Search results for: Decision Points
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2204

Search results for: Decision Points

134 COVID_ICU_BERT: A Fine-tuned Language Model for COVID-19 Intensive Care Unit Clinical Notes

Authors: Shahad Nagoor, Lucy Hederman, Kevin Koidl, Annalina Caputo

Abstract:

Doctors’ notes reflect their impressions, attitudes, clinical sense, and opinions about patients’ conditions and progress, and other information that is essential for doctors’ daily clinical decisions. Despite their value, clinical notes are insufficiently researched within the language processing community. Automatically extracting information from unstructured text data is known to be a difficult task as opposed to dealing with structured information such as physiological vital signs, images and laboratory results. The aim of this research is to investigate how Natural Language Processing (NLP) techniques and machine learning techniques applied to clinician notes can assist in doctors’ decision making in Intensive Care Unit (ICU) for coronavirus disease 2019 (COVID-19) patients. The hypothesis is that clinical outcomes like survival or mortality can be useful to influence the judgement of clinical sentiment in ICU clinical notes. This paper presents two contributions: first, we introduce COVID_ICU_BERT, a fine-tuned version of a clinical transformer model that can reliably predict clinical sentiment for notes of COVID patients in ICU. We train the model on clinical notes for COVID-19 patients, ones not previously seen by Bio_ClinicalBERT or Bio_Discharge_Summary_BERT. The model which was based on Bio_ClinicalBERT achieves higher predictive accuracy than the one based on Bio_Discharge_Summary_BERT (Acc 93.33%, AUC 0.98, and Precision 0.96). Second, we perform data augmentation using clinical contextual word embedding that is based on a pre-trained clinical model to balance the samples in each class in the data (survived vs. deceased patients). Data augmentation improves the accuracy of prediction slightly (Acc 96.67%, AUC 0.98, and Precision 0.92).

Keywords: BERT fine-tuning, clinical sentiment, COVID-19, data augmentation.

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133 Evaluation of the Mechanical Behavior of a Retaining Wall Structure on a Weathered Soil through Probabilistic Methods

Authors: P. V. S. Mascarenhas, B. C. P. Albuquerque, D. J. F. Campos, L. L. Almeida, V. R. Domingues, L. C. S. M. Ozelim

Abstract:

Retaining slope structures are increasingly considered in geotechnical engineering projects due to extensive urban cities growth. These kinds of engineering constructions may present instabilities over the time and may require reinforcement or even rebuilding of the structure. In this context, statistical analysis is an important tool for decision making regarding retaining structures. This study approaches the failure probability of the construction of a retaining wall over the debris of an old and collapsed one. The new solution’s extension length will be of approximately 350 m and will be located over the margins of the Lake Paranoá, Brasilia, in the capital of Brazil. The building process must also account for the utilization of the ruins as a caisson. A series of in situ and laboratory experiments defined local soil strength parameters. A Standard Penetration Test (SPT) defined the in situ soil stratigraphy. Also, the parameters obtained were verified using soil data from a collection of masters and doctoral works from the University of Brasília, which is similar to the local soil. Initial studies show that the concrete wall is the proper solution for this case, taking into account the technical, economic and deterministic analysis. On the other hand, in order to better analyze the statistical significance of the factor-of-safety factors obtained, a Monte Carlo analysis was performed for the concrete wall and two more initial solutions. A comparison between the statistical and risk results generated for the different solutions indicated that a Gabion solution would better fit the financial and technical feasibility of the project.

Keywords: Economical analysis, probability of failure, retaining walls, statistical analysis.

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132 A Novel Approach to Allocate Channels Dynamically in Wireless Mesh Networks

Authors: Y. Harold Robinson, M. Rajaram

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Wireless mesh networking is rapidly gaining in popularity with a variety of users: from municipalities to enterprises, from telecom service providers to public safety and military organizations. This increasing popularity is based on two basic facts: ease of deployment and increase in network capacity expressed in bandwidth per footage; WMNs do not rely on any fixed infrastructure. Many efforts have been used to maximizing throughput of the network in a multi-channel multi-radio wireless mesh network. Current approaches are purely based on either static or dynamic channel allocation approaches. In this paper, we use a hybrid multichannel multi radio wireless mesh networking architecture, where static and dynamic interfaces are built in the nodes. Dynamic Adaptive Channel Allocation protocol (DACA), it considers optimization for both throughput and delay in the channel allocation. The assignment of the channel has been allocated to be codependent with the routing problem in the wireless mesh network and that should be based on passage flow on every link. Temporal and spatial relationship rises to re compute the channel assignment every time when the pattern changes in mesh network, channel assignment algorithms assign channels in network. In this paper a computing path which captures the available path bandwidth is the proposed information and the proficient routing protocol based on the new path which provides both static and dynamic links. The consistency property guarantees that each node makes an appropriate packet forwarding decision and balancing the control usage of the network, so that a data packet will traverse through the right path.

Keywords: Wireless mesh network, spatial time division multiple access, hybrid topology, timeslot allocation.

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131 Productivity Effect of Urea Deep Placement Technology: An Empirical Analysis from Irrigation Rice Farmers in the Northern Region of Ghana

Authors: Shaibu Baanni Azumah, Ignatius Tindjina, Stella Obanyi, Tara N. Wood

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This study examined the effect of Urea Deep Placement (UDP) technology on the output of irrigated rice farmers in the northern region of Ghana. Multi-stage sampling technique was used to select 142 rice farmers from the Golinga and Bontanga irrigation schemes, around Tamale. A treatment effect model was estimated at two stages; firstly, to determine the factors that influenced farmers’ decision to adopt the UDP technology and secondly, to determine the effect of the adoption of the UDP technology on the output of rice farmers. The significant variables that influenced rice farmers’ adoption of the UPD technology were sex of the farmer, land ownership, off-farm activity, extension service, farmer group participation and training. The results also revealed that farm size and the adoption of UDP technology significantly influenced the output of rice farmers in the northern region of Ghana. In addition to the potential of the technology to improve yields, it also presents an employment opportunity for women and youth, who are engaged in the deep placement of Urea Super Granules (USG), as well as in the transplantation of rice. It is recommended that the government of Ghana work closely with the IFDC to embed the UDP technology in the national agricultural programmes and policies. The study also recommends an effective collaboration between the government, through the Ministry of Food and Agriculture (MoFA) and the International Fertilizer Development Center (IFDC) to train agricultural extension agents on UDP technology in the rice producing areas of the country.

Keywords: Northern Ghana, output, irrigation rice farmers, treatment effect model, urea deep placement.

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130 Acceptance of Health Information Application in Smart National Identity Card (SNIC) Using a New I-P Framework

Authors: Ismail Bile Hassan, Masrah Azrifah Azmi Murad

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This study discovers a novel framework of individual level technology adoption known as I-P (Individual- Privacy) towards health information application in Smart National Identity Card. Many countries introduced smart national identity card (SNIC) with various applications such as health information application embedded inside it. However, the degree to which citizens accept and use some of the embedded applications in smart national identity remains unknown to many governments and application providers as well. Moreover, the factors of trust, perceived risk, Privacy concern and perceived credibility need to be incorporated into more comprehensive models such as extended Unified Theory of Acceptance and Use of Technology known as UTAUT2. UTAUT2 is a mainly widespread and leading theory up to now. This research identifies factors affecting the citizens’ behavioural intention to use health information application embedded in SNIC and extends better understanding on the relevant factors that the government and the application providers would need to consider in predicting citizens’ new technology acceptance in the future. We propose a conceptual framework by combining the UTAUT2 and Privacy Calculus Model constructs and also adding perceived credibility as a new variable. The proposed framework may provide assistance to any government planning, decision, and policy makers involving e-government projects. Empirical study may be conducted in the future to provide proof and empirically validate this I-P framework.

Keywords: Unified Theory of Acceptance and Use of Technology (UTAUT) model, UTAUT2 model, Smart National Identity Card (SNIC), Health information application, Privacy Calculus Model (PCM).

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129 Leveraging xAPI in a Corporate e-Learning Environment to Facilitate the Tracking, Modelling, and Predictive Analysis of Learner Behaviour

Authors: Libor Zachoval, Daire O Broin, Oisin Cawley

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E-learning platforms, such as Blackboard have two major shortcomings: limited data capture as a result of the limitations of SCORM (Shareable Content Object Reference Model), and lack of incorporation of Artificial Intelligence (AI) and machine learning algorithms which could lead to better course adaptations. With the recent development of Experience Application Programming Interface (xAPI), a large amount of additional types of data can be captured and that opens a window of possibilities from which online education can benefit. In a corporate setting, where companies invest billions on the learning and development of their employees, some learner behaviours can be troublesome for they can hinder the knowledge development of a learner. Behaviours that hinder the knowledge development also raise ambiguity about learner’s knowledge mastery, specifically those related to gaming the system. Furthermore, a company receives little benefit from their investment if employees are passing courses without possessing the required knowledge and potential compliance risks may arise. Using xAPI and rules derived from a state-of-the-art review, we identified three learner behaviours, primarily related to guessing, in a corporate compliance course. The identified behaviours are: trying each option for a question, specifically for multiple-choice questions; selecting a single option for all the questions on the test; and continuously repeating tests upon failing as opposed to going over the learning material. These behaviours were detected on learners who repeated the test at least 4 times before passing the course. These findings suggest that gauging the mastery of a learner from multiple-choice questions test scores alone is a naive approach. Thus, next steps will consider the incorporation of additional data points, knowledge estimation models to model knowledge mastery of a learner more accurately, and analysis of the data for correlations between knowledge development and identified learner behaviours. Additional work could explore how learner behaviours could be utilised to make changes to a course. For example, course content may require modifications (certain sections of learning material may be shown to not be helpful to many learners to master the learning outcomes aimed at) or course design (such as the type and duration of feedback).

Keywords: Compliance Course, Corporate Training, Learner Behaviours, xAPI.

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128 An Overall Approach to the Communication of Organizations in Conventional and Virtual Offices

Authors: Mehmet Altınöz

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Organizational communication is an administrative function crucial especially for executives in the implementation of organizational and administrative functions. Executives spend a significant part of their time on communicative activities. Doing his or her daily routine, arranging meeting schedules, speaking on the telephone, reading or replying to business correspondence, or fulfilling the control functions within the organization, an executive typically engages in communication processes. Efficient communication is the principal device for the adequate implementation of administrative and organizational activities. For this purpose, management needs to specify the kind of communication system to be set up and the kind of communication devices to be used. Communication is vital for any organization. In conventional offices, communication takes place within the hierarchical pyramid called the organizational structure, and is known as formal or informal communication. Formal communication is the type that works in specified structures within the organizational rules and towards the organizational goals. Informal communication, on the other hand, is the unofficial type taking place among staff as face-to-face or telephone interaction. Communication in virtual as well as conventional offices is essential for obtaining the right information in administrative activities and decision-making. Virtual communication technologies increase the efficiency of communication especially in virtual teams. Group communication is strengthened through an inter-group central channel. Further, ease of information transmission makes it possible to reach the information at the source, allowing efficient and correct decisions. Virtual offices can present as a whole the elements of information which conventional offices produce in different environments. At present, virtual work has become a reality with its pros and cons, and will probably spread very rapidly in coming years, in line with the growth in information technologies.

Keywords: Organization, conventional office, virtual office, communication, communication model, communication functions, communication methods, vertical communication, linear communication, diagonal communication

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127 Financial Regulations in the Process of Global Financial Crisis and Macroeconomics Impact of Basel III

Authors: M. Okan Tasar

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Basel III (or the Third Basel Accord) is a global regulatory standard on bank capital adequacy, stress testing and market liquidity risk agreed upon by the members of the Basel Committee on Banking Supervision in 2010-2011, and scheduled to be introduced from 2013 until 2018. Basel III is a comprehensive set of reform measures. These measures aim to; (1) improve the banking sector-s ability to absorb shocks arising from financial and economic stress, whatever the source, (2) improve risk management and governance, (3) strengthen banks- transparency and disclosures. Similarly the reform target; (1) bank level or micro-prudential, regulation, which will help raise the resilience of individual banking institutions to periods of stress. (2) Macro-prudential regulations, system wide risk that can build up across the banking sector as well as the pro-cyclical implication of these risks over time. These two approaches to supervision are complementary as greater resilience at the individual bank level reduces the risk system wide shocks. Macroeconomic impact of Basel III; OECD estimates that the medium-term impact of Basel III implementation on GDP growth is in the range -0,05 percent to -0,15 percent per year. On the other hand economic output is mainly affected by an increase in bank lending spreads as banks pass a rise in banking funding costs, due to higher capital requirements, to their customers. Consequently the estimated effects on GDP growth assume no active response from monetary policy. Basel III impact on economic output could be offset by a reduction (or delayed increase) in monetary policy rates by about 30 to 80 basis points. The aim of this paper is to create a framework based on the recent regulations in order to prevent financial crises. Thus the need to overcome the global financial crisis will contribute to financial crises that may occur in the future periods. In the first part of the paper, the effects of the global crisis on the banking system examine the concept of financial regulations. In the second part; especially in the financial regulations and Basel III are analyzed. The last section in this paper explored the possible consequences of the macroeconomic impacts of Basel III.

Keywords: Banking Systems, Basel III, Financial regulation, Global Financial Crisis.

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126 Heuristics Analysis for Distributed Scheduling using MONARC Simulation Tool

Authors: Florin Pop

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Simulation is a very powerful method used for highperformance and high-quality design in distributed system, and now maybe the only one, considering the heterogeneity, complexity and cost of distributed systems. In Grid environments, foe example, it is hard and even impossible to perform scheduler performance evaluation in a repeatable and controllable manner as resources and users are distributed across multiple organizations with their own policies. In addition, Grid test-beds are limited and creating an adequately-sized test-bed is expensive and time consuming. Scalability, reliability and fault-tolerance become important requirements for distributed systems in order to support distributed computation. A distributed system with such characteristics is called dependable. Large environments, like Cloud, offer unique advantages, such as low cost, dependability and satisfy QoS for all users. Resource management in large environments address performant scheduling algorithm guided by QoS constrains. This paper presents the performance evaluation of scheduling heuristics guided by different optimization criteria. The algorithms for distributed scheduling are analyzed in order to satisfy users constrains considering in the same time independent capabilities of resources. This analysis acts like a profiling step for algorithm calibration. The performance evaluation is based on simulation. The simulator is MONARC, a powerful tool for large scale distributed systems simulation. The novelty of this paper consists in synthetic analysis results that offer guidelines for scheduler service configuration and sustain the empirical-based decision. The results could be used in decisions regarding optimizations to existing Grid DAG Scheduling and for selecting the proper algorithm for DAG scheduling in various actual situations.

Keywords: Scheduling, Simulation, Performance Evaluation, QoS, Distributed Systems, MONARC

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125 Development of Moving Multifocal Electroretinogram with a Precise Perimetry Apparatus

Authors: Naoto Suzuki

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A decline in visual sensitivity at arbitrary points on the retina can be measured using a precise perimetry apparatus along with a fundus camera. However, the retinal layer associated with this decline cannot be identified accurately with current medical technology. To investigate cryptogenic diseases, such as macular dystrophy, acute zonal occult outer retinopathy (AZOOR), and multiple evanescent white dot syndrome (MEWDS), we evaluated an electroretinogram (ERG) function that allows moving the center of the multifocal hexagonal stimulus array to a chosen position. Macular dystrophy is a generalized term used for a variety of functional disorders of the macula lutea, and the ERG shows a diminution of the b-wave in these disorders. AZOOR causes an acute functional disorder to an outer layer of the retina, and the ERG shows a-wave and b-wave amplitude reduction as well as delayed 30 Hz flicker responses. MEWDS causes acute visual loss and the ERG shows a decrease in a-wave amplitude. We combined an electroretinographic optical system and a perimetric optical system into an experimental apparatus that has the same optical system as that of a fundus camera. We also deployed an EO-50231 Edmund infrared camera, a 45-degree cold mirror, a lens with a 25-mm focal length, a halogen lamp, and an 8-inch monitor. Then, we also employed a differential amplifier with gain 10, a 50 Hz notch filter, a high-pass filter with a 21.2 Hz cut-off frequency, and two non-inverting amplifiers with gains 1001 and 11. In addition, we used a USB-6216 National Instruments I/O device, a NE-113A Nihon Kohden plate electrode, a SCB-68A shielded connector block, and LabVIEW 2017 software for data retrieval. The software was used to generate the multifocal hexagonal stimulus array on the computer monitor with C++Builder 10.2 and to move the center of the array toward the left and right and up and down. Cone and bright flash ERG results were observed using the moving ERG function. The a-wave, b-wave, c-wave, and the photopic negative response were identified with cone ERG. The moving ERG function allowed the identification of the retinal layer causing visual alterations.

Keywords: Moving ERG, multifocal ERG, precise perimetry, retinal layers, visual sensitivity

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124 Improving Air Temperature Prediction with Artificial Neural Networks

Authors: Brian A. Smith, Ronald W. McClendon, Gerrit Hoogenboom

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The mitigation of crop loss due to damaging freezes requires accurate air temperature prediction models. Previous work established that the Ward-style artificial neural network (ANN) is a suitable tool for developing such models. The current research focused on developing ANN models with reduced average prediction error by increasing the number of distinct observations used in training, adding additional input terms that describe the date of an observation, increasing the duration of prior weather data included in each observation, and reexamining the number of hidden nodes used in the network. Models were created to predict air temperature at hourly intervals from one to 12 hours ahead. Each ANN model, consisting of a network architecture and set of associated parameters, was evaluated by instantiating and training 30 networks and calculating the mean absolute error (MAE) of the resulting networks for some set of input patterns. The inclusion of seasonal input terms, up to 24 hours of prior weather information, and a larger number of processing nodes were some of the improvements that reduced average prediction error compared to previous research across all horizons. For example, the four-hour MAE of 1.40°C was 0.20°C, or 12.5%, less than the previous model. Prediction MAEs eight and 12 hours ahead improved by 0.17°C and 0.16°C, respectively, improvements of 7.4% and 5.9% over the existing model at these horizons. Networks instantiating the same model but with different initial random weights often led to different prediction errors. These results strongly suggest that ANN model developers should consider instantiating and training multiple networks with different initial weights to establish preferred model parameters.

Keywords: Decision support systems, frost protection, fruit, time-series prediction, weather modeling

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123 Switching Studies on Ge15In5Te56Ag24 Thin Films

Authors: Diptoshi Roy, G. Sreevidya Varma, S. Asokan, Chandasree Das

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Germanium Telluride based quaternary thin film switching devices with composition Ge15In5Te56Ag24, have been deposited in sandwich geometry on glass substrate with aluminum as top and bottom electrodes. The bulk glassy form of the said composition is prepared by melt quenching technique. In this technique, appropriate quantity of elements with high purity are taken in a quartz ampoule and sealed under a vacuum of 10-5 mbar. Then, it is allowed to rotate in a horizontal rotary furnace for 36 hours to ensure homogeneity of the melt. After that, the ampoule is quenched into a mixture of ice - water and NaOH to get the bulk ingot of the sample. The sample is then coated on a glass substrate using flash evaporation technique at a vacuum level of 10-6 mbar. The XRD report reveals the amorphous nature of the thin film sample and Energy - Dispersive X-ray Analysis (EDAX) confirms that the film retains the same chemical composition as that of the base sample. Electrical switching behavior of the device is studied with the help of Keithley (2410c) source-measure unit interfaced with Lab VIEW 7 (National Instruments). Switching studies, mainly SET (changing the state of the material from amorphous to crystalline) operation is conducted on the thin film form of the sample. This device is found to manifest memory switching as the device remains 'ON' even after the removal of the electric field. Also it is found that amorphous Ge15In5Te56Ag24 thin film unveils clean memory type of electrical switching behavior which can be justified by the absence of fluctuation in the I-V characteristics. The I-V characteristic also reveals that the switching is faster in this sample as no data points could be seen in the negative resistance region during the transition to on state and this leads to the conclusion of fast phase change during SET process. Scanning Electron Microscopy (SEM) studies are performed on the chosen sample to study the structural changes at the time of switching. SEM studies on the switched Ge15In5Te56Ag24 sample has shown some morphological changes at the place of switching wherein it can be explained that a conducting crystalline channel is formed in the device when the device switches from high resistance to low resistance state. From these studies it can be concluded that the material may find its application in fast switching Non-Volatile Phase Change Memory (PCM) Devices.

Keywords: Chalcogenides, vapor deposition, electrical switching, PCM.

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122 Forecasting Foreign Direct Investment with Modified Diffusion Model

Authors: Bi-Huei Tsai

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Prior research has not effectively investigated how the profitability of Chinese branches affect FDIs in China [1, 2], so this study for the first time incorporates realistic earnings information to systematically investigate effects of innovation, imitation, and profit factors of FDI diffusions from Taiwan to China. Our nonlinear least square (NLS) model, which incorporates earnings factors, forms a nonlinear ordinary differential equation (ODE) in numerical simulation programs. The model parameters are obtained through a genetic algorithms (GA) technique and then optimized with the collected data for the best accuracy. Particularly, Taiwanese regulatory FDI restrictions are also considered in our modified model to meet the realistic conditions. To validate the model-s effectiveness, this investigation compares the prediction accuracy of modified model with the conventional diffusion model, which does not take account of the profitability factors. The results clearly demonstrate the internal influence to be positive, as early FDI adopters- consistent praises of FDI attract potential firms to make the same move. The former erects a behavior model for the latter to imitate their foreign investment decision. Particularly, the results of modified diffusion models show that the earnings from Chinese branches are positively related to the internal influence. In general, the imitating tendency of potential consumers is substantially hindered by the losses in the Chinese branches, and these firms would invest less into China. The FDI inflow extension depends on earnings of Chinese branches, and companies will adjust their FDI strategies based on the returns. Since this research has proved that earning is an influential factor on FDI dynamics, our revised model explicitly performs superior in prediction ability than conventional diffusion model.

Keywords: diffusion model, genetic algorithms, nonlinear leastsquares (NLS) model, prediction error.

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121 A Sustainable Design Model by Integrated Evaluation of Closed-loop Design and Supply Chain Using a Mathematical Model

Authors: Yuan-Jye Tseng, Yi-Shiuan Chen

Abstract:

The paper presented a sustainable design model for integrated evaluation of the design and supply chain of a product for the sustainable objectives. To design a product, there can be alternative ways to assign the detailed specifications to fulfill the same design objectives. In the design alternative cases, different material and manufacturing processes with various supply chain activities may be required for the production. Therefore, it is required to evaluate the different design cases based on the sustainable objectives. In this research, a closed-loop design model is developed by integrating the forward design model and reverse design model. From the supply chain point of view, the decisions in the forward design model are connected with the forward supply chain. The decisions in the reverse design model are connected with the reverse supply chain considering the sustainable objectives. The purpose of this research is to develop a mathematical model for analyzing the design cases by integrated evaluating the criteria in the closed-loop design and the closed-loop supply chain. The decision variables are built to represent the design cases of the forward design and reverse design. The cost parameters in a forward design include the costs of material and manufacturing processes. The cost parameters in a reverse design include the costs of recycling, disassembly, reusing, remanufacturing, and disposing. The mathematical model is formulated to minimize the total cost under the design constraints. In practical applications, the decisions of the mathematical model can be used for selecting a design case for the purpose of sustainable design of a product. An example product is demonstrated in the paper. The test result shows that the sustainable design model is useful for integrated evaluation of the design and the supply chain to achieve the sustainable objectives.

Keywords: Closed-loop design, closed-loop supply chain, design evaluation, mathematical model, supply chain management, sustainable design model.

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120 Internet of Health Things as a Win-Win Solution for Mitigating the Paradigm Shift inside Senior Patient-Physician Shared Health Management

Authors: Marilena Ianculescu, Adriana Alexandru

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Internet of Health Things (IoHT) has already proved to be a persuasive means to support a proper assessment of the living conditions by collecting a huge variety of data. For a customized health management of a senior patient, IoHT provides the capacity to build a dynamic solution for sustaining the shift inside the patient-physician relationship by allowing a real-time and continuous remote monitoring of the health status, well-being, safety and activities of the senior, especially in a non-clinical environment. Thus, is created a win-win solution in which both the patient and the physician enhance their involvement and shared decision-making, with significant outcomes. Health monitoring systems in smart environments are becoming a viable alternative to traditional healthcare solutions. The ongoing “Non-invasive monitoring and health assessment of the elderly in a smart environment (RO-SmartAgeing)” project aims to demonstrate that the existence of complete and accurate information is critical for assessing the health condition of the seniors, improving wellbeing and quality of life in relation to health. The researches performed inside the project aim to highlight how the management of IoHT devices connected to the RO-SmartAgeing platform in a secure way by using a role-based access control system, can allow the physicians to provide health services at a high level of efficiency and accessibility, which were previously only available in hospitals. The project aims to identify deficient aspects in the provision of health services tailored to a senior patient’s specificity and to offer a more comprehensive perspective of proactive and preventive medical acts.

Keywords: Health management, Internet of Health Things, remote monitoring, senior patient.

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119 MFCA: An Environmental Management Accounting Technique for Optimal Resource Efficiency in Production Processes

Authors: Omolola A. Tajelawi, Hari L. Garbharran

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Revenue leakages are one of the major challenges manufacturers face in production processes, as most of the input materials that should emanate as products from the lines are lost as waste. Rather than generating income from material input which is meant to end-up as products, losses are further incurred as costs in order to manage waste generated. In addition, due to the lack of a clear view of the flow of resources on the lines from input to output stage, acquiring information on the true cost of waste generated have become a challenge. This has therefore given birth to the conceptualization and implementation of waste minimization strategies by several manufacturing industries. This paper reviews the principles and applications of three environmental management accounting tools namely Activity-based Costing (ABC), Life-Cycle Assessment (LCA) and Material Flow Cost Accounting (MFCA) in the manufacturing industry and their effectiveness in curbing revenue leakages. The paper unveils the strengths and limitations of each of the tools; beaming a searchlight on the tool that could allow for optimal resource utilization, transparency in production process as well as improved cost efficiency. Findings from this review reveal that MFCA may offer superior advantages with regards to the provision of more detailed information (both in physical and monetary terms) on the flow of material inputs throughout the production process compared to the other environmental accounting tools. This paper therefore makes a case for the adoption of MFCA as a viable technique for the identification and reduction of waste in production processes, and also for effective decision making by production managers, financial advisors and other relevant stakeholders.

Keywords: MFCA, environmental management accounting, resource efficiency, waste reduction, revenue losses.

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118 Novel Hybrid Approaches For Real Coded Genetic Algorithm to Compute the Optimal Control of a Single Stage Hybrid Manufacturing Systems

Authors: M. Senthil Arumugam, M.V.C. Rao

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This paper presents a novel two-phase hybrid optimization algorithm with hybrid genetic operators to solve the optimal control problem of a single stage hybrid manufacturing system. The proposed hybrid real coded genetic algorithm (HRCGA) is developed in such a way that a simple real coded GA acts as a base level search, which makes a quick decision to direct the search towards the optimal region, and a local search method is next employed to do fine tuning. The hybrid genetic operators involved in the proposed algorithm improve both the quality of the solution and convergence speed. The phase–1 uses conventional real coded genetic algorithm (RCGA), while optimisation by direct search and systematic reduction of the size of search region is employed in the phase – 2. A typical numerical example of an optimal control problem with the number of jobs varying from 10 to 50 is included to illustrate the efficacy of the proposed algorithm. Several statistical analyses are done to compare the validity of the proposed algorithm with the conventional RCGA and PSO techniques. Hypothesis t – test and analysis of variance (ANOVA) test are also carried out to validate the effectiveness of the proposed algorithm. The results clearly demonstrate that the proposed algorithm not only improves the quality but also is more efficient in converging to the optimal value faster. They can outperform the conventional real coded GA (RCGA) and the efficient particle swarm optimisation (PSO) algorithm in quality of the optimal solution and also in terms of convergence to the actual optimum value.

Keywords: Hybrid systems, optimal control, real coded genetic algorithm (RCGA), Particle swarm optimization (PSO), Hybrid real coded GA (HRCGA), and Hybrid genetic operators.

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117 Machine Learning Techniques for COVID-19 Detection: A Comparative Analysis

Authors: Abeer Aljohani

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The COVID-19 virus spread has been one of the extreme pandemics across the globe. It is also referred as corona virus which is a contagious disease that continuously mutates into numerous variants. Currently, the B.1.1.529 variant labeled as Omicron is detected in South Africa. The huge spread of COVID-19 disease has affected several lives and has surged exceptional pressure on the healthcare systems worldwide. Also, everyday life and the global economy have been at stake. Numerous COVID-19 cases have produced a huge burden on hospitals as well as health workers. To reduce this burden, this paper predicts COVID-19 disease based on the symptoms and medical history of the patient. As machine learning is a widely accepted area and gives promising results for healthcare, this research presents an architecture for COVID-19 detection using ML techniques integrated with feature dimensionality reduction. This paper uses a standard University of California Irvine (UCI) dataset for predicting COVID-19 disease. This dataset comprises symptoms of 5434 patients. This paper also compares several supervised ML techniques on the presented architecture. The architecture has also utilized 10-fold cross validation process for generalization and Principal Component Analysis (PCA) technique for feature reduction. Standard parameters are used to evaluate the proposed architecture including F1-Score, precision, accuracy, recall, Receiver Operating Characteristic (ROC) and Area under Curve (AUC). The results depict that Decision tree, Random Forest and neural networks outperform all other state-of-the-art ML techniques. This result can be used to effectively identify COVID-19 infection cases.

Keywords: Supervised machine learning, COVID-19 prediction, healthcare analytics, Random Forest, Neural Network.

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116 Air Handling Units Power Consumption Using Generalized Additive Model for Anomaly Detection: A Case Study in a Singapore Campus

Authors: Ju Peng Poh, Jun Yu Charles Lee, Jonathan Chew Hoe Khoo

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The emergence of digital twin technology, a digital replica of physical world, has improved the real-time access to data from sensors about the performance of buildings. This digital transformation has opened up many opportunities to improve the management of the building by using the data collected to help monitor consumption patterns and energy leakages. One example is the integration of predictive models for anomaly detection. In this paper, we use the GAM (Generalised Additive Model) for the anomaly detection of Air Handling Units (AHU) power consumption pattern. There is ample research work on the use of GAM for the prediction of power consumption at the office building and nation-wide level. However, there is limited illustration of its anomaly detection capabilities, prescriptive analytics case study, and its integration with the latest development of digital twin technology. In this paper, we applied the general GAM modelling framework on the historical data of the AHU power consumption and cooling load of the building between Jan 2018 to Aug 2019 from an education campus in Singapore to train prediction models that, in turn, yield predicted values and ranges. The historical data are seamlessly extracted from the digital twin for modelling purposes. We enhanced the utility of the GAM model by using it to power a real-time anomaly detection system based on the forward predicted ranges. The magnitude of deviation from the upper and lower bounds of the uncertainty intervals is used to inform and identify anomalous data points, all based on historical data, without explicit intervention from domain experts. Notwithstanding, the domain expert fits in through an optional feedback loop through which iterative data cleansing is performed. After an anomalously high or low level of power consumption detected, a set of rule-based conditions are evaluated in real-time to help determine the next course of action for the facilities manager. The performance of GAM is then compared with other approaches to evaluate its effectiveness. Lastly, we discuss the successfully deployment of this approach for the detection of anomalous power consumption pattern and illustrated with real-world use cases.

Keywords: Anomaly detection, digital twin, Generalised Additive Model, Power Consumption Model.

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115 Software Architecture and Support for Patient Tracking Systems in Critical Scenarios

Authors: Gianluca Cornetta, Abdellah Touhafi, David J. Santos, Jose Manuel Vazquez

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In this work a new platform for mobile-health systems is presented. System target application is providing decision support to rescue corps or military medical personnel in combat areas. Software architecture relies on a distributed client-server system that manages a wireless ad-hoc networks hierarchy in which several different types of client operate. Each client is characterized for different hardware and software requirements. Lower hierarchy levels rely in a network of completely custom devices that store clinical information and patient status and are designed to form an ad-hoc network operating in the 2.4 GHz ISM band and complying with the IEEE 802.15.4 standard (ZigBee). Medical personnel may interact with such devices, that are called MICs (Medical Information Carriers), by means of a PDA (Personal Digital Assistant) or a MDA (Medical Digital Assistant), and transmit the information stored in their local databases as well as issue a service request to the upper hierarchy levels by using IEEE 802.11 a/b/g standard (WiFi). The server acts as a repository that stores both medical evacuation forms and associated events (e.g., a teleconsulting request). All the actors participating in the diagnostic or evacuation process may access asynchronously to such repository and update its content or generate new events. The designed system pretends to optimise and improve information spreading and flow among all the system components with the aim of improving both diagnostic quality and evacuation process.

Keywords: IEEE 802.15.4 (ZigBee), IEEE 802.11 a/b/g (WiFi), distributed client-server systems, embedded databases, issue trackers, ad-hoc networks.

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114 Thermodynamic Analyses of Information Dissipation along the Passive Dendritic Trees and Active Action Potential

Authors: Bahar Hazal Yalçınkaya, Bayram Yılmaz, Mustafa Özilgen

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Brain information transmission in the neuronal network occurs in the form of electrical signals. Neural work transmits information between the neurons or neurons and target cells by moving charged particles in a voltage field; a fraction of the energy utilized in this process is dissipated via entropy generation. Exergy loss and entropy generation models demonstrate the inefficiencies of the communication along the dendritic trees. In this study, neurons of 4 different animals were analyzed with one dimensional cable model with N=6 identical dendritic trees and M=3 order of symmetrical branching. Each branch symmetrically bifurcates in accordance with the 3/2 power law in an infinitely long cylinder with the usual core conductor assumptions, where membrane potential is conserved in the core conductor at all branching points. In the model, exergy loss and entropy generation rates are calculated for each branch of equivalent cylinders of electrotonic length (L) ranging from 0.1 to 1.5 for four different dendritic branches, input branch (BI), and sister branch (BS) and two cousin branches (BC-1 & BC-2). Thermodynamic analysis with the data coming from two different cat motoneuron studies show that in both experiments nearly the same amount of exergy is lost while generating nearly the same amount of entropy. Guinea pig vagal motoneuron loses twofold more exergy compared to the cat models and the squid exergy loss and entropy generation were nearly tenfold compared to the guinea pig vagal motoneuron model. Thermodynamic analysis show that the dissipated energy in the dendritic tress is directly proportional with the electrotonic length, exergy loss and entropy generation. Entropy generation and exergy loss show variability not only between the vertebrate and invertebrates but also within the same class. Concurrently, single action potential Na+ ion load, metabolic energy utilization and its thermodynamic aspect contributed for squid giant axon and mammalian motoneuron model. Energy demand is supplied to the neurons in the form of Adenosine triphosphate (ATP). Exergy destruction and entropy generation upon ATP hydrolysis are calculated. ATP utilization, exergy destruction and entropy generation showed differences in each model depending on the variations in the ion transport along the channels.

Keywords: ATP utilization, entropy generation, exergy loss, neuronal information transmittance.

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113 Reducing Later Life Loneliness: A Systematic Literature Review of Loneliness Interventions

Authors: Dhruv Sharma, Lynne Blair, Stephen Clune

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Later life loneliness is a social issue that is increasing alongside an upward global population trend. As a society, one way that we have responded to this social challenge is through developing non-pharmacological interventions such as befriending services, activity clubs, meet-ups, etc. Through a systematic literature review, this paper suggests that currently there is an underrepresentation of radical innovation, and underutilization of digital technologies in developing loneliness interventions for older adults. This paper examines intervention studies that were published in English language, within peer reviewed journals between January 2005 and December 2014 across 4 electronic databases. In addition to academic databases, interventions found in grey literature in the form of websites, blogs, and Twitter were also included in the overall review. This approach yielded 129 interventions that were included in the study. A systematic approach allowed the minimization of any bias dictating the selection of interventions to study. A coding strategy based on a pattern analysis approach was devised to be able to compare and contrast the loneliness interventions. Firstly, interventions were categorized on the basis of their objective to identify whether they were preventative, supportive, or remedial in nature. Secondly, depending on their scope, they were categorized as one-to-one, community-based, or group based. It was also ascertained whether interventions represented an improvement, an incremental innovation, a major advance or a radical departure, in comparison to the most basic form of a loneliness intervention. Finally, interventions were also assessed on the basis of the extent to which they utilized digital technologies. Individual visualizations representing the four levels of coding were created for each intervention, followed by an aggregated visual to facilitate analysis. To keep the inquiry within scope and to present a coherent view of the findings, the analysis was primarily concerned the level of innovation, and the use of digital technologies. This analysis highlights a weak but positive correlation between the level of innovation and the use of digital technologies in designing and deploying loneliness interventions, and also emphasizes how certain existing interventions could be tweaked to enable their migration from representing incremental innovation to radical innovation for example. This analysis also points out the value of including grey literature, especially from Twitter, in systematic literature reviews to get a contemporary view of latest work in the area under investigation.

Keywords: Loneliness, ageing, innovation, digital.

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112 Clustering for Detection of Population Groups at Risk from Anticholinergic Medication

Authors: Amirali Shirazibeheshti, Tarik Radwan, Alireza Ettefaghian, Farbod Khanizadeh, George Wilson, Cristina Luca

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Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. This work evaluates the association between the average risk score and measures of socioeconomic status (index of multiple deprivation) and health (index of health and disability). The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, suggesting that females are more at risk from this kind of multiple medication. The risk may be monitored and controlled in a healthcare management system that is well-equipped with tools implementing appropriate techniques of artificial intelligence.

Keywords: Anticholinergic medication, socioeconomic status, deprivation, clustering, risk analysis.

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111 Evaluation of the Analytic for Hemodynamic Instability as A Prediction Tool for Early Identification of Patient Deterioration

Authors: Bryce Benson, Sooin Lee, Ashwin Belle

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Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: Clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring.

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110 Water and Soil Environment Pollution Reduction by Filter Strips

Authors: Roy R. Gu, Mahesh Sahu, Xianggui Zhao

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Contour filter strips planted with perennial vegetation can be used to improve surface and ground water quality by reducing pollutant, such as NO3-N, and sediment outflow from cropland to a river or lake. Meanwhile, the filter strips of perennial grass with biofuel potentials also have economic benefits of producing ethanol. In this study, The Soil and Water Assessment Tool (SWAT) model was applied to the Walnut Creek Watershed to examine the effectiveness of contour strips in reducing NO3-N outflows from crop fields to the river or lake. Required input data include watershed topography, slope, soil type, land-use, management practices in the watershed and climate parameters (precipitation, maximum/minimum air temperature, solar radiation, wind speed and relative humidity). Numerical experiments were conducted to identify potential subbasins in the watershed that have high water quality impact, and to examine the effects of strip size and location on NO3-N reduction in the subbasins under various meteorological conditions (dry, average and wet). Variable sizes of contour strips (10%, 20%, 30% and 50%, respectively, of a subbasin area) planted with perennial switchgrass were selected for simulating the effects of strip size and location on stream water quality. Simulation results showed that a filter strip having 10%-50% of the subbasin area could lead to 55%- 90% NO3-N reduction in the subbasin during an average rainfall year. Strips occupying 10-20% of the subbasin area were found to be more efficient in reducing NO3-N when placed along the contour than that when placed along the river. The results of this study can assist in cost-benefit analysis and decision-making in best water resources management practices for environmental protection.

Keywords: modeling, SWAT, water quality, NO3-N, watershed.

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109 Computer-Assisted Piston-Driven Ventilator for Total Liquid Breathing

Authors: Miguel A. Gómez, Enrique Hilario, Francisco J. Alvarez, Elena Gastiasoro, Antonia Alvarez, Jose A. Casla, Jorge Arguinchona, Juan L. Larrabe

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Total liquid ventilation can support gas exchange in animal models of lung injury. Clinical application awaits further technical improvements and performance verification. Our aim was to develop a liquid ventilator, able to deliver accurate tidal volumes, and a computerized system for measuring lung mechanics. The computer-assisted, piston-driven respirator controlled ventilatory parameters that were displayed and modified on a real-time basis. Pressure and temperature transducers along with a lineal displacement controller provided the necessary signals to calculate lung mechanics. Ten newborn lambs (<6 days old) with respiratory failure induced by lung lavage, were monitored using the system. Electromechanical, hydraulic and data acquisition/analysis components of the ventilator were developed and tested in animals with respiratory failure. All pulmonary signals were collected synchronized in time, displayed in real-time, and archived on digital media. The total mean error (due to transducers, A/D conversion, amplifiers, etc.) was less than 5% compared to calibrated signals. Improvements in gas exchange and lung mechanics were observed during liquid ventilation, without impairment of cardiovascular profiles. The total liquid ventilator maintained accurate control of tidal volumes and the sequencing of inspiration/expiration. The computerized system demonstrated its ability to monitor in vivo lung mechanics, providing valuable data for early decision-making.

Keywords: Immature lamb, perfluorocarbon, pressure-limited, total liquid ventilation, ventilator, volume-controlled.

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108 A Closed-Loop Design Model for Sustainable Manufacturing by Integrating Forward Design and Reverse Design

Authors: Yuan-Jye Tseng, Yi-Shiuan Chen

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In this paper, a new concept of closed-loop design for a product is presented. The closed-loop design model is developed by integrating forward design and reverse design. Based on this new concept, a closed-loop design model for sustainable manufacturing by integrated evaluation of forward design, reverse design, and green manufacturing using a fuzzy analytic network process is developed. In the design stage of a product, with a given product requirement and objective, there can be different ways to design the detailed components and specifications. Therefore, there can be different design cases to achieve the same product requirement and objective. Subsequently, in the design evaluation stage, it is required to analyze and evaluate the different design cases. The purpose of this research is to develop a model for evaluating the design cases by integrated evaluating the criteria in forward design, reverse design, and green manufacturing. A fuzzy analytic network process method is presented for integrated evaluation of the criteria in the three models. The comparison matrices for evaluating the criteria in the three groups are established. The total relational values among the three groups represent the total relational effects. In applications, a super matrix model is created and the total relational values can be used to evaluate the design cases for decision-making to select the final design case. An example product is demonstrated in this presentation. It shows that the model is useful for integrated evaluation of forward design, reverse design, and green manufacturing to achieve a closed-loop design for sustainable manufacturing objective.

Keywords: Design evaluation, forward design, reverse design, closed-loop design, supply chain management, closed-loop supply chain, fuzzy analytic network process.

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107 Farmers’ Perception, Willingness and Capacity in Utilization of Household Sewage Sludge as Organic Resources for Peri-Urban Agriculture around Jos Nigeria

Authors: C. C. Alamanjo, A. O. Adepoju, H. Martin, R. N. Baines

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Peri-urban agriculture in Jos Nigeria serves as a major means of livelihood for both urban and peri-urban poor, and constitutes huge commercial inclination with a target market that has spanned beyond Plateau State. Yet, the sustainability of this sector is threatened by intensive application of urban refuse ash contaminated with heavy metals, as a result of the highly heterogeneous materials used in ash production. Hence, this research aimed to understand the current fertilizer employed by farmers, their perception and acceptability in utilization of household sewage sludge for agricultural purposes and their capacity in mitigating risks associated with such practice. Mixed methods approach was adopted, and data collection tools used include survey questionnaire, focus group discussion with farmers, participants and field observation. The study identified that farmers maintain a complex mixture of organic and chemical fertilizers, with mixture composition that is dependent on fertilizer availability and affordability. Also, farmers have decreased the rate of utilization of urban refuse ash due to labor and increased logistic cost and are keen to utilize household sewage sludge for soil fertility improvement but are mainly constrained by accessibility of this waste product. Nevertheless, farmers near to sewage disposal points have commenced utilization of household sewage sludge for improving soil fertility. Farmers were knowledgeable on composting but find their strategic method of dewatering and sun drying more convenient. Irrigation farmers were not enthusiastic for treatment, as they desired both water and sludge. Secondly, household sewage sludge observed in the field is heterogeneous due to nearness between its disposal point and that of urban refuse, which raises concern for possible cross-contamination of pollutants and also portrays lack of extension guidance as regards to treatment and management of household sewage sludge for agricultural purposes. Hence, farmers concerns need to be addressed, particularly in providing extension advice and establishment of decentralized household sewage sludge collection centers, for continuous availability of liquid and concentrated sludge. Urgent need is also required for the Federal Government of Nigeria to increase commitment towards empowering her subsidiaries for efficient discharge of corporate responsibilities.

Keywords: Ash, farmers, household, peri-urban, refuse, sewage, sludge, urban.

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106 A Hybrid Multi-Criteria Hotel Recommender System Using Explicit and Implicit Feedbacks

Authors: Ashkan Ebadi, Adam Krzyzak

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Recommender systems, also known as recommender engines, have become an important research area and are now being applied in various fields. In addition, the techniques behind the recommender systems have been improved over the time. In general, such systems help users to find their required products or services (e.g. books, music) through analyzing and aggregating other users’ activities and behavior, mainly in form of reviews, and making the best recommendations. The recommendations can facilitate user’s decision making process. Despite the wide literature on the topic, using multiple data sources of different types as the input has not been widely studied. Recommender systems can benefit from the high availability of digital data to collect the input data of different types which implicitly or explicitly help the system to improve its accuracy. Moreover, most of the existing research in this area is based on single rating measures in which a single rating is used to link users to items. This paper proposes a highly accurate hotel recommender system, implemented in various layers. Using multi-aspect rating system and benefitting from large-scale data of different types, the recommender system suggests hotels that are personalized and tailored for the given user. The system employs natural language processing and topic modelling techniques to assess the sentiment of the users’ reviews and extract implicit features. The entire recommender engine contains multiple sub-systems, namely users clustering, matrix factorization module, and hybrid recommender system. Each sub-system contributes to the final composite set of recommendations through covering a specific aspect of the problem. The accuracy of the proposed recommender system has been tested intensively where the results confirm the high performance of the system.

Keywords: Tourism, hotel recommender system, hybrid, implicit features.

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105 Assessment of the Situation and the Cause of Junk Food Consumption in Iranians: A Qualitative Study

Authors: A. Rezazadeh, B Damari, S. Riazi-Esfahani, M. Hajian

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The consumption of junk food in Iran is alarmingly increasing. This study aimed to investigate the influencing factors of junk food consumption and amendable interventions that are criticized and approved by stakeholders, in order to presented to health policy makers. The articles and documents related to the content of study were collected by using the appropriate key words such as junk food, carbonated beverage, chocolate, candy, sweets, industrial fruit juices, potato chips, French fries, puffed corn, cakes, biscuits, sandwiches, prepared foods and popsicles, ice cream, bar, chewing gum, pastilles and snack, in scholar.google.com, pubmed.com, eric.ed.gov, cochrane.org, magiran.com, medlib.ir, irandoc.ac.ir, who.int, iranmedex.com, sid.ir, pubmed.org and sciencedirect.com databases. The main key points were extracted and included in a checklist and qualitatively analyzed. Then a summarized abstract was prepared in a format of a questionnaire to be presented to stakeholders. The design of this was qualitative (Delphi). According to this method, a questionnaire was prepared based on reviewing the articles and documents and it was emailed to stakeholders, who were asked to prioritize and choose the main problems and effective interventions. After three rounds, consensus was obtained.            Studies revealed high consumption of junk foods in the Iranian population, especially in children and adolescents. The most important affecting factors include availability, low price, media advertisements, preference of fast foods taste, the variety of the packages and their attractiveness, low awareness and changing in lifestyle. Main interventions recommended by stakeholders include developing a protective environment, educational interventions, increasing healthy food access and controlling media advertisements and putting pressure from the Industry and Mining Ministry on producers to produce healthy snacks. According to the findings, the results of this study may be proposed to public health policymakers as an advocacy paper and to be integrated in the interventional programs of Health and Education ministries and the media. Also, implementation of supportive meetings with the producers of alternative healthy products is suggested.

Keywords: Junk foods, situation, qualitative study, Iran.

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