circulating through the sandstones during shallow burial. Decomposition of organic matter in the bottom anoxic waters released additional carbon dioxide to pore fluids for azurite stability. In this manner localized reducing environments were also generated in which Cu was fixed as Cu-sulphide and sulphosalts. Microscopic examinations of textural features of azurite nodules give evidence of primary malachite/azurite deposition rather than supergene oxidation in place of primary sulfides. Photomicrographs show nuclei of azurite and malachite surrounded by newly formed microcrystalline carbonates which constitute the matrix. The typical pleochroism of crystals can be observed also when this mineral fills microscopic fissures or cracks. Sedimentological evidence of transgression and regression indicates that the pore water would have been a variable mixture of marine water and groundwaters with a possible meteoric component in an alternatively exposed and subaqueous environment owing to water-level fluctuation. Salinity data of the pore fluids, assessed at random intervals along the mineralised strata confirmed the values between about 7000 and 30,000 ppm measured in coeval sediments at the base of Miocene falling in the range of a more or less diluted sea water. This suggests a variation in mean pore-fluids pH between 5.5 and 8.5, compatible with the oxidized and reduced mineral paragenesis described in this work. The results of stable isotopes studies reflect the marine transgressive-regressive cyclicity of events and are compatibile with carbon derivation from sea water. During the last oxidative stage of diagenesis, under surface conditions of higher activity of H₂O and O₂, CO₂ partial pressure decreased, and malachite becomes the stable Cu mineral. The potential for these small but high grade deposits does exist.

Keywords: sedimentary, Cu-carbonates, authigenic, tertiary, Sardinia

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