Search results for: quality of life

Authors: Kaviyarasan D., Satish Kumar S. R.

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India being vast in area and population with great scope of international business, roadways and railways network connection within the country is expected to have a big growth. There are numerous rail-cum-road bridges constructed across many major rivers in India and few are getting very old. So there is more possibility of repairing or coming up with such new bridges in India. Analysis and design of such bridges are practiced through conventional procedure and end up with heavy and uneconomical sections. Such heavy class steel bridges when subjected to high seismic shaking has more chance to fail by stability because the members are too much rigid and stocky rather than being flexible to dissipate the energy. This work is the collective study of the researches done in the truss bridge and steel concrete composite truss bridges presenting the method of analysis, tools for numerical and analytical modeling which evaluates its seismic behaviour and collapse mechanisms. To ascertain the inelastic and nonlinear behaviour of the structure, generally at research level static pushover analysis is adopted. Though the static pushover analysis is now extensively used for the framed steel and concrete buildings to study its lateral action behaviour, those findings by pushover analysis done for the buildings cannot directly be used for the bridges as such, because the bridges have completely a different performance requirement, behaviour and typology as compared to that of the buildings. Long span steel bridges are mostly the truss bridges. Truss bridges being formed by many members and connections, the failure of the system does not happen suddenly with single event or failure of one member. Failure usually initiates from one member and progresses gradually to the next member and so on when subjected to further loading. This kind of progressive collapse of the truss bridge structure is dependent on many factors, in which the live load distribution and span to length ratio are most significant. The ultimate collapse is anyhow by the buckling of the compression members only. For regular bridges, single step pushover analysis gives results closer to that of the non-linear dynamic analysis. But for a complicated bridge like heavy class steel bridge or the skewed bridges or complicated dynamic behaviour bridges, nonlinear analysis capturing the progressive yielding and collapse pattern is mandatory. With the knowledge of the postelastic behaviour of the bridge and advancements in the computational facility, the current level of analysis and design of bridges has moved to state of ascertaining the performance levels of the bridges based on the damage caused by seismic shaking. This is because the buildings performance levels deals much with the life safety and collapse prevention levels, whereas the bridges mostly deal with the extent damages and how quick it can be repaired with or without disturbing the traffic after a strong earthquake event. The paper would compile the wide spectrum of modeling to analysis of the steel concrete composite truss bridges in general.

Keywords: bridge engineering, performance based design of steel truss bridge, seismic design of composite bridge, steel-concrete composite bridge

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Authors: Tesfaye Dagne, Dagmawit Solomon, Firmaye Bogale, Yosef Gebreyohannes, Samson Mideksa, Mamuye Hadis, Desalegn Ararso, Ermias Woldie, Tsegaye Getachew, Sabit Ababor, Zelalem Kebede

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Globally, road traffic accident (RTA) is causing millions of deaths and injuries every year. It is one of the leading causes of death among people of all age groups and the problem is worse among young reproductive age group. Moreover the problem is increasing with an increasing number of vehicles. The majority of the problem happen in low and middle income countries (LMIC), even if the number of vehicles in these countries is low compared to their population. So, the objective of this paper is to summarize the best available evidence on interventions that can reduce road traffic accidents in low and middle income countries (LMIC). Method: A rapid evidence synthesis approach adapted from the SURE Rapid Response Service was applied to search, appraise and summarize the best available evidence on effective intervention in reducing road traffic injury. To answer the question under review, we searched for relevant studies from databases including PubMed, the Cochrane Library, TRANSPORT, Health system evidence, Epistemonikos, and SUPPORT summary. The following key terms were used for searching: Road traffic accident, RTA, Injury, Reduc*, Prevent*, Minimiz*, “Low and middle-income country”, LMIC. We found 18 articles through a search of different databases mentioned above. After screening for the titles and abstracts of the articles, four of them which satisfy the inclusion criteria were included in the final review. Then we appraised and graded the methodological quality of systematic reviews that are deemed to be highly relevant using AMSTAR. Finding: The identified interventions to reduce road traffic accidents were legislation and enforcement, public awareness/education, speed control/ rumble strips, road improvement, mandatory motorcycle helmet, graduated driver license, street lighting. Legislation and Enforcement: Legislation focusing on mandatory motorcycle helmet usage, banning cellular phone usage when driving, seat belt laws, decreasing the legal blood alcohol content (BAC) level from 0.06 g/L to 0.02 g/L bring the best result where enforcement is there. Public Awareness/Education: focusing on seat belt use, child restraint use, educational training in health centers and schools/universities, and public awareness with media through the distribution of videos, posters/souvenirs, and pamphlets are effective in the short run. Speed Control: through traffic calming bumps, or speed bumps, rumbled strips are effective in reducing accidents and fatality. Mandatory Motorcycle Helmet: is associated with reduction in mortality. Graduated driver’s license (GDL): reduce road traffic injury by 19%. Street lighting: is a low-cost intervention which may reduce road traffic accidents.

Keywords: evidence synthesis, injury, rapid review, reducing, road traffic accident

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Authors: Mona Isazad Mashinchi, Davood Roshan Sangachin, Francis J. Sullivan, Dietrich Rebholz-Schuhmann

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Background: Decision-making processes are nowadays driven by data, data analytics and Business Intelligence (BI). BI as a software platform can provide a wide variety of capabilities such as organization memory, information integration, insight creation and presentation capabilities. Visualizing data through dashboards is one of the BI solutions (for a variety of areas) which helps managers in the decision making processes to expose the most informative information at a glance. In the healthcare domain to date, dashboard presentations are more frequently used to track performance related metrics and less frequently used to monitor those quality parameters which relate directly to patient outcomes. Providing effective and timely care for patients and improving the health outcome are highly dependent on presenting and visualizing data and information. Objective: In this research, the focus is on the presentation capabilities of BI to design a dashboard for prostate cancer (PC) data that allows better decision making for the patients, the hospital and the healthcare system related to a cancer dataset. The aim of this research is to customize a retrospective PC dataset in a dashboard interface to give a better understanding of data in the categories (risk factors, treatment approaches, disease control and side effects) which matter most to patients as well as other stakeholders. By presenting the outcome in the dashboard we address one of the major targets of a value-based health care (VBHC) delivery model which is measuring the value and presenting the outcome to different actors in HC industry (such as patients and doctors) for a better decision making. Method: For visualizing the stored data to users, three interactive dashboards based on the PC dataset have been developed (using the Tableau Software) to provide better views to the risk factors, treatment approaches, and side effects. Results: Many benefits derived from interactive graphs and tables in dashboards which helped to easily visualize and see the patients at risk, better understanding the relationship between patient's status after treatment and their initial status before treatment, or to choose better decision about treatments with fewer side effects regarding patient status and etc. Conclusions: Building a well-designed and informative dashboard is related to three important factors including; the users, goals and the data types. Dashboard's hierarchies, drilling, and graphical features can guide doctors to better navigate through information. The features of the interactive PC dashboard not only let doctors ask specific questions and filter the results based on the key performance indicators (KPI) such as: Gleason Grade, Patient's Age and Status, but may also help patients to better understand different treatment outcomes, such as side effects during the time, and have an active role in their treatment decisions. Currently, we are extending the results to the real-time interactive dashboard that users (either patients and doctors) can easily explore the data by choosing preferred attribute and data to make better near real-time decisions.

Keywords: business intelligence, dashboard, decision making, healthcare, prostate cancer, value-based healthcare

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Authors: M. Louise Humbert, Karen E. Chad, Natalie E. Houser, Marta E. Erlandson

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Physical literacy is the motivation, confidence, physical competence, knowledge, and understanding to value and takes responsibility for engagement in physical activities for life. In recent years, physical literacy has emerged as a determinant of health, promoting a positive lifelong physical activity trajectory. Physical literacy’s holistic approach and emphasis on the intrinsic valuation of movement provide an encouraging avenue for intervention among children to develop competent and confident movers. Although there is research on physical literacy interventions, no evidence exists on the outcomes of multi-sectoral interventions involving a combination of home, school, and community contexts. Since children interact with and in a wide range of contexts (home, school, community) daily, interventions designed to address a combination of these contexts are critical to the development of physical literacy. Working with school administrators and teachers, sports and recreation leaders, and community members, our team of university and community researchers conducted and evaluated one of the first multi-contextual and multi-sectoral physical literacy interventions in Canada. Schools played a critical role in this multi-sector intervention, and in this project, teachers and administrators focused their actions on developing physical literacy in students 10 to 14 years of age through the instruction of physical literacy-focused physical education lessons. Little is known about the experiences of educators when they work alongside an array of community representatives to develop physical literacy in school-aged children. Given the uniqueness of this intervention, we sought to answer the question, ‘What were the experiences of school-based educators involved in a multi-sectoral partnership focused on creating a physical literacy enriched community intervention?’ A thematic analysis approach was used to analyze data collected from interviews with educators and administrators, informal conversations, documents, and observations at workshops and meetings. Results indicated that schools and educators played the largest role in this multi-sector intervention. Educators initially reported a limited understanding of physical literacy and expressed a need for resources linked to the physical education curriculum. Some anxiety was expressed by the teachers as their students were measured, and educators noted they wanted to increase their understanding and become more involved in the assessment of physical literacy. Teachers reported that the intervention’s focus on physical literacy positively impacted the scheduling and their instruction of physical education. Administrators shared their desire for school and division-level actions targeting physical literacy development like the current focus on numeracy and literacy, treaty education, and safe schools. As this was one of the first multi-contextual and multi-sectoral physical literacy interventions, it was important to document creation and delivery experiences to encourage future growth in the area and develop suggested best practices.

Keywords: physical literacy, multi sector intervention, physical education, teachers

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Authors: Marina Shargorodsky

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Aim: Gestational weight gain (GWG) has been related to altering future weight-gain curves and increased risks of obesity later in life. Obesity may contribute to vascular atherosclerotic changes as well as excess cardiovascular morbidity and mortality observed in these patients. Noninvasive arterial testing, such as ultrasonographic measurement of carotid IMT, is considered a surrogate for systemic atherosclerotic disease burden and is predictive of cardiovascular events in asymptomatic individuals as well as recurrent events in patients with known cardiovascular disease. Currently, there is no consistent evidence regarding the vascular impact of excessive GWG. The present study was designed to investigate the impact of GWG on early atherosclerotic changes during late pregnancy, using intima-media thickness, as well as placental vascular circulation and inflammatory lesions and pregnancy outcomes. Methods: The study group consisted of 59 pregnant women who gave birth and underwent a placental histopathological examination at the Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Israel, in 2019. According to the IOM guidelines the study group has been divided into two groups: Group 1 included 32 women with pregnancy weight gain within recommended range; Group 2 included 27 women with excessive weight gain during pregnancy. The IMT was measured from non-diseased intimal and medial wall layers of the carotid artery on both sides, visualized by high-resolution 7.5 MHz ultrasound (Apogee CX Color, ATL). Placental histology subdivided placental findings to lesions consistent with maternal vascular and fetal vascular malperfusion according to the criteria of the Society for Pediatric Pathology, subdividing placental findings to lesions consistent with maternal vascular and fetal vascular malperfusion, as well as the inflammatory response of maternal and fetal origin. Results: IMT levels differed between groups and were significantly higher in Group 1 compared to Group 2 (0.7+/-0.1 vs 0.6+/-0/1, p=0.028). Multiple linear regression analysis of IMT included variables based on their associations in univariate analyses with a backward approach. Included in the model were pre-gestational BMI, HDL cholesterol and fasting glucose. The model was significant (p=0.001) and correctly classified 64.7% of study patients. In this model, pre-pregnancy BMI remained a significant independent predictor of subclinical atherosclerosis assessed by IMT (OR 4.314, 95% CI 0.0599-0.674, p=0.044). Among placental lesions related to fetal vascular malperfusion, villous changes consistent with fetal thrombo-occlusive disease (FTOD) were significantly higher in Group 1 than in Group 2, p=0.034). In Conclusion, the present study demonstrated that excessive weight gain during pregnancy is associated with an adverse effect on early stages of subclinical atherosclerosis, placental vascular circulation and neonatal complications. The precise mechanism for these vascular changes, as well as the overall clinical impact of weight control during pregnancy on IMT, placental vascular circulation as well as pregnancy outcomes, deserves further investigation.

Keywords: obesity, pregnancy, complications, weight gain

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Authors: Shiyi He, Yan Xia, Xiaoping Ouyang, Liang Chen, Zhongbing Zhang, Jinlu Ruan

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As the key system of the spacecraft, various propelling system have been developing rapidly, including ion thrust, laser thrust, solar sail and other micro-thrusters. However, there still are some shortages in these systems. The ion thruster requires the high-voltage or magnetic field to accelerate, resulting in extra system, heavy quantity and large volume. The laser thrust now is mostly ground-based and providing pulse thrust, restraint by the station distribution and the capacity of laser. The thrust direction of solar sail is limited to its relative position with the Sun, so it is hard to propel toward the Sun or adjust in the shadow.In this paper, a novel nuclear thruster based on alpha decay and spontaneous fission is proposed and the principle of this radiation-thrust with alpha particle has been expounded. Radioactive materials with different released energy, such as 210Po with 5.4MeV and 238Pu with 5.29MeV, attached to a metal film will provides various thrust among 0.02-5uN/cm2. With this repulsive force, radiation is able to be a power source. With the advantages of low system quantity, high accuracy and long active time, the radiation thrust is promising in the field of space debris removal, orbit control of nano-satellite array and deep space exploration. To do further study, a formula lead to the amplitude and direction of thrust by the released energy and decay coefficient is set up. With the initial formula, the alpha radiation elements with the half life period longer than a hundred days are calculated and listed. As the alpha particles emit continuously, the residual charge in metal film grows and affects the emitting energy distribution of alpha particles. With the residual charge or extra electromagnetic field, the emitting of alpha particles performs differently and is analyzed in this paper. Furthermore, three more complex situations are discussed. Radiation element generating alpha particles with several energies in different intensity, mixture of various radiation elements, and cascaded alpha decay are studied respectively. In combined way, it is more efficient and flexible to adjust the thrust amplitude. The propelling model of the spontaneous fission is similar with the one of alpha decay, which has a more complex angular distribution. A new quasi-sphere space propelling system based on the radiation-thrust has been introduced, as well as the collecting and processing system of excess charge and reaction heat. The energy and spatial angular distribution of emitting alpha particles on unit area and certain propelling system have been studied. As the alpha particles are easily losing energy and self-absorb, the distribution is not the simple stacking of each nuclide. With the change of the amplitude and angel of radiation-thrust, orbital variation strategy on space debris removal is shown and optimized.

Keywords: alpha decay, angular distribution, emitting energy, orbital variation, radiation-thruster

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Authors: Sandra Young

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The biodiversity literature is vast and heterogeneous. In today’s data age, numbers of data integration and standardisation initiatives aim to facilitate simultaneous access to all the literature across biodiversity domains for research and forecasting purposes. Ontologies are being used increasingly to organise this information, but the rationalisation intrinsic to ontologies can hit obstacles when faced with the intrinsic fluidity and inconsistency found in the domains comprising biodiversity. Essentially the problem is a conceptual one: biological taxonomies are formed on the basis of specific, physical specimens yet nomenclatural rules are used to provide labels to describe these physical objects. These labels are ambiguous representations of the physical specimen. An example of this is with the genus Melpomene, the scientific nomenclatural representation of a genus of ferns, but also for a genus of spiders. The physical specimens for each of these are vastly different, but they have been assigned the same nomenclatural reference. While there is much research into the conceptual stability of the taxonomic concept versus the nomenclature used, to the best of our knowledge as yet no research has looked empirically at the literature to see the conceptual plurality or singularity of the use of these species’ names, the linguistic representation of a physical entity. Language itself uses words as symbols to represent real world concepts, whether physical entities or otherwise, and as such lexicography has a well-founded history in the conceptual mapping of words in context for dictionary making. This makes it an ideal candidate to explore this problem. The lexicographic approach uses corpus-based analysis to look at word use in context, with a specific focus on collocated word frequencies (the frequencies of words used in specific grammatical and collocational contexts). It allows for inconsistencies and contradictions in the source data and in fact includes these in the word characterisation so that 100% of the available evidence is counted. Corpus analysis is indeed suggested as one of the ways to identify concepts for ontology building, because of its ability to look empirically at data and show patterns in language usage, which can indicate conceptual ideas which go beyond words themselves. In this sense it could potentially be used to identify if the hierarchical structures present within the empirical body of literature match those which have been identified in ontologies created to represent them. The first stages of this research have revealed a hierarchical structure that becomes apparent in the biodiversity literature when annotating scientific species’ names, common names and more general names as classes, which will be the focus of this paper. The next step in the research is focusing on a larger corpus in which specific words can be analysed and then compared with existing ontological structures looking at the same material, to evaluate the methods by means of an alternative perspective. This research aims to provide evidence as to the validity of the current methods in knowledge representation for biological entities, and also shed light on the way that scientific nomenclature is used within the literature.

Keywords: ontology, biodiversity, lexicography, knowledge representation, corpus linguistics

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Authors: Shilpa Murthy, Hazlina Binti Abu Bakar, Juliet Mathew, Chandrashekhar Thummala Hlly Sreerama Reddy, Pathiyil Ravi Shankar

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Simulation is defined as a technique that replaces or expands real experiences with guided experiences that interactively imitate real-world processes or systems. Simulation enables learners to train in a safe and non-threatening environment. For decades, simulation has been considered an integral part of clinical teaching and learning strategy in medical education. The several types of simulation used in medical education and the clinical environment can be applied to several models, including full-body mannequins, task trainers, standardized simulated patients, virtual or computer-generated simulation, or Hybrid simulation that can be used to facilitate learning. Simulation allows healthcare practitioners to acquire skills and experience while taking care of patient safety. The recent COVID pandemic has also led to an increase in simulation use, as there were limitations on medical student placements in hospitals and clinics. The learning is tailored according to the educational needs of students to make the learning experience more valuable. Simulation in the pre-clinical years has challenges with resource constraints, effective curricular integration, student engagement and motivation, and evidence of educational impact, to mention a few. As instructors, we may have more reliance on the use of simulation for pre-clinical students while the students’ confidence levels and perceived competence are to be evaluated. Our research question was whether the implementation of simulation-based learning positively influences preclinical medical students' confidence levels and perceived competence. This study was done to align the teaching activities with the student’s learning experience to introduce more low-fidelity simulation-based teaching sessions for pre-clinical years and to obtain students’ input into the curriculum development as part of inclusivity. The study was carried out at International Medical University, involving pre-clinical year (Medical) students who were started with low-fidelity simulation-based medical education from their first semester and were gradually introduced to medium fidelity, too. The Student Satisfaction and Self-Confidence in Learning Scale questionnaire from the National League of Nursing was employed to collect the responses. The internal consistency reliability for the survey items was tested with Cronbach’s alpha using an Excel file. IBM SPSS for Windows version 28.0 was used to analyze the data. Spearman’s rank correlation was used to analyze the correlation between students’ satisfaction and self-confidence in learning. The significance level was set at p value less than 0.05. The results from this study have prompted the researchers to undertake a larger-scale evaluation, which is currently underway. The current results show that 70% of students agreed that the teaching methods used in the simulation were helpful and effective. The sessions are dependent on the learning materials that are provided and how the facilitators engage the students and make the session more enjoyable. The feedback provided inputs on the following areas to focus on while designing simulations for pre-clinical students. There are quality learning materials, an interactive environment, motivating content, skills and knowledge of the facilitator, and effective feedback.

Keywords: low-fidelity simulation, pre-clinical simulation, students satisfaction, self-confidence

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Authors: Amir E. Amirzadeh, Richard K. Strand

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Moisture-induced problems are a significant concern for building owners, architects, construction managers, and building engineers, as they can have substantial impacts on building enclosures' durability and performance. Computational analyses, such as hygrothermal and thermal analysis, can provide valuable information and demonstrate the expected relative performance of building enclosure systems but are not grounded in absolute certainty. This paper evaluates the hygrothermal performance of common enclosure systems in hospitals in cold climates. The study aims to investigate the impact of exterior wall systems on hospitals, focusing on factors such as durability, construction deficiencies, and energy performance. The study primarily examines the impact of air leakage and vapor retarding layers relative to energy consumption. While these factors have been studied in residential and commercial buildings, there is a lack of information on their impact on hospitals in a holistic context. The study integrates various research studies and professional experience in hospital building design to achieve its objective. The methodology involves surveying and observing exterior wall assemblies, reviewing common exterior wall assemblies and details used in hospital construction, performing simulations and numerical analyses of various variables, validating the model and mechanism using available data from industry and academia, visualizing the outcomes of the analysis, and developing a mechanism to demonstrate the relative performance of exterior wall systems for hospitals under specific conditions. The data sources include case studies from real-world projects and peer-reviewed articles, industry standards, and practices. This research intends to integrate and analyze the in-situ and as-designed performance and durability of building enclosure assemblies with numerical analysis. The study's primary objective is to provide a clear and precise roadmap to better visualize and comprehend the correlation between the durability and performance of common exterior wall systems used in the construction of hospitals and the energy consumption of these buildings under certain static and dynamic conditions. As the construction of new hospitals and renovation of existing ones have grown over the last few years, it is crucial to understand the effect of poor detailing or construction deficiencies on building enclosure systems' performance and durability in healthcare buildings. This study aims to assist stakeholders involved in hospital design, construction, and maintenance in selecting durable and high-performing wall systems. It highlights the importance of early design evaluation, regular quality control during the construction of hospitals, and understanding the potential impacts of improper and inconsistent maintenance and operation practices on occupants, owner, building enclosure systems, and Heating, Ventilation, and Air Conditioning (HVAC) systems, even if they are designed to meet the project requirements.

Keywords: hygrothermal analysis, building enclosure, hospitals, energy efficiency, optimization and visualization, uncertainty and decision making

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Authors: Gabriel Acha Ekobi

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Fathers play a crucial role in meeting family needs such as affection, protection, and socio-economic needs of children in the world in general and South Africa in particular. Fathers’ role in children’s lives is important in providing socialization, leadership skills, and teaching societal norms. Fathers influence is very significant for children’s well-being and development as it provides the child with moral lessons, guidance, and economic support. However, there is a paucity of information regarding the effects of fathers on children. In addition, despite legal frameworks such as the African Charter on the Rights and Welfare of the child (1999) introduced by the African Union to promote child rights nevertheless, it appears maltreatment, abuse, and poor health care continue to face children. Also, the Constitution of 1996 of the Republic of South Africa (Section 28 of the Bill of Rights) and the Children’s Act 38 of 2005 were introduced by the South African government to foster the rights of children. Nevertheless, these legal frameworks remain ineffective as children’s rights are still neglected by resident fathers. This paper explores the impact of resident fathers on children in the Golf View, Alice town of the Eastern Cape Province, South Africa. A qualitative research method and an exploratory research design were utilized, and 30 participants took part in the study. The participants comprised of single mothers or caregivers of children, resident fathers and social workers. Eighteen (18) single mothers or caregivers, 10 resident fathers, and two (2) social workers participated in the study. Data was collected using semi-structured and unstructured interviews and analysed thematically. Two main themes were identified: the role of fathers on children and the effects of resident fathers on children. The study found that the presence of fathers in the lives of children prevented psychosocial issues such as stress, depression, violence, and substance abuse. A father’s presence in a household was crucial in instilling moral values in children. This allowed them to build positive characters such as respect, kindness, humility, and compassion. Children with more involved fathers tend to have fewer impulse control problems, longer attention spans, and a higher level of sociability. The study concludes that the fathers’ role prevented anxiety, depression, and stress and led to the improvement of children’s education performance. Nevertheless, the absence of a father as a role model to act as a leader by instilling moral values hinders positive behaviours in children. This study recommended that occupational training and life skills programmes should be introduced by the government and other stakeholders to empower the fathers as this might provide the platform for them to bring up their children properly.

Keywords: children, fathering, household, resident, single parent

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Authors: Jamie Lee Harder

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In the context of rapidly changing social and economic circumstances in the developing world, this paper analyses access to public healthcare for poor people with disabilities in Cambodia. Like other countries of South East Asia, Cambodia is developing at rapid pace. The historical past of Cambodia, however, has set former social policy structures to zero. This past forces Cambodia and its citizens to implement new public health policies to align with the needs of social care, healthcare, and urban planning. In this context, the role of people with disabilities (PwDs) is crucial as new developments should and can take into consideration their specific needs from the beginning onwards. This paper is based on qualitative research with expert interviews and focus group discussions in Cambodia. During the field work it became clear that the identification tool for the poorest households (HHs) does not count disability as a financial risk to fall into poverty neither when becoming sick nor because of higher health expenditures and/or lower income because of the disability. The social risk group of poor PwDs faces several barriers in accessing public healthcare. The urbanization, the socio-economic health status, and opportunities for education; all influence social status and have an impact on the health situation of these individuals. Cambodia has various difficulties with providing access to people with disabilities, mostly due to barriers regarding finances, geography, quality of care, poor knowledge about their rights and negative social and cultural beliefs. Shortened budgets and the lack of prioritizations lead to the need for reorientation of local communities, international and national non-governmental organizations and social policy. The poorest HHs are identified with a questionnaire, the IDPoor program, for which the Ministry of Planning is responsible. The identified HHs receive an ‘Equity Card’ which provides access free of charge to public healthcare centers and hospitals among other benefits. The dataset usually does not include information about the disability status. Four focus group discussions (FGD) with 28 participants showed various barriers in accessing public healthcare. These barriers go far beyond a missing ramp to access the healthcare center. The contents of the FGDs were ratified and repeated during the expert interviews with the local Ministries, NGOs, international organizations and private persons working in the field. The participants of the FGDs faced and continue to face high discrimination, low capacity to work and earn an own income, dependency on others and less social competence in their lives. When discussing their health situation, we identified, a huge difference between those who are identified and hold an Equity Card and those who do not. Participants reported high costs without IDPoor identification, positive experiences when going to the health center in terms of attitude and treatment, low satisfaction with specific capacities for treatments, negative rumors, and discrimination with the consequence of fear to seek treatment in many cases. The problem of accessing public healthcare by risk groups can be adapted to situations in other countries.

Keywords: access, disability, health, inequality, Cambodia

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Authors: Simone Cinquemani, Lorenzo Mantovani, Aleksander Dabek

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New technologies in agriculture are opening new challenges and new opportunities. Among these, certainly, robotics, vision, and artificial intelligence are the ones that will make a significant leap, compared to traditional agricultural techniques, possible. In particular, the indoor farming sector will be the one that will benefit the most from these solutions. Vertical farming is a new field of research where mechanical engineering can bring knowledge and know-how to transform a highly labor-based business into a fully autonomous system. The aim of the research is to develop a multi-purpose, modular, and perfectly integrated platform for crop production in indoor vertical farming. Activities will be based both on hardware development such as automatic tools to perform different activities on soil and plants, as well as research to introduce an extensive use of monitoring techniques based on machine learning algorithms. This paper presents the preliminary results of a research project of a vertical farm living lab designed to (i) develop and test vertical farming cultivation practices, (ii) introduce a very high degree of mechanization and automation that makes all processes replicable, fully measurable, standardized and automated, (iii) develop a coordinated control and management environment for autonomous multiplatform or tele-operated robots in environments with the aim of carrying out complex tasks in the presence of environmental and cultivation constraints, (iv) integrate AI-based algorithms as decision support system to improve quality production. The coordinated management of multiplatform systems still presents innumerable challenges that require a strongly multidisciplinary approach right from the design, development, and implementation phases. The methodology is based on (i) the development of models capable of describing the dynamics of the various platforms and their interactions, (ii) the integrated design of mechatronic systems able to respond to the needs of the context and to exploit the strength characteristics highlighted by the models, (iii) implementation and experimental tests performed to test the real effectiveness of the systems created, evaluate any weaknesses so as to proceed with a targeted development. To these aims, a fully automated laboratory for growing plants in vertical farming has been developed and tested. The living lab makes extensive use of sensors to determine the overall state of the structure, crops, and systems used. The possibility of having specific measurements for each element involved in the cultivation process makes it possible to evaluate the effects of each variable of interest and allows for the creation of a robust model of the system as a whole. The automation of the laboratory is completed with the use of robots to carry out all the necessary operations, from sowing to handling to harvesting. These systems work synergistically thanks to the knowledge of detailed models developed based on the information collected, which allows for deepening the knowledge of these types of crops and guarantees the possibility of tracing every action performed on each single plant. To this end, artificial intelligence algorithms have been developed to allow synergistic operation of all systems.

Keywords: automation, vertical farming, robot, artificial intelligence, vision, control

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Authors: Tibor Ajtai, Máté Pintér, Noémi Utry, Gergely Kiss-Albert, Andrea Palágyi, László Manczinger, Csaba Vágvölgyi, Gábor Szabó, Zoltán Bozóki

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According to the best knowledge of the authors, here we experimentally demonstrate first, a quantified correlation between the real-time measured optical feature of the ambient and the off-line measured toxicity data. Finally, using these correlations we are presenting a novel methodology for real time characterisation of ambient toxicity based on the multi wavelength aerosol phase photoacoustic measurement. Ambient carbonaceous particulate matter is one of the most intensively studied atmospheric constituent in climate science nowadays. Beyond their climatic impact, atmospheric soot also plays an important role as an air pollutant that harms human health. Moreover, according to the latest scientific assessments ambient soot is the second most important anthropogenic emission source, while in health aspect its being one of the most harmful atmospheric constituents as well. Despite of its importance, generally accepted standard methodology for the quantitative determination of ambient toxicology is not available yet. Dominantly, ambient toxicology measurement is based on the posterior analysis of filter accumulated aerosol with limited time resolution. Most of the toxicological studies are based on operational definitions using different measurement protocols therefore the comprehensive analysis of the existing data set is really limited in many cases. The situation is further complicated by the fact that even during its relatively short residence time the physicochemical features of the aerosol can be masked significantly by the actual ambient factors. Therefore, decreasing the time resolution of the existing methodology and developing real-time methodology for air quality monitoring are really actual issues in the air pollution research. During the last decades many experimental studies have verified that there is a relation between the chemical composition and the absorption feature quantified by Absorption Angström Exponent (AAE) of the carbonaceous particulate matter. Although the scientific community are in the common platform that the PhotoAcoustic Spectroscopy (PAS) is the only methodology that can measure the light absorption by aerosol with accurate and reliable way so far, the multi-wavelength PAS which are able to selectively characterise the wavelength dependency of absorption has become only available in the last decade. In this study, the first results of the intensive measurement campaign focusing the physicochemical and toxicological characterisation of ambient particulate matter are presented. Here we demonstrate the complete microphysical characterisation of winter time urban ambient including optical absorption and scattering as well as size distribution using our recently developed state of the art multi-wavelength photoacoustic instrument (4λ-PAS), integrating nephelometer (Aurora 3000) as well as single mobility particle sizer and optical particle counter (SMPS+C). Beyond this on-line characterisation of the ambient, we also demonstrate the results of the eco-, cyto- and genotoxicity measurements of ambient aerosol based on the posterior analysis of filter accumulated aerosol with 6h time resolution. We demonstrate a diurnal variation of toxicities and AAE data deduced directly from the multi-wavelength absorption measurement results.

Keywords: photoacoustic spectroscopy, absorption Angström exponent, toxicity, Ames-test

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Authors: Fabrizio Ascione, Martina Borrelli, Rosa Francesca De Masi, Silvia Ruggiero, Giuseppe Peter Vanoli

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The Directive 2010/31/EC 'Directive of the European Parliament and of the Council of 19 may 2010 on the energy performance of buildings' moved the targets of the previous version toward more ambitious targets, for instance by establishing that, by 31 December 2020, all new buildings should demand nearly zero-energy. Moreover, the demonstrative role of public buildings is strongly affirmed so that also the target nearly zero-energy buildings is anticipated, in January 2019. On the other hand, given the very low turn-over rate of buildings (in Europe, it ranges between 1-3%/yearly), each policy that does not consider the renovation of the existing building stock cannot be effective in the short and medium periods. According to this proposal, the study provides a novel, holistic approach to design the refurbishment of educational buildings in colder cities of Mediterranean regions enabling stakeholders to understand the uncertainty to use numerical modelling and the real environmental and economic impacts of adopting some energy efficiency technologies. The case study is a university building of Molise region in the centre of Italy. The proposed approach is based on the application of the cost-optimal methodology as it is shown in the Delegate Regulation 244/2012 and Guidelines of the European Commission, for evaluating the cost-optimal level of energy performance with a macroeconomic approach. This means that the refurbishment scenario should correspond to the configuration that leads to lowest global cost during the estimated economic life-cycle, taking into account not only the investment cost but also the operational costs, linked to energy consumption and polluting emissions. The definition of the reference building has been supported by various in-situ surveys, investigations, evaluations of the indoor comfort. Data collection can be divided into five categories: 1) geometrical features; 2) building envelope audit; 3) technical system and equipment characterization; 4) building use and thermal zones definition; 5) energy building data. For each category, the required measures have been indicated with some suggestions for the identifications of spatial distribution and timing of the measurements. With reference to the case study, the collected data, together with a comparison with energy bills, allowed a proper calibration of a numerical model suitable for the hourly energy simulation by means of EnergyPlus. Around 30 measures/packages of energy, efficiency measure has been taken into account both on the envelope than regarding plant systems. Starting from results, two-point will be examined exhaustively: (i) the importance to use validated models to simulate the present performance of building under investigation; (ii) the environmental benefits and the economic implications of a deep energy refurbishment of the educational building in cold climates.

Keywords: energy simulation, modelling calibration, cost-optimal retrofit, university building

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Authors: Avi Shrivastava

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In 2021, two heart-wrenching scenes, shown live on television screens across countries, painted a grim picture of refugees. One of them was of people clinging onto an airplane's wings in their desperate attempt to flee war-torn Afghanistan. They ultimately fell to their death. The other scene was the U.S. government authorities separating children from their parents or guardians to deter migrants/refugees from coming to the U.S. These events show the desperation refugees feel when they are trying to leave their homes in disaster zones. However, data paints a grave picture of the current refugee situation. It also indicates that a bleak future lies ahead for the refugees across the globe. Data and information are the two threads that intertwine to weave the shimmery fabric of modern society. Data and information are often used interchangeably, but they differ considerably. For example, information analysis reveals rationale, and logic, while data analysis, on the other hand, reveals a pattern. Moreover, patterns revealed by data can enable us to create the necessary tools to combat huge problems on our hands. Data analysis paints a clear picture so that the decision-making process becomes simple. Geopolitical and economic data can be used to predict future refugee hotspots. Accurately predicting the next refugee hotspots will allow governments and relief agencies to prepare better for future refugee crises. The refugee crisis does not have binary answers. Given the emotionally wrenching nature of the ground realities, experts often shy away from realistically stating things as they are. This hesitancy can cost lives. When decisions are based solely on data, emotions can be removed from the decision-making process. Data also presents irrefutable evidence and tells whether there is a solution or not. Moreover, it also responds to a nonbinary crisis with a binary answer. Because of all that, it becomes easier to tackle a problem. Data science and A.I. can predict future refugee crises. With the recent explosion of data due to the rise of social media platforms, data and insight into data has solved many social and political problems. Data science can also help solve many issues refugees face while staying in refugee camps or adopted countries. This paper looks into various ways data science can help solve refugee problems. A.I.-based chatbots can help refugees seek legal help to find asylum in the country they want to settle in. These chatbots can help them find a marketplace where they can find help from the people willing to help. Data science and technology can also help solve refugees' many problems, including food, shelter, employment, security, and assimilation. The refugee problem seems to be one of the most challenging for social and political reasons. Data science and machine learning can help prevent the refugee crisis and solve or alleviate some of the problems that refugees face in their journey to a better life. With the explosion of data in the last decade, data science has made it possible to solve many geopolitical and social issues.

Keywords: refugee crisis, artificial intelligence, data science, refugee camps, Afghanistan, Ukraine

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Authors: Jessica To

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Feedback is one of the powerful levers for enhancing students’ performance. However, some students are under-engaged with feedback because they lack responsibility for feedback uptake. To resolve this conundrum, recent literature proposes feedback partnerships in which students and teachers share the power and responsibilities to co-construct feedback. During feedback co-construction, students express feedback needs to teachers, and teachers respond to individuals’ needs in return. Though this approach can increase students’ feedback ownership, its application is lagging as the field lacks conceptual clarity and implementation guide. This presentation aims to discuss the conceptual framework of feedback partnerships and feedback co-construction strategies. It identifies the components of feedback partnerships and strategies which could facilitate feedback co-construction. A systematic literature review was conducted to answer the questions. The literature search was performed using ERIC, PsycINFO, and Google Scholar with the keywords “assessment partnership”, “student as partner,” and “feedback engagement”. No time limit was set for the search. The inclusion criteria encompassed (i) student-teacher partnerships in feedback, (ii) feedback engagement in higher education, (iii) peer-reviewed publications, and (iv) English as the language of publication. Those without addressing conceptual understanding and implementation strategies were excluded. Finally, 65 publications were identified and analysed using thematic analysis. For the procedure, the texts relating to the questions were first extracted. Then, codes were assigned to summarise the ideas of the texts. Upon subsuming similar codes into themes, four themes emerged: students’ responsibilities, teachers’ responsibilities, conditions for partnerships development, and strategies. Their interrelationships were examined iteratively for framework development. Establishing feedback partnerships required different responsibilities of students and teachers during feedback co-construction. Students needed to self-evaluate performance against task criteria, identify inadequacies and communicate their needs to teachers. During feedback exchanges, they interpreted teachers’ comments, generated self-feedback through reflection, and co-developed improvement plans with teachers. Teachers had to increase students’ understanding of criteria and evaluation skills and create opportunities for students’ expression of feedback needs. In feedback dialogue, teachers responded to students’ needs and advised on the improvement plans. Feedback partnerships would be best grounded in an environment with trust and psychological safety. Four strategies could facilitate feedback co-construction. First, students’ understanding of task criteria could be increased by rubrics explanation and exemplar analysis. Second, students could sharpen evaluation skills if they participated in peer review and received teacher feedback on the quality of peer feedback. Third, provision of self-evaluation checklists and prompts and teacher modeling of self-assessment process could aid students in articulating feedback needs. Fourth, the trust could be fostered when teachers explained the benefits of feedback co-construction, showed empathy, and provided personalised comments in dialogue. Some strategies were applied in interactive cover sheets in which students performed self-evaluation and made feedback requests on a cover sheet during assignment submission, followed by teachers’ response to individuals’ requests. The significance of this presentation lies in unpacking the conceptual framework of feedback partnerships and outlining feedback co-construction strategies. With a solid foundation in theory and practice, researchers and teachers could better enhance students’ engagement with feedback.

Keywords: conceptual framework, feedback co-construction, feedback partnerships, implementation strategies

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Authors: Heikki Ruohomaa, Vesa Salminen

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Regions are facing huge competition to attract companies, businesses, inhabitants, students, etc. This way to improve living and business environment, which is rapidly changing due to digitalization. On the other hand, from the industry's point of view, the availability of a skilled labor force and an innovative environment are crucial factors. In this context, qualified staff has been seen to utilize the opportunities of digitalization and respond to the needs of future skills. World Manufacturing Forum has stated in the year 2019- report that in next five years, 40% of workers have to change their core competencies. Through digital transformation, new technologies like cloud, mobile, big data, 5G- infrastructure, platform- technology, data- analysis, and social networks with increasing intelligence and automation, enterprises can capitalize on new opportunities and optimize existing operations to achieve significant business improvement. Digitalization will be an important part of the everyday life of citizens and present in the working day of the average citizen and employee in the future. For that reason, the education system and education programs on all levels of education from diaper age to doctorate have been directed to fulfill this ecosystem strategy. Goal: The Fourth Industrial Revolution will bring unprecedented change to societies, education organizations and business environments. This article aims to identify how education, education content, the way education has proceeded, and overall whole the education business is changing. Most important is how we should respond to this inevitable co- evolution. Methodology: The study aims to verify how the learning process is boosted by new digital content, new learning software and tools, and customer-oriented learning environments. The change of education programs and individual education modules can be supported by applied research projects. You can use them in making proof- of- the concept of new technology, new ways to teach and train, and through the experiences gathered change education content, way to educate and finally education business as a whole. Major findings: Applied research projects can prove the concept- phases on real environment field labs to test technology opportunities and new tools for training purposes. Customer-oriented applied research projects are also excellent for students to make assignments and use new knowledge and content and teachers to test new tools and create new ways to educate. New content and problem-based learning are used in future education modules. This article introduces some case study experiences on customer-oriented digital transformation projects and how gathered knowledge on new digital content and a new way to educate has influenced education. The case study is related to experiences of research projects, customer-oriented field labs/learning environments and education programs of Häme University of Applied Sciences.

Keywords: education process, digitalization content, digital tools for education, learning environments, transdisciplinary co-operation

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Authors: Sonika Sharma, Mohan G. Vairale, Sibnarayan Datta, Soumya Chatterjee, Dharmendra Dubey, Rajesh Prasad, Raghvendra Budhauliya, Bidisha Das, Vijay Veer

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Bacteriophages are viruses that parasitize specific bacteria and multiply in metabolising host bacteria. Bacteriophages hunt for a single or a subset of bacterial species, making them potential antibacterial agents. Utilizing the ability of phages to control bacterial populations has several applications from medical to the fields of agriculture, aquaculture and the food industry. However, harnessing phage based techniques in wastewater treatments to improve quality of effluent and sludge release into the environment is a potential area for R&D application. Phage mediated bactericidal effect in any wastewater treatment process has many controlling factors that lead to treatment performance. In laboratory conditions, titer of bacteriophages (coliphages) isolated from effluent water of a specially designed anaerobic digester of human night soil (DRDO Biotoilet) was successfully increased with a modified protocol of the classical double layer agar technique. Enrichment of the same was carried out and efficacy of the phage enriched medium was evaluated at different conditions (specific media, temperature, storage conditions). Growth optimization study was carried out on different media like soybean casein digest medium (Tryptone soya medium), Luria-Bertani medium, phage deca broth medium and MNA medium (Modified nutrient medium). Further, temperature-phage yield relationship was also observed at three different temperatures 27˚C, 37˚C and 44˚C at laboratory condition. Results showed the higher activity of coliphage 27˚C and at 37˚C. Further, addition of divalent ions (10mM MgCl2, 5mM CaCl2) and 5% glycerol resulted in a significant increase in phage titer. Besides this, effect of antibiotics addition like ampicillin and kanamycin at different concentration on plaque formation was analysed and reported that ampicillin at a concentration of 1mg/ml ampicillin stimulates phage infection and results in more number of plaques. Experiments to test viability of phage showed that it can remain active for 6 months at 4˚C in fresh tryptone soya broth supplemented with fresh culture of coliforms (early log phase). The application of bacteriophages (especially coliphages) for treatment of effluent of human faecal matter contaminated effluent water is unique. This environment-friendly treatment system not only reduces the pathogenic coliforms, but also decreases the competition between nuisance bacteria and functionally important microbial populations. Therefore, the phage based cocktail to treat fecal pathogenic bacteria present in black water has many implication in wastewater treatment processes including ‘DRDO Biotoilet’, which is an ecofriendly appropriate and affordable human faecal matter treatment technology for different climates and situations.

Keywords: wastewater, microbes, virus, biotoilet, phage viability

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Authors: Tamir Michal

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The subject of Bedouin dispersion has accompanied the State of Israel from the day of its establishment. From a legal point of view, this subject has offered a launchpad for creative judicial decisions. Thus, for example, the first court decision in Israel to recognize affirmative action (Avitan), dealt with a petition submitted by a Jew appealing the refusal of the State to recognize the Petitioner’s entitlement to the long-term lease of a plot designated for Bedouins. The Supreme Court dismissed the petition, holding that there existed a public interest in assisting Bedouin to establish permanent urban settlements, an interest which justifies giving them preference by selling them plots at subsidized prices. In another case (The Forum for Coexistence in the Negev) the Supreme Court extended equitable relief for the purpose of constructing a bridge, even though the construction infringed the Law, in order to allow the children of dispersed Bedouin to reach school. Against this background, the recent verdict, delivered during the Protective Edge military campaign, which dismissed a petition aimed at forcing the State to spread out Protective Structures in Bedouin villages in the Negev against the risk of being hit from missiles launched from Gaza (Abu Afash) is disappointing. Even if, in arguendo, no selective discrimination was involved in the State’s decision not to provide such protection, the decision, and its affirmation by the Court, is problematic when examined through the prism of the Theory of Recognition. The article analyses the issue by tools of theory of Recognition, according to which people develop their identities through mutual relations of recognition in different fields. In the social context, the path to recognition is cognitive respect, which is provided by means of legal rights. By seeing other participants in Society as bearers of rights and obligations, the individual develops an understanding of his legal condition as reflected in the attitude to others. Consequently, even if the Court’s decision may be justified on strict legal grounds, the fact that Jewish settlements were protected during the military operation, whereas Bedouin villages were not, is a setback in the struggle to make the Bedouin citizens with equal rights in Israeli society. As the Court held, ‘Beyond their protective function, the Migunit [Protective Structures] may make a moral and psychological contribution that should not be undervalued’. This contribution is one that the Bedouin did not receive in the Abu Afash verdict. The basic thesis is that the Court’s verdict analyzed above clearly demonstrates that the reliance on classical liberal instruments (e.g., equality) cannot secure full appreciation of all aspects of Bedouin life, and hence it can in fact prejudice them. Therefore, elements of the recognition theory should be added, in order to find the channel for cognitive dignity, thereby advancing the Bedouins’ ability to perceive themselves as equal human beings in the Israeli society.

Keywords: bedouin dispersion, cognitive respect, recognition theory, sustainable development

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Authors: Chettyparambil Lalchand Thejalakshmi, Sonal Sabu Edattukaran

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Hair loss is one of the main issues that contemporary society is dealing with. It can be attributable to a wide range of factors, listing from one's genetic composition and the anxiety we experience on a daily basis. Telogen effluvium [TE] is a condition that causes temporary hair loss after a stressor that might shock the body and cause the hair follicles to temporarily rest, leading to hair loss. Most frequently, women are the ones who bring up these difficulties. Extreme illness or trauma, an emotional or important life event, rapid weight loss and crash dieting, a severe scalp skin problem, a new medication, or ceasing hormone therapy are examples of potential causes. Men frequently do not notice hair thinning with time, but women with long hair may be easily identified when shedding, which can occasionally result in bias because women tend to be more concerned with aesthetics and beauty standards of the society, and approach frequently with the concerns .The woman, who formerly possessed a full head of hair, is worried about the hair loss from her scalp . There are several cases of hair loss reported every day, and Telogen effluvium is said to be the most prevalent one of them all without any hereditary risk factors. While the patient has loss in hair volume, baldness is not the result of this problem . The exponentially growing Dermatology and Aesthetic medical division has discovered that this problem is the most common and also the easiest to cure since it is feasible for these people to regrow their hair, unlike those who have scarring alopecia, in which the follicle itself is damaged and non-viable. Telogen effluvium comes in two different forms: acute and chronic. Acute TE occurs in all the age groups with a hair loss of less than three months, while chronic TE is more common in those between the ages of 30 and 60 with a hair loss of more than six months . Both kinds are prevalent throughout all age groups, regardless of the predominance. It takes between three and six months for the lost hair to come back, although this condition is readily reversed by eliminating stresses. After shedding their hair, patients frequently describe having noticeable fringes on their forehead. The current medical treatments for this condition include topical corticosteroids, systemic corticosteroids, minoxidil and finasteride, CNDPA (caffeine, niacinamide, panthenol, dimethicone, and an acrylate polymer) .Individual terminal hair growth was increased by 10% as a result of the innovative intervention CNDPA. Botulinum Toxin A, Scalp Micro Needling, Platelet Rich Plasma Therapy [PRP], and sessions with Multivitamin Mesotherapy Injections are some recently enhanced techniques with partially or completely reversible hair loss. Also, it has been shown that supplements like Nutrafol and Biotin are producing effective outcomes. There is virtually little evidence to support the claim that applying sulfur-rich ingredients to the scalp, such as onion juice, can help TE patients' hair regenerate.

Keywords: dermatology, telogen effluvium, hair loss, modern hair loass treatments

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Authors: Anudeep Appe, Bhanu Poluparthi, Lakshmi Kasivajjula, Udai Mv, Sobha Bagadi, Punya Modi, Aditya Singh, Hemanth Gunupudi, Spenser Troiano, Jeff Paul, Justin Stovall, Justin Yamamoto

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The necessity of data-driven decisions in healthcare strategy formulation is rapidly increasing. A reliable framework which helps identify factors impacting a healthcare provider facility or a hospital (from here on termed as facility) market share is of key importance. This pilot study aims at developing a data-driven machine learning-regression framework which aids strategists in formulating key decisions to improve the facility’s market share which in turn impacts in improving the quality of healthcare services. The US (United States) healthcare business is chosen for the study, and the data spanning 60 key facilities in Washington State and about 3 years of historical data is considered. In the current analysis, market share is termed as the ratio of the facility’s encounters to the total encounters among the group of potential competitor facilities. The current study proposes a two-pronged approach of competitor identification and regression approach to evaluate and predict market share, respectively. Leveraged model agnostic technique, SHAP, to quantify the relative importance of features impacting the market share. Typical techniques in literature to quantify the degree of competitiveness among facilities use an empirical method to calculate a competitive factor to interpret the severity of competition. The proposed method identifies a pool of competitors, develops Directed Acyclic Graphs (DAGs) and feature level word vectors, and evaluates the key connected components at the facility level. This technique is robust since its data-driven, which minimizes the bias from empirical techniques. The DAGs factor in partial correlations at various segregations and key demographics of facilities along with a placeholder to factor in various business rules (for ex. quantifying the patient exchanges, provider references, and sister facilities). Identified are the multiple groups of competitors among facilities. Leveraging the competitors' identified developed and fine-tuned Random Forest Regression model to predict the market share. To identify key drivers of market share at an overall level, permutation feature importance of the attributes was calculated. For relative quantification of features at a facility level, incorporated SHAP (SHapley Additive exPlanations), a model agnostic explainer. This helped to identify and rank the attributes at each facility which impacts the market share. This approach proposes an amalgamation of the two popular and efficient modeling practices, viz., machine learning with graphs and tree-based regression techniques to reduce the bias. With these, we helped to drive strategic business decisions.

Keywords: competition, DAGs, facility, healthcare, machine learning, market share, random forest, SHAP

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Authors: Serhat Tüzün, Tufan Demirel

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Decision Support Systems (DSS) have been investigated by researchers and technologists for more than 35 years. This paper analyses the developments in the architecture and software of these systems, provides a systematic analysis for different Web-based DSS approaches and Intelligent Decision-making Technologies (IDT), with the suggestion for future studies. Decision Support Systems literature begins with building model-oriented DSS in the late 1960s, theory developments in the 1970s, and the implementation of financial planning systems and Group DSS in the early and mid-80s. Then it documents the origins of Executive Information Systems, online analytic processing (OLAP) and Business Intelligence. The implementation of Web-based DSS occurred in the mid-1990s. With the beginning of the new millennia, intelligence is the main focus on DSS studies. Web-based technologies are having a major impact on design, development and implementation processes for all types of DSS. Web technologies are being utilized for the development of DSS tools by leading developers of decision support technologies. Major companies are encouraging its customers to port their DSS applications, such as data mining, customer relationship management (CRM) and OLAP systems, to a web-based environment. Similarly, real-time data fed from manufacturing plants are now helping floor managers make decisions regarding production adjustment to ensure that high-quality products are produced and delivered. Web-based DSS are being employed by organizations as decision aids for employees as well as customers. A common usage of Web-based DSS has been to assist customers configure product and service according to their needs. These systems allow individual customers to design their own products by choosing from a menu of attributes, components, prices and delivery options. The Intelligent Decision-making Technologies (IDT) domain is a fast growing area of research that integrates various aspects of computer science and information systems. This includes intelligent systems, intelligent technology, intelligent agents, artificial intelligence, fuzzy logic, neural networks, machine learning, knowledge discovery, computational intelligence, data science, big data analytics, inference engines, recommender systems or engines, and a variety of related disciplines. Innovative applications that emerge using IDT often have a significant impact on decision-making processes in government, industry, business, and academia in general. This is particularly pronounced in finance, accounting, healthcare, computer networks, real-time safety monitoring and crisis response systems. Similarly, IDT is commonly used in military decision-making systems, security, marketing, stock market prediction, and robotics. Even though lots of research studies have been conducted on Decision Support Systems, a systematic analysis on the subject is still missing. Because of this necessity, this paper has been prepared to search recent articles about the DSS. The literature has been deeply reviewed and by classifying previous studies according to their preferences, taxonomy for DSS has been prepared. With the aid of the taxonomic review and the recent developments over the subject, this study aims to analyze the future trends in decision support systems.

Keywords: decision support systems, intelligent decision-making, systematic analysis, taxonomic review

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Authors: Linyi Fan, C.J. Schumaker

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Background: Biomedical efforts to treat Alzheimer’s disease (AD) have typically produced mixed to poor results, while more lifestyle-focused treatments such as exercise may fare better than existing biomedical treatments. A few promising studies have indicated that activities of daily life (ADL) may be a useful way of predicting AD. However, the existing cross-sectional studies fail to show how functional-related issues such as ADL in early years predict AD and how social factors influence health either in addition to or in interaction with individual risk factors. This study would helpbetterscreening and early treatments for the elderly population and healthcare practice. The findings have significance academically and practically in terms of creating positive social change. Methodology: The purpose of this quantitative historical, correlational study was to examine the relationship between early years’ ADL and the development of AD in later years. The studyincluded 4,526participantsderived fromRAND HRS dataset. The Health and Retirement Study (HRS) is a longitudinal household survey data set that is available forresearchof retirement and health among the elderly in the United States. The sample was selected by the completion of survey questionnaire about AD and dementia. The variablethat indicates whether the participant has been diagnosed with AD was the dependent variable. The ADL indices and changes in ADL were the independent variables. A four-step multilevel regression model approach was utilized to address the research questions. Results: Amongst 4,526 patients who completed the AD and dementia questionnaire, 144 (3.1%) were diagnosed with AD. Of the 4,526 participants, 3,465 (76.6%) have high school and upper education degrees,4,074 (90.0%) were above poverty threshold. The model evaluatedthe effect of ADL and change in ADL on onset of AD in late years while allowing the intercept of the model to vary by level of education. The results suggested that the only significant predictor of the onset of AD was changes in early years’ ADL (b = 20.253, z = 2.761, p < .05). However, the result of the sensitivity analysis (b = 7.562, z = 1.900, p =.058), which included more control variables and increased the observation period of ADL, are not supported this finding. The model also estimated whether the variances of random effect vary by Level-2 variables. The results suggested that the variances associated with random slopes were approximately zero, suggesting that the relationship between early years’ ADL were not influenced bysociodemographic factors. Conclusion: The finding indicated that an increase in changes in ADL leads to an increase in the probability of onset AD in the future. However, this finding is not support in a broad observation period model. The study also failed to reject the hypothesis that the sociodemographic factors explained significant amounts of variance in random effect. Recommendations were then made for future research and practice based on these limitations and the significance of the findings.

Keywords: alzheimer’s disease, epidemiology, moderation, multilevel modeling

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Authors: Lazzat M. Zhamaliyeva, Nurgul A. Abenova, Gauhar S. Dilmagambetova, Ziyash Zh. Tanbetova, Moldir B. Ahmetzhanova, Tatyana P. Ostretcova, Aliya A. Yegemberdiyeva

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Introduction: There are many reasons for the weak training of family doctors in Kazakhstan: the unified national educational program is not focused on competencies, the role of a general practitioner (GP) is not clear, poor funding for the health care and education system, outdated teaching and assessment methods, inefficient management. We highlight two issues in particular. Firstly, academic teachers of family medicine (FM) in Kazakhstan do not practice as family doctors; most of them are narrow specialists (pediatricians, therapists, surgeons, etc.); they usually hold one-time consultations; clinical mentors from practical healthcare (non-academic teachers) do not have the teaching competences, and the vast majority of them are also narrow specialists. Secondly, clinical sites (polyclinics) are unprepared for general practice and do not follow the principles of family medicine; residents do not like to be in primary health care (PHC) settings due to the chaos that is happening there, as well as due to the lack of the necessary equipment for mastering and consolidating practical skills. Aim: We present the concept of the family physicians’ training office (FPTO), which is being created as a friendly learning environment for young general practitioners and for the involvement of academic teachers of family medicine in the practical work and innovative development of PHC. Methodology: In developing the conceptual framework and identifying practical activities, we drew on literature and expert input, and interviews. Results: The goal of the FPTO is to create a favorable educational and clinical environment for the development of the FM residents’ competencies, in which the residents with academic teachers and clinical mentors could understand and accept the principles of family medicine, improve clinical knowledge and skills, and gain experience in improving the quality of their practice in scientific basis. Three main areas of office activity are providing primary care to the patients, improving educational services for FM residents and other medical workers, and promoting research in PHC and innovations. The office arranges for residents to see outpatients at least 50% of the time, and teachers of FM departments at least 1/4 of their working time conduct general medical appointments next to residents. Taking into account the educational and scientific workload, the number of attached population for one GP does not exceed 500 persons. The equipment of the office allows FPTO workers to perform invasive and other manipulations without being sent to other clinics. In the office, training for residents is focused on their needs and aimed at achieving the required level of competence. International methodologies and assessment tools are adapted to local conditions and evaluated for their effectiveness and acceptability. Residents and their faculty actively conduct research in the field of family medicine. Conclusions: We propose to change the learning environment in order to create teams of like-minded people, to unite residents and teachers even more for the development of family medicine. The offices will also invest resources in developing and maintaining young doctors' interest in family medicine.

Keywords: educational environment, family medicine residents, family physicians’ training office, primary care research

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Authors: Betelhem M. Negede, Maarten Voors, Hugo De Groote, Bart Minten

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Farmers in Ethiopia produce most of their own food during one agricultural season per year. Therefore, they need to use on-farm storage technologies to bridge the lean season and benefit from price arbitrage. Maize stored using traditional storage bags offer no protection from insects and molds, leading to high storage losses. In Ethiopia access to and use of modern storage technologies are still limited, restraining farmers to benefit from local maize price fluctuations. We used a randomized controlled trial among 871 maize farmers to evaluate the impacts of Purdue Improved Crop Storage (PICS) bags, also known as hermetic bags, on storage losses, and especially on behavioral changes with respect to consumption, marketing, and income among maize farmers in Ethiopia. This study builds upon the limited previous experimental research that has tried to understand farmers’ grain storage and post-harvest losses and identify mechanisms behind the persistence of these challenges. Our main hypothesis is that access to PICS bags allows farmers to increase production, storage and maize income. Also delay the length of maize storage, reduce maize post-harvest losses and improve their food security. Our results show that even though farmers received only three PICS bags that represent 10percent of their total maize stored, they delay their length of maize storage for sales by two weeks. However, we find no treatment effect on maize income, suggesting that the arbitrage of two weeks is too small. Also, we do not find any reduction in storage losses due to farmers’ reaction by selling early and by using cheap and readily available but potentially harmful storage chemicals. Looking at the heterogeneity treatment effects between the treatment variable and highland and lowland villages, we find a decrease in the percentage of maize stored by 4 percent in the highland villages. This confirms that location specific factors, such as agro-ecology and proximity to markets are important factors that influence whether and how much of the harvest a farmer stores. These findings highlight the benefits of hermetic storage bags, by allowing farmers to make inter-temporal arbitrage and by reducing potential health risks from storage chemicals. The main policy recommendation that emanates from our study is that postharvest losses reduction throughout the whole value chain is an important pathway to food and income security in Sub-Saharan Africa (SSA). However, future storage loss interventions with hermetic storage technologies should take into account the agro-ecology of the study area and quantify storage losses beyond farmers self-reported losses, such as the count and weigh method. Finally, studies on hermetic storage technologies indicate positive impacts on post-harvest losses and in improving food security, but the adoption and use of these technologies is currently still low in SSA. Therefore, future works on the scaling up of hermetic bags, should consider reasons why farmers only use PICS bags to store grains for consumption, which is usually related to a safety-first approach or due to lack of incentives (higher price from maize not treated with chemicals), and no grain quality check.

Keywords: arbitrage, PICS hermetic bags, post-harvest storage loss, RCT

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Authors: Esteban Maioli

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Generational studies have an important research tradition in social and human sciences. On the one hand, the speed of social change in the context of globalization imposes the need to research the transformations are identified both the subjectivity of the agents involved and its inclusion in the institutional matrix, specifically employment. Generation Z, (generally considered as the population group whose birth occurs after 1995) have unique psycho-social characteristics. Gen Z is characterized by a different set of values, beliefs, attitudes and ambitions that impact in their concrete action in organizational structures. On the other hand, managers often have to deal with generational differences in the workplace. Organizations have members who belong to different generations; they had never before faced the challenge of having such a diverse group of members. The members of each historical generation are characterized by a different set of values, beliefs, attitudes and ambitions that are manifest in their concrete action in organizational structures. Gen Z it’s the only one who can fully be considered "global," while its members were born in the consolidated context of globalization. Some salient features of the Generation Z can be summarized as follows. They’re the first fully born into a digital world. Social networks and technology are integrated into their lives. They are concerned about the challenges of the modern world (poverty, inequality, climate change, among others). They are self-expressive, more liberal and open to change. They often bore easily, with short attention spans. They do not like routine tasks. They want to achieve a good life-work balance, and they are interested in a flexible work environment, as opposed to traditional work schedule. They are critical thinkers, who come with innovative and creative ideas to help. Research design considered methodological triangulation. Data was collected with two techniques: a self-administered survey with multiple choice questions and attitudinal scales applied over a non-probabilistic sample by reasoned decision. According to the multi-method strategy, also it was conducted in-depth interviews. Organizations constantly face new challenges. One of the biggest ones is to learn to manage a multi-generational scope of work. While Gen Z has not yet been fully incorporated (expected to do so in five years or so), many organizations have already begun to implement a series of changes in its recruitment and development. The main obstacle to retaining young talent is the gap between the expectations of iGen applicants and what companies offer. Members of the iGen expect not only a good salary and job stability but also a clear career plan. Generation Z needs to have immediate feedback on their tasks. However, many organizations have yet to improve both motivation and monitoring practices. It is essential for companies to take a review of organizational practices anchored in the culture of the organization.

Keywords: employment, expectations, generation Z, organizational culture, organizations, psycho-social characteristics

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Authors: Dipendra Kumar Yadav, Nabaraj Paudel, Anjana Yadav

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Background: Low Birth weight (LBW) is defined as the weight at birth less than 2500 grams, irrespective of the period of their gestation. LBW is an important indicator of general health status of population and is considered as the single most important predictors of infant mortality especially of deaths within the first month of life that is birth weight determines the chances of newborn survival. Objective of this study was to identify the maternal risk factors associated with low birth weight neonates. Materials and Methods: A hospital based case-control study was conducted in maternity ward of Manipal Teaching Hospital, Pokhara, Nepal from 23 September 2014 to 12 November 2014. During study period 59 cases were obtained and twice number of control group were selected with frequency matching of the mother`s age with ± 3 years and total controls were 118. Interview schedule was used for data collection along with record review. Data were entered in Epi-data program and analysis was done with help of SPSS software program. Results: From bivariate logistic regression analysis, eighteen variables were found significantly associated with LBW and these were place of residence, family monthly income, education, previous still birth, previous LBW, history of STD, history of vaginal bleeding, anemia, ANC visits, less than four ANC visits, de-worming status, counseling during pregnancy, CVD, physical workload, stress, extra meal during pregnancy, smoking and alcohol consumption status. However after adjusting confounding variables, only six variables were found significantly associated with LBW. Mothers who had family monthly income up to ten thousand rupees were 4.83 times more likely to deliver LBW with CI (1.5-40.645) and p value 0.014 compared to mothers whose family income NRs.20,001-60,000. Mothers who had previous still birth were 2.01 times more likely to deliver LBW with CI (0.69-5.87) and p value 0.02 compared to mothers who did not has previous still birth. Mothers who had previous LBW were 5.472 times more likely to deliver LBW with CI (1.2-24.93) and p value 0.028 compared to mothers who did not has previous LBW. Mothers who had anemia during pregnancy were 3.36 times more likely to deliver LBW with CI (0.77-14.57) and p value 0.014 compared to mothers who did not has anemia. Mothers who delivered female newborn were 2.96 times more likely to have LBW with 95% CI (1.27-7.28) and p value 0.01 compared to mothers who deliver male newborn. Mothers who did not get extra meal during pregnancy were 6.04 times more likely to deliver LBW with CI (1.11-32.7) and p value 0.037 compared to mothers who getting the extra meal during pregnancy. Mothers who consumed alcohol during pregnancy were 4.83 times more likely to deliver LBW with CI (1.57-14.83) and p value 0.006 compared to mothers who did not consumed alcohol during pregnancy. Conclusions: To reduce low birth weight baby through economic empowerment of family and individual women. Prevention and control of anemia during pregnancy is one of the another strategy to control the LBW baby and mothers should take full dose of iron supplements with screening of haemoglobin level. Extra nutritional food should be provided to women during pregnancy. Health promotion program will be focused on avoidance of alcohol and strengthen of health services that leads increasing use of maternity services.

Keywords: low birth weight, case-control, risk factors, hospital based study

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Authors: Maylen Villamanan Alba

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Latin America is marked by its history: conquest, colonialism, and slavery left deep footprints in most Latin American countries. Also, the past century has been affected by wars, military dictatorships, and political violence, which profoundly influenced Latin American popular culture. Consequently, reminiscences of historical crimes are frequently present in daily life, media, public opinion, and arts. This legacy is remembered in novels, paintings, songs, and films. In fact, Latin American cinema has a trend which refers to the verisimilitude with reality in fiction films. These films about historical violence are narrated as fictional characters, but their stories are based on real historical contexts. Therefore, cultural criminology has considered films as a significant field to understand social representations of violence related to historical crimes. The aim of the present contribution is to analyze the legacy of past and historical memory in social representations of violence in Latin American cinema as a critical approach to historical crimes. This qualitative research is based on content analysis. The sample is seven multi-award winning films of the International Festival of New Latin American Cinema of Havana. The films selected are Kamchatka, Argentina (2002); Carandiru, Brazil (2003); Enlightened by fire, Argentina (2005); Post-mortem, Chile (2010); No, Chile (2012) Wakolda; Argentina (2013) and The Clan, Argentina (2015). Cultural criminology highlights that cinema shapes meanings of social practices such as historical crimes. Critical criminology offers a critical theory framework to interpret Latin American cinema. This analysis reveals historical conditions deeply associated with power relationships, policy, and inequality issues. As indicated by this theory, violence is characterized as a structural process based on social asymmetries. These social asymmetries are crossed by social scopes, including institutional and personal dimensions. Thus, institutions of the states are depicted through personal stories of characters involved with human conflicts. Intimacy and social background are linked in the personages who simultaneously perform roles such as soldiers, policemen, professionals or inmates and they are at the same time depict as human beings with family, gender, racial, ideological or generational issues. Social representations of violence related to past legacy are a portrait of historical crimes perpetrated against Latin American citizens. Thereby, they have contributed to political positions, social behaviors, and public opinion. The legacy of these historical crimes suggests a path that should never be taken again. It means past legacy is a reminder, a warning, and a historic lesson for Latin American people. Social representations of violence are permeated by historical memory as denunciation under a critical approach.

Keywords: Latin American cinema, historical memory, social representation, violence

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Authors: Junaid Hamid Bhat

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Background: Musculoskeletal disorders are one of the main causes of occupational illness. Mechanisms and the factors like repetitive work, physical effort and posture, endangering the risk of musculoskeletal disorders would now appear to have been properly identified. Teacher’s exposure to work-related musculoskeletal disorders appears to be insufficiently described in the literature. Little research has investigated the prevalence and risk factors of musculoskeletal disorders in teaching profession. Very few studies are available in this regard and there are no studies evident in India. Purpose: To determine the prevalence of musculoskeletal disorders and to identify and measure the association of such risk factors responsible for developing musculoskeletal disorders among school teachers. Methodology: An observational cross sectional study was carried out. 500 school teachers from primary, middle, high and secondary schools were selected, based on eligibility criteria. A signed consent was obtained and a self-administered, validated questionnaire was used. Descriptive statistics was used to compute the statistical mean and standard deviation, frequency and percentage to estimate the prevalence of musculoskeletal disorders among school teachers. The data analysis was done by using SPSS version 16.0. Results: Results indicated higher pain prevalence (99.6%) among school teachers during the past 12 months. Neck pain (66.1%), low back pain (61.8%) and knee pain (32.0%) were the most prevalent musculoskeletal complaints of the subjects. Prevalence of shoulder pain was also found to be high among school teachers (25.9%). 52.0% subjects reported pain as disabling in nature, causing sleep disturbance (44.8%) and pain was found to be associated with work (87.5%). A significant association was found between musculoskeletal disorders and sick leaves/absenteeism. Conclusion: Work-related musculoskeletal disorders particularly neck pain, low back pain, and knee pain, is highly prevalent and risk factors are responsible for the development of same in school teachers. There is little awareness of musculoskeletal disorders among school teachers, due to work load and prolonged/static postures. Further research should concentrate on specific risk factors like repetitive movements, psychological stress, and ergonomic factors and should be carried out all over the country and the school teachers should be studied carefully over a period of time. Also, an ergonomic investigation is needed to decrease the work-related musculoskeletal disorder problems. Implication: Recall bias and self-reporting can be considered as limitations. Also, cause and effect inferences cannot be ascertained. Based on these results, it is important to disseminate general recommendations for prevention of work-related musculoskeletal disorders with regards to the suitability of furniture, equipment and work tools, environmental conditions, work organization and rest time to school teachers. School teachers in the early stage of their careers should try to adapt the ergonomically favorable position whilst performing their work for a safe and healthy life later. Employers should be educated on practical aspects of prevention to reduce musculoskeletal disorders, since changes in workplace and work organization and physical/recreational activities are required.

Keywords: work related musculoskeletal disorders, school teachers, risk factors funding, medical and health sciences

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Authors: María Canal-Rodríguez, María Arnaiz, Natalia Rey-Raap, Ana Arenillas, Jon Ajuria

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The constant demand of electrical energy, as well as the increase in environmental concern, lead to the necessity of investing in clean and eco-friendly energy sources that implies the development of enhanced energy storage devices. Li-ion batteries (LIBs) and Electrical double layer capacitors (EDLCs) are the most widespread energy systems. Batteries are able to storage high energy densities contrary to capacitors, which main strength is the high-power density supply and the long cycle life. The combination of both technologies gave rise to Li-ion capacitors (LICs), which offers all these advantages in a single device. This is achieved combining a capacitive, supercapacitor-like positive electrode with a faradaic, battery-like negative electrode. Due to the abundance and affordability, dual carbon-based LICs are nowadays the common technology. Normally, an Active Carbon (AC) is used as the EDLC like electrode, while graphite is the material commonly employed as anode. LICs are potential systems to be used in applications in which high energy and power densities are required, such us kinetic energy recovery systems. Although these devices are already in the market, some drawbacks like the limited power delivered by graphite or the energy limiting nature of AC must be solved to trigger their used. Focusing on the anode, one possibility could be to replace graphite with Hard Carbon (HC). The better rate capability of the latter increases the power performance of the device. Moreover, the disordered carbonaceous structure of HCs enables storage twice the theoretical capacity of graphite. With respect to the cathode, the ACs are characterized for their high volume of micropores, in which the charge is storage. Nevertheless, they normally do not show mesoporous, which are really important mainly at high C-rates as they act as transport channels for the ions to reach the micropores. Usually, the porosity of ACs cannot be tailored, as it strongly depends on the precursor employed to get the final carbon. Moreover, they are not characterized for having a high electrical conductivity, which is an important characteristic to get a good performance in energy storage applications. A possible candidate to substitute ACs are carbon aerogels (CAs). CAs are materials that combine a high porosity with great electrical conductivity, opposite characteristics in carbon materials. Furthermore, its porous properties can be tailored quite accurately according to with the requirements of the application. In the present study, CAs with controlled porosity were obtained from polymerization of resorcinol and formaldehyde by microwave heating. Varying the synthesis conditions, mainly the amount of precursors and pH of the precursor solution, carbons with different textural properties were obtained. The way the porous characteristics affect the performance of the cathode was studied by means of a half-cell configuration. The material with the best performance was evaluated as cathode in a LIC versus a hard carbon as anode. An analogous full LIC made by a high microporous commercial cathode was also assembled for comparison purposes.

Keywords: li-ion capacitors, energy storage, tailored porosity, carbon aerogels

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