Search results for: healthcare supply chain

Authors: A.Beril Tugrul, Selahattin Cimen

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Dependency of humanity on the energy is ever-increasing today and the energy policies are reaching undeniable and un-ignorable dimensions steering the political events as well. Therefore, energy has the highest priority for Turkey like any other country. In this study, the energy supply security for Turkey evaluated according to the strategic criteria of energy policy. Under these circumstances, different alternatives are described and assessed with in terms of the energy expansion of Turkey. With this study, different opportunities in the energy expansion of Turkey is clarified and emphasized.

Keywords: energy policy, energy strategy, future projection, Turkey

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Authors: Thuraya Ahmed Al Shidhani, Yahya Al Farsi, Alya Al Husni, Samir Al Adawi

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Background: Knee osteoarthritis (knee OA) represents a major public health burden worldwide, particularly among older adults. However, little has been documented from Arabian Gulf countries, which have left an information gap. Objective: This study describes the socio-demographic, clinical risk factors, and use of herbal medicine among men and women seeking consultation for knee OA at two secondary healthcare facilities in Muscat, Oman. Methods: A cross-sectional study was conducted among 213 Omani adults with knee OA attending a referral polyclinic in Muscat, Oman, over 12 months from January to December. Socio-demographic data were collected from the participants who are seeking consultation for knee OA. Results: Among the 213 study participants, 171 were females and 42 males. The females were comparatively older than the males, had lower education and lower-income, and more overweight. The majority of the participants were normal weight or underweight. About one-third of participants reported OA in other joints as well. Most participants recalled that they had knee OA for less than a year. About 12% reported a history of trauma. The majority (63%) concurrently had other chronic illnesses, and 33% reported having at least one complication. About 22% were using herbal medicines. About 77% are using herbal local applications in form of powder and creams. Conclusion: This study, to our knowledge, is the first to explore socio-demographic characteristics, clinical risk factors and use of herbal medicine among sufferers of knee OA in Oman. Knee OA tended to occur among our participants at younger ages than reported elsewhere, while obesity appeared orthogonal to the severity of knee OA. Women were more affected than men. About one quarter of Omani patients are using herbal medicine. More studies are needed to understand the causal factors and development of knee OA in Oman. Targeted health education and rehabilitation programs are needed, particularly among Omani women, to improve their physical quality of life.

Keywords: knee joint, osteoarthritis, herbal medicine, Oman

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Authors: Yi-Chiang Huang, Hsu-Feng Lee, Yu-Chao Tseng, Wen-Yao Huang

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Proton exchange membranes as a key component in fuel cells have been widely studying over the past few decades. As proton exchange, membranes should have some main characteristics, such as good mechanical properties, low oxidative stability and high proton conductivity. In this work, trifluoromethyl groups had been introduced on polymer backbone and phenyl side chain which can provide densely located sulfonic acid group substitution and also promotes solubility, thermal and oxidative stability. Herein, a series of novel sulfonated aromatic hydrocarbon polyelectrolytes was synthesized by polycondensation of 4,4''''-difluoro-3,3''''- bis(trifluoromethyl)-2'',3''-bis(3-(trifluoromethyl)phenyl)-1,1':4',1'':4'',1''':4''',1''''-quinquephenyl with 2'',3''',5'',6''-tetraphenyl-[1,1':4',1'': 4'',1''':4''',1''''-quinquephenyl]-4,4''''-diol and post-sulfonated was through chlorosulfonic acid to given sulfonated polymers (SFC3-X) possessing ion exchange capacities ranging from 1.93, 1.91 and 2.53 mmol/g. ¹H NMR and FT-IR spectroscopy were applied to confirm the structure and composition of sulfonated polymers. The membranes exhibited considerably dimension stability (10-27.8% in length change; 24-56.5% in thickness change) and excellent oxidative stability (weight remain higher than 97%). The mechanical properties of membranes demonstrated good tensile strength on account of the high rigidity multi-phenylated backbone. Young's modulus were ranged 0.65-0.77GPa which is much larger than that of Nafion 211 (0.10GPa). Proton conductivities of membranes ranged from 130 to 240 mS/cm at 80 °C under fully humidified which were comparable or higher than that of Nafion 211 (150 mS/cm). The morphology of membranes was investigated by transmission electron microscopy which demonstrated a clear hydrophilic/hydrophobic phase separation with spherical ionic clusters in the size range of 5-20 nm. The SFC3-1.97 single fuel cell performance demonstrates the maximum power density at 1.08W/cm², and Nafion 211 was 1.24W/cm² as a reference in this work. The result indicated that SFC3-X are good candidates for proton exchange membranes in fuel cell applications. Fuel cell of other membranes is under testing.

Keywords: fuel cells, polyelectrolyte, proton exchange membrane, sulfonated polymers

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Authors: Hung-Chieh Chen, Kuo-Hui Wang, Tsu-Lin Yeh

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Proteomics represent the performance of genomic complement proteins and the protein level on functional genomics. This study adopted proteomic strategies for comparing serum proteins among three groups: elite sprinter (sprint runner group, SR), long-distance runners (long-distance runner group, LDR), and the untrained control group (control group, CON). Purposes: This study aims to identify elite sprinters and long-distance runners’ serum protein and to provide a comparison of their serum proteome’ composition. Methods: Serum protein fractionations that separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and analyzed by a quantitative nano-LC-MS/MS-based proteomic profiling. The one-way analysis of variance (ANOVA) and Scheffe post hoc comparison (α= 0.05) was used to determine whether there is any significant difference in each protein level among the three groups. Results: (1) After analyzing the 307 identified proteins, there were 26 unique proteins in the SR group, and 18 unique proteins in the LDR group. (2) For the LDR group, 7 coagulation function-associated proteins’ expression levels were investigated: vitronectin, serum paraoxonase/arylesterase 1, fibulin-1, complement C3, vitamin K-dependent protein, inter-alpha-trypsin inhibitor heavy chain H3 and von Willebrand factor, and the findings show the seven coagulation function-associated proteins were significantly lower than the group of SR. (3) Comparing to the group of SR, this study found that the LDR group’s expression levels of the 2 antioxidant proteins (afamin and glutathione peroxidase 3) were also significantly lower. (4) The LDR group’s expression levels of seven immune function-related proteins (Ig gamma-3 chain C region, Ig lambda-like polypeptide 5, clusterin, complement C1s subcomponent, complement factor B, complement C4-A, complement C1q subcomponent subunit A) were also significantly lower than the group of SR. Conclusion: This study identified the potential serum protein markers for elite sprinters and long-distance runners. The changes in the regulation of coagulation, antioxidant, or immune function-specific proteins may also provide further clinical applications for these two different track athletes.

Keywords: biomarkers, coagulation, immune response, oxidative stress

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Authors: Karima Abdel Aty Hassan Mohamed, Manal Mohamed Ismail, Mona Hassan Gamal Eldein, Ahmed Hassan Hussein, Abdel Aziz Mohamed Elsingerg

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Background: Patellofemoral pain (PFP) is a common musculoskeletal pain condition, especially in females. Decreased hip muscle strength has been implicated as a contributing factor, yet the relationships between pain, hip muscle strength and function are not known. Objective: The purpose of this study is to investigate the effects of strengthening hip abductors and lateral rotators on pain intensity, function and hip abductor and hip lateral rotator eccentric and concentric torques in patients with PFPS. Methods: Thirty patients had participated in this study; they were assigned into two experimental groups. With age ranged for eighty to thirty five years. Group A consisted of 15 patients (11females and 4 males) with mean age 20.8 (±2.73) years, received closed kinetic chain exercises program, stretching exercises for tight lower extremity soft tissues, and hip strengthening exercises .Group B consisted of 15 patients (12 females and 3 males) with mean age 21.2(±3.27) years, received closed kinetic chain exercises program and stretching exercises for tight lower extremity soft tissues. Treatment was given 2-3times/week, for 6 weeks. Patients were evaluated pre and post treatment for their pain severity, function of knee joint, hip abductors and external rotators concentric/eccentric peak torque. Result: the results revealed that there were significant differences in pain and function between both groups, while there was improvement for all values for both group. Conclusion: Six weeks rehabilitation program focusing on knee strengthening exercises either supplemented by hip strengthening exercises or not effective in improving function, reducing pain and improving hip muscles torque in patients with PFPS. However, adding hip abduction and lateral rotation strengthening exercises seem to reduce pain and improve function more efficiently.

Keywords: patellofemoral pain syndrome, hip muscles, rehabilitation, isokinetic

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Authors: Morteza Sharifhasan, Davoud Hosseini, Mohammad. R. Salimpour

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The geothermal energy is considered as a worldwide important renewable energy in recent years due to rising environmental pollution concerns. Low- and medium-grade geothermal heat (< 200 ºC) is commonly employed for space heating and in domestic hot water supply. However, there is also much interest in converting the abundant low- and medium-grade geothermal heat into electrical power. The Iranian Ministry of Power - through the Iran Renewable Energy Organization (SUNA) – is going to build the first Geothermal Power Plant (GPP) in Iran in the Sabalan area in the Northwest of Iran. This project is a 5.5 MWe single flash steam condensing power plant. The efficiency of GPPs is low due to the relatively low pressure and temperature of the saturated steam. In addition to GPPs, Gas Turbines (GTs) are also known by their relatively low efficiency. The Iran ministry of Power is trying to increase the efficiency of these GTs by adding bottoming steam cycles to the GT to form what is known as combined gas/steam cycle. One of the most effective methods for increasing the efficiency is combined heat and power (CHP). This paper investigates the feasibility of superheating the saturated steam that enters the steam turbine of the Sabalan GPP (SGPP-1) to improve the energy efficiency and power output of the GPP. This purpose is achieved by combining the GPP with two 3.5 MWe GTs. In this method, the hot gases leaving GTs are utilized through a superheater similar to that used in the heat recovery steam generator of combined gas/steam cycle. Moreover, brine separated in the separator, hot gases leaving GTs and superheater are used for the supply of domestic hot water (in this paper, the cycle combined of GTs and CHP systems is named the modified SGPP-1) . In this research, based on the Heat Balance presented in the basic design documents of the SGPP-1, mathematical/numerical model of the power plant are developed together with the mentioned GTs and CHP systems. Based on the required hot water, the amount of hot gasses needed to pass through CHP section directly can be adjusted. For example, during summer when hot water is less required, the hot gases leaving both GTs pass through the superheater and CHP systems respectively. On the contrary, in order to supply the required hot water during the winter, the hot gases of one of the GTs enter the CHP section directly, without passing through the super heater section. The results show that there is an increase in thermal efficiency up to 40% through using the modified SGPP-1. Since the gross efficiency of SGPP-1 is 9.6%, the achieved increase in thermal efficiency is significant. The power output of SGPP-1 is increased up to 40% in summer (from 5.5MW to 7.7 MW) while the GTs power output remains almost unchanged. Meanwhile, the combined-cycle power output increases from the power output of the two separate plants of 12.5 MW [5.5+ (2×3.5)] to the combined-cycle power output of 14.7 [7.7+(2×3.5)]. This output is more than 17% above the output of the two separate plants. The modified SGPP-1 is capable of producing 215 T/Hr hot water ( 90 ºC ) for domestic use in the winter months.

Keywords: combined cycle, chp, efficiency, gas turbine, geothermal power plant, gas turbine, power output

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Authors: Abid Boudiar

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We propose a simple model to obtain an exact expression of Tc/(Tc,max) for the temperature-doping phase diagram of superconducting cuprates. We showed that our model predicted most phase diagram scenario. We found the exact special doping points p(opt), p(qcp) and an accurate E(g,max). Some other properties such as the stripes length 100.1°A and the energy gap in cuprates chain
6meV can also be calculated exactly. Another interesting consequence of this simple picture is the new magic numbers and the ability to express everything using a (Tc,p) diagram via the golden ratio.

Keywords: superconducting cuprates, phase, pseudogap, hole doping, strips, golden ratio, soliton

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Authors: M. Brockes, S. Beck, A. Sigaroudi, C. Brockes

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Over the last years, telemedicine and telemonitoring have become a popular way of treatment, especially in other chronic diseases. Therefore this type of treatment methodology was also implemented in interstitial lung disease (ILD) patients. In January 2024, a new service for patients with interstitial lung disease (ILD) treated with Nintedanib was established, which contains daily telemonitoring (home spirometry, pulse oximetry, and daily level of activity), daily evaluation of parameters as well as a telemedical availability answered by doctors and telemedical specialists throughout 365 days per year. The main motivational points of this service are the early detection of first signs of exacerbations and/or other symptoms/complications as well as easier access to healthcare professionals. The evaluation of the patient’s quality of life and the subjective feeling of safetyness was measured through patient reported experience measurements (PREMs) and patient reported outcome measurements (PROMs). Patients were introduced to the telemedical and telemonitoring service six-months ago. Within this period, every sixty days, the questionnaires were conducted by the scientific employees. Due to the unlimited time frame of the long-term service the evaluation is not completed. The first analysis of patient reported experience measurements (PREMs) and patient reported outcome measurements (PROMs) have shown an increased positive effect on the patients' quality of life as well as an increased positive effect on the subjective feeling of safety at home, plus a reduction and avoidance of secondary damages (e.g., exacerbations, deterioration of typical interstitial lung disease ILD symptoms and pharmaceutical side effects). The first results have shown a tendency that the telemedical treatment combined with telemonitoring at home and the encouragement of patients to actively participate in their healthcare has a positive effect on the patient’s overall well-being and could be implemented as a complementation of the traditional standard of care.

Keywords: avoidance of secondary damages, interstitial lung disease, telemedicine and telemonitoring, subjective feeling of safety

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Authors: M. D. Antoine

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Despite the widespread use of complementary and alternative medicine (CAM) for autistic children, little is known about the communication flow between the different parties involved in autism care (e.g., parents/caregivers, conventional providers, alternative practitioners). This study aimed to describe how communication occurs through the first year following an autism spectrum disorder (ASD) diagnosis to identify challenges and potential barriers to communication within the healthcare system in Ottawa, Canada. From an ecological perspective, we collected qualitative data through 12 semi-structured interviews with six parents/caregivers, three conventional providers (e.g., family doctor, neurodevelopmental pediatrician, psychologist), and three alternative practitioners (e.g., naturopath, occupational therapist, speech and language pathologist) operating in Ottawa. We interpreted the data using thematic analysis. Findings revealed communication challenges between the parents/caregivers and conventional providers while they experience better communication flow with fewer challenges in alternative care settings. However, parents/caregivers are the only links between the health professionals of both streams. From the five contexts examined: organizational, interpersonal, media, cultural, and political-legal, we found four themes (provider knowledge, care integration, flexible care, and time constraints) underlining specific barriers to communication flow between the parties involved in the care of autistic children. The increasing interest in alternative medicine is forcing changes in the healthcare system. Communications occur outside the norms making openings for better communication and information-sharing increasingly essential. Within the identified themes in the current study, the necessity for better communication between all parties involved in the care of autistic children is evident. More ASD and CAM-related training for providers would support effective parent/caregiver-provider communication. The findings of the current study contribute to a better understanding of the role of communication in the care management of autism, which has implications for effective autism care.

Keywords: alternative medicine, autism care management, autism spectrum disorder, conventional medicine, parent-provider communication

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Authors: Shreya Poddar

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Legal drafting and revising are recognized as highly demanding tasks for legal professionals. This paper introduces an approach to automate and refine these processes through the use of advanced Artificial Intelligence (AI). The method employs Large Language Models (LLMs), with a specific focus on 'Chain of Thoughts' (CoT) and knowledge injection via prompt engineering. This approach differs from conventional methods that depend on comprehensive training or fine-tuning of models with extensive legal knowledge bases, which are often expensive and time-consuming. The proposed method incorporates knowledge injection directly into prompts, thereby enabling the AI to generate more accurate and contextually appropriate legal texts. This approach substantially decreases the necessity for thorough model training while preserving high accuracy and relevance in drafting. Additionally, the concept of guardrails is introduced. These are predefined parameters or rules established within the AI system to ensure that the generated content adheres to legal standards and ethical guidelines. The practical implications of this method for legal work are considerable. It has the potential to markedly lessen the time lawyers allocate to document drafting and revision, freeing them to concentrate on more intricate and strategic facets of legal work. Furthermore, this method makes high-quality legal drafting more accessible, possibly reducing costs and expanding the availability of legal services. This paper will elucidate the methodology, providing specific examples and case studies to demonstrate the effectiveness of 'Chain of Thoughts' and knowledge injection in legal drafting. The potential challenges and limitations of this approach will also be discussed, along with future prospects and enhancements that could further advance legal work. The impact of this research on the legal industry is substantial. The adoption of AI-driven methods by legal professionals can lead to enhanced efficiency, precision, and consistency in legal drafting, thereby altering the landscape of legal work. This research adds to the expanding field of AI in law, introducing a method that could significantly alter the nature of legal drafting and practice.

Keywords: AI-driven legal drafting, legal automation, futureoflegalwork, largelanguagemodels

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Authors: Nayak Amar, Turner Naomi, Gobina Edward

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The Scottish Higher Education Institutes must report their scope 1 & 2 emissions, whereas reporting scope 3 is optional. Scope 3 is indirect emissions which embodies a significant component of total carbon footprint and therefore it is important to record, measure and report it accurately. Robert Gordon University (RGU) reported only business travel, grid transmission and distribution, water supply and transport, and recycling scope 3 emissions. This study estimates the RGUs total scope 3 emissions by comparing it with a similar HEI in scale. The scope 3 emission reporting of sixteen Scottish HEI was studied. Glasgow Caledonian University was identified as the nearest neighbour by comparing its students' full time equivalent, staff full time equivalent, research-teaching split, budget, and foundation year. Apart from the peer, data was also collected from the Higher Education Statistics Agency database. RGU reported emissions from business travel, grid transmission and distribution, water supply, and transport and recycling. This study estimated RGUs scope 3 emissions from procurement, student-staff commute, and international student trip. The result showed that RGU covered only 11% of the scope 3 emissions. The major contributor to scope 3 emissions were procurement (48%), student commute (21%), international student trip (16%), and staff commute (4%). The estimated scope 3 emission was more than 14 times the reported emissions. This study has shown the relative importance of each scope 3 emissions source, which gives a guideline for the HEIs, on where to focus their attention to capture maximum scope 3 emissions. Moreover, it has demonstrated that it is possible to estimate the scope 3 emissions with limited data.

Keywords: HEI, university, emission calculations, scope 3 emissions, emissions reporting

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Authors: Wesam Rohouma

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The aim of this paper is to investigate the use of repetitive controller to regulate the output voltage of three phase four leg matric converter for an Aircraft Ground Power Supply Unit. The proposed controller improve the steady state error and provide good regulation during different loading. Simulation results of 7.5 KW converter are presented to verify the operation of the proposed controller.

Keywords: matrix converter, Power electronics, controller, regulation

Procedia PDF Downloads 1506

Authors: Timothy Akinwande, Eddie C. M. Hui

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Housing the urban poor has remained a challenge for many years across the world, especially in developing economies, despite the apparent research attention and policy interventions. It is apt to investigate the prevalent affordable housing (AH) provision challenges using unconventional approaches. It is pragmatic to thoroughly examine housing experts to provide supply-side solutions to AH challenges and investigate informal settlers to deduce solutions from AH demand viewpoints. This study being the supply-side investigation of an ongoing research, interrogated housing experts to determine significant expert solutions. Focus group discussions and in-depth interviews were conducted with housing experts in Nigeria. Through descriptive, content, and systematic thematic analyses of data, major findings are that deliberate finance models designed for the urban poor are the most significant housing finance solution in developing economies. Other findings are that adequately implemented rent control policies, deliberate PPP approaches like inclusionary housing and land-value capture, and urban renewal programmes to enlighten and tutor the urban poor on how to earn more, spend wisely, and invest in their own better housing will effectively solve AH finance challenges. Study findings are informative for the best approaches to achieve effective, affordable housing finance for the urban poor in Nigeria, which is indispensable for the achievement of sustainable development goals. This research’s originality lies in the exploration of experts’ opinions in relation to AH finance to produce an equation model of critical solutions to AH finance challenges. Study data are useful resources for future pro-poor housing studies. This study makes housing policy-oriented recommendations toward effective, affordable housing for the urban poor in developing countries.

Keywords: affordable housing, effective affordable housing, housing policy, housing research, sustainable development, urban poor

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Authors: Yu-Yao Wang, Xiao-Meng Hu, Joanne Yeung, Xiao-Yan Li

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The high private cost and unquantified external cost limit the development of reclaimed water. In this study, an integrated framework comprising life cycle assessment (LCA), quantitative microbial risk assessment (QMRA), and life cycle costing (LCC) was developed to evaluate both costs of reclaimed water supply in water systems of various scales. LCA assesses the environmental impacts, and QMRA estimates the associated pathogenic impacts. These impacts are monetized as external costs and analyzed with the private cost by LCC to count the total life cycle cost. The framework evaluated the Hong Kong urban water system in the baseline scenario (BS) and five wastewater reuse scenarios (RS). They are RSI: substituting freshwater for toilet flushing only, RSII: substituting both freshwater and seawater for toilet flushing, RSIII: using reclaimed water for all non-potable uses, RSIV: using reclaimed water for all non-potable uses and indirect potable uses, and RSV: non-potable use and indirect potable use by conveying 100% reclaimed water to recharge the reservoirs. The results show that substituting freshwater and seawater for toilet flushing has the least total life cycle cost, exhibiting that it is the most cost-effective option for Hong Kong. Meanwhile, the evaluation results show that the external cost of each scenario is comparable to the corresponding private cost, indicating the importance of the inclusion of comprehensive external cost evaluation in private cost assessment of water systems with reclaimed water supply.

Keywords: life cycle assessment, life cycle costing, quantitative microbial risk assessment, water reclamation, reclaimed water, alternative water resources

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Authors: Michael Campbell, Malaz Elsaddig, Kevin Jones

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Background: Despite encouraging progress, global maternal mortality has remained stubbornly high since the declaration of the Millennium development goals. Sub-Saharan Africa accounts for well over half of maternal deaths with Post-Partum Haemorrhage (PPH) being the lead cause. ‘In house’ simulation training delivered by local doctors may be a sustainable approach for improving emergency obstetric care. The aim of this study was to evaluate the use of a Train-the-Trainer (TtT) model in a rural Ugandan hospital to ascertain whether it can feasibly improve practitioners’ management of PPH. Methods: Three Ugandan doctors underwent a training course to enable them to design and deliver simulation training. These doctors used MamaNatalie® models to simulate PPH scenarios for midwives, nurses and medical students. The main outcome was improvement in participants’ knowledge and confidence, assessed using self-reported scores on a 10-point scale. Results: The TtT model produced significant improvements in the confidence and knowledge scores of the ten participants. The mean confidence score rose significantly (p=0.0005) from 6.4 to 8.6 following the simulation training. There was also a significant increase in the mean knowledge score from 7.2 to 9.0 (p=0.04). Medical students demonstrated the greatest overall increase in confidence scores whilst increases in knowledge scores were largest amongst nurses. Conclusions: This study demonstrates that a TtT model can be used in a low resource setting to improve healthcare professionals’ confidence and knowledge in managing obstetric emergencies. This Train-the-Trainer model represents a sustainable approach to addressing skill deficits in low resource settings. We believe that its expansion across healthcare institutions in Sub-Saharan Africa will help to reduce the region’s high maternal mortality rate and step closer to achieving the ambitions of the Millennium development goals.

Keywords: low resource setting, post-partum haemorrhage, simulation training, train the trainer

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Authors: Jessica Raven Gates, Gemma Wilson-Menzfeld, Professor Alison Steven

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In 2019, the Primary Care system in the UK National Health Service (NHS) was subject to reform and restructuring. Primary Care Networks (PCNs) were established, which aligned with a trend towards integrated care both within the NHS and internationally. The introduction of PCNs brought groups of GP practices in a locality together, to operate as a network, build on existing services and collaborate at a larger scale. PCNs were expected to bring a range of benefits to patients and address some of the workforce pressures in the NHS, through an expanded and collaborative workforce. The early establishment of PCNs was disrupted by the emerging COVID-19 pandemic. This study, set in the context of the pandemic, aimed to explore experiences of the PCN workforce, and their perceptions of the establishment of PCNs. Specific objectives focussed on examining factors perceived as enabling or hindering the success of a PCN, the impact on day-to-day work, the approach to implementing change, and the influence of the COVID-19 pandemic upon PCN development. This study is part of a three-phase PhD project that utilized qualitative approaches and was underpinned by social constructionist philosophy. Phase 1: a systematic narrative review explored the provision of preventative healthcare services in UK primary settings and examined facilitators and barriers to delivery as experienced by the workforce. Phase 2: informed by the findings of phase 1, semi-structured interviews were conducted with fifteen participants (PCN workforce). Phase 3: follow-up interviews were conducted with original participants to examine any changes to their experiences and perceptions of PCNs. Three main themes span across phases 2 and 3 and were generated through a Framework Analysis approach: 1) working together at scale, 2) network infrastructure, and 3) PCN leadership. Findings suggest that through efforts to work together at scale and collaborate as a network, participants have broadly accepted the concept of PCNs. However, the workforce has been hampered by system design and system complexity. Operating against such barriers has led to a negative psychological impact on some PCN leaders and others in the PCN workforce. While the pandemic undeniably increased pressure on healthcare systems around the world, it also acted as a disruptor, offering a glimpse into how collaboration in primary care can work well. Through the integration of findings from all phases, a new theoretical model has been developed, which conceptualises the findings from this Ph.D. study and demonstrates how the workforce has experienced change associated with the establishment of PCNs. The model includes a contextual component of the COVID-19 pandemic and has been informed by concepts from Complex Adaptive Systems theory. This model is the original contribution to knowledge of the PhD project, alongside recommendations for practice, policy and future research. This study is significant in the realm of health services research, and while the setting for this study is the UK NHS, the findings will be of interest to an international audience as the research provides insight into how the healthcare workforce may experience imposed policy and service changes.

Keywords: health services research, qualitative research, NHS workforce, primary care

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Authors: Sania Bashir

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A promising approach to healthcare delivery, telemedicine makes use of communication technology to reach out to remote regions of the world, allowing for beneficial interactions between diabetic patients and healthcare professionals as well as the provision of affordable and easily accessible medical care. The emergence of contemporary care models, fueled by the pervasiveness of mobile devices, provides better information, offers low cost with the best possible outcomes, and is known as digital health. It involves the integration of collected data using software and apps, as well as low-cost, high-quality outcomes. The goal of this study is to assess how well telemedicine works for diabetic patients and how it impacts their HbA1c levels. A questionnaire-based survey of 300 diabetics included 150 patients in each of the groups receiving usual care and via telemedicine. A descriptive and observational study that lasted from September 2021 to May 2022 was conducted. HbA1c has been gathered for both categories every three months. A remote monitoring tool has been used to assess the efficacy of telemedicine and continuing therapy instead of the customary three monthly meetings like in-person consultations. The patients were (42.3) 18.3 years old on average. 128 men were outnumbered by 172 women (57.3% of the total). 200 patients (66.6%) have type 2 diabetes, compared to over 100 (33.3%) candidates for type 1. Despite the average baseline BMI being within normal ranges at 23.4 kg/m², the mean baseline HbA1c (9.45 1.20) indicates that glycemic treatment is not well-controlled at the time of registration. While patients who use telemedicine experienced a mean percentage change of 10.5, those who visit the clinic experienced a mean percentage change of 3.9. Changes in HbA1c are dependent on several factors, including improvements in BMI (61%) after 9 months of research and compliance with healthy lifestyle recommendations for diet and activity. More compliance was achieved by the telemedicine group. It is an undeniable reality that patient-physician communication is crucial for enhancing health outcomes and avoiding long-term issues. Telemedicine has shown its value in the management of diabetes and holds promise as a novel technique for improved clinical-patient communication in the twenty-first century.

Keywords: diabetes, digital health, mobile app, telemedicine

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Authors: Apurva Patil, Maithilee Kulkarni, Ashay Aswale

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This paper proposes an algorithm to develop the kinematic model of a 5 DOF robot arm. The formulation of the problem is based on finding the D-H parameters of the arm. Brute Force iterative method is employed to solve the system of non linear equations. The focus of the paper is to obtain the accurate solutions by reducing the root mean square error. The result obtained will be implemented to grip the objects. The trajectories followed by the end effector for the required workspace coordinates are plotted. The methodology used here can be used in solving the problem for any other kinematic chain of up to six DOF.

Keywords: 5 DOF robot arm, D-H parameters, inverse kinematics, iterative method, trajectories

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Authors: K. Anas, M. Selvakumar, Samson David, R. R. Babu, S. Chattopadhyay

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The dynamic deformation of a visco elastic material can cause heat generation. This heat generation is aspect energy dissipation. The present work investigates the contribution of various factors like; elastomer structure, cross link type and density, filler networking, reinforcement potential and temperature at energy dissipation mechanism. The influences of these elements are investigated using very high frequency analyzer (VHF ) and dynamical mechanical analysis(DMA).VHF follows transmissibility and vibration isolation principle whereas DMA works on dynamical mechanical deformation principle. VHF analysis of different types of elastomers reveals that elastomer can act as a transmitter or damper of energy depending on the applied frequency ratio (ω/ωn). Dynamic modulus (G') of low damping rubbers like natural rubber does not varies rapidly with frequency but vice-versa for high damping rubber like butyl rubber (IIR). VHF analysis also depicts that polysulfidic linkages has high damping ratio (ζ) than mono sulfidic linkages due to its dissipative nature. At comparable cross link density, mono sulfidic linkages shows higher glass transition temperature (Tg) than poly sulfidic linkages. The intensity and location of loss modulus (G'') peak of different types of carbon black filled natural rubber compounds suggests that segmental relaxation at glass transition temperature (Tg) is seldom affected by filler particles, but the filler networks can influence the cross link density by absorbing the curatives. The filler network breaking and reformation during a dynamic strain is a thermally activated process. Thus, stronger aggregates are highly dissipative in nature. Measurements indicate that at lower temperature regimes polymeric chain friction is highly dissipative in nature.

Keywords: damping ratio, natural frequency, crosslinking density, segmental motion, surface activity, dissipative, polymeric chain friction

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Authors: Joseph Ndegwa

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Changes are required if energy systems are to foster long-term growth. The main problems are increasing access to inexpensive, dependable, and sufficient energy supply while addressing environmental implications at all levels. Policies can help to promote sustainable development by providing adequate and inexpensive energy sources to underserved regions, such as liquid and gaseous fuels for cooking and electricity for household and commercial usage. Promoting energy efficiency. Increased utilization of new renewables. Spreading and implementing additional innovative energy technologies. Markets can achieve many of these goals with the correct policies, pricing, and regulations. However, if markets do not work or fail to preserve key public benefits, tailored government policies, programs, and regulations can achieve policy goals. The main strategies for promoting sustainable energy systems are simple. However, they need a broader recognition of the difficulties we confront, as well as a firmer commitment to specific measures. Making markets operate better by minimizing pricing distortions, boosting competition, and removing obstacles to energy efficiency are among the measures. Complementing the reform of the energy industry with policies that promote sustainable energy. Increasing investments in renewable energy. Increasing the rate of technical innovation at each level of the energy innovation chain. Fostering technical leadership in underdeveloped nations by transferring technology and enhancing institutional and human capabilities. promoting more international collaboration. Governments, international organizations, multilateral financial institutions, and civil society—including local communities, business and industry, non-governmental organizations (NGOs), and consumers—all have critical enabling roles to play in the problem of sustainable energy. Partnerships based on integrated and cooperative approaches and drawing on real-world experience will be necessary. Setting the required framework conditions and ensuring that public institutions collaborate effectively and efficiently with the rest of society are common themes across all industries and geographical areas in order to achieve sustainable development. Powerful tools for sustainable development include energy. However, significant policy adjustments within the larger enabling framework will be necessary to refocus its influence in order to achieve that aim. Many of the options currently accessible will be lost or the price of their ultimate realization (where viable) will grow significantly if such changes don't take place during the next several decades and aren't started right enough. In any case, it would seriously impair the capacity of future generations to satisfy their demands.

Keywords: sustainable development, reliable, price, policy

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Authors: Imad Khan, Imran Shafi, Sarmad Farooq

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Large diameter pipes, barrels, tubes, and ducts are used in a variety of applications covering civil and defense-related technologies. This may include heating/cooling networks, sign poles, bracing, casing, and artillery and tank gun barrels. These large diameter assemblies require regular inspection and cleaning to increase their life and reduce replacement costs. This paper describes the design, development, and testing results of an efficient yet simplified, low maintenance mechanical design controlled with minimal essential electronics using an electric motor for a non-technical staff. The proposed solution provides a simplified user interface and an automated cleaning mechanism that requires a single user to optimally clean pipes and barrels in the range of 105 mm to 203 mm caliber. The proposed system employs linear motion of specially designed brush along the barrel using a chain of specific strength and a pulley anchor attached to both ends of the barrel. A specially designed and manufactured gearbox is coupled with an AC motor to allow movement of contact brush with high torque to allow efficient cleaning. A suitably powered AC motor is fixed to the front adapter mounted on the muzzle side whereas the rear adapter has a pulley-based anchor mounted towards the breach block in case of a gun barrel. A mix of soft nylon and hard copper bristles-based large surface brush is connected through a strong steel chain to motor and anchor pulley. The system is equipped with limit switches to auto switch the direction when one end is reached on its operation. The testing results based on carefully established performance indicators indicate the superiority of the proposed user-friendly cleaning mechanism vis-à-vis its life cycle cost.

Keywords: pipe cleaning mechanism, limiting switch, pipe cleaning robot, large pipes

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Authors: Rajkumar Ghosh

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The present study focuses on conducting a socio-economic assessment of groundwater contamination by arsenic and iron and explores the feasibility of rainwater harvesting (RWH) as an alternative water source in the Amdanga Block of North 24 Parganas, West Bengal, India. The region is plagued by severe groundwater contamination, primarily due to excessive concentrations of arsenic and iron, which pose significant health risks to the local population. The study utilizes a mixed-methods approach, combining quantitative analysis of water samples collected from different locations within the Amdanga Block and socio-economic surveys conducted among the affected communities. The results reveal alarmingly high levels of arsenic and iron contamination in the groundwater, surpassing the World Health Organization (WHO) and Indian government's permissible limits. This contamination significantly impacts the health and well-being of the local population, leading to a range of health issues such as skin The water samples are analyzed for arsenic and iron levels, while the surveys gather data on water usage patterns, health conditions, and socio-economic factors. lesions, respiratory disorders, and gastrointestinal problems. Furthermore, the socio-economic assessment highlights the vulnerability of the affected communities due to limited access to safe drinking water. The findings reveal the adverse socio-economic implications, including increased medical expenditures, reduced productivity, and compromised educational opportunities. To address these challenges, the study explores the feasibility of rainwater harvesting as an alternative source of clean water. RWH systems have the potential to mitigate groundwater contamination by providing a sustainable and independent water supply. The assessment includes evaluating the rainwater availability, analyzing the infrastructure requirements, and estimating the potential benefits and challenges associated with RWH implementation in the study area. The findings of this study contribute to a comprehensive understanding of the socio-economic impact of groundwater contamination by arsenic and iron, emphasizing the urgency to address this critical issue in the Amdanga Block. The feasibility assessment of rainwater harvesting serves as a practical solution to ensure a safe and sustainable water supply, reducing the dependency on contaminated groundwater sources. The study's results can inform policymakers, researchers, and local stakeholders in implementing effective mitigation measures and promoting the adoption of rainwater harvesting as a viable alternative in similar arsenic and iron-contaminated regions.

Keywords: contamination, rainwater harvesting, groundwater, sustainable water supply

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Authors: Eman Hegazy, Stefan Anderberg, Joakim Krook

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Urban water infrastructure is crucial for efficient and reliable water supply in growing cities. With the growth of cities, the need for maintenance and renewal of these systems increases but often goes unfulfilled due to a variety of reasons, such as limited funding, political priorities, or lack of public awareness. Neglecting the renewal needs of these systems can lead to frequent malfunctions and reduced quality and reliability of water supply, as well as increased costs and health and environmental hazards. It is important for cities to prioritize investment in water infrastructure and develop long-term plans to address renewal needs. Drawing general conclusions about the rate of renewal of urban water infrastructure systems at an international or national level can be challenging due to the influence of local management decisions. In many countries, the responsibility for water infrastructure management lies with the municipal authorities, who are responsible for making decisions about the allocation of resources for repair, maintenance, and renewal. These decisions can vary widely based on factors such as local finances, political priorities, and public perception of the importance of water infrastructure. As a result, it is difficult to make generalizations about the rate of renewal across different countries or regions. In Sweden, the situation is not different, and the information from Svenskt Vatten indicates that the rate of renewal varies across municipalities and can be insufficient, leading to a buildup of maintenance and renewal needs. This study aims to examine the adequacy of the rate of renewal of urban water infrastructure in Linköping case city in Sweden. Using a case study framework, the study will assess the current status of the urban water system and the need for renewal. The study will also consider the role of factors such as proper identification processes, limited funding, competing for political priorities, and local management decisions in contributing to insufficient renewal. The study investigates the following questions: (1) What is the current status of water and sewerage networks in terms of length, age distribution, and material composition, estimated total water leakage in the network per year, damages, leaks, and outages occur per year, both overall and by district? (2) What are the main causes of these damages, leaks, and interruptions, and how are they related to lack of maintenance and renewal? (3) What is the current status of renewal work for the water and sewerage networks, including the renewal rate and changes over time, recent renewal material composition, and the budget allocation for renewal and emergency repairs? (4) What factors influence the need for renewal and what conditions should be considered in the assessment? The findings of the study provide insights into the challenges facing urban water infrastructure and identify strategies for improving the rate of renewal to ensure a reliable and sustainable water supply.

Keywords: case study, infrastructure, management, renewal need, Sweden

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Authors: Haoshu Li, Shaolong Wan

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The recent focus has been on directional signal amplification of a signal input at one end of a one-dimensional chain and measured at the other end. The amplification rate is given by the end-to-end Green’s functions of the system. In this work, we derive the exact formulas for the end-to-end Green's functions of non-Hermitian single-band systems. While in the bulk region, it is found that the Green's functions are displaced from the prior established integral formula by O(e⁻ᵇᴸ). The results confirm the correspondence between the signal amplification and the non-Hermitian skin effect.

Keywords: non-Hermitian, Green's function, non-Hermitian skin effect, signal amplification

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Authors: Hicham Maklache, Rajae Delhi, Fatiha Benzha, Mohamed Tahiri

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In Morocco, where semi-arid climate is dominant, the supply of industrial and drink water is provided primarily by surface water. Morocco has currently 118 multi-purpose dams. If the construction of these works was a necessity to ensure in all seasons, the water essential to our country, it is impartial to control and protect the quality of running water. -Most dam reservoir used are threatened by eutrophication due to increased terrigenous and anthropogenic pollutants, coming from an over-fertilization of water by phosphorus and nitrogen nutrients and accelerated by uncontrolled development of microalgae aging. It should also be noted that the daily practices of citizens with respect to the resource, an essential component involved in almost all human activities (agriculture, agro-industries, hydropower, ...), has contributed significantly to the deterioration of water quality despite its treatment in several plants. Therefore, the treated water, provides a legacy of bad tastes and odors unacceptable to the consumer. -The present work exhibits results of water quality watershed Oum Erbia used to supply drinking water to the whole terraced area connecting the city of Khenifra to the city of Azemmour. The area south west of Great Casablanca (metropolis of the kingdom with about 4 million inhabitants) supplied 50% of its water needs by sourcing Dam Sidi Said Maachou located, last anchor point of the watershed before the spill in the Atlantic Ocean. The results were performed in a spatio-temporal scale and helped to establish a history of monitoring water quality during the 2009-2011 cycles, the study also presents the development of quality according to the seasonal rhythmicity and rainfall. It gives also an overview on the concept of watershed stewardship.

Keywords: crude surface water quality, Oum Er Rbia hydraulic basin, spatio-temporal monitoring, Great Casablanca drink water quality, Morocco

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Authors: Warnakulasuriya Arachichige Malisha Ann Rosary Fernando, Udalamatta Gamage Omila Chalanka Jinadasa, Bihini Pabasara Amandi Amarasinghe, Manul Thisuraka Mandalawatta, Uthpala Samarakoon, Manori Gamage

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The surge in sexually transmitted diseases (STDs) has become a critical public health crisis demanding urgent attention and action. Like many other nations, Sri Lanka is grappling with a significant increase in STDs due to a lack of education and awareness regarding their dangers. Presently, the available applications for tracking and managing STDs cover only a limited number of easily detectable infections, resulting in a significant gap in effectively controlling their spread. To address this gap and combat the rising STD rates, it is essential to leverage technology and data. Employing technology to enhance the tracking and management of STDs is vital to prevent their further propagation and to enable early intervention and treatment. This requires adopting a comprehensive approach that involves raising public awareness about the perils of STDs, improving access to affordable healthcare services for early detection and treatment, and utilizing advanced technology and data analysis. The proposed mobile application aims to cater to a broad range of users, including STD patients, recovered individuals, and those unaware of their STD status. By harnessing cutting-edge technologies like image detection, symptom-based identification, prevention methods, doctor and clinic recommendations, and virtual counselor chat, the application offers a holistic approach to STD management. In conclusion, the escalating STD rates in Sri Lanka and across the globe require immediate action. The integration of technology-driven solutions, along with comprehensive education and healthcare accessibility, is the key to curbing the spread of STDs and promoting better overall public health.

Keywords: STD, machine learning, NLP, artificial intelligence

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Authors: T. Manzur

Abstract:

Concrete is the predominant construction material in Bangladesh. In large projects, stringent quality control procedures are usually followed under the supervision of experienced engineers and skilled labors. However, in the case of small projects and particularly at distant locations from major cities, proper quality control is often an issue. It has been found from experience that such quality related issues mainly arise from inappropriate proportioning of concrete mixes and improper curing conditions. In most cases external curing method is followed which requires supply of adequate quantity of water along with proper protection against evaporation. Often these conditions are found missing in the general construction sites and eventually lead to production of weaker concrete both in terms of strength and durability. In this study, an attempt has been made to investigate the performance of general concreting works of the country when subjected to several adverse curing conditions that are quite common in various small to medium construction sites. A total of six different types of adverse curing conditions were simulated in the laboratory and samples were kept under those conditions for several days. A set of samples was also submerged in normal curing condition having proper supply of curing water. Performance of concrete was evaluated in terms of compressive strength, tensile strength, chloride permeability and drying shrinkage. About 37% and 25% reduction in 28-day compressive and tensile strength were observed respectively, for samples subjected to most adverse curing condition as compared to the samples under normal curing conditions. Normal curing concrete exhibited moderate permeability (close to low permeability) whereas concrete under adverse curing conditions showed very high permeability values. Similar results were also obtained for shrinkage tests. This study, thus, will assist concerned engineers and supervisors to understand the importance of quality assurance during the curing period of concrete.

Keywords: adverse, concrete, curing, compressive strength, drying shrinkage, permeability, tensile strength

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Authors: Guenther Schuh, Stephan Schroeder, Marcel Faulhaber

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Companies are facing an increasing pressure to innovate faster, cheaper and more radical in last years, due to shrinking product lifecycles and higher volatility of markets and customer demands. Especially established companies struggle meeting those demands. Thus, many producing companies are adapting their development processes to address this increasing pressure. One approach taken by many companies is the use of agile, highly iterative development processes to reduce development times and costs as well as to increase the fulfilled customer requirements and the realized level of innovation. At the same time decreasing depths of added value and increasing focus on core competencies as well as a growing product complexity result in a high dependency on suppliers and external development partners during the product development. Thus, a successful introduction of agile development methods into the development of physical products requires also a successful integration of the necessary external partners and suppliers into the new processes and procedures and an adaption of the organizational interfaces to external partners according to the new circumstances and requirements of agile development processes. For an effective and efficient product development, the design of customer-supplier-relationships should be demand-oriented. A significant influence on the required design has the characteristics of the procurement object. Examples therefore are the complexity of technical interfaces between supply object and final product or the importance of the supplied component for the major product functionalities. Thus, this paper presents an approach to derive general requirements on the design of supplier integration according to the characteristics of supply objects. First, therefore the most relevant evaluation criteria and characteristics have been identified based on a thorough literature review. Subsequently the resulting requirements on the design of the supplier integration were derived depending on the different possible values of these criteria.

Keywords: iterative development processes, agile new product development, procurement, supplier integration

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Authors: Yevheniia Varyvoda, Douglas Taren

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At the aggregate level, climate variability, the rising number of active violent conflicts, globalization and industrialization of agriculture, the loss in diversity of crop species, the increase in demand for agricultural production, and the adoption of healthy and sustainable dietary patterns are exacerbating factors of food system destabilization. The importance of pseudocereals to fuel and sustain resilient food systems is recognized by leading organizations working to end hunger, particularly for their critical capability to diversify livelihood portfolios and provide plant-sourced healthy nutrition in the face of systemic shocks and stresses. Amaranth, buckwheat, and quinoa are the most promising and used pseudocereals for ensuring food system resilience in the reality of climate change due to their high nutritional profile, good digestibility, palatability, medicinal value, abiotic stress tolerance, pest and disease resistance, rapid growth rate, adaptability to marginal and degraded lands, high genetic variability, low input requirements, and income generation capacity. The study provides the rationale and examples of advancing local and regional food systems' resilience by scaling up the utilization of amaranth, buckwheat, and quinoa along all components of food systems to architect indirect nutrition interventions and climate-smart approaches. Thus, this study aims to explore the drivers for ancient pseudocereal utilization, the potential resilience benefits that can be derived from using them, and the challenges and opportunities for pseudocereal utilization within the food system components. The PSALSAR framework regarding the method for conducting systematic review and meta-analysis for environmental science research was used to answer these research questions. Nevertheless, the utilization of pseudocereals has been slow for a number of reasons, namely the increased production of commercial and major staples such as maize, rice, wheat, soybean, and potato, the displacement due to pressure from imported crops, lack of knowledge about value-adding practices in food supply chain, limited technical knowledge and awareness about nutritional and health benefits, absence of marketing channels and limited access to extension services and information about resilient crops. The success of climate-resilient pathways based on pseudocereal utilization underlines the importance of co-designed activities that use modern technologies, high-value traditional knowledge of underutilized crops, and a strong acknowledgment of cultural norms to increase community-level economic and food system resilience.

Keywords: resilience, pseudocereals, food system, climate change

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Authors: Julie Mariam Abraham, G. J. Melendez-Torres

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Background. Maternal mortality is disproportionately higher in low- and middle- income countries (LMICs) compared to other parts of the world. At the current pace of progress, the Sustainable Development Goals for maternal mortality rate will not be achieved by 2030. A variety of factors influence the increased risk of maternal complications in LMICs. These are exacerbated by socio-economic and political factors, including poverty, illiteracy, and gender inequality. This paper aims to use realist synthesis to identify the contexts, mechanisms, and outcomes (CMOs) of maternal health interventions conducted in LMICs to inform evidence-based practice for future maternal health interventions. Methods. In May 2022, we searched four electronic databases for systematic reviews of maternal health interventions in LMICs published in the last five years. We used open and axial coding of CMOs to develop an explanatory framework for intervention effectiveness. Results. After eligibility screening and full-text analysis, 44 papers were included. The intervention strategies and measured outcomes varied within reviews. Healthcare system level contextual factors were the most frequently reported, and infrastructural capacity was the most reported context. The most prevalent mechanism was increased knowledge and awareness. Discussion. Health system infrastructure must be considered in interventions to ensure effective implementation and sustainability. Healthcare-seeking behaviours are embedded within social and cultural norms, environmental conditions, family influences, and provider attitudes. Therefore, effective engagement with communities and families is important to create new norms surrounding pregnancy and delivery. Future research should explore community mobilisation and involvement to enable tailored interventions with optimal contextual fit.

Keywords: maternal mortality, service delivery and organisation, realist synthesis, sustainable development goals, overview of reviews

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