Search results for: formal definition
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1748

Search results for: formal definition

188 Motivations, Communication Dimensions, and Perceived Outcomes in the Multi-Sectoral Collaboration of the Visitor Management Program of Mount Makiling Forest Reserve in Los Banos, Laguna, Philippines

Authors: Charmaine B. Distor

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Collaboration has long been recognized in different fields, but there’s been little research on operationalizing it especially on a multi-sectoral setting as per the author’s best knowledge. Also, communication is one of the factors that is usually overlooked when studying it. Specifically, this study aimed to describe the organizational profile and tasks of collaborators in the visitor management program of Make It Makiling (MIM). It also identified the factors that motivated collaborators to collaborate in MIM while determining the communication dimensions in the collaborative process. It also determined the communication channels used by collaborators in MIM while identifying the outcomes of collaboration in MIM. This study also found out if a relationship exists between collaborators’ motivations for collaboration and their perceived outcomes of collaboration, and collaborators' communication dimensions and their perceived outcomes of collaboration. Lastly, it also provided recommendations to improve the communication in MIM. Data were gathered using a self-administered survey that was patterned after Mattessich and Monsey’s (1992) collaboration experience questionnaire. Interviews and secondary sources mainly provided by the Makiling Center for Mountain Ecosystems (MCME) were also used. From the seven MIM collaborating organizations that were selected through purposive sampling, 86 respondents were chosen. Then, data were analyzed through frequency counts, percentages, measures of central tendencies, and Pearson’s and Spearman rho correlations. Collaborators’ length of collaboration ranged from seven to twenty years. Furthermore, six out of seven of the collaborators were involved in the task of 'emergency, rescue, and communication'. For the other aspect of the antecedents, the history of previous collaboration efforts ranked as the highest rated motivation for collaboration. In line with this, the top communication dimension is the governance while perceived effectiveness garnered the highest overall average among the perceived outcomes of collaboration. Results also showed that the collaborators highly rely on formal communication channels. Meetings and memos were the most commonly used communication channels throughout all tasks under the four phases of MIM. Additionally, although collaborators have a high view towards their co-collaborators, they still rely on MCME to act as their manager in coordinating with one another indirectly. Based on the correlation analysis, antecedent (motivations)-outcome relationship generally had positive relationships. However, for the process (communication dimensions)-outcome relationship, both positive and negative relationships were observed. In conclusion, this study exhibited the same trend with existing literature which also used the same framework. For the antecedent-outcome relationship, it can be deduced that MCME, as the main organizer of MIM, can focus on these variables to achieve their desired outcomes because of the positive relationships. For the process-outcome relationship, MCME should also take note that there were negative relationships where an increase in the said communication dimension may result in a decrease in the desired outcome. Recommendations for further study include a methodology that contains: complete enumeration or any parametric sampling, a researcher-administered survey, and direct observations. These might require additional funding, but all may yield to richer data.

Keywords: antecedent-outcome relationship, carrying capacity, organizational communication, process-outcome relationship

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187 The Decision-Making Mechanisms of Tax Regulations

Authors: Nino Pailodze, Malkhaz Sulashvili, Vladimer Kekenadze, Tea Khutsishvili, Irma Makharashvili, Aleksandre Kekenadze

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In the nearest future among the important problems which Georgia has solve the most important is economic stability, that bases on fiscal policy and the proper definition of the its directions. The main source of the Budget revenue is the national income. The State uses taxes, loans and emission in order to create national income, were the principal weapon are taxes. As well as fiscal function of the fulfillment of the budget, tax systems successfully implement economic and social development and the regulatory functions of foreign economic relations. A tax is a mandatory, unconditional monetary payment to the budget made by a taxpayer in accordance with this Code, based on the necessary, nonequivalent and gratuitous character of the payment. Taxes shall be national and local. National taxes shall be the taxes provided for under this Code, the payment of which is mandatory across the whole territory of Georgia. Local taxes shall be the taxes provided for under this Code, introduced by normative acts of local self-government representative authorities (within marginal rates), the payment of which is mandatory within the territory of the relevant self-governing unit. National taxes have the leading role in tax systems, but also the local taxes have an importance role in tax systems. Exactly in the means of local taxes, the most part of the budget is formatted. National taxes shall be: income tax, profit tax, value added tax (VAT), excise tax, import duty, property tax shall be a local tax The property tax is one of the significant taxes in Georgia. The paper deals with the taxation mechanism that has been operated in Georgia. The above mention has the great influence in financial accounting. While comparing foreign legislation towards Georgian legislation we discuss the opportunity of using their experience. Also, we suggested recommendations in order to improve the tax system in financial accounting. In addition to accounting, which is regulated according the International Accounting Standards we have tax accounting, which is regulated by the Tax Code, various legal orders / regulations of the Minister of Finance. The rules are controlled by the tax authority, Revenue Service. The tax burden from the tax values are directly related to expenditures of the state from the emergence of the first day. Fiscal policy of the state is as well as expenditure of the state and decisions of taxation. In order to get the best and the most effective mobilization of funds, Government’s primary task is to decide the kind of taxation rules. Tax function is to reveal the substance of the act. Taxes have the following functions: distribution or the fiscal function; Control and regulatory functions. Foreign tax systems evolved in the different economic, political and social conditions influence. The tax systems differ greatly from each other: taxes, their structure, typing means, rates, the different levels of fiscal authority, the tax base, the tax sphere of action, the tax breaks.

Keywords: international accounting standards, financial accounting, tax systems, financial obligations

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186 Basic Life Support Training in Rural Uganda: A Mixed Methods Study of Training and Attitudes towards Resuscitation

Authors: William Gallagher, Harriet Bothwell, Lowri Evans, Kevin Jones

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Background: Worldwide, a third of adult deaths are caused by cardiovascular disease, a high proportion occurring in the developing world. Contributing to these poor outcomes are suboptimal assessments, treatments and monitoring of the acutely unwell patient. Successful training in trauma and neonates is recognised in the developing world but there is little literature supporting adult resuscitation. As far as the authors are aware no literature has been published on resuscitation training in Uganda since 2000 when a resuscitation training officer ran sessions in neonatal and paediatric resuscitation. The aim of this project was to offer training in Basic Life Support ( BLS) to staff and healthcare students based at Villa Maria Hospital in the Kalungu District, Central Uganda. This project was undertaken as a student selected component (SSC) offered by Swindon Academy, based at the Great Western Hospital, to medical students in their fourth year of the undergraduate programme. Methods: Semi-structured, informal interviews and focus groups were conducted with different clinicians in the hospital. These interviews were designed to focus on the level of training and understanding of BLS. A training session was devised which focused on BLS (excluding the use of an automatic external defribrillator) involving pre and post-training questionnaires and clinical assessments. Three training sessions were run for different cohorts: a pilot session for 5 Ugandan medical students, a second session for a group of 8 nursing and midwifery students and finally, a third was devised for physicians. The data collected was analysed in excel. Paired T-Tests determined statistical significance between pre and post-test scores and confidence before and after the sessions. Average clinical skill assessment scores were converted to percentages based on the area of BLS being assessed. Results: 27 participants were included in the analysis. 14 received ‘small group training’ whilst 13 received’ large group training’ 88% of all participants had received some form of resuscitation training. Of these, 46% had received theory training, 27% practical training and only 15% received both. 12% had received no training. On average, all participants demonstrated a significant increase of 5.3 in self-assessed confidence (p <0.05). On average, all participants thought the session was very useful. Analysis of qualitative date from clinician interviews in ongoing but identified themes identified include rescue breaths being considered the most important aspect resuscitation and doubts of a ‘good’ outcome from resuscitation. Conclusions: The results of this small study reflect the need for regular formal training in BLS in low resource settings. The active engagement and positive opinions concerning the utility of the training are promising as well as the evidence of improvement in knowledge.

Keywords: basic life support, education, resuscitation, sub-Saharan Africa, training, Uganda

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185 Cultural Heritage, Urban Planning and the Smart City in Indian Context

Authors: Paritosh Goel

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The conservation of historic buildings and historic Centre’s over recent years has become fully encompassed in the planning of built-up areas and their management following climate changes. The approach of the world of restoration, in the Indian context on integrated urban regeneration and its strategic potential for a smarter, more sustainable and socially inclusive urban development introduces, for urban transformations in general (historical centers and otherwise), the theme of sustainability. From this viewpoint, it envisages, as a primary objective, a real “green, ecological or environmental” requalification of the city through interventions within the main categories of sustainability: mobility, energy efficiency, use of sources of renewable energy, urban metabolism (waste, water, territory, etc.) and natural environment. With this the concept of a “resilient city” is also introduced, which can adapt through progressive transformations to situations of change which may not be predictable, behavior that the historical city has always been able to express. Urban planning on the other hand, has increasingly focused on analyses oriented towards the taxonomic description of social/economic and perceptive parameters. It is connected with human behavior, mobility and the characterization of the consumption of resources, in terms of quantity even before quality to inform the city design process, which for ancient fabrics, and mainly affects the public space also in its social dimension. An exact definition of the term “smart city” is still essentially elusive, since we can attribute three dimensions to the term: a) That of a virtual city, evolved based on digital networks and web networks b) That of a physical construction determined by urban planning based on infrastructural innovation, which in the case of historic Centre’s implies regeneration that stimulates and sometimes changes the existing fabric; c) That of a political and social/economic project guided by a dynamic process that provides new behavior and requirements of the city communities that orients the future planning of cities also through participation in their management. This paper is a preliminary research into the connections between these three dimensions applied to the specific case of the fabric of ancient cities with the aim of obtaining a scientific theory and methodology to apply to the regeneration of Indian historical Centre’s. The Smart city scheme if contextualize with heritage of the city it can be an initiative which intends to provide a transdisciplinary approach between various research networks (natural sciences, socio-economics sciences and humanities, technological disciplines, digital infrastructures) which are united in order to improve the design, livability and understanding of urban environment and high historical/cultural performance levels.

Keywords: historical cities regeneration, sustainable restoration, urban planning, smart cities, cultural heritage development strategies

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184 An Absolute Femtosecond Rangefinder for Metrological Support in Coordinate Measurements

Authors: Denis A. Sokolov, Andrey V. Mazurkevich

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In the modern world, there is an increasing demand for highly precise measurements in various fields, such as aircraft, shipbuilding, and rocket engineering. This has resulted in the development of appropriate measuring instruments that are capable of measuring the coordinates of objects within a range of up to 100 meters, with an accuracy of up to one micron. The calibration process for such optoelectronic measuring devices (trackers and total stations) involves comparing the measurement results from these devices to a reference measurement based on a linear or spatial basis. The reference used in such measurements could be a reference base or a reference range finder with the capability to measure angle increments (EDM). The base would serve as a set of reference points for this purpose. The concept of the EDM for replicating the unit of measurement has been implemented on a mobile platform, which allows for angular changes in the direction of laser radiation in two planes. To determine the distance to an object, a high-precision interferometer with its own design is employed. The laser radiation travels to the corner reflectors, which form a spatial reference with precisely known positions. When the femtosecond pulses from the reference arm and the measuring arm coincide, an interference signal is created, repeating at the frequency of the laser pulses. The distance between reference points determined by interference signals is calculated in accordance with recommendations from the International Bureau of Weights and Measures for the indirect measurement of time of light passage according to the definition of a meter. This distance is D/2 = c/2nF, approximately 2.5 meters, where c is the speed of light in a vacuum, n is the refractive index of a medium, and F is the frequency of femtosecond pulse repetition. The achieved uncertainty of type A measurement of the distance to reflectors 64 m (N•D/2, where N is an integer) away and spaced apart relative to each other at a distance of 1 m does not exceed 5 microns. The angular uncertainty is calculated theoretically since standard high-precision ring encoders will be used and are not a focus of research in this study. The Type B uncertainty components are not taken into account either, as the components that contribute most do not depend on the selected coordinate measuring method. This technology is being explored in the context of laboratory applications under controlled environmental conditions, where it is possible to achieve an advantage in terms of accuracy. In general, the EDM tests showed high accuracy, and theoretical calculations and experimental studies on an EDM prototype have shown that the uncertainty type A of distance measurements to reflectors can be less than 1 micrometer. The results of this research will be utilized to develop a highly accurate mobile absolute range finder designed for the calibration of high-precision laser trackers and laser rangefinders, as well as other equipment, using a 64 meter laboratory comparator as a reference.

Keywords: femtosecond laser, pulse correlation, interferometer, laser absolute range finder, coordinate measurement

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183 A Method Intensive Top-down Approach for Generating Guidelines for an Energy-Efficient Neighbourhood: A Case of Amaravati, Andhra Pradesh, India

Authors: Rituparna Pal, Faiz Ahmed

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Neighbourhood energy efficiency is a newly emerged term to address the quality of urban strata of built environment in terms of various covariates of sustainability. The concept of sustainability paradigm in developed nations has encouraged the policymakers for developing urban scale cities to envision plans under the aegis of urban scale sustainability. The concept of neighbourhood energy efficiency is realized a lot lately just when the cities, towns and other areas comprising this massive global urban strata have started facing a strong blow from climate change, energy crisis, cost hike and an alarming shortfall in the justice which the urban areas required. So this step of urban sustainability can be easily referred more as a ‘Retrofit Action’ which is to cover up the already affected urban structure. So even if we start energy efficiency for existing cities and urban areas the initial layer remains, for which a complete model of urban sustainability still lacks definition. Urban sustainability is a broadly spoken off word with end number of parameters and policies through which the loop can be met. Out of which neighbourhood energy efficiency can be an integral part where the concept and index of neighbourhood scale indicators, block level indicators and building physics parameters can be understood, analyzed and concluded to help emerge guidelines for urban scale sustainability. The future of neighbourhood energy efficiency not only lies in energy efficiency but also important parameters like quality of life, access to green, access to daylight, outdoor comfort, natural ventilation etc. So apart from designing less energy-hungry buildings, it is required to create a built environment which will create less stress on buildings to consume more energy. A lot of literary analysis has been done in the Western countries prominently in Spain, Paris and also Hong Kong, leaving a distinct gap in the Indian scenario in exploring the sustainability at the urban strata. The site for the study has been selected in the upcoming capital city of Amaravati which can be replicated with similar neighbourhood typologies in the area. The paper suggests a methodical intent to quantify energy and sustainability indices in detail taking by involving several macro, meso and micro level covariates and parameters. Several iterations have been made both at macro and micro level and have been subjected to simulation, computation and mathematical models and finally to comparative analysis. Parameters at all levels are analyzed to suggest the best case scenarios which in turn is extrapolated to the macro level finally coming out with a proposal model for energy efficient neighbourhood and worked out guidelines with significance and correlations derived.

Keywords: energy quantification, macro scale parameters, meso scale parameters, micro scale parameters

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182 Determination of Cyanotoxins from Leeukraal and Klipvoor Dams

Authors: Moletsane Makgotso, Mogakabe Elijah, Marrengane Zinhle

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South Africa’s water resources quality is becoming more and more weakened by eutrophication, which deteriorates its usability. Thirty five percent of fresh water resources are eutrophic to hypertrophic, including grossly-enriched reservoirs that go beyond the globally-accepted definition of hypertrophy. Failing infrastructure adds to the problem of contaminated urban runoff which encompasses an important fraction of flows to inland reservoirs, particularly in the non-coastal, economic heartland of the country. Eutrophication threatens the provision of potable and irrigation water in the country because of the dependence on fresh water resources. Eutrophicated water reservoirs increase water treatment costs, leads to unsuitability for recreational purposes and health risks to human and animal livelihood due to algal proliferation. Eutrophication is caused by high concentrations of phosphorus and nitrogen in water bodies. In South Africa, Microsystis and Anabaena are widely distributed cyanobacteria, with Microcystis being the most dominant bloom-forming cyanobacterial species associated with toxin production. Two impoundments were selected, namely the Klipvoor and Leeukraal dams as they are mainly used for fishing, recreational, agricultural and to some extent, potable water purposes. The total oxidized nitrogen and total phosphorus concentration were determined as causative nutrients for eutrophication. Chlorophyll a and total microcystins, as well as the identification of cyanobacteria was conducted as indicators of cyanobacterial infestation. The orthophosphate concentration was determined by subjecting the samples to digestion and filtration followed by spectrophotometric analysis of total phosphates and dissolved phosphates using Aquakem kits. The total oxidized nitrates analysis was conducted by initially conducting filtration followed by spectrophotometric analysis. Chlorophyll a was quantified spectrophotometrically by measuring the absorbance of before and after acidification. Microcystins were detected using the Quantiplate Microcystin Kit, as well as microscopic identification of cyanobacterial species. The Klipvoor dam was found to be hypertrophic throughout the study period as the mean Chlorophyll a concentration was 269.4µg/l which exceeds the mean value for the hypertrophic state. The mean Total Phosphorus concentration was >0.130mg/l, and the total microcystin concentration was > 2.5µg/l throughout the study. The most predominant algal species were found to be the Microcystis. The Leeukraal dam was found to be mesotrophic with the potential of it becoming eutrophic as the mean concentration for chlorophyll a was 18.49 µg/l with the mean Total Phosphorus > 0.130mg/l and the Total Microcystin concentration < 0.16µg/l. The cyanobacterial species identified in Leeukraal have been classified as those that do not pose a potential risk to any impoundment. Microcystis was present throughout the sampling period and dominant during the warmer seasons. The high nutrient concentrations led to the dominance of Microcystis that resulted in high levels of microcystins rendering the impoundments, particularly Klipvoor undesirable for utilisation.

Keywords: nitrogen, phosphorus, cyanobacteria, microcystins

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181 Approach-Avoidance Conflict in the T-Maze: Behavioral Validation for Frontal EEG Activity Asymmetries

Authors: Eva Masson, Andrea Kübler

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Anxiety disorders (AD) are the most prevalent psychological disorders. However, far from most affected individuals are diagnosed and receive treatment. This gap is probably due to the diagnosis criteria, relying on symptoms (according to the DSM-5 definition) with no objective biomarker. Approach-avoidance conflict tasks are one common approach to simulate such disorders in a lab setting, with most of the paradigms focusing on the relationships between behavior and neurophysiology. Approach-avoidance conflict tasks typically place participants in a situation where they have to make a decision that leads to both positive and negative outcomes, thereby sending conflicting signals that trigger the Behavioral Inhibition System (BIS). Furthermore, behavioral validation of such paradigms adds credibility to the tasks – with overt conflict behavior, it is safer to assume that the task actually induced a conflict. Some of those tasks have linked asymmetrical frontal brain activity to induced conflicts and the BIS. However, there is currently no consensus for the direction of the frontal activation. The authors present here a modified version of the T-Maze paradigm, a motivational conflict desktop task, in which behavior is recorded simultaneously to the recording of high-density EEG (HD-EEG). Methods: In this within-subject design, HD-EEG and behavior of 35 healthy participants was recorded. EEG data was collected with a 128 channels sponge-based system. The motivational conflict desktop task consisted of three blocks of repeated trials. Each block was designed to record a slightly different behavioral pattern, to increase the chances of eliciting conflict. This variety of behavioral patterns was however similar enough to allow comparison of the number of trials categorized as ‘overt conflict’ between the blocks. Results: Overt conflict behavior was exhibited in all blocks, but always for under 10% of the trials, in average, in each block. However, changing the order of the paradigms successfully introduced a ‘reset’ of the conflict process, therefore providing more trials for analysis. As for the EEG correlates, the authors expect a different pattern for trials categorized as conflict, compared to the other ones. More specifically, we expect an elevated alpha frequency power in the left frontal electrodes at around 200ms post-cueing, compared to the right one (relative higher right frontal activity), followed by an inversion around 600ms later. Conclusion: With this comprehensive approach of a psychological mechanism, new evidence would be brought to the frontal asymmetry discussion, and its relationship with the BIS. Furthermore, with the present task focusing on a very particular type of motivational approach-avoidance conflict, it would open the door to further variations of the paradigm to introduce different kinds of conflicts involved in AD. Even though its application as a potential biomarker sounds difficult, because of the individual reliability of both the task and peak frequency in the alpha range, we hope to open the discussion for task robustness for neuromodulation and neurofeedback future applications.

Keywords: anxiety, approach-avoidance conflict, behavioral inhibition system, EEG

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180 A Survey of Digital Health Companies: Opportunities and Business Model Challenges

Authors: Iris Xiaohong Quan

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The global digital health market reached 175 billion U.S. dollars in 2019, and is expected to grow at about 25% CAGR to over 650 billion USD by 2025. Different terms such as digital health, e-health, mHealth, telehealth have been used in the field, which can sometimes cause confusion. The term digital health was originally introduced to refer specifically to the use of interactive media, tools, platforms, applications, and solutions that are connected to the Internet to address health concerns of providers as well as consumers. While mHealth emphasizes the use of mobile phones in healthcare, telehealth means using technology to remotely deliver clinical health services to patients. According to FDA, “the broad scope of digital health includes categories such as mobile health (mHealth), health information technology (IT), wearable devices, telehealth and telemedicine, and personalized medicine.” Some researchers believe that digital health is nothing else but the cultural transformation healthcare has been going through in the 21st century because of digital health technologies that provide data to both patients and medical professionals. As digital health is burgeoning, but research in the area is still inadequate, our paper aims to clear the definition confusion and provide an overall picture of digital health companies. We further investigate how business models are designed and differentiated in the emerging digital health sector. Both quantitative and qualitative methods are adopted in the research. For the quantitative analysis, our research data came from two databases Crunchbase and CBInsights, which are well-recognized information sources for researchers, entrepreneurs, managers, and investors. We searched a few keywords in the Crunchbase database based on companies’ self-description: digital health, e-health, and telehealth. A search of “digital health” returned 941 unique results, “e-health” returned 167 companies, while “telehealth” 427. We also searched the CBInsights database for similar information. After merging and removing duplicate ones and cleaning up the database, we came up with a list of 1464 companies as digital health companies. A qualitative method will be used to complement the quantitative analysis. We will do an in-depth case analysis of three successful unicorn digital health companies to understand how business models evolve and discuss the challenges faced in this sector. Our research returned some interesting findings. For instance, we found that 86% of the digital health startups were founded in the recent decade since 2010. 75% of the digital health companies have less than 50 employees, and almost 50% with less than 10 employees. This shows that digital health companies are relatively young and small in scale. On the business model analysis, while traditional healthcare businesses emphasize the so-called “3P”—patient, physicians, and payer, digital health companies extend to “5p” by adding patents, which is the result of technology requirements (such as the development of artificial intelligence models), and platform, which is an effective value creation approach to bring the stakeholders together. Our case analysis will detail the 5p framework and contribute to the extant knowledge on business models in the healthcare industry.

Keywords: digital health, business models, entrepreneurship opportunities, healthcare

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179 Assessment of Food Safety Culture in Select Restaurants and a Produce Market in Doha, Qatar

Authors: Ipek Goktepe, Israa Elnemr, Hammad Asim, Hao Feng, Mosbah Kushad, Hee Park, Sheikha Alzeyara, Mohammad Alhajri

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Food safety management in Qatar is under the shared oversight of multiple agencies in two government ministries (Ministry of Public Health and Ministry of Municipality and Environment). Despite the increasing number and diversity of the food service establishments, no systematic food surveillance system is in place in the country, which creates a gap in terms of determining the food safety attitudes and practices applied in the food service operations. Therefore, this study seeks to partially address this gap through determination of food safety knowledge among food handlers, specifically with respect to food preparation and handling practices, and sanitation methods applied in food service providers (FSPs) and a major market in Doha, Qatar. The study covered a sample of 53 FSPs randomly selected out of 200 FSPs. Face-to-face interviews with managers at participating FSPs were conducted using a 40-questions survey. Additionally, 120 produce handlers who are in direct contact with fresh produce at the major produce market in Doha were surveyed using a questionnaire containing 21 questions. A written informed consent was obtained from each survey participant. The survey data were analyzed using the chi-square test and correlation test. The significance was evaluated at p ˂ 0.05. The results from the FSPs surveys indicated that the average age of FSPs was 11 years, with the oldest and newest being established in 1982 and 2015, respectively. Most managers (66%) had college degree and 68% of them were trained on the food safety management system known as HACCP. These surveys revealed that FSP managers’ training and education level were highly correlated with the probability of their employees receiving food safety training while managers with lower education level had no formal training on food safety for themselves nor for their employees. Casual sit-in and fine dine-in restaurants consistently kept records (100%), followed by fast food (36%), and catering establishments (14%). The produce handlers’ survey results showed that none of the workers had any training on safe produce handling practices. The majority of the workers were in the age range of 31-40 years (37%) and only 38% of them had high-school degree. Over 64% of produce handlers claimed to wash their hands 4-5 times per day but field observations pointed limited handwashing as there was soap in the settings. This observation suggests potential food safety risks since a significant correlation (p ˂ 0.01) between the educational level and the hand-washing practices was determined. This assessment on food safety culture through determination of food and produce handlers' level of knowledge and practices, the first of its kind in Qatar, demonstrated that training and education are important factors which directly impact the food safety culture in FSPs and produce markets. These findings should help in identifying the need for on-site training of food handlers for effective food safety practices in food establishments in Qatar.

Keywords: food safety, food safety culture, food service providers, food handlers

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178 Analyzing the Websites of Institutions Publishing Global Rankings of Universities: A Usability Study

Authors: Nuray Baltaci, Kursat Cagiltay

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University rankings which can be seen as nouveau topic are at the center of focus and followed closely by different parties. Students are interested in university rankings in order to make informed decisions about the selection of their candidate future universities. University administrators and academicians can utilize them to see and evaluate their universities’ relative performance compared to other institutions in terms of including but not limited to academic, economic, and international outlook issues. Local institutions may use those ranking systems, as TUBITAK (The Scientific and Technological Research Council of Turkey) and YOK (Council of Higher Education) do in Turkey, to support students and give scholarships when they want to apply for undergraduate and graduate studies abroad. When it is considered that the ranking systems are concerned by this many different parties, the importance of having clear, easy to use and well-designed websites by ranking institutions will be apprehended. In this paper, a usability study for the websites of four different global university ranking institutions, namely Academic Ranking of World Universities (ARWU), Times Higher Education, QS and University Ranking by Academic Performance (URAP), was conducted. User-based approach was adopted and usability tests were conducted with 10 graduate students at Middle East Technical University in Ankara, Turkey. Before performing the formal usability tests, a pilot study had been completed to reflect the necessary changes to the settings of the study. Participants’ demographics, task completion times, paths traced to complete tasks, and their satisfaction levels on each task and website were collected. According to the analyses of the collected data, those ranking websites were compared in terms of efficiency, effectiveness and satisfaction dimensions of usability as pointed in ISO 9241-11. Results showed that none of the selected ranking websites is superior to other ones in terms of overall effectiveness and efficiency of the website. However the only remarkable result was that the highest average task completion times for two of the designed tasks belong to the Times Higher Education Rankings website. Evaluation of the user satisfaction on each task and each website produced slightly different but rather similar results. When the satisfaction levels of the participants on each task are examined, it was seen that the highest scores belong to ARWU and URAP websites. The overall satisfaction levels of the participants for each website showed that the URAP website has highest score followed by ARWU website. In addition, design problems and powerful design features of those websites reported by the participants are presented in the paper. Since the study mainly tackles about the design problems of the URAP website, the focus is on this website. Participants reported 3 main design problems about the website which are unaesthetic and unprofessional design style of the website, improper map location on ranking pages, and improper listing of the field names on field ranking page.

Keywords: university ranking, user-based approach, website usability, design

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177 Developing Creative and Critically Reflective Digital Learning Communities

Authors: W. S. Barber, S. L. King

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This paper is a qualitative case study analysis of the development of a fully online learning community of graduate students through arts-based community building activities. With increasing numbers and types of online learning spaces, it is incumbent upon educators to continue to push the edge of what best practices look like in digital learning environments. In digital learning spaces, instructors can no longer be seen as purveyors of content knowledge to be examined at the end of a set course by a final test or exam. The rapid and fluid dissemination of information via Web 3.0 demands that we reshape our approach to teaching and learning, from one that is content-focused to one that is process-driven. Rather than having instructors as formal leaders, today’s digital learning environments require us to share expertise, as it is the collective experiences and knowledge of all students together with the instructors that help to create a very different kind of learning community. This paper focuses on innovations pursued in a 36 hour 12 week graduate course in higher education entitled “Critical and Reflective Practice”. The authors chronicle their journey to developing a fully online learning community (FOLC) by emphasizing the elements of social, cognitive, emotional and digital spaces that form a moving interplay through the community. In this way, students embrace anywhere anytime learning and often take the learning, as well as the relationships they build and skills they acquire, beyond the digital class into real world situations. We argue that in order to increase student online engagement, pedagogical approaches need to stem from two primary elements, both creativity and critical reflection, that are essential pillars upon which instructors can co-design learning environments with students. The theoretical framework for the paper is based on the interaction and interdependence of Creativity, Intuition, Critical Reflection, Social Constructivism and FOLCs. By leveraging students’ embedded familiarity with a wide variety of technologies, this case study of a graduate level course on critical reflection in education, examines how relationships, quality of work produced, and student engagement can improve by using creative and imaginative pedagogical strategies. The authors examine their professional pedagogical strategies through the lens that the teacher acts as facilitator, guide and co-designer. In a world where students can easily search for and organize information as self-directed processes, creativity and connection can at times be lost in the digitized course environment. The paper concludes by posing further questions as to how institutions of higher education may be challenged to restructure their credit granting courses into more flexible modules, and how students need to be considered an important part of assessment and evaluation strategies. By introducing creativity and critical reflection as central features of the digital learning spaces, notions of best practices in digital teaching and learning emerge.

Keywords: online, pedagogy, learning, communities

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176 Understanding How to Increase Restorativeness of Interiors: A Qualitative Exploratory Study on Attention Restoration Theory in Relation to Interior Design

Authors: Hande Burcu Deniz

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People in the U.S. spend a considerable portion of their time indoors. This makes it crucial to provide environments that support the well-being of people. Restorative environments aim to help people recover their cognitive resources that were spent due to intensive use of directed attention. Spending time in nature and taking a nap are two of the best ways to restore these resources. However, they are not possible to do most of the time. The problem is that many studies have revealed how nature and spending time in natural contexts can help boost restoration, but there are fewer studies conducted to understand how cognitive resources can be restored in interior settings. This study aims to explore the answer to this question: which qualities of interiors increase the restorativeness of an interior setting and how do they mediate restorativeness of an interior. To do this, a phenomenological qualitative study was conducted. The study was interested in the definition of attention restoration and the experiences of the phenomena. As the themes emerged, they were analyzed to match with Attention Restoration Theory components (being away, extent, fascination, compatibility) to examine how interior design elements mediate the restorativeness of an interior. The data was gathered from semi-structured interviews with international residents of Minnesota. The interviewees represent young professionals who work in Minnesota and often experience mental fatigue. Also, they have less emotional connections with places in Minnesota, which enabled data to be based on the physical qualities of a space rather than emotional connections. In the interviews, participants were asked about where they prefer to be when they experience mental fatigue. Next, they were asked to describe the physical qualities of the places they prefer to be with reasons. Four themes were derived from the analysis of interviews. The themes are in order according to their frequency. The first, and most common, the theme was “connection to outside”. The analysis showed that people need to be either physically or visually connected to recover from mental fatigue. Direct connection to nature was reported as preferable, whereas urban settings were the secondary preference along with interiors. The second theme emerged from the analysis was “the presence of the artwork,” which was experienced differently by the interviewees. The third theme was “amenities”. Interviews pointed out that people prefer to have the amenities that support desired activity during recovery from mental fatigue. The last theme was “aesthetics.” Interviewees stated that they prefer places that are pleasing to their eyes. Additionally, they could not get rid of the feeling of being worn out in places that are not well-designed. When we matched the themes with the four art components (being away, extent, fascination, compatibility), some of the interior qualities showed overlapping since they were experienced differently by the interviewees. In conclusion, this study showed that interior settings have restorative potential, and they are multidimensional in their experience.

Keywords: attention restoration, fatigue, interior design, qualitative study, restorative environments

Procedia PDF Downloads 219
175 Analysis of the Outcome of the Treatment of Osteoradionecrosis in Patients after Radiotherapy for Head and Neck Cancer

Authors: Petr Daniel Kovarik, Matt Kennedy, James Adams, Ajay Wilson, Andy Burns, Charles Kelly, Malcolm Jackson, Rahul Patil, Shahid Iqbal

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Introduction: Osteoradionecrosis (ORN) is a recognised toxicity of radiotherapy (RT) for head and neck cancer (HNC). Existing literature lacks any generally accepted definition and staging system for this toxicity. Objective: The objective is to analyse the outcome of the surgical and nonsurgical treatments of ORN. Material and Method: Data on 2303 patients treated for HNC with radical or adjuvant RT or RT-chemotherapy from January 2010 - December 2021 were retrospectively analysed. Median follow-up to the whole group of patients was 37 months (range 0–148 months). Results: ORN developed in 185 patients (8.1%). The location of ORN was as follows; mandible=170, maxilla=10, and extra oral cavity=5. Multiple ORNs developed in 7 patients. 5 patients with extra oral cavity ORN were excluded from treatment analysis as the management is different. In 180 patients with oral cavity ORN, median follow-up was 59 months (range 5–148 months). ORN healed in 106 patients, treatment failed in 74 patients (improving=10, stable=43, and deteriorating=21). Median healing time was 14 months (range 3-86 months). Notani staging is available in 158 patients with jaw ORN with no previous surgery to the mandible (Notani class I=56, Notani class II=27, and Notani class III=76). 28 ORN (mandible=27, maxilla=1; Notani class I=23, Notani II=3, Notani III=1) healed spontaneously with a median healing time 7 months (range 3–46 months). In 20 patients, ORN developed after dental extraction, in 1 patient in the neomandible after radical surgery as a part of the primary treatment. In 7 patients, ORN developed and spontaneously healed in irradiated bone with no previous surgical/dental intervention. Radical resection of the ORN (segmentectomy, hemi-mandibulectomy with fibula flap) was performed in 43 patients (all mandible; Notani II=1, Notani III=39, Notani class was not established in 3 patients as ORN developed in the neomandible). 27 patients healed (63%); 15 patients failed (improving=2, stable=5, deteriorating=8). The median time from resection to healing was 6 months (range 2–30 months). 109 patients (mandible=100, maxilla=9; Notani I=3, Notani II=23, Notani III=35, Notani class was not established in 9 patients as ORN developed in the maxilla/neomandible) were treated conservatively using a combination of debridement, antibiotics and Pentoclo. 50 patients healed (46%) with a median healing time 14 months (range 3–70 months), 59 patients are recorded with persistent ORN (improving=8, stable=38, deteriorating=13). Out of 109 patients treated conservatively, 13 patients were treated with Pentoclo only (all mandible; Notani I=6, Notani II=3, Notani III=3, 1 patient with neomandible). In total, 8 patients healed (61.5%), treatment failed in 5 patients (stable=4, deteriorating=1). Median healing time was 14 months (range 4–24 months). Extra orally (n=5), 3 cases of ORN were in the auditory canal and 2 in mastoid. ORN healed in one patient (auditory canal after 32 months. Treatment failed in 4 patients (improving=3, stable=1). Conclusion: The outcome of the treatment of ORN remains in general, poor. Every effort should therefore be made to minimise the risk of development of this devastating toxicity.

Keywords: head and neck cancer, radiotherapy, osteoradionecrosis, treatment outcome

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174 The Roles of Mandarin and Local Dialect in the Acquisition of L2 English Consonants Among Chinese Learners of English: Evidence From Suzhou Dialect Areas

Authors: Weijing Zhou, Yuting Lei, Francis Nolan

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In the domain of second language acquisition, whenever pronunciation errors or acquisition difficulties are found, researchers habitually attribute them to the negative transfer of the native language or local dialect. To what extent do Mandarin and local dialects affect English phonological acquisition for Chinese learners of English as a foreign language (EFL)? Little evidence, however, has been found via empirical research in China. To address this core issue, the present study conducted phonetic experiments to explore the roles of local dialects and Mandarin in Chinese EFL learners’ acquisition of L2 English consonants. Besides Mandarin, the sole national language in China, Suzhou dialect was selected as the target local dialect because of its distinct phonology from Mandarin. The experimental group consisted of 30 junior English majors at Yangzhou University, who were born and lived in Suzhou, acquired Suzhou Dialect since their early childhood, and were able to communicate freely and fluently with each other in Suzhou Dialect, Mandarin as well as English. The consonantal target segments were all the consonants of English, Mandarin and Suzhou Dialect in typical carrier words embedded in the carrier sentence Say again. The control group consisted of two Suzhou Dialect experts, two Mandarin radio broadcasters, and two British RP phoneticians, who served as the standard speakers of the three languages. The reading corpus was recorded and sampled in the phonetic laboratories at Yangzhou University, Soochow University and Cambridge University, respectively, then transcribed, segmented and analyzed acoustically via Praat software, and finally analyzed statistically via EXCEL and SPSS software. The main findings are as follows: First, in terms of correct acquisition rates (CARs) of all the consonants, Mandarin ranked top (92.83%), English second (74.81%) and Suzhou Dialect last (70.35%), and significant differences were found only between the CARs of Mandarin and English and between the CARs of Mandarin and Suzhou Dialect, demonstrating Mandarin was overwhelmingly more robust than English or Suzhou Dialect in subjects’ multilingual phonological ecology. Second, in terms of typical acoustic features, the average duration of all the consonants plus the voice onset time (VOT) of plosives, fricatives, and affricatives in 3 languages were much longer than those of standard speakers; the intensities of English fricatives and affricatives were higher than RP speakers but lower than Mandarin and Suzhou Dialect standard speakers; the formants of English nasals and approximants were significantly different from those of Mandarin and Suzhou Dialects, illustrating the inconsistent acoustic variations between the 3 languages. Thirdly, in terms of typical pronunciation variations or errors, there were significant interlingual interactions between the 3 consonant systems, in which Mandarin consonants were absolutely dominant, accounting for the strong transfer from L1 Mandarin to L2 English instead of from earlier-acquired L1 local dialect to L2 English. This is largely because the subjects were knowingly exposed to Mandarin since their nursery and were strictly required to speak in Mandarin through all the formal education periods from primary school to university.

Keywords: acquisition of L2 English consonants, role of Mandarin, role of local dialect, Chinese EFL learners from Suzhou Dialect areas

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173 [Keynote] Implementation of Quality Control Procedures in Radiotherapy CT Simulator

Authors: B. Petrović, L. Rutonjski, M. Baucal, M. Teodorović, O. Čudić, B. Basarić

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Purpose/Objective: Radiotherapy treatment planning requires use of CT simulator, in order to acquire CT images. The overall performance of CT simulator determines the quality of radiotherapy treatment plan, and at the end, the outcome of treatment for every single patient. Therefore, it is strongly advised by international recommendations, to set up a quality control procedures for every machine involved in radiotherapy treatment planning process, including the CT scanner/ simulator. The overall process requires number of tests, which are used on daily, weekly, monthly or yearly basis, depending on the feature tested. Materials/Methods: Two phantoms were used: a dedicated phantom CIRS 062QA, and a QA phantom obtained with the CT simulator. The examined CT simulator was Siemens Somatom Definition as Open, dedicated for radiation therapy treatment planning. The CT simulator has a built in software, which enables fast and simple evaluation of CT QA parameters, using the phantom provided with the CT simulator. On the other hand, recommendations contain additional test, which were done with the CIRS phantom. Also, legislation on ionizing radiation protection requires CT testing in defined periods of time. Taking into account the requirements of law, built in tests of a CT simulator, and international recommendations, the intitutional QC programme for CT imulator is defined, and implemented. Results: The CT simulator parameters evaluated through the study were following: CT number accuracy, field uniformity, complete CT to ED conversion curve, spatial and contrast resolution, image noise, slice thickness, and patient table stability.The following limits are established and implemented: CT number accuracy limits are +/- 5 HU of the value at the comissioning. Field uniformity: +/- 10 HU in selected ROIs. Complete CT to ED curve for each tube voltage must comply with the curve obtained at comissioning, with deviations of not more than 5%. Spatial and contrast resultion tests must comply with the tests obtained at comissioning, otherwise machine requires service. Result of image noise test must fall within the limit of 20% difference of the base value. Slice thickness must meet manufacturer specifications, and patient stability with longitudinal transfer of loaded table must not differ of more than 2mm vertical deviation. Conclusion: The implemented QA tests gave overall basic understanding of CT simulator functionality and its clinical effectiveness in radiation treatment planning. The legal requirement to the clinic is to set up it’s own QA programme, with minimum testing, but it remains user’s decision whether additional testing, as recommended by international organizations, will be implemented, so to improve the overall quality of radiation treatment planning procedure, as the CT image quality used for radiation treatment planning, influences the delineation of a tumor and calculation accuracy of treatment planning system, and finally delivery of radiation treatment to a patient.

Keywords: CT simulator, radiotherapy, quality control, QA programme

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172 The Messy and Irregular Experience of Entrepreneurial Life

Authors: Hannah Dean

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The growth ideology, and its association with progress, is an important construct in the narrative of modernity. This ideology is embedded in neoclassical economic growth theory which conceptualises growth as linear and predictable, and the entrepreneur as a rational economic manager. This conceptualisation has been critiqued for reinforcing the managerial discourse in entrepreneurship studies. Despite these critiques, both the neoclassical growth theory and its adjacent managerial discourse dominate entrepreneurship studies notably the literature on female entrepreneurs. The latter is the focus of this paper. Given this emphasis on growth, female entrepreneurs are portrayed as problematic because their growth lags behind their male counterparts. This image which ignores the complexity and diversity of female entrepreneurs’ experience persists in the literature due to the lack of studies that analyse the process and contextual factors surrounding female entrepreneurs’ experience. This study aims to address the subordination of female entrepreneurs by questioning the hegemonic logic of economic growth and the managerial discourse as a true representation for the entrepreneurial experience. This objective is achieved by drawing on Schumpeter’s theorising and narrative inquiry. This exploratory study undertakes in depth interviews to gain insights into female entrepreneurs’ experience and the impact of the economic growth model and the managerial discourse on their performance. The narratives challenge a number of assumptions about female entrepreneurs. The participants occupied senior positions in the corporate world before setting up their businesses. This is at odds with much writing which assumes that women underperform because they leave their career without gaining managerial experience to achieve work-life balance. In line with Schumpeter, who distinguishes the entrepreneur from the manager, the participants’ main function was innovation. They did not believe that the managerial paradigm governing their corporate careers was applicable to their entrepreneurial experience. Formal planning and managerial rationality can hinder their decision making process. The narratives point to the gap between the two worlds which makes stepping into entrepreneurship a scary move. Schumpeter argues that the entrepreneurial process is evolutionary and that failure is an integral part of it. The participants’ entrepreneurial process was in fact irregular. The performance of new combinations was not always predictable. They therefore relied on their initiative. The inhibition to deploy these traits had an adverse effect on business growth. The narratives also indicate that over-reliance on growth threaten the business survival as it faces competing pressures. The study offers theoretical and empirical contributions to (female) entrepreneurship studies by presenting Schumpeter’s theorising as an alternative theoretical framework to the neoclassical economic growth theory. The study also reduces entrepreneurs’ vulnerability by making them aware of the negative influence that the linear growth model and the managerial discourse hold upon their performance. The study has implications for policy makers as it generates new knowledge that incorporates the current social and economic changes in the context of entrepreneurs that can no longer be sustained by the linear growth models especially in the current economic climate.

Keywords: economic growth, female entrepreneurs, managerial discourse, Schumpeter

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171 Emphasis on Difference: Ethnic and National Cultural Heritage Identities and Issues in East Asia Focusing on Korea Cases

Authors: Hyuk-Jin Lee

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Even though 23 years have passed in the 21st century, nation-state and nationality-centered cultural identities are still the sentiments and ideologies that dominate the world. Nevertheless, as seen in many cases in Europe, a new perspective is needed to recognize mutual exchanges and influences and to view them as natural cultural exchanges between countries. The situation in East Asia is completely different from Europe. This is presumed to be from the long tradition of having an ethnocentric state concept for at least hundreds of years, quite different from Europe, where the concept of a nation-state was established relatively recently. In other words, unlike Europe, where active exchanges took place, the problem stems from the unique characteristics of East Asia, which has a strong tradition of finding its identity in 'difference'. Thus, it would not be hard to find cultural studies or news of the three East Asian countries emphasizing differences among one another. This applies to all cultural areas, including traditional architecture. For example, in the Korean traditional architecture field, buildings with effects from neighboring countries tend to be ignored, even if they are traditional Korean architecture. In addition to this, in the case of Korea, there seems to be one more cultural harmful aftereffect caused by the 36 years of Japanese colonial rule in the early 20th century; the obsessive filtering concept of 'it must be different from Japan'. In other words, the implicit ideological coercion that the definition of 'Korean cultural heritage' should not be influenced by exchanges with Japan may be found throughout Korean studies. The architectural and cultural aspects of the vast period of time, from the Three Kingdoms era to the beginning of Joseon, which was a period in which cultural influence exchanges with neighboring countries were relatively strong compared to the late Joseon Dynasty, also reflect the 'distorted filtering' caused by finding a repulsive identity against the Japanese colonial period. It is important to look the cultural heritage and traditions as they are inductively, not deductively. If not, we may often ignore or limit our own precious cultural heritage. Conversely, If Baekje, the ancient Korean Kingdom, helped Japan in construction and craftsmen played a big role in building the ancient temple, it would be a healthier perspective to view it as a cultural exchange rather than proudly seeing it as a cultural owner's perspective because this point of view is a proper reconstruction of our ancient and medieval Asian culture (strictly speaking, the color common to East Asia at the time). In particular, this study will examine this topic by giving specific examples from each field of Korean cultural studies. In the search for cultural identity, it would be more helpful for healthy relations between countries and collaborative research in the sensitive part of the interpretation of historical facts as well as cultural circles to minimize excessive meanings on originality and difference.

Keywords: cultural heritage identity, cultural ideology, East Asia, Korea

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170 Applications of Digital Tools, Satellite Images and Geographic Information Systems in Data Collection of Greenhouses in Guatemala

Authors: Maria A. Castillo H., Andres R. Leandro, Jose F. Bienvenido B.

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During the last 20 years, the globalization of economies, population growth, and the increase in the consumption of fresh agricultural products have generated greater demand for ornamentals, flowers, fresh fruits, and vegetables, mainly from tropical areas. This market situation has demanded greater competitiveness and control over production, with more efficient protected agriculture technologies, which provide greater productivity and allow us to guarantee the quality and quantity that is required in a constant and sustainable way. Guatemala, located in the north of Central America, is one of the largest exporters of agricultural products in the region and exports fresh vegetables, flowers, fruits, ornamental plants, and foliage, most of which were grown in greenhouses. Although there are no official agricultural statistics on greenhouse production, several thesis works, and congress reports have presented consistent estimates. A wide range of protection structures and roofing materials are used, from the most basic and simple ones for rain control to highly technical and automated structures connected with remote sensors for monitoring and control of crops. With this breadth of technological models, it is necessary to analyze georeferenced data related to the cultivated area, to the different existing models, and to the covering materials, integrated with altitude, climate, and soil data. The georeferenced registration of the production units, the data collection with digital tools, the use of satellite images, and geographic information systems (GIS) provide reliable tools to elaborate more complete, agile, and dynamic information maps. This study details a methodology proposed for gathering georeferenced data of high protection structures (greenhouses) in Guatemala, structured in four phases: diagnosis of available information, the definition of the geographic frame, selection of satellite images, and integration with an information system geographic (GIS). It especially takes account of the actual lack of complete data in order to obtain a reliable decision-making system; this gap is solved through the proposed methodology. A summary of the results is presented in each phase, and finally, an evaluation with some improvements and tentative recommendations for further research is added. The main contribution of this study is to propose a methodology that allows to reduce the gap of georeferenced data in protected agriculture in this specific area where data is not generally available and to provide data of better quality, traceability, accuracy, and certainty for the strategic agricultural decision öaking, applicable to other crops, production models and similar/neighboring geographic areas.

Keywords: greenhouses, protected agriculture, GIS, Guatemala, satellite image, digital tools, precision agriculture

Procedia PDF Downloads 169
169 Urban Planning Patterns after (COVID-19): An Assessment toward Resiliency

Authors: Mohammed AL-Hasani

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The Pandemic COVID-19 altered the daily habits and affected the functional performance of the cities after this crisis leaving remarkable impacts on many metropolises worldwide. It is so obvious that having more densification in the city leads to more threats altering this main approach that was called for achieving sustainable development. The main goal to achieve resiliency in the cities, especially in forcing risks, is to deal with a planning system that is able to resist, absorb, accommodate and recover from the impacts that had been affected. Many Cities in London, Wuhan, New York, and others worldwide carried different planning approaches and varied in reaction to safeguard the impacts of the pandemic. The cities globally varied from the radiant pattern predicted by Le Corbusier, or having multi urban centers more like the approach of Frank Lloyd Wright’s Broadacre City, or having linear growth or gridiron expansion that was common by Doxiadis, compact pattern, and many other hygiene patterns. These urban patterns shape the spatial distribution and Identify both open and natural spaces with gentrified and gentrifying areas. This crisis paid attention to reassess many planning approaches and examine the existing urban patterns focusing more on the aim of continuity and resiliency in managing the crises within the rapid transformation and the power of market forces. According to that, this paper hypothesized that those urban planning patterns determine the method of reaction in assuring quarantine for the inhabitance and the performance of public services and need to be updated through carrying out an innovative urban management system and adopt further resilience patterns in prospective urban planning approaches. This paper investigates the adaptivity and resiliency of variant urban planning patterns regarding selected cities worldwide that affected by COVID-19 and their role in applying certain management strategies in controlling the pandemic spread, finding out the main potentials that should be included in prospective planning approaches. The examination encompasses the spatial arrangement, blocks definition, plots arrangement, and urban space typologies. This paper aims to investigate the urban patterns to deliberate also the debate between densification as one of the more sustainable planning approaches and disaggregation tendency that was followed after the pandemic by restructuring and managing its application according to the assessment of the spatial distribution and urban patterns. The biggest long-term threat to dense cities proves the need to shift to online working and telecommuting, creating a mixture between using cyber and urban spaces to remobilize the city. Reassessing spatial design and growth, open spaces, urban population density, and public awareness are the main solutions that should be carried out to face the outbreak in our current cities that should be managed from global to tertiary levels and could develop criteria for designing the prospective cities

Keywords: COVID-19, densification, resiliency, urban patterns

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168 Identifying the Effects of the Rural Demographic Changes in the Northern Netherlands: A Holistic Approach to Create Healthier Environment

Authors: A. R. Shokoohi, E. A. M. Bulder, C. Th. van Alphen, D. F. den Hertog, E. J. Hin

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The Northern region of the Netherlands has beautiful landscapes, a nice diversity of green and blue areas, and dispersed settlements. However, some recent population changes can become threats to health and wellbeing in these areas. The rural areas in the three northern provinces -Groningen, Friesland, and Drenthe, see youngsters leave the region for which reason they are aging faster than other regions in the Netherlands. As a result, some villages have faced major population decline that is leading to loss of facilities/amenities and a decrease in accessibility and social cohesion. Those who still live in these villages are relatively old, low educated and have low-income. To develop a deeper understanding of the health status of the people living in these areas, and help them to improve their living environment, the GO!-Method is being applied in this study. This method has been developed by the National Institute for Public Health and the Environment (RIVM) of the Netherlands and is inspired by the broad definition of health by Machteld Huber: the ability to adapt and direct control, in terms of the physical, emotional and social challenges of life, while paying extra attention to vulnerable groups. A healthy living environment is defined as an environment that residents find it pleasant and encourages and supports healthy behavior. The GO!-method integrates six domains that constitute a healthy living environment: health and lifestyle, facilities and development, safety and hygiene, social cohesion and active citizens, green areas, and air and noise pollution. First of all, this method will identify opportunities for a healthier living environment using existing information and perceptions of residents and other local stakeholders in order to strengthen social participation and quality of life in these rural areas. Second, this approach will connect identified opportunities with available and effective evidence-based interventions in order to develop an action plan from the residents and local authorities perspective which will help them to design their municipalities healthier and more resilient. This method is being used for the first time in rural areas to our best knowledge, in close collaboration with the residents and local authorities of the three provinces to create a sustainable process and stimulate social participation. Our paper will present the outcomes of the first phase of this project in collaboration with the municipality of Westerkwartier, located in the northwest of the province of Groningen. And will describe the current situation, and identify local assets, opportunities, and policies relating to healthier environment; as well as needs and challenges to achieve goals. The preliminary results show that rural demographic changes in the northern Netherlands have negative impacts on service provisions and social cohesion, and there is a need to understand this complicated situation and improve the quality of life in those areas.

Keywords: population decline, rural areas, healthy environment, Netherlands

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167 A Negotiation Model for Understanding the Role of International Law in Foreign Policy Crises

Authors: William Casto

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Studies that consider the actual impact of international law upon foreign affairs crises are flawed by an unrealistic model of decision making. The common, unexamined assumption is that a nation has a unitary executive or ruler who considers a wide variety of considerations, including international law, in attempting to resolve a crisis. To the extent that negotiation theory is considered, the focus is on negotiations between or among nations. The unsettling result is a shallow focus that concentrates on each country’s public posturing about international law. The country-to-country model ignores governments’ internal negotiations that lead to their formal position in a crisis. The model for foreign policy crises needs to be supplemented to include a model of internal negotiations. Important foreign policy decisions come from groups within a government committee, advisers, etc. Within these groups, participants may have differing agendas and resort to international law to bolster their positions. To understand the influence of international law in international crises, these internal negotiations must be considered. These negotiations are crucial to creating a foreign policy agenda or recommendations. External negotiations between the two nations are significant, but the internal negotiations provide a better understanding of the actual influence of international law upon international crises. Discovering the details of specific internal negotiations is quite difficult but not necessarily impossible. The present proposal will use a specific crisis to illustrate the role of international law. In 1861 during the American Civil War, a United States navy captain stopped a British mail ship and removed two ambassadors of the rebelling southern states. The result was what is commonly called the Trent Affair. In the wake of the captain’s unauthorized and rash action, Great Britain seriously considered going to war against the United States. A detailed analysis of the Trent Affair is possible using the available and extensive internal British correspondence and memoranda to reach an understanding of the effect of international law upon decision making. The extensive trove of internal British documents is particularly valuable because in 1861, the only effective means of communication was face-to-face or through letters. Telephones did not exist, and travel by horse and carriage was tedious. The British documents tell us how individual participants viewed the process. We can approach an accurate understanding of what actually happened as the British government strove to resolve the crisis. For example, British law officers initially concluded that the American captain’s rash act was permissible under international law. Later, the law officers revised their opinion. A model of internal negotiation is particularly valuable because it strips away nations’ public posturing about disputed international law principles. In internal decision making, there is room for meaningful debate over the relevant principles. This fluid debate tells how international law is used to develop a hard, public bargaining position. The Trent Affair indicates that international law had an actual influence upon the crisis and that law was not mere window dressing for the government’s public position.

Keywords: foreign affairs crises, negotiation, international law, Trent affair

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166 Analysis of Long-Term Response of Seawater to Change in CO₂, Heavy Metals and Nutrients Concentrations

Authors: Igor Povar, Catherine Goyet

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The seawater is subject to multiple external stressors (ES) including rising atmospheric CO2 and ocean acidification, global warming, atmospheric deposition of pollutants and eutrophication, which deeply alter its chemistry, often on a global scale and, in some cases, at the degree significantly exceeding that in the historical and recent geological verification. In ocean systems the micro- and macronutrients, heavy metals, phosphor- and nitrogen-containing components exist in different forms depending on the concentrations of various other species, organic matter, the types of minerals, the pH etc. The major limitation to assessing more strictly the ES to oceans, such as pollutants (atmospheric greenhouse gas, heavy metals, nutrients as nitrates and phosphates) is the lack of theoretical approach which could predict the ocean resistance to multiple external stressors. In order to assess the abovementioned ES, the research has applied and developed the buffer theory approach and theoretical expressions of the formal chemical thermodynamics to ocean systems, as heterogeneous aqueous systems. The thermodynamic expressions of complex chemical equilibria, involving acid-base, complex formation and mineral ones have been deduced. This thermodynamic approach utilizes thermodynamic relationships coupled with original mass balance constraints, where the solid phases are explicitly expressed. The ocean sensitivity to different external stressors and changes in driving factors are considered in terms of derived buffering capacities or buffer factors for heterogeneous systems. Our investigations have proved that the heterogeneous aqueous systems, as ocean and seas are, manifest their buffer properties towards all their components, not only to pH, as it has been known so far, for example in respect to carbon dioxide, carbonates, phosphates, Ca2+, Mg2+, heavy metal ions etc. The derived expressions make possible to attribute changes in chemical ocean composition to different pollutants. These expressions are also useful for improving the current atmosphere-ocean-marine biogeochemistry models. The major research questions, to which the research responds, are: (i.) What kind of contamination is the most harmful for Future Ocean? (ii.) What are chemical heterogeneous processes of the heavy metal release from sediments and minerals and its impact to the ocean buffer action? (iii.) What will be the long-term response of the coastal ocean to the oceanic uptake of anthropogenic pollutants? (iv.) How will change the ocean resistance in terms of future chemical complex processes and buffer capacities and its response to external (anthropogenic) perturbations? The ocean buffer capacities towards its main components are recommended as parameters that should be included in determining the most important ocean factors which define the response of ocean environment at the technogenic loads increasing. The deduced thermodynamic expressions are valid for any combination of chemical composition, or any of the species contributing to the total concentration, as independent state variable.

Keywords: atmospheric greenhouse gas, chemical thermodynamics, external stressors, pollutants, seawater

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165 Sexual and Reproductive Rights After the Signing of the Peace Process: A Territorial Commitment

Authors: Rocio Murad, Juan Carlos Rivillas, Nury Alejandra Rodriguez, Daniela Roldán

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In Colombia, around 5 million women have suffered forced displacement and all forms of gender-based violence, mostly adolescents and young women, single mothers, or widows with children affected by the war. After the signing of the peace agreements, the department of Antioquia has been one of the most affected by the armed conflict, from a territorial and gender perspective in the period. The objective of the research was to analyze the situation of sexual and reproductive rights in the department of Antioquia from a territorial and gender perspective in the period after the signing of the Peace Agreement. A mixed methodology was developed. The quantitative component conducted a cross-sectional descriptive study of barriers to access to contraceptive methods, safe abortion and gender-based violence based on microdata from the 2015 National Demographic and Health Survey. In the qualitative component, a case study was developed in Dabeiba, a municipality of Antioquia prioritized in order to deepen the experiences before, during and after the armed conflict in sexual and reproductive rights; using three research techniques: Focused observation, Semi-structured interviews, and Documentary review. The results showed that there is a gradient of greater vulnerability to greater effects of the conflict and that the subregion of Urabá Antioqueño, to which Dabeiba belongs, has the highest levels of vulnerability in relation to departmental data. In this subregion, the percentage of women with an unmet need for contraceptive methods (9%), women with unintended pregnancies (31%), of women between 15 and 19 years of age who are already mothers or are pregnant with their first child (32%) and the percentage of women victims of physical violence (42%) and sexual violence (13%) by their partners are significantly higher. Women, particularly rural and indigenous women, were doubly affected due to the existence of violence that is specifically directed at them or that has a greater impact on their life projects. There was evidence of insufficient, fragmented and disjointed social and institutional action in relation to women's rights and the existence of androcentric and patriarchal social imaginaries through which women and the feminine are undervalued. These results provide evidence of violations of sexual and reproductive rights in contexts of armed conflict and make it possible to identify mechanisms to guarantee the re-establishment of the rights of the victims, particularly women and girls. Among the mechanisms evidenced are: working for the elimination of gender stereotypes; supporting the formation and strengthening of women's social organizations; working for the concerted definition and articulated implementation of actions necessary to respond to sexual and reproductive health needs; and working for the recognition of reproductive violence as specific and different from sexual violence in the context of armed conflict. Also, it was evidenced that it is necessary to implement prevention, attention and reparation actions.

Keywords: sexual and reproductive rights, Colombia, armed conflict, violence against women

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164 The Politics of Identity: A Longitudinal Study of the Sociopolitical Development of Education Leaders

Authors: Shelley Zion

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This study examines the longitudinal impact (10 years) of a course for education leaders designed to encourage the development of critical consciousness surrounding issues of equity, oppression, power, and privilege. The ability to resist and challenge oppression across social and cultural contexts can be acquired through the use of transformative pedagogies that create spaces that use the practice of exploration to make connections between pervasive structural and institutional practices and race and ethnicity. This study seeks to extend this understanding by exploring the longitudinal influence of participating in a course that utilizes transformative pedagogies, course materials, exercises, and activities to encourage the practice of exploration of student experiences with racial and ethnic discrimination with the end goal of providing them with the necessary knowledge and skills that foster their ability to resist and challenge oppression and discrimination -critical action- in their lives. To this end, we use the explanatory power of the theories of critical consciousness development, sociopolitical development, and social identity construction that view exploration as a crucial practice in understanding the role ethnic and racial differences play in creating opportunities or barriers in the lives of individuals. When educators use transformative pedagogies, they create a space where students collectively explore their experiences with racial and ethnic discrimination through course readings, in-class activities, and discussions. The end goal of this exploration is twofold: first, to encourage the student’s ability to understand how differences are identified, given meaning to, and used to position them in specific places and spaces in their world; second, to scaffold students’ ability to make connections between their individual and collective differences and particular institutional and structural practices that create opportunities or barriers in their lives. Studies have found the formal exploration of students’ individual and collective differences in relation to their experiences with racial and ethnic discrimination results in developing an understanding of the roles race and ethnicity play in their lives. To trace the role played by exploration in identity construction, we utilize an integrative approach to identity construction informed by multiple theoretical frameworks grounded in cultural studies, social psychology, and sociology that understand social-cultural, racial, and ethnic -identities as dynamic and ever-changing based on context-specific environments. Stuart Hall refers to this practice as taking “symbolic detours through the past” while reflecting on the different ways individuals have been positioned based on their roots (group membership) and also how they, in turn, chose to position themselves through collective sense-making of the various meanings their differences carried through the routes they have taken. The practice of exploration in the construction of ethnic-racial identities has been found to be beneficial to sociopolitical development.

Keywords: political polarization, civic participation, democracy, education

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163 Digital Twins in the Built Environment: A Systematic Literature Review

Authors: Bagireanu Astrid, Bros-Williamson Julio, Duncheva Mila, Currie John

Abstract:

Digital Twins (DT) are an innovative concept of cyber-physical integration of data between an asset and its virtual replica. They have originated in established industries such as manufacturing and aviation and have garnered increasing attention as a potentially transformative technology within the built environment. With the potential to support decision-making, real-time simulations, forecasting abilities and managing operations, DT do not fall under a singular scope. This makes defining and leveraging the potential uses of DT a potential missed opportunity. Despite its recognised potential in established industries, literature on DT in the built environment remains limited. Inadequate attention has been given to the implementation of DT in construction projects, as opposed to its operational stage applications. Additionally, the absence of a standardised definition has resulted in inconsistent interpretations of DT in both industry and academia. There is a need to consolidate research to foster a unified understanding of the DT. Such consolidation is indispensable to ensure that future research is undertaken with a solid foundation. This paper aims to present a comprehensive systematic literature review on the role of DT in the built environment. To accomplish this objective, a review and thematic analysis was conducted, encompassing relevant papers from the last five years. The identified papers are categorised based on their specific areas of focus, and the content of these papers was translated into a through classification of DT. In characterising DT and the associated data processes identified, this systematic literature review has identified 6 DT opportunities specifically relevant to the built environment: Facilitating collaborative procurement methods, Supporting net-zero and decarbonization goals, Supporting Modern Methods of Construction (MMC) and off-site manufacturing (OSM), Providing increased transparency and stakeholders collaboration, Supporting complex decision making (real-time simulations and forecasting abilities) and Seamless integration with Internet of Things (IoT), data analytics and other DT. Finally, a discussion of each area of research is provided. A table of definitions of DT across the reviewed literature is provided, seeking to delineate the current state of DT implementation in the built environment context. Gaps in knowledge are identified, as well as research challenges and opportunities for further advancements in the implementation of DT within the built environment. This paper critically assesses the existing literature to identify the potential of DT applications, aiming to harness the transformative capabilities of data in the built environment. By fostering a unified comprehension of DT, this paper contributes to advancing the effective adoption and utilisation of this technology, accelerating progress towards the realisation of smart cities, decarbonisation, and other envisioned roles for DT in the construction domain.

Keywords: built environment, design, digital twins, literature review

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162 Performance Improvement of Piston Engine in Aeronautics by Means of Additive Manufacturing Technologies

Authors: G. Andreutti, G. Saccone, D. Lucariello, C. Pirozzi, S. Franchitti, R. Borrelli, C. Toscano, P. Caso, G. Ferraro, C. Pascarella

Abstract:

The reduction of greenhouse gases and pollution emissions is a worldwide environmental issue. The amount of CO₂ released by an aircraft is associated with the amount of fuel burned, so the improvement of engine thermo-mechanical efficiency and specific fuel consumption is a significant technological driver for aviation. Moreover, with the prospect that avgas will be phased out, an engine able to use more available and cheaper fuels is an evident advantage. An advanced aeronautical Diesel engine, because of its high efficiency and ability to use widely available and low-cost jet and diesel fuels, is a promising solution to achieve a more fuel-efficient aircraft. On the other hand, a Diesel engine has generally a higher overall weight, if compared with a gasoline one of same power performances. Fixing the MTOW, Max Take-Off Weight, and the operational payload, this extra-weight reduces the aircraft fuel fraction, partially vinifying the associated benefits. Therefore, an effort in weight saving manufacturing technologies is likely desirable. In this work, in order to achieve the mentioned goals, innovative Electron Beam Melting – EBM, Additive Manufacturing – AM technologies were applied to a two-stroke, common rail, GF56 Diesel engine, developed by the CMD Company for aeronautic applications. For this purpose, a consortium of academic, research and industrial partners, including CMD Company, Italian Aerospace Research Centre – CIRA, University of Naples Federico II and the University of Salerno carried out a technological project, funded by the Italian Minister of Education and Research – MIUR. The project aimed to optimize the baseline engine in order to improve its performance and increase its airworthiness features. This project was focused on the definition, design, development, and application of enabling technologies for performance improvement of GF56. Weight saving of this engine was pursued through the application of EBM-AM technologies and in particular using Arcam AB A2X machine, available at CIRA. The 3D printer processes titanium alloy micro-powders and it was employed to realize new connecting rods of the GF56 engine with an additive-oriented design approach. After a preliminary investigation of EBM process parameters and a thermo-mechanical characterization of titanium alloy samples, additive manufactured, innovative connecting rods were fabricated. These engine elements were structurally verified, topologically optimized, 3D printed and suitably post-processed. Finally, the overall performance improvement, on a typical General Aviation aircraft, was estimated, substituting the conventional engine with the optimized GF56 propulsion system.

Keywords: aeronautic propulsion, additive manufacturing, performance improvement, weight saving, piston engine

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161 Young People’s Perceptions of Disability: The New Generation’s View of a Public Seen as Vulnerable and Marginalized

Authors: Ulysse Lecomte, Maryline Thenot

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For a long time, disabled people lived in isolation within the family environment, with little interaction with the outside world and a high risk of social exclusion. However, in a number of countries, progress has been made thanks to changes in legislation on the social integration of disabled people, a significant change in attitudes and the development of CSR. But the problem of their social, economic and professional exclusion persists and has been further exacerbated by the COVID-19 pandemic. This societal phenomenon is sufficiently important to be the subject of management science research. We have therefore focused our work on society's current perception of people with disabilities and their possible integration. Our aim is to find out what levers could be put in place to bring about positive change in the situation. We have chosen to focus on the perception of young people in France, who are the new generation responsible for the future of our society and from whom tomorrow's decision-makers, future employers and stakeholders who can influence the living conditions of disabled people will be drawn. Our study sample corresponds to the 18-30 age group, which is the population of young adults likely to have sufficient experience and maturity. The aim of this study is not only to find out how this population currently perceives disability but also to identify the factors influencing this perception and the most effective levers for action to act positively on this phenomenon and thus promote better social integration of people with disabilities in the future. The methodology is based on theoretical and empirical research. The literature review includes a historical and etymological approach to disability, a definition of the different concepts of disability, an approach to disability as a vector of social exclusion and the role of perception and representations in defining the social image of disability. This literature review is followed by an empirical part carried out by means of a questionnaire administered to 110 young people aged 18 to 30. Analysis of our results suggests that, despite a recent improvement, disabled people are still perceived as vulnerable and socially marginalized. The following factors stand out as having a significant influence (positive or negative) on the perception of disability: the individual's familiarity with the 'world of disability', cultural factors, the degree of 'visibility' of the disability and the empathy level of the disabled person him/herself. Others, on the other hand, such as socio-political and economic factors, have little impact on this perception. In addition, it is possible to classify the various levers of action likely to improve the social perception of disability according to their degree of effectiveness. Our study population prioritized training initiatives for the various players and stakeholders (teachers, students, disabled people themselves, companies, sports clubs, etc.). This was followed by communication, e-communication and media campaigns in favour of disability. Lastly, the sample was judged as 'less effective' positive discrimination actions such as setting a minimum percentage for the representation of disabled people in various fields (studies, employment, politics ...).

Keywords: disability, perception, social image, young people, influencing factors, levers for action

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160 Quantification of the Non-Registered Electrical and Electronic Equipment for Domestic Consumption and Enhancing E-Waste Estimation: A Case Study on TVs in Vietnam

Authors: Ha Phuong Tran, Feng Wang, Jo Dewulf, Hai Trung Huynh, Thomas Schaubroeck

Abstract:

The fast increase and complex components have made waste of electrical and electronic equipment (or e-waste) one of the most problematic waste streams worldwide. Precise information on its size on national, regional and global level has therefore been highlighted as prerequisite to obtain a proper management system. However, this is a very challenging task, especially in developing countries where both formal e-waste management system and necessary statistical data for e-waste estimation, i.e. data on the production, sale and trade of electrical and electronic equipment (EEE), are often lacking. Moreover, there is an inflow of non-registered electronic and electric equipment, which ‘invisibly’ enters the EEE domestic market and then is used for domestic consumption. The non-registration/invisibility and (in most of the case) illicit nature of this flow make it difficult or even impossible to be captured in any statistical system. The e-waste generated from it is thus often uncounted in current e-waste estimation based on statistical market data. Therefore, this study focuses on enhancing e-waste estimation in developing countries and proposing a calculation pathway to quantify the magnitude of the non-registered EEE inflow. An advanced Input-Out Analysis model (i.e. the Sale–Stock–Lifespan model) has been integrated in the calculation procedure. In general, Sale-Stock-Lifespan model assists to improve the quality of input data for modeling (i.e. perform data consolidation to create more accurate lifespan profile, model dynamic lifespan to take into account its changes over time), via which the quality of e-waste estimation can be improved. To demonstrate the above objectives, a case study on televisions (TVs) in Vietnam has been employed. The results show that the amount of waste TVs in Vietnam has increased four times since 2000 till now. This upward trend is expected to continue in the future. In 2035, a total of 9.51 million TVs are predicted to be discarded. Moreover, estimation of non-registered TV inflow shows that it might on average contribute about 15% to the total TVs sold on the Vietnamese market during the whole period of 2002 to 2013. To tackle potential uncertainties associated with estimation models and input data, sensitivity analysis has been applied. The results show that both estimations of waste and non-registered inflow depend on two parameters i.e. number of TVs used in household and the lifespan. Particularly, with a 1% increase in the TV in-use rate, the average market share of non-register inflow in the period 2002-2013 increases 0.95%. However, it decreases from 27% to 15% when the constant unadjusted lifespan is replaced by the dynamic adjusted lifespan. The effect of these two parameters on the amount of waste TV generation for each year is more complex and non-linear over time. To conclude, despite of remaining uncertainty, this study is the first attempt to apply the Sale-Stock-Lifespan model to improve the e-waste estimation in developing countries and to quantify the non-registered EEE inflow to domestic consumption. It therefore can be further improved in future with more knowledge and data.

Keywords: e-waste, non-registered electrical and electronic equipment, TVs, Vietnam

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159 Cut-Off of CMV Cobas® Taqman® (CAP/CTM Roche®) for Introduction of Ganciclovir Pre-Emptive Therapy in Allogeneic Hematopoietic Stem Cell Transplant Recipients

Authors: B. B. S. Pereira, M. O. Souza, L. P. Zanetti, L. C. S. Oliveira, J. R. P. Moreno, M. P. Souza, V. R. Colturato, C. M. Machado

Abstract:

Background: The introduction of prophylactic or preemptive therapies has effectively decreased the CMV mortality rates after hematopoietic stem cell transplantation (HSCT). CMV antigenemia (pp65) or quantitative PCR are methods currently approved for CMV surveillance in pre-emptive strategies. Commercial assays are preferred as cut-off levels defined by in-house assays may vary among different protocols and in general show low reproducibility. Moreover, comparison of published data among different centers is only possible if international standards of quantification are included in the assays. Recently, the World Health Organization (WHO) established the first international standard for CMV detection. The real time PCR COBAS Ampliprep/ CobasTaqMan (CAP/CTM) (Roche®) was developed using the WHO standard for CMV quantification. However, the cut-off for the introduction of antiviral has not been determined yet. Methods: We conducted a retrospective study to determine: 1) the sensitivity and specificity of the new CMV CAP/CTM test in comparison with pp65 antigenemia to detect episodes of CMV infection/reactivation, and 2) the cut-off of viral load for introduction of ganciclovir (GCV). Pp65 antigenemia was performed and the corresponding plasma samples were stored at -20°C for further CMV detection by CAP/CTM. Comparison of tests was performed by kappa index. The appearance of positive antigenemia was considered the state variable to determine the cut-off of CMV viral load by ROC curve. Statistical analysis was performed using SPSS software version 19 (SPSS, Chicago, IL, USA.). Results: Thirty-eight patients were included and followed from August 2014 through May 2015. The antigenemia test detected 53 episodes of CMV infection in 34 patients (89.5%), while CAP/CTM detected 37 episodes in 33 patients (86.8%). AG and PCR results were compared in 431 samples and Kappa index was 30.9%. The median time for first AG detection was 42 (28-140) days, while CAP/CTM detected at a median of 7 days earlier (34 days, ranging from 7 to 110 days). The optimum cut-off value of CMV DNA was 34.25 IU/mL to detect positive antigenemia with 88.2% of sensibility, 100% of specificity and AUC of 0.91. This cut-off value is below the limit of detection and quantification of the equipment which is 56 IU/mL. According to CMV recurrence definition, 16 episodes of CMV recurrence were detected by antigenemia (47.1%) and 4 (12.1%) by CAP/CTM. The duration of viremia as detected by antigenemia was shorter (60.5% of the episodes lasted ≤ 7 days) in comparison to CAP/CTM (57.9% of the episodes lasting 15 days or more). This data suggests that the use of antigenemia to define the duration of GCV therapy might prompt early interruption of antiviral, which may favor CMV reactivation. The CAP/CTM PCR could possibly provide a safer information concerning the duration of GCV therapy. As prolonged treatment may increase the risk of toxicity, this hypothesis should be confirmed in prospective trials. Conclusions: Even though CAP/CTM by ROCHE showed great qualitative correlation with the antigenemia technique, the fully automated CAP/CTM did not demonstrate increased sensitivity. The cut-off value below the limit of detection and quantification may result in delayed introduction of pre-emptive therapy.

Keywords: antigenemia, CMV COBAS/TAQMAN, cytomegalovirus, antiviral cut-off

Procedia PDF Downloads 166