Jakarta is the capital city of Indonesia, which has its own problems in building transportation facilities, especially on land routes. For private vehicle users, congestion is a common thing, given the very dense number of people living in Jakarta, both natives and migrants from outside the region. And for users of public transportation services such as city transportation (angkot) and transjakarta, convenience is the main obstacle. And even though it is a public vehicle, it cannot avoid congestion because it is in one lane with private vehicles except for the transjakarta bus which has its own lane. Meanwhile, for train-based public transportation such as MRT (Mass Rapid Transit), LRT (Light rail Transit), and electric railroad (KRL), the problem is the lack of integration, namely that many stations are not yet integrated with other transportation. Various policies have been implemented to overcome these problems. This study aims to determine the level of effectiveness and efficiency of public transportation in DKI Jakarta today. The method used in this research is qualitative-descriptive through a literature review on 16 journal articles and 4 websites. The results of this study indicate that congestion is a major problem in the means of transportation in Jakarta. This is due to the increase in population due to urbanization which is also accompanied by an increase in the number of private vehicles. Therefore, to overcome this, the Jakarta Provincial Government has made improvements, reforms, and developments in public transportation. And it is hoped that people who originally used private vehicles will switch to using public transportation. But in reality, various problems in public transportation in Jakarta have not been resolved properly. Especially why traffic jams still occur?, and what are the solutions to overcome them?. It is hoped that the results of the findings of this study can be used as a reference in making or designing policies and can contribute to overcoming problems in the transportation sector, especially in the DKI Jakarta area. The limit of this research is that it only focuses on land transportation facilities in Jakarta.

OBJETIVES: During the COVID-19 pandemic, the risk of collapse of the health system created great difficulties. We will demonstrate that Intermediate Respiratory Care Units (IRCU) provide adequate management of patients with non-invasive respiratory support, which is particularly important in patients with SARS-CoV-2 pneumonia. METHODS: A prospective observational study of patients with COVID-19 admitted to the ICU of a tertiary hospital. Sociodemographic data, comorbidities, pharmacological, respiratory support, laboratory and blood gas variables were collected. The overall cost of the unit was subsequently analyzed. RESULTS: 991 patients were admitted, 56 to the IRCU (of the 81 a critical care unit). Mean age was 65 years (SD 12.8), Barthel Index 75 (SD 8.3), Charlson 3.1 (SD 2.2), HTN 27%, COPD 89% and obesity 24%. Significant relationship (p <0.05) with higher mortality of the following: fever greater than or equal to 39oC [OR 5.6; 95% CI (1.2-2.7); p = 0.020], protocolized pharmacological treatment [OR 0.3; 95% CI (0.1-0.9); p = 0.023] and IOI [OR 3.7; 95% CI (1.1-12.3); p = 0.025]. NIMV showed less of a negative impact [OR 1.8; 95% CI (0.4-8.4); p = 0.423] than IOI. The total cost of the IRCUs amounted to €66,233. The cost per day of stay in the IRCU was €164 per patient. The total cost avoided was €214,865. CONCLUSION: The pandemic has highlighted the importance of IRCUs in facilitating the management of a high patient volume. The treatment carried out in IRCUs is effective and efficient, reducing both admissions to and stays in the ICU.

The study examined the effectiveness of developed instructional module on the enhancement of learners’ academic achievements specifically this current situation of COVID-19 pandemic under distance learning delivery modalities. This instructional module in Physics was personally developed by the researcher and intended to used in teaching-learning process in Senior High School under the Department of Education. The participants of the study are the grade 12 SHS students at Aliaga National High School into two groups –the controlled and experimental. The parameters are the content knowledge, alignment to learning competencies, learning tasks, assessment method, design course, friendliness and timeliness. To examine the effectiveness, the experimental research designed was employed. The following findings were made: the mean pre-test scores of two groups had 5.40 and 5.33 which means almost the same while the post-test mean scores of controlled group had 14.40 and experimental group had 17.80 which means the mean scores of experimental group were higher than the mean scores of the controlled groups. The pretest of two groups of participants had value of 14.976 with significant value of .000 and found out “not significant” while the post-test had value of 14.976 with significant value of .000 and interpreted as “significant” therefore the developed instructional module in Physics found “effective” and had impact to students’ academic performance. On the assessment made on the effectiveness of developed instructional module in Physics the overall weighted mean got 3.77 with an interpretation of “Very Satisfactory”. Continuous development and enhance of instructional module is recommended.

In Malaysia, as in many parts of the world, vocational education and training (VET) is frequently perceived as the solution to improving the opportunities of youths who lack the resources, skills or motivation to continue with higher education. The focus of the study falls on the effectiveness of the apprenticeship scheme during the 10^th Malaysia Plan. This study may provide an opportunity to find out how the related parties react towards the apprenticeship scheme. This is important, as feedbacks are central to the success or failure of any scheme. It is expected that the relevant government bodies, private sectors, trainers and trainees will have a valuable insight on the progress this far and what need to be done in the future based on the outcome of the research. This study follows snowballing sampling method and gathers the information from apprentices from variety of industrial sectors. The findings indicate effectiveness at some types of training but lacks comprehensiveness and efficient use of resources and future direction, especially during the 10^th Malaysia plan period from 2011 to 2016. This exploratory research is a first chapter of the deeper study in this niche.

This paper is focused on the analysis of methods used to assess effectiveness and efficiency of the occupational safety and health management system (OSHMS) in a company. It reviews current Russian and international occupational safety and health standards. The paper details the method outlined in International Standard GOST 12.0.230.3-2016 “Occupational safety standards system. Management systems for occupational safety. Evaluation of effectiveness and efficiency” based on the data collected during the external audit of OSHMS function efficiency in a Russian mining company. Effectiveness and efficiency indicators were determined, and a generalized desirability coefficient was calculated. Weaknesses of the method proposed in GOST 12.0.230.3-2016 were identified and mathematical and linguistic solutions were proposed to improve it. Harrington function was used to determine a numerical and linguistic score. The performed calculation demonstrated that the company needed strategic management decisions to improve the current situation. Practical approaches were offered to enhance the company's systems-based occupational safety and health performance..

Abundant animal manure in livestock areas has the potential to be used as organic fertilizer which can restore soil fertility by turning it into compost and biochar. The goal of this study was to as-sess how well soil fertility and red chili yield might be increased by using biochar and poschar made from various animal wastes. In this investigation, a factorial pattern and randomized block design were used. The first factor was the biochar treatment type, which included no biochar, biochar made from cow manure, biochar made from goat manure, and biochar made from chicken manure. The second factor was the type of poschar, which included no poschar, poschar made from cow manure, poschar made from goat manure, and poschar made from chicken manure. The findings of this study suggest that using biochar in conjunction with poschar can significantly improve soil parameters such as soil water content, pH, EC, humic acid, fulvic acid, C, N, P, K, and CEC. Red chilies grow and yield more per hectare when different types of biochar and poschar are used. The use of biochar from cow manure together with poschar from chicken manure shows the best agronomic effectiveness.

Older adults (age ≥65) are at high risk of influenza morbidity and mortality. This study evaluated the impact of a hypothetical two-dose influenza vaccine regimen per season to reduce symptomatic flu cases by providing preseason (first dose) and mid-season (second dose) protection to offset waning vaccine effectiveness (VE). The Framework for Reconstructing Epidemiological Dynamics (FRED), an agent-based modeling platform, was used to compare typical one-dose vaccination to a two-dose vaccination strategy. Primary models incorporated waning VE of 10% per month and varied influenza season timing (December through March) to estimate cases and hospitalizations in older adults. Additional scenarios modeled reductions in uptake and VE of the second dose, and overall waning. In seasons with later peaks, two vaccine doses had the largest potential to reduce cases (14.4% with February peak, 18.7% with March peak) and hospitalizations (13.1% with February peak, 16.8% with March peak). Reductions in cases and hospitalizations still resulted but decreased when 30% of individuals failed to receive a second dose, second dose VE was reduced, or overall waning was reduced to 7% per month. Agent-based modeling indicates that two influenza vaccine doses could decrease cases and hospitalizations in older individuals. The highest impact occurred in the more frequently observed late-peak seasons. The beneficial impact of the two-dose regimen persisted despite model scenarios of reduced uptake of the second dose, decreased VE of the second dose, or overall VE waning.

The Covid-19 pandemic caused very serious problems almost to the whole world, so every opportunity must be considered to improve the situation. Decontamination carried out from the air can also be considered for surface clearance of larger areas, so the possibility of this application should also be investigated regarding pandemic. There are many examples of the use of drones for disinfection to improve the epidemic situation, but good practices, as well as factors influencing the effectiveness, have not yet been identified. In the case of using drone for disinfections during a pandemic, based on the reports, we can clearly discover the adapted use of agricultural drones. In this paper, the authors perform calculations with different values of flight speed (10 to 50 km/h), flight altitude (1 to 5 m), and flow rate (1 to 5 l / min) to determine the possible amount of disinfectant fluid per unit area. The results show that by changing the parameters, the amount of disinfectant per unit area can be given within quite wide limits (30 - 0.24 g/m2). Although the results raise many new questions it can help to identify adequate flight parameters depending on different disinfectant liquids.

Even though the rules for free movement of machinery within the European Union market have existed for more than 30 years, accidents related to their activities have constantly been achieving significant value. When designing the machine, a designer must stem from risk assessment, whereas all stages of its life cycle and ways of its use must be taken into consideration. In industrial operations, there is old machinery, which, although fulfilling its function reliably, the safety level is not in accordance with the developing requirements for their safe operation. The proposed methodology of assessment of the machinery safety condition comes out from the presupposition of the right application of steps of risk assessment and their reduction mainly by means of implementation of both effective and efficient preventive measures. The aim of the research applied in 3 operations, was to verify the method of machinery safety management. The created methodology based on 19 requirements for safety evaluates the level of the actual measures by means of the so-called criterion of current status and total efficiency of measures. Its output is the assessment of the efficiency level of implemented safety of each machine as well as of the whole operation.

Background: Trichomoniasis is the most common non-viral STI globally and yet is not a reportable disease. Trichomonas Vaginalis is an important source of reproductive morbidity and may increase risk of acquisition and transmission of HIV. WHO and CDC recommend various regimens of Nitro-Imidazoles for treatment. The common Nitro-Imidazoles used for Trichomoniasis are Metronidazole and Tinidazole, which vary in their cost, efficacy and side effect profile and it is relevant to study these factors, for better management of the patients. Objectives: This study aims to compare and study the efficacy, compliance of various treatment regimens, their outcomes and side-effects for Trichomoniasis, among STI clinic attendees in Trinidad. Methods: A clinical trial study was designed and after obtaining the informed consent a routine clinical examination was conducted and the swabs for Trichomoniasis tests were collected for diagnosis from the 692 participants. Out of 692 participants, Eighty two (82) patients with established diagnosis of Trichomonas infection were quasi-randomly treated using different regimens. Compliance to treatment, side effects and outcome were evaluated. Results: The prevalence of the Trichomoniasis in population attending our STI clinic is 11.9% and prevalence of HIV is 9%. Of the total 82 participants for the treatment, 80% were females; nearly 90% of the patients belonged to age group 15-45 years and over 60% were below 30 yrs. Among those diagnosed for Trichomonas vaginalis, 13.3% had associated HIV infection. The compliance with respect to single dose treatment was significantly better than the long duration oral regimen and has significant relation with side effects of the treatment. The outcome is generally better and comparable and shows no significant difference between different treatment regimens used in the study. Conclusions: Metronidazole and Tinidazole are commonly used drugs in various regimens. compliance is better with those treated with Tinidazole and Metronidazole stat, than with other groups. Outcome is comparable between these regimens, especially when combined with other important factors like abstinence and treatment of the partners. The treatment regimens mainly differ in the compliance and side effects profile, which suggests that to improve the compliance the drugs with less side effects, short course regimen would be a preferred choice.

Nowadays the relationship between planning land use and actual land use is not so clear in general. A lot of efforts have been put in the failures of regulation for the expansion of construction land. However, it still lacks an integrated approach to study the effectiveness of land use regulation in terms of different land use types. Furthermore, the existing evaluation of land use plan mainly focuses on a general level, a detailed research on the regulation effectiveness of each construction land use type is absent. Therefore, this research tries to evaluate regulation effectiveness of land use plan, which takes Cangwu country, Guangxi Province as an example. The finding by analysis is that the total area of construction land expansion was about 3494.73 ha, nearly 1.1 times of the plan quota. Moreover, the effectiveness differs greatly in various construction land use types. Town, industrial/mining sites can be well regulated through the quota of land use plan. While, the quota regulation system is not as effective for other type of construction land. Thus, we suggest to improve the regulation effectiveness of construction land through different plan instruments.

School-aged children may benefit from education interventions focused on healthy eating and physical activity to improve their quality of life. This article aims to review scientific evidence on food and nutrition education (FNE) in Spanish-speaking countries for the prevention of overweight and obesity in school-aged children (6-12 y). Articles were searched between April and August 2021. The searches were conducted using MEDLINE, Google Scholar, and SciELO. The primary search for articles focused on the experience of FNE interventions in Spanish-speaking countries. Overall, 518 articles were found and 33 studies were eligible for data extraction. Forty-two percent of the studies had a focus on FNE and 64% were focused on describing the eating habits of schoolchildren. Nutritional assessments (anthropometric) were found frequently with 91% and 30% of the studies focused on physical activity. All interventions focused on preventing or reducing overweight and obesity in school-age children. Educational, cognitive, dietary, and physical activity practices were described, whit being educational the most frequent intervention. Interventions reported positive effects of FNE interventions to improve knowledge and practices of healthy lifestyles in school-age children.

The reason for this dissertation is to establish the effects of vaccination on the elderly (>65 years old) in Hong Kong in reducing flu infection. Influenza vaccine uptake in the elderly (˃65 years old) in Hong Kong significantly increased in 2003 after the SARS epidemic. The exact impacts of influenza vaccine among the elderly in Hong Kong are a subject of contention. The effectiveness of the influenza vaccine comes from observed studies which may be prejudiced since it is difficult to identify and justify the evidence. A review of various literatures has shown that influenza causes serious illness and death particularly highly vulnerable groups such as adults aged 65 years and above. Therefore, more efforts should be initiated to reduce mortality caused by influenza among the elderly. According to the WHO (2005), vaccination is among the most effective approach for preventing death associated with influenza to vulnerable groups such as the elderly.

Seasonal influenza is a common cause of hospital admission, especially in older people and those with comorbidities. The objective of this study was to determine influenza vaccine effectiveness (VE) in preventing intensive care admissions and shortening the length of stay (LOS) in hospitalized laboratory-confirmed influenza cases (HLCI) in Catalonia (Spain).A retrospective cohort study was carried out during the 2017-2018 season in HLCI aged ≥ 18 years from 14 public hospitals. Differences in means and proportions were assessed using a t-test or a chi-square test as necessary and the differences were quantified using standardized effect measures; Cohen’s d for quantitative and Cohen’s w for categorical variables. Adjusted influenza vaccine effectiveness in preventing severity was estimated by multivariate logistic regression where the adjusted VE = (1-adjusted odds ratio) ·100%; adjustment was also made using the propensity score.We analyzed 1414 HLCI aged ≥ 18 years; 465 (33%) were vaccinated, of whom 437 (94%) were aged ≥ 60 years, 269 (57.8%) were male and 295 (63.4%) were positive for influenza type B. ICU admission was required in 214 (15.1%) cases. There were 141/1118 (12.6%) ICU admissions in patients aged ≥ 60 years and 73/296 (24.7%) in those aged < 60 years (p<0.001). The mean LOS and ICU LOS did not differ significantly between vaccinated and unvaccinated patients. There were 52/465 (11.2%) in vaccinated cases) ICU admissions in vaccinated cases vs. 162/949 (17.1%) in unvaccinated cases. Patients admitted to the ICU had a longer hospital LOS (mean: 22.4 [SD 20.3] days) than those who were not (mean: 11.1 [SD14.4] days); p<0.001. Overall, vaccination was associated with a lower risk of ICU admission. Taking virus types A and B together, the estimated adjusted VE in preventing ICU admission was 31% (95% CI 1-52; p=0.04). When stratified by viral type, the aVE was 40% for type A (95% CI -11-68; p = 0.09) and 25% for type B (95% CI -18-52; p = 0.21). Annual influenza vaccination may prevent ICU admission in cases of HLCI. A non-significantly shorter mean hospital stay was observed in vaccinated cases. Our results support the need to increase vaccination uptake and public perception of the benefits of influenza vaccination in groups at a higher risk of hospitalization and severe outcomes.

The experimental determination of the relative biological effectiveness of thermal neutron factors is fundamental in Boron Neutron Capture Therapy. Present values have been obtained using mixed beams consisting of both neutrons and photons of various energies. A common weighting factor has been used for both thermal and fast neutron doses, although such an approach has been questioned. At the nuclear reactor of the Institut Laue-Langevin a pure low-energy neutron beam has been used to determine thermal neutron relative biological effectiveness factors. Different tumor cell lines, corresponding to glioblastoma, melanoma, and head and neck squamous cell carcinoma, and non-tumor cell lines (lung fibroblast and embryonic kidney) have been irradiated using an experimental arrangement designed to minimise neutron-induced secondary gamma radiation. Additionally, the cells were irradiated with photons at a medical linear accelerator, providing reference data for comparison with that from neutron irradiation. Survival and proliferation were studied after irradiation, yielding the Relative Biological Effectiveness corresponding to the damage of thermal neutrons for the different tissue types.

On the eve of the Brexit process, in the context of a rising Euroscepticism that fuels the modest confidence of European citizens in their national and European institutions, the article assesses the efficiency and effectiveness of the European Parliament within the framework of the ordinary legislative procedure (co-decision). After defining and formulating the main indicators, the paper analyses the micro- and macro-performance of the European Parliament within the decision-making process from a quantitative-qualitative and a qualitative-quantitative perspective, highlighting the relativizing factors and the responsiveness of the European decision-making process to the Europeans’ needs.

The pollution of the bays in Abidjan is a major concern for the Ivorian policy makers. In fact, the pollution of the bays induce high costs to the society while impacting population health dramatically. As a result, pollution reduction management of production activities has been undertaken in the Cocody Bay area. To our knowledge, no study has yet proposed a model to evaluate the cost-effectiveness of these pollution management strategies. A cost-effectiveness model, based on Monte Carlo simulation, was developed to assess the economic and environmental impacts of various scenarios characterized by a set of production practices, both in the short term and in the long term. The authors discuss the steps and input parameters of the model presented. The proposed model may serve as the basis for identifying an optimal production scenario defined as the scenario with the best incremental cost-effectiveness ratio considering a willingness to pay (WTP) threshold. The WTP, to be estimated based on the gross domestic product of Côte d’Ivoire, represents the opportunity costs associated with selecting the optimal scenario. The current framework can also be applied to other settings facing similar challenge.

This paper aims to explore the effect of humble leadership on project success by integrating the mediating role of employee creativity. Top management support moderates the direct relationship (humble leadership and project management effectiveness) and indirect relationships through employee creativity. Time-lagged data were obtained from 332 persons working in the matrix organization across the information technology. The results showed that humble leadership enhance project management effectiveness by mediating and moderating processes. This study provides a solution to an underlying research question that has gone unanswered in prior studies. What are the strategies proposed for humble leadership in fostering the effectiveness of the project?

The widely spread CoronaVirus Disease (COVID)- 19 is one of the worst infectious disease outbreaks in history and has become an emergency of primary international concern. As the pandemic evolves, academic communities have been actively involved in various capacities, including accurate epidemic estimation, fast clinical diagnosis, policy effectiveness evaluation and development of contract tracing technologies. There are more than 23,000 academic papers on the COVID-19 outbreak, and this number is doubling every 20 days while the pandemic is still on-going [1]. The literature, however, at its early stage, lacks a comprehensive survey from a data analytics perspective. In this paper, we review the latest models for analyzing COVID19 related data, conduct post-publication model evaluations and cross-model comparisons, and collect data sources from different projects.

Background: Real-time remote monitoring of pulmonary artery pressures has previously shown to reduce heart failure (HF) related hospitalisations and to improve quality of life of selected HF patients. The value of CardioMEMS in Southern Europe, where healthcare costs are significantly lower, remains uncertain. Objective: To evaluate the cost-effectiveness of the CardioMEMS HF system in the Spanish healthcare setting. Methodology: This single-centre study included 35 HF patients with a CardioMEMS device (treatment group) and compared them with similar patients receiving standard HF treatment (control group). The Propensity Score Matching method was used and the comparators were found using the variables age, sex, New York Heart Association class, left ventricular ejection fraction, and diabetes mellitus. Cost-effectiveness was measured as the incremental cost per quality-adjusted life year gained. Results: The CardioMEMS HF system outperformed usual management with a net monetary value difference of 2,731€ per patient at 1 year. The incremental cost per quality-adjusted life year gained was 15,896€. Results were consistent in the sensitivity analyses performed. Conclusion: This analysis suggests that remote monitoring of pulmonary artery pressure with CardioMEMS HF system is a cost-effective strategy in the Spanish healthcare setting.

This paper studied the combined influences of the hot streak and swirl on the cooling performances of the NASA C3X guide vane coated with or without TBCs. The results show that: (1) Even under uniform velocity inlet conditions, the hot streak core can be stretched as it impinges the leading edge which causes higher heat load on the suction side of the forward portion. (2) The swirl significantly affects circumferential and radial migration of the hot streak core in the NGV passage. On the passage inlet plane, positive swirl leads to a hotter tip region on the suction side. In comparison, negative swirl leads to a hotter hub region on the pressure side. (3) Under the influence of swirl, migration of coolant improve the coverage of film cooling close to the midspan, while in the regions close to the hub and tip end-wall, the overall cooling performance decrease simultaneously. (4) In the regions with enough internal cooling, the cooling effectiveness increment is always larger than that in other regions. Besides, the overall cooling effectiveness increment decreases on the region covered by film cooling for the coated vane, especially in the region with negative local heat flux.

Humanity will soon define a new era for nature – one that seeks to correct decades of underwhelming responses to the global biodiversity crisis. Area-based conservation efforts, which include both protected areas and other effective area-based conservation measures, are likely to extend and diversify. But persistent shortfalls in ecological representation, management effectiveness and measurable biodiversity outcomes diminish the potential role of area-based conservation in stemming biodiversity loss. Here we show how protected area expansion by governments since 2010 has had limited success in increasing biodiversity coverage, and identify four emergent issues that –if addressed – will enhance the performance of area-based conservation post-2020. We close with recommendations for a broad biodiversity agenda that maximises the potential of area-based conservation. Parties to the Convention on Biological Diversity must recognise that area-based conservation primarily focuses on local threats to species and ecosystems, and needs enhanced emphasis on biodiversity outcomes to better track and fund its contribution to global conservation efforts.

This economic evaluation aims to support policy-making on the combined use of pre-exposure prophylaxis (PrEP) with HIV vaccines by evaluating the potential cost-effectiveness of implementation that would support the design of clinical trials for assessment of combined product safety and efficacy. The target study population is a cohort of men who have sex with men (MSM) in the United States. Policy strategies considered include standard HIV prevention, daily oral PrEP, HIV vaccine, and their combination. We constructed a Markov model based on clinical trial data and published literature. We used a payer perspective, monthly cycle length, a lifetime horizon, and a 3% discount rate. We assumed a price of $500 per HIV vaccine series in the base case. HIV vaccines dominated standard care and PrEP. At current prices,PrEP was not cost-effective alone or in combination. A combination strategy had the greatest health benefit but was not cost-effective (ICER=$463,448/QALY) as compared to vaccination alone. Sensitivity analyses suggest a combination may be valuable for higher-risk men with good adherence. Vaccine durability and PrEP drug prices were key drivers of cost-effectiveness. Results suggest that boosting potential may be key to HIV vaccine value.

This paper analyzes the mitigation of enteric methane (CH4) emissions from ruminants with the use of feed additives inhibiting of rumen methanogenesis to limit global temperature increase to 1.5 °C. A mathematical simulation conducted herein predicted that pronounced inhibition of rumen methanogenesis with pure chemicals or bromoform-containing algae can contribute to limit global temperature increase by 2050 to 1.5 °C only if widely adopted at a global level and considering an efficacy higher than obtained in most studies. Currently, the most important limitations to the adoption of antimethanogenic feed additives are probably increased feeding cost without a consistent return in production efficiency, and achieving sustained delivery of inhibitors to the rumens of non-supplemented, extensively ranging animals. Economic incentives, and changes in rumen microbial metabolism caused by inhibiting methanogenesis, could potentially be used to make the methanogenesis inhibition intervention cost effective. Also, the composition of the methanogenic community, and rate of disappearance of inhibitors of methanogenesis in the rumen can influence the effective dose of the inhibitors, and hence the cost of their adoption. Possible means for sustained delivery of antimethanogenic compounds to extensively grazing animals are discussed. Limitations and knowledge gaps of these approaches, and future research directions, are examined.

The number of entrepreneurship education programs (EEP) has increased exponentially over the past two decades. However, a systematic review has not yet been carried out to confirm the effectiveness of EEPs and their presence in the current global world. The main objective of this study was to provide a systematic synthesis of EEP, exploring their characteristics and effectiveness. The search was carried out in the following databases: Scopus, Web of Science, ProQuest and ERIC. Twenty-nine articles were included, with programs developed mainly in European (n=15), Asian (n=6) and American (n=5) countries. The programs were mainly aimed at higher education students (n=17), addressing the development of business plans and entrepreneurial skills. However, greater attention is paid to the entrepreneurial skills in both basic and secondary education. The development of the programs under analysis varied between one week and two years. The results of the studies showed the effectiveness of most of these programs in promoting entrepreneurial skills at all levels of education. In turn, there was not a verified increase in the intention to start a business, since this intention is determined by predisposition, namely socio-cultural and family aspects. This systematic review of the EEP points to the need for this type of program to be preferentially developed since the early school years, since it is at that time that predispositions are created for the development of entrepreneurial skills and intentions. This condition is corroborated by the global geography of the EEP, which demonstrates that, where there is currently an entrepreneurial culture, countries have made a long educational journey, with strategic options from the perspective of educational policies defending entrepreneurship among the younger generations.

Social media has become part and parcel of the world of today. These days, it’s still the most talked about thing. It cannot be overlooked because it plays a key role in our business functions such as marketing and advertising. Social Media is all about collaboration on files, ideas and projects that help users and stakeholders to successfully complete the project. It influences how people communicate, develop relationship, build trust, increase transparency and provide cultural context. The fundamental aim of this research is to investigate the capacity for project management in social media. This paper explains how social media is used for project management knowledge areas and process groups. Also this research aims to identify SM tools that can be suitable for project management processes. Two studies Delphi Study of three rounds and structured case study interview are used to investigate the impact on the performance of the project team and process robustness. These studies support social media use by accessing the contribution to relationship building, trusts, coordination and cohesion.

Objective: To perform a systematic review of real-world outcomes for anti-CGRP-mAbs. Methods: Following the PRISMA guidelines, we searched PubMed for real-world data of Erenumab, Galcanezumab, Fremanezumab, or Eptinezumab in patients with migraine. Results: We identified 104 publications (73 retrospective), comprising 8 pharmaco-epidemiologic and 63 clinic-based studies, 30 case reports and 3 other articles. None of the clinic-based studies provided follow-up data over more than one year in more than 200 patients. Findings suggest reductions in health insurance claims and days with sick-leave as well as better treatment adherence with anti-CGRP-mAbss. Effectiveness, reported in 59 clinic-based studies, was comparable to randomized controlled trials. A treatment pause was associated with an increase in migraine frequency and switching to another antibody resulted in a better response in some of the patients. Adverse events and safety issues were addressed in 70 papers including 22 single case reports. Conclusion: Real-world data on anti-CGRP-mAbs are limited by retrospective data collection, small patient numbers and short follow-up periods. The majority of papers seem to support good effectiveness and tolerability of anti-CGRP-mAbs in the real-world setting. There is an unmet need for large prospective real-world studies providing long-term follow-up of patients treated with anti-CGRP-mAbs.

This paper examines interlinkages and hedging opportunities between nine major cryptocurrencies for the period between 30 September 2015 and 4 June 2020, which notably includes the coronavirus disease 2019 (COVID-19) outbreak lasting from early 2020 through the end of the sample period. The results of dynamic conditional correlation (DCC) analysis using a minimum connectedness approach show a high degree of correlation between cryptocurrencies throughout the sample period. However, the correlations reach their minimum values during the COVID-19 pandemic, which indicates that cryptocurrencies acted as a hedge or safe haven during the stressful period of the COVID-19 pandemic. The weight of cryptocurrencies was significantly reduced and their hedging effectiveness varied greatly during the pandemic, which indicates that investors’ preferences changed during the COVID-19 period.

State legitimacy and effectiveness could be seen by the way to deliver welfare to citizens to mitigate social grievances, that could eventually lead to conflicts (Kivimäki, 2021). Social security systems in Maghreb countries are quite similar in their architecture and aims to provide social insurance to all the workers in the labor market. However, they suffer from the same main problem: the low rate of enrollment of workers. Many workers (employees and self-employed) work informally without any social security coverage. The issue of whether informal jobs are chosen voluntarily by workers or as a strategy of last resort is controversial. Many authors recognize that the informal sector is heterogeneous and it is made up of workers who voluntary choose it and others who are pushed inside because of entry barriers to the formal sector (Günther & Launov, 2012). Using the SAHWA survey and discrete choice models, this article confirms the heterogeneity of the informal labor market in three Maghreb countries: Algeria, Morocco, and Tunisia. Furthermore, this article highlights the profiles of workers who voluntarily choose informality, which is missing from previous studies. Finally, this article proposes policy recommendations in order to extend social security to informal workers and to include them in the formal labour market.

Results-Based Funding (RBF) for Reducing Emissions from Deforestation and Forest Degradation (REDD+) has become an important instrument for channeling financial resources to forest conservation activities. At the same time, much literature on conservation funding is ambiguous about the effectiveness of existing RBF schemes. Many effectiveness evaluations follow a simplified version of the principal-agent model, although in practice the relation between aid providers and funding recipients is much more complex. As a consequence, intermediary steps of conservation funding are often not accounted for effectiveness studies. This research paper aims to provide a nuanced understanding of conservation funding by analyzing the allocation of financial resources for one of the largest RBF schemes for REDD+ in the world: the Brazilian Amazon Fund. As part of this analysis, this study has built a dataset of information on Amazon Fund projects at unprecedented detail in order to accurately reconstruct the allocation of financial resources across different stakeholders (i.e. governments, NGOs, research institutions), geographies and activities. The results show that stakeholders seem to hold preferences with respect to the type of activities that they support, thereby suggesting that project owners exert much influence on how deforestation reduction is to be attained. There are evidences that governmental organizations lack financial additionality of their projects, which renders the growing share of funding to this type of stakeholder particularly worrisome. By contrast, the geographical distribution of financial resources seemed to follow a more focused rationale as financial support tends to concentrate in areas where deforestation threats are highest. Overall, the allocation of the financial resources from the Amazon Fund reflects an arbitrary support of different projects that adopt very diverging theories of change that are not primarily concerned with attaining further deforestation reductions. As projects owners exert influence on funding effectiveness to some extent, the Amazon Fund may either seek to regulate the allocation of financial resources more actively or adopt funding effectiveness evaluations that account for this influence more comprehensively.

The ageing of workers is one of the most important issues for occupational health and safety in Europe. A number of intervention studies on health promotion for older workers were conducted in European workplaces between 2000 and 2015. This review gives an overview of these studies and considers perspectives for workplace health promotion.

Methods to handle uncertainty in economic evaluation have gained much attention in the literature and the cost-effectiveness acceptability curve (CEAC) is the most widely used method to summarize and present uncertainty associated with program costs and effects in cost-effectiveness analysis. Some researchers have emphasized the limitations of the CEAC for informing decision and policy makers as the CEAC is insensitive to radial shifts of the joint distribution of incremental costs and effects in the North-East and South-West quadrants of the cost-effective plane (CEP). Furthermore, it has been pointed out that the CEAC does not incorporate risk-aversion in valuing uncertain costs and effects. In the present article we show that the cost-effectiveness affordability curve (CEAFC) captures both dimensions of the joint distribution of incremental costs and effects on the CEP and is therefore sensitive to radial shifts of the joint distribution on the CEP. Furthermore, the CEAFC also informs about the budget impact of a new intervention as it estimates the joint probability an intervention is both affordable and cost-effective. Moreover, we show that the cost-effectiveness risk-aversion curve (CERAC) allows to incorporate risk-aversion into the analysis and can therefore be used to inform decision-makers who are risk-averse. We use data from a published cost-effectiveness model of palbociclib in addition to letrozole versus letrozole alone for the treatment of oestrogen-receptor positive, HER-2 negative, advanced breast cancer to demonstrate the differences between CEAC, CEAFC and CERAC and show how these can jointly be used to inform decision and policy makers.

The growth of social media has changed the face of many aspects of marketing such as online, digital, etc. It also has changed the way modern human communicates and connects with others. Moreover, the behavior on this platform could not and should not be justified with strategies of other marketing channels and media. Due to the nature of social media, they are rich in precise and lean data, but processing these data and extracting knowledge and insights from them are problematic. Evaluating the effectiveness of a marketing endeavor is also a task related to these data. The current research attempts to assess the effectiveness of an advertising campaign on Instagram via advertising cost and sentiment classification of audience opinion regarding the campaign. The methodology used in this research is the standard process of data mining, i.e., CRISP-DM. Furthermore, multiple machine learning models and approaches were studied to train a prediction model based on data. In order to find the most accurate algorithm, grid search was used among the trained models and different algorithms with different combinations of hyper-parameters. The obtained results revealed that although the number of not profitable advertising media was higher than the profitable media, the overall status of the campaign was profitable, both in the cost-effectiveness approach and sentiment analysis approach. The other valued outcome of this research was important general and specific insights which can be used to shape a better-performing and effective advertising campaign on Instagram.

During the COVID-19 outbreak, most university courses have been offered on online platforms. A sudden shift from face-to-face classroom learning to online formats could influence the learning effectiveness of classes. This study aims to investigate differences in the learning effectiveness of online and face-to-face lecture courses. It also explores factors that impact the effectiveness of online instruction. These factors include interactions among learners, interactions between learners and the instructor, the quality of online platforms, learners’ ability to use devices and follow instructions, and learners’ situational challenges. The study participants were 261 university students at King Mongkut’s University of Technology Thonburi in Bangkok, Thailand. All participants were enrolled in at least one lecture course, such as history, humans and the environment, the environment and development, or general philosophy, during the 2019 academic year. A questionnaire was distributed to participants after they completed these courses in May 2020. Paired simple t-test analyses were used to compare the effectiveness of online and face-to-face classes, and a multiple regression analysis was used to identify factors that impact the learning effectiveness of online classes. The results show that online classes are less effective than face-to-face courses. The multiple regression analysis also revealed that the effectiveness of online learning was significantly impacted by learners’ ability to interact with classmates during class, their ability to interact with instructors after the class, the quality of online platforms, and disturbances or distractions in learners’ environments.

Late pear cultivars, such as ‘Conference’, can be stored for a long period, with their storability depending on storage conditions. A three-year study (2011-2013) compared the impact of half-year storage using four technologies – normal atmosphere, normal atmosphere + 1-methylcyclopropene (1-MCP), controlled atmosphere, controlled atmosphere + 1-MCP – on the quality parameters of ‘Conference’ pears, such as mass loss, firmness, total soluble solids, acidity, antioxidant capacity, and the incidence of diseases and disorders. Additionally, the study analysed different storage conditions in terms of profitability, based on the market prices for pears in the seasons during which the pears were stored. The storage conditions had a very strong influence on the fruit quality parameters, and was found to affect most visibly the mass loss and the incidence of postharvest diseases and disorders. The storage of ‘Conference’ pears for 180 days in normal atmosphere is not economically viable, even if the fruit is subjected to 1-MCP treatment.

Background: The phase III KEYNOTE-604 study confirmed the benefit of pembrolizumab combined with chemotherapy in the first-line treatment of extensive-stage small-cell lung cancer(ES-SCLC). Intergrated the clinical benefits of pembrolizumab and its high cost into account, this study aim to assess the cost-effectiveness of adding pembrolizumab to standard first-line etoposide-platinum (EP) for patients with ES-SCLC from the the US payer perspective. Methods: A Markov model was developed to compared the costs and quality-adjusted life-years (QALYs) of pembrolizumab plus EP and placebo plus EP over a 10-year time horizon. Clinical efficacy, treatment utilization and safety data were pooled from the KEYNOTE-604 trial. Utilities were obtained from published resources. Costs were mainly collected from Medicare in 2020. Sensitivity analyses were performed to examined the robustness of our model. Results: Adding pembrolizumab to standard first-line EP, resulted in better effectiveness than the use of EP alone for ES-SCLC by 0.22 QALYs. Pembrolizumab plus EP was dominated economically by placebo plus EP, leading to an incremental cost-effectiveness ratio(ICER) of $334,373/ QALY. Deterministic sensitivity analyses indicated that the uncertainty in model parameters exerts no substantial effect on our results. Probability sensitivity analysis indicated that probabilities for pembrolizumab plus EP being cost-effective within a wide rang of willingness to pay were modest. Conclusion: From the US payer perspective, the first-line treatment for ES-SCLC with pembrolizumab plus EP was not cost-effective compare with placebo plus EP. Although pembrolizumab combination chemotherapy was beneficial to the survival of ES-SCLC, price reduction may be the necessary measure to improve its cost-effectiveness.

The asymmetry in the dynamics of an electro-pneumatic actuating device consisting of an electro-pneumatic transducer and a single-action pneumatic actuator was unexpectedly found experimentally. This asymmetry manifests in response to large step excitations. The dynamic asymmetry effect is understood as a change in the shape of the response of an actuator depending on the direction of the actuators stem movement. The questions appears: How to explain this effect? Does this phenomenon reflect thermodynamic air processes? Is it connected with air-to-mechanical energy conversion? Together, six working hypotheses explaining this effect were formulated. The asymmetry was studied in detail using analytical and simulation modeling, as well as experimental research. In this respect, a nonlinear analytical model was developed, tuned, and later solved using simulations. The simulation model was verified based on the experiment data. In addition, the problem of the efficiency in the energy conversion of a single-action actuator was discussed and, in result, the maximum theoretical energy efficiency was determined. Subsequently, all six working hypotheses were verified. Finally, the hypothesis explaining asymmetry as an effect of the different thermodynamic air processes in both actuator’s stem travel directions was confirmed.

Already more than 140 countries consider or have pledged to reach net-zero emission targets by 2050 or earlier and the share of global emissions falling into an emission pricing scheme has steeply increased over the past three years. Even where there are no direct implications for industry (yet), there is a series of subtle pressure points driving an increasing number of companies across the globe to work towards climate neutrality and pledging ambitious emission reduction goals. This article sheds light on the pressure points, the subtle triggers, the underlying considerations as well as the hoped-for benefits for industrial companies from achieving net-zero emissions. The observations and ideas presented in this paper are derived from quantitative data obtained via the Energy Efficiency Index of German Industry (EEI) and qualitative data. Not only societal, work force, supply chain and investor expectations play a large role, but also many strategic considerations which have the potential to make the company more resilient and profitable, particularly in time of crisis. Those companies that do not move towards decarbonisation, on the other hand, may face a costly late-mover disadvantage. This piece uncovers subtle interconnections, helping stakeholders from industry and beyond to grasp opportunities and challenges ahead.

Nonparametric assessments of police technical and scale efficiency is challenging because of the stochastic nature of criminal behavior and because of the subjective dependence on multiple decision criteria, which can lead to a more or less efficiency prospect depending on the regulation, necessity, or organizational objective. There is a trade-off between efficiency and effectiveness in many police performance assessments, i.e., efficient departments (producing more clear-ups with a given resource) are crime-specialized or cannot reproduce those good results effectively on more severe or complex occurrences. This study proposes a combined methodology for carrying out efficiency and effectiveness analysis of Police departments. A conditional non-parametric approach, which allows to include crime as an external factor in the analysis, is combined with a non-compensatory ranking based on the PROMETHEE II methodology for the approach illustrated on the multidimensional efficiency and effectiveness comparison of 145 Pernambuco (Brazil)'s police departments. The application results offer compelling perspectives for public administrations concerning the strategic prioritization of units for rewards or interventions.

The urgency to address the adverse impacts of climate change on livelihoods and ecosystems has seen an increase in global driven initiatives. However, shifting vulnerabilities associated with land use resource based adaptation and maladaptive feedback loops they create have been given low attention. Policy discourses that frame adaptation as a local responsibility and bias towards reducing industrial Greenhouse gas (GHG) emissions at the expense of Agricultural emissions across scale are thought to account for the undesirable situation. This calls for a reflective policy framework and climate policy innovation. We provide counter arguments using Drivers, Pressure, State, Impact, Response (DPSIR) model and telecoupling principles to suggest use of resilience as an integrative lens in visualising the proposal. Using a case study on resource constrained smallholder dairy production systems, western Kenya, we analyse the critical issues in the context of decision making and environmental externalities. The effect of price risks on dairy cattle feeding strategies and ultimately carbon footprints and ecoefficiencies were examined through methane simulation and gross margin analysis (GM). The lowest ecoefficiency was associated with exclusively local coping strategies i.e. Maize Stover (Ms), while the highest ecoefficiency was observed in feeding strategies that utilise external resources and/or legume fodders. We conclude that management of externalities need to capture institutional, economic processes and incentive systems, as well as organizational and policy coherence to shape the interests and behaviour of individual land user. In particular, policy innovation should focus on price and market risks as critical factors that mediate actor decision making at implementation level as they impact GHG emissions which transcend individual decision boundaries.

Education for Sustainable Development (ESD) is considered vital to the success of the United Nations’ Sustainable Development Goals. Systems Thinking has been identified as a core competency necessary to incorporate into ESD. Systems Thinking orientated ESD learning tools, established methods of assessment of sustainability skills, and studies to demonstrate effectiveness of such learning tools, are all lacking. There is a wealth of experience in the System Dynamics field regarding the application of Systems Thinking and simulation to environmental problems, sustainability and systems education. Many System Dynamicists regard simulation as essential for teaching Systems Thinking. The substantial body of research into the design of effective simulation-based learning environments (SBLEs) can also inform ESD initiatives. This research describes a randomised controlled trial (n=106) to investigate whether an online sustainability learning tool that incorporates Systems Thinking and System Dynamics simulation increases understanding of a specific problem and supports transfer of knowledge to a second problem with a similar systemic structure. The effects of Systems Thinking and simulation were tested separately and in combination. The learning tool was designed for a single online learning session. Simulation was found to increase ESD learning outcomes significantly, and also to support transfer of skills, although less significantly.

Work has begun in earnest to formulate a post-2020 Global Biodiversity Framework which will outline the vision and targets for the next decade of biodiversity conservation and beyond. However, the performance of the 2011-2020 Strategic Plan for Biodiversity suggests that even a meaningful target can fail to deliver if not accompanied by fit-for-purpose indicators. Here we provide a review of how ‘protected area’ effectiveness was addressed in the 2011-2020 plan and based on this, provide recommendations for fit-for-purpose indicators that will measure how such efforts contribute to the conservation of biodiversity. Indicators need to be built on quantitative data from site-level biodiversity monitoring of species and ecosystems combined with measurements of the state of nature in near-time, informed by remote-sensed products and other technologies. Additionally, indicators need to capture whether the essential elements of good management are in place including the identification of ecological values, threats, and objectives, equitable governance, and sufficient management resources and capacity. These fit-for-purpose indicators will require multilateral collaboration to galvanize support for, and resources to develop, the necessary infrastructure to collate and store information from countries.

Celiac disease (CD) is a genetically conditioned autoimmune process that appears in susceptible people. It can affect people of any age, and slightly predominates in females. It has a fairly homogenous global distribution, with an average prevalence of 1-2%, the frequency having increased in recent decades. The only effective treatment is a strict and permanent gluten-free diet (GFD), although the level of compliance with it is poor, at about 50% of cases. To monitor the effectiveness of the GFD, several procedures involving various approaches are employed: a) periodic interviews by nutritionists; b) clinical follow-up; c) serological controls of specific antibodies; d) endoscopies with collection of duodenal biopsies; e) structured questionnaires; f) determination of gluten peptides derived from gluten in feces and/or urine. All of these procedures are useful when applied, alone or in combination, depending on the cases. Some patients will only need to consult to their doctors, while others will require a multidisciplinary approach to assess their compliance with the GFD. In children, normalization of duodenal mucosa was achieved in 95% of cases within 2 years, while it is more delayed in adults, whose mucosa take longer to heal completely.

Avian mutations in vaccine strains obtained from embryonated eggs could impair vaccine effec-tiveness. We performed a systematic review and meta-analysis of the adjusted relative vaccine effectiveness (arVE) of seed cell-cultured influenza vaccines (ccIV) compared to egg-based influ-enza vaccines (eIV) in preventing laboratory-confirmed influenza related outcomes (IRO) or IRO by clinical codes, in subjects 18 and over. We completed the literature search in January 2021; ap-plied exclusion criteria, evaluated risk of bias of the evidence, and performed heterogeneity, pub-lication bias, qualitative, quantitative and sensitivity analyses. All estimates were computed us-ing a random approach. International Prospective Register of Systematic Reviews, CRD42021228290. We identified 12 publications that reported 26 adjusted arVE results. Five publications reported 13 laboratory confirmed arVE and seven reported 13 code-ascertained arVE. Nine publications with 22 results were at low risk of bias. Heterogeneity was explained by season and risk of bias. We found a significant 11% (8 to 14%) adjusted arVE favoring ccIV in preventing any IRO in the 2017-2018 influenza season. The arVE was 3% (-01 to 7%) in the 2018-2019 influenza season. We found moderate evidence of a significant advantage of the ccIV in preventing IRO, compared to eIV, in a well-matched A(H3N2) predominant season.

This prospective study provides data on long-term humoral immunogenicity of a heterologous off-label vaccine regimen combining the adenoviral vectored ChAdOx1 nCoV-19 from Astra-Zeneca (ChAd) with the mRNA-1273 vaccine from Moderna (m1273) in comparison to two different homologous mRNA vaccine schedules. Of the 316 COVID-19 naïve adult health care workers (HCW) included to complete a survey on vaccine-associated symptoms (VAS), 197 had received the homologous BNT162b2 mRNA vaccine from Pfizer/BioNTech (BNT/BNT), 76 the homologous m1273/m1273, and 43 the heterologous ChAd/m1273 vaccine regimen. Concentration of antibodies against SARS-CoV-2 spike protein in plasma 5-7 months after the second vaccine dose was higher in the m1273/m1273 and ChAd/m1273 than the BNT/BNT vaccine group. The frequency of systemic VAS after first vaccine dose was 86% after ChAd compared to 35% and 39% after BNT and m1273, respectively (p &lt; 0.0001), and after second vaccine dose highest (89%) in the m1273/m1273 group (p &lt; 0.001). Individuals with systemic VAS achieved higher levels of antibodies irrespective of vaccine regimen. In conclusion, VAS serve as a strong predictor of long-term humoral immune response, and the heterologous ChAd/m1273 vaccine regimen provides an at least equal long-term humoral immune response compared with the standard vaccine regimens used in Denmark.