Smart Cities and ICT – Insights from the Morgenstadt project

According to the United Nations, 60% of the world’s population will live in urban areas by 2030 (United Nations 2012). While many cities around the world are growing and expanding, at the same time, a big number of cities in the northern hemisphere is facing reverse trends, e.g. caused by the demographic change. As a result of these trends and the comprehensive globalization, cities are competing within a global market for companies and well educated inhabitants. As an additional challenge, the climate change revealed his powerful forces during the last decades as seen in hurricanes Katrina and Sandy in 2005 respectively 2012 or typhoon Haiyan in 2013. In this context, cities are facing an extremely difficult assignment: an innovative sustainable development of the city, including ecologic, economic and social dimensions. This task includes two central requirements, making the city livable on the one hand and resilient against external factors as natural disasters or other crises on the other. This paper outlines innovative approaches of cities all over the world, in order to achieve the goal of a sustainable city of tomorrow, concentrating on the contribution of innovative information and communication technologies (ICT). The paper is based on an interdisciplinary long-term research project called “Morgenstadt: City Insights” (m:ci), which analyzed innovative and sustainable solutions and projects of the city sectors mobility, water infrastructure, production and logistics, governance, buildings, energy, security and ICT in six leading cities around the world in order to identify common characteristics and structures of success stories. Therefore, the paper first presents the research methodology of the m:ci project, followed by an overview of the examined sectors, projects and cities. Subsequently the key findings regarding the ICT sector will be presented and the role of ICT for an innovative and sustainable city development will be outlined. In this context it will be elaborated for instance how ICT enables innovative solutions of other sectors and to which extent the collection and procession of urban data contributes to a sustainable development. Finally, the paper discusses the transferability of the identified approaches and tries to illustrate possible strategies to implement such innovative and sustainable solutions

'Doktorspiele' : a psychodramatic exploration of relationships between HIV-infected patients and their doctors with regard to existing adherence problems

In der vorliegenden Arbeit wurde die Arzt-Patient-Beziehung von HIV-Patienten im Hinblick auf bestehende Adherence-Probleme mithilfe qualitativer Methoden untersucht. Dieser Aspekt wurde in der Adherence-Forschung im HIV-Bereich entgegen den Tendenzen der allgemeinen Adherence-Forschung, im Rahmen derer die Arzt-Patient-Beziehung als bedeutsamer Einflussfaktor gilt, bislang nur wenig berücksichtigt. 20 an der Untersuchung teilnehmende Patienten wurden in der HIV-Ambulanz der Universität Frankfurt dergestalt rekrutiert, dass durch ärztliche Zuordnung zwei vergleichbare Gruppen, adhärente und wenig adhärente Patienten, entstanden. Gleichzeitig schätzen die behandelnden Ärzte und die Patienten das Medikamenteneinnahmeverhalten mithilfe von Fragebögen ein. Die Einstufung der Ärzte in eine der beiden Gruppen „adhärent/nicht adhärent“ zeigte in der vorliegenden Untersuchung eine relative Übereinstimmung mit der Selbstbeurteilung der Patienten (Exakter Test nach Fisher: p=0,017). Den Patienten schien es ungeachtet ihrer Adherence schwer zu fallen, sich an ein exaktes zeitliches Einnahmeschema zu halten. Das Mittel der eingenommenen Medikamente lag nach ärztlicher Schätzung für die Patienten der adhärenten Gruppe bei 97% (SD=4) der verordneten Medikamente und für die der nicht adhärenten Gruppe bei 69% (SD=17). Bei der Auswertung des Ärztefragebogens fiel auf, dass der Schwellenwert der Adherence für die befragten Ärzte nicht klar definiert zu sein scheint. Eine wissenschaftlich gesicherte (Neu-)Bestimmung dieses Schwellenwertes der Adherence könnte eine Entlastung von den aus dieser Unsicherheit resultierenden Konflikten für den Patienten bedeuten. Zur Exploration der Arzt-Patient-Beziehung aus der Patientensichtweise wurde auf die handlungsorientierte Methode des Psychodramas zurückgegriffen. Die mittels Rollentausch ermöglichten Inszenierungen eines Arzt-Patient-Gespräches wurden mit Videokameras dokumentiert. Die Auswertung der transkribierten Videos geschah mithilfe der Methode der objektiven Hermeneutik. Aus der Stichprobe wurde durch Kontrastierung eine Auswahl von vier Patienten getroffen. Dies geschah nach den Kriterien „adhärent“ vs. „nicht adhärent“ und „Rollentausch möglich“ vs. „kein Rollentausch möglich“. Es konnte eine Spezifität der untersuchten Patienten abgebildet werden, die nach Heranziehung einschlägiger Literatur durchaus als HIV-typisch verstanden werden kann: In den Darstellungen der Arzt-Patient-Beziehungen imponierten diffuse Nähe-Distanz-Regelungen sowie eine Nicht-Einhaltung des traditionellen asymmetrischen Arzt-Patient-Verhältnisses. Die Patienten traten in übertragungsreichen Beziehungen mit Vergemeinschaftungstendenzen an den Arzt heran. Erklärungsansätze hierfür könnten sein: Eine Traumatisierung durch die HIV-Infektion, eventuell ein kumulatives Trauma einschließend; eine vermeintliche, auf bereits bestehende subkulturelle Identitäten aufbauende „HIV-Identität“; die besondere Stellung der HIV-Infektion im Gesundheitssystem sowie das Fortdauern bereits der Prä-HAART-Ära entstammender Strukturen; ein allgemeinen Wandel des Gesundheitssystems und/oder ein einrichtungsspezifischer Einfluss. Aufbauend auf diese strukturellen Besonderheiten wurde eine Hypothese für die weitere Beschäftigung mit dem Thema „Adherence bei HIV-infizierten Patienten“ generiert: Entsprechend der Kontrastierung nach adhärenten vs. nicht adhärenten Patienten ließe sich als Erklärungsmodell folgern, dass die HIV-Patienten unter der Bedingung, dass ihr Verhältnis zum Arzt ein Besonderes ist, bereit sind, den ärztlichen Anweisungen zu folgen. Daraus könnte ein individueller Grad der Bedürftigkeit bzw. eines Wunsches, als etwas Besonderes in der Beziehung zu ihrem Arzt anerkannt zu werden, resultieren, bei dessen Überschreitung der Patient sich adhärent verhielte. Demnach könnte sich die Zufriedenheit mit der Arzt-Patient-Beziehung als Befriedigung der Bedürftigkeit bzw. o.g. Wunsches verstehen lassen. Die Hypothese legt weiterhin nahe, dass Adherence-Probleme vornehmlich auf einen Selbstwertkonflikt als Konfliktmuster bzw. eine Selbstwertregulierung innerhalb der bestehenden Arzt-Patient-Beziehung zurückführbar wären. Inwieweit die Ausprägung dieser Konfliktstruktur für adhärentes bzw. nicht adhärentes Verhalten verantwortlich ist, ist in weiterführenden Untersuchungen zu klären. Im Rahmen der Einzelfallanalysen offenbarten sich Probleme, die in einer normalen Arzt-Patient-Beziehung kaum lösbar sind. Den hohen Erwartungen an die Adherence entsprechend sollten demnach Strategien ausgebildet werden, mittels derer nach hinreichender Diagnostik eine Behandlung der nicht zur Adherence fähigen Patienten durch verschiedene Interventionen möglich wird. Diese sollten dem individuellen Problem gebührend von psychoedukativen Herangehensweisen über psychotherapeutischen Maßnahmen bis hin zu speziellen Projekten, innerhalb derer eine Behandlung der nicht zur der Adherence fähigen Patienten angeboten wird, reichen.This qualitative study examines the relationship between doctors and HIV-infected patients with regard to existing problems of adherence to antiretroviral medication. While there is growing acceptance of the importance of the doctor-patient relationship as a predictor in general research on adherence, it tends to be neglected in research on adherence of HIV-infected individuals. The sample contains 20 HIV-infected patients, who were recruited in the HIV centre of University Frankfurt. The attending physicians divided the adherent and the non-adherent patients into two comparable groups. Simultaneously, both doctors and patients were asked to complete questionnaires estimating the adherence. Within this study the doctors' classification of their patients into one of the two groups, adherent or non-adherent, was relatively corresponding with the results of the patients' self-report (Fisher Exact Test: p=0,017). For the patients it seemed to be difficult to keep to the exact dosing schedule regardless of their individual adherence rate. On average the doctors estimated the amount of medication taken by the patient at 97% (SD=4) of the prescribed medication in the adherent group compared to only 67% (SD=17) in the non-adherent group. However, the evaluation of the doctors’ questionnaire showed an uncertainty concerning the threshold value of non-adherence. A scientific (re-)determination of this threshold value could relieve patients of conflicts resulting from this uncertainty. Psychodrama has been the method used to explore the doctor-patient relationship from the patient's point of view, utilizing all possible devices for bringing the individual actor into operation. The scene of a doctor-patient conversation was produced through role reversal, videotaped, and transcribed. Objective hermeneutics was used to analyze the collected material: four patients were chosen from the sample, being in maximum contrast to each other with respect to 'adherence' vs. 'non-adherence' and 'role reversal possible' vs. 'role reversal not possible'. One specific trait was shared by the patients in question. After consulting relevant sources, this trait may be considered typical for HIV-infected patients: A diffuse regulation of closeness and distance, as well as a non-maintenance of the traditional asymmetrical doctor-patient relation impressed within the presentation of the doctor-patient relationship. Within this relationship the patients faced the doctors on a high level of transference and showed the tendency to involve the doctor into their community. Several explanations are possible: a trauma of being HIV-positive, possibly including a cumulative trauma; a supposed 'HIV-identity' which might be built on an identity experienced subculturally; a particular attitude of the health care system towards HIV-infection, as well as the carry-over of structures which grew during in the years before HAART; a general change of the health care system itself; a specific influence resulting from the institution wherein the patients were recruited. Based on this structural peculiarity, a hypothesis was generated for further research on adherence of HIV-infected patients: According to the maximum contrast of adherent patients vs. non-adherent patients the conclusion for a model explaining HIV-infected patients’ adherence may be that a patient will adhere to his physician’s advice only on condition of the relationship between him and the doctor being a special one. Hence, there might result an individual level of the need or desire for being accepted by the doctor as somebody special. If this level is reached, i.e. the individual claims are met and personal desires are satisfied, the patient will adhere to the doctor’s advice. Several dimensions of personality could shift this level of need or in extreme cases be dominant enough to apparently override this model. Thus the patient's satisfaction with the physician could be understood as the fulfillment of his need or desire mentioned above. Furthermore this hypothesis suggests that adherence-problems are especially based on an intrapsychic conflict of self-worth as central conflict pattern resp. regulation of self-esteem within an existing doctor-patient relationship. To what extent the characteristic structure of this conflict is responsible for adherence or non-adherence will have to be clarified in further research. The analysis of the four individual cases has pointed out problems which can hardly be solved in a common doctor-patient relationship. According to the high expectations of adherence, strategies should be developed based on sufficient diagnosis of reasons for non-adherence which allow a treatment of the non-adherent patients by various interventions. Taking into account the individual problems of the patients, the interventions should include measures of psycho-education and psychotherapy, as well as special projects offering alternative strategies for medical treatment

Les Oiseaux d’ Angkor et leur identification sur le terrain

Engelbach P. Les oiseaux d'Angkor et leur identification sur le terrain. In: La Terre et La Vie, Revue d'Histoire naturelle, tome 7, n°3, 1953. pp. 148-166

Ancient Egypt 1922 Part 1

Part 1 of the 1922 Ancient Egypt books. Contents include the tree of the Herakleopolite Nome, the sarcophagus of Pa-Ramessu, and knots.https://knowledge.e.southern.edu/kweeks_coll/1018/thumbnail.jp

Fine-tuning and aligning question answering models for complex information extraction tasks

The emergence of Large Language Models (LLMs) has boosted performance and possibilities in various NLP tasks. While the usage of generative AI models like ChatGPT opens up new opportunities for several business use cases, their current tendency to hallucinate fake content strongly limits their applicability to document analysis, such as information retrieval from documents. In contrast, extractive language models like question answering (QA) or passage retrieval models guarantee query results to be found within the boundaries of an according context document, which makes them candidates for more reliable information extraction in productive environments of companies. In this work we propose an approach that uses and integrates extractive QA models for improved feature extraction of German business documents such as insurance reports or medical leaflets into a document analysis solution. We further show that fine-tuning existing German QA models boosts performance for tailored extraction tasks of complex linguistic features like damage cause explanations or descriptions of medication appearance, even with using only a small set of annotated data. Finally, we discuss the relevance of scoring metrics for evaluating information extraction tasks and deduce a combined metric from Levenshtein distance, F1-Score, Exact Match and ROUGE-L to mimic the assessment criteria from human experts.Comment: Accepted at: 15th International Conference on Knowledge Discovery an Information Retrieval (KDIR 2023), part of IC3

Ancient Egypt 1923 Part 3

Part 3 of the 1923 Ancient Egypt books. Contents include types of early scarabs, the Ka in Egypt and Arabia, supports of Pylon flagstaves, Pithom and Raamses, and current fallacies about history.https://knowledge.e.southern.edu/kweeks_coll/1024/thumbnail.jp

Ancient Egypt 1922 Part 4

Part 4 of the 1922 Ancient Egypt books. Contents include the Shellal mosaic, Old World cubit in America, the Constantinople obelisk, the rise of prices in Egypt, dualism in African religions, and Egyptian mathematics.https://knowledge.e.southern.edu/kweeks_coll/1021/thumbnail.jp

Ancient Egypt 1923 Part 2

Part 2 of the 1923 Ancient Egypt books. Contents include the tomb at Byblos, a tomb with Aramaic inscriptions, the British school at Qau, the magic skin, Apries and the possibility of royal blood, and obelisks at Pylon VII.https://knowledge.e.southern.edu/kweeks_coll/1023/thumbnail.jp