Point of View: The importance of Leadership towards universal health coverage in Low Income Countries

Universal health coverage—defined as access to the full range of the most appropriate health care and technology for all people at the lowest possible price or with social health protection—was the goal of the 1978 Alma-Ata Conference on Primary Health Care in Kazakhstan. Many low-income (developing) countries are currently unable to reach this goal despite having articulated the same in their health-related documents. In this paper we argue that, over 30 years on, inadequate political and technical leadership has prevented the realization of universal health coverage in low-income countries.

The importance of Leadership towards universal health coverage in Low Income Countries

Universal health coverage—defined as access to the full range of the most appropriate health care and technology for all people at the lowest possible price or with social health protection—was the goal of the 1978 Alma-Ata Conference on Primary Health Care in Kazakhstan. Many low-income (developing) countries are currently unable to reach this goal despite having articulated the same in their health-related documents. In this paper we argue that, over 30 years on, inadequate political and technical leadership has prevented the realization of universal health coverage in low-income countries.

Flow around a hemisphere-cylinder at high angle of attack and low Reynolds number. Part II: POD and DMD applied to reduced domains

Three-dimensional direct numerical simulations (DNS) have been performed on a finite-size hemispherecylinder model at angle of attack AoA = 20◦ and Reynolds numbers Re = 350 and 1000. Under these conditions, massive separation exists on the nose and lee-side of the cylinder, and at both Reynolds numbers the flow is found to be unsteady. Proper orthogonal decomposition (POD) and dynamic mode decomposition (DMD) are employed in order to study the primary instability that triggers unsteadiness at Re = 350. The dominant coherent flow structures identified at the lower Reynolds number are also found to exist at Re = 1000; the question is then posed whether the flow oscillations and structures found at the two Reynolds numbers are related. POD and DMD computations are performed using different subdomains of the DNS computational domain. Besides reducing the computational cost of the analyses, this also permits to isolate spatially localized oscillatory structures from other, more energetic structures present in the flow. It is found that POD and DMD are in general sensitive to domain truncation and noneducated choices of the subdomain may lead to inconsistent results. Analyses at Re = 350 show that the primary instability is related to the counter rotating vortex pair conforming the three-dimensional afterbody wake, and characterized by the frequency St ≈ 0.11, in line with results in the literature. At Re = 1000, vortex-shedding is present in the wake with an associated broadband spectrum centered around the same frequency. The horn/leeward vortices at the cylinder lee-side, upstream of the cylinder base, also present finite amplitude oscillations at the higher Reynolds number. The spatial structure of these oscillations, described by the POD modes, is easily differentiated from that of the wake oscillations. Additionally, the frequency spectra associated with the lee-side vortices presents well defined peaks, corresponding to St ≈ 0.11 and its few harmonics, as opposed to the broadband spectrum found at the wake.

Flow around a hemisphere-cylinder at high angle of attack and low Reynolds number. Part I: Experimental and numerical investigation

Three-dimensional Direct Numerical Simulations combined with Particle Image Velocimetry experiments have been performed on a hemisphere-cylinder at Reynolds number 1000 and angle of attack 20◦. At these flow conditions, a pair of vortices, so-called “horn” vortices, are found to be associated with flow separation. In order to understand the highly complex phenomena associated with this fully threedimensional massively separated flow, different structural analysis techniques have been employed: Proper Orthogonal and Dynamic Mode Decompositions, POD and DMD, respectively, as well as criticalpoint theory. A single dominant frequency associated with the von Karman vortex shedding has been identified in both the experimental and the numerical results. POD and DMD modes associated with this frequency were recovered in the analysis. Flow separation was also found to be intrinsically linked to the observed modes. On the other hand, critical-point theory has been applied in order to highlight possible links of the topology patterns over the surface of the body with the computed modes. Critical points and separation lines on the body surface show in detail the presence of different flow patterns in the base flow: a three-dimensional separation bubble and two pairs of unsteady vortices systems, the horn vortices, mentioned before, and the so-called “leeward” vortices. The horn vortices emerge perpendicularly from the body surface at the separation region. On the other hand, the leeward vortices are originated downstream of the separation bubble, as a result of the boundary layer separation. The frequencies associated with these vortical structures have been quantified.

A mobile image enhancement technology for visually impaired

In this thesis, an image enhancement application is developed for low-vision patients when they use iPhones to see images/watch videos. The thesis has two contributions. The first contribution is the new image enhancement algorithm which combines human vision features. The new image enhancement algorithm is modified from a wavelet transform based image enhancement algorithm developed by Dr. Jinshan Tang. Different from the original algorithm, the new image enhancement algorithm combines human visual feature into the algorithm and thus can make the new algorithm more effective. Experimental simulation results show that the proposed algorithm has better visual results than the algorithm without combining visual features. The second contribution of this thesis is the development of a mobile image enhancement application. In this application, users with low-vision can see clearer images on an iPhone which is installed with the application I have developed.

Computational Evaluation of Wind Loads on Low- and High- Rise Buildings

Buildings and other infrastructures located in the coastal regions of the US have a higher level of wind vulnerability. Reducing the increasing property losses and causalities associated with severe windstorms has been the central research focus of the wind engineering community. The present wind engineering toolbox consists of building codes and standards, laboratory experiments, and field measurements. The American Society of Civil Engineers (ASCE) 7 standard provides wind loads only for buildings with common shapes. For complex cases it refers to physical modeling. Although this option can be economically viable for large projects, it is not cost-effective for low-rise residential houses. To circumvent these limitations, a numerical approach based on the techniques of Computational Fluid Dynamics (CFD) has been developed. The recent advance in computing technology and significant developments in turbulence modeling is making numerical evaluation of wind effects a more affordable approach. The present study targeted those cases that are not addressed by the standards. These include wind loads on complex roofs for low-rise buildings, aerodynamics of tall buildings, and effects of complex surrounding buildings. Among all the turbulence models investigated, the large eddy simulation (LES) model performed the best in predicting wind loads. The application of a spatially evolving time-dependent wind velocity field with the relevant turbulence structures at the inlet boundaries was found to be essential. All the results were compared and validated with experimental data. The study also revealed CFD’s unique flow visualization and aerodynamic data generation capabilities along with a better understanding of the complex three-dimensional aerodynamics of wind-structure interactions. With the proper modeling that realistically represents the actual turbulent atmospheric boundary layer flow, CFD can offer an economical alternative to the existing wind engineering tools. CFD’s easy accessibility is expected to transform the practice of structural design for wind, resulting in more wind-resilient and sustainable systems by encouraging optimal aerodynamic and sustainable structural/building design. Thus, this method will help ensure public safety and reduce economic losses due to wind perils.

Factors affecting the adoption of new technology: The case of 311 government call centers

Government call centers (311) were first created to reduce the volume of non-emergency calls that were being placed to emergency 911 call centers. The number of 311 call centers increased from 57 in 2008 to about 300 in 2013. Considering that there are over 2,700 municipal government units across the United States, the adoption rate of the 311 centers is arguably low in the country. This dissertation is an examination of the adoption of 311 call centers by municipal governments. My focus is specifically on why municipal governments adopt 311 and identifying which barriers result in the non-adoption of 311 call centers. This dissertation is possibly the first study to examine the adoption of 311 call centers in the United States. ^ The dissertation study has identified several significant factors in the adoption and non-adoption of 311 government call centers. The following factors were significant in the adoption of 311 government call centers: managerial support, financial constraints, organizational responsiveness, strategic plan placement, and technology champion. The following factors were significant barriers that resulted in the non-adoption of a 311 government call center; no demand from citizens, start up costs, annual operating costs, unavailability of funding, and no obvious need for one. ^ If local government entities that do not have a 311 government call center decide to adopt one, this study will help them identify the conditions that need to be in place for successful adoption to occur. Local government officials would first need to address the barriers in setting up the 311 call centers. ^

Efficient wireless coverage of in-building environments with low electromagnetic impact

The city of tomorrow is a major integrating stake, which crosses a set of major broad spectrum domains. One of these areas is the instrumentation of this city and the ubiquity of the exchange of data, which will give the pulse of this city (sensors) and its breathing in a hyper-connected world within indoor and outdoor dense areas (data exchange, 5G and 6G). Within this context, the proposed doctorate project has the objective to realize cost- and energy- effective, short-range communication systems for the capillary wireless coverage of in-door environments with low electromagnetic impact and for highly dense outdoor networks. The result will be reached through the combined use of: 1) Radio over Fiber (RoF) Technology, to bring the Radio Frequency (RF) signal to the different areas to be covered. 2) Beamforming antennas to send in real time the RF power just in the direction(s) where it is really necessary.

Modelling of ORC components and systems for low-medium temperature heat recovery applications with reduced environmental impact

Although its great potential as low to medium temperature waste heat recovery (WHR) solution, the ORC technology presents open challenges that still prevent its diffusion in the market, which are different depending on the application and the size at stake. Focusing on the micro range power size and low temperature heat sources, the ORC technology is still not mature due to the lack of appropriate machines and working fluids. Considering instead the medium to large size, the technology is already available but the investment is still risky. The intention of this thesis is to address some of the topical themes in the ORC field, paying special attention in the development of reliable models based on realistic data and accounting for the off-design performance of the ORC system and of each of its components. Concerning the “Micro-generation” application, this work: i) explores the modelling methodology, the performance and the optimal parameters of reciprocating piston expanders; ii) investigates the performance of such expander and of the whole micro-ORC system when using Hydrofluorocarbons as working fluid or their new low GWP alternatives and mixtures; iii) analyzes the innovative ORC reversible architecture (conceived for the energy storage), its optimal regulation strategy and its potential when inserted in typical small industrial frameworks. Regarding the “Industrial WHR” sector, this thesis examines the WHR opportunity of ORCs, with a focus on the natural gas compressor stations application. This work provides information about all the possible parameters that can influence the optimal sizing, the performance and thus the feasibility of installing an ORC system. New WHR configurations are explored: i) a first one, relying on the replacement of a compressor prime mover with an ORC; ii) a second one, which consists in the use of a supercritical CO2 cycle as heat recovery system.

Temporary teams learning and performance: the case of 3D printing technology in orthopaedic surgery

This dissertation contributes to the scholarly debate on temporary teams by exploring team interactions and boundaries.The fundamental challenge in temporary teams originates from temporary participation in the teams. First, as participants join the team for a short period of time, there is not enough time to build trust, share understanding, and have effective interactions. Consequently, team outputs and practices built on team interactions become vulnerable. Secondly, as team participants move on and off the teams, teams’ boundaries become blurred over time. It leads to uncertainty among team participants and leaders about who is/is not identified as a team member causing collective disagreement within the team. Focusing on the above mentioned challenges, we conducted this research in healthcare organisations since the use of temporary teams in healthcare and hospital setting is prevalent. In particular, we focused on orthopaedic teams that provide personalised treatments for patients using 3D printing technology. Qualitative and quantitative data were collected using interviews, observations, questionnaires and archival data at Rizzoli Orthopaedic Institute, Bologna, Italy. This study provides the following research outputs. The first is a conceptual study that explores temporary teams’ literature using bibliometric analysis and systematic literature review to highlight research gaps. The second paper qualitatively studies temporary relationships within the teams by collecting data using group interviews and observations. The results highlighted the role of short-term dyadic relationships as a ground to share and transfer knowledge at the team level. Moreover, hierarchical structure of the teams facilitates knowledge sharing by supporting dyadic relationships within and beyond the team meetings. The third paper investigates impact of blurred boundaries on temporary teams’ performance. Using quantitative data collected through questionnaires and archival data, we concluded that boundary blurring in terms of fluidity, overlap and dispersion differently impacts team performance at high and low levels of task complexity.

Appropriate technologies and natural systems for wastewater treatment in low- and middle-income countries

Wastewater management is an environmental and social burden that primarily affects populations in Low- and Middle-Income Countries and the global environment. Wastewater collection, treatment, and reuse have become urgent, especially considering that 80% of the world's wastewater is untreated or improperly treated and discharged directly into water bodies. In recent years, the role of wastewater treatment plants in a sustainable water cycle has become even more critical, as they are the final destination of the collected wastewater. Indeed, the management of wastewater treatment plants should play an essential role in achieving SDG target 6.3 of the United Nations 2030 Agenda for SD. In this context, water reuse, especially wastewater reuse, plays a key role. This research focuses on investigating the valorization of wastewater resources applying Appropriate Technologies and Natural Systems for wastewater treatment in two different Low- and Middle-Income Countries, the Palestinian Territories and Sub-Saharan Africa. The research objectives are: (1) Determine the characteristics and quality of wastewater in the two case studies analysed. (2) Identify Appropriate Technology to be used in the Palestinian Territories to treat wastewater for reuse in agriculture. (3) Assess the environmental, economic, and social impacts of this project. (4) Assess the feasibility of using natural wetlands for household wastewater treatment in Sub-Saharan region. The first study, conducted in Rafah, Gaza Strip, showed that implementing existing primary treatment plant with a natural secondary treatment plant properly optimized the wastewater quality for reuse in agriculture and was suitable for the study area. The second case study was conducted in Cape Coast, Ghana. It shows that the natural wetland studied is currently overly polluted and threatened by various anthropogenic factors that cannot remove pollutants from the incoming domestic wastewater. Therefore, some recommendations were made in order to improve the efficiency of this natural wetland.

Towards cheaper, safer and low environmental impact materials for energy storage devices: natural resources-derived carbon based electrodes and aqueous electrolytes for supercapacitors

The growing market of electrical cars, portable electronics, photovoltaic systems..etc. requires the development of efficient, low-cost, and low environmental impact energy storage devices (ESDs) including batteries and supercapacitors.. Due to their extended charge-discharge cycle, high specific capacitance, and power capabilities supercapacitors are considered among the most attractive ESDs. Over the last decade, research and development in supercapacitor technology have accelerated: thousands of articles have been published in the literature describing the electrochemical properties of the electrode materials and electrolyte in addition to separators and current collectors. Carbon-based supercapacitor electrodes materials have gained increasing attention due to their high specific surface area, good electrical conductivity, and excellent stability in harsh environments, as well as other characteristics. Recently, there has been a surge of interest in activated carbon derived from low-cost abundant sources such as biomass for supercapacitor electrode materials. Also, particular attention was given to a major challenging issue concerning the substitution of organic solutions currently used as electrolytes due to their highest electrochemical stability window even though their high cost, toxicity, and flammability. In this regard, the main objective of this thesis is to investigate the performances of supercapacitors using low cost abundant safe, and low environmental impact materials for electrodes and electrolytes. Several prototypes were constructed and tested using natural resources through optimization of the preparation of appropriate carbon electrodes using agriculture by-products waste or coal (i.e. Argan shell or Anthracite from Jerrada). Such electrodes were tested using several electrolyte formulations (aqueous and water in salt electrolytes) beneficing their non-flammability, lower cost, and environmental impact; the characteristics that provide a promising opportunity to design safer, inexpensive, and environmentally friendly devices compared to organic electrolytes.

Study of low grade temperature CCHP systems for the realization of zero power buildings

Combined Cooling Heat and Power Generation (CCHP) or trigeneration has been considered worldwide as a suitable alternative to traditional energy systems in terms of significant energy saving and environmental conservation. The development and evaluation of a solar driven micro-CCHP system based on a ORC cogenerator and an Adsorption Chiller (AC) experimental prototypes has been the focus of this PhD research. The specific objectives of the overall project are: • To design, construct and evaluate an innovative Adsorption Chiller in order to improve the performances of the AC technology. • To thermodynamically model the proposed micro-scale solar driven CHP system and to prove that the concept of trigeneration through solar energy combined with an organic Rankine turbine cycle (ORC) and an adsorption chiller (AC) is suitable for residential applications.

Characterization of a 3D-printed low-cost flexible dielectric material for the realization of innovative WPT wearable applications

The aim of this thesis is to demonstrate that 3D-printing technologies can be considered significantly attractive in the production of microwave devices and in the antenna design, with the intention of making them lightweight, cheaper, and easily integrable for the production of wireless, battery-free, and wearable devices for vital signals monitoring. In this work, a new 3D-printable, low-cost resin material, the Flexible80A, is proposed as RF substrate in the implementation of a rectifying antenna (rectenna) operating at 2.45 GHz for wireless power transfer. A careful and accurate electromagnetic characterization of the abovementioned material, revealing it to be a very lossy substrate, has paved the way for the investigation of innovative transmission line and antenna layouts, as well as etching techniques, possible thanks to the design freedom enabled by 3D-printing technologies with the aim of improving the wave propagation performance within lossy materials. This analysis is crucial in the design process of a patch antenna, meant to be successively connected to the rectifier. In fact, many different patch antenna layouts are explored varying the antenna dimensions, the substrate etchings shape and position, the feeding line technology, and the operating frequency. Before dealing with the rectification stage of the rectenna design, the hot and long-discussed topic of the equivalent receiving antenna circuit representation is addressed, providing an overview of the interpretation of different authors about the issue, and the position that has been adopted in this thesis. Furthermore, two rectenna designs are proposed and simulated with the aim of minimizing the dielectric losses. Finally, a prototype of a rectenna with the antenna conjugate matched to the rectifier, operating at 2.45 GHz, has been fabricated with adhesive copper on a substrate sample of Flexible80A and measured, in order to validate the simulated results.