Search results for: high intensity exercise

Authors: Natalie Hoyer

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Bridges in both roadway and railway systems depend on bearings to ensure extended service life and functionality. These bearings enable proper load distribution from the superstructure to the substructure while permitting controlled movement of the superstructure. The design of bridge bearings, according to Eurocode DIN EN 1337 and the relevant sections of DIN EN 1993, increasingly requires the use of thick plates, especially for long-span bridges. However, these plate thicknesses exceed the limits specified in the national appendix of DIN EN 1993-2. Furthermore, compliance with DIN EN 1993-1-10 regulations regarding material toughness and through-thickness properties necessitates further modifications. Consequently, these standards cannot be directly applied to the selection of bearing materials without supplementary guidance and design rules. In this context, a recommendation was developed in 2011 to regulate the selection of appropriate steel grades for bearing components. Prior to the initiation of the research project underlying this contribution, this recommendation had only been available as a technical bulletin. Since July 2023, it has been integrated into guideline 804 of the German railway. However, recent findings indicate that certain bridge-bearing components are exposed to high fatigue loads, which necessitate consideration in structural design, material selection, and calculations. Therefore, the German Centre for Rail Traffic Research called a research project with the objective of defining a proposal to expand the current standards in order to implement a sufficient choice of steel material for bridge bearings to avoid brittle fracture, even for thick plates and components subjected to specific fatigue loads. The results obtained from theoretical considerations, such as finite element simulations and analytical calculations, are validated through large-scale component tests. Additionally, experimental observations are used to calibrate the calculation models and modify the input parameters of the design concept. Within the large-scale component tests, a brittle failure is artificially induced in a bearing component. For this purpose, an artificially generated initial defect is introduced at the previously defined hotspot into the specimen using spark erosion. Then, a dynamic load is applied until the crack initiation process occurs to achieve realistic conditions in the form of a sharp notch similar to a fatigue crack. This initiation process continues until the crack length reaches a predetermined size. Afterward, the actual test begins, which requires cooling the specimen with liquid nitrogen until a temperature is reached where brittle fracture failure is expected. In the next step, the component is subjected to a quasi-static tensile test until failure occurs in the form of a brittle failure. The proposed paper will present the latest research findings, including the results of the conducted component tests and the derived definition of the initial crack size in bridge bearings.

Keywords: bridge bearings, brittle fracture, fatigue, initial crack size, large-scale tests

Procedia PDF Downloads 46

Authors: Walter W. Loo

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China declared the “zero discharge rules which leave no toxics into our living environment and deliver blue sky, green land and clean water to many generations to come”. The achievement of ZWD will provide conservation of water, soil and energy and provide drastic increase in Gross Domestic Products (GDP). Our society’s engine needs a major tune up; it is sputtering. ZWD is achieved in world’s space stations – no toxic air emission and the water is totally recycled and solid wastes all come back to earth. This is all done with solar power. These are all achieved under extreme temperature, pressure and zero gravity in space. ZWD can be achieved on earth under much less fluctuations in temperature, pressure and normal gravity environment. ZWD systems are not expensive and will have multiple beneficial returns on investment which are both financially and environmentally acceptable. The paper will include successful case histories since the mid-1970s. ZWD discharge can be applied to the following types of projects: nuclear and coal fire power plants with a closed loop system that will eliminate thermal water discharge; residential communities with wastewater treatment sump and recycle the water use as a secondary water supply; waste water treatment Plants with complete water recycling including water distillation to produce distilled water by very economical 24-hours solar power plant. Landfill remediation is based on neutralization of landfilled gas odor and preventing anaerobic leachate formation. It is an aerobic condition which will render landfill gas emission explosion proof. Desert development is the development of recovering soil moisture from soil and completing a closed loop water cycle by solar energy within and underneath an enclosed greenhouse. Salt-alkali land development can be achieved by solar distillation of salty shallow water into distilled water. The distilled water can be used for soil washing and irrigation and complete a closed loop water cycle with energy and water conservation. Heavy metals remediation can be achieved by precipitation of dissolved toxic metals below the plant or vegetation root zone by solar electricity without pumping and treating. Soil and groundwater remediation - abandoned refineries, chemical and pesticide factories can be remediated by in-situ electrobiochemical and bioventing treatment method without pumping or excavation. Toxic organic chemicals are oxidized into carbon dioxide and heavy metals precipitated below plant and vegetation root zone. New water sources: low temperature distilled water can be recycled for repeated use within a greenhouse environment by solar distillation; nano bubble water can be made from the distilled water with nano bubbles of oxygen, nitrogen and carbon dioxide from air (fertilizer water) and also eliminate the use of pesticides because the nano oxygen will break the insect growth chain in the larvae state. Three dimensional high yield greenhouses can be constructed by complete water recycling using the vadose zone soil as a filter with no farming wastewater discharge.

Keywords: greenhouses, no discharge, remediation of soil and water, wastewater

Procedia PDF Downloads 345

Authors: Iraklis Argyriou

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The transition to net-zero emission urban bus (ZEB) systems is receiving increased attention in research and policymaking throughout the globe. Most studies in this area tend to address techno-economic aspects and the perspectives of a narrow group of stakeholders, while they largely overlook analysis of current bus system dynamics. This offers limited insight into the types of ZEB governance challenges and opportunities that are encountered in real-world contexts, as well as into some of the immediate actions that need to be taken to set off the transition over the longer term. This research offers a multi-stakeholder perspective into both the technical and non-technical factors that influence ZEB transitions within a particular context, the UK. It does so by drawing from a recent transition visioning stakeholder workshop (June 2023) with key public, private and civic actors of the urban bus transportation system. Using NVivo software to qualitatively analyze the workshop discussions, the research examines the key technological and funding aspects, as well as the short-term actions (over the next five years), that need to be addressed for supporting the ZEB transition in UK cities. It finds that ZEB technology has reached a mature stage (i.e., high efficiency of batteries, motors and inverters), but important improvements can be pursued through greater control and integration of ZEB technological components and systems. In this regard, telemetry, predictive maintenance and adaptive control strategies pertinent to the performance and operation of ZEB vehicles have a key role to play in the techno-economic advancement of the transition. Yet, more pressing gaps were identified in the current ZEB funding regime. Whereas the UK central government supports greater ZEB adoption through a series of grants and subsidies, the scale of the funding and its fragmented nature do not match the needs for a UK-wide transition. Funding devolution arrangements (i.e., stable funding settlement deals between the central government and the devolved administrations/local authorities), as well as locally-driven schemes (i.e., congestion charging/workplace parking levy), could then enhance the financial prospects of the transition. As for short-term action, three areas were identified as critical: (1) the creation of whole value chains around the supply, use and recycling of ZEB components; (2) the ZEB retrofitting of existing fleets; and (3) integrated transportation that prioritizes buses as a first-choice, convenient and reliable mode while it simultaneously reduces car dependency in urban areas. Taken together, the findings point to the need for place-based transition approaches that create a viable techno-economic ecosystem for ZEB development but at the same time adopt a broader governance perspective beyond a ‘net-zero’ and ‘bus sectoral’ focus. As such, multi-actor collaborations and the coordination of wider resources and agency, both vertically across institutional scales and horizontally across transport, energy and urban planning, become fundamental features of comprehensive ZEB responses. The lessons from the UK case can inform a broader body of empirical contextual knowledge of ZEB transition governance within domestic political economies of public transportation.

Keywords: net-zero emission transition, stakeholders, transition governance, UK, urban bus transportation

Procedia PDF Downloads 76

Authors: Kimberley Adamek

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According to the Council on Tall Buildings, there has been a rapid increase in the construction of tall or “megatall” buildings over the past two decades. Simultaneously, the New England Journal of Medicine has reported that there has been a steady increase in climate related natural disasters since the 1970s; the eastern expansion of the USA's infamous Tornado Alley being just one of many current issues. In the future, this could mean that tall buildings, which already guide high speed winds down to pedestrian levels would have to withstand stronger forces and protect pedestrians in more extreme ways. Although many projects are required to be verified within wind tunnels and a handful of cities such as San Francisco have included wind testing within building code standards, there are still many examples where wind is only considered for basic loading. This typically results in and an increase of structural expense and unwanted mitigation strategies that are proposed late within a project. When building cities, architects rarely consider how each building alters the invisible patterns of wind and how these alterations effect other areas in different ways later on. It is not until these forces move, overpower and even destroy cities that people take notice. For example, towers have caused winds to blow objects into people (Walkie-Talkie Tower, Leeds, England), cause building parts to vibrate and produce loud humming noises (Beetham Tower, Manchester), caused wind tunnels in streets as well as many other issues. Alternatively, there exist towers which have used their form to naturally draw in air and ventilate entire facilities in order to eliminate the needs for costly HVAC systems (The Met, Thailand) and used their form to increase wind speeds to generate electricity (Bahrain Tower, Dubai). Wind and weather exist and effect all parts of the world in ways such as: Science, health, war, infrastructure, catastrophes, tourism, shopping, media and materials. Working in partnership with a leading wind engineering company RWDI, a series of tests, images and animations documenting discovered interactions of different building forms with wind will be collected to emphasize the possibilities for wind use to architects. A site within San Francisco (due to its increasing tower development, consistently wind conditions and existing strict wind comfort criteria) will host a final design. Iterations of this design will be tested within the wind tunnel and computational fluid dynamic systems which will expose, utilize and manipulate wind flows to create new forms, technologies and experiences. Ultimately, this thesis aims to question the amount which the environment is allowed to permeate building enclosures, uncover new programmatic possibilities for wind in buildings, and push the boundaries of working with the wind to ensure the development and safety of future cities. This investigation will improve and expand upon the traditional understanding of wind in order to give architects, wind engineers as well as the general public the ability to broaden their scope in order to productively utilize this living phenomenon that everyone constantly feels but cannot see.

Keywords: wind engineering, climate, visualization, architectural aerodynamics

Procedia PDF Downloads 361

Authors: Brogan Guest, Amy Donaldson-Perrott

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The Master’s of Physician Associate Studies (MPAS) programme at St George’s, University of London (SGUL), is an intensive two-year course that trains students to become physician associates (PAs). PAs are generalized healthcare providers who work in primary and secondary care across the UK. PA programmes face the difficult task of preparing students to become safe medical providers in two short years. Our goal is to teach students to develop clinical reasoning early on in their studies and historically, this has been done predominantly though problem-based learning (PBL). We have had an increase concern about student engagement in PBL and difficulty recruiting facilitators to maintain the low student to facilitator ratio required in PBL. To address this issue, we created ‘Clinical Application of Anatomy and Physiology (CAAP)’. These peer-led, interactive, problem-based, small group sessions were designed to facilitate students’ clinical reasoning skills. The sessions were designed using the concept of Team-Based Learning (TBL). Students were divided into small groups and each completed a pre-session quiz consisting of difficult questions devised to assess students’ application of medical knowledge. The quiz was completed in small groups and they were not permitted access of external resources. After the quiz, students worked through a series of openended, clinical tasks using all available resources. They worked at their own pace and the session was peer-led, rather than facilitator-driven. For a group of 35 students, there were two facilitators who observed the sessions. The sessions utilised an infinite space whiteboard software. Each group member was encouraged to actively participate and work together to complete the 15-20 tasks. The session ran for 2 hours and concluded with a post-session quiz, identical to the pre-session quiz. We obtained subjective feedback from students on their experience with CAAP and evaluated the objective benefit of the sessions through the quiz results. Qualitative feedback from students was generally positive with students feeling the sessions increased engagement, clinical understanding, and confidence. They found the small group aspect beneficial and the technology easy to use and intuitive. They also liked the benefit of building a resource for their future revision, something unique to CAAP compared to PBL, which out students participate in weekly. Preliminary quiz results showed improvement from pre- and post- session; however, further statistical analysis will occur once all sessions are complete (final session to run December 2022) to determine significance. As a post-graduate healthcare professional programme, we have a strong focus on self-directed learning. Whilst PBL has been a mainstay in our curriculum since its inception, there are limitations and concerns about its future in view of student engagement and facilitator availability. Whilst CAAP is not TBL, it draws on the benefits of peer-led, small group work with pre- and post- team-based quizzes. The pilot of these sessions has shown that students are engaged by CAAP, and they can make significant progress in clinical reasoning in a short amount of time. This can be achieved with a high student to facilitator ratio.

Keywords: problem based learning, team based learning, active learning, peer-to-peer teaching, engagement

Procedia PDF Downloads 83

Authors: N. Naz, A. D. Domenico, M. N. Huda

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Soft Robotics is a rapidly growing multidisciplinary field where robots are fabricated using highly deformable materials motivated by bioinspired designs. The high dexterity and adaptability to the external environments during contact make soft robots ideal for applications such as gripping delicate objects, locomotion, and biomedical devices. The actuation system of soft robots mainly includes fluidic, tendon-driven, and smart material actuation. Among them, Soft Pneumatic Actuator, also known as SPA, remains the most popular choice due to its flexibility, safety, easy implementation, and cost-effectiveness. However, at present, most of the fabrication of SPA is still based on traditional molding and casting techniques where the mold is 3d printed into which silicone rubber is cast and consolidated. This conventional method is time-consuming and involves intensive manual labour with the limitation of repeatability and accuracy in design. Recent advancements in direct 3d printing of different soft materials can significantly reduce the repetitive manual task with an ability to fabricate complex geometries and multicomponent designs in a single manufacturing step. The aim of this research work is to design and analyse the Soft Pneumatic Actuator (SPA) utilizing both conventional casting and modern direct 3d printing technologies. The mold of the SPA for traditional casting is 3d printed using fused deposition modeling (FDM) with the polylactic acid (PLA) thermoplastic wire. Hyperelastic soft materials such as Ecoflex-0030/0050 are cast into the mold and consolidated using a lab oven. The bending behaviour is observed experimentally with different pressures of air compressor to ensure uniform bending without any failure. For direct 3D-printing of SPA fused deposition modeling (FDM) with thermoplastic polyurethane (TPU) and stereolithography (SLA) with an elastic resin are used. The actuator is modeled using the finite element method (FEM) to analyse the nonlinear bending behaviour, stress concentration and strain distribution of different hyperelastic materials after pressurization. FEM analysis is carried out using Ansys Workbench software with a Yeon-2nd order hyperelastic material model. FEM includes long-shape deformation, contact between surfaces, and gravity influences. For mesh generation, quadratic tetrahedron, hybrid, and constant pressure mesh are used. SPA is connected to a baseplate that is in connection with the air compressor. A fixed boundary is applied on the baseplate, and static pressure is applied orthogonally to all surfaces of the internal chambers and channels with a closed continuum model. The simulated results from FEM are compared with the experimental results. The experiments are performed in a laboratory set-up where the developed SPA is connected to a compressed air source with a pressure gauge. A comparison study based on performance analysis is done between FDM and SLA printed SPA with the molded counterparts. Furthermore, the molded and 3d printed SPA has been used to develop a three-finger soft pneumatic gripper and has been tested for handling delicate objects.

Keywords: finite element method, fused deposition modeling, hyperelastic, soft pneumatic actuator

Procedia PDF Downloads 90

Authors: Mohamad F. Jamiluddin, Emeline Sarry, Ana Bejanariu, Cécile Bauche

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Introduction: Over 360 million people are chronically infected with hepatitis B virus (HBV), of whom 1 million die each year from HBV-associated liver cirrhosis or hepatocellular carcinoma. Current treatment options for chronic hepatitis B depend on interferon-α (IFNα) or nucleos(t)ide analogs, which control virus replication but rarely eliminate the virus. Treatment with PEG-IFNα leads to a sustained antiviral response in only one third of patients. After withdrawal of the drugs, the rebound of viremia is observed in the majority of patients. Furthermore, the long-term treatment is subsequently associated with the appearance of drug resistant HBV strains that is often the cause of the therapy failure. Among the new therapeutic avenues being developed, therapeutic vaccine aimed at inducing immune responses similar to those found in resolvers is of growing interest. The high prevalence of chronic hepatitis B necessitates the design of better vaccination strategies capable of eliciting broad-spectrum of cell-mediated immunity(CMI) and humoral immune response that can control chronic hepatitis B. Induction of HBV-specific T cells and B cells by therapeutic vaccination may be an innovative strategy to overcome virus persistence. Lentiviral vectors developed and optimized by THERAVECTYS, due to their ability to transduce non-dividing cells, including dendritic cells, and induce CMI response, have demonstrated their effectiveness as vaccination tools. Method: To develop a HBV therapeutic vaccine that can induce a broad but specific immune response, we generated recombinant lentiviral vector carrying IRES(Internal Ribosome Entry Site)-containing bicistronic constructs which allow the coexpression of two vaccine products, namely HBV T- cell epitope vaccine and HBV virus like particle (VLP) vaccine. HBV T-cell epitope vaccine consists of immunodominant cluster of CD4 and CD8 epitopes with spacer in between them and epitopes are derived from HBV surface protein, HBV core, HBV X and polymerase. While HBV VLP vaccine is a HBV core protein based chimeric VLP with surface protein B-cell epitopes displayed. In order to evaluate the immunogenicity, mice were immunized with lentiviral constructs by intramuscular injection. The T cell and antibody immune responses of the two vaccine products were analyzed using IFN-γ ELISpot assay and ELISA respectively to quantify the adaptive response to HBV antigens. Results: Following a single administration in mice, lentiviral construct elicited robust antigen-specific IFN-γ responses to the encoded antigens. The HBV T- cell epitope vaccine demonstrated significantly higher T cell immunogenicity than HBV VLP vaccine. Importantly, we demonstrated by ELISA that antibodies are induced against both HBV surface protein and HBV core protein when mice injected with vaccine construct (p < 0.05). Conclusion: Our results highlight that THERAVECTYS lentiviral vectors may represent a powerful platform for immunization strategy against chronic hepatitis B. Our data suggests the likely importance of Lentiviral vector based novel bicistronic construct for further study, in combination with drugs or as standalone antigens, as a therapeutic lentiviral based HBV vaccines. THERAVECTYS bicistronic HBV vaccine will be further evaluated in animal efficacy studies.

Keywords: chronic hepatitis B, lentiviral vectors, therapeutic vaccine, virus-like particle

Procedia PDF Downloads 335

Authors: A. Kourou, A. Ioakeimidou, E. Pelli, M. Panoutsopoulou, V. Abramea

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Worldwide there is a growing recognition that education is a critical component of any disaster impacts reduction effort and a great challenge too. Given this challenge, a broad range of awareness raising projects at all levels are implemented and are continuously evaluated by Earthquake Planning and Protection Organization (EPPO). This paper presents an overview of EPPO educational initiative (seminars, lectures, workshops, campaigns and educational material) and its evaluation results. The abovementioned initiative is focused to aware the public, train teachers and civil protection staff, inform students and educate people with disabilities on subjects related to earthquake reduction issues. The better understating of how human activity can link to disaster and what can be done at the individual, family or workplace level to contribute to seismic reduction are the main issues of EPPO projects. Survey results revealed that a high percentage of teachers (included the ones of special schools) from all over the country have taken the appropriate preparedness measures at schools. On the other hand, the implementation of earthquake preparedness measures at various workplaces (kindergartens, banks, utilities etc.) has still significant room for improvement. Results show that the employees in banks and public utilities have substantially higher rates in preventive and preparedness actions in their workplaces than workers in kindergartens and other workplaces. One of the EPPO educational priorities is to enhance earthquake preparedness of people with disabilities. Booklets, posters and applications have been created with the financial support of the Council of Europe, addressed to people who have mobility impairments, learning difficulties or cognitive disability (ή intellectual disabilities). Part of the educational material was developed using the «easy-to-read» method and Makaton language program with the collaboration of experts on special needs education and teams of people with cognitive disability. Furthermore, earthquake safety seminars and earthquake drills have been implemented in order to develop children’s, parents’ and teachers abilities and skills on earthquake impacts reduction. To enhance the abovementioned efforts, EPPO is a partner at prevention and preparedness projects supported by EU Civil Protection Financial Instrument. One of them is E-PreS’ project (Monitoring and Evaluation of Natural Hazard Preparedness at School Environment). The main objectives of E-PreS project are: 1) to create smart tools which define, simulate and evaluate drills procedure at schools, centers of vocational training of people with disabilities or other workplaces, and 2) to involve students or adults with disabilities in the E-PreS system evacuation procedure in case of earthquake, flood, or volcanic occurrence. Two other EU projects (RACCE educational kit and EVANDE educational platform) are also with the aim of contributing to raising awareness among people with disabilities, students, teachers, volunteers etc. It is worth mentioning that even though in Greece many efforts have been done till now to build awareness towards earthquakes and establish preparedness status for prospective earthquakes, there are still actions to be taken.

Keywords: earthquake, emergency plans, E-PreS project, people with disabilities, special needs education

Procedia PDF Downloads 266

Authors: T. Heiman, D. Olenik-Shemesh

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Over the past decade, with the rapid growth of electronic communication, the internet and, in particular, social networking has become an inseparable part of people's daily lives. Along with its benefits, a new type of online aggression has emerged, defined as cyber bullying, a form of interpersonal aggressive behavior that takes place through electronic means. Cyber-bullying is characterized by repetitive behavior over time of maladaptive authority and power usage using computers and cell phones via sending insulting messages and hurtful pictures. Preliminary findings suggest that the prevalence of involvement in cyber-bullying among higher education students varies between 10 and 35%. As to date, universities are facing an uphill effort in trying to restrain online misbehavior. As no studies examined the relationships between cyber-bullying involvement with personal aspects, and its impacts on academic achievement and work functioning, this present study examined the nature of cyber-bullying involvement among 1,052 undergraduate students (mean age = 27.25, S.D = 4.81; 66.2% female), coping with, as well as the effects of social support, perceived self-efficacy, well-being, and body-perception, in relation to cyber-victimization. We assume that students in higher education are a vulnerable population and at high risk of being cyber-victims. We hypothesize that social support might serve as a protective factor and will moderate the relationships between the socio-emotional variables and the occurrence of cyber- victimization. The findings of this study will present the relationships between cyber-victimization and the social-emotional aspects, which constitute risk and protective factors. After receiving approval from the Ethics Committee of the University, a Google Drive questionnaire was sent to a random sample of students, studying in the various University study centers. Students' participation was voluntary, and they completed the five questionnaires anonymously: Cyber-bullying, perceived self-efficacy, subjective well-being, social support and body perception. Results revealed that 11.6% of the students reported being cyber-victims during last year. Examining the emotional and behavioral reactions to cyber-victimization revealed that female emotional and behavioral reactions were significantly greater than the male reactions (p < .001). Moreover, females reported on a significant higher social support compared to men; male reported significantly on a lower social capability than female; and men's body perception was significantly more positive than women's scores. No gender differences were observed for subjective well-being scale. Significant positive correlations were found between cyber-victimization and fewer friends, lower grades, and work ineffectiveness (r = 0.37- .40, p < 0 .001). The results of the Hierarchical regression indicated significantly that cyber-victimization can be predicted by lower social support, lower body perception, and gender (female), that explained 5.6% of the variance (R2 = 0.056, F(5,1047) = 12.47, p < 0.001). The findings deepen our understanding of the students' involvement in cyber-bullying, and present the relationships of the social-emotional and academic aspects on cyber-victim students. In view of our findings, higher education policy could help facilitate coping with cyber-bullying incidents, and student support units could develop intervention programs aimed at reducing cyber-bullying and its impacts.

Keywords: academic and personal factors, cyber-victimization, social support, higher education

Procedia PDF Downloads 289

Authors: Julia A. Ermakova

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As a member of a multicultural society, it is imperative that individuals demonstrate the highest level of decorum in order to exemplify the beauty of their culture. Adab, the practice of praiseworthy words and deeds, as well as possessing good manners and pursuing that which is considered good, is a fundamental concept that guards against all types of mistakes. In Islam, etiquette for every situation in life is taught, and it constitutes the way of life for a Muslim. In light of this, the personality of an elegant Muslim woman can be described as one who embodies the following qualities: Firstly, cultural speech and erudition are essential components. Improving one's intellect, learning new things, reading diverse literature, expanding one's vocabulary, working on articulation, and avoiding obscene speech and verbosity are crucial. Additionally, listening more than speaking and being willing to discuss one's culture when asked are commendable qualities. Conversely, it is important to avoid discussing foolish matters with foolish people and to be able to respond appropriately and change the subject if someone attempts to hurt or manipulate. Secondly, the style of speech is also of paramount importance. It is recommended to speak in a measured tone with a quiet voice and deep breathing. Avoiding rushing and shortness of breath is also recommended. Thirdly, awareness of how to greet others is essential. Combining Shariah and small talk etiquette, such as making a gesture of respect by putting one's hand to the chest and smiling slightly when a man offers a handshake, is recommended. Understanding the rules of small talk, taboo topics, and self-presentation is also important. Fourthly, knowing how to give and receive compliments without devaluing them is imperative. Knowledge of the rules of good manners and etiquette, both secular and Shariah, is also essential. Fifthly, avoiding arguments and responding elegantly to rudeness and tactlessness is a sign of an elegant Muslim woman. Treating everyone with respect and avoiding prejudices, taboo topics, inappropriate questions, and bad habits are all aspects of politeness. Sixthly, a neat appearance appropriate to Shariah and the local community, as well as a well-put-together outfit with a touch of elegance and style, are crucial. Posture, graceful movement, and a pleasant gaze are also important. Finally, good spirits and inner calm are key to projecting a harmonious image, which encourages people to listen attentively. Giving thanks to Allah in every situation in life is the key to maintaining good spirits. In conclusion, an elegant Muslim woman in a multicultural society is characterized by her high moral qualities and adherence to Islamic etiquette. These qualities, such as cultural speech and erudition, style of speech, awareness of how to greet, knowledge of good manners and etiquette, avoiding arguments, politeness, a neat appearance, and good spirits, all contribute to projecting an image of elegance and respectability. By exemplifying these qualities, Muslim women can serve as positive ambassadors for their culture and religion in diverse societies.

Keywords: adab, elegance, muslim woman, multicultural societies, good manners, etiquette

Procedia PDF Downloads 69

Authors: Kari Björn

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Introduction of games has expanded the application area of computer-aided learning tools to wide variety of age groups of learners. Serious games engage the learners into a real-world -type of simulation and potentially enrich the learning experience. Institutional background of a Bachelor’s level engineering program in Information and Communication Technology is introduced, with detailed focus on one of its majors, Health Technology. As part of a Customer Oriented Software Application thematic semester, one particular course of “eHealth Business and Solutions” is described and reflected in a gamified framework. Learning a consistent view into vast literature of business management, strategies, marketing and finance in a very limited time enforces selection of topics relevant to the industry. Health Technology is a novel and growing industry with a growing sector in consumer wearable devices and homecare applications. The business sector is attracting new entrepreneurs and impatient investor funds. From engineering education point of view the sector is driven by miniaturizing electronics, sensors and wireless applications. However, the market is highly consumer-driven and usability, safety and data integrity requirements are extremely high. When the same technology is used in analysis or treatment of patients, very strict regulatory measures are enforced. The paper introduces a course structure using gamification as a tool to learn the most essential in a new market: customer value proposition design, followed by a market entry game. Students analyze the existing market size and pricing structure of eHealth web-service market and enter the market as a steering group of their company, competing against the legacy players and with each other. The market is growing but has its rules of demand and supply balance. New products can be developed with an R&D-investment, and targeted to market with unique quality- and price-combinations. Product cost structure can be improved by investing to enhanced production capacity. Investments can be funded optionally by foreign capital. Students make management decisions and face the dynamics of the market competition in form of income statement and balance sheet after each decision cycle. The focus of the learning outcome is to understand customer value creation to be the source of cash flow. The benefit of gamification is to enrich the learning experience on structure and meaning of financial statements. The paper describes the gamification approach and discusses outcomes after two course implementations. Along the case description of learning challenges, some unexpected misconceptions are noted. Improvements of the game or the semi-gamified teaching pedagogy are discussed. The case description serves as an additional support to new game coordinator, as well as helps to improve the method. Overall, the gamified approach has helped to engage engineering student to business studies in an energizing way.

Keywords: engineering education, integrated curriculum, learning experience, learning outcomes

Procedia PDF Downloads 240

Authors: Amandeep Kaur

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Farming is one of the most influential traditions which started around 10000 BC and has revolutionized human civilization. It is believed that farming originated at a separate location. Thus it has a great impact on local culture, which in turn gave rise to diversified farming practices. Farming activities are influenced by the culture of a particular region or community as local people have their own knowledge and belief system about soil and crops. With the inception of the Green Revolution, 'a high tech machinery model' in Punjab, various traditional farming methods and techniques changed. The present research concentrates on the local knowledge of farmers and local farming systems from an anthropological perspective. In view of the prevailing agrarian crisis in Punjab, this research is focused on farmer’s experiences and their perception regarding farming practices. Thus an attempt has to be made to focus on the local knowledge, perception, and experience of farmers for eco-friendly and sustainable agricultural development. Farmers voices are used to understand the relationship between farming practices and socio-cultural life of farmers in Faridkot district, Punjab. The research aims to comprehend the nature of changes taking place in the socio-cultural life of people with the development of capitalism and agricultural modernization. The study is based on qualitative methods of ethnography in Sarawan village of Faridkot District. Inferences drawn from in-depth case studies collected from 60 agricultural households lead to the concept of the process of diffusion, innovation, and adoption of farming technology, a variety of crops and the dissemination of agricultural skills regarding various cultural farming practices. The data is based on random sampling; the respondents were both males and females above the age of 18 years to attain a holistic understanding across the generations. A Quasi-participant observation related to lifestyle, the standard of living, and various farming practices performed by them were done. Narratives derived from the fieldwork depicts that farmers usually oppose the restrictions imposed by the government on certain farming practices, especially ban on stubble burning. This paper presents the narratives of farmers regarding the dissemination of awareness about the use of new varieties of seeds, technology, fertilizers, pesticides, etc. The study reveals that farming systems have developed in ways reflecting the activities and choices of farmers influenced by environmental, socio-cultural, economic, and political situations. Modern farming practices have forced small farmers into debt as farmers feel pride in buying new machinery. It has also led to the loss of work culture and excessive use of drugs among youngsters. Even laborers did not want to work on the land with cultivating farmers primarily for social and political reasons. Due to lack of proper marketing of crops, there is a continuum of the wheat-rice cycle instead of crop diversification in Punjab. Change in the farming system also affects the social structure of society. Agricultural modernization has commercialized the socio-cultural relations in Punjab and is slowly urbanizing the rural landscape revolutionizing the traditional social relations to capitalistic relations.

Keywords: agricultural modernization, capitalism, farming practices, narratives

Procedia PDF Downloads 150

Authors: Collen T. Masilo, Brane Semolic, Pieter Steyn

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The Internet Protocol Television (IPTV) and Hybrid Fibre-Coaxial (HFC) Broadband industrial sector landscape are rapidly changing and organisations within the industry need to stay competitive by exploring new business models so that they can be able to offer new services and products to customers. The business challenge in this industrial sector is meeting or exceeding high customer expectations across multiple content delivery modes. The increasing challenges in the IPTV and HFC broadband industrial sector encourage service providers to form strategic partnerships with key suppliers, marketing partners, advertisers, and technology partners. The need to form enterprise collaborative networks poses a challenge for any organisation in this sector, in selecting the right strategic partners who will ensure that the organisation’s services and products are marketed in new markets. Partners who will ensure that customers are efficiently supported by meeting and exceeding their expectations. Lastly, selecting cooperation partners who will represent the organisation in a positive manner, and contribute to improving the performance of the organisation. Companies in the IPTV and HFC broadband industrial sector tend to form informal partnerships with suppliers, vendors, system integrators and technology partners. Generally, partnerships are formed without thorough analysis of the real reason a company is forming collaborations, without proper evaluations of prospective partners using specific selection criteria, and with ineffective performance monitoring of partners to ensure that a firm gains real long term benefits from its partners and gains competitive advantage. Similar tendencies are illustrated in the research case study and are based on Skyline Communications, a global leader in end-to-end, multi-vendor network management and operational support systems (OSS) solutions. The organisation’s flagship product is the DataMiner network management platform used by many operators across multiple industries and can be referred to as a smart system that intelligently manages complex technology ecosystems for its customers in the IPTV and HFC broadband industry. The approach of the research is to develop the most efficient business model that can be deployed to improve a strategic partnership programme in order to significantly improve the performance and growth of organisations participating in a collaborative network in the IPTV and HFC broadband industrial sector. This involves proposing and implementing a new strategic partnership model and its main features within the industry which should bring about significant benefits for all involved companies to achieve value add and an optimal growth strategy. The proposed business model has been developed based on the research of existing relationships, value chains and business requirements in this industrial sector and validated in 'Skyline Communications'. The outputs of the business model have been demonstrated and evaluated in the research business case study the IPTV and HFC broadband service provider 'Skyline Communications'.

Keywords: growth, partnership, selection criteria, value chain

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Authors: Utpal Das, Sona Das

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InAs/GaSb type-II superlattice (T2SL) Mid-wave infrared (MWIR) focal plane arrays (FPAs) have recently seen rapid development. However, in small pixel size large format FPAs, the occurrence of high mesa sidewall surface leakage current is a major constraint necessitating proper surface passivation. A simple pixel isolation technique in InAs/GaSb T2SL detector arrays without the conventional mesa etching has been proposed to isolate the pixels by forming a more resistive higher band gap material from the SL, in the inter-pixel region. Here, a single step femtosecond (fs) laser anneal of the T2SL structure of the inter-pixel T2SL regions, have been used to increase the band gap between the pixels by QW-intermixing and hence increase isolation between the pixels. The p-i-n photodiode structure used here consists of a 506nm, (10 monolayer {ML}) InAs:Si (1x10¹⁸cm⁻³)/(10ML) GaSb SL as the bottom n-contact layer grown on an n-type GaSb substrate. The undoped absorber layer consists of 1.3µm, (10ML)InAs/(10ML)GaSb SL. The top p-contact layer is a 63nm, (10ML)InAs:Be(1x10¹⁸cm⁻³)/(10ML)GaSb T2SL. In order to improve the carrier transport, a 126nm of graded doped (10ML)InAs/(10ML)GaSb SL layer was added between the absorber and each contact layers. A 775nm 150fs-laser at a fluence of ~6mJ/cm² is used to expose the array where the pixel regions are masked by a Ti(200nm)-Au(300nm) cap. Here, in the inter-pixel regions, the p+ layer have been reactive ion etched (RIE) using CH₄+H₂ chemistry and removed before fs-laser exposure. The fs-laser anneal isolation improvement in 200-400μm pixels due to spatially selective quantum well intermixing for a blue shift of ~70meV in the inter-pixel regions is confirmed by FTIR measurements. Dark currents are measured between two adjacent pixels with the Ti(200nm)-Au(300nm) caps used as contacts. The T2SL quality in the active photodiode regions masked by the Ti-Au cap is hardly affected and retains the original quality of the detector. Although, fs-laser anneal of p+ only etched p-i-n T2SL diodes show a reduction in the reverse dark current, no significant improvement in the full RIE-etched mesa structures is noticeable. Hence for a 128x128 array fabrication of 8μm square pixels and 10µm pitch, SU8 polymer isolation after RIE pixel delineation has been used. X-n+ row contacts and Y-p+ column contacts have been used to measure the optical response of the individual pixels. The photo-response of these 8μm and other 200μm pixels under a 2ns optical pulse excitation from an Optical-Parametric-Oscillator (OPO), shows a peak responsivity of ~0.03A/W and 0.2mA/W, respectively, at λ~3.7μm. Temporal response of this detector array is seen to have a fast response ~10ns followed typical slow decay with ringing, attributed to impedance mismatch of the connecting co-axial cables. In conclusion, response times of a few ns have been measured in 8µm pixels of a 128x128 array. Although fs-laser anneal has been found to be useful in increasing the inter-pixel isolation in InAs/GaSb T2SL arrays by QW inter-mixing, it has not been found to be suitable for passivation of full RIE etched mesa structures with vertical walls on InAs/GaSb T2SL.

Keywords: band-gap blue-shift, fs-laser-anneal, InAs/GaSb T2SL, Inter-pixel isolation, ns-Response, photodiode array

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Authors: Abiodun Amusan, Olugbenga Akinola, Kazeem Akano, María Hernández-Castañeda, Jenna Dick, Akintunde Sowunmi, Geoffrey Hart, Grace Gbotosho

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Introduction: Artemisinin-based Combination Therapy (ACTs) is the cornerstone malaria treatment option in most malaria-endemic countries. Unfortunately, the malaria control effort is constantly being threatened by resistance of Plasmodium falciparum to ACTs. The recent evidence of artemisinin resistance in East Africa and its possibility of spreading to other African regions portends an imminent health catastrophe. This study aimed at evaluating the occurrence, prevalence, and influence of artemisinin-resistance markers on treatment outcomes in Ibadan before and after post-adoption of artemisinin combination therapy (ACTs) in Nigeria in 2005. Method: The study involved day zero dry blood spot (DBS) obtained from malaria patients during retrospective (2000-2005) and prospective (2021) studies. A cohort in the prospective study received oral dihydroartemisinin-piperaquine and underwent a 42-day follow-up to observe treatment outcomes. Genomic DNA was extracted from the DBS samples using a QIAamp blood extraction kit. Fragments of P. falciparum kelch13 (Pfkelch13), P. falciparum coronin (Pfcoronin), P. falciparum multidrug resistance 2 (PfMDR2), and P. falciparum chloroquine resistance transporter (PfCRT) genes were amplified and sequenced on a sanger sequencing platform to identify artemisinin resistance-associated mutations. Mutations were identified by aligning sequenced data with reference sequences obtained from the National Center for Biotechnology Information. Data were analyzed using descriptive statistics and student t-tests. Results: Mean parasite clearance time (PCT) and fever clearance time (FCT) were 2.1 ± 0.6 days (95% CI: 1.97-2.24) and 1.3 ± 0.7 days (95% CI: 1.1-1.6) respectively. Four mutations, K189T [34/53(64.2%)], R255K [2/53(3.8%)], K189N [1/53(1.9%)] and N217H [1/53(1.9%)] were identified within the N-terminal (Coiled-coil containing) domain of Pfkelch13. No artemisinin resistance-associated mutation usually found within the β-propeller domain of the Pfkelch13 gene was found in these analyzed samples. However, K189T and R255K mutations showed a significant correlation with longer parasite clearance time in the patients (P<0.002). The observed Pfkelch13 gene changes did not influence the baseline mean parasitemia (P = 0.44). P76S [17/100 (17%)] and V62M [1/100 (1%)] changes were identified in the Pfcoronin gene fragment without any influence on the parasitological parameters. No change was observed in the PfMDR2 gene, while no artemisinin resistance-associated mutation was found in the PfCRT gene. Furthermore, a sample each in the retrospective study contained the Pfkelch13 K189T and Pfcoronin P76S mutations. Conclusion: The study revealed absence of genetic-based evidence of artemisinin resistance in the study population at the time of study. The high frequency of K189T Pfkelch13 mutation and its correlation with increased parasite clearance time in this study may depict geographical variation of resistance mediators and imminent artemisinin resistance, respectively. The study also revealed an inherent potential of parasites to harbour drug-resistant genotypes before the introduction of ACTs in Nigeria.

Keywords: artemisinin resistance, plasmodium falciparum, Pfkelch13 mutations, Pfcoronin

Procedia PDF Downloads 51

Authors: E. Carraro, Sa. Bonetta, Si. Bonetta, E. Ceretti, G. C. V. Viola, C. Pignata, S. Levorato, T. Salvatori, S. Vannini, V. Romanazzi, A. Carducci, G. Donzelli, T. Schilirò, A. De Donno, T. Grassi, S. Bonizzoni, A. Bonetti, G. Gilli, U. Gelatti

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In 2013, air pollution and particulate matter were classified as carcinogenic to human by the IARC. At present, PM is Europe's most problematic pollutant in terms of harm to health, as reported by European Environmental Agency (EEA) in the EEA Technical Report on Air quality in Europe, 2015. A percentage between 17-30 of the EU urban population lives in areas where the EU air quality 24-hour limit value for PM10 is exceeded. Many studies have found a consistent association between exposure to PM and the incidence and mortality for some chronic diseases (i.e. lung cancer, cardiovascular diseases). Among the mechanisms responsible for these adverse effects, genotoxic damage is of particular concern. Children are a high-risk group in terms of the health effects of air pollution and early exposure during childhood can increase the risk of developing chronic diseases in adulthood. The MAPEC_LIFE (Monitoring Air Pollution Effects on Children for supporting public health policy) is a project founded by EU Life+ Programme (LIFE12 ENV/IT/000614) which intends to evaluate the associations between air pollution and early biological effects in children and to propose a model for estimating the global risk of early biological effects due to air pollutants and other factors in children. This work is focused on the micronuclei frequency in child buccal cells in association with airborne PM levels taking into account the influence of other factors associated with the lifestyle of children. The micronucleus test was performed in exfoliated buccal cells of 6–8 years old children from 5 Italian towns with different air pollution levels. Data on air quality during the study period were obtained from the Regional Agency for Environmental Protection. A questionnaire administered to children’s parents was used to obtain details on family socio-economic status, children health condition, exposures to other indoor and outdoor pollutants (i.e. passive smoke) and life-style, with particular reference to eating habits. During the first sampling campaign (winter 2014-15) 1315 children were recruited and sampled for Micronuclei test in buccal cells. In the sampling period the levels of the main pollutants and PM10 were, as expected, higher in the North of Italy (PM10 mean values 62 μg/m3 in Torino and 40 μg/m3 in Brescia) than in the other towns (Pisa, Perugia, Lecce). A higher Micronucleus frequency in buccal cells of children was found in Brescia (0.6/1000 cells) than in the other towns (range 0.3-0.5/1000 cells). The statistical analysis underlines a relation of the micronuclei frequency with PM concentrations, traffic level near child residence, and level of education of parents. The results suggest that, in addition to air pollution exposure, some other factors, related to lifestyle or further exposures, may influence micronucleus frequency and cellular response to air pollutants.

Keywords: air pollution, buccal cells, children, micronucleus cytome assay

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Authors: M. Petunia Tsweleng

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Statement of the Problem: Research and aid organisations report that children and adolescents orphaned due to HIV and AIDS are particularly vulnerable as they are often exposed to negative effects of both HIV and AIDS and orphanhood. Without much-needed parental love, care, and support, these children and adolescents are at risk of poor developmental outcomes. A cursory look at the available literature on AIDS-orphaned adolescents, and the quality of caregiving relationships with caregivers, shows that this is a relatively under-researched terrain. This article is a review of the literature on caregiving relationships of adolescents orphaned due to AIDS and their current primary caregivers. It aims to inform community programmes and policymakers by providing insight into the qualities of these relationships. Methodology: A comprehensive search of both peer-reviewed and non-peer-reviewed literature was conducted through EBSCOhost, SpringLINK, PsycINFO, SAGE, PubMed, Elsevier ScienceDirect, JSTOR, Wiley Online Library databases, and Google Scholar. The combination of keywords used for the search were: (caregiving relationships); (orphans OR AIDS orphaned children OR AIDS orphaned adolescents); (primary caregivers); and (quality caregiving); (orphans); (HIV and AIDS). The search took place between 24 January and 28 February 2022. Both qualitative and quantitative research studies published between 2010 and 2020 were reviewed. However, only qualitative studies were selected in the end -as they presented more profound findings concerning orphan-caregiver relationships. The following three stages of meta-synthesis analysis were used to analyse data: refutational syntheses, reciprocal syntheses, and line of argument. Results: The search resulted in a total of 2090 titles, of which 750 were duplicates and therefore subtracted. The researcher reviewed all the titles and abstracts of the remaining 1340 articles. 329 articles were identified as relevant, and full texts were reviewed. Following the review of the full texts, 313 studies were excluded for relevance and 4 for methodology. Twelve articles representing 11 studies fulfilled the inclusion criteria and were selected. These studies, representing different countries across the globe, reported similar forms of hardships experienced by caregivers economically, psychosocially, and healthwise. However, the studies also show that the majority of caregivers found contentment in caring for orphans, particularly grandmother carers, and were thus enabled to provide love, care, and support despite hardships. This resulted in positive caregiving relationships -as orphans fared well emotionally and psychosocially. Some relationships, however, were found negative due to unhealed emotional wounds suffered by both caregivers and orphans and others due to the caregiver’s lack of interest in providing care. These findings were based on self-report data from both orphans and caregivers. Conclusion: Findings suggest that intervention efforts need to be intensified to: alleviate poverty in households that are affected by HIV and AIDS pandemic, strengthen the community psychosocial support programmes for orphans and their caregivers; and integrate clinical services with community programmes for the healing of emotional and psychological wounds. Contributions: Findings inform community programmes and policymakers by providing insight into the qualities of the mentioned relationships as well as identifying factors commonly associated with high-quality caregiving and poor-quality caregiving.

Keywords: systematic review, caregiving relationships, orphans and primary caregivers, AIDS

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Authors: Miroslava Cuperlovic-Culf, Lipu Wang, Ketty Boyle, Nadine Makley, Ian Burton, Anissa Belkaid, Mohamed Touaibia, Marc E. Surrette

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Metabolic changes are one of the major factors in the development of a variety of diseases in various species. Metabolism of agricultural plants is altered the following infection with pathogens sometimes contributing to resistance. At the same time, pathogens use metabolites for infection and progression. In humans, metabolism is a hallmark of cancer development for example. Quantified metabolomics data combined with other omics or clinical data and analyzed using various unsupervised and supervised methods can lead to better diagnosis and prognosis. It can also provide information about resistance as well as contribute knowledge of compounds significant for disease progression or prevention. In this work, different methods for metabolomics quantification and analysis from Nuclear Magnetic Resonance (NMR) measurements that are used for investigation of disease development in wheat and human cells will be presented. One-dimensional 1H NMR spectra are used extensively for metabolic profiling due to their high reliability, wide range of applicability, speed, trivial sample preparation and low cost. This presentation will describe a new method for metabolite quantification from NMR data that combines alignment of spectra of standards to sample spectra followed by multivariate linear regression optimization of spectra of assigned metabolites to samples’ spectra. Several different alignment methods were tested and multivariate linear regression result has been compared with other quantification methods. Quantified metabolomics data can be analyzed in the variety of ways and we will present different clustering methods used for phenotype determination, network analysis providing knowledge about the relationships between metabolites through metabolic network as well as biomarker selection providing novel markers. These analysis methods have been utilized for the investigation of fusarium head blight resistance in wheat cultivars as well as analysis of the effect of estrogen receptor and carbonic anhydrase activation and inhibition on breast cancer cell metabolism. Metabolic changes in spikelet’s of wheat cultivars FL62R1, Stettler, MuchMore and Sumai3 following fusarium graminearum infection were explored. Extensive 1D 1H and 2D NMR measurements provided information for detailed metabolite assignment and quantification leading to possible metabolic markers discriminating resistance level in wheat subtypes. Quantification data is compared to results obtained using other published methods. Fusarium infection induced metabolic changes in different wheat varieties are discussed in the context of metabolic network and resistance. Quantitative metabolomics has been used for the investigation of the effect of targeted enzyme inhibition in cancer. In this work, the effect of 17 β -estradiol and ferulic acid on metabolism of ER+ breast cancer cells has been compared to their effect on ER- control cells. The effect of the inhibitors of carbonic anhydrase on the observed metabolic changes resulting from ER activation has also been determined. Metabolic profiles were studied using 1D and 2D metabolomic NMR experiments, combined with the identification and quantification of metabolites, and the annotation of the results is provided in the context of biochemical pathways.

Keywords: metabolic biomarkers, metabolic network, metabolomics, multivariate linear regression, NMR quantification, quantified metabolomics, spectral alignment

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Authors: Trenten Theis, Trevor Daubert, Kennedy Kluthe, Austin Nuxoll

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Staphylococcus aureus is a gram-positive bacterium responsible for an estimated 23,000 deaths in the United States and 25,000 deaths in the European Union annually. Recurring S. aureus bacteremia is associated with biofilm-mediated infections and can occur in 5 - 20% of cases, even with the use of antibiotics. Despite these infections being caused by drug-susceptible pathogens, they are surprisingly difficult to eradicate. One potential explanation for this is the presence of persister cells—a dormant type of cell that shows a high tolerance to antibiotic treatment. Recent studies have shown a connection between low intracellular ATP and persister cell formation. Specifically, this decrease in ATP, and therefore increase in persister cell formation, is due to an interrupted tricarboxylic acid (TCA) cycle. However, S. aureus persister cells’ role in pathogenesis remains unclear. Initial studies have shown that a fumC (TCA cycle gene) knockout survives challenge from aspects of the innate immune system better than wild-type S. aureus. Specifically, challenges from two antimicrobial peptides--LL-37 and hBD-3—show a log increase in survival of the fumC::N∑ strain compared to wild type S. aureus after 18 hours. Furthermore, preliminary studies show that the fumC knockout has a log more survival within a macrophage. These data lead us to hypothesize that the fumC knockout is better suited to other aspects of the innate immune system compared to wild-type S. aureus. To further investigate the mechanism for increased survival of fumC::N∑ within a macrophage, we tested bacterial growth in the presence of reactive oxygen species (ROS), reactive nitrogen species (RNS), and a low pH. Preliminary results suggest that the fumC knockout has increased growth compared to wild-type S. aureus in the presence of all three antimicrobial factors; however, no difference was observed in any single factor alone. To investigate survival within a host, a nine-day biofilm-associated catheter infection was performed on 6–8-week-old male and female C57Bl/6 mice. Although both sexes struggled to clear the infection, female mice were trending toward more frequently clearing the HG003 wild-type infection compared to the fumC::N∑ infection. One possible reason for the inability to reduce the bacterial burden is that biofilms are largely composed of persister cells. To test this hypothesis further, flow cytometry in conjunction with a persister cell marker was used to measure persister cells within a biofilm. Cap5A (a known persister cell marker) expression was found to be increased in a maturing biofilm, with the lowest levels of expression seen in immature biofilms and the highest expression exhibited by the 48-hour biofilm. Additionally, bacterial cells in a biofilm state closely resemble persister cells and exhibit reduced membrane potential compared to cells in planktonic culture, further suggesting biofilms are largely made up of persister cells. These data may provide an explanation as to why infections caused by antibiotic-susceptible strains remain difficult to treat.

Keywords: antibiotic tolerance, Staphylococcus aureus, host-pathogen interactions, microbial pathogenesis

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Authors: Raha Bahreini

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This paper discusses the roll-back of women’s sexual and reproductive rights in the Islamic Republic of Iran, which has come in the wake of a striking shift in the country’s official population policies. Since the late 1980s, Iran has won worldwide praise for its sexual and reproductive health and services, which have contributed to a steady decline in the country’s fertility rate–from 7.0 births per women in 1980 to 5.5 in 1988, 2.8 in 1996 and 1.85 in 2014. This is owed to a significant increase in the voluntary use of modern contraception in both rural and urban areas. In 1976, only 37 per cent of women were using at least one method of contraception; by 2014 this figure had reportedly risen to a high of nearly 79 per cent for married girls and women living in urban areas and 73.78 per cent for those living in rural areas. Such progress may soon be halted. In July 2012, Iran’s Supreme Leader Ayatollah Sayed Ali Khamenei denounced Iran’s family planning policies as an imitation of Western lifestyle. He exhorted the authorities to increase Iran’s population to 150 to 200 million (from around 78.5 million), including by cutting subsidies for contraceptive methods and dismantling the state’s Family and Population Planning Programme. Shortly thereafter, Iran’s Minister of Health and Medical Education announced the scrapping of the budget for the state-funded Family and Population Planning Programme. Iran’s Parliament subsequently introduced two bills; the Comprehensive Population and Exaltation of Family Bill (Bill 315), and the Bill to Increase Fertility Rates and Prevent Population Decline (Bill 446). Bill 446 outlaws voluntary tubectomies, which are believed to be the second most common method of modern contraception in Iran, and blocks access to information about contraception, denying women the opportunity to make informed decisions about the number and spacing of their children. Coupled with the elimination of state funding for Iran’s Family and Population Programme, the move would undoubtedly result in greater numbers of unwanted pregnancies, forcing more women to seek illegal and unsafe abortions. Bill 315 proposes various discriminatory measures in the areas of employment, divorce, and protection from domestic violence in order to promote a culture wherein wifedom and child-bearing is seen as women’s primary duty. The Bill, for example, instructs private and public entities to prioritize, in sequence, men with children, married men without children and married women with children when hiring for certain jobs. It also bans the recruitment of single individuals as family law lawyers, public and private school teachers and members of the academic boards of universities and higher education institutes. The paper discusses the consequences of these initiatives which would, if continued, set the human rights of women and girls in Iran back by decades, leaving them with a future shaped by increased inequality, discrimination, poor health, limited choices and restricted freedoms, in breach of Iran’s international human rights obligations.

Keywords: family planning and reproductive health, gender equality and empowerment of women, human rights, population growth

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Authors: Mishak Rahul, Naveen Kumar, Bharath Kumar

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Conceived as a high-end engine to revolutionise sustainable agri-food production, the intelligent crop circle (ICC) aims to incorporate the Internet of Things (IoT), blockchain technology and artificial intelligence (AI) to bolster resource efficiency and prevent waste, increase the volume of production and bring about sustainable solutions with long-term ecosystem conservation as the guiding principle. The operating principle of the ICC relies on bringing together multidisciplinary bottom-up collaborations between producers, researchers and consumers. Key elements of the framework include IoT-based smart sensors for sensing soil moisture, temperature, humidity, nutrient and air quality, which provide short-interval and timely data; blockchain technology for data storage on a private chain, which maintains data integrity, traceability and transparency; and AI-based predictive analysis, which actively predicts resource utilisation, plant growth and environment. This data and AI insights are built into the ICC platform, which uses the resulting DSS (Decision Support System) outlined as help in decision making, delivered through an easy-touse mobile app or web-based interface. Farmers are assumed to use such a decision-making aid behind the power of the logic informed by the data pool. Building on existing data available in the farm management systems, the ICC platform is easily interoperable with other IoT devices. ICC facilitates connections and information sharing in real-time between users, including farmers, researchers and industrial partners, enabling them to cooperate in farming innovation and knowledge exchange. Moreover, ICC supports sustainable practice in agriculture by integrating gamification techniques to stimulate farm adopters, deploying VR technologies to model and visualise 3D farm environments and farm conditions, framing the field scenarios using VR headsets and Real-Time 3D engines, and leveraging edge technologies to facilitate secure and fast communication and collaboration between users involved. And through allowing blockchain-based marketplaces, ICC offers traceability from farm to fork – that is: from producer to consumer. It empowers informed decision-making through tailor-made recommendations generated by means of AI-driven analysis and technology democratisation, enabling small-scale and resource-limited farmers to get their voice heard. It connects with traditional knowledge, brings together multi-stakeholder interactions as well as establishes a participatory ecosystem to incentivise continuous growth and development towards more sustainable agro-ecological food systems. This integrated approach leverages the power of emerging technologies to provide sustainable solutions for a resilient food system, ensuring sustainable agriculture worldwide.

Keywords: blockchain, internet of things, artificial intelligence, decision support system, virtual reality, gamification, traceability, sustainable agriculture

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Authors: Delphine Ribes Lemay, Valentine Bernasconi, André Andrade, Lara DéFayes, Mathieu Salzmann, FréDéRic Kaplan, Nicolas Henchoz

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Digitization and preservation of large heritage induce high maintenance costs to keep up with the technical standards and ensure sustainable access. Creating impactful usage is instrumental to justify the resources for long-term preservation. The Museum für Gestaltung of Zurich holds one of the biggest poster collections of the world from which 52’000 were digitised. In the process of building a digital installation to valorize the collection, one objective was to develop an algorithm capable of predicting the next poster to show according to the ones already displayed. The work presented here describes the steps to build an algorithm able to automatically create sequences of posters reflecting associations performed by curator and professional designers. The exposed challenge finds similarities with the domain of song playlist algorithms. Recently, artificial intelligence techniques and more specifically, deep-learning algorithms have been used to facilitate their generations. Promising results were found thanks to Recurrent Neural Networks (RNN) trained on manually generated playlist and paired with clusters of extracted features from songs. We used the same principles to create the proposed algorithm but applied to a challenging medium, posters. First, a convolutional autoencoder was trained to extract features of the posters. The 52’000 digital posters were used as a training set. Poster features were then clustered. Next, an RNN learned to predict the next cluster according to the previous ones. RNN training set was composed of poster sequences extracted from a collection of books from the Gestaltung Museum of Zurich dedicated to displaying posters. Finally, within the predicted cluster, the poster with the best proximity compared to the previous poster is selected. The mean square distance between features of posters was used to compute the proximity. To validate the predictive model, we compared sequences of 15 posters produced by our model to randomly and manually generated sequences. Manual sequences were created by a professional graphic designer. We asked 21 participants working as professional graphic designers to sort the sequences from the one with the strongest graphic line to the one with the weakest and to motivate their answer with a short description. The sequences produced by the designer were ranked first 60%, second 25% and third 15% of the time. The sequences produced by our predictive model were ranked first 25%, second 45% and third 30% of the time. The sequences produced randomly were ranked first 15%, second 29%, and third 55% of the time. Compared to designer sequences, and as reported by participants, model and random sequences lacked thematic continuity. According to the results, the proposed model is able to generate better poster sequencing compared to random sampling. Eventually, our algorithm is sometimes able to outperform a professional designer. As a next step, the proposed algorithm should include a possibility to create sequences according to a selected theme. To conclude, this work shows the potentiality of artificial intelligence techniques to learn from existing content and provide a tool to curate large sets of data, with a permanent renewal of the presented content.

Keywords: Artificial Intelligence, Digital Humanities, serendipity, design research

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Authors: Kamolvara Sirisuksakulchai, Soamwadee Chaianansutcharit, Kazunori Sato

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Solid Oxide Fuel Cells (SOFCs) have been considered as one of the most efficient large unit power generators for household and industrial applications. The efficiency of an electronic cell depends mainly on the electrochemical reactions in the anode. The development of anode materials has been intensely studied to achieve higher kinetic rates of redox reactions and lower internal resistance. Recent studies have introduced an efficient cermet (ceramic-metallic) material for its ability in fuel oxidation and oxide conduction. This could expand the reactive site, also known as the triple-phase boundary (TPB), thus increasing the overall performance. In this study, a bimetallic catalyst Ni₀.₇₅Co₀.₂₅Oₓ was combined with Gd₀.₁Ce₀.₉O₁.₉₅ (GDC) to be used as a cermet anode (NiCo-GDC) for an anode-supported type SOFC. The synthesis of Ni₀.₇₅Co₀.₂₅Oₓ was carried out by ball milling NiO and Co3O4 powders in ethanol and calcined at 1000 °C. The Gd₀.₁Ce₀.₉O₁.₉₅ was prepared by a urea co-precipitation method. Precursors of Gd(NO₃)₃·6H₂O and Ce(NO₃)₃·6H₂O were dissolved in distilled water with the addition of urea and were heated subsequently. The heated mixture product was filtered and rinsed thoroughly, then dried and calcined at 800 °C and 1500 °C, respectively. The two powders were combined followed by pelletization and sintering at 1100 °C to form an anode support layer. The fabrications of an electrolyte layer and cathode layer were conducted. The electrochemical performance in H₂ was measured from 800 °C to 600 °C while for CH₄ was from 750 °C to 600 °C. The maximum power density at 750 °C in H₂ was 13% higher than in CH₄. The difference in performance was due to higher polarization resistances confirmed by the impedance spectra. According to the standard enthalpy, the dissociation energy of C-H bonds in CH₄ is slightly higher than the H-H bond H₂. The dissociation of CH₄ could be the cause of resistance within the anode material. The results from lower temperatures showed a descending trend of power density in relevance to the increased polarization resistance. This was due to lowering conductivity when the temperature decreases. The long-term stability was measured at 750 °C in CH₄ monitoring at 12-hour intervals. The maximum power density tends to increase gradually with time while the resistances were maintained. This suggests the enhanced stability from charge transfer activities in doped ceria due to the transition of Ce⁴⁺ ↔ Ce³⁺ at low oxygen partial pressure and high-temperature atmosphere. However, the power density started to drop after 60 h, and the cell potential also dropped from 0.3249 V to 0.2850 V. These phenomena was confirmed by a shifted impedance spectra indicating a higher ohmic resistance. The observation by FESEM and EDX-mapping suggests the degradation due to mass transport of ions in the electrolyte while the anode microstructure was still maintained. In summary, the electrochemical test and stability test for 60 h was achieved by NiCo-GDC cermet anode. Coke deposition was not detected after operation in CH₄, hence this confirms the superior properties of the bimetallic cermet anode over typical Ni-GDC.

Keywords: bimetallic catalyst, ceria-based SOFCs, methane oxidation, solid oxide fuel cell

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Authors: Mirosław Krzemieniewski, Marcin Zieliński, Marcin Dębowski

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Electrokinetic disintegration is one of the high-voltage electric methods. The design of systems is exceptionally simple. Biomass flows through a system of pipes with alongside mounted electrodes that generate an electric field. Discharges in the electric field deform cell walls and lead to their successive perforation, thereby making their contents easily available to bacteria. The spark-over occurs between electrode surface and pipe jacket which is the second pole and closes the circuit. The value of voltage ranges from 10 to 100kV. Electrodes are supplied by normal “power grid” monophase electric current (230V, 50Hz). Next, the electric current changes into direct current of 24V in modules serving for particular electrodes, and this current directly feeds the electrodes. The installation is completely safe because the value of generated current does not exceed 250mA and because conductors are grounded. Therefore, there is no risk of electric shock posed to the personnel, even in the case of failure or incorrect connection. Low values of the electric current mean small energy consumption by the electrode which is extremely low – only 35W per electrode – compared to other methods of disintegration. Pipes with electrodes with diameter of DN150 are made of acid-proof steel and connected from both sides with 90º elbows ended with flanges. The available S and U types of pipes enable very convenient fitting with system construction in the existing installations and rooms or facilitate space management in new applications. The system of pipes for electrokinetic disintegration may be installed horizontally, vertically, askew, on special stands or also directly on the wall of a room. The number of pipes and electrodes is determined by operating conditions as well as the quantity of substrate, type of biomass, content of dry matter, method of disintegration (single or circulatory), mounting site etc. The most effective method involves pre-treatment of substrate that may be pumped through the disintegration system on the way to the fermentation tank or recirculated in a buffered intermediate tank (substrate mixing tank). Biomass structure destruction in the process of electrokinetic disintegration causes shortening of substrate retention time in the tank and acceleration of biogas production. A significant intensification of the fermentation process was observed in the systems operating in the technical scale, with the greatest increase in biogas production reaching 18%. The secondary, but highly significant for the energetic balance, effect is a tangible decrease of energy input by agitators in tanks. It is due to reduced viscosity of the biomass after disintegration, and may result in energy savings reaching even 20-30% of the earlier noted consumption. Other observed phenomena include reduction in the layer of surface scum, reduced sewage capability for foaming and successive decrease in the quantity of bottom sludge banks. Considering the above, the system for electrokinetic disintegration seems a very interesting and valuable solutions meeting the offer of specialist equipment for the processing of plant biomass, including Virginia fanpetals, before the process of methane fermentation.

Keywords: electrokinetic disintegration, biomass, biogas production, fermentation, Virginia fanpetals

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Authors: Panagiota Katsikouli, William Hamilton Byrne, Thomas Gammeltoft-Hansen, Tijs Slaats

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An individual who demonstrates a well-founded fear of persecution or faces real risk of being subjected to torture is eligible for asylum. In Danish law, the exact legal thresholds reflect those established by international conventions, notably the 1951 Refugee Convention and the 1950 European Convention for Human Rights. These international treaties, however, remain largely silent when it comes to how states should assess asylum claims. As a result, national authorities are typically left to determine an individual’s legal eligibility on a narrow basis consisting of an oral testimony, which may itself be hampered by several factors, including imprecise language interpretation, insecurity or lacking trust towards the authorities among applicants. The leaky ground, on which authorities must assess their subjective perceptions of asylum applicants' credibility, questions whether, in all cases, adjudicators make the correct decision. Moreover, the subjective element in these assessments raises questions on whether individual asylum cases could be afflicted by implicit biases or stereotyping amongst adjudicators. In fact, recent studies have uncovered significant correlations between decision outcomes and the experience and gender of the assigned judge, as well as correlations between asylum outcomes and entirely external events such as weather and political elections. In this study, we analyze a publicly available dataset containing approximately 8,000 summaries of asylum cases, initially rejected, and re-tried by the Refugee Appeals Board (RAB) in Denmark. First, we look for variations in the recognition rates, with regards to a number of applicants’ features: their country of origin/nationality, their identified gender, their identified religion, their ethnicity, whether torture was mentioned in their case and if so, whether it was supported or not, and the year the applicant entered Denmark. In order to extract those features from the text summaries, as well as the final decision of the RAB, we applied natural language processing and regular expressions, adjusting for the Danish language. We observed interesting variations in recognition rates related to the applicants’ country of origin, ethnicity, year of entry and the support or not of torture claims, whenever those were made in the case. The appearance (or not) of significant variations in the recognition rates, does not necessarily imply (or not) bias in the decision-making progress. None of the considered features, with the exception maybe of the torture claims, should be decisive factors for an asylum seeker’s fate. We therefore investigate whether the decision can be predicted on the basis of these features, and consequently, whether biases are likely to exist in the decisionmaking progress. We employed a number of machine learning classifiers, and found that when using the applicant’s country of origin, religion, ethnicity and year of entry with a random forest classifier, or a decision tree, the prediction accuracy is as high as 82% and 85% respectively. tentially predictive properties with regards to the outcome of an asylum case. Our analysis and findings call for further investigation on the predictability of the outcome, on a larger dataset of 17,000 cases, which is undergoing.

Keywords: asylum adjudications, automated decision-making, machine learning, text mining

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Authors: Inês Amorim Leitão, Loes van Shaick, António Dinis Ferreira, Violette Geissen

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Plastic pollution is a growing concern worldwide: plastics are commercialized in large quantities and it takes a long time for them to degrade. When in the environment, plastic is fragmented into microplastics (<5mm), which have been found in all environmental compartments at different locations. Microplastics contribute to the environmental pollution in water, air and soil and are linked to human health problems. The progressive increase of population living in cities led to the aggravation of the pollution problem worldwide, especially in urban environments. Urban areas represent a strong source of pollution, through the roads, industrial production, wastewater, landfills, etc. It is expected that pollutants such as microplastics are transported diffusely from the sources through different pathways such as wind and rain. Therefore, it is very complex to quantify, control and treat these pollutants, designated current problematic issues by the European Commission. Green areas are pointed out by experts as natural filters for contaminants in cities, through their capacity of retention by vegetation. These spaces have thus the capacity to control the load of pollutants transported. This study investigates the spatial distribution of microplastics in urban soils of different land uses, their transport through atmospheric deposition, wind erosion, runoff and streams, as well as their deposition in vegetation like grass and tree leaves in urban environment. Coimbra, a medium large city located in the central Portugal, is the case-study. All the soil, sediments, water and vegetation samples were collected in Coimbra and were later analyzed in the Wageningen University & Research laboratory. Microplastics were extracted through the density separation using Sodium Phosphate as solution (~1.4 g cm−3) and filtration methods, visualized under a stereo microscope and identified using the u-FTIR method. Microplastic particles were found in all the different samples. In terms of soils, higher concentrations of microplastics were found in green parks, followed by landfills and industrial places, and the lowest concentrations in forests and pasture land-uses. Atmospheric deposition and streams after rainfall events seems to represent the strongest pathways of microplastics. Tree leaves can retain microplastics on their surfaces. Small leaves such as needle leaves seem to present higher amounts of microplastics per leaf area than bigger leaves. Rainfall episodes seem to reduce the concentration of microplastics on leaves surface, which suggests the wash of microplastics down to lower levels of the tree or to the soil. When in soil, different types of microplastics could be transported to the atmosphere through wind erosion. Grass seems to present high concentrations of microplastics, and the enlargement of the grass cover leads to a reduction of the amount of microplastics in soil, but also of the microplastics moved from the ground to the atmosphere by wind erosion. This study proof that vegetation can help to control the transport and dispersion of microplastics. In order to control the entry and the concentration of microplastics in the environment, especially in cities, it is essential to defining and evaluating nature-based land-use scenarios, considering the role of green urban areas in filtering small particles.

Keywords: microplastics, cities, sources, pathways, vegetation

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Authors: Taboka Motlhabane, Pradeep Sahoo

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The global demand for cooling has grown exponentially over the past century to meet economic development and social needs, accounting for approximately 10% of the global electricity consumption. As global temperatures continue to rise, the demand for cooling and heating, ventilation and air-conditioning (HVAC) equipment is set to rise with it. The increased use of HVAC equipment has significantly contributed to the growth of greenhouse gas (GHG) emissions which aid the climate crisis- one of the biggest challenges faced by the current generation. The need to address emissions caused directly by HVAC equipment and electricity generated to meet the cooling or heating demand is ever more pressing. Currently, developed countries account for the largest cooling and heating demand, however developing countries are anticipated to experience a huge increase in population growth in 10 years, resulting in a shift in energy demand. Developing countries, which are projected to account for nearly 60% of the world's GDP by 2030, are rapidly building infrastructure and economies to meet their growing needs and meet these projections. Cooling, a very energy-intensive process that can account for 20 % to 75% of a building's energy, depending on the building's use. Solar photovoltaic (PV) driven air-conditioning offers a great cost-effective alternative for adoption in both residential and non-residential buildings to offset grid electricity, particularly in countries with high irradiation, such as Botswana. This research paper explores the potential of a grid-connected solar photovoltaic vapor-compression air-conditioning system for the Peter-Smith herbarium at the Okavango Research Institute (ORI) University of Botswana campus in Maun, Botswana. The herbarium plays a critical role in the collection and preservation of botanical data, dating back over 100 years, with pristine collection from the Okavango Delta, a UNESCO world heritage site and serves as a reference and research site. Due to the herbarium’s specific needs, it operates throughout the day and year in an attempt to maintain a constant herbarium temperature of 16°?. The herbarium model studied simulates a variable-air-volume HVAC system with a system rating of 30 kW. Simulation results show that the HVAC system accounts for 68.9% of the building's total electricity at 296 509.60 kWh annually. To offset the grid electricity, a 175.1 kWp nominal power rated PV system requiring 416 modules to match the required power, covering an area of 928 m2 is used to meet the HVAC system annual needs. An economic assessment using PVsyst found that for an installation priced with average solar PV prices in Botswana totalled to be 787 090.00 BWP, with annual operating costs of 30 500 BWP/year. With self-project financing, the project is estimated to have recouped its initial investment within 6.7 years. At an estimated project lifetime of 20 years, the Net Present Value is projected at 1 565 687.00 BWP with a ROI of 198.9%, with 74 070.67 tons of CO2 saved at the end of the project lifetime. This study investigates the performance of the HVAC system to meet the indoor air comfort requirements, the annual PV system performance, and the building model has been simulated using DesignBuilder Software.

Keywords: vapor compression refrigeration, solar cooling, renewable energy, herbarium

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Authors: Rakesh Tiwary, D. M. Diwakar, Sandhya Mahapatro

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Agro-forestry offers huge opportunities for diversification of agriculture in middle Gangetic Basin of India, particularly in the state of Bihar as the region is identified with traditional & stagnant agriculture, low productivity, high population pressure, rural poverty and lack of agro- industrial development. The region is endowed with favourable agro-climatic, soil & drainage conditions; interestingly, there has been an age old tradition of agro-forestry in the state. However, due to demographic pressures, declining land holdings and other socio- economic factors, agro forestry practices have declined in recent decades. The government of Bihar has initiated a special program for expansion of agro-forestry based on modern practices with an aim to raise income level of farmers, make available raw material for wood based industries and increase green cover in the state. The Agro-forestry Schemes – Poplar & Other Species are the key components of the program being implemented by Department of Environment & Forest, Govt. of Bihar. The paper is based on fieldwork based evaluation study on experiences of implementation of the agro-forestry schemes. Understanding adoption patterns, identification of key motives for practising agro-forestry, experiences of farmers well analysing the barriers in expansion constituted the major themes of the research study. This paper is based on primary as well as secondary data. The primary data consists of beneficiary household survey, Focus Group Discussions among beneficiary communities, dialogue and multi stakeholder meetings and field visit to the sites. The secondary data information was collected and analysed from official records, policy documents and reports. Primary data was collected from about 500 beneficiary households of Muzaffarpur & Saharsa- two populous, large and agriculture dominated districts of middle Gangetic basin of North Bihar. Survey also covers 100 households of non-beneficiaries. Probability Proportionate to Size method was used to determine the number of samples to be covered in different blocks of two districts. Qualitative tools were also implemented to have better insights about key research questions. Present paper discusses socio-economic background of farmers practising agro-forestry; the adoption patterns of agro- forestry (choice of plants, methods of plantation and others); and motivation behind adoption of agro-forestry and the comparative benefits of agro-forestry (vis-a-vis traditional agriculture). Experience of beneficiary farmers with agro-forestry based on government programs & promotional campaigns (in terms of awareness, ease of access, knowhow and others) have been covered in the paper. Different aspects of survival of plants have been closely examined. Non beneficiaries but potential adopters were also interviewed to understand barriers of adoption of agro- forestry. Paper provides policy recommendations and interventions required for effective expansion of the agro- forestry and realisation of its future prospects for agricultural diversification in the region.

Keywords: agro-forestry adoption patterns, farmers’ motivations & experiences, Indian middle Gangetic plains, strategies for expansion

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Authors: Phenphak Horadee, Rodchares Hanrinth, Saithip Suttiruksa

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Inappropriate use of antibiotics has happened in several hospitals, Thailand. Drug use evaluation (DUE) is one strategy to overcome this difficulty. However, most community hospitals still encounter incomplete evaluation resulting overuse of antibiotics with high cost. Consequently, drug-resistant bacteria have been rising due to inappropriate antibiotic use. The aim of this study was to involve stakeholders in conceptualizing, developing, and prioritizing a feasible intervention strategy to promote and support appropriate antibiotic prescribing in a community hospital, Thailand. Study antibiotics included four antibiotics such as Meropenem, Piperacillin/tazobactam, Amoxicillin/clavulanic acid, and Vancomycin. The study was conducted for the 1-year period between March 1, 2018, and March 31, 2019, in a community hospital in the northeastern part of Thailand. Concept mapping was used in a purposive sample, including doctors (one was an administrator), pharmacists, and nurses who involving drug use evaluation of antibiotics. In-depth interviews for each participant and survey research were conducted to seek the problems for inappropriate use of antibiotics based on drug use evaluation system. Seventy-seven percent of DUE reported appropriate antibiotic prescribing, which still did not reach the goal of 80 percent appropriateness. Meropenem led other antibiotics for inappropriate prescribing. The causes of the unsuccessful DUE program were classified into three themes such as personnel, lack of public relation and communication, and unsupported policy and impractical regulations. During the first meeting, stakeholders (n = 21) expressed the generation of interventions. During the second meeting, participants who were almost the same group of people in the first meeting (n = 21) were requested to independently rate the feasibility and importance of each idea and to categorize them into relevant clusters to facilitate multidimensional scaling and hierarchical cluster analysis. The outputs of analysis included the idealist, cluster list, point map, point rating map, cluster map, and cluster rating map. All of these were distributed to participants (n = 21) during the third meeting to reach consensus on an intervention model. The final proposed intervention strategy included 29 feasible and crucial interventions in seven clusters: development of information technology system, establishing policy and taking it into the action plan, proactive public relations of the policy, action plan and workflow, in cooperation of multidisciplinary teams in drug use evaluation, work review and evaluation with performance reporting, promoting and developing professional and clinical skill for staff with training programs, and developing practical drug use evaluation guideline for antibiotics. These interventions are relevant and fit to several intervention strategies for antibiotic stewardship program in many international organizations such as participation of the multidisciplinary team, developing information technology to support antibiotic smart use, and communication. These interventions were prioritized for implementation over a 1-year period. Once the possibility of each activity or plan is set up, the proposed program could be applied and integrated into hospital policy after evaluating plans. Effectiveness of each intervention could be promoted to other community hospitals to promote and support antibiotic smart use.

Keywords: antibiotic, concept mapping, drug use evaluation, multidisciplinary teams

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Authors: Piotr Romaniuk, Krzysztof Kaczmarek, Adam Szromek

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Background: A number of approaches to assess the performance of health system have been proposed so far. Nonetheless, they lack a consensus regarding the key components of assessment procedure and criteria of evaluation. The WHO and OECD have developed methods of assessing health system to counteract the underlying issues, but they are not free of controversies and did not manage to produce a commonly accepted consensus. The aim of the study: On the basis of WHO and OECD approaches we decided to develop own methodology to assess the performance of health systems in Central and Eastern European countries. We have applied the method to compare the effects of health systems reforms in 20 countries of the region, in order to evaluate the dynamic of changes in terms of health system outcomes.Methods: Data was collected from a 25-year time period after the fall of communism, subsetted into different post-reform stages. Datasets collected from individual countries underwent one-, two- or multi-dimensional statistical analyses, and the Synthetic Measure of health system Outcomes (SMO) was calculated, on the basis of the method of zeroed unitarization. A map of dynamics of changes over time across the region was constructed. Results: When making a comparative analysis of the tested group in terms of the average SMO value throughout the analyzed period, we noticed some differences, although the gaps between individual countries were small. The countries with the highest SMO were the Czech Republic, Estonia, Poland, Hungary and Slovenia, while the lowest was in Ukraine, Russia, Moldova, Georgia, Albania, and Armenia. Countries differ in terms of the range of SMO value changes throughout the analyzed period. The dynamics of change is high in the case of Estonia and Latvia, moderate in the case of Poland, Hungary, Czech Republic, Croatia, Russia and Moldova, and small when it comes to Belarus, Ukraine, Macedonia, Lithuania, and Georgia. This information reveals fluctuation dynamics of the measured value in time, yet it does not necessarily mean that in such a dynamic range an improvement appears in a given country. In reality, some of the countries moved from on the scale with different effects. Albania decreased the level of health system outcomes while Armenia and Georgia made progress, but lost distance to leaders in the region. On the other hand, Latvia and Estonia showed the most dynamic progress in improving the outcomes. Conclusions: Countries that have decided to implement comprehensive health reform have achieved a positive result in terms of further improvements in health system efficiency levels. Besides, a higher level of efficiency during the initial transition period generally positively determined the subsequent value of the efficiency index value, but not the dynamics of change. The paths of health system outcomes improvement are highly diverse between different countries. The instrument we propose constitutes a useful tool to evaluate the effectiveness of reform processes in post-communist countries, but more studies are needed to identify factors that may determine results obtained by individual countries, as well as to eliminate the limitations of methodology we applied.

Keywords: health system outcomes, health reforms, health system assessment, health system evaluation

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