Bottom-up Approaches Research Articles

The economic burden of bipolar disorder: a case study in Southern Iran

BackgroundBipolar Disorder (BD) imposes considerable economic and social burdens on the community. Therefore, the present study aimed to determine the economic burden of bipolar disorder in patients referred to single-specialty psychiatric hospitals at the secondary and tertiary care level in 2022.MethodsThis partial economic evaluation was conducted as a cross-sectional study in the south of Iran in 2022, and 916 patients were selected through the census method. The prevalence-based and bottom-up approaches were used to collect cost information and calculate the costs, respectively. The data on Direct Medical Costs (DMC), Direct Non-Medical Costs (DNMC), and Indirect costs (IC) were obtained using the information from the patients’ medical records and bills as well as the self-reports by the patients or their companions. The human capital approach was also used to calculate IC.Findings: The results showed that in 2022, the annual cost of bipolar disorder was $4,227 per patient. The largest share of the costs was that of DMC (77.66%), with hoteling and ordinary beds accounting for the highest expenses (55.40%). The shares of DNMC and IC were 6.37% and 15.97%, respectively, and the economic burden of the disease in the country was estimated at $2,799,787,266 as well.ConclusionIn general, the costs of bipolar disorder treatment could impose a heavy economic burden on the community, the health system, the insurance system, and the patients themselves. Considering the high costs of hoteling and ordinary beds, it is suggested that hospitalization of BD patients be reduced by managing treatment solutions along with prevention methods to reduce the economic burden of this disease. Furthermore, in order to reduce the costs, proper and fair distribution of psychiatrists and psychiatric beds as well as expansion of home care services and use of the Internet and virtual technologies to follow up the treatment of these patients are recommended.

Bottom-up development as framed freedom: developmentality and donor power

ABSTRACT International development assistance is founded on and reproduces a set of conceptual and structural binaries. Development actors themselves have attempted to alter lopsided aid relations, as illustrated by the prominent policy agendas of ownership and localisation in the 2010s. These are both expressions of bottom-up approaches to international aid, which challenge the very hierarchical nature of development as a particular Western instrument and historical project of intervention. This article argues that the top-heavy, donor-driven policies to turn development bottom-up fail not simply because of these discursive challenges. Aid asymmetries also persist because of the neoliberal audit culture evolving in tandem with the liberal contours of ownership and localisation agendas. This is analysed in terms of developmentality, which, as a tacit and indirect form of power, is both produced by and simultaneously undermines the liberal tenets of bottom-up approaches.

Fabricating vascularized, anatomically accurate bone grafts using 3D bioprinted sectional bone modules, in-situ angiogenesis, BMP-2 controlled release, and bioassembly

Bone grafting is the most common treatment for repairing bone defects. However, current bone grafting methods have several drawbacks. Bone tissue engineering emerges as a promising solution to these problems. An ideal engineered bone graft should exhibit high mechanical strength, osteogenic properties, and pre-vascularization. Both top-down (using bulk scaffold) and bottom-up (using granular modules) approaches face challenges in fulfilling these requirements. In this paper, we propose a novel sectional modular bone approach to construct osteogenic, pre-vascularized bone grafts in anatomical shapes. We 3D-printed a series of rigid, thin, sectional, porous scaffolds from a biodegradable polymer, tailored to the dimensions of a femur bone shaft. These thin sectional modules promote efficient nutrition and waste removal due to a shorter diffusion distance. The modules were pre-vascularized viain-situangiogenesis, achieved through endothelial cell sprouting from the scaffold struts. Angiogenesis was further enhanced through co-culture with bioprinted fibroblast microtissues, which secreted pre-angiogenic growth factors. Sectional modules were assembled around a porous rod incorporated with Bone Morphogenetic Protein-2 (BMP-2), which released over 3 weeks, demonstrating sustained osteogenic activity. The assembled scaffold, in the anatomical shape of a human femur shaft, was pre-vascularized, osteogenic, and possessed high mechanical strength, supporting 12 times the average body weight. The feasibility of implanting the assembled bone graft was demonstrated using a 3D-printed femur bone defect model. Our method provides a novel modular engineering approach for regenerating tissues that require high mechanical strength and vascularization.

Formative Evaluation of the Implementation of eHealth in the Philippines: A Qualitative Study.

The utilization of information and communications technology (ICT) to support health, known as eHealth, is a crucial enabler of universal healthcare. It is important to identify various aspects that could support or hinder eHealth, especially in limited-resource settings. This study determined the factors influencing the implementation of eHealth solutions in the Philippines, in consideration of the development process and initial outputs of the Philippine eHealth Strategic Framework and Plan 2014-2020. The descriptive-qualitative study was conducted among 15 municipalities/cities in the Philippines, recognized as early adopters of eHealth programs. Records review of eHealth solutions and key informant interviews among stakeholders (i.e., physicians and nurses) per study site were facilitated to gather data. Using directed content analysis, contextual, process, and content factors influencing eHealth implementation in the country were synthesized. Results showed a range of eHealth solutions in the selected facilities, majority of which involved electronic medical records. Various contextual, process, and content-related factors could serve as facilitators or barriers to eHealth implementation in the country. Particularly, contextual factors include individual characteristics (ICT experience/training, organizational commitment, readiness for change), perceived need/urgency for eHealth (provisions, policies, regulatory issues), and third-party involvement for financial/technical support. Meanwhile, process-related factors involve implementation team practices, appropriate top-down and bottom-up approaches in leader/member engagement, and resource management (ICT equipment, stable internet connection, power supply). Content-specific factors mainly include the eHealth design (complexity, adaptability to local context and service demands, interoperability or the capacity to connect or exchange information with other platforms/systems). Notably, limitations across the three dimensions could make eHealth implementation more complicated, which could lead to poor time management and resource wastage. This study highlighted the importance of a multidimensional understanding of factors that influence the utility of eHealth in the health system. There is a need for leadership and governance, stakeholder engagement, resource and funding, implementation readiness, appropriate design of eHealth solutions, and proper training to ensure the successful implementation of eHealth in the country.

Toward Practical Applications of Engineered Living Materials with Advanced Fabrication Techniques.

Engineered Living Materials (ELMs) are materials composed of or incorporating living cells as essential functional units. These materials can be created using bottom-up approaches, where engineered cells spontaneously form well-defined aggregates. Alternatively, top-down methods employ advanced materials science techniques to integrate cells with various kinds of materials, creating hybrids where cells and materials are intricately combined. ELMs blend synthetic biology with materials science, allowing for dynamic responses to environmental stimuli such as stress, pH, humidity, temperature, and light. These materials exhibit unique "living" properties, including self-healing, self-replication, and environmental adaptability, making them highly suitable for a wide range of applications in medicine, environmental conservation, and manufacturing. Their inherent biocompatibility and ability to undergo genetic modifications allow for customized functionalities and prolonged sustainability. This review highlights the transformative impact of ELMs over recent decades, particularly in healthcare and environmental protection. We discuss current preparation methods, including the use of endogenous and exogenous scaffolds, living assembly, 3D bioprinting, and electrospinning. Emphasis is placed on ongoing research and technological advancements necessary to enhance the safety, functionality, and practical applicability of ELMs in real-world contexts.

Fluorescent carbon dots for sensing applications: a review.

Luminescent carbon dots (CDs) are important class of nanomaterials with fantastic photoluminescence (PL) properties, great biocompatibility, extraordinary solubility in water, minimal expense, and so on. There are many methods for their preparation and they are mainly classed into two groups, top-down and bottom-up approaches. In order to understand the origin of fluorescence in quantum CDs, three mechanisms have been proposed namely molecular state, surface state, and quantum confinement phenomenon. Fluorescent CDs have significant application in the fields of biochemical sensing, photocatalysis, bioimaging, delivery of drugs, and other related fields. In this review article the application of quantum dots as detecting component, for the sensing of different targets, has been summed up. In fact, the detection of several analytes including, anions, cations, small molecules, polymers, cells, and microscopic organisms has been discoursed. Moreover, the future aspects of CDs as detecting resources have been explored.

Energy Transition in Northern Netherlands: seeking a balance between top-down and bottom-up initiatives

This study focuses on top-down and bottom-up processes within the field of energy transition. It aims at gaining insights into the ways that a more balanced approach can be achieved, by taking into consideration the (mutual) interests, barriers and expectations of the municipality and local citizen initiatives. The theoretical framework of the study is the implementation analysis framework, distinguishing top-down and bottom-up approaches. Specifically, this qualitative (thematic analysis) research study investigates the mismatch in expectations between a number of local energy initiatives and the municipality of Groningen regarding their roles within the local energy transition context. To this end, semi-structured interviews have been conducted with members of the municipality of Groningen, Grunneger Power (a local energy intermediary), and four local energy initiatives. Need and expectation gaps have been identified and potential solutions have been explored. The main findings of the study illustrate the need of professional support for citizen initiatives, at both technical and organizational level, especially in the first phases of their development. Additionally, clear mutual communication on short and long-term planning and ambitions of the involved parties is of key importance for the alignment of the interests and the course of actions. Consequently, a clear context is needed, within which an exchange of feedback on the envisioned strategies, and the subsequent energy saving or generation interventions, can take place in an efficient and effective way. Additionally, such a context increases confidence and provides a clear understanding to the citizen initiatives regarding their role and the level and nature of support they can expect in their intended projects and activities. Based on these findings, policy implications have been drawn.

A review of Global Carbon Markets from Kyoto to Paris and beyond: the persistent failure of implementation

This review article provides a comprehensive multidisciplinary and in-depth analysis of how the idea of Global Carbon Markets (GCM) has evolved from the Kyoto Protocol to the Paris Agreement and the post-Paris Agreement period (2015–2022) and why no real consensus has been reached after 25 years of negotiations, based on the categorisation of different arguments from different authors. We apply a semi-systematic review to 32 scientific articles, special reports, and relevant websites to analyse the failure in reaching international consensus on GCM. We apply three dichotomies, market vs. non-market-based approaches, top-down vs. bottom-up and national vs. international level. There are two striking findings. First (out of the articles that can easily be placed along all three dichotomies), there is an overwhelming majority of articles combining market-based, top-down, and international level explanations. This is however countered by a second finding, namely, that there is also a clear historical trend which is unlikely to change away from top-down and towards bottom-up approaches since the Paris agreement, combined with a movement towards more non-market-based and national approaches.

A Hybrid Approach for Hierarchical Forecasting of Industrial Electricity Consumption in Brazil

The Brazilian industrial sector is the largest electricity consumer in the power system. Energy planning in this sector is important mainly due to its economic, social, and environmental impact. In this context, electricity consumption analysis and projections are highly relevant for the decision-making of the industrial sectorand organizations operating in the energy system. The electricity consumption data from the Brazilian industrial sector can be organized into a hierarchical structure composed of each geographic region (South, Southeast, Midwest, Northeast, and North) and their respective states. This work proposes a hybrid approach that incorporates the projections obtained by the exponential smoothing and Box–Jenkins models to obtain the hierarchical forecasting of electricity consumption in the Brazilian industrial sector. The proposed approach was compared with the bottom-up, top-down, and optimal combination approaches, which are widely used for time series hierarchical forecasting. The performance of the models was evaluated using the mean absolute percentage error (MAPE) and root mean squared error (RMSE) precision measures. The results indicate that the proposed hybrid approach can contribute to the projection and analysis of industrial sector electricity consumption in Brazil.

Template-assisted growth of Ga-based nanoparticle clusters on Si: effect of post-annealing process on the Ga ion beam exposed 2D arrays fabricated by focused ion beam nanolithography

We demonstrate template-assisted growth of gallium-based nanoparticle clusters on silicon substrate using a focused ion beam (FIB) nanolithography technique. The nanolithography counterpart of the technique steers a focussed 30 kV accelerated gallium ion beam on the surface of Si to create template patterns of two-dimensional dot arrays. Growth of the nanoparticles is governed by two vital steps namely implantation of gallium into the substrate via gallium beam exposure and formation of the stable nanoparticles on the surface of the substrate by subsequent annealing at elevated temperature in ammonia atmosphere. The growth primarily depends on the dose of implanted gallium which is in the order of 107 atoms per spot and it is also critically influenced by the temperature and duration of the post-annealing treatment. By controlling the growth parameters, it is possible to obtain one particle per spot and particle densities as high as 109 particles per square centimetre could be achieved in this case. The demonstrated growth process, utilizing the advantages of FIB nanolithography, is categorized under the guided organization approach as it combines both the classical top-down and bottom-up approaches. Patterned growth of the particles could be utilized as templates or nucleation sites for the growth of an organized array of nanostructures or quantum dot structures.

Shifting lakefronts: Alternative waterfront politics in Wuhan

ABSTRACT The transformation of lakefronts from spaces of privatization and contamination to vibrant public areas signifies a significant urban shift in Wuhan over the past 2 decades. This article explores a shift toward integrating bottom-up participatory approaches to sustainable environmental management with the top-down planning system amid this profound urban transition. By examining the unintended planning consequences and civic actions across Sha Lake and Dong Lake, this study uncovers a complex urban process marked by conflicts over waste management, property rights, and cultural identity issues at the water-land interface. In this process, new forms of civic participation emerged in Wuhan’s environmental management in the digital age, despite the lack of official participatory mechanisms. The study identifies parallels in the formalization of community engagements between Wuhan and other locales, notwithstanding China’s continued dominance of centralized governance, as middle-class activists increasingly play active roles in environmental management projects, utilizing skills, networks, and dedication.

Innovative Adaptive Multiscale 3D Simulation Platform for the Yellow River Using Sphere Geodesic Octree Grid Techniques

Earth system simulation technology is fundamental for ecological protection and high-quality development in the Yellow River Basin. To address the lack of a Yellow River simulation platform, this study proposes an adaptive multiscale true 3D crust simulation platform using the Sphere Geodesic Octree Grid (SGOG). Twelve models in four categories were designed: single fine-scale models, geomorphic zone-based models, and models using both top-down and bottom-up approaches. The models were evaluated based on terrain feature representation and computational efficiency. The results show that single fine-scale models preserve detailed terrain features but are computationally intensive. They are suitable for the precise simulation of surface processes. Top-down and bottom-up models balance terrain detail and efficiency, and are thereby widely applicable. Geomorphic zone-based models provide detailed focal area representation and higher computational efficiency, being more targeted. Various methods offer flexible scale transformations, each with its own strengths, allowing researchers to select a method according to practical application needs. Consequently, this research demonstrates that spherical discrete grids offer reliable support for constructing basin simulation platforms, providing new technological and scientific insights for the Yellow River Basin’s ecological protection and development.

A holistic framework for integrated sustainability assessment of pharmaceuticals

Environmental pollution of pharmaceuticals arises during drug development, production, use and disposal and can damage ecosystems, increase antimicrobial resistance and generate substantial greenhouse gas emissions. As a result, environmental sustainability of pharmaceuticals is an expanding theme in today's society. Several sustainability assessment methods have been developed for pharmaceuticals, however, most assessments typically consider only parts of the pharmaceutical chain and focus on the burdens of resource use and emissions, defined as the ‘footprint’. On the other hand, these assessments usually do not simultaneously consider the societal benefits of pharmaceuticals, called the ‘handprint’, in addition to the benefit/risk assessment for the patient. Existing sustainability assessments are often limited to traditional impact categories, neglecting other dimensions of sustainability. A comprehensive sustainability assessment should capture more than just the environmental dimension and could thus holistically capture the three pillars of sustainability, i.e., environment, social, and economic. Currently, holistic methods that cover all impacts over the entire life cycle of pharmaceuticals are lacking. The objective of this study is to conceptualise and propose a holistic framework for integrated sustainability assessment of pharmaceuticals, based on the three pillars of sustainability and taking into account both footprint and handprint outcomes. The framework was developed using both top-down (literature search) and bottom-up approaches (stakeholder involvement). Gaps, barriers and opportunities to achieve sustainability are identified. As a result, this holistic framework can be helpful in decision making.

Top-down or bottom-up digital transformation? A comparison of institutional changes and outcomes

IMPACT Investigating two major digitalization projects in Germany, the authors conclude that to fully utilize the potential of digitalization, old processes should be replaced with newly-designed and optimized digital ones (displacement) instead of layering new digital tools on top of analogue ones. Digitalization should be an opportunity for public sector managers and policy-makers to adjust administrative processes and structures. To implement such changes, top-down approaches are expected to contribute more effectively than bottom-up approaches to the standardization of processes and outcomes. However, this may also create challenges regarding adaptation to local needs, acceptance, and the risk of resistance to change. To guarantee effective and efficient digitalization processes and locally matching, well-accepted solutions, policy-makers in multi-level contexts are advised to strive for a well-calibrated digitalization approach, potentially consolidating digitalization efforts. Bundling certain tasks related to the provision of digital services can help to reduce the pressure on the local level.

Modeling COVID-19 Transmission in Closed Indoor Settings: An Agent-Based Approach with Comprehensive Sensitivity Analysis

Computational simulation models have been widely used to study the dynamics of COVID-19. Among those, bottom-up approaches such as agent-based models (ABMs) can account for population heterogeneity. While many studies have addressed COVID-19 spread at various scales, insufficient studies have investigated the spread of COVID-19 within closed indoor settings. This study aims to develop an ABM to simulate the spread of COVID-19 in a closed indoor setting using three transmission sub-models. Moreover, a comprehensive sensitivity analysis encompassing 4374 scenarios is performed. The model is calibrated using data from Calabria, Italy. The results indicated a decent consistency between the observed and predicted number of infected people (MAPE = 27.94%, RMSE = 0.87 and χ2(1,N=34)=(44.11,p=0.11)). Notably, the transmission distance was identified as the most influential parameter in this model. In nearly all scenarios, this parameter had a significant impact on the outbreak dynamics (total cases and epidemic peak). Also, the calibration process showed that the movement of agents and the number of initial asymptomatic agents are vital model parameters to simulate COVID-19 spread accurately. The developed model may provide useful insights to investigate different scenarios and dynamics of other similar infectious diseases in closed indoor settings.

Basic immunologic study as a foundation for engineered therapeutic development.

Bioengineering and drug delivery technologies play an important role in bridging the gap between basic scientific discovery and clinical application of therapeutics. To identify the optimal treatment, the most critical stage is to diagnose the problem. Often these two may occur simultaneously or in parallel, but in this review, we focus on bottom-up approaches in understanding basic immunologic phenomena to develop targeted therapeutics. This can be observed in several fields; here, we will focus on one of the original immunotherapy targets-cancer-and one of the more recent targets-regenerative medicine. By understanding how our immune system responds in processes such as malignancies, wound healing, and medical device implantation, we can isolate therapeutic targets for pharmacologic and bioengineered interventions.

Socio-political dynamics in clean energy transition

A rapid and effective transition to low-carbon energy production is essential to limit climate change impacts. While the scientific community has mostly focused on research and development and techno-economic aspects, quantifying the role of public acceptability and policy in shaping emission trajectories has been much more elusive. This study investigates the coupled dynamics of nonlinear socio-political acceptance and anthropogenic CO2 emissions, with implications for climate policies and clean energy investments. Our findings show that a top-down policy approach alone may not be sufficient for effective emission cuts, highlighting the need for a multi-level strategy that combines top-down and bottom-up approaches. Additionally, opinion polarization can trigger detrimental CO2 emission oscillations when governments decide to take heavy-handed policy interventions in highly polarized socio-political systems. Delayed perception of climate change damage or abrupt reactions to extreme weather events may also significantly affect emission reduction efforts, although in the opposite direction. Integrating these socio-political dynamics into climate models can enhance our understanding of the complex interplay between human and natural systems, enabling the development of more effective and resilient mitigation strategies.

Biologically Active Micropatterns of Biomolecules and Living Matter Using Microbubble Lithography.

In situ patterning of biomolecules and living organisms while retaining their biological activity is extremely challenging, primarily because such patterning typically involves thermal stresses that could be substantially higher than the physiological thermal or stress tolerance level. Top-down patterning approaches are especially prone to these issues, while bottom-up approaches suffer from a lack of control in developing defined structures and the time required for patterning. A microbubble generated and manipulated by optical tweezers (microbubble lithography) is used to self-assemble and pattern living organisms in continuous microscopic structures in real-time, where the material thus patterned remains biologically active due to their ability to withstand elevated temperatures for short exposures. Successful patterns of microorganisms (Escherichia coli, Lactococcus. lactis and the Type A influenza virus) are demonstrated, as well as reporter proteins such as green fluorescent protein (GFP) on functionalized substrates with high signal-to-noise ratio and selectivity. Together, the data presented herein may open up fascinating possibilities in rapid in situ parallelized diagnostics of multiple pathogens andbioelectronics.

The Study of National Identities at World Fairs – from Methodological Nationalism to Transnational Approaches and Cultural Isomorphism

The study of national representations at world fairs could provide a strong incentive to the field of nationalism studies, since it enables the construction of national identities to be studied as a global process. This way, it can be shown that the process of national identity construction during the heyday of the world fairs between 1851 and the 1930s demonstrated many converging tendencies. This introductory article is divided into five sections. First, I will show how national and other territorial identities have been shaped at world fairs during the second half of the nineteenth and early decades of the twentieth century. The second section will provide a brief overview of developments in the field of nationalism studies, where scholars have recently placed more emphasis on transnational and bottom-up approaches, while trying to overcome the dichotomy between nation-states and empires. The third section assesses the contributions on nationalism at world fairs published in this and the previous issue of Studies on National Movements, showing how they already integrate many fresh perspectives. In the fourth part, I argue that more attention should be given to the construction of national identities as a global process, showing that world fairs actually had a strong isomorphic effect, as countries increasingly adopted common elements and templates in order to give shape to their national identities. The final section shows that world fairs reflected the existing international order, developed a common taxonomy to categorize human productivity, created a global conceptual framework, defined the main components of a national identity and created successful templates in order to display them for an international audience. World fairs as a consequence had a lasting and homogenizing effect on national identities around the globe.

Computational single-cell methods for predicting cancer risk.

Despite recent biotechnological breakthroughs, cancer risk prediction remains a formidable computational and experimental challenge. Addressing it is critical in order to improve prevention, early detection and survival rates. Here, I briefly summarize some key emerging theoretical and computational challenges as well as recent computational advances that promise to help realize the goals of cancer-risk prediction. The focus is on computational strategies based on single-cell data, in particular on bottom-up network modeling approaches that aim to estimate cancer stemness and dedifferentiation at single-cell resolution from a systems-biological perspective. I will describe two promising methods, a tissue and cell-lineage independent one based on the concept of diffusion network entropy, and a tissue and cell-lineage specific one that uses transcription factor regulons. Application of these tools to single-cell and single-nucleus RNA-seq data from stages prior to invasive cancer reveal that they can successfully delineate the heterogeneous inter-cellular cancer-risk landscape, identifying those cells that are more likely to turn cancerous. Bottom-up systems biological modeling of single-cell omic data is a novel computational analysis paradigm that promises to facilitate the development of preventive, early detection and cancer-risk prediction strategies.