Search results for: honeycomb panel

Authors: Stefano M. Spagocci

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The efficiency of photovoltaic panels can be calculated with such software packages as RETScreen that allow design engineers to take financial as well as technical considerations into account. RETScreen is interfaced with meteorological databases, so that efficiency calculations can be realistically carried out. The author has recently contributed to the development of solar modules with accumulation capability and an embedded water purifier, aimed at off-grid users such as users in developing countries. The software packages examined do not allow to take ancillary equipment into account, hence the decision to implement a technical and financial model of the system. The author realized that, rather than re-implementing the quite sophisticated model of RETScreen - a mathematical description of which is anyway not publicly available - it was possible to drastically simplify it, including the meteorological factors which, in RETScreen, are presented in a numerical form. The day-by-day efficiency of a photovoltaic solar panel was parametrized by the product of factors expressing, respectively, daytime duration, solar right ascension motion, solar declination motion, cloudiness, temperature. For the sun-motion-dependent factors, positional astronomy formulae, simplified by the author, were employed. Meteorology-dependent factors were fitted by simple trigonometric functions, employing numerical data supplied by RETScreen. The accuracy of our model was tested by comparing it to the predictions of RETScreen; the accuracy obtained was 11%. In conclusion, our study resulted in a model that can be easily implemented in a spreadsheet - thus being easily manageable by non-specialist personnel - or in more sophisticated software packages. The model was used in a number of design exercises, concerning photovoltaic solar panels and ancillary equipment like the above-mentioned water purifier.

Keywords: clean energy, energy engineering, mathematical modelling, photovoltaic panels, solar energy

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Authors: Kay Fielden, Eelin Tan, Lan Nguyen

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In this research project, data was gathered at a Covid 19 Conference held in June 2021 from industry leaders who discussed the impact of the global pandemic on the status of the New Zealand hospitality industry. Panel discussions on financials, human resources, health and safety, and recovery were conducted. The themes explored for the finance panel were customer demographics, hospitality sectors, financial practices, government impact, and cost of compliance. The aim was to see how the hospitality industry has responded to the global pandemic and the steps that have been taken for the industry to recover or sustain their business. The main research question for this qualitative study is: What are the factors that have impacted on finance for the hospitality industry in New Zealand due to Covid 19? For financials, literature has been gathered to study global effects, and this is being compared with the data gathered from the discussion panel through the lens of resilience theory. Resilience theory applied to the hospitality industry suggests that the challenges imposed by Covid 19 have been the catalyst for government initiatives, technical innovation, engaging local communities, and boosting confidence. Transformation arising from these ground shifts have been a move towards sustainability, wellbeing, more awareness of climate change, and community engagement. Initial findings suggest that there has been a shift in customer base that has prompted regional accommodation providers to realign offers and to become more flexible to attract and maintain this realigned customer base. Dynamic pricing structures have been required to meet changing customer demographics. Flexible staffing arrangements include sharing staff between different accommodation providers, owners with multiple properties adopting different staffing arrangements, maintaining a good working relationship with the bank, and conserving cash. Uncertain times necessitate changing revenue strategies to cope with external factors. Financial support offered by the government has cushioned the financial downturn for many in the hospitality industry, and managed isolation and quarantine (MIQ) arrangements have offered immediate financial relief for those hotels involved. However, there is concern over the long-term effects. Compliance with mandated health and safety requirements has meant that the hospitality industry has streamlined its approach to meeting those requirements and has invested in customer relations to keep paying customers informed of the health measures in place. Initial findings from this study lie within the resilience theory framework and are consistent with findings from the literature.

Keywords: global pandemic, hospitality industry, new Zealand, resilience

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Authors: Atia Alam

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Growing liberalisation and intense market competition increase firm’s risk exposure and induce corporations to use derivatives extensively as a risk management instrument, which results in decrease in firm’s risk, and increase in value. Present study contributes towards existing literature by providing an in-depth analysis regarding the effect of extent of derivative usage on firm’s risk and value by using panel data models and seemingly unrelated regression technique. New evidence is established in current literature by dividing the sample data based on firm’s Exchange Rate (ER) and Interest Rate (IR) exposure. Analysis is performed for the effect of extent of derivative usage on firm’s risk and value and its variation with respect to the ER and IR exposure. Sample data consists of 166 Pakistani firms listed on Pakistan stock exchange for the period of 2004-2010. Results show that extensive usage of derivative instruments significantly increases firm value and reduces firm’s risk. Furthermore, comprehensive analysis depicts that Pakistani corporations having higher exchange rate exposure, with respect to foreign sales, and higher interest rate exposure, on the basis of industry adjusted leverage, have higher firm value and lower risk. Findings from seemingly unrelated regression also provide robustness to results obtained through panel data analysis. Study also highlights the role of derivative usage as a risk management instrument in high and low ER and IR risk and helps practitioners in understanding how value increasing effect of extent of derivative usage varies with the intensity of firm’s risk exposure.

Keywords: extent of derivative usage, firm value, risk, Pakistan, non-financial firms

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Authors: Muhammad Maqsood, Yasir Nawab, Syed Talha Ali Hamdani

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Stretchable fabrics have diverse applications ranging from casual apparel to performance sportswear and compression therapy. Compression therapy is the universally accepted treatment for the management of hypertrophic scarring after severe burns. Mostly stretchable knitted fabrics are used in compression therapy but in the recent past, some studies have also been found on bi-stretch woven fabrics being used as compression garments as they also have been found quite effective in the treatment of oedema. Therefore, the objective of the present study is to compare the compression properties of stretchable knitted and bi-stretch woven fabrics for compression garments. For this purpose four woven structures and four knitted structures were produced having the same areal density and their compression, comfort and mechanical properties were compared before and after 5, 10 and 15 washes. Four knitted structures used were single jersey, single locaste, plain pique and the honeycomb, whereas four woven structures produced were 1/1 plain, 2/1 twill, 3/1 twill and 4/1 twill. The compression properties of the produced samples were tested by using kikuhime pressure sensor and it was found that bi-stretch woven fabrics possessed better compression properties before and after washes and retain their durability after repeated use, whereas knitted stretchable fabrics lost their compression ability after repeated use and the required sub garment pressure of the knitted structures after 15 washes was almost half to that of woven bi-stretch fabrics.

Keywords: compression garments, knitted structures, medical textiles, woven bi-stretch

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Authors: Tan Swee Liang

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This paper estimates bank and stock market efficiency associations with real per capita GDP growth by examining panel-data across three different regions using Panel-Corrected Standard Errors (PCSE) regression developed by Beck and Katz (1995). Data from five economies in ASEAN (Singapore, Malaysia, Thailand, Philippines, and Indonesia), five economies in Asia (Japan, China, Hong Kong SAR, South Korea, and India) and seven economies in OECD (Australia, Canada, Denmark, Norway, Sweden, United Kingdom U.K., and United States U.S.), between 1990 and 2017 are used. Empirical findings suggest one, for Asia-5 high bank net interest margin means greater bank profitability, hence spurring economic growth. Two, for OECD-7 low bank overhead costs (as a share of total assets) may reflect weak competition and weak investment in providing superior banking services, hence dampening economic growth. Three, stock market turnover ratio has negative association with OECD-7 economic growth, but a positive association with Asia-5, which suggest the relationship between liquidity and growth is ambiguous. Lastly, for ASEAN-5 high bank overhead costs (as a share of total assets) may suggest expenses have not been channelled efficiently to income generating activities. One practical implication of the findings is that policy makers should take necessary measures toward financial liberalisation policies that boost growth through the efficiency channel, so that funds are efficiently allocated through the financial system between financial and real sectors.

Keywords: financial development, banking system, capital markets, economic growth

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Authors: Alfiah Hasanah, Silvia Mendolia, Oleg Yerokhin

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This paper explores the impacts of adult child migration on the health of elderly parents left behind. The maternal and children health are a priority of health-related policy in most low and middle-income country, and so there is lack of evidence on the health of older population particularly in Indonesia. With increasing life expectancy and limited access to social security and social services for the elderly in this country, the consequences of increasing number of out-migration of adult children to parent health are important to investigate. This study use Indonesia Family Life Survey (IFLS), the only large-scale continuing longitudinal socioeconomic and health survey that based on a sample of households representing about 83 percent of the Indonesian population in its first wave. Using four waves of IFLS including the recent wave of 2014, several indicators of the self-rated health status, interviewer-rated health status and days of illness are used to estimate the impact of labour out-migration of adult children on parent health status. Incorporate both individual fixed effects to control for unobservable factors in migrant and non-migrant households and the ordered response of self-rated health, this study apply the ordered logit of “Blow-up and Cluster” (BUC ) estimator. The result shows that labour out-migration of adult children significantly improves the self-rated health status of the elderly parent left behind. Findings of this study are consistent with the view that migration increases family resources and contribute to better health care and nutrition of the family left behind.

Keywords: aging, migration, panel data, self-rated health

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Authors: Mehwish Azam, Muhammad Imran, Humaira Jabeen, Sumreen Begum, Rashida Qasim

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Background: Metabolic syndrome is a cluster of metabolic risk factors including obesity, glucose intolerance, insulin resistance, dyslipidemia and hypertension. Metabolic syndrome in obese and type 2 diabetic subjects increases the risk of cardiovascular diseases (CVD). Globally, the prevalence of metabolic syndrome ranges from 10%-50% and in Pakistan ranges from 18%-46%. The objective of the present study is to estimate the prevalence of metabolic syndrome (MS) in obese type 2 diabetic subjects by using International Diabetes Federation (IDF) and National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) definitions. Methods: Obese type 2 diabetic subjects and normal healthy subjects of both genders were selected from diabetic clinics and hospitals of various localities of Karachi, Pakistan. The frequency of metabolic syndrome was estimated by the proposed definitions of IDF and NCEP-ATP III. Results: The prevalence of metabolic syndrome using International Diabetes Federation (IDF) definition in obese type 2 diabetic subjects was 85.7%. It is significantly higher (p<0.05) in females (47.1%) as compared to males (38.6%). While, using National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) definition the overall prevalence of metabolic syndrome in obese type 2 diabetic subjects was 75.7%, the prevalence is significantly higher (p<0.05) in females (45.7%) than males (30.0%). Conclusion: It is concluded that, the overall prevalence of metabolic syndrome is increasing significantly in obese type 2 diabetic subjects by using IDF and NCEP–ATP III definitions. Therefore, it is need to initiate the preventive measures by arranging public awareness programmes to highlight the significance of a healthy lifestyle and emphasis should be given to reduce weight, increase physical activity, and increase intake of healthy low-glycemic-index foods.

Keywords: metabolic syndrome, diabetes mellitus, obesity, IDF, NCEP-ATP III

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Authors: Jackson Niyongabo

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This study addresses a notable gap in the existing literature on the relationship between energy consumption, economic growth, and CO₂ emissions, particularly within the African context. While numerous studies have explored these dynamics globally and regionally across various development levels, few have delved into the nuances of regions and income levels specific to African countries. Furthermore, the evaluation of the interplay between green growth policies, green energy technologies, and their impact on environmental quality has been underexplored. This research aims to fill these gaps by conducting a comprehensive analysis of the transition from conventional economic growth and energy consumption to a paradigm of green growth coupled with green energy utilization across the African continent from 1980 to 2018. The study is structured into three main parts: an empirical examination of the long-term effects of energy intensity, renewable energy consumption, and economic growth on CO₂ emissions across diverse African regions and income levels; an estimation of the long-term impact of green growth and green energy use on CO₂ emissions for countries implementing green policies within Africa, as well as at regional and global levels; and a comparative analysis of the impact of green growth policies on environmental degradation before and after implementation. Employing advanced econometric methods and panel estimators, the study utilizes a testing framework, panel unit tests, and various estimators to derive meaningful insights. The anticipated results and conclusions will be elucidated through causality tests, impulse response, and variance decomposition analyses, contributing valuable knowledge to the discourse on sustainable development in the African context.

Keywords: economic growth, green growth, energy consumption, CO₂ emissions, econometric models, green energy

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Authors: Zeljko Crljen, Predrag Lazic

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Graphene has attracted a tremendous interest in the field of nanoelectronics and spintronics due to its exceptional electronic properties. However, pristine graphene has no band gap, a feature needed in building some of the electronic elements. Recently, a growing attention has been given to a class of carbon allotropes of graphene with honeycomb structures, in particular to graphyne and graphdiyne. They are characterized with a single and double acetylene bonding chains respectively, connecting the nearest-neighbor hexagonal rings. With an electron density comparable to that of graphene and a prominent gap in electronic band structures they appear as promising materials for nanoelectronic components. We studied the electronic structure and transport of infinite sheets of graphyne and graphdiyne and compared them with graphene. The method based on the non-equilibrium Green functions and density functional theory has been used in order to obtain a full ab initio self-consistent description of the transport current with different electrochemical bias potentials. The current/voltage (I/V) characteristics show a semi-conducting behavior with prominent nonlinearities at higher voltages. The calculated band gaps are 0.52V and 0.59V, respectively, and the effective masses are considerably smaller compared to typical semiconductors. We analyzed the results in terms of transmission eigenchannels and showed that the difference in conductance is directly related to the difference of the internal structure of the allotropes.

Keywords: electronic transport, graphene-like structures, nanoelectronics, two-dimensional materials

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Authors: Ayoola Femi J., Kayode Balogun

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In some African Countries, increase in Gross Domestic Products (GDP) has not translated to real development as expected by common-man in his household. For decades, a lot of contests on economic growth and development has been a nagging issues. The focus of this study is to analysing the effects of economic determinants/factors on economic advances in some African Countries by employing panel data analysis. The yearly (1990-2013) data were obtained from the world economic outlook database of the International Monetary Fund (IMF), for probing the effects of these variables on growth rate in some selected African countries which include: Nigeria, Algeria, Angola, Benin, Botswana, Burundi, Cape-Verde, Cameroun, Central African Republic, Chad, Republic Of Congo, Cote di’ Voire, Egypt, Equatorial-Guinea, Ethiopia, Gabon, Ghana, Guinea Bissau, Kenya, Lesotho, Madagascar, Mali, Mauritius, Morocco, Mozambique, Niger, Rwanda, Senegal, Seychelles, Sierra Leone, South Africa, Sudan, Swaziland, Tanzania, Togo, Tunisia, and Uganda. The effects of 6 macroeconomic variables on GDP were critically examined. We used 37 Countries GDP as our dependent variable and 6 independent variables used in this study include: Total Investment (totinv), Inflation (inf), Population (popl), current account balance (cab), volume of imports of goods and services (vimgs), and volume of exports of goods and services (vexgs). The results of our analysis shows that total investment, population and volume of exports of goods and services strongly affect the economic growth. We noticed that population of these selected countries positively affect the GDP while total investment and volume of exports negatively affect GDP. On the contrary, inflation, current account balance and volume of imports of goods and services’ contribution to the GDP are insignificant. The results of our analysis shows that total investment, population and volume of exports of goods and services strongly affect the economic growth. We noticed that population of these selected countries positively affect the GDP while total investment and volume of exports negatively affect GDP. On the contrary, inflation, current account balance and volume of imports of goods and services’ contribution to the GDP are insignificant. The results of this study would be useful for individual African governments for developing a suitable and appropriate economic policies and strategies. It will also help investors to understand the economic nature and viability of Africa as a continent as well as its individual countries.

Keywords: African countries, economic growth and development, gross domestic products, static panel data models

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Authors: Diogo Ferreira Lima Filho, José Roberto Amazonas

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Nanotechnology opens the door to new paradigms that introduces a variety of novel tools enabling a plethora of potential applications in the biomedical, industrial, environmental, and military fields. This work proposes an integrated node model by applying the same concepts of TCNet to networks of nanodevices where the nodes are cooperatively interconnected with a low-complexity Mealy Machine (MM) topology integrating in the same electronic system the modules necessary for independent operation in wireless sensor networks (WSNs), consisting of Rectennas (RF to DC power converters), Code Generators based on Finite State Machine (FSM) & Trellis Decoder and On-chip Transmit/Receive with autonomy in terms of energy sources applying the Energy Harvesting technique. This approach considers the use of a Graphene Composite Substrate (GCS) for the integrated electronic circuits meeting the following characteristics: mechanical flexibility, miniaturization, and optical transparency, besides being ecological. In addition, graphene consists of a layer of carbon atoms with the configuration of a honeycomb crystal lattice, which has attracted the attention of the scientific community due to its unique Electrical Characteristics.

Keywords: composite substrate, energy harvesting, finite state machine, graphene, nanotechnology, rectennas, wireless sensor networks

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Authors: Stamatis Zoras, Boris Ceranic, Ashley Redfern

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Green House Gas emissions from domestic properties currently account for a substantial part of the total UK’s carbon emissions and is a priority area for UK to reach zero carbon emissions. However, GHG emissions of urban complexes depend on building, road, structural developments etc surfaces that form urban microclimate. This in turn may further influence renewable energy system power generation that depend on solar or wind potential. Moreover, urban climatic conditions are also influenced by the installation of those power generation systems that may impact their own power generation efficiency. Increased air temperature is attributed to densely installed roof based solar panels that consequently impact their own production efficiency. Installation of roof based solar panels requires adequate guidance to enable housing businesses, councils and organisations to implement sufficient measures for improved power generation in relation to local urban microclimate. How microclimate is affected and how, in return, it affects solar power productivity. Derby Council & Derby Homes have been collecting solar panel power generation data for a large number of properties. The different building areas and system operation performance will be studied against microclimate conditions through time. It is envisaged that the outcomes of the study will support a working up strategy for Derby city to ensure that owned homes would be able to access information and data of solar photo voltaic PV and solar thermal panels potential on social housing, helping residents on low incomes create their own green energy to power their homes and heat their homeshot water.

Keywords: microclimate, solar power, urban climatology, urban morphology

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Authors: Lauren M. Cook, Tove A. Larsen

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Due to their potential to provide numerous ecosystem services, green roofs have been proposed as a solution to mitigate a growing list of environmental challenges, like urban flooding and urban heat island effect. Because of their cooling effect, green roofs placed below rooftop photovoltaic (PV) panels also have the potential to increase PV panel efficiency. Sedums, a type of succulent plant, are commonly used on green roofs because they are drought and heat tolerant. However, other plant species, such as grasses or plants with reflective properties, have been shown to reduce more runoff and cool the rooftop more than succulent species due to high evapotranspiration (ET) and reflectivity, respectively. The goal of this study is to evaluate whether vegetation with high ET or reflectivity can influence multiple co-benefits of the green roof. Four small scale green roofs in Zurich are used as an experiment to evaluate differences in (1) the timing and amount of runoff discharged from the roof, (2) the air temperature above the green roof, and (3) the temperature and efficiency of solar panels placed above the green roof. One grass species, Silene vulgaris, and one silvery species, Stachys byzantia, are compared to a baseline of Sedum album and black roof. Initial results from August to November 2019 show that the grass species has retained more cumulative runoff and led to a lower canopy temperature than the other species. Although the results are not yet statistically significant, they may suggest that plants with higher ET will have a greater effect on canopy temperature than plants with high reflectivity. Future work will confirm this hypothesis and evaluate whether it holds true for solar panel temperature and efficiency.

Keywords: co-benefit estimation, green cities, green roofs, solar panels

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Authors: Antoni Grau, Yolanda Bolea, Alberto Sanfeliu

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Mobile robots can be used in many different applications, including mapping, search, rescue, reconnaissance, hazard detection, and carpet cleaning, exploration, etc. However, they are limited due to their reliance on traditional energy sources such as electricity and oil which cannot always provide a convenient energy source in all situations. In an ever more eco-conscious world, solar energy offers the most environmentally clean option of all energy sources. Electricity presents threats of pollution resulting from its production process, and oil poses a huge threat to the environment. Not only does it pose harm by the toxic emissions (for instance CO2 emissions), it produces the combustion process necessary to produce energy, but there is the ever present risk of oil spillages and damages to ecosystems. Solar energy can help to mitigate carbon emissions by replacing more carbon intensive sources of heat and power. The challenge of this work is to propose the design and the implementation of electric battery recharge stations. Those recharge docks are based on the use of renewable energy such as solar energy (with photovoltaic panels) with the object to reduce the CO2 emissions. In this paper, a comparative study of the CO2 emission productions (from the use of different energy sources: natural gas, gas oil, fuel and solar panels) in the charging process of the Segway PT batteries is carried out. To make the study with solar energy, a photovoltaic panel, and a Buck-Boost DC/DC block has been used. Specifically, the STP005S-12/Db solar panel has been used to carry out our experiments. This module is a 5Wp-photovoltaic (PV) module, configured with 36 monocrystalline cells serially connected. With those elements, a battery recharge station is made to recharge the robot batteries. For the energy storage DC/DC block, a series of ultracapacitors have been used. Due to the variation of the PV panel with the temperature and irradiation, and the non-integer behavior of the ultracapacitors as well as the non-linearities of the whole system, authors have been used a fractional control method to achieve that solar panels supply the maximum allowed power to recharge the robots in the lesser time. Greenhouse gas emissions for production of electricity vary due to regional differences in source fuel. The impact of an energy technology on the climate can be characterised by its carbon emission intensity, a measure of the amount of CO2, or CO2 equivalent emitted by unit of energy generated. In our work, the coal is the fossil energy more hazardous, providing a 53% more of gas emissions than natural gas and a 30% more than fuel. Moreover, it is remarkable that existing fossil fuel technologies produce high carbon emission intensity through the combustion of carbon-rich fuels, whilst renewable technologies such as solar produce little or no emissions during operation, but may incur emissions during manufacture. The solar energy thus can help to mitigate carbon emissions.

Keywords: autonomous robots, CO2 emissions, DC/DC buck-boost, solar energy

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Authors: Mona Vijayaran, Gurleen Oberoi, Sanjay Mishra

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Introduction: p190 BCR‐ABL1 in CML is often associated with monocytosis. In the case described here, monocytosis is associated with coexisting p210 BCR‐ABL and CMML clones. Mutation analysis using next‐generation sequence (NGS) in our case showed TET2 and SRSF2 mutations. Aims & Objectives: A 75-year male was evaluated for monocytosis and thrombocytopenia. CBC showed Hb-11.8g/dl, TLC-12,060/cmm, Monocytes-35%, Platelets-39,000/cmm. Materials & Methods: Bone marrow examination showed a hypercellular marrow with myeloid series showing sequential maturation up to neutrophils with 30% monocytes. Immunophenotyping by flow cytometry from bone marrow had 3% blasts. Making chronic myelomonocytic leukemia as the likely diagnosis. NGS for myeloid mutation panel had TET2 (48.9%) and SRSF2 (32.5%) mutations. This report further supported the diagnosis of CMML. To fulfil the WHO diagnostic criteria for CMML, a BCR ABL1 by RQ-PCR was sent. The report came positive for p210 (B3A2, B2A2) Major Transcript (M-BCR) % IS of 38.418. Result: The patient was counselled regarding the unique presentation of the presence of 2 clones- P210 CML and CMML. After discussion with an international faculty with vast experience in CMML. It was decided to start this elderly gentleman on Imatinib 200mg and not on azacytidine, as ASXL1 was not present; hence, his chances of progressing to AML would be less and on the other end, if CML is left untreated then chances of progression to blast phase would always be a possibility. After 3 months on Imatinib his platelet count improved to 80,000 to 90,000/cmm, but his monocytosis persists. His 3rd month BCR-ABL1 IS% is 0.004%. Conclusion: After searching the literature, there were no case reports of a coexisting CML p210 with CMML. This case might be the first case report. p190 BCR ABL1 is often associated with monocytosis. There are few case reports of p210 BCR ABL1 positivity in patients with monocytosis but none with coexisting CMML. This case highlights the need for extensively evaluating patients with monocytosis with next-generation sequencing for myeloid mutation panel and BCR-ABL1 by RT-PCR to correctly diagnose and treat them.

Keywords: CMML, NGS, p190 CML, Imatinib

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Authors: Sofia Papadimitriou

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INTRODUCTION: The differential diagnosis between acute viral and bacterial infections is an important cost-effectiveness parameter at the stage of the treatment process in order to achieve the maximum benefits in therapeutic intervention by combining the minimum cost to ensure the proper use of antibiotics.The discovery of sensitive and robust molecular diagnostic tests in response to the role of the host in infections has enhanced the accurate diagnosis and differentiation of infections. METHOD: The study used a sample of six independent blood samples (total=756) which are associated with human proteins-proteins, each of which at the transcription stage expresses a different response in the host network between viral and bacterial infections.Τhe individual blood samples are subjected to a sequence of computer filters that identify a gene panel corresponding to an autonomous diagnostic score. The data set and the correspondence of the gene panel to the diagnostic patents a new Bangalore -Viral Bacterial (BL-VB). FINDING: We use a biomarker based on the blood of 10 genes(Panel-VB) that are an important prognostic value for the detection of viruses from bacterial infections with a weighted average AUROC of 0.97(95% CL:0.96-0.99) in eleven independent samples (sets n=898). We discovered a base with a patient score (VB 10 ) according to the table, which is a significant diagnostic value with a weighted average of AUROC 0.94(95% CL: 0.91-0.98) in 2996 patient samples from 56 public sets of data from 19 different countries. We also studied VB 10 in a new cohort of South India (BL-VB,n=56) and found 97% accuracy in confirmed cases of viral and bacterial infections. We found that VB 10 (a)accurately identifies the type of infection even in unspecified cases negative to the culture (b) shows its clinical condition recovery and (c) applies to all age groups, covering a wide range of acute bacterial and viral infectious, including non-specific pathogens. We applied our VB 10 rating to publicly available COVID 19 data and found that our rating diagnosed viral infection in patient samples. RESULTS: Τhe results of the study showed the diagnostic power of the biomarker VB 10 as a diagnostic test for the accurate diagnosis of acute infections in recovery conditions. We look forward to helping you make clinical decisions about prescribing antibiotics and integrating them into your policies management of antibiotic stewardship efforts. CONCLUSIONS: Overall, we are developing a new property of the RNA-based biomarker and a new blood test to differentiate between viral and bacterial infections to assist a physician in designing the optimal treatment regimen to contribute to the proper use of antibiotics and reduce the burden on antimicrobial resistance, AMR.

Keywords: acute infections, antimicrobial resistance, biomarker, blood transcriptome, systems biology, classifier diagnostic score

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Authors: Ghada Esheba, Ghadeer Aldoobi, Salwa Almalk, Abrar Alshareef, Eman Al-khairi, Eman Yaseen

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Background: In Saudi Arabia, ovarian cancer ranked seventh among female population and is the most common female genital tract malignancy after endometrial cancer. A slight increase in the incidence of ovarian cancer was observed from 2001–2008. Makkah, Riyadh, and the eastern region of Saudi Arabia had the highest incidence rate ratio for the number of ovarian cancer cases (1). Differentiating metastatic adenocarcinomas from primary ovarian carcinomas, especially those of endometrioid and mucinous type is clinically significant and a challenge for clinicians and pathologists, yet the distinction has important therapeutic and prognostic implications. Aim: To clarify the most important histopathological criteria to differentiate between primary ovarian surface epithelial tumors especially mucinous and endometrioid subtypes, and metastatic adenocarcinoma and to evaluate the value of a panel of antibodies consisting of CK7, CK20, and CDX-2 in the distinction between primary ovarian surface epithelial tumors and metastatic adenocarcinoma. Material and methods: This study was carried out on 26 cases of primary ovarian surface epithelial neoplasms and 14 cases of metastatic ovarian adenocarcinoma. All cases were studied immunohistochemically using CK7, CK20, and CDX-2. Results: All cases of primary ovarian adenocarcinoma were positive for CK7. 25% and 58% of mucinous borderline mucinous tumor and mucinous carcinoma respectively were positive for CK20. Only 42% of mucinous carcinoma were positive for CDX-2. All cases of endometrioid carcinomas were negative for both CK20 and CDX-2. All cases of metastatic adenocarcinoma from the colon were negative for CK7 and positive for CK20 and CDX-2. Conclusions: CK7 is an important positive marker for primary ovarian tumors, while CK20 and CDX-2 are useful markers for colorectal carcinoma metastatic to the ovary. Caution should be taken as primary ovarian mucinous tumors may stain positive for CK20, CDX-2, or both, however, they usually exhibit a focal pattern of reactivity.

Keywords: adenoma, endometrioid, malignancy, ovarian

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Authors: H. C. Woo, F. Bouanis, C. S. Cojocaur

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Graphene, which consists of a single layer of carbon atoms in a honeycomb lattice, is an interesting potential optoelectronic material because of graphene’s high carrier mobility, zero bandgap, and electron–hole symmetry. Graphene can absorb light and convert it into a photocurrent over a wide range of the electromagnetic spectrum, from the ultraviolet to visible and infrared regimes. Over the last several years, a variety of graphene-based photodetectors have been reported, such as graphene transistors, graphene-semiconductor heterojunction photodetectors, graphene based bolometers. It is also reported that there are several physical mechanisms enabling photodetection: photovoltaic effect, photo-thermoelectric effect, bolometric effect, photogating effect, and so on. In this work, we report a simple approach for the realization of graphene based resistive photo-detection devices and the measurements of their photoelectrical response. The graphene were synthesized directly on the glass substrate by novel growth method patented in our lab. Then, the metal electrodes were deposited by thermal evaporation on it, with an electrode length and width of 1.5 mm and 300 μm respectively, using Co to fabricate simple graphene based resistive photosensor. The measurements show that the graphene resistive devices exhibit a photoresponse to the illumination of visible light. The observed re-sistance response was reproducible and similar after many cycles of on and off operations. This photoelectrical response may be attributed not only to the direct photocurrent process but also to the desorption of oxygen. Our work shows that the simple graphene resistive devices have potential in photodetection applications.

Keywords: graphene, resistive sensor, optoelectronics, photoresponse

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Authors: P. Makendran, M. Pragadeesh, N. Narash, N. Manikandan, A. Rajasri, V. Sanal Kumar

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The growing severity of government-obligatory emissions legislation has required continuous improvement in catalysts performance and the associated reactor systems. IC engines emit a lot of harmful gases into the atmosphere. These gases are toxic in nature and a catalytic converter is used to convert these toxic gases into less harmful gases. The catalytic converter converts these gases by Oxidation and reduction reaction. Stoichiometric engines usually use the three-way catalyst (TWC) for simultaneously destroying all of the emissions. CO and NO react to form CO2 and N2 over one catalyst, and the remaining CO and HC are oxidized in a subsequent one. Literature review reveals that typically precious metals are used as a catalyst. The actual reactor is composed of a washcoated honeycomb-style substrate, with the catalyst being contained in the washcoat. The main disadvantage of a catalytic converter is that it exerts a back pressure to the exhaust gases while entering into them. The objective of this paper is to optimize the back pressure developed by the catalytic converter through geometric optimization of catalystic converter. This can be achieved by designing a catalyst with a optimum cone angle and a more surface area of the catalyst substrate. Additionally, the arrangement of the pores in the catalyst substrate can be changed. The numerical studies have been carried out using k-omega turbulence model with varying inlet angle of the catalytic converter and the length of the catalyst substrate. We observed that the geometry optimization is a meaningful objective for the lucrative design optimization of a catalytic converter for industrial applications.

Keywords: catalytic converter, emission control, reactor systems, substrate for emission control

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Authors: Manmeet Kaur, Madhu Vij

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The Board of Directors in a firm performs the primary role of an internal control mechanism. This Study seeks to understand the relationship between internal governance and performance of banks in India. The research paper investigates the effect of board structure (proportion of nonexecutive directors, gender diversity, board size and meetings per year) on the firm performance. This paper evaluates the impact of corporate governance mechanisms on bank’s financial performance using panel data for 28 listed banks in National Stock Exchange of India for the period of 2008-2014. Returns on Asset, Return on Equity, Tobin’s Q and Net Interest Margin were used as the financial performance indicators. To estimate the relationship among governance and bank performance initially the Study uses Pooled Ordinary Least Square (OLS) Estimation and Generalized Least Square (GLS) Estimation. Then a well-developed panel Generalized Method of Moments (GMM) Estimator is developed to investigate the dynamic nature of performance and governance relationship. The Study empirically confirms that two-step system GMM approach controls the problem of unobserved heterogeneity and endogeneity as compared to the OLS and GLS approach. The result suggests that banks with small board, boards with female members, and boards that meet more frequently tend to be more efficient and subsequently have a positive impact on performance of banks. The study offers insights to policy makers interested in enhancing the quality of governance of banks in India. Also, the findings suggest that board structure plays a vital role in the improvement of corporate governance mechanism for financial institutions. There is a need to have efficient boards in banks to improve the overall health of the financial institutions and the economic development of the country.

Keywords: board of directors, corporate governance, GMM estimation, Indian banking

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Authors: T. Abdelkrim, K. Ben Seddik, B. Bezza, K. Benamrane, Aeh. Benkhelifa

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This paper proposes an implementation of boost converter for a resistive load using photovoltaic energy as a source. The model of photovoltaic cell and operating principle of boost converter are presented. A PIC micro controller is used in the close loop control to generate pulses for controlling the converter circuit. To performance evaluation of boost converter, a variation of output voltage of PV panel is done by shading one and two cells.

Keywords: boost converter, microcontroller, photovoltaic power generation, shading cells

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Authors: E. S. Umdu, Ilker Kahraman, Nurdan Yildirim, Levent Bilir

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Algae-culture offers new applications in sustainable architecture with its continuous productive cycle, and a potential for high carbon dioxide capture. Microalgae itself has multiple functions such as carbon dioxide fixation, biomass production, oxygen generation and waste water treatment. Incorporating microalgae cultivation processes and systems to building design to utilize this potential is promising. Microalgae cultivation systems, especially closed photo bioreactors can be implemented as components in buildings. And these systems be accommodated in the façade of a building, or in other urban infrastructure in the future. Application microalgae bio-reactors of on building’s façade has the added benefit of acting as an effective insulation system, keeping out the heat of the summer and the chill of the winter. Furthermore, microalgae can give a dynamic appearance with a liquid façade that also works as an adaptive sunshade. Recently, potential of microalgae to use as a building component to reduce net energy demand in buildings becomes a popular topic and innovative design proposals and a handful of pilot applications appeared. Yet there is only a handful of examples in application and even less information on how these systems affect building energy behavior. Further studies on microalgae mostly focused on single application approach targeting either carbon dioxide utilization through biomass production or biofuel production. The main objective of this study is to investigate effects of design parameters of microalgae panel bio-reactors on light transmission characteristics and CO2 capture potential during growth of Nannochloropsis occulata sp. A maximum reduction of 18 ppm in CO2 levels of input air during the experiments with a % light transmission of 14.10, was achieved in 6 day growth cycles. Heat transfer behavior during these cycles was also inspected for possible façade applications.

Keywords: building façade, CO2 capture, light transmittance, microalgae

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Authors: Azadeh Shahbazi

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This study tries to find out the determinants of capital structure in hotel industry in 7 important hotel chains in USA within the period of 12 years of 2000 to 2012. The study is used a panel pooled regression to realize the relation among different variables. Results show that the variables which could make changes in the capital structure of firms are Non-Debt Tax Shield and Tangibility.

Keywords: capital structure, service industry, hospitality, finance

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Authors: Diana Kwok

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Introduction: There is a rising concern on the educational needs of school guidance teachers, counselors, and sex educators to work effectively with students from multicultural groups, such as racial minorities, gender minorities, sexual minorities, and disability groups etc., and to respect cultural diversities. A specialized training model, the multicultural framework based on contact theory is recognized as necessary training model for professional training programs. Methodology: While the major focus of this project is on improving teaching and learning in teacher training courses within the department of Special Education and Counselling, it specifically aims to enhance the cultural competence of 102 participants enrolled in counseling and sexuality education courses by integrating the following teaching and learning strategies: 1) Panel presentation; 2) Case studies; 3) Experiential learning. Data sources from the participants consisted of the following: (a) questionnaires (MCKAS and ATLG) administered in classes; (b) weekly reflective journals, and c) focus group interviews with panel members. The focus group interviews with panel members were documented. Qualitatively, the weekly reflections were content analyzed. The presentation in this specific conference put focus on themes we found from qualitative content analysis of weekly reflective journals from 102 participants. Findings: Content analysis had found the following preliminary emergent themes: Theme I) Cultural knowledge and challenges to personal limitation. Students had gained a new perspective that specific cultural knowledge involved unique values and worldview. Awareness of limitation of counsellors is very important after actively acquiring the cultural knowledge. Theme 2 - Observation, engagement and active learning. Through the sharing and case studies, as well as visits to the communities, students recognized that observation and listening to the needs of cultural group members were the essential steps before taking any intervention steps. Theme 3 - Curiosity and desire for further inter-group dialogue. All students expressed their desire, curiosity, and motivation to have further inter-group dialogue in their future work settings. Theme 4: Experience with teaching and learning strategies. Students shared their perspectives on how teaching and learning strategies had facilitated their acquisition of cultural competence. Results of this analysis suggests that diverse teaching and learning strategies based on contact perspective had stimulated their curiosity to re-examine their values and motivated them to acquire cultural knowledge relevant to the cultural groups. Acknowledgment: The teaching and learning project was funded by the Teaching and Development Grant, Hong Kong Institute of Education (Project Number T0142).

Keywords: cultural competence, Chinese teacher students, teaching and learning, contacts

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Authors: Katarzyna Lubecka, Kirsty Flower, Megan Beetch, Lucinda Kurzava, Hannah Buvala, Samer Gawrieh, Suthat Liangpunsakul, Tracy Gonzalez, George McCabe, Naga Chalasani, James M. Flanagan, Barbara Stefanska

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Hepatocellular carcinoma (HCC), the most prevalent type of primary liver cancer, is the second leading cause of cancer death worldwide. Late onset of clinical symptoms in HCC results in late diagnosis and poor disease outcome. Approximately 85% of individuals with HCC have underlying liver cirrhosis. However, not all cirrhotic patients develop cancer. Reliable early detection biomarkers that can distinguish cirrhotic patients who will develop cancer from those who will not are urgently needed and could increase the cure rate from 5% to 80%. We used Illumina-450K microarray to test whether blood DNA, an easily accessible source of DNA, bear site-specific changes in DNA methylation in response to HCC before diagnosis with conventional tools (pre-diagnostic). Top 11 differentially methylated sites were selected for validation by pyrosequencing. The diagnostic potential of the 11 pyrosequenced probes was tested in blood samples from a prospective cohort of cirrhotic patients. We identified 971 differentially methylated CpG sites in pre-diagnostic HCC cases as compared with healthy controls (P < 0.05, paired Wilcoxon test, ICC ≥ 0.5). Nearly 76% of differentially methylated CpG sites showed lower levels of methylation in cases vs. controls (P = 2.973E-11, Wilcoxon test). Classification of the CpG sites according to their location relative to CpG islands and transcription start site revealed that those hypomethylated loci are located in regulatory regions important for gene transcription such as CpG island shores, promoters, and 5’UTR at higher frequency than hypermethylated sites. Among 735 CpG sites hypomethylated in cases vs. controls, 482 sites were assigned to gene coding regions whereas 236 hypermethylated sites corresponded to 160 genes. Bioinformatics analysis using GO, KEGG and DAVID knowledgebase indicate that differentially methylated CpG sites are located in genes associated with functions that are essential for gene transcription, cell adhesion, cell migration, and regulation of signal transduction pathways. Taking into account the magnitude of the difference, statistical significance, location, and consistency across the majority of matched pairs case-control, we selected 11 CpG loci corresponding to 10 genes for further validation by pyrosequencing. We established that methylation of CpG sites within 5 out of those 10 genes distinguish cirrhotic patients who subsequently developed HCC from those who stayed cancer free (cirrhotic controls), demonstrating potential as biomarkers of early detection in populations at risk. The best predictive value was detected for CpGs located within BARD1 (AUC=0.70, asymptotic significance ˂0.01). Using an additive logistic regression model, we further showed that 9 CpG loci within those 5 genes, that were covered in pyrosequenced probes, constitute a panel with high diagnostic accuracy (AUC=0.887; 95% CI:0.80-0.98). The panel was able to distinguish pre-diagnostic cases from cirrhotic controls free of cancer with 88% sensitivity at 70% specificity. Using blood as a minimally invasive material and pyrosequencing as a straightforward quantitative method, the established biomarker panel has high potential to be developed into a routine clinical test after validation in larger cohorts. This study was supported by Showalter Trust, American Cancer Society (IRG#14-190-56), and Purdue Center for Cancer Research (P30 CA023168) granted to BS.

Keywords: biomarker, DNA methylation, early detection, hepatocellular carcinoma

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Authors: Davood Mousanezhad, Ashkan Vaziri

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As a traditional cellular structure, hexagonal honeycombs are known for their high strength-to-weight ratio. Here, we introduce a class of fractal-appearing hierarchical metamaterials by replacing the vertices of the original non-hierarchical hexagonal grid with smaller hexagons and iterating this process to achieve higher levels of hierarchy. It has been recently shown that the isotropic in-plane Young's modulus of this hierarchical structure at small deformations becomes 25 times greater than its regular counterpart with the same mass. At large deformations, we find that hierarchy-dependent elastic buckling introduced at relatively early stages of deformation decreases the value of Poisson's ratio as the structure is compressed uniaxially leading to auxeticity (i.e., negative Poisson's ratio) in subsequent stages of deformation. We also show that the topological hierarchical architecture and instability-induced pattern transformations of the structure under compression can be effectively used to tune the propagation of elastic waves within the structure. We find that the hierarchy tends to shift the existing phononic bandgaps (defined as frequency ranges of strong wave attenuation) to lower frequencies while opening up new bandgaps. Deformation is also demonstrated as another mechanism for opening more bandgaps in hierarchical structures. The results provide new insights into the role of structural organization and hierarchy in regulating mechanical properties of materials at both the static and dynamic regimes.

Keywords: cellular structures, honeycombs, hierarchical structures, metamaterials, multifunctional structures, phononic crystals, auxetic structures

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Authors: Manav Sabharwal, Ruda Rai Md, Candace Parker, James Ridley

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Wheat is one of the most commonly consumed grains worldwide, which contains gluten. Nowadays, gluten intake is considered to be a trigger for GRDs, including Celiac disease (CD), a common genetic disease affecting 1% of the US population, non-celiac gluten sensitivity (NCGS) and wheat allergy. NCGS is being recognized as an acquired gluten-sensitive enteropathy that is prevalent across age, ethnic and geographic groups. The cause of this entity is not fully understood, and recent studies suggest that it is more common in participants with irritable bowel syndrome (IBS), with iron deficiency anemia, symptoms of fatigue, and has considerable overlap in symptoms with IBS and Crohn’s disease. However, these studies were lacking in availability of complete serologies, imaging tests and/or pan-endoscopy. We performed a prospective study of 745 adult patients who presented to an outpatient clinic for evaluation of chronic upper gastro-intestinal symptoms and subsequently underwent an upper endoscopic (EGD) examination as standard of care. Evaluation comprised of comprehensive celiac antibody panel, inflammatory bowel disease (IBD) serologic markers, duodenal biopsies and Small Bowel Video Capsule Endoscopy (VCE), when available. At least 6 biopsy specimens were obtained from the duodenum and proximal jejunum during EGD, and CD3+ Intraepithelial lymphocytes (IELs) and villous architecture were evaluated by a single experienced pathologist, and VCE was performed by a single experienced gastroenterologist. Of the 745 patients undergoing EGD, 12% (93/745) patients showed elevated CD3+ IELs in the duodenal biopsies. 52% (387/745) completed a comprehensive CD panel and 7.2% (28/387) were positive for at least 1 CD antibody (Tissue transglutaminase (tTG), being the most common antibody in 65% (18/28)). Of these patients, 18% (5/28) showed increased duodenal CD3+ IELs, but 0% showed villous blunting or distortion to meet criteria for CD. Surprisingly, 43% (12/28) were positive for at 1 IBD serology (ASCA, ANCA or expanded IBD panel (LabCorp)). Of these 28 patients, 29% (8/28) underwent a SB VCE, of which 100 % (8/8) showed significant jejuno-ileal mucosal lesions diagnostic for IBD. Findings of abnormal CD antibodies (7.2%, 28/387) and increased CD3+ IELs on duodenal biopsy (12%, 93/745) were observed frequently in patients with UGI symptoms undergoing EGD in an outpatient clinic. None met criteria for CD, and a high proportion (43%, 12/28) showed evidence of overlap with IBD. This suggests a potential causal link of acquired GRDs to underlying inflammation and gut mucosal barrier disruption. Further studies to investigate a role for abnormal antigen presentation of dietary gluten to gut associated lymphoid tissue as a cause are justified. This may explain a high prevalence of GRDs in the population and correlation with IBS, IBD and other gut inflammatory disorders.

Keywords: celiac, gluten sensitive enteropathy, lymphocitic enteritis, IBS, IBD

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Authors: Rahma Fitriani, Eni Sumarminingsih, Suci Astutik

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In a fast growing region, conversion of agricultural lands which are surrounded by some new development sites will occur sooner than expected. This phenomenon has been experienced by many regions in Indonesia, especially the fringe of Jakarta (BoDeTaBek). Being Indonesia’s capital city, rapid conversion of land in this area is an unavoidable process. The land conversion expands spatially into the fringe regions, which were initially dominated by agricultural land or conservation sites. Without proper control or growth management, this activity will invite greater costs than benefits. The current land use is the use which maximizes its value. In order to maintain land for agricultural activity or conservation, some efforts are needed to keep the land value of this activity as high as possible. In this case, the knowledge regarding the functional relationship between land value and its driving forces is necessary. In a fast growing region, development externalities are the assumed dominant driving force. Land value is the product of the past decision of its use leading to its value. It is also affected by the local characteristics and the observed surrounded land use (externalities) from the previous period. The effect of each factor on land value has dynamic and spatial virtues; an empirical spatial dynamic land value model will be more useful to capture them. The model will be useful to test and to estimate the extent of land use externalities on land value in the short run as well as in the long run. It serves as a basis to formulate an effective urban growth management’s policy. This study will apply the model to the case of land value in the fringe of Jakarta Metropolitan. The model will be used further to predict the effect of externalities on land value, in the form of prediction map. For the case of Jakarta’s fringe, there is some evidence about the significance of neighborhood urban activity – negative externalities, the previous land value and local accessibility on land value. The effects are accumulated dynamically over years, but they will fully affect the land value after six years.

Keywords: growth management, land use externalities, land value, spatial panel dynamic

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Authors: Stefanie M. Vanneste, Stijn Goeminne

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This paper studies the effect of political characteristics of 308 Flemish municipalities on their budget balance in the period 1995-2011. All local governments experience the same economic and financial setting, however some governments have high budget balances, while others have low budget balances. The aim of this paper is to explain the differences in municipal budget balances by a number of economic, socio-demographic and political variables. The economic and socio-demographic variables will be used as control variables, while the focus of this paper will be on the political variables. We test four hypotheses resulting from the literature, namely (i) the partisan hypothesis tests if left wing governments have lower budget balances, (ii) the fragmentation hypothesis stating that more fragmented governments have lower budget balances, (iii) the hypothesis regarding the power of the government, higher powered governments would resolve in higher budget balances, and (iv) the opportunistic budget cycle to test whether politicians manipulate the economic situation before elections in order to maximize their reelection possibilities and therefore have lower budget balances before elections. The contributions of our paper to the existing literature are multiple. First, we use the whole array of political variables and not just a selection of them. Second, we are dealing with a homogeneous database with the same budget and election rules, making it easier to focus on the political factors without having to control for the impact of differences in the political systems. Third, our research extends the existing literature on Flemish municipalities as this is the first dynamic research on local budget balances. We use a dynamic panel data model. Because of the two lagged dependent variables as explanatory variables, we employ the system GMM (Generalized Method of Moments) estimator. This is the best possible estimator as we are dealing with political panel data that is rather persistent. Our empirical results show that the effect of the ideological position and the power of the coalition are of less importance to explain the budget balance. The political fragmentation of the government on the other hand has a negative and significant effect on the budget balance. The more parties in a coalition the worse the budget balance is ceteris paribus. Our results also provide evidence of an opportunistic budget cycle, the budget balances are lower in pre-election years relative to the other years to try and increase the incumbents reelection possibilities. An additional finding is that the incremental effect of the budget balance is very important and should not be ignored like is being done in a lot of empirical research. The coefficients of the lagged dependent variables are always positive and very significant. This proves that the budget balance is subject to incrementalism. It is not possible to change the entire policy from one year to another so the actions taken in recent past years still have an impact on the current budget balance. Only a relatively small amount of research concerning the budget balance takes this considerable incremental effect into account. Our findings survive several robustness checks.

Keywords: budget balance, fragmentation, ideology, incrementalism, municipalities, opportunistic budget cycle, panel data, political characteristics, power, system GMM

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Authors: Camila Plaza, Stefan Felder

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In October 2014, the TARMED reform was implemented in Switzerland. In an effort to even out the financial standing of general practitioners (including pediatricians) relative to that of specialists in the outpatient sector, the reform tackled two aspects: on the one hand, GPs would be able to bill an additional 9 CHF per patient, once per consult per day. This is referred to as the surcharge position. As a second measure, it reduced the fees for certain technical services targeted to specialists (e.g., imaging, surgical technical procedures, etc.). Given the fee-for-service reimbursement system in Switzerland, we predict that physicians reacted to the economic incentives of the reform by increasing the consults per patient and decreasing the average amount of time per consult. Within this framework, our treatment group is formed by GPs and our control group by those specialists who were not affected by the reform. Using monthly insurance claims panel data aggregated at the physician praxis level (provided by SASIS AG), for the period of January 2013-December 2015, we run difference in difference panel data models with physician and time fixed effects in order to test for the causal effects of the reform. We account for seasonality, and control for physician characteristics such as age, gender, specialty, and physician experience. Furthermore, we run the models on subgroups of physicians within our sample so as to account for heterogeneity and treatment intensities. Preliminary results support our hypothesis. We find evidence of an increase in consults per patients and a decrease in time per consult. Robustness checks do not significantly alter the results for our outcome variable of consults per patient. However, we do find a smaller effect of the reform for time per consult. Thus, the results of this paper could provide policymakers a better understanding of physician behavior and their sensitivity to financial incentives of reforms (both past and future) under the current reimbursement system.

Keywords: difference in differences, financial incentives, health reform, physician behavior

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