Search results for: systematic%20literature%20review
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1734

Search results for: systematic%20literature%20review

204 Developing a Culturally Adapted Family Intervention for Relatives Living with Schizophrenia in Oman

Authors: Aziza Al-Sawafi

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Introduction: The evidence of family interventions in schizophrenia is robust primarily in high-income settings. However, they have been adapted to other settings and cultures to improve effectiveness and acceptability. In Oman, there is limited integration of psychosocial interventions in the treatment of schizophrenia. Therefore, the adaptation of family intervention to the Omani culture may facilitate its uptake. Most service users in Oman live with their families outside the healthcare system, and nothing is known about their experience, needs, or resources. Furthermore, understanding caregivers' and mental health professionals' preferences, perceptions, and experience is a fundamental element in the process of intervention development. Therefore, this study aims to develop a culturally sensitive, feasible, and acceptable family intervention for relatives living with schizophrenia in Oman. Method: The Medical Research Council's framework for the evaluation of complex health care interventions provided the conceptual structure for the study. The development phase was carried out, which involved three stages: 1) systematically reviewing the available literature regarding culturally adapted family interventions in the Arab world 2) In-depth interviews with caregivers to explore their experience and perceived needs and preferences regarding intervention 3) A focus group study involving health professionals to explore the acceptability and feasibility of delivering the family intervention in the Omani context. Data synthesis determined the design of the proposed intervention according to the findings obtained from the previous stages. Results: Stage one: The systematic review found limited evidence of culturally-adapted family interventions in the Arab region. However, the cultural adaptation process was comprehensive, and the implementation was reported to be feasible and acceptable. Stage two: The experience of family caregivers illuminated four main themes: burden, stigma, violence, and family needs. Burdens of care included objective and subjective burdens, positive feelings, and coping mechanisms. Caregivers gave their opinion about the content and preference of the intervention from their personal experiences. Stage three: mental health professionals discussed the delivery system of the intervention from a clinical standpoint concerning issues and barriers to implementation. They recommended modifications to the components of the intervention to ensure its acceptability and feasibility in the local setting. Data synthesis was carried out, and the intervention was designed. Conclusion: This study provides evidence of the potential applicability and acceptability of a culturally sensitive family intervention for families of individuals with schizophrenia in Oman. However, more work needs to be done to test the feasibility of the study and overcome the practical challenges.

Keywords: cultural-adaptation, family intervention, Oman, schizophrenia

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203 Open Theism in Confinement: A Conversation between Open and Confined Views of God

Authors: Charles Atkins

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Anakainosis-desmios is the experience of spiritual renewal during incarceration. "Anakainosis” is a Greek word for “renovation or renewal" that has taken on profound meaning in Christocentric theology where it is defined as the phenomenon of spiritual renewal or a change of heart that is achieved by God’s power. “Desmios” is another Greek word found in the Bible which stands for “one who is bound or a prisoner. Anakainosis-desmios occurs when a person, while residing in an environment of surveillance and coercion, has his consciousness renewed in such a way that he generates unexpected emancipatory and hospitable attitudes. They expressed an awareness of the prison environment and a willingness to engage that environment through their transformed relationships with time, space, matter, and people. By the end of the 20th century, Open Theism, gained the attention of many American evangelicals and theologians. Open Theism was born out of the concerns people had about those scriptures which demonstrate a dynamic God who has unparalled wisdom instead of omniscience; liberating power instead of omnipotence; and abiding faithfulness instead of immutability—all of these attributes being aspects of God’s love for humanity. Scriptural exegesis is one of the primary factors that informed the creation of the open view of God and many who hold this view claim that the divine attributes of omniscience, omnipotence and immutability are not necessarily Scriptural but rather philosophical attempts to define the nature of God. Scriptures that do not support such divine attributes have been a source of distress for many. Some would say that open theists have created lenses that enable a Bible student to gain comfort from those scriptures which seem to show God demonstrating repentance, disappointment and a readiness to learn. This paper will bring Open Theism into conversation with anakainosis-desmios. For open theists the reading of Scripture is an important part of the foundation of their perspectives. Open theists focus on certain Scriptures which demonstrate God showing repentance, disappointment and a readiness to learn. This focus led to their questioning of the systematic theologies that have been created and the biblical hermeneutics that have been used historically as lenses for interpreting such Scriptures. The perspective of anakainosis-desmios is also significantly influenced by the reading of Scripture. Spiritual renewal while incarcerated can occur largely through the religious practice of Bible study. Studying Scriptures during incarceration has supported many people who are seeking to develop new renderings of reality that empower them to flourish in some way despite the hostile environment of prisons. A conversation between the two points of view on the God of the Bible will lead to an expansion of both and to a deepening of a person's experience of Scripture Study.

Keywords: open theism, anakainosis-desmios, religion in prison, open theology, practical theology, Bible, scripture, openness of God, incarceration, prison

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202 Enhancing AI for Global Impact: Conversations on Improvement and Societal Benefits

Authors: C. P. Chukwuka, E. V. Chukwuka, F. Ukwadi

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This paper focuses on the advancement and societal impact of artificial intelligence (AI) systems. It explores the need for a theoretical framework in corporate governance, specifically in the context of 'hybrid' companies that have a mix of private and government ownership. The paper emphasizes the potential of AI to address challenges faced by these companies and highlights the importance of the less-explored state model in corporate governance. The aim of this research is to enhance AI systems for global impact and positive societal outcomes. It aims to explore the role of AI in refining corporate governance in hybrid companies and uncover nuanced insights into complex ownership structures. The methodology involves leveraging the capabilities of AI to address the challenges faced by hybrid companies in corporate governance. The researchers will analyze existing theoretical frameworks in corporate governance and integrate AI systems to improve problem-solving and understanding of intricate systems. The paper suggests that improved AI systems have the potential to shape a more informed and responsible corporate landscape. AI can uncover nuanced insights and navigate complex ownership structures in hybrid companies, leading to greater efficacy and positive societal outcomes. The theoretical importance of this research lies in the exploration of the role of AI in corporate governance, particularly in the context of hybrid companies. By integrating AI systems, the paper highlights the potential for improved problem-solving and understanding of intricate systems, contributing to a more informed and responsible corporate landscape. The data for this research will be collected from existing literature on corporate governance, specifically focusing on hybrid companies. Additionally, data on AI capabilities and their application in corporate governance will be collected. The collected data will be analyzed through a systematic review of existing theoretical frameworks in corporate governance. The researchers will also analyze the capabilities of AI systems and their potential application in addressing the challenges faced by hybrid companies. The findings will be synthesized and compared to identify patterns and potential improvements. The research concludes that AI systems have the potential to enhance corporate governance in hybrid companies, leading to greater efficacy and positive societal outcomes. By leveraging AI capabilities, nuanced insights can be uncovered, and complex ownership structures can be navigated, shaping a more informed and responsible corporate landscape. The findings highlight the importance of integrating AI in refining problem-solving and understanding intricate systems for global impact.

Keywords: advancement, artificial intelligence, challenges, societal impact

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201 A Delphi Study to Build Consensus for Tuberculosis Control Guideline to Achieve Who End Tb 2035 Strategy

Authors: Pui Hong Chung, Cyrus Leung, Jun Li, Kin On Kwok, Ek Yeoh

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Introduction: Studies for TB control in intermediate tuberculosis burden countries (IBCs) comprise a relatively small proportion in TB control literature, as compared to the effort put in high and low burden counterparts. It currently lacks of consensus in the optimal weapons and strategies we can use to combat TB in IBCs; guidelines of TB control are inadequate and thus posing a great obstacle in eliminating TB in these countries. To fill-in the research and services gap, we need to summarize the findings of the effort in this regard and to seek consensus in terms of policy making for TB control, we have devised a series of scoping and Delphi studies for these purposes. Method: The scoping and Delphi studies are conducted in parallel to feed information for each other. Before the Delphi iterations, we have invited three local experts in TB control in Hong Kong to participate in the pre-assessment round of the Delphi study to comments on the validity, relevance, and clarity of the Delphi questionnaire. Result: Two scoping studies, regarding LTBI control in health care workers in IBCs and TB control in elderly of IBCs respectively, have been conducted. The result of these two studies is used as the foundation for developing the Delphi questionnaire, which tapped on seven areas of question, namely: characteristics of IBCs, adequacy of research and services in LTBI control in IBCs, importance and feasibility of interventions for TB control and prevention in hospital, screening and treatment of LTBI in community, reasons of refusal to/ default from LTBI treatment, medical adherence of LTBI treatment, and importance and feasibility of interventions for TB control and prevention in elderly in IBCs. The local experts also commented on the two scoping studies conducted, thus act as the sixth phase of expert consultation in Arksey and O’Malley framework of scoping studies, to either nourish the scope and strategies used in these studies or to supplement ideas for further scoping or systematic review studies. In the subsequent stage, an international expert panel, comprised of 15 to 20 experts from IBCs in Western Pacific Region, will be recruited to join the two-round anonymous Delphi iterations. Four categories of TB control experts, namely clinicians, policy makers, microbiologists/ laboratory personnel, and public health clinicians will be our target groups. A consensus level of 80% is used to determine the achievement of consensus on particular issues. Key messages: 1. Scoping review and Delphi method are useful to identify gaps and then achieve consensus in research. 2. Lots of resources are put in the high burden countries now. However, the usually neglected intermediate-burden countries with TB is an indispensable part for achieving the ambitious WHO End TB 2035 target.

Keywords: dephi questionnaire, tuberculosis, WHO, latent TB infection

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200 Biorefinery as Extension to Sugar Mills: Sustainability and Social Upliftment in the Green Economy

Authors: Asfaw Gezae Daful, Mohsen Alimandagari, Kathleen Haigh, Somayeh Farzad, Eugene Van Rensburg, Johann F. Görgens

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The sugar industry has to 're-invent' itself to ensure long-term economic survival and opportunities for job creation and enhanced community-level impacts, given increasing pressure from fluctuating and low global sugar prices, increasing energy prices and sustainability demands. We propose biorefineries for re-vitalisation of the sugar industry using low value lignocellulosic biomass (sugarcane bagasse, leaves, and tops) annexed to existing sugar mills, producing a spectrum of high value platform chemicals along with biofuel, bioenergy, and electricity. Opportunity is presented for greener products, to mitigate climate change and overcome economic challenges. Xylose from labile hemicellulose remains largely underutilized and the conversion to value-add products a major challenge. Insight is required on pretreatment and/or extraction to optimize production of cellulosic ethanol together with lactic acid, furfural or biopolymers from sugarcane bagasse, leaves, and tops. Experimental conditions for alkaline and pressurized hot water extraction dilute acid and steam explosion pretreatment of sugarcane bagasse and harvest residues were investigated to serve as a basis for developing various process scenarios under a sugarcane biorefinery scheme. Dilute acid and steam explosion pretreatment were optimized for maximum hemicellulose recovery, combined sugar yield and solids digestibility. An optimal range of conditions for alkaline and liquid hot water extraction of hemicellulosic biopolymers, as well as conditions for acceptable enzymatic digestibility of the solid residue, after such extraction was established. Using data from the above, a series of energy efficient biorefinery scenarios are under development and modeled using Aspen Plus® software, to simulate potential factories to better understand the biorefinery processes and estimate the CAPEX and OPEX, environmental impacts, and overall viability. Rigorous and detailed sustainability assessment methodology was formulated to address all pillars of sustainability. This work is ongoing and to date, models have been developed for some of the processes which can ultimately be combined into biorefinery scenarios. This will allow systematic comparison of a series of biorefinery scenarios to assess the potential to reduce negative impacts on and maximize the benefits of social, economic, and environmental factors on a lifecycle basis.

Keywords: biomass, biorefinery, green economy, sustainability

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199 A 'Systematic Literature Review' of Specific Types of Inventory Faced by the Management of Firms

Authors: Rui Brito

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This contribution regards a literature review of inventory management that is a relevant topic for the firms, due to its important use of capital with implications in firm’s profitability within the complexity of a more competitive and globalized world. Firms look for small inventories in order to reduce holding costs, namely opportunity cost, warehousing and handling costs, deterioration and being out of style, but larger inventories are required by some reasons, such as customer service, ordering cost, transportation cost, supplier’s payment to reduce unit costs or to take advantage of price increase in the near future, and equipment setup cost. Thus, management shall address a trade-off between small inventories and larger inventories. This literature review concerns three types of inventory (spare parts, safety stock, and vendor) whose management usually is beyond the scope of logistics. The applied methodology consisted of an online search of databases regarding scientific documents in English, namely Elsevier, Springer, Emerald, Wiley, and Taylor & Francis, but excluding books except if edited, using search engines, such as Google Scholar and B-on. The search was based on three keywords/strings (themes) which had to be included just as in the article title, suggesting themes were very relevant to the researchers. The whole search period was between 2009 and 2018 with the aim of collecting between twenty and forty studies considered relevant within each of the key words/strings specified. Documents were sorted by relevance and to prevent the exclusion of the more recent articles, based on lower quantity of citations partially due to less time to be cited in new research articles, the search period was divided into two sub-periods (2009-2015 and 2016-2018). The number of surveyed articles by theme showed a variation from 40 to 200 and the number of citations of those articles showed a wider variation from 3 to 216. Selected articles from the three themes were analyzed and the first seven of the first sub-period and the first three of the second sub-period with more citations were read in full to make a synopsis of each article. Overall, the findings show that the majority of article types were models, namely mathematical, although with different sub-types for each theme. Almost all articles suggest further studies, with some mentioning it for their own author(s), which widen the diversity of the previous research. Identified research gaps concern the use of surveys to know which are the models more used by firms, the reasons for not using the models with more performance and accuracy, and which are the satisfaction levels with the outcomes of the inventories management and its effect on the improvement of the firm’s overall performance. The review ends with the limitations and contributions of the study.

Keywords: inventory management, safety stock, spare parts inventory, vendor managed inventory

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198 Influence of Intra-Yarn Permeability on Mesoscale Permeability of Plain Weave and 3D Fabrics

Authors: Debabrata Adhikari, Mikhail Matveev, Louise Brown, Andy Long, Jan Kočí

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A good understanding of mesoscale permeability of complex architectures in fibrous porous preforms is of particular interest in order to achieve efficient and cost-effective resin impregnation of liquid composite molding (LCM). Fabrics used in structural reinforcements are typically woven or stitched. However, 3D fabric reinforcement is of particular interest because of the versatility in the weaving pattern with the binder yarn and in-plain yarn arrangements to manufacture thick composite parts, overcome the limitation in delamination, improve toughness etc. To predict the permeability based on the available pore spaces between the inter yarn spaces, unit cell-based computational fluid dynamics models have been using the Stokes Darcy model. Typically, the preform consists of an arrangement of yarns with spacing in the order of mm, wherein each yarn consists of thousands of filaments with spacing in the order of μm. The fluid flow during infusion exchanges the mass between the intra and inter yarn channels, meaning there is no dead-end of flow between the mesopore in the inter yarn space and the micropore in the yarn. Several studies have employed the Brinkman equation to take into account the flow through dual-scale porosity reinforcement to estimate their permeability. Furthermore, to reduce the computational effort of dual scale flow, scale separation criteria based on the ratio between yarn permeability to the yarn spacing was also proposed to quantify the dual scale and negligible micro-scale flow regime for the prediction of mesoscale permeability. In the present work, the key parameter to identify the influence of intra yarn permeability on the mesoscale permeability has been investigated with the systematic study of weft and warp yarn spacing on the plane weave as well as the position of binder yarn and number of in-plane yarn layers on 3D weave fabric. The permeability tensor has been estimated using an OpenFOAM-based model for the various weave pattern with idealized geometry of yarn implemented using open-source software TexGen. Additionally, scale separation criterion has been established based on the various configuration of yarn permeability for the 3D fabric with both the isotropic and anisotropic yarn from Gebart’s model. It was observed that the variation of mesoscale permeability Kxx within 30% when the isotropic porous yarn is considered for a 3D fabric with binder yarn. Furthermore, the permeability model developed in this study will be used for multi-objective optimizations of the preform mesoscale geometry in terms of yarn spacing, binder pattern, and a number of layers with an aim to obtain improved permeability and reduced void content during the LCM process.

Keywords: permeability, 3D fabric, dual-scale flow, liquid composite molding

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197 Assessing the Material Determinants of Cavity Polariton Relaxation using Angle-Resolved Photoluminescence Excitation Spectroscopy

Authors: Elizabeth O. Odewale, Sachithra T. Wanasinghe, Aaron S. Rury

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Cavity polaritons form when molecular excitons strongly couple to photons in carefully constructed optical cavities. These polaritons, which are hybrid light-matter states possessing a unique combination of photonic and excitonic properties, present the opportunity to manipulate the properties of various semiconductor materials. The systematic manipulation of materials through polariton formation could potentially improve the functionalities of many optoelectronic devices such as lasers, light-emitting diodes, photon-based quantum computers, and solar cells. However, the prospects of leveraging polariton formation for novel devices and device operation depend on more complete connections between the properties of molecular chromophores, and the hybrid light-matter states they form, which remains an outstanding scientific goal. Specifically, for most optoelectronic applications, it is paramount to understand how polariton formation affects the spectra of light absorbed by molecules coupled strongly to cavity photons. An essential feature of a polariton state is its dispersive energy, which occurs due to the enhanced spatial delocalization of the polaritons relative to bare molecules. To leverage the spatial delocalization of cavity polaritons, angle-resolved photoluminescence excitation spectroscopy was employed in characterizing light emission from the polaritonic states. Using lasers of appropriate energies, the polariton branches were resonantly excited to understand how molecular light absorption changes under different strong light-matter coupling conditions. Since an excited state has a finite lifetime, the photon absorbed by the polariton decays non-radiatively into lower-lying molecular states, from which radiative relaxation to the ground state occurs. The resulting fluorescence is collected across several angles of excitation incidence. By modeling the behavior of the light emission observed from the lower-lying molecular state and combining this result with the output of angle-resolved transmission measurements, inferences are drawn about how the behavior of molecules changes when they form polaritons. These results show how the intrinsic properties of molecules, such as the excitonic lifetime, affect the rate at which the polaritonic states relax. While it is true that the lifetime of the photon mediates the rate of relaxation in a cavity, the results from this study provide evidence that the lifetime of the molecular exciton also limits the rate of polariton relaxation.

Keywords: flourescece, molecules in cavityies, optical cavity, photoluminescence excitation, spectroscopy, strong coupling

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196 A Literature Review on the Use of Information and Communication Technology within and between Emergency Medical Teams during a Disaster

Authors: Badryah Alshehri, Kevin Gormley, Gillian Prue, Karen McCutcheon

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In a disaster event, sharing patient information between the pre-hospitals Emergency Medical Services (EMS) and Emergency Department (ED) hospitals is a complex process during which important information may be altered or lost due to poor communication. The aim of this study was to critically discuss the current evidence base in relation to communication between pre-EMS hospital and ED hospital professionals by the use of Information and Communication Systems (ICT). This study followed the systematic approach; six electronic databases were searched: CINAHL, Medline, Embase, PubMed, Web of Science, and IEEE Xplore Digital Library were comprehensively searched in January 2018 and a second search was completed in April 2020 to capture more recent publications. The study selection process was undertaken independently by the study authors. Both qualitative and quantitative studies were chosen that focused on factors which are positively or negatively associated with coordinated communication between pre-hospital EMS and ED teams in a disaster event. These studies were assessed for quality and the data were analysed according to the key screening themes which emerged from the literature search. Twenty-two studies were included. Eleven studies employed quantitative methods, seven studies used qualitative methods, and four studies used mixed methods. Four themes emerged on communication between EMTs (pre-hospital EMS and ED staff) in a disaster event using the ICT. (1) Disaster preparedness plans and coordination. This theme reported that disaster plans are in place in hospitals, and in some cases, there are interagency agreements with pre-hospital and relevant stakeholders. However, the findings showed that the disaster plans highlighted in these studies lacked information regarding coordinated communications within and between the pre-hospital and hospital. (2) Communication systems used in the disaster. This theme highlighted that although various communication systems are used between and within hospitals and pre-hospitals, technical issues have influenced communication between teams during disasters. (3) Integrated information management systems. This theme suggested the need for an integrated health information system which can help pre-hospital and hospital staff to record patient data and ensure the data is shared. (4) Disaster training and drills. While some studies analysed disaster drills and training, the majority of these studies were focused on hospital departments other than EMTs. These studies suggest the need for simulation disaster training and drills, including EMTs. This review demonstrates that considerable gaps remain in the understanding of the communication between the EMS and ED hospitals staff in relation to response in disasters. The review shows that although different types of ICTs are used, various issues remain which affect coordinated communication among the relevant professionals.

Keywords: communication, emergency communication services, emergency medical teams, emergency physicians, emergency nursing, paramedics, information and communication technology, communication systems

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195 Making the Invisible Visible: Exploring Immersion Teacher Perceptions of Online Content and Language Integrated Learning Professional Development Experiences

Authors: T. J. O Ceallaigh

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Subject matter driven programs such as immersion programs are increasingly popular across the world. These programs have allowed for extensive experimentation in the realm of second language teaching and learning and have been at the centre of many research agendas since their inception. Even though immersion programs are successful, especially in terms of second language development, they remain complex to implement and not always as successful as what we would hope them to be. Among all the challenges these varied programs face, research indicates that the primary issue lies in the difficulty to create well-balanced programs where both content instruction and language/literacy instruction can be targeted simultaneously. Initial teacher education and professional development experiences are key drivers of successful language immersion education globally. They are critical to the supply of teachers with the mandatory linguistic and cultural competencies as well as associated pedagogical practices required to ensure learners’ success. However, there is a significant dearth of research on professional development experiences of immersion teachers. We lack an understanding of the nature of their expertise and their needs in terms of professional development as well as their perceptions of the primary challenges they face as they attempt to formulate a coherent pedagogy of integrated language and content instruction. Such an understanding is essential if their specific needs are to be addressed appropriately and thus improve the overall quality of immersion programs. This paper reports on immersion teacher perceptions of online professional development experiences that have a positive impact on their ability to facilitate language and content connections in instruction. Twenty Irish-medium immersion teachers engaged in the instructional integration of language and content in a systematic and developmental way during a year-long online professional development program. Data were collected from a variety of sources e.g., an extensive online questionnaire, individual interviews, reflections, assignments and focus groups. This study provides compelling evidence of the potential of online professional development experiences as a pedagogical framework for understanding the complex and interconnected knowledge demands that arise in content and language integration in immersion. Findings illustrate several points of access to classroom research and pedagogy and uncover core aspects of high impact online experiences. Teachers identified aspects such as experimentation and risk-taking, authenticity and relevance, collegiality and collaboration, motivation and challenge and teacher empowerment. The potential of the online experiences to foster teacher language awareness was also identified as a contributory factor to success. The paper will conclude with implications for designing meaningful and effective online CLIL professional development experiences.

Keywords: content and language integrated learning , immersion pedagogy, professional development, teacher language awareness

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194 Lead Removal From Ex- Mining Pond Water by Electrocoagulation: Kinetics, Isotherm, and Dynamic Studies

Authors: Kalu Uka Orji, Nasiman Sapari, Khamaruzaman W. Yusof

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Exposure of galena (PbS), tealite (PbSnS2), and other associated minerals during mining activities release lead (Pb) and other heavy metals into the mining water through oxidation and dissolution. Heavy metal pollution has become an environmental challenge. Lead, for instance, can cause toxic effects to human health, including brain damage. Ex-mining pond water was reported to contain lead as high as 69.46 mg/L. Conventional treatment does not easily remove lead from water. A promising and emerging treatment technology for lead removal is the application of the electrocoagulation (EC) process. However, some of the problems associated with EC are systematic reactor design, selection of maximum EC operating parameters, scale-up, among others. This study investigated an EC process for the removal of lead from synthetic ex-mining pond water using a batch reactor and Fe electrodes. The effects of various operating parameters on lead removal efficiency were examined. The results obtained indicated that the maximum removal efficiency of 98.6% was achieved at an initial PH of 9, the current density of 15mA/cm2, electrode spacing of 0.3cm, treatment time of 60 minutes, Liquid Motion of Magnetic Stirring (LM-MS), and electrode arrangement = BP-S. The above experimental data were further modeled and optimized using a 2-Level 4-Factor Full Factorial design, a Response Surface Methodology (RSM). The four factors optimized were the current density, electrode spacing, electrode arrangements, and Liquid Motion Driving Mode (LM). Based on the regression model and the analysis of variance (ANOVA) at 0.01%, the results showed that an increase in current density and LM-MS increased the removal efficiency while the reverse was the case for electrode spacing. The model predicted the optimal lead removal efficiency of 99.962% with an electrode spacing of 0.38 cm alongside others. Applying the predicted parameters, the lead removal efficiency of 100% was actualized. The electrode and energy consumptions were 0.192kg/m3 and 2.56 kWh/m3 respectively. Meanwhile, the adsorption kinetic studies indicated that the overall lead adsorption system belongs to the pseudo-second-order kinetic model. The adsorption dynamics were also random, spontaneous, and endothermic. The higher temperature of the process enhances adsorption capacity. Furthermore, the adsorption isotherm fitted the Freundlish model more than the Langmuir model; describing the adsorption on a heterogeneous surface and showed good adsorption efficiency by the Fe electrodes. Adsorption of Pb2+ onto the Fe electrodes was a complex reaction, involving more than one mechanism. The overall results proved that EC is an efficient technique for lead removal from synthetic mining pond water. The findings of this study would have application in the scale-up of EC reactor and in the design of water treatment plants for feed-water sources that contain lead using the electrocoagulation method.

Keywords: ex-mining water, electrocoagulation, lead, adsorption kinetics

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193 Optimization Principles of Eddy Current Separator for Mixtures with Different Particle Sizes

Authors: Cao Bin, Yuan Yi, Wang Qiang, Amor Abdelkader, Ali Reza Kamali, Diogo Montalvão

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The study of the electrodynamic behavior of non-ferrous particles in time-varying magnetic fields is a promising area of research with wide applications, including recycling of non-ferrous metals, mechanical transmission, and space debris. The key technology for recovering non-ferrous metals is eddy current separation (ECS), which utilizes the eddy current force and torque to separate non-ferrous metals. ECS has several advantages, such as low energy consumption, large processing capacity, and no secondary pollution, making it suitable for processing various mixtures like electronic scrap, auto shredder residue, aluminum scrap, and incineration bottom ash. Improving the separation efficiency of mixtures with different particle sizes in ECS can create significant social and economic benefits. Our previous study investigated the influence of particle size on separation efficiency by combining numerical simulations and separation experiments. Pearson correlation analysis found a strong correlation between the eddy current force in simulations and the repulsion distance in experiments, which confirmed the effectiveness of our simulation model. The interaction effects between particle size and material type, rotational speed, and magnetic pole arrangement were examined. It offer valuable insights for the design and optimization of eddy current separators. The underlying mechanism behind the effect of particle size on separation efficiency was discovered by analyzing eddy current and field gradient. The results showed that the magnitude and distribution heterogeneity of eddy current and magnetic field gradient increased with particle size in eddy current separation. Based on this, we further found that increasing the curvature of magnetic field lines within particles could also increase the eddy current force, providing a optimized method to improving the separation efficiency of fine particles. By combining the results of the studies, a more systematic and comprehensive set of optimization guidelines can be proposed for mixtures with different particle size ranges. The separation efficiency of fine particles could be improved by increasing the rotational speed, curvature of magnetic field lines, and electrical conductivity/density of materials, as well as utilizing the eddy current torque. When designing an ECS, the particle size range of the target mixture should be investigated in advance, and the suitable parameters for separating the mixture can be fixed accordingly. In summary, these results can guide the design and optimization of ECS, and also expand the application areas for ECS.

Keywords: eddy current separation, particle size, numerical simulation, metal recovery

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192 An Exploration of Policy-related Documents on District Heating and Cooling in Flanders: a Slow and Bottom-up Process

Authors: Isaura Bonneux

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District heating and cooling (DHC) is increasingly recognized as a viable path towards sustainable heating and cooling. While some countries like Sweden and Denmark have a longstanding tradition of DHC, Belgium is lacking behind. The Northern part of Belgium, Flanders, had only a total of 95 heating networks in July 2023. Nevertheless, it is increasingly exploring its possibilities to enhance the scope of DHC. DHC is a complex energy system, requiring a lot of collaboration between various stakeholders on various levels. Therefore, it is of interest to look closer at policy-related documents at the Flemish (regional) level, as these policies set the scene for DHC development in the Flemish region. This kind of analysis has not been undertaken so far. This paper has the following research question: “Who talks about DHC, and in which way and context is DHC discussed in Flemish policy-related documents?” To answer this question, the Overton policy database was used to search and retrieve relevant policy-related documents. Overton retrieves data from governments, think thanks, NGOs, and IGOs. In total, out of the 244 original results, 117 documents between 2009 and 2023 were analyzed. Every selected document included theme keywords, policymaking department(s), date, and document type. These elements were used for quantitative data description and visualization. Further, qualitative content analysis revealed patterns and main themes regarding DHC in Flanders. Four main conclusions can be drawn: First, it is obvious from the timeframe that DHC is a new topic in Flanders with still limited attention; 2014, 2016 and 2017 were the years with the most documents, yet this number is still only 12 documents. In addition, many documents talked about DHC but not much in depth and painted it as a future scenario with a lot of uncertainty around it. The largest part of the issuing government departments had a link to either energy or climate (e.g. Flemish Environmental Agency) or policy (e.g. Socio-Economic Council of Flanders) Second, DHC is mentioned most within an ‘Environment and Sustainability’ context, followed by ‘General Policy and Regulation’. This is intuitive, as DHC is perceived as a sustainable heating and cooling technique and this analysis compromises policy-related documents. Third, Flanders seems mostly interested in using waste or residual heat as a heating source for DHC. The harbors and waste incineration plants are identified as potential and promising supply sources. This approach tries to conciliate environmental and economic incentives. Last, local councils get assigned a central role and the initiative is mostly taken by them. The policy documents and policy advices demonstrate that Flanders opts for a bottom-up organization. As DHC is very dependent on local conditions, this seems a logic step. Nevertheless, this can impede smaller councils to create DHC networks and slow down systematic and fast implementation of DHC throughout Flanders.

Keywords: district heating and cooling, flanders, overton database, policy analysis

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191 Deasphalting of Crude Oil by Extraction Method

Authors: A. N. Kurbanova, G. K. Sugurbekova, N. K. Akhmetov

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The asphaltenes are heavy fraction of crude oil. Asphaltenes on oilfield is known for its ability to plug wells, surface equipment and pores of the geologic formations. The present research is devoted to the deasphalting of crude oil as the initial stage refining oil. Solvent deasphalting was conducted by extraction with organic solvents (cyclohexane, carbon tetrachloride, chloroform). Analysis of availability of metals was conducted by ICP-MS and spectral feature at deasphalting was achieved by FTIR. High contents of asphaltenes in crude oil reduce the efficiency of refining processes. Moreover, high distribution heteroatoms (e.g., S, N) were also suggested in asphaltenes cause some problems: environmental pollution, corrosion and poisoning of the catalyst. The main objective of this work is to study the effect of deasphalting process crude oil to improve its properties and improving the efficiency of recycling processes. Experiments of solvent extraction are using organic solvents held in the crude oil JSC “Pavlodar Oil Chemistry Refinery. Experimental results show that deasphalting process also leads to decrease Ni, V in the composition of the oil. One solution to the problem of cleaning oils from metals, hydrogen sulfide and mercaptan is absorption with chemical reagents directly in oil residue and production due to the fact that asphalt and resinous substance degrade operational properties of oils and reduce the effectiveness of selective refining of oils. Deasphalting of crude oil is necessary to separate the light fraction from heavy metallic asphaltenes part of crude oil. For this oil is pretreated deasphalting, because asphaltenes tend to form coke or consume large quantities of hydrogen. Removing asphaltenes leads to partly demetallization, i.e. for removal of asphaltenes V/Ni and organic compounds with heteroatoms. Intramolecular complexes are relatively well researched on the example of porphyinous complex (VO2) and nickel (Ni). As a result of studies of V/Ni by ICP MS method were determined the effect of different solvents-deasphalting – on the process of extracting metals on deasphalting stage and select the best organic solvent. Thus, as the best DAO proved cyclohexane (C6H12), which as a result of ICP MS retrieves V-51.2%, Ni-66.4%? Also in this paper presents the results of a study of physical and chemical properties and spectral characteristics of oil on FTIR with a view to establishing its hydrocarbon composition. Obtained by using IR-spectroscopy method information about the specifics of the whole oil give provisional physical, chemical characteristics. They can be useful in the consideration of issues of origin and geochemical conditions of accumulation of oil, as well as some technological challenges. Systematic analysis carried out in this study; improve our understanding of the stability mechanism of asphaltenes. The role of deasphalted crude oil fractions on the stability asphaltene is described.

Keywords: asphaltenes, deasphalting, extraction, vanadium, nickel, metalloporphyrins, ICP-MS, IR spectroscopy

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190 Person-Centered Approaches in Face-to-Face Interventions to Support Enrolment in Cardiac Rehabilitation: A Scoping Review Study

Authors: Birgit Rasmussen, Thomas Maribo, Bente S. Toft

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BACKGROUND: Cardiac rehabilitation is the standard treatment for ischemic heart disease. Cardiac rehabilitation improves quality of life, reduces mortality and the risk of readmission, and provides patients with valuable knowledge and encouragement from peers and staff. Still, less than half of eligible patients enroll. Face-to-face interventions have the potential to support patients' decision-making and increase enrolment in cardiac rehabilitation. However, we lack knowledge of the content and characteristics of interventions. AIM: The aim was to outline and evaluate the content and characteristics of studies that have reported on face-to-face interventions to encourage enrolment in cardiac rehabilitation in patients with ischemic heart disease. METHOD: This scoping review followed the Joanne Briggs Institute methodology. Based on an a-priori protocol that defined the systematic search criteria, six databases were searched for studies published between 2001 and 2023. Two reviewers independently screened and selected studies. All authors discussed the summarized data prior to the narrative presentation. RESULTS: After screening and full text review of 5583 records, 20 studies of heterogeneous design and content were included. Four studies described the key contents in face-to-face interventions to be education, support of autonomy, addressing reasons for change, and emotional and cognitive support while showing understanding. Two studies used motivational interviewing to target patients' experiences and address worries and anticipated difficulties. Four quantitative studies found associations between enrolment and intention to attend, cardiac rehabilitation barriers, exercise self-efficacy, and perceived control. When patients asked questions, enrolment rates were higher, while providing reassurance and optimism could lead to non-attendance if patients had a high degree of worry. In qualitative studies, support to overcome barriers and knowledge about health benefits from participation in cardiac rehabilitation facilitated enrolment. Feeling reassured that the cardiac condition was good could lead to non-attendance. DISCUSSION AND CONCLUSION: To support patients' enrolment in cardiac rehabilitation, it is recommended that interventions integrate a person-centered dialogue. Individual worries and barriers to cardiac rehabilitation should be jointly explored. When talking with patients for whom worries predominate, the recommendation is to focus on the patients' perspectives and avoid too much focus on reassurance and problem-solving. The patients' perspectives, the mechanisms of change, and the process evaluation of the intervention including person-centeredness are relevant to include in future studies.

Keywords: ischemic heart disease, cardiac rehabilitation, enrolment, person-centered, in-hospital interventions

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189 Benefits of Shaping a Balance on Environmental and Economic Sustainability for Population Health

Authors: Edna Negron-Martinez

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Our time's global challenges and trends —like those associated with climate change, demographics displacements, growing health inequalities, and increasing burden of diseases— have complex connections to the determinants of health. Information on the burden of disease causes and prevention is fundamental for public health actions, like preparedness and responses for disasters, and recovery resources after the event. For instance, there is an increasing consensus about key findings of the effects and connections of the global burden of disease, as it generates substantial healthcare costs, consumes essential resources and prevents the attainment of optimal health and well-being. The goal of this research endeavor is to promote a comprehensive understanding of the connections between social, environmental, and economic influences on health. These connections are illustrated by pulling from clearly the core curriculum of multidisciplinary areas —as urban design, energy, housing, and economy— as well as in the health system itself. A systematic review of primary and secondary data included a variety of issues as global health, natural disasters, and critical pollution impacts on people's health and the ecosystems. Environmental health is challenged by the unsustainable consumption patterns and the resulting contaminants that abound in many cities and urban settings around the world. Poverty, inadequate housing, and poor health are usually linked. The house is a primary environmental health context for any individual and especially for more vulnerable groups; such as children, older adults and those who are sick. Nevertheless, very few countries show strong decoupling of environmental degradation from economic growth, as indicated by a recent 2017 Report of the World Bank. Worth noting, the environmental fraction of the global burden of disease in a 2016 World Health Organization (WHO) report estimated that 12.6 million global deaths, accounting for 23% (95% CI: 13-34%) of all deaths were attributable to the environment. Among the environmental contaminants include heavy metals, noise pollution, light pollution, and urban sprawl. Those key findings make a call to the significance to urgently adopt in a global scale the United Nations post-2015 Sustainable Development Goals (SDGs). The SDGs address the social, environmental, and economic factors that influence health and health inequalities, advising how these sectors, in turn, benefit from a healthy population. Consequently, more actions are necessary from an inter-sectoral and systemic paradigm to enforce an integrated sustainability policy implementation aimed at the environmental, social, and economic determinants of health.

Keywords: building capacity for workforce development, ecological and environmental health effects of pollution, public health education, sustainability

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188 The Scenario Analysis of Shale Gas Development in China by Applying Natural Gas Pipeline Optimization Model

Authors: Meng Xu, Alexis K. H. Lau, Ming Xu, Bill Barron, Narges Shahraki

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As an emerging unconventional energy, shale gas has been an economically viable step towards a cleaner energy future in U.S. China also has shale resources that are estimated to be potentially the largest in the world. In addition, China has enormous unmet for a clean alternative to substitute coal. Nonetheless, the geological complexity of China’s shale basins and issues of water scarcity potentially impose serious constraints on shale gas development in China. Further, even if China could replicate to a significant degree the U.S. shale gas boom, China faces the problem of transporting the gas efficiently overland with its limited pipeline network throughput capacity and coverage. The aim of this study is to identify the potential bottlenecks in China’s gas transmission network, as well as to examine the shale gas development affecting particular supply locations and demand centers. We examine this through application of three scenarios with projecting domestic shale gas supply by 2020: optimistic, medium and conservative shale gas supply, taking references from the International Energy Agency’s (IEA’s) projections and China’s shale gas development plans. Separately we project the gas demand at provincial level, since shale gas will have more significant impact regionally than nationally. To quantitatively assess each shale gas development scenario, we formulated a gas pipeline optimization model. We used ArcGIS to generate the connectivity parameters and pipeline segment length. Other parameters are collected from provincial “twelfth-five year” plans and “China Oil and Gas Pipeline Atlas”. The multi-objective optimization model uses GAMs and Matlab. It aims to minimize the demands that are unable to be met, while simultaneously seeking to minimize total gas supply and transmission costs. The results indicate that, even if the primary objective is to meet the projected gas demand rather than cost minimization, there’s a shortfall of 9% in meeting total demand under the medium scenario. Comparing the results between the optimistic and medium supply of shale gas scenarios, almost half of the shale gas produced in Sichuan province and Chongqing won’t be able to be transmitted out by pipeline. On the demand side, the Henan province and Shanghai gas demand gap could be filled as much as 82% and 39% respectively, with increased shale gas supply. To conclude, the pipeline network in China is currently not sufficient in meeting the projected natural gas demand in 2020 under medium and optimistic scenarios, indicating the need for substantial pipeline capacity expansion for some of the existing network, and the importance of constructing new pipelines from particular supply to demand sites. If the pipeline constraint is overcame, Beijing, Shanghai, Jiangsu and Henan’s gas demand gap could potentially be filled, and China could thereby reduce almost 25% its dependency on LNG imports under the optimistic scenario.

Keywords: energy policy, energy systematic analysis, scenario analysis, shale gas in China

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187 Code-Switching as a Bilingual Phenomenon among Students in Prishtina International Schools

Authors: Festa Shabani

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This paper aims at investigating bilingual speech in the International Schools of Prishtina. More particularly, it seeks to analyze bilingual phenomena among adolescent students highly exposed to English with the latter as the language of instruction at school in naturally-occurring conversations within school environment. Adolescence was deliberately chosen since it is regarded as an age when peer influence on language choice is the greatest. Driven by daily unsystematic observation and prior research already undertaken, the hypothesis stated is that Albanian continues to be the dominant language among Prishtina international schools’ students with a lot of code-switched items from the English. Furthermore, they will also use lexical borrowings - words already adapted in the receiving language, from the language they have been in contact with, in their speech often in the lack of existing equivalents in Albanian or for other reasons. This is done owing to the fact that the language of instruction at school is English, and any topic related to the language they have been exposed to will trigger them to use English. Therefore, this needs special attention in an attempt to identify patterns of their speech; in this way, linguistic and socio-pragmatic factors will be considered when analyzing the motivations behind their language choice. Methodology for collecting data include participant systematic observation and tape-recording. While observing them in their natural conversations, the fieldworker also took notes, which helped transcribe details better. The paper starts by raising the question of whether code-switching is occurring among Prishtina International Schools’ students highly exposed to English. The data gathered from students in informal settings suggests that there are well-founded grounds for an affirmative answer. The participants in this study are observed to be code-switching, although showing differences in degree. However, a generalization cannot be made on the basis of the findings except in so far it appears that English has, in turn, became a language to which they turn when identifying with the group when discussing about particular school topics. Particularly, participants seemed to use intra-sentential CS in cases when they seem to find an English expression rather easier than an Albanian one when repeating or emphasizing a point when urged to talk about educational issues with English being their language of instruction, and inter-sentential code-switching, particularly when quoting others. Concerning the grammatical aspect of code-switching, the intrasentential CS is used more than the intersentetial one. Speaking of gender, the results show that there were really no significant differences in regards quantity between male and female participants. However, the slight tendency for men to code switch intrasententially more than women was manifested. Similarly, a slight tendency again for a difference to emerge is on intersentential switching, which contributes 21% to the total number of switches for women, but 11% to the total number of switches for men.

Keywords: Albanian, code-switching contact linguistics, bilingual phenomena, lexical borrowing, English

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186 Homeless Population Modeling and Trend Prediction Through Identifying Key Factors and Machine Learning

Authors: Shayla He

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Background and Purpose: According to Chamie (2017), it’s estimated that no less than 150 million people, or about 2 percent of the world’s population, are homeless. The homeless population in the United States has grown rapidly in the past four decades. In New York City, the sheltered homeless population has increased from 12,830 in 1983 to 62,679 in 2020. Knowing the trend on the homeless population is crucial at helping the states and the cities make affordable housing plans, and other community service plans ahead of time to better prepare for the situation. This study utilized the data from New York City, examined the key factors associated with the homelessness, and developed systematic modeling to predict homeless populations of the future. Using the best model developed, named HP-RNN, an analysis on the homeless population change during the months of 2020 and 2021, which were impacted by the COVID-19 pandemic, was conducted. Moreover, HP-RNN was tested on the data from Seattle. Methods: The methodology involves four phases in developing robust prediction methods. Phase 1 gathered and analyzed raw data of homeless population and demographic conditions from five urban centers. Phase 2 identified the key factors that contribute to the rate of homelessness. In Phase 3, three models were built using Linear Regression, Random Forest, and Recurrent Neural Network (RNN), respectively, to predict the future trend of society's homeless population. Each model was trained and tuned based on the dataset from New York City for its accuracy measured by Mean Squared Error (MSE). In Phase 4, the final phase, the best model from Phase 3 was evaluated using the data from Seattle that was not part of the model training and tuning process in Phase 3. Results: Compared to the Linear Regression based model used by HUD et al (2019), HP-RNN significantly improved the prediction metrics of Coefficient of Determination (R2) from -11.73 to 0.88 and MSE by 99%. HP-RNN was then validated on the data from Seattle, WA, which showed a peak %error of 14.5% between the actual and the predicted count. Finally, the modeling results were collected to predict the trend during the COVID-19 pandemic. It shows a good correlation between the actual and the predicted homeless population, with the peak %error less than 8.6%. Conclusions and Implications: This work is the first work to apply RNN to model the time series of the homeless related data. The Model shows a close correlation between the actual and the predicted homeless population. There are two major implications of this result. First, the model can be used to predict the homeless population for the next several years, and the prediction can help the states and the cities plan ahead on affordable housing allocation and other community service to better prepare for the future. Moreover, this prediction can serve as a reference to policy makers and legislators as they seek to make changes that may impact the factors closely associated with the future homeless population trend.

Keywords: homeless, prediction, model, RNN

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185 Schema Therapy as Treatment for Adults with Autism Spectrum Disorder and Comorbid Personality Disorder: A Multiple Baseline Case Series Study Testing Cognitive-Behavioral and Experiential Interventions

Authors: Richard Vuijk, Arnoud Arntz

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Rationale: To our knowledge treatment of personality disorder comorbidity in adults with autism spectrum disorder (ASD) is understudied and is still in its infancy: We do not know if treatment of personality disorders may be applicable to adults with ASD. In particular, it is unknown whether patients with ASD benefit from experiential techniques that are part of schema therapy developed for the treatment of personality disorders. Objective: The aim of the study is to investigate the efficacy of a schema mode focused treatment with adult clients with ASD and comorbid personality pathology (i.e. at least one personality disorder). Specifically, we investigate if they can benefit from both cognitive-behavioral, and experiential interventions. Study design: A multiple baseline case series study. Study population: Adult individuals (age > 21 years) with ASD and at least one personality disorder. Participants will be recruited from Sarr expertise center for autism in Rotterdam. The study requires 12 participants. Intervention: The treatment protocol consists of 35 weekly offered sessions, followed by 10 monthly booster sessions. A multiple baseline design will be used with baseline varying from 5 to 10 weeks, with weekly supportive sessions. After baseline, a 5-week exploration phase follows with weekly sessions during which current and past functioning, psychological symptoms, schema modes are explored, and information about the treatment will be given. Then 15 weekly sessions with cognitive-behavioral interventions and 15 weekly sessions with experiential interventions will be given. Finally, there will be a 10-month follow-up phase with monthly booster sessions. Participants are randomly assigned to baseline length, and respond weekly during treatment and monthly at follow-up on Belief Strength of negative core beliefs (by VAS), and fill out SMI, SCL-90 and SRS-A 7 times during screening procedure (i.e. before baseline), after baseline, after exploration, after cognitive and behavioral interventions, after experiential interventions, and after 5- and 10- month follow-up. The SCID-II will be administered during screening procedure (i.e. before baseline), at 5- and at 10-month follow-up. Main study parameters: The primary study parameter is negative core beliefs. Secondary study parameters include schema modes, personality disorder manifestations, psychological symptoms, and social interaction and communication. Discussion: To the best of author’s knowledge so far no study has been published on the application of schema mode focused interventions in adult patients with ASD and comorbid PD(s). This study offers the first systematic test of application of schema therapy for adults with ASD. The results of this study will provide initial evidence for the effectiveness of schema therapy in treating adults with both ASD and PD(s). The study intends to provide valuable information for future development and implementation of therapeutic interventions for adults with both ASD and PD(s).

Keywords: adults, autism spectrum disorder, personality disorder, schema therapy

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184 Perception of Nurses and Caregivers on Fall Preventive Management for Hospitalized Children Based on Ecological Model

Authors: Mirim Kim, Won-Oak Oh

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Purpose: The purpose of this study was to identify hospitalized children's fall risk factors, fall prevention status and fall prevention strategies recognized by nurses and caregivers of hospitalized children and present an ecological model for fall preventive management in hospitalized children. Method: The participants of this study were 14 nurses working in medical institutions and having more than one year of child care experience and 14 adult caregivers of children under 6 years of age receiving inpatient treatment at a medical institution. One to one interview was attempted to identify their perception of fall preventive management. Transcribed data were analyzed through latent content analysis method. Results: Fall risk factors in hospitalized children were 'unpredictable behavior', 'instability', 'lack of awareness about danger', 'lack of awareness about falls', 'lack of child control ability', 'lack of awareness about the importance of fall prevention', 'lack of sensitivity to children', 'untidy environment around children', 'lack of personalized facilities for children', 'unsafe facility', 'lack of partnership between healthcare provider and caregiver', 'lack of human resources', 'inadequate fall prevention policy', 'lack of promotion about fall prevention', 'a performanceism oriented culture'. Fall preventive management status of hospitalized children were 'absence of fall prevention capability', 'efforts not to fall', 'blocking fall risk situation', 'limit the scope of children's activity when there is no caregiver', 'encourage caregivers' fall prevention activities', 'creating a safe environment surrounding hospitalized children', 'special management for fall high risk children', 'mutual cooperation between healthcare providers and caregivers', 'implementation of fall prevention policy', 'providing guide signs about fall risk'. Fall preventive management strategies of hospitalized children were 'restrain dangerous behavior', 'inspiring awareness about fall', 'providing fall preventive education considering the child's eye level', 'efforts to become an active subject of fall prevention activities', 'providing customed fall prevention education', 'open communication between healthcare providers and caregivers', 'infrastructure and personnel management to create safe hospital environment', 'expansion fall prevention campaign', 'development and application of a valid fall assessment instrument', 'conversion of awareness about safety'. Conclusion: In this study, the ecological model of fall preventive management for hospitalized children reflects various factors that directly or indirectly affect the fall prevention of hospitalized children. Therefore, these results can be considered as useful baseline data for developing systematic fall prevention programs and hospital policies to prevent fall accident in hospitalized children. Funding: This study was funded by the National Research Foundation of South Korea (grant number NRF-2016R1A2B1015455).

Keywords: fall down, safety culture, hospitalized children, risk factors

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183 Neighborhood Sustainability Assessment Tools: A Conceptual Framework for Their Use in Building Adaptive Capacity to Climate Change

Authors: Sally Naji, Julie Gwilliam

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Climate change remains a challenging matter for the human and the built environment in the 21st century, where the need to consider adaptation to climate change in the development process is paramount. However, there remains a lack of information regarding how we should prepare responses to this issue, such as through developing organized and sophisticated tools enabling the adaptation process. This study aims to build a systematic framework approach to investigate the potentials that Neighborhood Sustainability Assessment tools (NSA) might offer in enabling both the analysis of the emerging adaptive capacity to climate change. The analysis of the framework presented in this paper aims to discuss this issue in three main phases. The first part attempts to link sustainability and climate change, in the context of adaptive capacity. It is argued that in deciding to promote sustainability in the context of climate change, both the resilience and vulnerability processes become central. However, there is still a gap in the current literature regarding how the sustainable development process can respond to climate change. As well as how the resilience of practical strategies might be evaluated. It is suggested that the integration of the sustainability assessment processes with both the resilience thinking process, and vulnerability might provide important components for addressing the adaptive capacity to climate change. A critical review of existing literature is presented illustrating the current lack of work in this field, integrating these three concepts in the context of addressing the adaptive capacity to climate change. The second part aims to identify the most appropriate scale at which to address the built environment for the climate change adaptation. It is suggested that the neighborhood scale can be considered as more suitable than either the building or urban scales. It then presents the example of NSAs, and discusses the need to explore their potential role in promoting the adaptive capacity to climate change. The third part of the framework presents a comparison among three example NSAs, BREEAM Communities, LEED-ND, and CASBEE-UD. These three tools have been selected as the most developed and comprehensive assessment tools that are currently available for the neighborhood scale. This study concludes that NSAs are likely to present the basis for an organized framework to address the practical process for analyzing and yet promoting Adaptive Capacity to Climate Change. It is further argued that vulnerability (exposure & sensitivity) and resilience (Interdependence & Recovery) form essential aspects to be addressed in the future assessment of NSA’s capability to adapt to both short and long term climate change impacts. Finally, it is acknowledged that further work is now required to understand impact assessment in terms of the range of physical sectors (Water, Energy, Transportation, Building, Land Use and Ecosystems), Actor and stakeholder engagement as well as a detailed evaluation of the NSA indicators, together with a barriers diagnosis process.

Keywords: adaptive capacity, climate change, NSA tools, resilience, sustainability

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182 Global Experiences in Dealing with Biological Epidemics with an Emphasis on COVID-19 Disease: Approaches and Strategies

Authors: Marziye Hadian, Alireza Jabbari

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Background: The World Health Organization has identified COVID-19 as a public health emergency and is urging governments to stop the virus transmission by adopting appropriate policies. In this regard, authorities have taken different approaches to cut the chain or controlling the spread of the disease. Now, the questions we are facing include what these approaches are? What tools should be used to implement each preventive protocol? In addition, what is the impact of each approach? Objective: The aim of this study was to determine the approaches to biological epidemics and related prevention tools with an emphasis on COVID-19 disease. Data sources: Databases including ISI web of science, PubMed, Scopus, Science Direct, Ovid, and ProQuest were employed for data extraction. Furthermore, authentic sources such as the WHO website, the published reports of relevant countries, as well as the Worldometer website were evaluated for gray studies. The time-frame of the study was from 1 December 2019 to 30 May 2020. Methods: The present study was a systematic study of publications related to the prevention strategies for the COVID-19 disease. The study was carried out based on the PRISMA guidelines and CASP for articles and AACODS for grey literature. Results: The study findings showed that in order to confront the COVID-19 epidemic, in general, there are three approaches of "mitigation", "active control" and "suppression" and four strategies of "quarantine", "isolation", "social distance" and "lockdown" in both individual and social dimensions to deal with epidemics. Selection and implementation of each approach requires specific strategies and has different effects when it comes to controlling and inhibiting the disease. Key finding: One possible approach to control the disease is to change individual behavior and lifestyle. In addition to prevention strategies, use of masks, observance of personal hygiene principles such as regular hand washing and non-contact of contaminated hands with the face, as well as an observance of public health principles such as sneezing and coughing etiquettes, safe extermination of personal protective equipment, must be strictly observed. Have not been included in the category of prevention tools. However, it has a great impact on controlling the epidemic, especially the new coronavirus epidemic. Conclusion: Although the use of different approaches to control and inhibit biological epidemics depends on numerous variables, however, despite these requirements, global experience suggests that some of these approaches are ineffective. The use of previous experiences in the world, along with the current experiences of countries, can be very helpful in choosing the accurate approach for each country in accordance with the characteristics of that country and lead to the reduction of possible costs at the national and international levels.

Keywords: novel corona virus, COVID-19, approaches, prevention tools, prevention strategies

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181 The Use of Rotigotine to Improve Hemispatial Neglect in Stroke Patients at the Charing Cross Neurorehabilitation Unit

Authors: Malab Sana Balouch, Meenakshi Nayar

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Hemispatial Neglect is a common disorder primarily associated with right hemispheric stroke, in the acute phase of which it can occur up to 82% of the time. Such individuals fail to acknowledge or respond to people and objects in their left field of vision due to deficits in attention and awareness. Persistent hemispatial neglect significantly impedes post-stroke recovery, leading to longer hospital stays post-stroke, increased functional dependency, longer-term disability in ADLs and increased risk of falls. Recently, evidence has emerged for the use of dopamine agonist Rotigotine in neglect. The aim of our Quality Improvement Project (QIP) is to evaluate and better the current protocols and practice in assessment, documentation and management of neglect and rotigotine use at the Neurorehabilitation unit at Charing Cross Hospital (CNRU). In addition, it brings light to rotigotine use in the management of hemispatial neglect and paves the way for future research in the field. Our QIP was based in the CNRU. All patients admitted to the CNRU suffering from a right-sided stroke from 2nd of February 2018 to the 2nd of February 2021 were included in the project. Each patient’s multidisciplinary team report and hospital notes were searched for information, including bio-data, fulfilment of the inclusion criteria (having hemispatial neglect) and data related to rotigotine use. This includes whether or not the drug was administered, any contraindications to drug in patients that did not receive it, and any therapeutic benefits(subjective or objective improvement in neglect) in those that did receive the rotigotine. Data was simultaneously entered into excel sheet and further statistical analysis was done on SPSS 20.0. Out of 80 patients suffering from right sided strokes, 72.5% were infarcts and 27.5% were hemorrhagic strokes, with vast majority of both types of strokes were in the middle cerebral artery territory (MCA). A total of 31 (38.8%) of our patients were noted to have hemispatial neglect, with the highest number of cases being associated with MCA strokes. Almost half of our patients with MCA strokes suffered from neglect. Neglect was more common in male patients. Out of the 31 patients suffering from visuospatial neglect, only 16% actually received rotigotine and 80% of them were noted to have an objective improvement in their neglect tests and 20% revealed subjective improvement. After thoroughly going through neglect-associated documentation, the following recommendations/plans were put in place for the future. We plan to liaise with the occupational therapy team at our rehab unit to set a battery of tests that would be done on all patients presenting with neglect and recommend clear documentation of outcomes of each neglect screen under it. Also to create two proformas; one for the therapy team to aid in systematic documentation of neglect screens done prior to and after rotigotine administration and a second proforma for the medical team with clear documentation of rotigotine use, its benefits and any contraindications if not administered.

Keywords: hemispatial Neglect, right hemispheric stroke, rotigotine, neglect, dopamine agonist

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180 The Relationship between Basic Human Needs and Opportunity Based on Social Progress Index

Authors: Ebru Ozgur Guler, Huseyin Guler, Sera Sanli

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Social Progress Index (SPI) whose fundamentals have been thrown in the World Economy Forum is an index which aims to form a systematic basis for guiding strategy for inclusive growth which requires achieving both economic and social progress. In this research, it has been aimed to determine the relations among “Basic Human Needs” (BHN) (including four variables of ‘Nutrition and Basic Medical Care’, ‘Water and Sanitation’, ‘Shelter’ and ‘Personal Safety’) and “Opportunity” (OPT) (that is composed of ‘Personal Rights’, ‘Personal Freedom and Choice’, ‘Tolerance and Inclusion’, and ‘Access to Advanced Education’ components) dimensions of 2016 SPI for 138 countries which take place in the website of Social Progress Imperative by carrying out canonical correlation analysis (CCA) which is a data reduction technique that operates in a way to maximize the correlation between two variable sets. In the interpretation of results, the first pair of canonical variates pointing to the highest canonical correlation has been taken into account. The first canonical correlation coefficient has been found as 0.880 indicating to the high relationship between BHN and OPT variable sets. Wilk’s Lambda statistic has revealed that an overall effect of 0.809 is highly large for the full model in order to be counted as statistically significant (with a p-value of 0.000). According to the standardized canonical coefficients, the largest contribution to BHN set of variables has come from ‘shelter’ variable. The most effective variable in OPT set has been detected to be ‘access to advanced education’. Findings based on canonical loadings have also confirmed these results with respect to the contributions to the first canonical variates. When canonical cross loadings (structure coefficients) are examined, for the first pair of canonical variates, the largest contributions have been provided by ‘shelter’ and ‘access to advanced education’ variables. Since the signs for structure coefficients have been found to be negative for all variables; all OPT set of variables are positively related to all of the BHN set of variables. In case canonical communality coefficients which are the sum of the squares of structure coefficients across all interpretable functions are taken as the basis; amongst all variables, ‘personal rights’ and ‘tolerance and inclusion’ variables can be said not to be useful in the model with 0.318721 and 0.341722 coefficients respectively. On the other hand, while redundancy index for BHN set has been found to be 0.615; OPT set has a lower redundancy index with 0.475. High redundancy implies high ability for predictability. The proportion of the total variation in BHN set of variables that is explained by all of the opposite canonical variates has been calculated as 63% and finally, the proportion of the total variation in OPT set that is explained by all of the canonical variables in BHN set has been determined as 50.4% and a large part of this proportion belongs to the first pair. The results suggest that there is a high and statistically significant relationship between BHN and OPT. This relationship is generally accounted by ‘shelter’ and ‘access to advanced education’.

Keywords: canonical communality coefficient, canonical correlation analysis, redundancy index, social progress index

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179 Development of the Integrated Quality Management System of Cooked Sausage Products

Authors: Liubov Lutsyshyn, Yaroslava Zhukova

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Over the past twenty years, there has been a drastic change in the mode of nutrition in many countries which has been reflected in the development of new products, production techniques, and has also led to the expansion of sales markets for food products. Studies have shown that solution of the food safety problems is almost impossible without the active and systematic activity of organizations directly involved in the production, storage and sale of food products, as well as without management of end-to-end traceability and exchange of information. The aim of this research is development of the integrated system of the quality management and safety assurance based on the principles of HACCP, traceability and system approach with creation of an algorithm for the identification and monitoring of parameters of technological process of manufacture of cooked sausage products. Methodology of implementation of the integrated system based on the principles of HACCP, traceability and system approach during the manufacturing of cooked sausage products for effective provision for the defined properties of the finished product has been developed. As a result of the research evaluation technique and criteria of performance of the implementation and operation of the system of the quality management and safety assurance based on the principles of HACCP have been developed and substantiated. In the paper regularities of influence of the application of HACCP principles, traceability and system approach on parameters of quality and safety of the finished product have been revealed. In the study regularities in identification of critical control points have been determined. The algorithm of functioning of the integrated system of the quality management and safety assurance has also been described and key requirements for the development of software allowing the prediction of properties of finished product, as well as the timely correction of the technological process and traceability of manufacturing flows have been defined. Based on the obtained results typical scheme of the integrated system of the quality management and safety assurance based on HACCP principles with the elements of end-to-end traceability and system approach for manufacture of cooked sausage products has been developed. As a result of the studies quantitative criteria for evaluation of performance of the system of the quality management and safety assurance have been developed. A set of guidance documents for the implementation and evaluation of the integrated system based on the HACCP principles in meat processing plants have also been developed. On the basis of the research the effectiveness of application of continuous monitoring of the manufacturing process during the control on the identified critical control points have been revealed. The optimal number of critical control points in relation to the manufacture of cooked sausage products has been substantiated. The main results of the research have been appraised during 2013-2014 under the conditions of seven enterprises of the meat processing industry and have been implemented at JSC «Kyiv meat processing plant».

Keywords: cooked sausage products, HACCP, quality management, safety assurance

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178 Air–Water Two-Phase Flow Patterns in PEMFC Microchannels

Authors: Ibrahim Rassoul, A. Serir, E-K. Si Ahmed, J. Legrand

Abstract:

The acronym PEM refers to Proton Exchange Membrane or alternatively Polymer Electrolyte Membrane. Due to its high efficiency, low operating temperature (30–80 °C), and rapid evolution over the past decade, PEMFCs are increasingly emerging as a viable alternative clean power source for automobile and stationary applications. Before PEMFCs can be employed to power automobiles and homes, several key technical challenges must be properly addressed. One technical challenge is elucidating the mechanisms underlying water transport in and removal from PEMFCs. On one hand, sufficient water is needed in the polymer electrolyte membrane or PEM to maintain sufficiently high proton conductivity. On the other hand, too much liquid water present in the cathode can cause “flooding” (that is, pore space is filled with excessive liquid water) and hinder the transport of the oxygen reactant from the gas flow channel (GFC) to the three-phase reaction sites. The experimental transparent fuel cell used in this work was designed to represent actual full scale of fuel cell geometry. According to the operating conditions, a number of flow regimes may appear in the microchannel: droplet flow, blockage water liquid bridge /plug (concave and convex forms), slug/plug flow and film flow. Some of flow patterns are new, while others have been already observed in PEMFC microchannels. An algorithm in MATLAB was developed to automatically determine the flow structure (e.g. slug, droplet, plug, and film) of detected liquid water in the test microchannels and yield information pertaining to the distribution of water among the different flow structures. A video processing algorithm was developed to automatically detect dynamic and static liquid water present in the gas channels and generate relevant quantitative information. The potential benefit of this software allows the user to obtain a more precise and systematic way to obtain measurements from images of small objects. The void fractions are also determined based on images analysis. The aim of this work is to provide a comprehensive characterization of two-phase flow in an operating fuel cell which can be used towards the optimization of water management and informs design guidelines for gas delivery microchannels for fuel cells and its essential in the design and control of diverse applications. The approach will combine numerical modeling with experimental visualization and measurements.

Keywords: polymer electrolyte fuel cell, air-water two phase flow, gas diffusion layer, microchannels, advancing contact angle, receding contact angle, void fraction, surface tension, image processing

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177 Hypoglossal Nerve Stimulation (Baseline vs. 12 months) for Obstructive Sleep Apnea: A Meta-Analysis

Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Hamza Al-Salhi, Salameh Alarood, Ibraheem Alkhawaldeh, Obada Abunar, Adam Abdallah

Abstract:

Obstructive sleep apnea (OSA) is a disorder caused by the repeated collapse of the upper airway during sleep. It is the most common cause of sleep-related breathing disorder, as OSA can cause loud snoring, daytime fatigue, or more severe problems such as high blood pressure, cardiovascular disease, coronary artery disease, insulin-resistant diabetes, and depression. The hypoglossal nerve stimulator (HNS) is an implantable medical device that reduces the occurrence of obstructive sleep apnea by electrically stimulating the hypoglossal nerve in rhythm with the patient's breathing, causing the tongue to move. This stimulation helps keep the patient's airways clear while they sleep. This systematic review and meta-analysis aimed to assess the clinical outcome of hypoglossal nerve stimulation as a treatment of obstructive sleep apnea. A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until August 2022. Studies assessing the following clinical outcomes (Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Oxygen Desaturation Indices (ODI), (Oxygen Saturation (SaO2)) were pooled in the meta-analysis using Review Manager Software. We assessed the quality of studies according to the Cochrane risk-of-bias tool for randomized trials (RoB2), Risk of Bias In Non-randomized Studies - of Interventions (ROBINS-I), and a modified version of NOS for the non-comparative cohort studies.13 Studies (Six Clinical Trials and Seven prospective cohort studies) with a total of 817 patients were included in the meta-analysis. The results of AHI were reported in 11 studies examining OSA 696 patients. We found that there was a significant improvement in the AHI after 12 months of HNS (MD = 18.2 with 95% CI, (16.7 to 19.7; I2 = 0%); P < 0.00001). Further, 12 studies reported the results of ESS after 12 months of intervention with a significant improvement in the range of sleepiness among the examined 757 OSA patients (MD = 5.3 with 95% CI, (4.75 to 5.86; I2 = 65%); P < 0.0001). Moreover, nine studies involving 699 participants reported the results of FOSQ after 12 months of HNS with a significant reported improvement (MD = -3.09 with 95% CI, (-3.41 to 2.77; I2 = 0%); P < 0.00001). In addition, ten studies reported the results of ODI with a significant improvement after 12 months of HNS among the 817 examined patients (MD = 14.8 with 95% CI, (13.25 to 16.32; I2 = 0%); P < 000001). The Hypoglossal Nerve Stimulation showed a significant positive impact on obstructive sleep apnea patients after 12 months of therapy in terms of apnea-hypopnea index, oxygen desaturation indices, manifestations of the behavioral morbidity associated with obstructive sleep apnea, and functional status resulting from sleepiness.

Keywords: apnea, meta-analysis, hypoglossal, stimulation

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176 Acquisition of Murcian Lexicon and Morphology by L2 Spanish Immigrants: The Role of Social Networks

Authors: Andrea Hernandez Hurtado

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Research on social networks (SNs) -- the interactions individuals share with others has shed important light in helping to explain differential use of variable linguistic forms, both in L1s and L2s. Nevertheless, the acquisition of nonstandard L2 Spanish in the Region of Murcia, Spain, and how learners interact with other speakers while sojourning there have received little attention. Murcian Spanish (MuSp) was widely influenced by Panocho, a divergent evolution of Hispanic Latin, and differs from the more standard Peninsular Spanish (StSp) in phonology, morphology, and lexicon. For instance, speakers from this area will most likely palatalize diminutive endings, producing animalico [̩a.ni.ma.ˈli.ko] instead of animalito [̩a.ni.ma.ˈli.to] ‘little animal’. Because L1 speakers of the area produce and prefer salient regional lexicon and morphology (particularly the palatalized diminutive -ico) in their speech, the current research focuses on how international residents in the Region of Murcia use Spanish: (1) whether or not they acquire (perceptively and/or productively) any of the salient regional features of MuSp, and (2) how their SNs explain such acquisition. This study triangulates across three tasks -recognition, production, and preference- addressing both lexicon and morphology, with each task specifically created for the investigation of MuSp features. Among other variables, the effects of L1, residence, and identity are considered. As an ongoing dissertation research, data are currently being gathered through an online questionnaire. So far, 7 participants from multiple nationalities have completed the survey, although a minimum of 25 are expected to be included in the coming months. Preliminary results revealed that MuSp lexicon and morphology were successfully recognized by participants (p<.001). In terms of regional lexicon production (10.0%) and preference (47.5%), although participants showed higher percentages of StSp, results showed that international residents become aware of stigmatized lexicon and may incorporate it into their language use. Similarly, palatalized diminutives (production 14.2%, preference 19.0%) were present in their responses. The Social Network Analysis provided information about participants’ relationships with their interactants, as well as among them. Results indicated that, generally, when residents were more immersed in the culture (i.e., had more Murcian alters) they produced and preferred more regional features. This project contributes to the knowledge of language variation acquisition in L2 speakers, focusing on a stigmatized Spanish dialect and exploring how stigmatized varieties may affect L2 development. Results will show how L2 Spanish speakers’ language is affected by their stay in Murcia. This, in turn, will shed light on the role of SNs in language acquisition, the acquisition of understudied and marginalized varieties, and the role of immersion on language acquisition. As the first systematic account on the acquisition of L2 Spanish lexicon and morphology in the Region of Murcia, it lays important groundwork for further research on the connection between SNs and the acquisition of regional variants, applicable to Murcia and beyond.

Keywords: international residents, L2 Spanish, lexicon, morphology, nonstandard language acquisition, social networks

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175 Diagnostic Performance of Mean Platelet Volume in the Diagnosis of Acute Myocardial Infarction: A Meta-Analysis

Authors: Kathrina Aseanne Acapulco-Gomez, Shayne Julieane Morales, Tzar Francis Verame

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Mean platelet volume (MPV) is the most accurate measure of the size of platelets and is routinely measured by most automated hematological analyzers. Several studies have shown associations between MPV and cardiovascular risks and outcomes. Although its measurement may provide useful data, MPV remains to be a diagnostic tool that is yet to be included in routine clinical decision making. The aim of this systematic review and meta-analysis is to determine summary estimates of the diagnostic accuracy of mean platelet volume for the diagnosis of myocardial infarction among adult patients with angina and/or its equivalents in terms of sensitivity, specificity, diagnostic odds ratio, and likelihood ratios, and to determine the difference of the mean MPV values between those with MI and those in the non-MI controls. The primary search was done through search in electronic databases PubMed, Cochrane Review CENTRAL, HERDIN (Health Research and Development Information Network), Google Scholar, Philippine Journal of Pathology, and Philippine College of Physicians Philippine Journal of Internal Medicine. The reference list of original reports was also searched. Cross-sectional, cohort, and case-control articles studying the diagnostic performance of mean platelet volume in the diagnosis of acute myocardial infarction in adult patients were included in the study. Studies were included if: (1) CBC was taken upon presentation to the ER or upon admission (within 24 hours of symptom onset); (2) myocardial infarction was diagnosed with serum markers, ECG, or according to accepted guidelines by the Cardiology societies (American Heart Association (AHA), American College of Cardiology (ACC), European Society of Cardiology (ESC); and, (3) if outcomes were measured as significant difference AND/OR sensitivity and specificity. The authors independently screened for inclusion of all the identified potential studies as a result of the search. Eligible studies were appraised using well-defined criteria. Any disagreement between the reviewers was resolved through discussion and consensus. The overall mean MPV value of those with MI (9.702 fl; 95% CI 9.07 – 10.33) was higher than in those of the non-MI control group (8.85 fl; 95% CI 8.23 – 9.46). Interpretation of the calculated t-value of 2.0827 showed that there was a significant difference in the mean MPV values of those with MI and those of the non-MI controls. The summary sensitivity (Se) and specificity (Sp) for MPV were 0.66 (95% CI; 0.59 - 0.73) and 0.60 (95% CI; 0.43 – 0.75), respectively. The pooled diagnostic odds ratio (DOR) was 2.92 (95% CI; 1.90 – 4.50). The positive likelihood ratio of MPV in the diagnosis of myocardial infarction was 1.65 (95% CI; 1.20 – 22.27), and the negative likelihood ratio was 0.56 (95% CI; 0.50 – 0.64). The intended role for MPV in the diagnostic pathway of myocardial infarction would perhaps be best as a triage tool. With a DOR of 2.92, MPV values can discriminate between those who have MI and those without. For a patient with angina presenting with elevated MPV values, it is 1.65 times more likely that he has MI. Thus, it is implied that the decision to treat a patient with angina or its equivalents as a case of MI could be supported by an elevated MPV value.

Keywords: mean platelet volume, MPV, myocardial infarction, angina, chest pain

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