Search results for: HIV/AIDS

Authors: Subramaniam Chandran

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This paper presents an assessment study conducted among the distance learners in India. Open and distance learning systems have traveled a long way since its inception and its journey has witnessed the evolution and adoption of different generations of technology. This study focuses on the distant learners in India. Sampling for this study has been derived from the mass enrollment from Tamil Nadu area, a southern state of India. Learners were chosen from dual mode universities, private universities, Tamil Nadu Open University and IGNOU. The main focus of the study is to examine the coverage and appropriation of students support services and learning aids. It explores two aspects: the facilities available and the awareness and use of such services. It includes, self-learning materials, face-to-face counseling, multimedia learning materials, website, e-learning, radio and television services etc. While exploring the student-s perspective on these learning aspects, it is important to understand the perspectives of the teachers. Two different interests are visible among the teachers. Majority of the teachers support faceto- face counseling. However, the young teachers are in favour of online learning and multimedia supports in teaching. Through the awareness is somewhat high, the actual participation in online is very low. This is due to the inadequate infrastructure as well as the traditional attitudes of the teachers. Still the face-to-face sessions remain popular than online.

Keywords: Face-to-face session, online session, distance learning, multimedia

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Authors: Ivana Šalinović

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The term gender emerged in the second half of the last century and since then a growing body of research dealing with the topic demonstrates its importance. Primarily, the research and the theories that were addressing the topic were focused on stating the differences between the terms sex and gender, where sex refers to the biological aspect of a person, while gender refers to the socially ascribed roles, attitudes, behaviors, and etc., and on gender discrimination whose visible and invisible repercussions are harming society and one of the agents of change should be educators on all educational levels since they are emotionally sculpting their students, that is why considerable effort should be put into implementing education about this topic into the standard curriculum. Not only educators, but it is also necessary to change the mindset of the younger generations because they will be important agents in the further elimination of gender discrimination, thus causing societal changes. Therefore, it is very important to hear their voices and their experiences and for these reasons, this research has been done, to see what the students of the second year at a private college university Aspira in Croatia have gone through in their educational ladder. The hypothesis was that the findings would most certainly show a huge difference between female and male students’ experiences and effects of gender discrimination, but the results have actually shown a very mixed picture and the original hypothesis was somewhat disapproved. Instead of finding out that girls experienced a lot of gender discrimination, it turned out that it was the boys who believed that in their previous and current education, there was no equal time distribution between genders, they noticed that the language was not gender-sensitive, teaching aids were not adopted to the genders. They were also the ones that pointed out that the discipline path was not the same for everyone, and they were the ones that the teacher’s gender had more influence on and were also the ones that experienced more gender discrimination.

Keywords: Gender, discrimination, elementary school, high school.

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Authors: U. Tancredi, D. Accardo, M. Grassi, G. Fasano, A. E. Tirri, A. Vitale, N. Genito, F. Montemari, L. Garbarino

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The development of guidance, navigation and control algorithms and avionic procedures requires the disposability of suitable analysis and verification tools, such as simulation environments, which support the design process and allow detecting potential problems prior to the flight test, in order to make new technologies available at reduced cost, time and risk. This paper presents a simulation environment for avionic software development and qualification, especially aimed at equipment for general aviation aircrafts and unmanned aerial systems. The simulation environment includes models for short and medium-range radio-navigation aids, flight assistance systems, and ground control stations. All the software modules are able to simulate the modeled systems both in fast-time and real-time tests, and were implemented following component oriented modeling techniques and requirement based approach. The paper describes the specific models features, the architectures of the implemented software systems and its validation process. Performed validation tests highlighted the capability of the simulation environment to guarantee in real-time the required functionalities and performance of the simulated avionics systems, as well as to reproduce the interaction between these systems, thus permitting a realistic and reliable simulation of a complete mission scenario.

Keywords: ADS-B, avionics, NAVAIDs, real time simulation, TCAS, UAS ground control station.

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Authors: Assem M. F. Sallam, Ah. El-S. Makled

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In this paper, there is an implementation, verification, and graphical demonstration of a software application, which can be used swiftly over different preliminary orbit determination methods. A passive orbit determination method is used in this study to determine the location of a satellite or a flying body. It is named a passive orbit determination because it depends on observation without the use of any aids (radio and laser) installed on satellite. In order to understand how these methods work and how their output is accurate when compared with available verification data, the built models help in knowing the different inputs used with each method. Output from the different orbit determination methods (Gibbs, Lambert, and Gauss) will be compared with each other and verified by the data obtained from Satellite Tool Kit (STK) application. A modified model including all of the orbit determination methods using the same input will be introduced to investigate different models output (orbital parameters) for the same input (azimuth, elevation, and time). Simulation software is implemented using MATLAB. A Graphical User Interface (GUI) application named OrDet is produced using the GUI of MATLAB. It includes all the available used inputs and it outputs the current Classical Orbital Elements (COE) of satellite under observation. Produced COE are then used to propagate for a complete revolution and plotted on a 3-D view. Modified model which uses an adapter to allow same input parameters, passes these parameters to the preliminary orbit determination methods under study. Result from all orbit determination methods yield exactly the same COE output, which shows the equality of concept in determination of satellite’s location, but with different numerical methods.

Keywords: Orbit determination, STK, MATLAB-GUI, satellite tracking.

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Authors: Chong-Yang Qiao

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Mobile augmented reality (MAR) tracking targets from the surroundings and aids operators for interactive data and procedures visualization, potential equipment and system understandably. Operators remotely communicate and coordinate with each other for the continuous tasks, information and data exchange between control room and work-site. In the routine work, distributed control system (DCS) monitoring and work-site manipulation require operators interact in real-time manners. The critical question is the improvement of user experience in cooperative works through applying Augmented Reality in the traditional industrial field. The purpose of this exploratory study is to find the cognitive model for the multiple task performance by MAR. In particular, the focus will be on the comparison between different tasks and environment factors which influence information processing. Three experiments use interface and interaction design, the content of start-up, maintenance and stop embedded in the mobile application. With the evaluation criteria of time demands and human errors, and analysis of the mental process and the behavior action during the multiple tasks, heuristic evaluation was used to find the operators performance with different situation factors, and record the information processing in recognition, interpretation, judgment and reasoning. The research will find the functional properties of MAR and constrain the development of the cognitive model. Conclusions can be drawn that suggest MAR is easy to use and useful for operators in the remote collaborative works.

Keywords: Mobile augmented reality, remote collaboration, user experience, cognitive model.

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Authors: Hasan Bulent Kantarcı

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This paper examines how “Zakat” provides fair income redistribution and aids the struggle against poverty. Providing fair income redistribution and combating poverty constitutes some of the fundamental tasks performed by countries all over the world. Each country seeks a solution for these problems according to their political, economic and administrative styles through applying various economic and financial policies. The same situation can be handled via “zakat” association in Islam. Nowadays, we observe different versions of “zakat” in developed countries. Applications such as negative income tax denote merely a different form of “zakat” that is being applied almost in the same way but under changed names. However, the minimum values to donate under zakat (e.g. 85 gr. gold and 40 animals) get altered and various amounts are put into practice. It might be named as negative income tax instead of zakat, nonetheless, these applications are based on the Holy Koran and the hadith released 1400 years ago. Besides, considering the savage and slavery in the world at those times, we might easily recognize the true value of the zakat being applied for the first time then in the Islamic system. Through zakat, governments are able to transfer incomes to the poor as a means of enabling them achieve the minimum standard of living required. With regards to who benefits from the Zakat, an objective and fair criteria was used to determine who benefits from the zakat contrary to the notion that it was based on peoples’ own choices. Since the zakat is obligatory, the transfers do not get forwarded directly but via the government and get distributed, which requires vast governmental organizations. Through the application of Zakat, reduced levels of poverty can be achieved and also ensure the fair income redistribution.

Keywords: Cycle of poverty, Islamic finance, income redistribution, zakat.

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Authors: Charlotte C. Shagol, Tongmin Sa

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One of the major pollutants in the environment is arsenic (As). Due to the toxic effects of As to all organisms, its remediation is necessary. Conventional technologies used in the remediation of As contaminated soils are expensive and may even compromise the structure of the soil. An attractive alternative is phytoremediation, which is the use of plants which can take up the contaminant in their tissues. Plant growth promoting bacteria (PGPB) has been known to enhance growth of plants through several mechanisms such as phytohormone production, phosphate solubilization, siderophore production and 1-aminocyclopropane-1- carboxylate (ACC) deaminase production, which is an essential trait that aids plants especially under stress conditions such as As stress. Twenty one bacteria were isolated from As-contaminated soils in the vicinity of the Janghang Smelter in Chungnam Province, South Korea. These exhibited high tolerance to either arsenite (As III) or arsenate (As V) or both. Most of these isolates possess several plant growth promoting traits which can be potentially exploited to increase phytoremediation efficiency. Among the identified isolates is Pseudomonas sp. JS1215, which produces ACC deaminase, indole acetic acid (IAA), and siderophore. It also has the ability to solubilize phosphate. Inoculation of JS1215 significantly enhanced root and shoot length and biomass accumulation of maize under normal conditions. In the presence of As, particularly in lower As level, inoculation of JS1215 slightly increased root length and biomass. Ethylene increased with increasing As concentration, but was reduced by JS1215 inoculation. JS1215 can be a potential bioinoculant for increasing phytoremediation efficiency.

Keywords: As-tolerant bacteria, plant growth promoting bacteria, As stress, phytoremediation.

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Authors: Jing Wu, Wei Lv, Yibing Li, Yuanfan You

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The separation of speech signals has become a research hotspot in the field of signal processing in recent years. It has many applications and influences in teleconferencing, hearing aids, speech recognition of machines and so on. The sounds received are usually noisy. The issue of identifying the sounds of interest and obtaining clear sounds in such an environment becomes a problem worth exploring, that is, the problem of blind source separation. This paper focuses on the under-determined blind source separation (UBSS). Sparse component analysis is generally used for the problem of under-determined blind source separation. The method is mainly divided into two parts. Firstly, the clustering algorithm is used to estimate the mixing matrix according to the observed signals. Then the signal is separated based on the known mixing matrix. In this paper, the problem of mixing matrix estimation is studied. This paper proposes an improved algorithm to estimate the mixing matrix for speech signals in the UBSS model. The traditional potential algorithm is not accurate for the mixing matrix estimation, especially for low signal-to noise ratio (SNR).In response to this problem, this paper considers the idea of an improved potential function method to estimate the mixing matrix. The algorithm not only avoids the inuence of insufficient prior information in traditional clustering algorithm, but also improves the estimation accuracy of mixing matrix. This paper takes the mixing of four speech signals into two channels as an example. The results of simulations show that the approach in this paper not only improves the accuracy of estimation, but also applies to any mixing matrix.

Keywords: Clustering algorithm, potential function, speech signal, the UBSS model.

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Authors: Mrinalini Amritkar, Disha Patil, Swapna Kulkarni, Sukratu Barve, Suresh Gosavi

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Micro-mixers play an important role in the lab-on-a-chip applications and micro total analysis systems to acquire the correct level of mixing for any given process. The mixing process can be classified as active or passive according to the use of external energy. Literature of microfluidics reports that most of the work is done on the models of steady laminar flow; however, the study of unsteady laminar flow is an active area of research at present. There are wide applications of this, out of which, we consider nanoparticle synthesis in micro-mixers. In this work, we have developed a model for unsteady flow to study the mixing performance of a passive micro mixer for reactants used for such synthesis. The model is developed in Finite Volume Method (FVM)-based software, OpenFOAM. The model is tested by carrying out the simulations at Re of 0.5. Mixing performance of the micro-mixer is investigated using simulated concentration values of mixed species across the width of the micro-mixer and calculating the variance across a line profile. Experimental validation is done by passing dyes through a Y shape micro-mixer fabricated using polydimethylsiloxane (PDMS) polymer and comparing variances with the simulated ones. Gold nanoparticles are later synthesized through the micro-mixer and collected at two different times leading to significantly different size distributions. These times match with the time scales over which reactant concentrations vary as obtained from simulations. Our simulations could thus be used to create design aids for passive micro-mixers used in nanoparticle synthesis.

Keywords: Lab-on-chip, micro-mixer, OpenFOAM, PDMS.

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Authors: Teka Haile, Behailu Hawulte, Solomon Alemayehu

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Background: HIV virological failure still remains a problem in HV/AIDS treatment and care. This study aimed to describe the prevalence and identify the factors associated with viral non-suppression among HIV-positive adult patients on antiretroviral therapy in Woliso Town, Oromia, Ethiopia. Methods: A retrospective cross-sectional study was conducted among 424 HIV-positive patient’s attending antiretroviral therapy (ART) in Woliso Town during the period from August 25, 2020 to August 30, 2020. Data collected from patient medical records were entered into Epi Info version 2.3.2.1 and exported to SPSS version 21.0 for analysis. Logistic regression analysis was done to identify factors associated with viral load non-suppression, and statistical significance of odds ratios were declared using 95% confidence interval and p-value < 0.05. Results: A total of 424 patients were included in this study. The mean age (± SD) of the study participants was 39.88 (± 9.995) years. The prevalence of HIV viral load non-suppression was 55 (13.0%) with 95% CI (9.9-16.5). Second-line ART treatment regimen (Adjusted Odds Ratio (AOR) = 8.98, 95% Confidence Interval (CI): 2.64, 30.58) and routine viral load testing (AOR = 0.01, 95% CI: 0.001, 0.02) were significantly associated with virological non-suppression. Conclusion: Virological non-suppression was high, which hinders the achievement of the third global 95 target. The second-line regimen and routine viral load testing were significantly associated with virological non-suppression. It suggests the need to assess the effectiveness of antiretroviral drugs for epidemic control. It also clearly shows the need to decentralize third-line ART treatment for those patients in need.

Keywords: Virological non-suppression, HIV-positive, ART, Woliso Town, Ethiopia.

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Authors: Anja Kurz, Marc Flynn, Tobias Good, Marco Caversaccio, Martin Kompis

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Bone Anchored Hearing Implants (BAHI) are  routinely used in patients with conductive or mixed hearing loss, e.g.  if conventional air conduction hearing aids cannot be used. New  sound processors and new fitting software now allow the adjustment  of parameters such as loudness compression ratios or maximum  power output separately. Today it is unclear, how the choice of these  parameters influences aided speech understanding in BAHI users.  In this prospective experimental study, the effect of varying the  compression ratio and lowering the maximum power output in a  BAHI were investigated.  Twelve experienced adult subjects with a mixed hearing loss  participated in this study. Four different compression ratios (1.0; 1.3;  1.6; 2.0) were tested along with two different maximum power output  settings, resulting in a total of eight different programs. Each  participant tested each program during two weeks. A blinded Latin  square design was used to minimize bias.  For each of the eight programs, speech understanding in quiet and  in noise was assessed. For speech in quiet, the Freiburg number test  and the Freiburg monosyllabic word test at 50, 65, and 80 dB SPL  were used. For speech in noise, the Oldenburg sentence test was  administered.  Speech understanding in quiet and in noise was improved  significantly in the aided condition in any program, when compared  to the unaided condition. However, no significant differences were  found between any of the eight programs. In contrast, on a subjective  level there was a significant preference for medium compression  ratios of 1.3 to 1.6 and higher maximum power output.

 

Keywords: Bone Anchored Hearing Implant, Compression, Maximum Power Output, Speech understanding.

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Authors: Langroudi B., Salehi E., Keshani S., Baghersad M.

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Transportation is of great importance in the current life of human beings. The transportation system plays many roles, from economical development to after-catastrophe aids such as rescue operation in the first hours and days after an earthquake. In after earthquakes response phase, transportation system acts as a basis for ground operations including rescue and relief operation, food providing for victims and etc. It is obvious that partial or complete obstruction of this system results in the stop of these operations. Bridges are one of the most important elements of transportation network. Failure of a bridge, in the most optimistic case, cuts the relation between two regions and in more developed countries, cuts the relation of numerous regions. In this paper, to evaluate the vulnerability and estimate the damage level of Tehran bridges, HAZUS method, developed by Federal Emergency Management Agency (FEMA) with the aid of National Institute of Building Science (NIBS), is used for the first time in Iran. In this method, to evaluate the collapse probability, fragility curves are used. Iran is located on seismic belt and thus, it is vulnerable to earthquakes. Thus, the study of the probability of bridge collapses, as an important part of transportation system, during earthquakes is of great importance. The purpose of this study is to provide fragility curves for Gisha Bridge, one of the longest steel bridges in Tehran, as an important lifeline element. Besides, the damage probability for this bridge during a specific earthquake, introduced as scenario earthquakes, is calculated. The fragility curves show that for the considered scenario, the probability of occurrence of complete collapse for the bridge is 8.6%.

Keywords: Bridge, Damage evaluation, Fragility curve, Lifelines, Seismic vulnerability.

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Authors: N. M. Sani, E. D. Jatau, O. S. Olonitola, M. Y. Gwarzo, P. Moodley, N. S. Mujahid

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Hemoglobin (HB) indicates anemia level and by extension may reflect the nutritional level and perhaps the immunity of an individual. Some antiretroviral drugs like Zidovudine are known to cause anemia in people living with HIV/AIDS (PLWHA). A cross sectional study using demographic data and blood specimen from 218 female commercial sex workers attending antiretroviral therapy (ART) clinics was conducted between December, 2009 and July, 2011 to assess the effect of zidovudine on hematologic, and RNA viral load of female sex workers receiving antiretroviral treatment in north western Nigeria. Anemia is a common and serious complication of both HIV infection and its treatment. In the setting of HIV infection, anemia has been associated with decreased quality of life, functional status, and survival. Antiretroviral therapy, particularly the highly active antiretroviral therapy (HAART), has been associated with a decrease in the incidence and severity of anemia in HIV-infected patients who have received a HAART regimen for at least 1 year. In this study, result has shown that of the 218 patients, 26 with hemoglobin count between 5.1 – 10g/dl were observed to have the highest viral load count of 300,000 – 350,000copies/ml. It was also observed that most patients (190) with HB of 10.1 – 15.0g/dl had viral load count of 200,000 – 250,000 copies /ml. An inverse relationship therefore exists i.e. the lower the hemoglobin level, the higher the viral load count even though the test statistics did not show any significance between the two (P = 0.206). This shows that multivariate logistic regression analysis demonstrated that anemia was associated with a CD4 + cell count below 50/μL, female sex workers with a viral load above 100,000 copies/mL, who use zidovudine. Severe anemia was less prevalent in this study population than in historical comparators; however, mild to moderate anemia rates remain high. The study therefore recommends that hematological and virologic parameters be monitored closely in patients receiving first line ART regimen.

Keywords: Female sex worker, Zidovudine, Hemoglobin, Anemia.

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Authors: K. S. Sivakumaran, T. Thanga, B. Halabieh

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The end panels of a large rectangular industrial duct, which experience significant internal pressures, also experience considerable transverse shear due to transfer of gravity loads to the supports. The current design practice of such thin plate panels for shear load is based on methods used for the design of plate girder webs. The structural arrangements, the loadings and the resulting behavior associated with the industrial duct end panels are, however, significantly different from those of the web of a plate girder. The large aspect ratio of the end panels gives rise to multiple bands of tension fields, whereas the plate girder web design is based on one tension field. In addition to shear, the industrial end panels are subjected to internal pressure which in turn produces significant membrane action. This paper reports a study which was undertaken to review the current industrial analysis and design methods and to propose a comprehensive method of designing industrial duct end panels for shear resistance. In this investigation, a nonlinear finite element model was developed to simulate the behavior of industrial duct end panel, along with the associated edge stiffeners, subjected to transverse shear and internal pressures. The model considered the geometric imperfections and constitutive relations for steels. Six scale independent dimensionless parameters that govern the behavior of such end panel were identified and were then used in a parametric study. It was concluded that the plate slenderness dominates the shear strength of stockier end panels, and whereas, both the plate slenderness and the aspect ratio influence the shear strength of slender end panels. Based on these studies, this paper proposes design aids for estimating the shear strength of rectangular duct end panels.

Keywords: Thin plate, transverse shear, tension field, finite element analysis, parametric study, design.

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Authors: Taru Hakanen, Mervi Murtonen

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This study aims to increase understanding of the transition of business models in servitization. The significance of service in all business has increased dramatically during the past decades. Service-dominant logic (SDL) describes this change in the economy and questions the goods-dominant logic on which business has primarily been based in the past. A business model canvas is one of the most cited and used tools in defining end developing business models. The starting point of this paper lies in the notion that the traditional business model canvas is inherently goods-oriented and best suits for product-based business. However, the basic differences between goods and services necessitate changes in business model representations when proceeding in servitization. Therefore, new knowledge is needed on how the conception of business model and the business model canvas as its representation should be altered in servitized firms in order to better serve business developers and interfirm co-creation. That is to say, compared to products, services are intangible and they are co-produced between the supplier and the customer. Value is always co-created in interaction between a supplier and a customer, and customer experience primarily depends on how well the interaction succeeds between the actors. The role of service experience is even stronger in service business compared to product business, as services are co-produced with the customer. This paper provides business model developers with a service business model canvas, which takes into account the intangible, interactive, and relational nature of service. The study employs a design science approach that contributes to theory development via design artifacts. This study utilizes qualitative data gathered in workshops with ten companies from various industries. In particular, key differences between Goods-dominant logic (GDL) and SDLbased business models are identified when an industrial firm proceeds in servitization. As the result of the study, an updated version of the business model canvas is provided based on service-dominant logic. The service business model canvas ensures a stronger customer focus and includes aspects salient for services, such as interaction between companies, service co-production, and customer experience. It can be used for the analysis and development of a current service business model of a company or for designing a new business model. It facilitates customer-focused new service design and service development. It aids in the identification of development needs, and facilitates the creation of a common view of the business model. Therefore, the service business model canvas can be regarded as a boundary object, which facilitates the creation of a common understanding of the business model between several actors involved. The study contributes to the business model and service business development disciplines by providing a managerial tool for practitioners in service development. It also provides research insight into how servitization challenges companies’ business models.

Keywords: Boundary object, business model canvas, managerial tool, service-dominant logic.

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Authors: Wann-Ming Wey, Yi-Chih Huang

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Proper maintenance and preservation of significant cultural heritages or historic buildings is necessary. It can not only enhance environmental benefits and a sense of community, but also preserve a city's history and people’s memory. It allows the next generation to be able to get a glimpse of our past, and achieve the goal of sustainable preserved cultural assets. However, the management of maintenance work has not been appropriate for many designated heritages or historic buildings so far. The planning and implementation of the reuse has yet to have a breakthrough specification. It leads the heritages to a mere formality of being “reserved”, instead of the real meaning of “conservation”. For the restoration and preservation of cultural heritages study issues, it is very important due to the consideration of historical significance, symbolism, and economic benefits effects. However, the decision makers such as the officials from public sector they often encounter which heritage should be prioritized to be restored first under the available limited budgets. Only very few techniques are available today to determine the appropriately restoration priorities for the diverse historical heritages, perhaps because of a lack of systematized decision-making aids been proposed before. In the past, the discussions of management and maintenance towards cultural assets were limited to the selection of reuse alternatives instead of the allocation of resources. In view of this, this research will adopt some integrated research methods to solve the existing problems that decision-makers might encounter when allocating resources in the management and maintenance of heritages and historic buildings.

The purpose of this study is to develop a sustainable decision making model for local governments to resolve these problems. We propose an alternative decision support model to prioritize restoration needs within the limited budgets. The model is constructed based on fuzzy Delphi, fuzzy analysis network process (FANP) and goal programming (GP) methods. In order to avoid misallocate resources; this research proposes a precise procedure that can take multi-stakeholders views, limited costs and resources into consideration. Also, the combination of many factors and goals has been taken into account to find the highest priority and feasible solution results. To illustrate the approach we propose in this research, seven cultural heritages in Taipei city as one example has been used as an empirical study, and the results are in depth analyzed to explain the application of our proposed approach.

Keywords: Cultural Heritage, Historic Buildings, Priority Evaluation, Multi-Criteria Decision Making, Goal Programming, Fuzzy Analytic Network Process, Resource Allocation.

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Authors: A. Appe, B. Poluparthi, L. Kasivajjula, U. Mv, S. Bagadi, P. Modi, A. Singh, H. Gunupudi, S. Troiano, J. Paul, J. Stovall, J. Yamamoto

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The necessity of data-driven decisions in healthcare strategy formulation is rapidly increasing. A reliable framework which helps identify factors impacting a healthcare provider facility or a hospital (from here on termed as facility) market share is of key importance. This pilot study aims at developing a data-driven machine learning-regression framework which aids strategists in formulating key decisions to improve the facility’s market share which in turn impacts in improving the quality of healthcare services. The US (United States) healthcare business is chosen for the study, and the data spanning 60 key facilities in Washington State and about 3 years of historical data are considered. In the current analysis, market share is termed as the ratio of the facility’s encounters to the total encounters among the group of potential competitor facilities. The current study proposes a two-pronged approach of competitor identification and regression approach to evaluate and predict market share, respectively. Leveraged model agnostic technique, SHAP (SHapley Additive exPlanations), to quantify the relative importance of features impacting the market share. Typical techniques in literature to quantify the degree of competitiveness among facilities use an empirical method to calculate a competitive factor to interpret the severity of competition. The proposed method identifies a pool of competitors, develops Directed Acyclic Graphs (DAGs) and feature level word vectors, and evaluates the key connected components at the facility level. This technique is robust since it is data-driven, which minimizes the bias from empirical techniques. The DAGs factor in partial correlations at various segregations and key demographics of facilities along with a placeholder to factor in various business rules (for e.g., quantifying the patient exchanges, provider references, and sister facilities). Identified are the multiple groups of competitors among facilities. Leveraging the competitors' identified developed and fine-tuned Random Forest Regression model to predict the market share. To identify key drivers of market share at an overall level, permutation feature importance of the attributes was calculated. For relative quantification of features at a facility level, incorporated SHAP, a model agnostic explainer. This helped to identify and rank the attributes at each facility which impacts the market share. This approach proposes an amalgamation of the two popular and efficient modeling practices, viz., machine learning with graphs and tree-based regression techniques to reduce the bias. With these, we helped to drive strategic business decisions.

Keywords: Competition, DAGs, hospital, healthcare, machine learning, market share, random forest, SHAP.

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