Search results for: equipercentile equating

Authors: Steven W. Carruthers

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The purpose of the present research is to equate two test forms as part of a study to evaluate the educational effectiveness of the ARTé: Mecenas art history learning game. The researcher applied Item Response Theory (IRT) procedures to calculate item, test, and mean-sigma equating parameters. With the sample size n=134, test parameters indicated “good” model fit but low Test Information Functions and more acute than expected equating parameters. Therefore, the researcher applied equipercentile equating and linear equating to raw scores and compared the equated form parameters and effect sizes from each method. Item scaling in IRT enables the researcher to select a subset of well-discriminating items. The mean-sigma step produces a mean-slope adjustment from the anchor items, which was used to scale the score on the new form (Form R) to the reference form (Form Q) scale. In equipercentile equating, scores are adjusted to align the proportion of scores in each quintile segment. Linear equating produces a mean-slope adjustment, which was applied to all core items on the new form. The study followed a quasi-experimental design with purposeful sampling of students enrolled in a college level art history course (n=134) and counterbalancing design to distribute both forms on the pre- and posttests. The Experimental Group (n=82) was asked to play ARTé: Mecenas online and complete Level 4 of the game within a two-week period; 37 participants completed Level 4. Over the same period, the Control Group (n=52) did not play the game. The researcher examined between group differences from post-test scores on test Form Q and Form R by full-factorial Two-Way ANOVA. The raw score analysis indicated a 1.29% direct effect of form, which was statistically non-significant but may be practically significant. The researcher repeated the between group differences analysis with all three equating methods. For the IRT mean-sigma adjusted scores, form had a direct effect of 8.39%. Mean-sigma equating with a small sample may have resulted in inaccurate equating parameters. Equipercentile equating aligned test means and standard deviations, but resultant skewness and kurtosis worsened compared to raw score parameters. Form had a 3.18% direct effect. Linear equating produced the lowest Form effect, approaching 0%. Using linearly equated scores, the researcher conducted an ANCOVA to examine the effect size in terms of prior knowledge. The between group effect size for the Control Group versus Experimental Group participants who completed the game was 14.39% with a 4.77% effect size attributed to pre-test score. Playing and completing the game increased art history knowledge, and individuals with low prior knowledge tended to gain more from pre- to post test. Ultimately, researchers should approach test equating based on their theoretical stance on Classical Test Theory and IRT and the respective  assumptions. Regardless of the approach or method, test equating requires a representative sample of sufficient size. With small sample sizes, the application of a range of equating approaches can expose item and test features for review, inform interpretation, and identify paths for improving instruments for future study.

Keywords: effectiveness, equipercentile equating, IRT, learning games, linear equating, mean-sigma equating

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Authors: Jiya Mohammed, Tsadu Shuaib, Yusuf Abdulhakeem

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The research work focuses on the cases of MHD boundary layer flow past a stretching plate with heat transfer and viscous dissipation. The non-linear of momentum and energy equation are transform into ordinary differential equation by using similarity transformation, the resulting equation are solved using Adomian Decomposition Method (ADM). An attempt has been made to show the potentials and wide range application of the Adomian decomposition method in the comparison with the previous one in solving heat transfer problems. The Pade approximates value (η= 11[11, 11]) is use on the difficulty at infinity. The results are compared by numerical technique method. A vivid conclusion can be drawn from the results that ADM provides highly precise numerical solution for non-linear differential equations. The result where accurate especially for η ≤ 4, a general equating terms of Eckert number (Ec), Prandtl number (Pr) and magnetic parameter ( ) is derived which was used to investigate velocity and temperature profiles in boundary layer.

Keywords: MHD, Adomian decomposition, boundary layer, viscous dissipation

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Authors: Prasanna Kumar Khaund, Sukanya Talukdar

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A concrete gravity dam is a major hydraulic structure and it is very essential to consider the earthquake forces, to get a proper design base width, so that the entire weight of the dam resists the overturning moment due to earthquake and other forces. The main objective of this study is to obtain the design base width of a dam for different seismic conditions by varying the earthquake coefficients in both vertical and horizontal directions. This shall be done by equating the factor of safety against overturning, factor of safety against sliding and factor of safety against shear friction factor for a dam with their limiting values, under both tail water and no tail water condition. The shape of the Mettur dam in India is considered for the study. The study has been done taking a constant head of water at the reservoir, which is the maximum reservoir water level and a constant height of tail water. Using linear approximation method of Newton Raphson, the obtained equations against different factors of safety under different earthquake conditions are solved using a programme in C++ to get different values of base width of dam for varying earthquake conditions.

Keywords: design base width, horizontal earthquake coefficient, tail water, vertical earthquake coefficient

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Authors: Serge B. Provost

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Numerous statistical inference and modeling methodologies are based on sample moments rather than the actual observations. A result justifying the validity of this approach is introduced. More specifically, it will be established that given the first n moments of a sample of size n, one can recover the original n sample points. This implies that a sample of size n and its first associated n moments contain precisely the same amount of information. However, it is efficient to make use of a limited number of initial moments as most of the relevant distributional information is included in them. Two types of density estimation techniques that rely on such moments will be discussed. The first one expresses a density estimate as the product of a suitable base density and a polynomial adjustment whose coefficients are determined by equating the moments of the density estimate to the sample moments. The second one assumes that the derivative of the logarithm of a density function can be represented as a rational function. This gives rise to a system of linear equations involving sample moments, the density estimate is then obtained by solving a differential equation. Unlike kernel density estimation, these methodologies are ideally suited to model ‘big data’ as they only require a limited number of moments, irrespective of the sample size. What is more, they produce simple closed form expressions that are amenable to algebraic manipulations. They also turn out to be more accurate as will be shown in several illustrative examples.

Keywords: density estimation, log-density, polynomial adjustments, sample moments

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Authors: Caleb B. Sagwa, Tobias O. Okeno, Alexander K. Kahi

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Dairy cattle production plays an important role in the Kenyan economy. However, high incidences of mastitis is a major setback to the productivity in this industry. The current dairy cattle breeding objective in Kenya does not include mastitis resistance, mainly because the economic value of mastitis resistance has not been determined. Therefore this study aimed at estimating the economic value of mastitis resistance in dairy cattle in Kenya. Initial input parameters were obtained from literature on dairy cattle production systems in the tropics. Selection index methodology was used to derive the economic value of mastitis resistance. Somatic cell count (SCC) was used an indicator trait for mastitis resistance. The economic value was estimated relative to milk yield (MY). Economic values were assigned to SCC in a selection index such that the overall gain in the breeding goal trait was maximized. The option of estimating the economic value for SCC by equating the response in the trait of interest to its index response was considered. The economic value of mastitis resistance was US $23.64 while maximum response to selection for MY was US $66.01. The findings of this study provide vital information that is a pre-requisite for the inclusion of mastitis resistance in the current dairy cattle breeding goal in Kenya.

Keywords: somatic cell count, milk quality, payment system, breeding goal

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Authors: Zhenyu Yang, Qiunan Chen, Xiaocheng Huang

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Reliable prediction of tunnel collapse remains a prominent challenge in the field of civil engineering. In this study, leveraging the nonlinear Hoek-Brown failure criterion and the upper-bound theorem, an analytical solution for the collapse surface of shallowly buried circular tunnels was derived, taking into account the coupled effects of surface loads and pore water pressures. Initially, surface loads and pore water pressures were introduced as external force factors, equating the energy dissipation rate to the external force, yielding our objective function. Subsequently, the variational method was employed for optimization, and the outcomes were juxtaposed with previous research findings. Furthermore, we utilized the deduced equation set to systematically analyze the influence of various rock mass parameters on collapse shape and extent. To validate our analytical solutions, a comparison with prior studies was executed. The corroboration underscored the efficacy of our proposed methodology, offering invaluable insights for collapse risk assessment in practical engineering applications.

Keywords: tunnel roof stability, analytical solution, hoek–brown failure criterion, limit analysis

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Authors: Aishwarya Rai

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This study explores the transformative influence of generative AI on startups, businesses, and industries. We will explore how large businesses can benefit in the area of customer operations, where AI-powered chatbots can improve self-service and agent effectiveness, greatly increasing efficiency. In marketing and sales, generative AI could transform businesses by automating content development, data utilization, and personalization, resulting in a substantial increase in marketing and sales productivity. In software engineering-focused startups, generative AI can streamline activities, significantly impacting coding processes and work experiences. It can be extremely useful in product R&D for market analysis, virtual design, simulations, and test preparation, altering old workflows and increasing efficiency. Zooming into the retail and CPG industry, industry findings suggest a 1-2% increase in annual revenues, equating to $400 billion to $660 billion. By automating customer service, marketing, sales, and supply chain management, generative AI can streamline operations, optimizing personalized offerings and presenting itself as a disruptive force. While celebrating economic potential, we acknowledge challenges like external inference and adversarial attacks. Human involvement remains crucial for quality control and security in the era of generative AI-driven transformative innovation. This talk provides a comprehensive exploration of generative AI's pivotal role in reshaping businesses, recognizing its strategic impact on customer interactions, productivity, and operational efficiency.

Keywords: generative AI, digital transformation, LLM, artificial intelligence, startups, businesses

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Authors: André Rui Coelho Fernandes, Mariana Rufino, Divakar Hamal, Amr Sousa, Emma Fossett, Kamalpreet Cheema

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Aim: A single patella tendon rupture is relatively uncommon, but a simultaneous bilateral event is a rare occurrence and has been scarcely reviewed in the literature. This review was carried out to analyse the existing literature on this event, with the aim of proposing a standardised approach to the diagnosis and management of this injury. Methods: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three independent reviewers conducted searches in PubMed, OvidSP for Medline and Embase, as well as Cochrane Library using the same search strategy. From a total of 183 studies, 45 were included, i.e. 90 patellas. Results: 46 patellas had a Type 1 Rupture equating to 51%, with Type 3 being the least common, with only 7 patellas sustaining this injury. The mean Insall-Salvio ratio for each knee was 1.62 (R) and 1.60 (L) Direct Primary Repair was the most common surgical technique compared to Tendon Reconstruction, with End to End and Transosseous techniques split almost equally. Brace immobilisation was preferred over cast, with a mean start to weight-bearing of 3.23 weeks post-op. Conclusions: Bilateral patellar tendon rupture is a rare injury that should be considered in patients with knee extensor mechanism disruption. The key limitation of this study was the low number of patients encompassed by the eligible literature. There is space for a higher level of evidence study, specifically regarding surgical treatment choice and methods, as well as post-operative management, which could potentially improve the outcomes in the management of this injury.

Keywords: trauma and orthopaedic surgery, bilateral patella, tendon rupture, trauma

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Authors: María José Benitez Jimenez

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This study seeks to make clear the importance of family reunification in order to establish consolidated habits of coexistence of immigrants, directly favoring the relationship of the family nucleus and indirectly the social integration of foreigners. In addition to the theoretical analysis of the subject, information has been reviewed by the National Institute of Statistics and Reports of Spanish organizations that compile data on immigrants and specifically on family reunification. The Spanish regulations on foreigners include the right of foreigners legally residing in Spain to regroup their families. The general conditions required to exercise this right are having legally resided in Spain for one year and having obtained authorization to reside for one more year. There are exceptions to the requirement of having resided for one year in our country. Article 39 of the Spanish Constitution, although it does not express what is to be understood as a family, does refer to the fact that ‘the public authorities ensure the social, economic and legal protection of the family’. Therefore for the Spanish State, the family institution, in a broad sense, enjoys a privileged treatment that is revealed in the Supreme Norm and that reflects the interest of our society to address the relationships that subjects have in their immediate environment. Although we are aware of the reluctant position of the Spanish Constitutional Court to consider as a fundamental right the right to family life despite being enshrined in Article 8 of the European Convention on Human Rights, it is questionable whether access to authorization for family reunification should be more uniform in terms of requirements related to nationality, employment or training of applicants in order to have an egalitarian character. The requirement of having resided one year in Spain to be able to request successful family reunification seems dispensable because if foreigners can obviate this requirement by having a certain status, its abolition would be feasible by equating all situations and benefiting foreigners in general. The achievement of this proposal would help to strengthen the family life of immigrants from the beginning of their life in Spain.

Keywords: family, immigrants, social integration, reunification

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Authors: Chi S. Lee

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Marvel superhero movies have obtained its unprecedented popularity around the globe. It is a dominant narrative in current scholarship on superhero studies that the political trauma of America, such as attack of September 11, and the masculinity represented in superhero genre are symbolically connected in a way of remasculinization, a standardized plot that before becoming a superhero, a man has to overcome its trauma in his life. Through this standardized plot, American audience finds their pleasure in the spectatorship of equating this plot of remasculinization with the situation of America, rewriting their traumatic memory and resolving around the economic, social, political, and psychological instability of precarity in their own context. Shifting the context to Hong Kong, where Marvel superhero movies have been reaching its dominant status in the local film market, this analysis finds its limitation in explaining the connection between text and context. This article aims to retain this connection through investigation of the Hong Kong audience’s spectatorship. It is argued that the masculinity represented in Marvel superhero movies no longer fits into the stereotypical image of superhero, but presents itself in crisis. This crisis is resolved by the technological excess of the superpower, namely, technological remasculinization. The technological remasculinization offers a sense of futurity through which it is felt that this remasculinization can be achieved in the foreseeable future instead of remaining imaginary and fictional. In this way, the political crisis of Hong Kong is gendered as masculinity in crisis which is worth being remasculinized in the future. This gendering process is a historical product as the symbolic equation between politics and masculinity has for long been encoded in the colonial history of Hong Kong. In short, Marvel superhero’s masculinity offers a sense of masculine hope for the Hong Kong audiences to overcome the political crisis they confront in reality through a postponed identification with the superhero’s masculinity. After the discussion of the Hong Kong audience’s spectatorship on Marvel superhero movies with the insights casted by spectatorship theory, above idea is generated.

Keywords: political crisis in Hong Kong, Marvel superhero movies, spectatorship, technological remasculinization

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Authors: Shikhar Shrivastava, Varun Khare

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Background: We are confronted by a society that is becoming more complex, more mobile, and more dysfunctional. Teen pregnancy, suicide, elopement, and the perusal of dangerous drugs have become commonplace. In addition, children do not settle their disputes as they once did. Guns and knives are quotidian. Therefore, it has been an exigent to have a "Juvenile Code" that would provide specific substantive and procedural rules for juveniles in the justice system. However, until the twentieth century, there was little difference between how the justice system treated adults and children. Age was considered only in terms of appropriate punishment and juveniles were eligible for the same punishment as adults. Findings: The increased prevalence and legislative support for specialized courts, Juvenile Justice Boards, including juvenile drug, mental health and truancy court programs, as well as diversion programs and evidence-based approaches into the fabric of juvenile justice are just a few examples of recent advances. In India, various measures were taken to prosecute young offenders who committed violent crimes as adults. But it was argued that equating juveniles with adult criminals was neither scientifically correct nor normatively defensible. It would defeat the very purpose of the justice system. Methodology and Conclusion: This paper attempts to bring forth the results of analytical and descriptive research that examined changing trends in juvenile justice legislation. It covers the investigative and inspective practices of police, the various administrative agencies who have roles in implementing the legislation, the courts, and the detention centers. In this paper we shall discuss about how the juvenile justice system is the dumping ground for many of a youths’ problem. The changing notions of justice, from retributive to restorative and rehabilitative shall be discussed. A comparative study of the Juvenile act in India and that of the U.S has been discussed. Specific social institutions and forces that explain juvenile delinquency are identified. In addition, various influences on juvenile delinquency are noted, such as families, schools, peer groups and communities. The text concludes by addressing socialization, deterrence, imprisonments, alternatives, restitution and preventions.

Keywords: juvenile, justice system, retributive, rehabilitative, delinquency

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Authors: Matthew D. Baffa

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Infrared thermography is a non-destructive test method used to estimate surface temperatures based on the amount of electromagnetic energy radiated by building envelope components. These surface temperatures are indicators of various qualitative building envelope deficiencies such as locations and extent of heat loss, thermal bridging, damaged or missing thermal insulation, air leakage, and moisture presence in roof, floor, and wall assemblies. Although infrared thermography is commonly used for qualitative deficiency detection in buildings, this study assesses its use as a quantitative method to estimate the overall thermal conductance value (U-value) of the exterior above-grade walls of a study home. The overall U-value of exterior above-grade walls in a home provides useful insight into the energy consumption and thermal comfort of a home. Three methodologies from the literature were employed to estimate the overall U-value by equating conductive heat loss through the exterior above-grade walls to the sum of convective and radiant heat losses of the walls. Outdoor infrared thermography field measurements of the exterior above-grade wall surface and reflective temperatures and emissivity values for various components of the exterior above-grade wall assemblies were carried out during winter months at the study home using a basic thermal imager device. The overall U-values estimated from each methodology from the literature using the recorded field measurements were compared to the nominal exterior above-grade wall overall U-value calculated from materials and dimensions detailed in architectural drawings of the study home. The nominal overall U-value was validated through calendarization and weather normalization of utility bills for the study home as well as various estimated heat loss quantities from a HOT2000 computer model of the study home and other methods. Under ideal environmental conditions, the estimated overall U-values deviated from the nominal overall U-value between ±2% to ±33%. This study suggests infrared thermography can estimate the overall U-value of exterior above-grade walls in low-rise residential homes with a fair amount of accuracy.

Keywords: emissivity, heat loss, infrared thermography, thermal conductance

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Authors: T. Lydon, A. McNabola, P. Coughlan

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Energy consumption in the water distribution network (WDN) is a well established problem equating to the industry contributing heavily to carbon emissions, with 0.9 kg CO2 emitted per m3 of water supplied. It is indicated that 85% of energy wasted in the WDN can be recovered by installing turbines. Existing potential in networks is present at small capacity sites (5-10 kW), numerous and dispersed across networks. However, traditional turbine technology cannot be scaled down to this size in an economically viable fashion, thus alternative approaches are needed. This research aims to enable energy recovery potential within the WDN by exploring the potential of pumps-as-turbines (PATs), to realise this potential. PATs are estimated to be ten times cheaper than traditional micro-hydro turbines, presenting potential to contribute to an economically viable solution. However, a number of technical constraints currently prohibit their widespread use, including the inability of a PAT to control pressure, difficulty in the selection of PATs due to lack of performance data and a lack of understanding on how PATs can cater for fluctuations as extreme as +/- 50% of the average daily flow, characteristic of the WDN. A PAT prototype is undergoing testing in order to identify the capabilities of the technology. Results of preliminary testing, which involved testing the efficiency and power potential of the PAT for varying flow and pressure conditions, in order to develop characteristic and efficiency curves for the PAT and a baseline understanding of the technologies capabilities, are presented here: •The limitations of existing selection methods which convert BEP from pump operation to BEP in turbine operation was highlighted by the failure of such methods to reflect the conditions of maximum efficiency of the PAT. A generalised selection method for the WDN may need to be informed by an understanding of impact of flow variations and pressure control on system power potential capital cost, maintenance costs, payback period. •A clear relationship between flow and efficiency rate of the PAT has been established. The rate of efficiency reductions for flows +/- 50% BEP is significant and more extreme for deviations in flow above the BEP than below, but not dissimilar to the reaction of efficiency of other turbines. •PAT alone is not sufficient to regulate pressure, yet the relationship of pressure across the PAT is foundational in exploring ways which PAT energy recovery systems can maintain required pressure level within the WDN. Efficiencies of systems of PAT energy recovery systems operating conditions of pressure regulation, which have been conceptualise in current literature, need to be established. Initial results guide the focus of forthcoming testing and exploration of PAT technology towards how PATs can form part of an efficiency energy recovery system.

Keywords: energy recovery, pump-as-turbine, water distribution network, water distribution network

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Authors: Magdalena Zabrocka

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The terror of women throughout the governance of the current populist ruling party in Poland, PiS, has been a subject of a heated debate alongside the issues of minorities’ rights, the rule of law, and democracy in the country. The challenges that women and other vulnerable groups are currently facing, however, come down to more than just a lack of comprehensive equality laws, severely limited reproductive rights, hateful slogans, and messages propagated by the central authority and its sympathisers, or a common disregard for women’s fundamental rights. Many sources and media reports are available only in Polish, while international rapporteurs fail to acknowledge the whole picture of the tragedy happening in the country and the variety of factors affecting it. Starting with the authorities’ and Polish catholic church’s propaganda concerning CEDAW and the Istanbul Convention Action against Violence against Women and Domestic Violence by spreading strategic disinformation that it codifies ‘gender ideology’ and ‘anti-Christian values’ in order to convince the electorate that the legal instruments should be ‘abandoned’. Alongside severely restricted abortion rights, bullying medical professionals helping women exercise their reproductive rights, violating women’s privacy by introducing a mandatory registry of pregnancies (so that one’s pregnancy or its ‘loss’ can be tracked and traced), restricting access to the ‘day after pill’ and real sex education at schools (most schools have a subject of ‘knowledge of living in a family’), introducing prison punishment for teachers accused of spreading ‘sex education’, and many other, the current tyrant government, has now decided to target the youngest with its misinformation and indoctrination, via strategically designed textbooks and curriculum. Biology books have seen a big restriction on the size of the chapters devoted to evolution, reproductive system, and sexual health. Approved religion books (which are taught 2-3 times a week as compared to 1 a week sciences) now cover false information about Darwin’s theory and arguments ‘against it’. Most recently, however, the public spoke up against the absurd messages contained in the politically rewritten history books, where the material about some figures not liked by the governing party has already been manipulated. In the recently approved changes to the history textbook, one can find a variety of strongly biased and politically-charged views representative of the conservatives in the states, most notably, equating the ‘gender ideology’ and feminism with Nazism. Thus, this work, by employing a human rights approach, would focus on the right to education and development as well as the considerate obstacles to access to scientific information by the youth.

Keywords: Poland, right to education, right to development, authoritarianism, access to information

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Authors: Krishmali N. Ekanayake, Brendan J. Holland, Colin J. Barrow, Rick Wood

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Globally, more than one-third of all food produced is lost or wasted, equating to 1.3 billion tonnes per year. Around 31.2 million tonnes of food waste are generated across the production, supply, and consumption chain in Australia. Generally, the food waste management processes adopt environmental-friendly and more sustainable approaches such as composting, anerobic digestion and energy implemented technologies. However, unavoidable, and non-recyclable food waste ends up as landfilling and incineration that involve many undesirable impacts and challenges on the environment. A biorefinery approach contributes to a waste-minimising circular economy by converting food and other organic biomass waste into valuable outputs, including feeds, nutrition, fertilisers, and biomaterials. As a solution, Green Eco Technologies has developed a food waste treatment process using WasteMaster system. The system uses charged oxygen and moderate temperatures to convert food waste, without bacteria, additives, or water, into a virtually odour-free, much reduced quantity of reusable residual material. In the context of a biorefinery, the WasteMaster dries and mills food waste into a form suitable for storage or downstream extraction/separation/concentration to create products. The focus of the study is to determine the nutritional composition of WasteMaster processed residue to potential develop aquafeed ingredients. The global aquafeed industry is projected to reach a high value market in future, which has shown high demand for the aquafeed products. Therefore, food waste can be utilized for aquaculture feed development by reducing landfill. This framework will lessen the requirement of raw crops cultivation for aquafeed development and reduce the aquaculture footprint. In the present study, the nutritional elements of processed residue are consistent with the input food waste type, which has shown that the WasteMaster is not affecting the expected nutritional distribution. The macronutrient retention values of protein, lipid, and nitrogen free extract (NFE) are detected >85%, >80%, and >95% respectively. The sensitive food components including omega 3 and omega 6 fatty acids, amino acids, and phenolic compounds have been found intact in each residue material. Preliminary analysis suggests a price comparability with current aquafeed ingredient cost making the economic feasibility. The results suggest high potentiality of aquafeed development as 5 to 10% of the ingredients to replace/partially substitute other less sustainable ingredients across biorefinery setting. Our aim is to improve the sustainability of aquaculture and reduce the environmental impacts of food waste.

Keywords: biorefinery, ffood waste residue, input, wasteMaster

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Authors: Saheed Shittu, Lolwa Alansari, Fahed Nattouf, Tawa Olukade, Naji Abdallah, Tamara Alshdafat, Sarra Amdouni

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Cesarean sections (CS), a highly regarded surgical intervention for improving fetal-maternal outcomes and serving as an integral part of emergency obstetric services, are not without complications. Although CS has many advantages, it poses significant risks to both mother and child and increases healthcare expenditures in the long run. The escalating global prevalence of CS, coupled with variations in rates among immigrant populations, has prompted an inquiry into the correlation between CS rates and the nationalities of women undergoing deliveries at Al-Wakra Hospital (AWH), Qatar's second-largest public maternity hospital. This inquiry is motivated by the notable CS rate of 36%, deemed high in comparison to the 34% recorded across other Hamad Medical Corporation (HMC) maternity divisions This is Qatar's first comprehensive investigation of Caesarean section rates and nationalities. A retrospective cross-sectional study was conducted, and data for all births delivered in 2019 were retrieved from the hospital's electronic medical records. The CS rate, the crude rate, and adjusted risks of Caesarean delivery for mothers from each nationality were determined. The common indications for CS were analysed based on nationality. The association between nationality and Caesarean rates was examined using binomial logistic regression analysis considering Qatari women as a standard reference group. The correlation between the CS rate in the country of nationality and the observed CS rate in Qatar was also examined using Pearson's correlation. This study included 4,816 births from 69 different nationalities. CS was performed in 1767 women, equating to 36.5%. The nationalities with the highest CS rates were Egyptian (49.6%), Lebanese (45.5%), Filipino and Indian (both 42.2%). Qatari women recorded a CS rate of 33.4%. The major indication for elective CS was previous multiple CS (39.9%) and one prior CS, where the patient declined vaginal birth after the cesarean (VBAC) option (26.8%). A distinct pattern was noticed: elective CS was predominantly performed on Arab women, whereas emergency CS was common among women of Asian and Sub-Saharan African nationalities. Moreover, a significant correlation was found between the CS rates in Qatar and the women's countries of origin. Also, a high CS rate was linked to instances of previous CS. As a result of these insights, strategic interventions were successfully implemented at the facility to mitigate unwarranted CS, resulting in a notable reduction in CS rate from 36.5% in 2019 to 34% in 2022. This proves the efficacy of the meticulously researched approach. The focus has now shifted to reducing primary CS rates and facilitating well-informed decisions regarding childbirth methods.

Keywords: maternal nationality, caesarean section rate variation, migrants, high-income country

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Authors: Frederick Huie, Lauren Fusfeld, William Burchenal, Scott Howell, Alyssa McVey, Thomas F. Goss

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Alzheimer’s Disease (AD) is a degenerative brain disease characterized by memory loss and cognitive decline that presents a substantial economic burden for patients and health insurers in the US. This study evaluates the payer budget impact of the DISCERN™ test in the diagnosis and management of patients with symptoms of dementia evaluated for AD. DISCERN™ comprises three assays that assess critical factors related to AD that regulate memory, formation of synaptic connections among neurons, and levels of amyloid plaques and neurofibrillary tangles in the brain and can provide a quicker, more accurate diagnosis than tests in the current diagnostic pathway (CDP). An Excel-based model with a three-year horizon was developed to assess the budget impact of DISCERN™ compared with CDP in a Medicare Advantage plan with 1M beneficiaries. Model parameters were identified through a literature review and were verified through consultation with clinicians experienced in diagnosis and management of AD. The model assesses direct medical costs/savings for patients based on the following categories: •Diagnosis: costs of diagnosis using DISCERN™ and CDP. •False Negative (FN) diagnosis: incremental cost of care avoidable with a correct AD diagnosis and appropriately directed medication. •True Positive (TP) diagnosis: AD medication costs; cost from a later TP diagnosis with the CDP versus DISCERN™ in the year of diagnosis, and savings from the delay in AD progression due to appropriate AD medication in patients who are correctly diagnosed after a FN diagnosis.•False Positive (FP) diagnosis: cost of AD medication for patients who do not have AD. A one-way sensitivity analysis was conducted to assess the effect of varying key clinical and cost parameters ±10%. An additional scenario analysis was developed to evaluate the impact of individual inputs. In the base scenario, DISCERN™ is estimated to decrease costs by $4.75M over three years, equating to approximately $63.11 saved per test per year for a cohort followed over three years. While the diagnosis cost is higher with DISCERN™ than with CDP modalities, this cost is offset by the higher overall costs associated with CDP due to the longer time needed to receive a TP diagnosis and the larger number of patients who receive a FN diagnosis and progress more rapidly than if they had received appropriate AD medication. The sensitivity analysis shows that the three parameters with the greatest impact on savings are: reduced sensitivity of DISCERN™, improved sensitivity of the CDP, and a reduction in the percentage of disease progression that is avoided with appropriate AD medication. A scenario analysis in which DISCERN™ reduces the utilization for patients of computed tomography from 21% in the base case to 16%, magnetic resonance imaging from 37% to 27% and cerebrospinal fluid biomarker testing, positive emission tomography, electroencephalograms, and polysomnography testing from 4%, 5%, 10%, and 8%, respectively, in the base case to 0%, results in an overall three-year net savings of $14.5M. DISCERN™ improves the rate of accurate, definitive diagnosis of AD earlier in the disease and may generate savings for Medicare Advantage plans.

Keywords: Alzheimer’s disease, budget, dementia, diagnosis.

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Authors: Rob Schindler

Abstract:

Industry-standard methods of mitigating erosion of seabed sediments rely on ‘hard engineering’ approaches which have numerous environmental shortcomings: (1) direct loss of habitat by smothering of benthic species, (2) disruption of sediment transport processes, damaging geomorphic and ecosystem functionality (3) generation of secondary erosion problems, (4) introduction of material that may propagate non-local species, and (5) provision of pathways for the spread of invasive species. Recent studies have also revealed the importance of biological cohesion, the result of naturally occurring extra-cellular polymeric substances (EPS), in stabilizing natural sediments. Mimicking the strong bonding kinetics through the deliberate addition of EPS to sediments – henceforth termed ‘biostabilisation’ - offers a means in which to mitigate against erosion induced by structures or episodic increases in hydrodynamic forcing (e.g. storms and floods) whilst avoiding, or reducing, hard engineering. Here we present unique experiments that systematically examine how biostabilisation reduces scour around a monopile in a current, a first step to realizing the potential of this new method of scouring reduction for a wide range of engineering purposes in aquatic substrates. Experiments were performed in Plymouth University’s recirculating sediment flume which includes a recessed scour pit. The model monopile was 0.048 m in diameter, D. Assuming a prototype monopile diameter of 2.0 m yields a geometric ratio of 41.67. When applied to a 10 m prototype water depth this yields a model depth, d, of 0.24 m. The sediment pit containing the monopile was filled with different biostabilised substrata prepared using a mixture of fine sand (D50 = 230 μm) and EPS (Xanthan gum). Nine sand-EPS mixtures were examined spanning EPS contents of 0.0% < b0 < 0.50%. Scour development was measured using a laser point gauge along a 530 mm centreline at 10 mm increments at regular periods over 5 h. Maximum scour depth and excavated area were determined at different time steps and plotted against time to yield equilibrium values. After 5 hours the current was stopped and a detailed scan of the final scour morphology was taken. Results show that increasing EPS content causes a progressive reduction in the equilibrium depth and lateral extent of scour, and hence excavated material. Very small amounts equating to natural communities (< 0.1% by mass) reduce scour rate, depth and extent of scour around monopiles. Furthermore, the strong linear relationships between EPS content, equilibrium scour depth, excavation area and timescales of scouring offer a simple index on which to modify existing scour prediction methods. We conclude that the biostabilisation of sediments with EPS may offer a simple, cost-effective and ecologically sensitive means of reducing scour in a range of contexts including OWFs, bridge piers, pipeline installation, and void filling in rock armour. Biostabilisation may also reduce economic costs through (1) Use of existing site sediments, or waste dredged sediments (2) Reduced fabrication of materials, (3) Lower transport costs, (4) Less dependence on specialist vessels and precise sub-sea assembly. Further, its potential environmental credentials may allow sensitive use of the seabed in marine protection zones across the globe.

Keywords: biostabilisation, EPS, marine, scour

Procedia PDF Downloads 139

Authors: Paul J. McKay

Abstract:

Large-scale genome-wide association studies (GWAS) investigating genetic contributions to sexual orientation and gender identity are largely lacking and may reduce stigma experienced in the LGBTQ+ community by providing an underlying biological explanation for queerness. While there is a growing consensus within the scientific community that genetic makeup contributes – at least in part – to sexual orientation and gender identity, there is a marked lack of genomics research exploring polygenic contributions to queerness. Based on recent (2019) findings from a large-scale GWAS investigating the genetic architecture of same-sex sexual behavior, and various additional peer-reviewed publications detailing novel insights into the molecular mechanisms of sexual orientation and gender identity, we hypothesize that sexual orientation and gender identity are complex, multifactorial, and polygenic; meaning that many genetic factors contribute to these phenomena, and environmental factors play a possible role through epigenetic modulation. In recent years, large-scale GWAS studies have been paramount to our modern understanding of many other complex human traits, such as in the case of autism spectrum disorder (ASD). Despite possible benefits of such research, including reduced stigma towards queer people, improved outcomes for LGBTQ+ in familial, socio-cultural, and political contexts, and improved access to healthcare (particularly for trans populations); important risks and considerations remain surrounding this type of research. To mitigate possibilities such as invalidation of the queer identities of existing LGBTQ+ individuals, genetic discrimination, or the possibility of euthanasia of embryos with a genetic predisposition to queerness (through reproductive technologies like IVF and/or gene-editing in utero), we propose a community-engaged research (CER) framework which emphasizes the privacy and confidentiality of research participants. Importantly, the historical legacy of scientific research attempting to pathologize queerness (in particular, falsely equating gender variance to mental illness) must be acknowledged to ensure any future research conducted in this realm does not propagate notions of homophobia, transphobia or stigma against queer people. Ultimately, in a world where same-sex sexual activity is criminalized in 69 UN member states, with 67 of these states imposing imprisonment, 8 imposing public flogging, 6 (Brunei, Iran, Mauritania, Nigeria, Saudi Arabia, Yemen) invoking the death penalty, and another 5 (Afghanistan, Pakistan, Qatar, Somalia, United Arab Emirates) possibly invoking the death penalty, the importance of this research cannot be understated, as finding a biological basis for queerness would directly oppose the harmful rhetoric that “being LGBTQ+ is a choice.” Anti-trans legislation is similarly widespread: In the United States in 2022 alone (as of Oct. 13), 155 anti-trans bills have been introduced preventing trans girls and women from playing on female sports teams, barring trans youth from using bathrooms and locker rooms that align with their gender identity, banning access to gender affirming medical care (e.g., hormone-replacement therapy, gender-affirming surgeries), and imposing legal restrictions on name changes. Understanding that a general lack of knowledge about the biological basis of queerness may be a contributing factor to the societal stigma faced by gender and sexual orientation minorities, we propose the initiation of large-scale GWAS studies investigating the genetic basis of gender identity and sexual orientation.

Keywords: genome-wide association studies (GWAS), sexual and gender minorities (SGM), polygenicity, community-engaged research (CER)

Procedia PDF Downloads 44