Search results for: coastal and marine physical factors

Authors: K. Raghu, M. N. Vathhsala, Naveen Aradya, Sharth

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River sand is the most preferred fine aggregate for mortar and concrete. River sand is a product of natural weathering of rocks over a period of millions of years and is mined from river beds. Sand mining has disastrous environmental consequences. The excessive mining of river bed is creating an ecological imbalance. This has lead to have restrictions imposed by ministry of environment on sand mining. Driven by the acute need for sand, stone dust or manufactured sand prepared from the crushing and screening of coarse aggregate is being used as sand in the recent past. However manufactured sand is also a natural material and has quarrying and quality issues. To reduce the burden on the environment, alternative materials to be used as fine aggregates are being extensively investigated all over the world. Looking to the quantum of requirements, quality and properties there has been a global consensus on a material – Granulated slags. Granulated slag has been proven as a suitable material for replacing natural sand / crushed fine aggregates. In developed countries, the use of granulated slag as fine aggregate to replace natural sand is well established and is in regular practice. In the present paper Granulated slag has been experimented for usage in mortar. Slags are the main by-products generated during iron and steel production in the steel industry. Over the past decades, the steel production has increased and, consequently, the higher volumes of by-products and residues generated which have driven to the reuse of these materials in an increasingly efficient way. In recent years new technologies have been developed to improve the recovery rates of slags. Increase of slags recovery and use in different fields of applications like cement making, construction and fertilizers help in preserving natural resources. In addition to the environment protection, these practices produced economic benefits, by providing sustainable solutions that can allow the steel industry to achieve its ambitious targets of “zero waste” in coming years. Slags are generated at two different stages of steel production, iron making and steel making known as BF(Blast Furnace) slag and steel slag respectively. The slagging agent or fluxes, such as lime stone, dolomite and quartzite added into BF or steel making furnaces in order to remove impurities from ore, scrap and other ferrous charges during smelting. The slag formation is the result of a complex series of physical and chemical reactions between the non-metallic charge(lime stone, dolomite, fluxes), the energy sources(coal, coke, oxygen, etc.) and refractory materials. Because of the high temperatures (about 15000 C) during their generation, slags do not contain any organic substances. Due to the fact that slags are lighter than the liquid metal, they float and get easily removed. The slags protect the metal bath from atmosphere and maintain temperature through a kind of liquid formation. These slags are in liquid state and solidified in air after dumping in the pit or granulated by impinging water systems. Generally, BF slags are granulated and used in cement making due to its high cementious properties, and steel slags are mostly dumped due to unfavourable physio-chemical conditions. The increasing dump of steel slag not only occupies a plenty of land but also wastes resources and can potentially have an impact on the environment due to water pollution. Since BF slag contains little Fe and can be used directly. BF slag has found a wide application, such as cement production, road construction, Civil Engineering work, fertilizer production, landfill daily cover, soil reclamation, prior to its application outside the iron and steel making process.

Keywords: steel slag, river sand, granulated slag, environmental

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Authors: Z. M. T. Lim, W. Q. Yow

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Diversity in individual problem-solving approaches, culture and nationality have been shown to have positive effects on collaborative creative processes in organizational and scholastic settings. For example, diverse graduate and organizational teams consisting of members with both structured and unstructured problem-solving styles were found to have more creative ideas on a collaborative idea generation task than teams that comprised solely of members with either structured or unstructured problem-solving styles. However, being different may not always provide benefits to the collaborative creative process. In particular, speaking different languages may hinder mutual engagement through impaired communication and thus collaboration. Instead, sharing similar languages may have facilitative effects on mutual engagement in collaborative tasks. However, no studies have explored the relations between language diversity and adults’ collaborative creative problem solving. Sixty-four Singaporean English-speaking bilingual undergraduates were paired up into similar or dissimilar language pairs based on the second language they spoke (e.g., for similar language pairs, both participants spoke English-Mandarin; for dissimilar language pairs, one participant spoke English-Mandarin and the other spoke English-Korean). Each participant completed the Ravens Progressive Matrices Task individually. Next, they worked in pairs to complete a collaborative divergent thinking task where they used mind-mapping techniques to brainstorm ideas on a given problem together (e.g., how to keep insects out of the house). Lastly, the pairs worked on a collaborative insight problem-solving task (Triangle of Coins puzzle) where they needed to flip a triangle of ten coins around by moving only three coins. Pairs who had prior knowledge of the Triangle of Coins puzzle were asked to complete an equivalent Matchstick task instead, where they needed to make seven squares by moving only two matchsticks based on a given array of matchsticks. Results showed that, after controlling for intelligence, similar language pairs completed the collaborative insight problem-solving task faster than dissimilar language pairs. Intelligence also moderated these relations. Among adults of lower intelligence, similar language pairs solved the insight problem-solving task faster than dissimilar language pairs. These differences in speed were not found in adults with higher intelligence. No differences were found in the number of ideas generated in the collaborative divergent thinking task between similar language and dissimilar language pairs. In conclusion, sharing similar languages seem to enrich collaborative creative processes. These effects were especially pertinent to pairs with lower intelligence. This provides guidelines for the formation of groups based on shared languages in collaborative creative processes. However, the positive effects of shared languages appear to be limited to the insight problem-solving task and not the divergent thinking task. This could be due to the facilitative effects of other factors of diversity as found in previous literature. Background diversity, for example, may have a larger facilitative effect on the divergent thinking task as compared to the insight problem-solving task due to the varied experiences individuals bring to the task. In conclusion, this study contributes to the understanding of the effects of language diversity in collaborative creative processes and challenges the general positive effects that diversity has on these processes.

Keywords: bilingualism, diversity, creativity, collaboration

Procedia PDF Downloads 282

Authors: Echo Wang, Andrew Li

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Transparency could be defined as the voluntary release of information by institutions that is relevant to their own evaluation. Transparency based on information disclosure is recognised to be vital for the Third Sector, as civil society organisations are under pressure to become more transparent to answer the call for accountability. The growing importance of social enterprises as hybrid organisations emerging from the nexus of the public, the private and the Third Sector makes their transparency a topic worth exploring. However, transparency for social enterprises has not yet been studied: as a new form of organisation that combines non-profit missions with commercial means, it is unclear to both the practical and the academic world if the shift in operational logics from non-profit motives to for-profit pursuits has significantly altered their transparency. This is especially so in China, where informational governance and practices of information disclosure by local governments, industries and civil society are notably different from other countries. This study investigates the transparency-seeking behaviour of social enterprises in Greater China to understand what factors at the organisational level may affect their transparency, measured by their willingness to disclose financial information. We make use of the Survey on the Models and Development Status of Social Enterprises in the Greater China Region (MDSSGCR) conducted in 2015-2016. The sample consists of more than 300 social enterprises from the Mainland, Hong Kong and Taiwan. While most respondents have provided complete answers to most of the questions, there is tremendous variation in the respondents’ demonstrated level of transparency in answering those questions related to the financial aspects of their organisations, such as total revenue, net profit, source of revenue and expense. This has led to a lot of missing data on such variables. In this study, we take missing data as data. Specifically, we use missing values as a proxy for an organisation’s level of transparency. Our dependent variables are constructed from missing data on total revenue, net profit, source of revenue and cost breakdown. In addition, we also take into consideration the quality of answers in coding the dependent variables. For example, to be coded as being transparent, an organization must report the sources of at least 50% of its revenue. We have four groups of predictors of transparency, namely nature of organization, decision making body, funding channel and field of concentration. Furthermore, we control for an organisation’s stage of development, self-identity and region. The results show that social enterprises that are at their later stages of organisational development and are funded by financial means are significantly more transparent than others. There is also some evidence that social enterprises located in the Northeast region in China are less transparent than those located in other regions probably because of local political economy features. On the other hand, the nature of the organisation, the decision-making body and field of concentration do not systematically affect the level of transparency. This study provides in-depth empirical insights into the information disclosure behaviour of social enterprises under specific social context. It does not only reveal important characteristics of Third Sector development in China, but also contributes to the general understanding of hybrid institutions.

Keywords: China, information transparency, organisational behaviour, social enterprise

Procedia PDF Downloads 152

Authors: S. Mamoucha, N. Tsafantakis, Α. Ioannidis, S. Chatzipanagiotou, C. Nikolaou, L. Skaltsounis, N. Fokialakis, N. Christodoulakis

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Introduction: Plant secondary metabolites (SM) can be grouped into three chemically distinct groups: terpenes, phenolics, and nitrogen-containing compounds. For many years the adaptive significance of SM was unknown. They were thought to be functionless end-products. Currently it is accepted that many secondary metabolites (also known as natural products) have important ecological roles in plants. For instance, they serve as attractants (odor, color, taste) for pollinators and seed-dispersing animals. Moreover, they protect plants from herbivores, microbial pathogens and from environmental stress (high and low temperatures, drought, alkalinity, salinity, radiation etc). It is well known that both biotic and abiotic stress often increase the accumulation of SM. The local climatic conditions, seasonal changes, external factors such as light, temperature, humidity affect the biosynthesis and composition of secondary metabolites. A well known dioecious evergreen plant, Pistacia lentiscus L. (mastic tree), was selected in order to study the metabolic variations occur in response to the different climate conditions, due to the seasonal variation and its effect on the biosynthesis of bioactive compounds. Materials-methods: Young and mature leaves were collected in January and July 2014, dried and extracted by accelerated solvent extraction (Dionex ASE™ 350) using solvents of increased polarity (DCM, MeOH, and H2O). GC-MS and UHPLC-HRMS analysis were carried out in order to define the nature and the relative abundance of SM. The antibacterial activity was evaluated by using the Agar Disc Diffusion Assay against ATCC and clinical isolates strains: Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans, Streptococcus mutans and Klebsiella pneumoniae. All tests were carried out in duplicate and the average radii of the inhibition zones were calculated for each extract. Results: According to the phytochemical profile obtained from each extract, the biosynthesis of SM varied both qualitatively and quantitatively under the two different types of seasonal stress. With exception of the biologically inactive nonpolar DCM extract of July, all extracts inhibited the growth of most of the investigated microorganisms. A clear positive correlation has been observed between the relative abundance of SM and the bioactivity of the DCM extracts of January and July. Observed changes during phytochemical analysis were mainly focused on the triterpenoid content. On the other hand, the bioactivity of the polar extracts (MeOH and H2O) of January and July resulted practically invariable against most of the microorganisms, besides the significant variation of the SM content due to the seasonal variation. Conclusion: Our results clearly confirmed the hypothesis of abiotic stress as an important regulating factor that significantly affects the biosynthesis of secondary metabolites and thus the presence of bioactive compounds. Acknowledgment: This work was supported by IKY - State Scholarship Foundation, Athens, Greece.

Keywords: antibacterial screening, phytochemical profile, Pistacia lentiscus, abiotic stress

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Authors: Mustafa Metin Donma, Orkide Donma

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Childhood obesity is an important clinical problem because it may lead to chronic diseases during the adulthood period of the individual. Obesity is a metabolic disease associated with low-grade inflammation. The liver occurs at the center of metabolic pathways. Adropin, fibroblast growth factor-21 (FGF-21), and fetuin-A are hepatokines. Due to the immense participation of the liver in glucose metabolism, these liver-derived factors may be associated with insulin resistance (IR), which is a phenomenon discussed within the scope of obesity problems. The aim of this study is to determine the concentrations of adropin, FGF-21, and fetuin-A in childhood obesity, to point out possible differences between the obesity groups, and to investigate possible associations among these three hepatokines in obese and morbidly obese children. A total of one hundred and thirty-two children were included in the study. Two obese groups were constituted. The groups were matched in terms of mean ± SD values of ages. Body mass index values of obese and morbidly obese groups were 25.0 ± 3.5 kg/m² and 29.8 ± 5.7 kg/m², respectively. Anthropometric measurements including waist circumference, hip circumference, head circumference, and neck circumference were recorded. Informed consent forms were taken from the parents of the participants. The ethics committee of the institution approved the study protocol. Blood samples were obtained after overnight fasting. Routine biochemical tests, including glucose- and lipid-related parameters, were performed. Concentrations of the hepatokines (adropin, FGF-21, fetuin A) were determined by enzyme-linked immunosorbent assay. Insulin resistance indices such as homeostasis model assessment for IR (HOMA-IR), alanine transaminase-to aspartate transaminase ratio (ALT/AST), diagnostic obesity notation model assessment laboratory index, diagnostic obesity notation model assessment metabolic syndrome index as well as obesity indices such as diagnostic obesity notation model assessment-II index, and fat mass index were calculated using the previously derived formulas. Statistical evaluation of the study data as well as findings of the study was performed by SPSS for Windows. Statistical difference was accepted significant when p is smaller than 0.05. Statistically significant differences were found for insulin, triglyceride, high-density lipoprotein cholesterol levels of the groups. A significant increase was observed for FGF-21 concentrations in the morbidly obese group. Higher adropin and fetuin-A concentrations were observed in the same group in comparison with the values detected in the obese group (p > 0.05). There was no statistically significant difference between the ALT/AST values of the groups. In all of the remaining IR and obesity indices, significantly increased values were calculated for morbidly obese children. Significant correlations were detected between HOMA-IR and each of the hepatokines. The highest one was the association with fetuin-A (r=0.373, p=0.001). In conclusion, increased levels observed in adropin, FGF-21, and fetuin-A have shown that these hepatokines possess increasing potential going from obese to morbid obese state. Out of the correlations found with the IR index, the most affected hepatokine was fetuin-A, the parameter possibly used as the indicator of the advanced obesity stage.

Keywords: adropin, fetuin A, fibroblast growth factor-21, insulin resistance, pediatric obesity

Procedia PDF Downloads 155

Authors: Maria C. Proença, Maria T. Rebelo, Marília Antunes, Maria J. Alves, Hugo Osório, Sofia Cunha, REVIVE team

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The environment of the mosquitoes complex Culex pipiens sl. in Portugal mainland is evaluated based in its abundance, using a data set georeferenced, collected during seven years (2006-2012) from May to October. The suitability of the different regions can be delineated using the relative abundance areas; the suitablility index is directly proportional to disease transmission risk and allows focusing mitigation measures in order to avoid outbreaks of vector-borne diseases. The interest in the Culex pipiens complex is justified by its medical importance: the females bite all warm-blooded vertebrates and are involved in the circulation of several arbovirus of concern to human health, like West Nile virus, iridoviruses, rheoviruses and parvoviruses. The abundance of Culex pipiens mosquitoes were documented systematically all over the territory by the local health services, in a long duration program running since 2006. The environmental factors used to characterize the vector habitat are land use/land cover, distance to cartographed water bodies, altitude and latitude. Focus will be on the mosquito females, which gonotrophic cycle mate-bloodmeal-oviposition is responsible for the virus transmission; its abundance is the key for the planning of non-aggressive prophylactic countermeasures that may eradicate the transmission risk and simultaneously avoid chemical ambient degradation. Meteorological parameters such as: air relative humidity, air temperature (minima, maxima and mean daily temperatures) and daily total rainfall were gathered from the weather stations network for the same dates and crossed with the standardized females’ abundance in a geographic information system (GIS). Mean capture and percentage of above average captures related to each variable are used as criteria to compute a threshold for each meteorological parameter; the difference of the mean capture above/below the threshold was statistically assessed. The meteorological parameters measured at the net of weather stations all over the country are averaged by month and interpolated to produce raster maps that can be segmented according to the meaningful thresholds for each parameter. The intersection of the maps of all the parameters obtained for each month show the evolution of the suitable meteorological conditions through the mosquito season, considered as May to October, although the first and last month are less relevant. In parallel, mean and above average captures were related to the physiographic parameters – the land use/land cover classes most relevant in each month, the altitudes preferred and the most frequent distance to water bodies, a factor closely related with the mosquito biology. The maps produced with these results were crossed with the meteorological maps previously segmented, in order to get an index of suitability for the complex Culex pipiens evaluated all over the country, and its evolution from the beginning to the end of the mosquitoes season.

Keywords: suitability index, Culex pipiens, habitat evolution, GIS model

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Authors: Alan Walsh, Peter Walker

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Differences in commercial, professional and personal cultural traditions between western consultants and project sponsors in the Gulf Cooperation Council (GCC) region are potentially significant in the workplace, and this can impact on project outcomes. These cultural differences can, for example, result in conflict amongst senior managers, which can negatively impact the megaproject. New entrants to the GCC often experience ‘culture shock’ as they attempt to integrate into their unfamiliar environments. Megaprojects are unique ventures with individual project characteristics, which need to be considered when managing their associated risks. Megaproject research to date has mostly ignored the significance of the absence of cultural congruence in the GCC, which is surprising considering that there are large volumes of megaprojects in various stages of construction in the GCC. An initial step to dealing with cultural issues is to acknowledge culture as a significant risk factor (SRF). This paper seeks to understand the criticality for western consultants to address these risks. It considers the cultural barriers that exist between GCC sponsors and western consultants and examines the cultural distance between the key actors. Initial findings suggest the presence to a certain extent of ethnocentricity. Other cultural clashes arise out of a lack of appreciation of the customs, practices and traditions of ‘the Other’, such as the need for avoiding public humiliation and the hierarchal significance rankings. The concept and significance of cultural shock as part of the integration process for new arrivals are considered. Culture shock describes the state of anxiety and frustration resulting from the immersion in a culture distinctly different from one's own. There are potentially substantial project risks associated with underestimating the process of cultural integration. This paper examines two distinct but intertwined issues: the societal and professional culture differences associated with expatriate assignments. A case study examines the cultural congruences between GCC sponsors and American, British and German consultants, over a ten-year cycle. This provides indicators as to which nationalities encountered the most profound cultural issues and the nature of these. GCC megaprojects are typically intensive fast track demanding ventures, where consultant turnover is high. The study finds that building trust-filled relationships is key to successful project team integration and therefore, to successful megaproject execution. Findings indicate that both professional and social inclusion processes have steep learning curves. Traditional risk management practice is to approach any uncertainty in a structured way to mitigate the potential impact on project outcomes. This research highlights cultural risk as a significant factor in the management of GCC megaprojects. These risks arising from high staff turnover typically include loss of project knowledge, delays to the project, cost and disruption in replacing staff. This paper calls for cultural risk to be recognised as an SRF, as the first step to developing risk management strategies, and to reduce staff turnover for western consultants in GCC megaprojects.

Keywords: western consultants in megaprojects, national culture impacts on GCC megaprojects, significant risk factors in megaprojects, professional culture in megaprojects

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Authors: Yulia V. Krasavtseva, Tatiana V. Kornilova

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Risk-taking behaviors are not only dictated by cognitive components but also involve emotional aspects. Anticipatory emotions, involving both cognitive and affective mechanisms, are involved in decision-making in general, and risk-taking in particular. Affective reactions are prompted when an expectation or prediction is either validated or invalidated in the achieved result. This study aimed to combine predictions, anticipatory emotions, affective reactions, and personality traits in the context of risk-taking behaviors. An experimental online method Emotion and Prediction In a Casino (EPIC) was used, based on a casino-like roulette game. In a series of choices, the participant is presented with progressively riskier roulette combinations, where the potential sums of wins and losses increase with each choice and the participant is given a choice: to 'walk away' with the current sum of money or to 'play' the displayed roulette, thus accepting the implicit risk. Before and after the result is displayed, participants also rate their emotions, using the Self-Assessment Mannequin [Bradley, Lang, 1994], picking a picture, representing the intensity of pleasure, arousal, and dominance. The following personality measures were used: 1) Personal Decision-Making Factors [Kornilova, 2003] assessing risk and rationality; 2) I7 – Impulsivity Questionnaire [Kornilova, 1995] assessing impulsiveness, risk readiness, and empathy and 3) Subjective Risk Intelligence Scale [Craparo et al., 2018] assessing negative attitude toward uncertainty, emotional stress vulnerability, imaginative capability, and problem-solving self-efficacy. Two groups of participants took part in the study: 1) 98 university students (Mage=19.71, SD=3.25; 72% female) and 2) 94 online participants (Mage=28.25, SD=8.25; 89% female). Online participants were recruited via social media. Students with high rationality rated their pleasure and dominance before and after choices as lower (ρ from -2.6 to -2.7, p < 0.05). Those with high levels of impulsivity rated their arousal lower before finding out their result (ρ from 2.5 - 3.7, p < 0.05), while also rating their dominance as low (ρ from -3 to -3.7, p < 0.05). Students prone to risk-rated their pleasure and arousal before and after higher (ρ from 2.5 - 3.6, p < 0.05). High empathy was positively correlated with arousal after learning the result. High emotional stress vulnerability positively correlates with arousal and pleasure after the choice (ρ from 3.9 - 5.7, p < 0.05). Negative attitude to uncertainty is correlated with high anticipatory and reactive arousal (ρ from 2.7 - 5.7, p < 0.05). High imaginative capability correlates negatively with anticipatory and reactive dominance (ρ from - 3.4 to - 4.3, p < 0.05). Pleasure (.492), arousal (.590), and dominance (.551) before and after the result were positively correlated. Higher predictions positively correlated with reactive pleasure and arousal. In a riskier scenario (6/8 chances to win), anticipatory arousal was negatively correlated with the pleasure emotion (-.326) and vice versa (-.265). Correlations occur regardless of the roulette outcome. In conclusion, risk-taking behaviors are linked not only to personality traits but also to anticipatory emotions and affect in a modeled casino setting. Acknowledgment: The study was supported by the Russian Foundation for Basic Research, project 19-29-07069.

Keywords: anticipatory emotions, casino game, risk taking, impulsiveness

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Authors: Gabriel Malgaresi, Sara Borazjani, Hadi Madani, Pavel Bedrikovetsky

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Suspension-Colloidal flow in porous media occurs in numerous engineering fields, such as industrial water treatment, the disposal of industrial wastes into aquifers with the propagation of contaminants and low salinity water injection into petroleum reservoirs. The main effects are particle mobilization and captured by the porous rock, which can cause pore plugging and permeability reduction which is known as formation damage. Various factors such as fluid salinity, pH, temperature, and rock properties affect particle detachment. Formation damage is unfavorable specifically near injection and production wells. One way to control formation damage is pre-treatment of the rock with nanoparticles. Adsorption of nanoparticles on fines and rock surfaces alters zeta-potential of the surfaces and enhances the attachment force between the rock and fine particles. The main objective of this study is to develop a two-stage mathematical model for (1) flow and adsorption of nanoparticles on the rock in the pre-treatment stage and (2) fines migration and permeability reduction during the water production after the pre-treatment. The model accounts for adsorption and desorption of nanoparticles, fines migration, and kinetics of particle capture. The system of equations allows for the exact solution. The non-self-similar wave-interaction problem was solved by the Method of Characteristics. The analytical model is new in two ways: First, it accounts for the specific boundary and initial condition describing the injection of nanoparticle and production from the pre-treated porous media; second, it contains the effect of nanoparticle sorption hysteresis. The derived analytical model contains explicit formulae for the concentration fronts along with pressure drop. The solution is used to determine the optimal injection concentration of nanoparticle to avoid formation damage. The mathematical model was validated via an innovative laboratory program. The laboratory study includes two sets of core-flood experiments: (1) production of water without nanoparticle pre-treatment; (2) pre-treatment of a similar core with nanoparticles followed by water production. Positively-charged Alumina nanoparticles with the average particle size of 100 nm were used for the rock pre-treatment. The core was saturated with the nanoparticles and then flushed with low salinity water; pressure drop across the core and the outlet fine concentration was monitored and used for model validation. The results of the analytical modeling showed a significant reduction in the fine outlet concentration and formation damage. This observation was in great agreement with the results of core-flood data. The exact solution accurately describes fines particle breakthroughs and evaluates the positive effect of nanoparticles in formation damage. We show that the adsorbed concentration of nanoparticle highly affects the permeability of the porous media. For the laboratory case presented, the reduction of permeability after 1 PVI production in the pre-treated scenario is 50% lower than the reference case. The main outcome of this study is to provide a validated mathematical model to evaluate the effect of nanoparticles on formation damage.

Keywords: nano-particles, formation damage, permeability, fines migration

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Authors: Ntandazo Dlatu, Benjamin Longo-Mbenza, Andre Renzaho, Ruffin Appalata, Yolande Yvonne Valeria Matoumona Mavoungou, Mbenza Ben Longo, Kenneth Ekoru, Blaise Makoso, Gedeon Longo Longo

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Background: The gap between complexities related to the integration of Tuberculosis /HIV control and evidence-based knowledge motivated the initiation of the study. Therefore, the objective of this study was to explore correlations between national TB management guidelines, multiple deprivation indexes, quantiles, components and levels of Tuberculosis control programme using mathematical modeling in rural O.R. Tambo District Health Facilities, South Africa. Methods: The study design used mixed secondary data analysis and cross-sectional analysis between 2009 and 2013 across O.R Tambo District, Eastern Cape, South Africa using univariate/ bivariate analysis, linear multiple regression models, and multivariate discriminant analysis. Health inequalities indicators and component of an impediment to the tuberculosis control programme were evaluated. Results: In total, 62 400 records for TB notification were analyzed for the period 2009-2013. There was a significant but negative between Financial Year Expenditure (r= -0.894; P= 0.041) Seropositive HIV status(r= -0.979; P= 0.004), Population Density (r = -0.881; P= 0.048) and the number of TB defaulter in all TB cases. It was shown unsuccessful control of TB management program through correlations between numbers of new PTB smear positive, TB defaulter new smear-positive, TB failure all TB, Pulmonary Tuberculosis case finding index and deprivation-concentration-dispersion index. It was shown successful TB program control through significant and negative associations between declining numbers of death in co-infection of HIV and TB, TB deaths all TB and SMIAD gradient/ deprivation-concentration-dispersion index. The multivariate linear model was summarized by unadjusted r of 96%, adjusted R2 of 95 %, Standard Error of estimate of 0.110, R2 changed of 0.959 and significance for variance change for P=0.004 to explain the prediction of TB defaulter in all TB with equation y= 8.558-0.979 x number of HIV seropositive. After adjusting for confounding factors (PTB case finding the index, TB defaulter new smear-positive, TB death in all TB, TB defaulter all TB, and TB failure in all TB). The HIV and TB death, as well as new PTB smear positive, were identified as the most important, significant, and independent indicator to discriminate most deprived deprivation index far from other deprivation quintiles 2-5 using discriminant analysis. Conclusion: Elimination of poverty such as overcrowding, lack of sanitation and environment of highest burden of HIV might end the TB threat in O.R Tambo District, Eastern Cape, South Africa. Furthermore, ongoing adequate budget comprehensive, holistic and collaborative initiative towards Sustainable Developmental Goals (SDGs) is necessary for complete elimination of TB in poor O.R Tambo District.

Keywords: tuberculosis, HIV/AIDS, success, failure, control program, health inequalities, South Africa

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Authors: Liou Shyhnan, Chia Han Yang

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The study aims to investigate the promotion of innovation in the development of cultural and creative industries (CCI) and apply research on culture and creativity to this promotion. Using the research perspectives of culture and creativity as the starting points, this study has examined the challenges, trends, and opportunities that have emerged from the development of the CCI until the present. It is found that a definite context of cause and effect exist between them, and that a homologous theoretical basis can be used to understand and interpret them. Based on the characteristics of the aforementioned challenges and trends, this study has compiled two main theoretical systems for conducting research on culture and creativity: (i) reciprocal process between creativity and culture, and (ii) a mechanism for innovation involving multicultural convergence. Both theoretical systems were then used as the foundation to arrive at possible research propositions relating to the two developmental systems. This was respectively done through identification of the theoretical context through a literature review, and interviews and observations of actual case studies within Taiwan’s CCI. In so doing, the critical factors that can address the aforementioned challenges and trends were discovered. Our results indicated that, for reciprocal process between creativity and culture, we recognize that culture serves as creative resources in cultural and creative industries. According to shared consensus, culture provides symbolic meanings and emotional attachment for products and experiences offered by CCI. Besides, different cultures vary in their effects on creativity processes and standards, thus engendering distinctive preferences for and evaluations of the creative expressions and experiences of CCIs. In addition, we identify that creativity serves as the engine for driving the continuation and rebirth of cultures. Accounting for the core of culture, the employment of technology, design, and business facilitates the transformation and innovation mechanism for promoting culture continuity. In addition, with cultural centered, the digital technology, design thinking, and business model are critical constitutes of the innovation mechanism to promote the cultural continuity. Regarding cultural preservation and regeneration of local spaces and folk customs, we argue that the preservation and regeneration of local spaces and cultural cultures must embody the interactive experiences of present-day life. And cultural space and folk custom would regenerate with interact and experience in modern life. Regarding innovation mechanism for multicultural convergence, we propose that innovative stakeholders from different disciplines (e.g., creators, designers, engineers, and marketers) in CCIs rely on the establishment of a cocreation mechanism to promote interdisciplinary interaction. Furthermore, CCI development needs to develop a cocreation mechanism for enhancing the interdisciplinary collaboration among CCI innovation stakeholders. We further argue multicultural mixing would enhance innovation in developing CCI, and assuming an open and mutually enlightening attitude to enrich one another’s cultures in the multicultural exchanges under globalization will create diversity in homogenous CCIs. Finally, for promoting innovation in developing cultural and creative industries, we further propose a model for joint knowledge creation that can be established for enhancing the mutual reinforcement of theoretical and practical research on culture and creativity.

Keywords: culture and creativity, innovation, cultural and creative industries, cultural mixing

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Authors: Md. Samsuddin Ansari, Ashish Arora

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Every year 10 million people fall ill with one of the oldest diseases known as tuberculosis, caused by Mycobacterium tuberculosis. The success of M. tuberculosis as a pathogen is because of its ability to persist in host tissues. Multidrug resistance (MDR) mycobacteria cases increase every day, which is associated with efflux pumps controlled at the level of transcription. The transcription regulators of MDR transporters in bacteria belong to one of the following four regulatory protein families: AraC, MarR, MerR, and TetR. Phenolic acid decarboxylase repressor (PadR), like a family of transcription regulators, is closely related to the MarR family. Phenolic acid decarboxylase repressor (PadR) was first identified as a transcription factor involved in the regulation of phenolic acid stress response in various microorganisms (including Mycobacterium tuberculosis H37Rv). Recently research has shown that the PadR family transcription factors are global, multifunction transcription regulators. Rv0047c is a PadR subfamily-1 protein. We are exploring the biophysical and structural characterization of Rv0047c. The Rv0047 gene was amplified by PCR using the primers containing EcoRI and HindIII restriction enzyme sites cloned in pET-NH6 vector and overexpressed in DH5α and BL21 (λDE3) cells of E. coli following purification with Ni2+-NTA column and size exclusion chromatography. We did DSC to know the thermal stability; the Tm (transition temperature) of protein is 55.29ºC, and ΔH (enthalpy change) of 6.92 kcal/mol. Circular dichroism to know the secondary structure and conformation and fluorescence spectroscopy for tertiary structure study of protein. To understand the effect of pH on the structure, function, and stability of Rv0047c we employed spectroscopy techniques such as circular dichroism, fluorescence, and absorbance measurements in a wide range of pH (from pH-2.0 to pH-12). At low and high pH, it shows drastic changes in the secondary and tertiary structure of the protein. EMSA studies showed the specific binding of Rv0047c with its own 30-bp promoter region. To determine the effect of complex formation on the secondary structure of Rv0047c, we examined the CD spectra of the complex of Rv0047c with promoter DNA of rv0047. The functional role of Rv0047c was characterized by over-expressing the Rv0047c gene under the control of hsp60 promoter in Mycobacterium tuberculosis H37Rv. We have predicted the three-dimensional structure of Rv0047c using the Swiss Model and Modeller, with validity checked by the Ramachandra plot. We did molecular docking of Rv0047c with dnaA, through PatchDock following refinement through FireDock. Through this, it is possible to easily identify the binding hot-stop of the receptor molecule with that of the ligand, the nature of the interface itself, and the conformational change undergone by the protein pattern. We are using X-crystallography to unravel the structure of Rv0047c. Overall the studies show that Rv0047c may have transcription regulation along with providing an insight into the activity of Rv0047c in the pH range of subcellular environment and helps to understand the protein-protein interaction, a novel target to kill dormant bacteria and potential strategy for tuberculosis control.

Keywords: mycobacterium tuberculosis, phenolic acid decarboxylase repressor, Rv0047c, Circular dichroism, fluorescence spectroscopy, docking, protein-protein interaction

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Authors: R. Yuan, S. Sivasankaran, N. Dutta, K. Ebrahimi

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This paper investigates the software capability and computer-aided engineering (CAE) method of modelling transient heat transfer process occurred in the vehicle underhood region during vehicle thermal soak phase. The heat retention from the soak period will be beneficial to the cold start with reduced friction loss for the second 14°C worldwide harmonized light-duty vehicle test procedure (WLTP) cycle, therefore provides benefits on both CO₂ emission reduction and fuel economy. When vehicle undergoes soak stage, the airflow and the associated convective heat transfer around and inside the engine bay is driven by the buoyancy effect. This effect along with thermal radiation and conduction are the key factors to the thermal simulation of the engine bay to obtain the accurate fluids and metal temperature cool-down trajectories and to predict the temperatures at the end of the soak period. Method development has been investigated in this study on a light-duty passenger vehicle using coupled aerodynamic-heat transfer thermal transient modelling method for the full vehicle under 9 hours of thermal soak. The 3D underhood flow dynamics were solved inherently transient by the Lattice-Boltzmann Method (LBM) method using the PowerFlow software. This was further coupled with heat transfer modelling using the PowerTHERM software provided by Exa Corporation. The particle-based LBM method was capable of accurately handling extremely complicated transient flow behavior on complex surface geometries. The detailed thermal modelling, including heat conduction, radiation, and buoyancy-driven heat convection, were integrated solved by PowerTHERM. The 9 hours cool-down period was simulated and compared with the vehicle testing data of the key fluid (coolant, oil) and metal temperatures. The developed CAE method was able to predict the cool-down behaviour of the key fluids and components in agreement with the experimental data and also visualised the air leakage paths and thermal retention around the engine bay. The cool-down trajectories of the key components obtained for the 9 hours thermal soak period provide vital information and a basis for the further development of reduced-order modelling studies in future work. This allows a fast-running model to be developed and be further imbedded with the holistic study of vehicle energy modelling and thermal management. It is also found that the buoyancy effect plays an important part at the first stage of the 9 hours soak and the flow development during this stage is vital to accurately predict the heat transfer coefficients for the heat retention modelling. The developed method has demonstrated the software integration for simulating buoyancy-driven heat transfer in a vehicle underhood region during thermal soak with satisfying accuracy and efficient computing time. The CAE method developed will allow integration of the design of engine encapsulations for improving fuel consumption and reducing CO₂ emissions in a timely and robust manner, aiding the development of low-carbon transport technologies.

Keywords: ATCT/WLTC driving cycle, buoyancy-driven heat transfer, CAE method, heat retention, underhood modeling, vehicle thermal soak

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Authors: Godfrey Omulo, Regina Birner, Karlheinz Koller, Thomas Daum

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Conservation agriculture (CA) as a climate-resilient and sustainable practice have been carried out for over three decades in Zambia. However, its continued promotion and adoption has been predominantly on a small-scale basis. Despite the plethora of scholarship pointing to the positive benefits of CA in regard to enhanced yield, profitability, carbon sequestration and minimal environmental degradation, these have not stimulated commensurate agricultural extensification desired for Zambia. The objective of this study was to investigate the potential differences between mechanized conventional and conservation tillage practices on operation time, fuel consumption, labor costs, soil moisture retention, soil temperature and crop yield. An on-farm mechanized conservation agriculture (MCA) experiment arranged in a randomized complete block design with four replications was used. The research was conducted on a 15 ha of sandy loam rainfed land: soybeans on 7ha with plot dimensions of 24 m by 210 m and maize on 8ha with plot dimensions of 24 m by 250 m. The three tillage treatments were: residue burning followed by disc harrowing, ripping tillage and no-till. The crops were rotated in two subsequent seasons. All operations were done using a 60hp 2-wheel tractor, a disc harrow, a two-tine ripper and a two-row planter. Soil measurements and the agro-economic factors were recorded for two farming seasons. The season results showed that the yield of maize and soybeans under no-till and ripping tillage practices were not significantly different from the conventional burning and discing. But, there was a significant difference in soil moisture content between no-till (25.31SFU±2.77) and disced (11.91SFU±0.59) plots at depths from 10-60 cm. Soil temperature in no-till plots (24.59°C±0.91) was significantly lower compared to the disced plots (26.20°C±1.75) at the depths 15 cm and 45 cm. For maize, there was a significant difference in operation time between disc-harrowed (3.68hr/ha±1.27) and no-till (1.85hr/ha±0.04) plots, and a significant difference in cost of labor between disc-harrowed (45.45$/ha±19.56) and no-till (21.76$/ha) plots. There was no significant difference in fuel consumption between ripping and disc-harrowing and direct seeding. For soybeans, there was a significant difference in operation time between no-tillage (1.96hr/ha±0.31) and ripping (3.34hr/ha±0.53) and disc harrowing (3.30hr/ha±0.16). Further, fuel consumption and labor on no-till plots were significantly different from both the ripped and disc-harrowed plots. The high seed emergence percentage on maize disc-harrowed plot (93.75%±5.87) was not significantly different from ripping and no-till plots. Again, the high seed emergence percentage for the soybean ripped plot (93.75%±13.03) had no significant difference with discing and ripping. The results show that it is economically sound and timesaving to practice MCA and get viable yields compared to conventional farming. This research fills the gap on the potential of MCA in the context of Zambia and its profitability in incentivizing policymakers to invest in appropriate and sustainable machinery and implements for extensive agricultural production.

Keywords: climate-smart agriculture, labor cost, mechanized conservation agriculture, soil moisture, Zambia

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Authors: Carly Madge, Melanie Zurba, Ryan Bullock

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The Boreal Forest has experienced some of the most drastic climate change-induced temperature rises in Canada, with average winter temperatures increasing by 3°C since 1948. One of the main concerns of the province of Saskatchewan, and particularly wildfire managers, is the increased risk of wildfires due to climate change. With these concerns in mind Sakaw Askiy Management Inc., a forestry corporation located in Prince Albert, Saskatchewan with operations in the Boreal Forest biome, is developing wildfire risk reduction strategies that are supported by the shareholders of the corporation as well as the stakeholders of the Prince Albert Forest Management Area (which includes citizens, hunters, trappers, cottage owners, and outfitters). In the past, wildfire management strategies implemented through harvesting have been received with skepticism by some community members of Prince Albert. Engagement of the stakeholders of the Prince Albert Management Area through the development of the wildfire risk reduction strategies aims to reduce this skepticism and rebuild some of the trust that has been lost between industry and community. This research project works with the framework of social learning, which is defined as the learning that occurs when individuals come together to form a group with the purpose of understanding environmental challenges and determining appropriate responses to them. The project evaluates the social learning processes that occur through the development of the risk reduction strategies and how the learning has allowed Sakaw to work towards implementing the strategies into their forest harvesting plans. The incorporation of wildfire risk reduction strategies works to increase the adaptive capacity of Sakaw, which in this case refers to the ability to adjust to climate change, moderate potential damages, take advantage of opportunities, and cope with consequences. Using semi-structured interviews and wildfire workshop meetings shareholders and stakeholders shared their knowledge of wildfire, their main wildfire concerns, and changes they would like to see made in the Prince Albert Forest Management Area. Interviews and topics discussed in the workshops were inductively coded for themes related to learning, adaptive capacity, areas of concern, and preferred methods of wildfire risk reduction strategies. Analysis determined that some of the learning that has occurred has resulted through social interactions and the development of networks oriented towards wildfire and wildfire risk reduction strategies. Participants have learned new knowledge and skills regarding wildfire risk reduction. The formation of wildfire networks increases access to information on wildfire and the social capital (trust and strengthened relations) of wildfire personnel. Both factors can be attributed to increases in adaptive capacity. Interview results were shared with the General Manager of Sakaw, where the areas of concern and preferred strategies of wildfire risk reduction will be considered and accounted for in the implementation of new harvesting plans. This research also augments the growing conceptual and empirical evidence of the important role of learning and networks in regional wildfire risk management efforts.

Keywords: adaptive capacity, community-engagement, social learning, wildfire risk reduction

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Authors: Seyed Reza Aghili, Tahereh Shokohi, Shirin Sadat Hashemi Fesharaki, Mohammad Ali Boroumand, Bahar Salmanian

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Introduction: Intravenous catheter-associated fungal infection as nosocomial infection continue to be a deep problem among hospitalized patients, decreasing quality of life and adding healthcare costs. The capacity of catheters in the spread of candidemia in heart failure patients is obvious. The aim of this study was to evaluate the prevalence and genetic identification of Candida species in heart disorder patients. Material and Methods: This study was conducted in Tehran Hospital of Cardiology Center (Tehran, Iran, 2014) during 1.5 years on the patients hospitalized for at least 7 days and who had central or peripheral vein catheter. Culture of catheters, blood and skin of the location of catheter insertion were applied for detecting Candida colonies in 223 patients. Identification of Candida species was made on the basis of a combination of various phenotypic methods and confirmed by sequencing the ITS1-5.8S-ITS2 region amplified from the genomic DNA using PCR and the NCBI BLAST. Results: Of the 223 patients samples tested, we identified totally 15 Candida isolates obtained from 9 (4.04%) catheter cultures, 3 (1.35%) blood cultures and 2 (0.90%) skin cultures of the catheter insertion areas. On the base of ITS region sequencing, out of nine Candida isolates from catheter, 5(55.6%) C. albicans, 2(22.2%) C. glabrata, 1(11.1%) C. membranifiaciens and 1 (11.1%) C. tropicalis were identified. Among three Candida isolates from blood culture, C. tropicalis, C. carpophila and C. membranifiaciens were identified. Non-candida yeast isolated from one blood culture was Cryptococcus albidus. One case of C. glabrata and one case of Candida albicans were isolated from skin culture of the catheter insertion areas in patients with positive catheter culture. In these patients, ITS region of rDNA sequence showed a similarity between Candida isolated from the skin and catheter. However, the blood samples of these patients were negative for fungal growth. We report two cases of catheter-related candidemia caused by C. membranifiaciens and C. tropicalis on the base of genetic similarity of species isolated from blood and catheter which were treated successfully with intravenous fluconazole and catheter removal. In phenotypic identification methods, we could only identify C. albicans and C. tropicalis and other yeast isolates were diagnosed as Candida sp. Discussion: Although more than 200 species of Candida have been identified, only a few cause diseases in humans. There is some evidence that non-albicans infections are increasing. Many risk factors, including prior antibiotic therapy, use of a central venous catheter, surgery, and parenteral nutrition are considered to be associated with candidemia in hospitalized heart failure patients. Identifying the route of infection in candidemia is difficult. Non-albicans candida as the cause of candidemia is increasing dramatically. By using conventional method, many non-albicans isolates remain unidentified. So, using more sensitive and specific molecular genetic sequencing to clarify the aspects of epidemiology of the unknown candida species infections is essential. The positive blood and catheter cultures for candida isolates and high percentage of similarity of their ITS region of rDNA sequence in these two patients confirmed the diagnosis of intravenous catheter-associated candidemia.

Keywords: catheter-associated infections, heart failure patient, molecular genetic sequencing, ITS region of rDNA, Candidemia

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Authors: Feyi Olorunshola

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Over the last few years, the senior travel market has been noted for its potential in the wider tourism industry. The tourism sector includes the hotel and hospitality, travel, transportation, and several other subdivisions to make it economically viable. In particular, the hotel attracts a substantial part of the expenditure in tourism activities as when people plan to travel, suitable accommodation for relaxation, dining, entertainment and so on is paramount to their decision-making. The global retail value of the hotel as of 2018 was significant for tourism. But, despite indications of the hotel to the tourism industry at large, very few empirical studies are available to establish how this sector can leverage on the senior demographic to achieve competitive advantage. Predominantly, studies on the mature market have focused on destination tourism, with a limited investigation on the hotel which makes a significant contribution to tourism. Also, several scholarly studies have demonstrated the importance of the senior travel market to the hotel, yet there is very little empirical research in the field which has explored the driving factors that will become the accepted new normal for this niche segment post-pandemic. Giving that the hotel already operates in a highly saturated business environment, and on top of this pre-existing challenge, the ongoing global health outbreak has further put the sector in a vulnerable position. Therefore, the hotel especially the full-service luxury category must evolve rapidly for it to survive in the current business environment. The hotel can no longer rely on corporate travelers to generate higher revenue since the unprecedented wake of the pandemic in 2020 many organizations have invented a different approach of conducting their businesses online, therefore, the hotel needs to anticipate a significant drop in business travellers. However, the rooms and the rest of the facilities must be occupied to keep their business operating. The way forward for the hotel lies in the leisure sector, but the question now is to focus on the potential demographics of travelers, in this case, the seniors who have been repeatedly recognized as the lucrative market because of increase discretionary income, availability of time and the global population trends. To achieve the study objectives, a mixed-method approach will be utilized drawing on both qualitative (netnography) and quantitative (survey) methods, cognitive and decision-making theories (means-end chain) and competitive theories to identify the salient drivers explaining senior hotel choice and its influence on their decision-making. The target population are repeated seniors’ age 65 years and over who are UK resident, and from the top tourist market to the UK (USA, Germany, and France). Structural equation modelling will be employed to analyze the datasets. The theoretical implication is the development of new concepts using a robust research design, and as well as advancing existing framework to hotel study. Practically, it will provide the hotel management with the latest information to design a competitive marketing strategy and activities to target the mature market post-pandemic and over a long period.

Keywords: competitive advantage, covid-19, full-service hotel, five-star, luxury hotels

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Authors: Sawang Saenghirunvattana, Chao Saenghirunvattana, Maria Christina Gonzales, Wilai Srimuk, Chitchamai Siangpro, Kritsana Sutthisri

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Introduction: Thailand is one of the fastest growing countries in Asia. It has emerged from agricultural to industrialized economy. Work places have shifted from farms to factories, offices and streets were employees are exposed to certain chemicals and pollutants causing occupational diseases particularly asthma. Work-related diseases are major concern and many studies have been published to demonstrate certain professions and their exposures that elevate the risk of asthma. Workers who exhibit coughing, wheezing and difficulty of breathing are brought to a health care setting where Pulmonary Function Test (PFT) is performed and based from results, they are then diagnosed of asthma. These patients, known to have occupational asthma eventually get well when removed from the exposure of the environment. Our study, focused on performing PFT or specific challenge test in diagnosing workers of occupational asthma with them executing the test within their workplace, maintaining the environment and their daily exposure to certain levels of chemicals and pollutants. This has provided us with an understanding and reliable diagnosis of occupational asthma. Objective: To identify the prevalence of Thai workers who develop asthma caused by exposure to pollutants and chemicals from their working environment by conducting interview and performing PFT or specific challenge test in their work places. Materials and Methods: This study was performed from January-March 2015 in Bangkok, Thailand. The percentage of abnormal symptoms of 940 workers in 5 different areas (factories of plastic, fertilizer, animal food, office and streets) were collected through a questionnaire. The demographic information, occupational history, and the state of health were determined using a questionnaire and checklists. PFT was executed in their work places and results were measured and evaluated. Results: Pulmonary Function test was performed by 940 participants. The specific challenge test was done in factories of plastic, fertilizer, animal food, office environment and on the streets of Thailand. Of the 100 participants working in the plastic industry, 65% complained of having respiratory symptoms. None of them had an abnormal PFT. From the participants who worked with fertilizers and are exposed to sulfur dioxide, out of 200 participants, 20% complained of having symptoms and 8% had abnormal PFT. The 300 subjects working with animal food reported that 45% complained of respiratory symptoms and 15% had abnormal PFT results. From the office environment where there is indoor pollution, Out of 140 subjects, 7% had symptoms and 4% had abnormal PFT. The 200 workers exposed to traffic pollution, 24% reported respiratory symptoms and 12% had abnormal PFT. Conclusion: We were able to identify and diagnose participants of occupational asthma through their abnormal lung function test done at their work places. The chemical agents and exposures were determined therefore effective management of workers with occupational asthma were advised to avoid further exposure for better chances of recovery. Further studies identifying the risk factors and causative agents of asthma in workplaces should be developed to encourage interventional strategies and programs that will prevent occupation related diseases particularly asthma.

Keywords: occupational asthma, pulmonary function test, specific challenge test, Thailand

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Authors: Michal Pachocki

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This study investigates the effects of mobility in the context of a different environment and work culture through analysing the learners perception of their international work experience. Since this kind of professional training abroad is becoming more popular in Europe, mainly due to the EU funding opportunities, it is of paramount importance to assess its long-term impact on educational and career paths of former students. Moreover, the tracer study aimed at defining what professional, social and intercultural competencies were gained or developed by the interns and to which extent those competences proved to be useful meeting the labor market requirements. Being a populous EU member state which actively modernizes its vocational education system (also with European funds), Poland can serve as an illustrative case study to investigate the above described research problems. However, the examined processes are most certainly universal, wherever mobility is included in the learning process. The target group of this research was the former mobility participants and the study was conducted using quantitative and qualitative methods, such as the online survey with over 2 600 questionnaires completed by the former mobility participants; -individual in-depth interviews (IDIs) with 20 Polish graduates already present in the labour market; - 5 focus group interviews (FGIs) with 60 current students of the Polish vocational schools, who have recently returned from the training abroad. As the adopted methodology included a data triangulation, the collected findings have also been supplemented with data obtained by the desk research (mainly contextual information and statistical summary of mobility implementation). The results of this research – to be presented in full scope within the conference presentation – include the participants’ perception of their work mobility. The vast majority of graduates agrees that such an experience has had a significant impact on their professional careers and claims that they would recommend training abroad to persons who are about to enter the labor market. Moreover, in their view, such form of practical training going beyond formal education provided them with an opportunity to try their hand in the world of work. This allowed them – as they accounted for them – to get acquainted with a work system and context different from the ones experienced in Poland. Although the work mobility becomes an important element of the learning process in the growing number of Polish schools, this study reveals that many sending institutions suffer from a lack of the coherent strategy for planning domestic and foreign training programmes. Nevertheless, the significant number of graduates claims that such a synergy improves the quality of provided training. Despite that, the research proved that the transnational mobilities exert an impact on their future careers and personal development. However, such impact is, in their opinion, dependant on other factors, such as length of the training period, the nature and extent of work, recruitment criteria and the quality of organizational arrangement and mentoring provided to learners. This may indicate the salience of the sending and receiving institutions organizational capacity to deal with mobility.

Keywords: learning mobility, transnational training, vocational education and training graduates, tracer study

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Authors: William Ho, Agus Wicaksana

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Anecdotal evidence in the last decade shows that the occurrence of disruptive events and uncertainties in the supply chain is increasing. The coupling of these events with the nature of an increasingly complex and interdependent business environment leads to devastating impacts that quickly propagate within and across organizations. For example, the recent COVID-19 pandemic increased the global supply chain disruption frequency by at least 20% in 2020 and is projected to have an accumulative cost of $13.8 trillion by 2024. This crisis raises attention to organizational resilience to weather business uncertainty. However, the concept has been criticized for being vague and lacking a consistent definition, thus reducing the significance of the concept for practice and research. This study is intended to solve that issue by providing a comprehensive review of the conceptualization, measurement, and antecedents of operational resilience that have been discussed in the supply chain risk management literature (SCRM). We performed a Scholarly Network Analysis, combining citation-based and text-based approaches, on 252 articles published from 2000 to 2021 in top-tier journals based on three parameters: AJG ranking and ABS ranking, UT Dallas and FT50 list, and editorial board review. We utilized a hybrid scholarly network analysis by combining citation-based and text-based approaches to understand the conceptualization, measurement, and antecedents of operational resilience in the SCRM literature. Specifically, we employed a Bibliographic Coupling Analysis in the research cluster formation stage and a Co-words Analysis in the research cluster interpretation and analysis stage. Our analysis reveals three major research clusters of resilience research in the SCRM literature, namely (1) supply chain network design and optimization, (2) organizational capabilities, and (3) digital technologies. We portray the research process in the last two decades in terms of the exemplar studies, problems studied, commonly used approaches and theories, and solutions provided in each cluster. We then provide a conceptual framework on the conceptualization and antecedents of resilience based on studies in these clusters and highlight potential areas that need to be studied further. Finally, we leverage the concept of abnormal operating performance to propose a new measurement strategy for resilience. This measurement overcomes the limitation of most current measurements that are event-dependent and focus on the resistance or recovery stage - without capturing the growth stage. In conclusion, this study provides a robust literature review through a scholarly network analysis that increases the completeness and accuracy of research cluster identification and analysis to understand conceptualization, antecedents, and measurement of resilience. It also enables us to perform a comprehensive review of resilience research in SCRM literature by including research articles published during the pandemic and connects this development with a plethora of articles published in the last two decades. From the managerial perspective, this study provides practitioners with clarity on the conceptualization and critical success factors of firm resilience from the SCRM perspective.

Keywords: supply chain risk management, organizational resilience, scholarly network analysis, systematic literature review

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Authors: Sarah Reker, Christiane H. Kellner

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From the perspective of people with disabilities, inequalities can also emerge from spatial segregation, the lack of social contacts or limited economic resources. In order to reduce or even eliminate these disadvantages and increase general well-being, community-based participation as well as decentralisation efforts within exclusively residential homes is essential. Therefore, the new research project “Index for participation development and quality of life for persons with disabilities”(TeLe-Index, 2014-2016), which is anchored at the Technische Universität München in Munich and at a large residential complex and service provider for persons with disabilities in the outskirts of Munich aims to assist the development of community-based living environments. People with disabilities should be able to participate in social life beyond the confines of the institution. Since a diverse society is a society in which different individual needs and wishes can emerge and be catered to, the ultimate goal of the project is to create an environment for all citizens–regardless of disability, age or ethnic background–that accommodates their daily activities and requirements. The UN-Convention on the Rights of Persons with Disabilities, which Germany also ratified, postulates the necessity of user-centered design, especially when it comes to evaluating the individual needs and wishes of all citizens. Therefore, a multidimensional approach is required. Based on this insight, the structure of the town-like center will be remodeled to open up the community to all people. This strategy should lead to more equal opportunities and open the way for a much more diverse community. Therefore, macro-level research questions were inspired by quality of life theory and were formulated as follows for different dimensions: •The user dimension: what needs and necessities can we identify? Are needs person-related? Are there any options to choose from? What type of quality of life can we identify? The economic dimension: what resources (both material and staff-related) are available in the region? (How) are they used? What costs (can) arise and what effects do they entail? •The environment dimension: what “environmental factors” such as access (mobility and absence of barriers) prove beneficial or impedimental? In this context, we have provided academic supervision and support for three projects (the construction of a new school, inclusive housing for children and teenagers with disabilities and the professionalization of employees with person-centered thinking). Since we cannot present all the issues of the umbrella-project within the conference framework, we will be focusing on one project more in-depth, namely “Outpatient Housing Options for Children and Teenagers with Disabilities”. The insights we have obtained until now will enable us to present the intermediary results of our evaluation. The most central questions pertaining to this part of the research were the following: •How have the existing network relations been designed? •What meaning (or significance) does the existing service offers and structures have for the everyday life of an external residential group? These issues underpinned the environmental analyses as well as the qualitative guided interviews and qualitative network analyses we carried out.

Keywords: decentralisation, environmental analyses, outpatient housing options for children and teenagers with disabilities, qualitative network analyses

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Authors: Alaa Abdellatif, Gabrièle Breda

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Background. Advanced therapy medicinal products (ATMPs) are innovative therapies that mainly target orphan diseases and high unmet medical needs. ATMP includes gene therapy medicinal products (GTMP), somatic cell therapy medicinal products (CTMP), and tissue-engineered therapies (TEP). Since legislation opened the way in 2007, 25 ATMPs have been approved in the EU, which is about the same amount as the U.S. Food and Drug Administration. However, not all of the ATMPs that have been approved have successfully reached the market and retained their approval. Objectives. We aim to understand all the factors limiting the market access to very promising therapies in a systemic approach, to be able to overcome these problems, in the future, with scientific, regulatory and commercial innovations. Further to recent reviews that focus either on specific countries, products, or dimensions, we will address all the challenges faced by ATMP development today. Methodology. We used mixed methods and a multi-level approach for data collection. First, we performed an updated academic literature review on ATMP development and their scientific and market access challenges (papers published between 2018 and April 2023). Second, we analyzed industry feedback from cell and gene therapy webinars and white papers published by providers and pharmaceutical industries. Finally, we established a comparative analysis of the regulatory guidelines published by EMA and the FDA for ATMP approval. Results: The main challenges in bringing these therapies to market are the high development costs. Developing ATMPs is expensive due to the need for specialized manufacturing processes. Furthermore, the regulatory pathways for ATMPs are often complex and can vary between countries, making it challenging to obtain approval and ensure compliance with different regulations. As a result of the high costs associated with ATMPs, challenges in obtaining reimbursement from healthcare payers lead to limited patient access to these treatments. ATMPs are often developed for orphan diseases, which means that the patient population is limited for clinical trials which can make it challenging to demonstrate their safety and efficacy. In addition, the complex manufacturing processes required for ATMPs can make it challenging to scale up production to meet demand, which can limit their availability and increase costs. Finally, ATMPs face safety and efficacy challenges: dangerous adverse events of these therapies like toxicity related to the use of viral vectors or cell therapy, starting material and donor-related aspects. Conclusion. As a result of our mixed method analysis, we found that ATMPs face a number of challenges in their development, regulatory approval, and commercialization and that addressing these challenges requires collaboration between industry, regulators, healthcare providers, and patient groups. This first analysis will help us to address, for each challenge, proper and innovative solution(s) in order to increase the number of ATMPs approved and reach the patients

Keywords: advanced therapy medicinal products (ATMPs), product development, market access, innovation

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Authors: Leen Al Kassab, Sarah Johns, Helen Noble, Nawal Nour, Elizabeth Janiak, Sarrah Shahawy

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Introduction: Immigrant and refugee women experience disparities in sexual and reproductive health (SRH) outcomes, partially as a result of barriers to SRH literacy and to regular healthcare access and engagement. Despite the existing data highlighting growing needs for culturally relevant and structurally competent care, interventions are scarce and not well-documented. Methods: In this IRB-approved study, we used a community-based participatory research approach, with the assistance of a community advisory board, to conduct a qualitative needs assessment of SRH knowledge and service engagement with immigrant and refugee women from Africa or the Middle East and currently residing in Boston. We conducted a total of nine focus group discussions (FGDs) in partnership with medical, community, and religious centers, in six languages: Arabic, English, French, Somali, Pashtu, and Dari. A total of 44 individuals participated. We explored migrant and refugee women’s current and evolving SRH care needs and gaps, specifically related to the development of interventions and clinical best practices targeting SRH literacy, healthcare engagement, and informed decision-making. Recordings of the FGDs were transcribed verbatim and translated by interpreter services. We used open coding with multiple coders who resolved discrepancies through consensus and iteratively refined our codebook while coding data in batches using Dedoose software. Results: Participants reported immigrant adaptation experiences, discrimination, and feelings of trust, autonomy, privacy, and connectedness to family, community, and the healthcare system as factors surrounding SRH knowledge and needs. The context of previously learned SRH knowledge was commonly noted to be in schools, at menstruation, before marriage, from family members, partners, friends, and online search engines. Common themes included empowering strength drawn from religious and cultural communities, difficulties bridging educational gaps with their US- born daughters, and a desire for more SRH education from multiple sources, including family, health care providers, and religious experts & communities. Regarding further SRH education, participants’ preferences varied regarding ideal platform (virtual vs. in-person), location (in religious and community centers or not), smaller group sizes, and the involvement of men. Conclusions: Based on these results, empowering SRH initiatives should include both community and religious center-based, as well as clinic-based, interventions. Interventions should be composed of frequent educational workshops in small groups involving age-grouped women, daughters, and (sometimes) men, tailored SRH messaging, and the promotion of culturally, religiously, and linguistically competent care.

Keywords: community, immigrant, religion, sexual & reproductive health, women's health

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Authors: Samar Saadeldin Abdelmotalab Omer, Ikram Mohamed Eltayeb Elsiddig, Saad Mohammed Hussein Ayoub

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A variety of herbal medicinal plants are known to confer beneficial effects in regards to modification of cardiovascular ri’=sk factors. The anti-hypercholesterolaemic and antioxidant activities of the crude ethanolic extracts of Citrus reticulate fruit peel, Zingiber officinale rhizome and Sesamum indicum seed extracts have been demonstrated. These plants are assumed to possess biologically active principles, which impart their pharmacologic activities. GC-MS analysis of the ethanolic extracts was carried out to identify the active principles and their percentages of occurrence in the analytes. Analysis of the extracts was carried out using (GS-MS QP) type Schimadzu 2010 equipped with a capillary column RTX-50 (restec), (length 30mm, diameter 0.25mm, and thickness 0.25mm). Helium was used as a carrier gas, the temperature was programmed at 200°C for 5 minutes at a rate of 15ml/minute, and the extracts were injected using split injection mode. The identification of different components was achieved from their Mass Spectra and Retention time, compared with those in the NIST library. The results revealed the presence of 80 compounds in Sudanese locally grown C. reticulata fruit peel extract, most of which were monoterpenoid compounds including Limonene (3.03%), Alpha & Gamma - terpinenes (2.61%), Linalool (1.38%), Citral (1.72%) which are known to have profound antioxidant effects. The Sesquiterpenoids Humulene (0.26%) and Caryophyllene (1.97%) were also identified, the latter known to have profound anti-anxiety and anti-depressant activity in addition to the beneficiary effects in lipid regulation. The analysis of the locally grown S. indicum oily and water soluble portions of seed extract revealed the presence of a total of 64 compounds with considerably high percentage of the mono-unsaturated fatty acid ester methyl oleate (66.99%) in addition to methyl stearate (9.35%) and palmitate (15.71%) of oil portion, whereas, plant sterols including Gamma-sitosterol (13.5%), fucosterol (2.11%) and stigmasterol (1.95%) in addition to gamma-tocopherol (1.16%) were detected in extract water-soluble portion. The latter indicate various principles known to have valuable pharmacological benefits including antioxidant activities and beneficiary effects on intestinal cholesterol absorption and regulation of serum cholesterol levels. Z. officinale rhizome extract analysis revealed the presence of 93 compounds, the most abundant were alpha-zingeberine (16.5%), gingerol (9.25%), alpha-sesquiphellandrene (8.3%), zingerone (6.78%), beta-bisabolene (4.19%), alpha-farnesene (3.56%), ar-curcumene (3.29%), gamma-elemene (1.25%) and a variety of other compounds. The presence of these active principles reflected on the activity of the extract. Activity could be assigned to a single or a combination of two or more extract components. GC-MS analysis concluded the occurrence of compounds known to possess antioxidant activity and lipid profile effects.

Keywords: gas chromatography, indicum, officinale, reticulata

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Authors: Zhao Gao, Eran Edirisinghe

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The production of an accurate sketch of a suspect based on a verbal description obtained from a witness is an essential task for most criminal investigations. The criminal investigation system employs specifically trained professional artists to manually draw a facial image of the suspect according to the descriptions of an eyewitness for subsequent identification. Within the advancement of Deep Learning, Recurrent Neural Networks (RNN) have shown great promise in Natural Language Processing (NLP) tasks. Additionally, Generative Adversarial Networks (GAN) have also proven to be very effective in image generation. In this study, a trained GAN conditioned on textual features such as keywords automatically encoded from a verbal description of a human face using an RNN is used to generate photo-realistic facial images for criminal investigations. The intention of the proposed system is to map corresponding features into text generated from verbal descriptions. With this, it becomes possible to generate many reasonably accurate alternatives to which the witness can use to hopefully identify a suspect from. This reduces subjectivity in decision making both by the eyewitness and the artist while giving an opportunity for the witness to evaluate and reconsider decisions. Furthermore, the proposed approach benefits law enforcement agencies by reducing the time taken to physically draw each potential sketch, thus increasing response times and mitigating potentially malicious human intervention. With publically available 'CelebFaces Attributes Dataset' (CelebA) and additionally providing verbal description as training data, the proposed architecture is able to effectively produce facial structures from given text. Word Embeddings are learnt by applying the RNN architecture in order to perform semantic parsing, the output of which is fed into the GAN for synthesizing photo-realistic images. Rather than the grid search method, a metaheuristic search based on genetic algorithms is applied to evolve the network with the intent of achieving optimal hyperparameters in a fraction the time of a typical brute force approach. With the exception of the ‘CelebA’ training database, further novel test cases are supplied to the network for evaluation. Witness reports detailing criminals from Interpol or other law enforcement agencies are sampled on the network. Using the descriptions provided, samples are generated and compared with the ground truth images of a criminal in order to calculate the similarities. Two factors are used for performance evaluation: The Structural Similarity Index (SSIM) and the Peak Signal-to-Noise Ratio (PSNR). A high percentile output from this performance matrix should attribute to demonstrating the accuracy, in hope of proving that the proposed approach can be an effective tool for law enforcement agencies. The proposed approach to criminal facial image generation has potential to increase the ratio of criminal cases that can be ultimately resolved using eyewitness information gathering.

Keywords: RNN, GAN, NLP, facial composition, criminal investigation

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Authors: Ali Aqa Mohammad Jawad

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Taking a relational approach, this paper analyzes the causal mechanisms associated with successful mobilization and rapid demobilization of the Enlightening Movement in post-2001 Afghanistan. The movement emerged after the state-owned Da Afghan Bereshna Sherkat (DABS) decided to divert the route for the Turkmenistan-Uzbekistan-Tajikistan-Afghanistan-Pakistan (TUTAP) electricity project. The grid was initially planned to go through the Hazara-inhabited province of Bamiyan, according to Afghanistan’s Power Sector Master Plan. The reroute served as an aide-mémoire of historical subordination to other ethno-religious groups for the Hazara community. It was also perceived as deprivation from post-2001 development projects, financed by international aid. This torched the accumulated grievances, which then gave birth to the Enlightening Movement. The movement had a successful mobilization. However, it demobilized after losing much of its mobilizing capabilities through an amalgamation of external and internal relational factors. The successful mobilization yet rapid demobilization constitutes the puzzle of this paper. From the theoretical perspective, this paper is significant as it establishes the applicability of contentious politics theory to protest mobilizations that occurred in Afghanistan, a context-specific, characterized by ethnic politics. Both primary and secondary data are utilized to address the puzzle. As for the primary resources, media coverage, interviews, reports, public media statements of the movement, involved in contentious performances, and data from Social Networking Services (SNS) are used. The covered period is from 2001-2018. As for the secondary resources, published academic articles and books are used to give a historical account of contentious politics. For data analysis, a qualitative comparative historical method is utilized to uncover the causal mechanisms associated with successful mobilization and rapid demobilization of the Movement. In this pursuit, both mobilization and demobilization are considered as larger political processes that could be decomposed to constituent mechanisms. Enlightening Movement’s framing and campaigns are first studied to uncover the associated mechanisms. Then, to avoid introducing some ad hoc mechanisms, the recurrence of mechanisms is checked against another case. Mechanisms qualify as robust if they are “recurrent” in different episodes of contention. Checking the recurrence of causal mechanisms is vital as past contentious events tend to reinforce future events. The findings of this paper suggest that the public sphere in Afghanistan is drastically different from Western democracies known as the birthplace of social movements. In Western democracies, when institutional politics did not respond, movement organizers occupied the public sphere, undermining the legitimacy of the government. In Afghanistan, the public sphere is ethicized. Considering the inter- and intra-relational dynamics of ethnic groups in Afghanistan, the movement reduced to an erosive inter- and intra-ethnic conflict. This undermined the cohesiveness of the movement, which then kicked-off its demobilization process.

Keywords: enlightening movement, contentious politics, mobilization, demobilization

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Authors: Euripides Antoniades

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In 1821 the Greek Revolution movement, under the political influence that arose from the French revolution, and the corresponding movements in Italy, Germany and America, requested the liberation of the nation and the establishment of an independent national state. Published topics in the British press regarding the Greek Revolution, focused on : a) the right of the Greeks to claim their freedom from Turkish domination in order to establish an independent state based on the principle of national autonomy, b) criticism regarding Turkish rule as illegal and the power of the Ottoman Sultan as arbitrary, c) the recognition of the Greek identity and its distinction from the Turkish one and d) the endorsement Greeks as the descendants of ancient Greeks. The advantage of newspaper as a media is sharing information and ideas and dealing with issues in greater depth and detail, unlike other media, such as radio or television. The London Times is a print publication that presents, in chronological or thematic order, the news, opinions or announcements about the most important events that have occurred in a place during a specified period of time. This paper employs the rich archive of The London Times archive by quoting extracts from publications of that period, to convey the British public perspective regarding the Greek Revolution from its beginning until the London Protocol of 1828. Furthermore, analyses the publications of the British newspaper in terms of the number of references to the Greek revolution, front page and editorial references as well as the size of publications on the revolution during the period 1821-1828. A combination of qualitative and quantitative content analysis was applied. An attempt was made to record Greek Revolution references along with the usage of specific words and expressions that contribute to the representation of the historical events and their exposure to the reading public. Key finds of this research reveal that a) there was a frequency of passionate daily articles concerning the events in Greece, their length, and context in The London Times, b) the British public opinion was influenced by this particular newspaper and c) the newspaper published various news about the revolution by adopting the role of animator of the Greek struggle. For instance, war events and the battles of Wallachin and Moldavia, Hydra, Crete, Psara, Mesollogi, Peloponnese were presented not only for informing the readers but for promoting the essential need for freedom and the establishment of an independent Greek state. In fact, this type of news was the main substance of the The London Times’ structure, establishing a positive image about the Greek Revolution contributing to the European diplomatic development such as the standpoint of France, - that did not wish to be detached from the conclusions regarding the English loans and the death of Alexander I of Russia and his succession by the ambitious Nicholas. These factors offered a change in the attitude of the British and Russians respectively assuming a positive approach towards Greece. The Great Powers maintained a neutral position in the Greek-Ottoman conflict, same time they engaged in Greek power increasement by offering aid.

Keywords: Greece, revolution, newspaper, the London times, London, great britain, mass media

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Authors: Jingsi Li, Neil S. Ferguson

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Time pressure could have an influence on the productivity, quality of decision making, and the efficiency of problem-solving. This has been mostly stemmed from cognitive research or psychological literature. However, a salient scarce discussion has been held for transport adjacent fields. It is conceivable that in many activity-travel contexts, time pressure is a potentially important factor since an excessive amount of decision time may incur the risk of late arrival to the next activity. The activity-travel rescheduling behavior is commonly explained by costs and benefits of factors such as activity engagements, personal intentions, social requirements, etc. This paper hypothesizes that an additional factor of perceived time pressure could affect travelers’ rescheduling behavior, thus leading to an impact on travel demand management. Time pressure may arise from different ways and is assumed here to be essentially incurred due to travelers planning their schedules without an expectation of unforeseen elements, e.g., transport disruption. In addition to a linear-additive utility-maximization model, the less computationally compensatory heuristic models are considered as an alternative to simulate travelers’ responses. The paper will contribute to travel behavior modeling research by investigating the following questions: how to measure the time pressure properly in an activity-travel day plan context? How do travelers reschedule their plans to cope with the time pressure? How would the importance of the activity affect travelers’ rescheduling behavior? What will the behavioral model be identified to describe the process of making activity-travel rescheduling decisions? How do these identified coping strategies affect the transport network? In this paper, a Mixed Heuristic Model (MHM) is employed to identify the presence of different choice heuristics through a latent class approach. The data about travelers’ activity-travel rescheduling behavior is collected via a web-based interactive survey where a fictitious scenario is created comprising multiple uncertain events on the activity or travel. The experiments are conducted in order to gain a real picture of activity-travel reschedule, considering the factor of time pressure. The identified behavioral models are then integrated into a multi-agent transport simulation model to investigate the effect of the rescheduling strategy on the transport network. The results show that an increased proportion of travelers use simpler, non-compensatory choice strategies instead of compensatory methods to cope with time pressure. Specifically, satisfying - one of the heuristic decision-making strategies - is adopted commonly since travelers tend to abandon the less important activities and keep the important ones. Furthermore, the importance of the activity is found to increase the weight of negative information when making trip-related decisions, especially route choices. When incorporating the identified non-compensatory decision-making heuristic models into the agent-based transport model, the simulation results imply that neglecting the effect of perceived time pressure may result in an inaccurate forecast of choice probability and overestimate the affectability to the policy changes.

Keywords: activity-travel rescheduling, decision making under uncertainty, mixed heuristic model, perceived time pressure, travel demand management

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Authors: G. Cunningham, E. Cantor, X. Wu, F. Shen, G. Jiang, S. Philips, C. Bales, Y. Xiao, T. R. Cummins, J. C. Fehrenbacher, B. P. Schneider

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Background: Taxane-induced peripheral neuropathy (TIPN) is the most devastating survivorship issue for patients receiving therapy. Dose reductions due to TIPN in the curative setting lead to inferior outcomes for African American patients, as prior research has shown that this group is more susceptible to developing severe neuropathy. The mechanistic underpinnings of TIPN, however, have not been entirely elucidated. While it would be appealing to use primary tissue to study the development of TIPN, procuring nerves from patients is not realistically feasible, as nerve biopsies are painful and may result in permanent damage. Therefore, our laboratory has investigated paclitaxel-induced neuronal morphological and molecular changes using an ex vivo model of human-induced pluripotent stem cell (iPSC)-derived neurons. Methods: iPSCs are undifferentiated and endlessly dividing cells that can be generated from a patient’s somatic cells, such as peripheral blood mononuclear cells (PBMCs). We successfully reprogrammed PBMCs into iPSCs using the Erythroid Progenitor Reprograming Kit (STEMCell Technologiesᵀᴹ); pluripotency was verified by flow cytometry analysis. iPSCs were then induced into neurons using a differentiation protocol that bypasses the neural progenitor stage and uses selected small-molecule modulators of key signaling pathways (SMAD, Notch, FGFR1 inhibition, and Wnt activation). Results: Flow cytometry analysis revealed expression of core pluripotency transcription factors Nanog, Oct3/4 and Sox2 in iPSCs overlaps with commercially purchased pluripotent cell line UCSD064i-20-2. Trilineage differentiation of iPSCs was confirmed with immunofluorescent imaging with germ-layer-specific markers; Sox17 and ExoA2 for ectoderm, Nestin, and Pax6 for mesoderm, and Ncam and Brachyury for endoderm. Sensory neuron markers, β-III tubulin, and Peripherin were applied to stain the cells for the maturity of iPSC-derived neurons. Patch-clamp electrophysiology and calcitonin gene-related peptide (CGRP) release data supported the functionality of the induced neurons and provided insight into the timing for which downstream assays could be performed (week 4 post-induction). We have also performed a cell viability assay and fluorescence-activated cell sorting (FACS) using four cell-surface markers (CD184, CD44, CD15, and CD24) to select a neuronal population. At least 70% of the cells were viable in the isolated neuron population. Conclusion: We have found that these iPSC-derived neurons recapitulate mature neuronal phenotypes and demonstrate functionality. Thus, this represents a patient-derived ex vivo neuronal model to investigate the molecular mechanisms of clinical TIPN.

Keywords: chemotherapy, iPSC-derived neurons, peripheral neuropathy, taxane, paclitaxel

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Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar

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Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.

Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement

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