Feasibility Issues Research Articles

Changes in physical activity in people with idiopathic pulmonary fibrosis before and after virtual pulmonary rehabilitation: a feasibility study

BackgroundPulmonary rehabilitation (PR) is recommended for the treatment of people with idiopathic pulmonary fibrosis (IPF). Physical activity is an important health behaviour, closely linked to survival in people with IPF. Little is known about the impact of virtual (V) PR on physical activity in people with IPF.ObjectiveTo explore the feasibility of conducting a trial to explore effect of virtual PR on objectively measured physical activity in people with IPF.MethodsAll patients with a diagnosis of IPF in a stable phase of the disease were invited to participate in VPR: a 10 week exercise programme delivered twice-weekly for one hour. Data were collected at baseline (BL) and post VPR (10 weeks): Kings Brief Interstitial Lung Disease (K-BILD), Exercise capacity (6-minute walk test (6MWT) or 1-minute sit-to-stand (STS)) and Physical Activity. Physical activity was measured with a triaxial accelerometer for seven days. Screening, recruitment, adherence and safety data were collected.Results68 people were screened for this study. N = 16 participants were recruited to the study. There was one dropout. N = 15 completed VPR. All results reported in mean (standard deviation) (SD). Participants attended 18.1(2.0) of the 20 sessions. No adverse events were detected. The mean age of participants was 71.5(11.5) years, range: 47–95 years; 7 M:9 F. Mean (SD) FEV1 2.3(0.3)L, FVC 2.8(0.7)L. No statistically significant changes were observed in outcome measures apart from exercise capacity. Light physical activity increased from 152(69.4) minutes per day (n = 16) to 161.9(88.7) minutes per day (n = 14), mean change (SD) (CI) p-value: 9.9 (39.8) [-12.3 to 30.9] p = 0.4. Moderate-to-vigorous physical activity increased from 19.1(18.6) minutes per day (n = 16) to 25.7(28.3) minutes per day (n = 14), mean change (SD) (CI) p-value: 6.7 (15.5) [-2.1 to 15.1] p = 0.1. Step count increased from 3838(2847) steps per day (n = 16) to 4537(3748) steps per day (n = 14), mean change (SD) (CI) p-value: 738 (1916) [-419.3 to 1734.6] p = 0.2. K-BILD (n = 15) increased from 55.1(7.4) at BL to 55.7(7.9) post VPR mean change (SD) [95% confidence interval] (CI) p-value: 1.7(6.5) [-1.7 to 5.3], p = 0.3. 6MWT (n = 5) increased from 361.5(127.1) to 452.2(136.1) meters, mean change (SD) (CI) p-value: 63.7 (48.2) [-3.8 to 123.6], p = 0.04 and 1-minute STS increased from 17.6(3.0) (n = 11) to 23.7(6.3) (n = 10), mean change (SD) (CI) p-value 5.8 (4.6) [2.6 to 9.1], p = 0.003.ConclusionVPR can improve physical activity in people with IPF. A number of important feasibility issues included recruitment, retention, adherence and safety have been reported which are crucial for future research in this area. A fully powered trial is needed to determine the response of people with IPF to PR with regard to physical activity.

Identifying priority areas to support primary care engagement in breast cancer survivorship care: A Delphi study.

Existing approaches in cancer survivorship care delivery have proven to be insufficient to engage primary care. This study aimed to identify stakeholder-informed priorities to improve primary care engagement in breast cancer survivorship care. Experts in U.S. cancer survivorship care delivery were invited to participate in a 4-round online Delphi panel to identify and evaluate priorities for defining and fostering primary care's engagement in breast cancer survivorship. Panelists were asked to identify and then assess (ratings of 1-9) the importance and feasibility of priority items to support primary care engagement in survivorship. Panelists were asked to review the group results and reevaluate the importance and feasibility of each item, aiming to reach consensus. Respondent panelists (n = 23, response rate 57.5%) identified 31 priority items to support survivorship care. Panelists consistently rated three items most important (scored 9) but with uncertain feasibility (scored 5-6). These items emphasized the need to foster connections and improve communication between primary care and oncology. Panelists reached consensus on four items evaluated as important and feasible: (1) educating patients on survivorship, (2) enabling screening reminders and monitoring alerts in the electronic medical record, (3) identifying patient resources for clinicians to recommend, and (4) distributing accessible reference guides of common breast cancer drugs. Role clarity and communication between oncology and primary care were rated as most important; however, uncertainty about feasibility remains. These findings indicate that cross-disciplinary capacity building to address feasibility issues may be needed to make the most important priority items actionable in primary care.

Monetizing Animal Welfare Impacts for Benefit–Cost Analysis

Abstract Animal welfare is often ignored in decision-making, despite widespread agreement about its importance. This is partly because of a lack of quantitative methods to assess the impacts of policies on humans and nonhumans alike on a common scale. At the same time, recent work in economics, philosophy, and animal welfare science has made progress on the fundamental theoretical challenge of estimating the well-being potential of different species on a single scale. By combining these estimates of each species’ well-being potential with assessments of how various policies impact the quality of life for these species, along with the number of animals affected, we can arrive at a framework for estimating the impact of policies on animal health and well-being. This framework allows for a quantifiable comparison between policies affecting humans and animals. For instance, it enables us to compare human QALYs to animal QALYs tailored to specific species. Hence, the intrinsic value of animal welfare impacts of policies can be monetized on the same scale as market and non-market impact for humans, facilitating benefit–cost analysis. Many challenges remain though, including issues of population ethics, political feasibility, and new complexities in addressing equity and uncertainty.

Mahalanobis balancing: A multivariate perspective on approximate covariate balancing

AbstractIn the past decade, various exact balancing‐based weighting methods were introduced to the causal inference literature. It eliminates covariate imbalance by imposing balancing constraints in a certain optimization problem, which can nevertheless be infeasible when there is bad overlap between the covariate distributions in the treated and control groups or when the covariates are high dimensional. Recently, approximate balancing was proposed as an alternative balancing framework. It resolves the feasibility issue by using inequality moment constraints instead. However, it can be difficult to select the threshold parameters. Moreover, moment constraints may not fully capture the discrepancy of covariate distributions. In this paper, we propose Mahalanobis balancing to approximately balance covariate distributions from a multivariate perspective. We use a quadratic constraint to control overall imbalance with a single threshold parameter, which can be tuned by a simple selection procedure. We show that the dual problem of Mahalanobis balancing is an norm‐based regularized regression problem, and establish interesting connection to propensity score models. We derive asymptotic properties, discuss the high‐dimensional scenario, and make extensive numerical comparisons with existing balancing methods.

Assessing feasibility of conducting medication review with follow-up among older adults at community pharmacy: a pilot randomised controlled trial

BackgroundMedication review with follow-up is essential for optimising medication utilisation among the older adult population in primary healthcare.AimThis study aimed to evaluate the feasibility of implementing medication reviews with follow-up for older adults in community pharmacies and examined potential outcomes on medication use.MethodA pilot randomised controlled trial was conducted with 4 cluster-randomised community pharmacies to assess the feasibility of the intervention. Two community pharmacies served as intervention and control groups. Both groups recruited older adults over 60 who were followed over 6 months. The translated Medication use Questionnaire (MedUseQ) was administered at baseline and 6 months for both groups. The outcomes were to assess the feasibility of conducting medication review with follow-up and the probable medication use outcomes from the intervention.ResultsThe intervention and control groups comprised 14 and 13 older adults. A total of 35 recommendations were made by pharmacists in the intervention group and 8 in the control group. MedUseQ was easily administered, providing some evidence the feasibility of the intervention. However, there were feasibility challenges such as a lack of pharmacists, collaborative practice, difficulties with the tool language, time constraints, and limited funds. Questionnaire results provided a signal of improvement in medication administration, adherence, and polypharmacy among intervention participants. The incidence of drug related problems was significantly higher in the control group (median = 1) after 6 months, U = 15, z = − 2.98, p = 0.01.ConclusionMedication review with follow-up is potentialy practical in community pharmacies, but there are feasibility issues. While these challenges can be addressed, it is essential to study larger sample sizes to establish more robust evidence regarding outcomes.Clinical trial registry: ClinicalTrials.Gov NCT05297461.

A Study on the Technical Feasibility and Legal Issues for the Introduction of Robot Police

A Study on the Technical Feasibility and Legal Issues for the Introduction of Robot Police

The Computational Turn in International Law

Abstract The recent computational turn carries the potential to both enrich and destabilise international law research. Epistemologically, it offers a repertoire of data science methods, including network analysis, text processing and analysis, machine learning, and large language and agent-based models. Ontologically, with its inductive and macroscopic logic, it can inflect and challenge our established understandings of the nature and role of international law. In this article, we review the growing use of computational approaches in international law research, with a focus on their methodological particularity and potential contributions to doctrinal and non-doctrinal research questions. At the same time, we discuss the limitations of the computational turn, especially issues of suitability, quality, and feasibility.

A Dried Blood Spot protocol for high-throughput quantitative analysis of SARS-CoV-2 RBD serology based on the Roche Elecsys system.

SARS-CoV-2 spreads pandemically since 2020; in 2021, effective vaccinations became available and vaccination campaigns commenced. Still, it is hard to track the spread of the infection or to assess vaccination success in the broader population. Measuring specific anti-SARS-CoV-2 antibodies is the most effective tool to track the spread of the infection or successful vaccinations. The need for venous-blood sampling however poses a significant barrier for large studies. Dried-blood-spots on filter-cards (DBS) have been used for SARS-CoV-2 serology in our laboratory, but so far not to follow quantitative SARS-CoV-2 anti-spike reactivity in a longitudinal cohort. We developed a semi-automated protocol or quantitative SARS-CoV-2 anti-spike serology from self-sampled DBS, validating it in a cohort of matched DBS and venous-blood samples (n = 825). We investigated chromatographic effects, reproducibility, and carry-over effects and calculated a positivity threshold as well as a conversion formula to determine the quantitative binding units in the DBS with confidence intervals. Sensitivity and specificity reached 96.63% and 97.81%, respectively, compared to the same test performed in paired venous samples. Between a signal of 0.018 and 250 U/mL, we calculated a correction formula. Measuring longitudinal samples during vaccinations, we demonstrated relative changes in titers over time in several individuals and in a longitudinal cohort over four follow-ups. DBS sampling has proven itself for anti-nucleocapsid serosurveys in our laboratory. Similarly, anti-spike high-throughput DBS serology is feasible as a complementary assay. Quantitative measurements are accurate enough to follow titer dynamics in populations also after vaccination campaigns. This work was supported by the Bavarian State Ministry of Science and the Arts; LMU University Hospital, LMU Munich; Helmholtz Center Munich; University of Bonn; University of Bielefeld; German Ministry for Education and Research (proj. nr.: 01KI20271 and others) and the Medical Biodefense Research Program of the Bundeswehr Medical Service. Roche Diagnostics provided kits and machines for analyses at discounted rates. The project is funded also by the European-wide Consortium ORCHESTRA. The ORCHESTRA project has received funding from the European Union's Horizon 2020 research and innovation program under grant agreement No 101016167. The views expressed in this publication are the sole responsibility of the author, and the Commission is not responsible for any use that may be made of the information it contains.IMPORTANCESARS-CoV-2 has been spreading globally as a pandemic since 2020. To determine the prevalence of SARS-CoV-2 antibodies among populations, the most effective public health tool is measuring specific anti-SARS-CoV-2 antibodies induced by infection or vaccination. However, conducting large-scale studies that involve venous-blood sampling is challenging due to the associated feasibility and cost issues. A more cost-efficient and less invasive method for SARS-CoV-2 serological testing is using Dried-Blood-Spots on filter cards (DBS). In this paper, we have developed a semi-automated protocol for quantifying SARS-CoV-2 anti-spike antibodies from self-collected DBS. Our laboratory has previously successfully used DBS sampling for anti-nucleocapsid antibody surveys. Likewise, conducting high-throughput DBS serology for anti-spike antibodies is feasible as an additional test that can be performed using the same sample preparation as the anti-nucleocapsid analysis. The quantitative measurements obtained are accurate enough to track the dynamics of antibody levels in populations, even after vaccination campaigns.

Mobile-based ecological momentary assessment and intervention: bibliometric analysis.

The aim of this article was to review existing documents in the field of mobile-based EMA and EMI, provide an overview of current hot topics, and predict future development trends. We conducted a bibliometric study on mobile-based EMA and EMI publications that were collected from the Web of Science Core Collection database. Biblioshiny and CiteSpace were utilized to analyze scientific productions, leading sources, authors, affiliations, documents, research hot topics, keywords, and trend topics. A total of 2222 documents related to EMA and EMI published between 1992 and 2023 were retrieved. In recent years, scholarly publications have generally increased in mobile-based EMA and EMI research, particularly in the last decade. JMIR mHealth and uHealth (n=86), as well as JMIR (n=73), showed the highest number of publications. The United States (n=1038), Germany (n=218) and Netherlands (n=175) were leading countries. Regarding keyword co-occurrence and trend topics analysis, mental health, health behaviors, and feasibility were hot topics in mobile-based EMA and EMI research. Future research trends included using EMA for tailoring EMI, just-in-time adaptive interventions (JITAI), and digital phenotyping. This bibliometric study on mobile-based EMA and EMI is a valuable resource for understanding the field's evolution and future trends. Our analysis indicates that EMA and EMI have great potential in health behaviors and mental health, but implementation should consider feasibility and reactivity issues carefully. Emerging trends include EMA-tailored EMI, JITAI, and digital phenotyping. In the future, strengthening multidisciplinary cooperation will be necessary to promote the continued development of the field.

Methods of sampling malaria vectors and their reliability in estimating entomological indices in Africa.

In efforts to intensify malaria control through vector control and hasten the progress towards elimination, the impact of control interventions needs to be evaluated. This requires sampling vector population using appropriate trapping methods. The aim of this article is to critically review methods of sampling malaria vectors and their reliability in estimating entomological indicators of malaria transmission in Africa. The standard methods are human landing catch (HLC), pyrethrum spray catch, and pit shelter for sampling host-seeking, indoor resting, and outdoor resting malaria vectors, respectively. However, these methods also have drawbacks such as exposure of collectors to infective mosquito bites, sampling bias, and feasibility issue. Centers for Disease Control and Prevention (CDC) light traps placed beside human-occupied bed nets have been used as an alternative to the HLC for sampling host-seeking malaria vectors. Efforts have been made to evaluate the CDC light traps against HLC to generate a conversion factor in order to use them as a proxy estimator of human biting rate and entomological inoculation rates in Africa. However, a reproducible conversion factor was not found, indicating that the trapping efficiency of the CDC light traps varies between different geographical locations. Several other alternative traps have also been developed and evaluated in different settings but most of them require further standardization. Among these, human-baited double net trap/CDC light trap combination and mosquito electrocuting trap have the potential to replace the HLC for routine malaria vector surveillance. Further research is needed to optimize the alternative sampling methods and/or develop new surveillance tools based on vector behavior.

Formative Evaluation of a Comprehensive Self-Management Intervention for Irritable Bowel Syndrome, Comorbid Anxiety, and Depression: Mixed Methods Study.

Irritable bowel syndrome (IBS) is a disorder of the gut-brain interaction that is associated with abdominal pain, altered bowel patterns, and reduced quality of life. Up to 50% of patients with IBS also report anxiety or depressive symptoms. Although effective self-management interventions exist for individuals with IBS, few have been effectively implemented, and most do not consider the unique needs of patients with comorbid IBS and anxiety or depression. This study aimed to determine the anticipated acceptability, appropriateness, feasibility, and usability of a comprehensive self-management intervention using an implementation science and human-centered design approach among individuals with comorbid IBS and anxiety or depression and health care providers. A convergent mixed methods design was used to elicit feedback on the comprehensive self-management intervention outline and content to identify refinement needs before testing. Patients with IBS and moderate to severe anxiety or depression and health care providers were purposefully sampled from primary care and gastroenterology settings. Participants completed semistructured interviews and surveys on anticipated acceptability, appropriateness, feasibility, and usability. Patient participants (n=12) were on average 36.8 (SD 12.2) years of age, and 42% (5/12) were currently receiving psychological therapy. Health care providers (n=14) were from primary care (n=7) and gastroenterology (n=7) settings. The mean usability scores (out of 100) were 52.5 (SD 14.5) for patients and 45.6 (SD 11.6) for providers. For patients and providers, qualitative data expanded the quantitative findings for acceptability and appropriateness. Acceptability findings were the comprehensive nature of the intervention and discussion of the gut-brain interaction. For appropriateness, participants reported that the intervention provided structure, accountability, and support. Feasibility was confirmed for patients, but there was a divergence of findings between quantitative and qualitative measures for providers. Patients focused on intervention feasibility, while providers focused on implementation feasibility in the clinic. Identified usability issues to address before implementation included the intervention delivery format, length, and lack of integration into health care settings that, if not addressed, may limit the reach of the intervention. Patients and health care providers found the intervention acceptable and appropriate. Several feasibility and usability issues were identified, including intervention delivery methods, length of intervention, and the best methods to implement in the clinic setting. The next steps are to refine the intervention to address the identified issues and test in a pilot study whether addressing usability issues leads to the anticipated improvements in implementation and uptake.

Foreword to the Special Issue on ‘Fertility control for wildlife in the 21st century’

The economic and environmental impacts of wildlife are increasing in parallel with renewed public interest in non-lethal methods, such as fertility control, to manage these impacts. The Wildlife Research 2008 Special Issue on Fertility Control for Wildlife (Vol. 35) published following the 6th International Conference on Fertility Control for Wildlife held in 2007 in York, United Kingdom, reported studies on the effects of contraceptives on individual animals and populations, with most papers focusing on ungulates. In the past 15 years, significant progress has been made in developing novel contraceptives for wildlife and in designing methods to deliver these agents. Concurrently, the general debate on wildlife management has widened to include public attitudes and perceptions of novel and traditional methods, animal welfare issues, costs, feasibility, and regulatory and ethical issues. These developments have broadened our understanding of contexts and species for which fertility control could be employed, either as a stand-alone method or to complement other population management options. These topics were reflected in the presentations given at the 9th International Conference on Wildlife Fertility Control, held in Colorado Springs (USA) in 2022. Here, we introduce a special issue featuring selected presentations from the 2022 conference. These studies showcase the wide spectrum of topics that covered novel contraceptives tested on several species, ranging from mice to elephants. They also illustrate new methods to deliver contraceptives, models on the impact of fertility control on populations, feasibility, cost of practical applications of fertility control, discussions on animal welfare and human dimension of these approaches.

TRASFORMATION OF UKRAINE'S FINANCIAL ASSETS AMID THE DEVELOPMENT OF THE INTERNATIONAL FINANCIAL SYSTEM

The work has analysed the state of financial assets and their dynamics in the international financial system, considering the global changes in the financial architecture and financial relationships observed over the last decade. It has been observed that in 2020, global financial assets exceeded world GDP more than 18 times and consisted of three main equivalent components: assets of the real sector of the economy, assets of the financial sector, and assets of the financial sphere. The study has revealed that investment in intangible assets has slowed over the past two decades while investment in real assets, particularly in real estate, has become more active. Regularities in the relationship between the decrease in interest rates, the growth rate of GDP, and the directions of investment of funds in the leading countries of the world have been followed. This provides a basis for conclusions regarding further changes in the structure of global financial assets. The article has also raised issues of feasibility and riskiness of further increasing the amount of debt capital on a global scale in the context of some revision of its impact on the world economy after the 2008 crisis. Integration processes in Ukraine prompt the analysis of trends in the formation of financial assets in our country, with indicators similar to those of developed countries and global indicators in general. A comparison of global trends and indicators of the development of Ukraine's financial assets has highlighted significant differences both in percentages of GDP and in their structure; in particular, attention has been paid to the uneven development of various sectors of the financial market of Ukraine — the significant development of the banking sector along with the laggards of the stock market. This indicates an important gap in the development of the Ukrainian financial sector and the need to reform it to integrate into the global economic space.

Challenges and opportunities in testing sensorimotor processing with tendon vibration and transcranial magnetic stimulation in subacromial impingement syndrome: A case series.

Non-invasive neurostimulation like muscle tendon vibration (VIB) and transcranial magnetic stimulation (TMS) can provide valuable insights on mechanisms underlying sensorimotor dysfunctions. However, their feasibility in the context of painful musculoskeletal disorders like shoulder impingement syndrome (SIS) remain uncertain. The present work used a case series design including 15 participants with SIS, as well as a secondary group-based analysis comparing participants with SIS to 15 healthy counterparts. Proprioceptive processing was tested by VIB-induced kinesthetic illusions of shoulder abduction, and TMS tested corticospinal excitability of the upper trapezius. Detailed individual data were collected, including any technical challenges and feasibility issues encountered. VIB was in general well-tolerated and elicited a perceptible kinesthetic illusion in 13 participants with SIS and 14 controls. TMS presented with several challenges related to discomfort, fear-related behaviors, technical problems and high motor thresholds, especially in participants with SIS. It was only possible to collect all TMS measures in 5 participants with SIS (for both the painful and non/less-painful sides), in 7 controls on their dominant side and 10 controls on the non-dominant side. The only significant group-based analysis was a lower illusion speed/amplitude on the painful versus non-painful side in persons with SIS (p = 0.035). Our study provides preliminary data on challenges encountered with TMS and VIB of trunk/proximal muscle in persons with SIS and healthy counterparts. It might help future studies to better address those challenges beforehand and improve the overall feasibility and impact of neurostimulation tools in musculoskeletal disorders.

EU NAVIGATE: Developing a European navigation intervention for older people with cancer and their family caregivers

Background: Most people who have cancer are older people, and this affects millions of Europeans yearly. Integrating high-quality, equitable, and cost-effective care across the continuum of supportive, palliative, end-of-life, and survivorship care for both patients and family caregivers is highly relevant from a healthcare, prevention, and economic perspective.
 Aims: EU NAVIGATE is an interdisciplinary, cross-country, and intersectoral project funded by the European Union and aiming to evaluate the effectiveness and cost-effectiveness of a patient and family navigation intervention (NavCare-EU) for older people with cancer and their family caregivers in different healthcare systems in Europe. It focuses on reaching underserved individuals, supporting and empowering them to access their own networks and available resources within their community. As the first step, the existing and promising Canadian Nav-Care intervention from will be adapted, contextualized, standardized and pilot-tested across six European countries.
 Concept and methods and anticipated results: NavCare-EU is a person- and family-centered non-pharmacological intervention in which volunteer navigators collaborate with patients and families to facilitate timely and equitable access to health and social care services and resources as needed. The Nav-CARE intervention involves a navigation model, including international blended training, and various tools to support navigators. We will share the model, different roles involved and training packages. Following the ADAPT guidance, the Nav-Care intervention will be translated and adapted in close collaboration with Local Adaptation Teams diverse users, and other stakeholders (according to principles of Patient and Public Involvement). To contextualize the original intervention, we follow the extended Normalization Process Theory. An International Oversight Group will safeguard the original intervention’s integrity and key components using the Model for Adaptation Design and Impact (MADI) to guide decision-making around the design of adaptations. The feasibility of the Nav-CARE intervention within local settings will be reviewed across countries in a pilot study to understand the practicalities of implementation, maximize feasibility, and troubleshoot issues that arise during implementation. Effectiveness and cost-effectiveness will be evaluated through an international pragmatic randomized controlled trial.
 Impact: The EU NAVIGATE will shift the state of the art of cancer care in Europe by providing an innovative solution to the complex care needs experienced by older cancer patients and their families. we pay particular attention to local healthcare contexts to ensure optimal implementation. We will present the final program ready for testing at the conference.

Multi-{Physics, Phase, Scale} Computational Modeling of Interface-Coupled Problems in Redox Flow Battery Design

Motivated by an urgent need to deploy large-scale energy storage technologies to integrate intermittent renewables, redox flow batteries (RFBs) are gaining prominent attention due to their interesting features including higher durability and power-energy decoupling. RFBs are rechargeable electrochemical systems in which an electrolyte solution containing dissolved or suspended active species is stored in external tanks and pumped through the electrochemical stack - consisting of flow fields, porous electrodes, and membranes - where the active species undergo electrochemical reactions to charge/discharge the battery. However, large-scale deployment of RFBs has feasibility issues regarding costs and efficiency, which can be tackled by tuning their multi-scale design parameters [1].Developing a coupled multi-scale computational model for RFBs can facilitate our understanding of the interplay between intricate phenomena occurring at several length and time scales (depicted schematically in the figure), ranging from transport phenomena, i.e., mass, charge, momentum, and heat, on the cell level (macro and meso scales) to microstructure effects and wettability behavior on the pore-scale (micro and nano scales). Furthermore, the modeling framework should capture the reaction kinetics and multi-phase chemistry of emerging flow battery concepts (e.g. metal-air) including plating and stripping reactions [2].In this research, we are developing a multi-{physics, phase, scale} model for the optimization of next-generation RFBs in the cell-, electrode-, and pore-scale. The model includes free fluid flow (representing flow field channels) over a porous medium (porous electrode) and solves the transport mechanisms over the entire computational domain with a focus on the electrolyte-electrode interface. The model is developed using finite element/volume methods combined with pore network modeling techniques, implemented using various open-source modeling frameworks including OpenFOAM [3], FEniCS [4], and OpenPNM [5].In this presentation, I will first discuss the structure of the modeling framework including the continuum transport models, the pore network model, and the employed numerical schemes. Then, I will present the coupling between continuum and porous medium models. Finally, I will highlight some initial results focused on the efficiency of the coupling of the electrolyte fluid transport with the porous medium and pore network representation of the electrode [6]. We hope that the developed model can be a functional tool to assess and optimize RFB materials and operating conditions and can be broadly adopted to model emerging flow battery chemistries. References K. Chakrabarti et al., Sustainable Energy & Fuels. 4, 5433–5468 (2020).Hein et al., ACS Applied Energy Materials. 3, 8519–8531 (2020).G. Weller et al., Computers in Physics. 12, 620 (1998).Alnæs et al., Archive of Numerical Software, in press, doi:10.11588/ANS.2015.100.20553.Gostick et al., Computing in Science & Engineering. 18, 60–74 (2016).van der Heijden et al., Journal of The Electrochemical Society. 169, 040505 (2022). Figure 1

Evaluation of the effect of a low-carbon green city policy on carbon abatement in South Korea: A city-level analysis based on PSM-DID and LSA models

Climate change response is a long-term, stage-specific global challenge that necessitates ongoing research on its routes. Although previous research has examined policy planning and indicator development for a low-carbon transition based on a variety of macropolicies, more research is needed to determine whether such policies can help reduce carbon emissions and accelerate urban transitions. Based on 2015–2021 panel data covering 17 South Korean first-level administrative districts, we employ a propensity score matching-difference in difference (PSM-DID) model and a mediating effect model to address issues of interregional development faults and policy feasibility and to investigate the impacts of the low-carbon green city (LCGC) policy in different regions on urban carbon emissions. To address the development gap and policy feasibility across regions, this study investigates the mechanism and path of the effect of the LCGC policy on urban carbon dioxide emissions in various regions, ultimately incorporating local spatial autocorrelation (LSA) to investigate the characteristics of the differences at the spatial level. The findings demonstrate that (1) the present regulations effectively limit total urban carbon emissions but are characterized by strong rebound elasticity and a short period. (2) Energy use and renewable energy production have the greatest influence on reducing total urban carbon emissions. (3) The local spatial autocorrelation clustering characteristics present the clustering characteristics of being high in the east and low in the north. The HH agglomerations have the largest coverage and are mainly distributed in the southeast and southwest directions of the study area. The results of the study provide a decision-making basis and theoretical support for relevant decision-makers to formulate differentiated carbon emission reduction policies and to eliminate the current transition dilemma with a new research methodology.

Exploring patients' experiences with telehealth in obstetrics care during the COVID-19 pandemic: A qualitative study.

The aim of this study was to evaluate patients' experiences with telehealth provision of obstetrics and gynecology care during the COVID-19 pandemic qualitatively. In this study, a qualitative research design, namely descriptive phenomenology, was employed. Participants were recruited from the OB department at UMass Memorial Medical center in Worcester, MA, between 6/2020 and 7/2020. Between June 2020 and July 2020, in-depth interviews were conducted with 18 women receiving care at the Obstetrics and Maternal and Fetal Medicine clinics. Data were analyzed using qualitative thematic analysis, as outlined by Braun and Clarke. Telehealth is a feasible and safe health-care tool that is available during these unprecedented times. This study provided qualitative evidence based on patients' perspectives and experiences. Participants' meanings in relation to their experiences of using telehealth services emerged from the data in four themes: the overall experience of using modern telehealth platforms, telehealth and its perceived benefits, telehealth and its perceived challenges, and telehealth and its potential future use. While this study highlights areas in telehealth implementation that require improvement, the overall positive experiences and consistent perceived benefits of most participants suggests that telehealth can be an important tool in healthcare delivery for appropriate patients and situations moving forward in a post-pandemic world. During the global pandemic, telehealth has been recognized to have the potential to play a critical role in healthcare delivery. Establishing qualitative evidence-based practices in the emerging field of telehealth for OB services is pivotal to mitigate potential safety, feasibility, and cost issues that could be associated with the rapid adoption of telehealth. Yet, this qualitative study However highlighted several challenges that are necessary to be addressed in order for telehealth to meet maximum effectiveness and functionality in the future.

PP127 Early Health Technology Assessment (HTA) Of Medical Technologies To Inform Subsidy Decision-making In Singapore

IntroductionMedical technologies are evolving rapidly, with many new and expensive technologies entering the market constantly, challenging the sustainability of the public healthcare system. Early health technology assessment (HTA) to inform subsidy decision for innovative medical technologies, before they diffuse into the public healthcare system, may drive appropriate early adoption or curtail inappropriate use. This abstract describes the Agency for Care Effectiveness (ACE)’s experience in conducting early HTAs and key challenges faced.MethodsDuring ACE’s 2021 topic prioritization exercise, ACE took a proactive approach by considering medical technologies identified from horizon scanning (HS) for subsidy evaluation. Two topics were shortlisted from HS. Standard HTA evaluation framework and local clinician consultation were used to define the evaluation scope and clinical pathways. Literature search and appraisal were conducted for safety, effectiveness, and economic evidence. Budget impact estimations and organizational feasibility assessment were additional domains considered for subsidy decision-making by the Ministry of Health Medical Technology Advisory Committee (MTAC).ResultsMTAC did not recommend subsidy for the two technologies due to weak evidence base, largely due to a lack of comparative evidence, small samples, short-term follow-ups, or heterogeneity of population. Additional considerations included potentially high budget impact or organizational feasibility issues such as substantial capital and maintenance cost and infrastructure reconfiguration required. During the evaluation, key challenges of assessing such technologies in their early diffusion within the healthcare system were: (i) differing clinical opinions on whether the technology meets an unmet need; (ii) uncertain place in the clinical management algorithm for the relevant indications; (iii) sparse and weak evidence; (iv) uncertain financial implications to the healthcare system due to a lack of available local costs.ConclusionsEarly HTA on medical technologies identified from HS can be a useful tool to guide subsidy decisions; however, several challenges exist. Careful selection of technologies and timing of evaluation are critical. Seeking stakeholder inputs earlier would ensure shortlisting appropriate technologies with greater clinical need for HTA.

A Comparative Analysis of Different Hydrogen Production Methods and Their Environmental Impact

This study emphasises the growing relevance of hydrogen as a green energy source in meeting the growing need for sustainable energy solutions. It foregrounds the importance of assessing the environmental consequences of hydrogen-generating processes for their long-term viability. The article compares several hydrogen production processes in terms of scalability, cost-effectiveness, and technical improvements. It also investigates the environmental effects of each approach, considering crucial elements such as greenhouse gas emissions, water use, land needs, and waste creation. Different industrial techniques have distinct environmental consequences. While steam methane reforming is cost-effective and has a high production capacity, it is coupled with large carbon emissions. Electrolysis, a technology that uses renewable resources, is appealing but requires a lot of energy. Thermochemical and biomass gasification processes show promise for long-term hydrogen generation, but further technological advancement is required. The research investigates techniques for improving the environmental friendliness of hydrogen generation through the use of renewable energy sources. Its ultimate purpose is to offer readers a thorough awareness of the environmental effects of various hydrogen generation strategies, allowing them to make educated judgements about ecologically friendly ways. It can ease the transition to a cleaner hydrogen-powered economy by considering both technological feasibility and environmental issues, enabling a more ecologically conscious and climate-friendly energy landscape.