Search results for: general medical

Authors: S. Ben Fredj, H. Ghali, M. Ben Rejeb, S. Layouni, S. Khefacha, L. Dhidah, H. Said

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Background: The Intensive Care Unit (ICU) provides continuous care and uses a high level of treatment technologies. Although developed country hospitals allocate only 5–10% of beds in critical care areas, approximately 20% of nosocomial infections (NI) occur among patients treated in ICUs. Whereas in the developing countries the situation is still less accurate. The aim of our study is to assess mortality rates in ICUs and to determine its predictive factors. Methods: We carried out a nested case-control study in a 630-beds public tertiary care hospital in Eastern Tunisia. We included in the study all patients hospitalized for more than two days in the surgical or medical ICU during the entire period of the surveillance. Cases were patients who died before ICU discharge, whereas controls were patients who survived to discharge. NIs were diagnosed according to the definitions of ‘Comité Technique des Infections Nosocomiales et les Infections Liées aux Soins’ (CTINLIS, France). Data collection was based on the protocol of Rea-RAISIN 2009 of the National Institute for Health Watch (InVS, France). Results: Overall, 301 patients were enrolled from medical and surgical ICUs. The mean age was 44.8 ± 21.3 years. The crude ICU mortality rate was 20.6% (62/301). It was 35.8% for patients who acquired at least one NI during their stay in ICU and 16.2% for those without any NI, yielding an overall crude excess mortality rate of 19.6% (OR= 2.9, 95% CI, 1.6 to 5.3). The population-attributable fraction due to ICU-NI in patients who died before ICU discharge was 23.46% (95% CI, 13.43%–29.04%). Overall, 62 case-patients were compared to 239 control patients for the final analysis. Case patients and control patients differed by age (p=0,003), simplified acute physiology score II (p < 10-3), NI (p < 10-3), nosocomial pneumonia (p=0.008), infection upon admission (p=0.002), immunosuppression (p=0.006), days of intubation (p < 10-3), tracheostomy (p=0.004), days with urinary catheterization (p < 10-3), days with CVC ( p=0.03), and length of stay in ICU (p=0.003). Multivariate analysis demonstrated 3 factors: age older than 65 years (OR, 5.78 [95% CI, 2.03-16.05] p=0.001), duration of intubation 1-10 days (OR, 6.82 [95% CI, [1.90-24.45] p=0.003), duration of intubation > 10 days (OR, 11.11 [95% CI, [2.85-43.28] p=0.001), duration of CVC 1-7 days (OR, 6.85[95% CI, [1.71-27.45] p=0.007) and duration of CVC > 7 days (OR, 5.55[95% CI, [1.70-18.04] p=0.004). Conclusion: While surveillance provides important baseline data, successful trials with more active intervention protocols, adopting multimodal approach for the prevention of nosocomial infection incited us to think about the feasibility of similar trial in our context. Therefore, the implementation of an efficient infection control strategy is a crucial step to improve the quality of care.

Keywords: intensive care unit, mortality, nosocomial infection, risk factors

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Authors: Pitchaporn Purngpiputtrakul, Suttasinee Petsakul, Sunisa Chatmongkolchart

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Nasogastric tube (NGT) insertion in anaesthetized and intubated patients can be challenging even for experienced anesthesiologists. Various techniques have been proposed to facilitate NGT insertion in these patients. This study aimed to compare the success rate and time required for NGT insertion between the GlideScope visualization and neck flexion with lateral neck pressure techniques. This randomized clinical trial was performed at a teaching hospital on 86 adult patients undergoing abdominal surgery under relaxant general anaesthesia who required intraoperative NGT insertion. The patients were randomized into two groups, the GlideScope group (group G) and the neck flexion with lateral neck pressure group (group F). The success rate of first and second attempts, duration of insertion, and complications were recorded. The total success rate was 79.1% in Group G compared with 76.7% in Group F (P=1) The median time required for NGT insertion was significantly longer in Group G, for both first and second attempts (97 vs 42 seconds P<0.001) and (70 vs 48.5 seconds P=0.015), respectively. Complications were reported in 23 patients (53.5%) in group G and 13 patients (30.2%) in group F. Bleeding and kinking were the most common complications in both techniques. Using GlideScope visualization to facilitate NGT insertion was comparable to neck flexion with lateral neck pressure technique in degree of success rate of insertion, while neck flexion with lateral neck pressure technique had fewer complications and was less time-consuming.

Keywords: anaesthesia, nasogastric tube, GlideScope, intubation

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Authors: Dorsa Rahi, Arghavan Tonkanbonbi, Soheila Manifar, Behzad Jafvarnejad

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Background and Aim: Intraoral manipulation is performed during endotracheal intubation for general anesthesia, which can traumatize the soft and hard tissue in the oral cavity and cause postoperative pain and discomfort. Dental trauma is the most common complication of intubation. This study aimed to assess the prevalence of dental complications due to intubation in patients hospitalized in Imam Khomeini Hospital during 2018-2019. Materials and Methods: A total of 805 patients presenting to the Cancer Institute of Imam Khomeini Hospital for preoperative anesthesia consultation were randomly enrolled. A dentist interviewed the patients and performed a comprehensive clinical oral examination preoperatively. The patients underwent clinical oral examination by another dentist postoperatively. Results: No significant correlation was found between dental trauma (tooth fracture, tooth mobility, or soft tissue injury) after intubation with the age or gender of patients. According to the Wilcoxon test and McNemar-Bowker Test, the rate of mobility before the intubation was significantly different from that after the intubation (P=0.000). Maxillary central incisors, maxillary left canine and mandibular right and left central incisors had the highest rate of fracture. Conclusion: Mobile teeth before the intubation are at higher risk of avulsion and aspiration during the procedure. Patients with primary temporomandibular joint disorders are more susceptible to post-intubation trismus.

Keywords: oral trauma, dental trauma, intubation, anesthesia

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Authors: Mateusz Paszko, Ksenia Siadkowska

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Due to the low-altitude and relatively low-speed flight, helicopters are easy targets for actual combat assets e.g. infrared-guided missiles. Current techniques aim to increase the combat effectiveness of the military helicopters. Protection of the helicopter in flight from early detection, tracking and finally destruction can be realized in many ways. One of them is cooling hot exhaust gasses, emitting from the engines to the atmosphere in special heat exchangers. Nowadays, this process is realized in ejective coolers, where strong heat and momentum exchange between hot exhaust gases and cold air ejected from atmosphere takes place. Flow effects of air, exhaust gases; mixture of those two and the heat transfer between cold air and hot exhaust gases are given by differential equations of: Mass transportation–flow continuity, ejection of cold air through expanding exhaust gasses, conservation of momentum, energy and physical relationship equations. Calculation of those processes in ejective cooler by means of classic mathematical analysis is extremely hard or even impossible. Because of this, it is necessary to apply the numeric approach with modern, numeric computer programs. The paper discussed the general usability of the Computational Fluid Dynamics (CFD) in a process of projecting the ejective exhaust gases cooler cooperating with helicopter turbine engine. In this work, the CFD calculations have been performed for ejective-based cooler cooperating with the PA W3 helicopter’s engines.

Keywords: aviation, CFD analysis, ejective-cooler, helicopter techniques

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Authors: Rinaldi Ikhram, R. A. Julia Satriani

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The discovery of historical objects in Indonesia, especially in the area around Bandung and Priangan zone in general, have been inventorized and recorded by Dutch geologists during the colonial time. Among artefacts such as axes made of chalcedony and quartzite; arrowheads, knives, shrivel, and drill bit all made from obsidian; grindstones, even bracelet from stones. Ceramic mold for smelting bronze or iron were also found. The abundance of artefacts inspired DR. W. Docters van Leeuwen and his colleagues to initiate the establishment of Sunda Open-air Museum "Soenda Openlucht Museum" in 1917, located in the hills of North Bandung area, the site of pre-historic settlements that needs conservation. Unfortunately, this plan was not implemented because shortly after, World War II occurred. The efforts of heritage conservation is one of our responsibilities as a geologist today. Open-air Museum may be one of the solutions of heritage conservation for historic sites around the world. In this paper, the study of the development of Open-air Museum will be focused on the area of Dago, North Bandung. Method used is data analysis of field surveys, and data analysis of the remaining artefacts stored at both the National Museum in Jakarta, and the Bandung Museum of Geology. The museum is based on Geotourism and further research on pre-historic culture, while its purpose is to give people a common interest and to motivate them to participate in the research and conservation of pre-historic relics. This paper will describe more details about the concept, form, and management of the geopark and the Open-air Museum within.

Keywords: geoparks, heritage conservation, open-air museum, sustainable tourism

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Authors: Nargiz Ismayilova

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The issue of modernism and the concept of postmodernism has been the focus of world researchers for many years, and there are very few researchers who have come to a common denominator about this term. During the independence period, the expansion of the relations of Azerbaijani literature with the world has led to the spread of many currents and tendencies formed in the West to the literary environment in our country. In this context, the works created in our environment are distinguished by their extreme richness in terms of subject matter and diversity in terms of genre. As an interesting example of contemporary postmodern prose in Azerbaijan, Parviz Jabrayil's novel "In a Foreign Language" pays attention with its more different plotline. The disagreement exists among the critics about the novel. Some are looking for high artistry in work; others are satisfied with the elements of postmodernism in work. Delimitation of the border between modernism and postmodernism can serve to carry out a deep scientific study of the novel. The novel depicts the world in the author's consciousness against the background of water shortage (thirst) in the Old City (Icharishahar). The author deconstructs today's Ichari Shahar mould. Along with modernism, elements of postmodernism occupy a large place in the work. When we look at the general tendencies of postmodernist art, we see that science and individuality are questioned, criticizing the sharp boundaries of modernism and the negativity of these restrictions, and modernism offers alternatives to artistic production by identifying its negatives and shortcomings in the areas of artistic freedom. The novel is extremely interesting in this point of view.

Keywords: concept of postmodernism, modernism, delimitation, political postmodernism, modern postmodern prose, Azerbaijani literature, novel, comparison, world literature, analysis

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Authors: Gregor Moncrieff, Ursula Bahlmann

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A number of incident reports were filed from the intensive care unit with regards to adult patients admitted following operations who had a central venous catheter inserted of the incorrect length for the relevant anatomical site and catheters not compatible with pressurised injection inserted whilst in theatre. Incorrect catheter length can lead to a variety of complications and pressurised injection is a requirement for contrast enhanced computerised tomography scans. This led to several patients having a repeat procedure to insert a catheter of the correct length and also compatible with pressurised injection. This project aimed to identify the types of central venous catheters used in theatres and ensure the correct equipment would be stocked and used in future cases in accordance the existing Association of Anaesthetics of Great Britain and Northern Ireland guidelines. A questionnaire was sent out to all of the anaesthetic department in our hospital aiming to determine what types of central venous catheters were preferably used by anaesthetists and why these had been chosen. We also explored any concerns regarding introduction of standardised, pressure injectable central venous catheters to the theatre department which were already in use in other parts of the hospital and in keeping with national guidance. A total of 56 responses were collected. 64% of respondents routinely used a central venous catheter which was significantly shorter than the national recommended guidance with a further 4 different types of central venous catheters used which were different to other areas of the hospital and not pressure injectable. 75% of respondents were in agreement to standardised introduction of the pressure injectable catheters of the recommended length in accordance with national guidance. Reasons why 25% respondents were opposed to introduction of these catheters were explored and discussed. We were successfully able to introduce the standardised central catheters to the theatre department following presentation at the local anaesthetic quality and safety meeting. Reasons against introduction of the catheters were discussed and a compromise was reached that the existing catheters would continue to be stocked but would only be available on request, with a focus on encouraging use of the standardised catheters. Additional changes achieved included removing redundant catheters from the theatre stock. Ongoing data is being collected to analyse positive and negative feedback from use of the introduced catheters.

Keywords: central venous catheter, medical equipment, medical safety, quality improvement

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Authors: Mitra Abtahi, Esmat Nasseri, Morteza Abodllahi

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Introduction: Adequate hydration is necessary for proper physical and mental function. The aim of this study is to determine the consumption of water and all other beverages in children (8-13 years) and adolescents (14-17 years) in Tehran metropolitan city of Iran. Materials and Methods: In this cross-sectional study, 455 children (8-13 years) and 334 adolescents (14-17 years) were retrieved from north, center, and south of Tehran (18 schools). Instrument for data collection consisted of a “demographic and general health” questionnaire and a “7-day fluid record”. Data analyses were performed with SPSS 16 software. Results: The mean total consumption of fluids in school children was 1302 ± 500.6 ml/day. The highest mean intakes were observed for water (666 ± 398 ml/day), followed by milk (239 ± 183 ml/day), regular soft beverages (RSB) (188 ± 148 ml/day), and juices (60 ± 74 ml/day). Water, hot drinks (mainly tea) and soft drinks intake was significantly more in boys than girls. A significantly lower intake of milk and a higher intake of RSB and hot beverages (mainly tea) have been seen among adolescents compared to children. Conclusion: The most important finding is that mean fluid intake of children and adolescents does not meet international adequate intake references for water and fluids. This finding may suggest the necessity of development of the local references. To improve fluid intake habits of children and adolescents, relevant policy making and actions are warranted.

Keywords: adolescents, beverages, children, water

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Authors: Owus Mathias Ibearugbulem

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The study presents Euler-Bernoulli’s approach for buckling analysis of thick rectangular plates using alternative I refined theory. No earlier study, to the best knowledge of the author, based on the literature available to this research, applied Euler-Bernoulli’s approach in the alternative I refined theory for buckling analysis of thick rectangular plates. In this study, basic kinematics and constitutive relations for thick rectangular plates are employed in the differential equations of equilibrium of stresses in a deformable elemental body to obtain alternative I governing differential equations of thick rectangular plates and the corresponding compatibility equations. Solving these equations resulted in a general deflection function of a thick rectangular plate. Using this function and satisfying the boundary conditions of three plates, their peculiar deflection functions are obtained. Going further, the study determined the non-dimensional critical buckling loads of the six plates. Values of the non-dimensional critical buckling load from the present study are compared with those from a three-dimensional buckling analysis of a thick plate. The highest percentage difference recorded for the plates: all edges simply supported (ssss), all edges clamped (cccc) and adjacent edges clamped with the other edges simply supported (ccss) are 3.31%, 5.57% and 3.38% respectively.

Keywords: Euler-Bernoulli, buckling, alternative I, kinematics, constitutive relation, governing differential equation, compatibility equation, thick plate

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Authors: Nader Khalafian, Mohsen Ghaderi

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Field observations have revealed many examples of structures which were damaged due to ground surface deformation caused by the faulting phenomena. In this paper some efforts were made in order to estimate the length and location of the ground surface where large displacements were created due to the reverse faulting. This research has conducted in two steps; (1) in the first step, a 2D explicit finite element model were developed using ABAQUS software. A subroutine for Mohr-Coulomb failure criterion with strain softening model was developed by the authors in order to properly model the stress strain behavior of the soil in the fault rapture zone. The results of the numerical analysis were verified with the results of available centrifuge experiments. Reasonable coincidence was found between the numerical and experimental data. (2) In the second step, the effects of the fault dip angle (δ), depth of soil layer (H), dilation and friction angle of sand (ψ and φ) and the amount of fault offset (d) on the soil surface displacement and fault rupture path were investigated. An artificial neural network-based model (ANN), as a powerful prediction tool, was developed to generate a general model for predicting faulting characteristics. A properly sized database was created to train and test network. It was found that the length and location of the zone of displaced ground surface can be accurately estimated using the proposed model.

Keywords: reverse faulting, surface deformation, numerical, neural network

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Authors: Ghazal Mortazavi, S. M. J. Mortazavi

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Although seems to be ultra-conservative, it has recently been suggested that whenever it is possible, pregnant women should postpone dental amalgam restorations to avoid the toxic effect of mercury on the foetus. Dental amalgam fillings cause significant exposure to elemental mercury vapour in the general population. Over the past several years, our lab has focused on the health effects of exposure of laboratory animals and humans to different sources of electromagnetic fields such as mobile phones and their base stations, mobile phone jammers, laptop computers, radars, dentistry cavitrons and MRI. Today, substantial evidence indicates that mercury even at low doses may lead to toxicity. Increased release of mercury from dental amalgam fillings after exposure to MRI or microwave radiation emitted by mobile phones has been previously shown by our team. Moreover, our recent studies on the effects of stronger magnetic fields entirely confirmed our previous findings. From the other point of view, we have also shown that papers which reported no increased release of mercury after MRI, may have some methodological flaws. As a strong positive correlation between maternal and cord blood mercury levels has been found in some studies, our findings regarding the effect of exposure to electromagnetic fields on the release of mercury from dental amalgam fillings lead us to this conclusion that pregnant women with dental amalgam fillings should limit their exposure to electromagnetic fields to prevent toxic effects of mercury in their foetuses.

Keywords: pregnancy, foetus, mercury release, dental amalgam, electromagnetic fields, MRI, mobile phones

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Authors: Genady Shlomper

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During the process of language teaching, each teacher faces some general and some specific problems. Some of these problems are mutual to all languages because they yield to the rules of cognition, conscience, perception, understanding and memory; to the physiological and psychological principles pertaining to the human race irrespective of origin and nationality. Still, every language is a distinctive system, possessing individual properties and an obvious identity, as a result of a development in specific natural, geographical, cultural and historical conditions. The individual properties emerge in the script, in the phonetics, morphology and syntax. All these problems can and should be a subject of a detailed research and scientific analysis, mainly from practical considerations and language teaching requirements. There are some formidable obstacles in the language acquisition process. Among the first to be mentioned is the existence of concepts and entire categories in foreign languages, which are absent in the language of the students. Such phenomena reflect specific ways of thinking and the world-outlook, which were shaped during the evolution. Hindi is the national language of India, which belongs to the group of Indo-Iranian languages from the Indo-European family of languages. The lecturer has gained experience in teaching Hindi language to native speakers of Uzbek, Russian and Hebrew languages. He will show the difficulties in the field of phonetics, morphology and syntax, which the students have to deal with during the acquisition of the language. In the proposed lecture the lecturer will share his experience in making the process of language teaching more efficient by using non-formal semantic approach.

Keywords: applied linguistics, foreign language teaching, language teaching methodology, semantics

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Authors: Lakhoua Najeh

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Aims of the work: After a presentation of the functionality of an example of a mechatronic system which is a paint mixer system, we present the concepts of modeling and safe operation. This paper briefly discusses how to model and protect the functioning of a mechatronic system relying mainly on functional analysis and safe operation techniques. Methods: For the study of an example of a mechatronic system, we use methods for external functional analysis that illustrate the relationships between a mechatronic system and its external environment. Thus, we present the Safe-Structured Analysis Design Technique method (Safe-SADT) which allows the representation of a mechatronic system. A model of operating safety and automation is proposed. This model enables us to use a functional analysis technique of the mechatronic system based on the GRAFCET (Graphe Fonctionnel de Commande des Etapes et Transitions: Step Transition Function Chart) method; study of the safe operation of the mechatronic system based on the Safe-SADT method; automation of the mechatronic system based on a software tool. Results: The expected results are to propose a model and safe operation of a mechatronic system. This methodology enables us to analyze the relevance of the different models based on Safe-SADT and GRAFCET in relation to the control and monitoring functions and to study the means allowing exploiting their synergy. Conclusion: In order to propose a general model of a mechatronic system, a model of analysis, safety operation and automation of a mechatronic system has been developed. This is how we propose to validate this methodology through a case study of a paint mixer system.

Keywords: mechatronic systems, system modeling, safe operation, Safe-SADT

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Authors: Ophir Nave

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In our research, we present the concept of singularly perturbed vector field (SPVF) method, and its application to thermal explosion of diesel spray combustion. Given a system of governing equations, which consist of hidden Multi-scale variables, the SPVF method transfer and decompose such system to fast and slow singularly perturbed subsystems (SPS). The SPVF method enables us to understand the complex system, and simplify the calculations. Later powerful analytical, numerical and asymptotic methods (e.g method of integral (invariant) manifold (MIM), the homotopy analysis method (HAM) etc.) can be applied to each subsystem. We compare the results obtained by the methods of integral invariant manifold and SPVF apply to spray droplets combustion model. The research deals with the development of an innovative method for extracting fast and slow variables in physical mathematical models. The method that we developed called singular perturbed vector field. This method based on a numerical algorithm applied to global quasi linearization applied to given physical model. The SPVF method applied successfully to combustion processes. Our results were compared to experimentally results. The SPVF is a general numerical and asymptotical method that reveals the hierarchy (multi-scale system) of a given system.

Keywords: polydisperse spray, model reduction, asymptotic analysis, multi-scale systems

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Authors: Alam Zeb, Glen W. Armstrong, Muhammad Qasim

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Loss of forest cover is one of the most important land cover changes and has been of great concern to policy makers. This study quantified forest cover changes over pre logging ban (1973-1993) and post logging ban (1993-2015) to examine the role of geophysical factors and spatial attributes of land in the two periods. We show that despite a complete ban on green felling, forest cover decreased by 28% and mostly converted to rangeland. Nevertheless, the logging ban was completely effective in controlling agriculture expansion. The binary logistic regression revealed that the south facing aspects at low elevation witnessed more deforestation in the pre-ban period compared to post-ban. Opposite to deforestation, forest degradation was more prominent on the northern aspects at higher elevation during the policy period. Agriculture expansion was widespread in the low elevation flat areas with gentle slope, while during the policy period agriculture contraction in the form of regeneration was observed on the low elevation areas of north facing slopes. All proximity variables, except distance to administrative boundary, showed a similar trend across the two periods and were important explanatory variables in understanding forest and agriculture expansion. The changes in determinants of forest and agriculture expansion and contraction over the two periods might be attributed to the influence of policy and a general decrease in resource availability.

Keywords: forest conservation , wood harvesting ban, logistic regression, deforestation, forest degradation, agriculture expansion, Chitral, Pakistan

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Authors: Sukhwinder K. Bhullar, M. B. G. Jun

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The developments in biomedical industry have demanded the development of biocompatible, high performance materials to meet higher engineering specifications. The general requirements of such materials are to provide a combination of high stiffness and strength with significant weight savings, resistance to corrosion, chemical resistance, low maintenance, and reduced costs. Auxetic materials which come under the category of smart materials offer huge potential through measured enhancements in mechanical properties. Unique deformation mechanism, providing cushioning on indentation, automatically adjustable with its strength and thickness in response to forces and having memory returns to its neutral state on dissipation of stresses make them good candidate in biomedical industry. As simple extension and compression of tissues is of fundamental importance in biomechanics, therefore, to study the elastic behaviour of auxetic soft tissues implant is targeted in this paper. Therefore development and characterization of auxetic soft tissue implant is studied in this paper. This represents a real life configuration where soft tissue such as meniscus in knee replacement, ligaments and tendons often are taken as transversely isotropic. Further, as composition of alternating polydisperse blocks of soft and stiff segments combined with excellent biocompatibility make polyurethanes one of the most promising synthetic biomaterials. Hence selecting auxetic polyurathylene foam functional characterization is performed and compared with conventional polyurathylene foam.

Keywords: auxetic materials, deformation mechanism, enhanced mechanical properties, soft tissues

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Authors: June Keeling, Christina Athanasiades, Vaiva Hendrixson, Delyth Wyndham

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Recognition and education in violence, abuse, and neglect for medical and healthcare practitioners (REVAMP) is a trans-European project aiming to introduce a training programme that has been specifically developed by partners across seven European countries to meet the needs of medical and healthcare practitioners. Amalgamating the knowledge and experience of clinicians, researchers, and educators from interdisciplinary and multi-professional backgrounds, REVAMP has tackled the under-resourced and underdeveloped area of domestic violence and abuse. The team designed an online training programme to support medical and healthcare practitioners to recognise and respond appropriately to survivors of domestic violence and abuse at their point of contact with a health provider. The REVAMP partner countries include Europe: France, Lithuania, Germany, Greece, Iceland, Norway, and the UK. The training is delivered through a series of interactive online modules, adapting evidence-based pedagogical approaches to learning. Capturing and addressing the complexities of the project impacted the methodological decisions and approaches to evaluation. The challenge was to find an evaluation methodology that captured valid data across all partner languages to demonstrate the extent of the change in knowledge and understanding. Co-development by all team members was a lengthy iterative process, challenged by a lack of consistency in terminology. A mixed methods approach enabled both qualitative and quantitative data to be collected, at the start, during, and at the conclusion of the training for the purposes of evaluation. The module content and evaluation instrument were accessible in each partner country's language. Collecting both types of data provided a high-level snapshot of attainment via the quantitative dataset and an in-depth understanding of the impact of the training from the qualitative dataset. The analysis was mixed methods, with integration at multiple interfaces. The primary focus of the analysis was to support the overall project evaluation for the funding agency. A key project outcome was identifying that the trans-European approach posed several challenges. Firstly, the project partners did not share a first language or a legal or professional approach to domestic abuse and neglect. This was negotiated through complex, systematic, and iterative interaction between team members so that consensus could be achieved. Secondly, the context of the data collection in several different cultural, educational, and healthcare systems across Europe challenged the development of a robust evaluation. The participants in the pilot evaluation shared that the training was contemporary, well-designed, and of great relevance to inform practice. Initial results from the evaluation indicated that the participants were drawn from more than eight partner countries due to the online nature of the training. The primary results indicated a high level of engagement with the content and achievement through the online assessment. The main finding was that the participants perceived the impact of domestic abuse and neglect in very different ways in their individual professional contexts. Most significantly, the participants recognised the need for the training and the gap that existed previously. It is notable that a mixed-methods evaluation of a trans-European project is unusual at this scale.

Keywords: domestic violence, e-learning, health professionals, trans-European

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Authors: Mina Samizadeh

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In the past few decades, there has been an explosion in the amount of available data produced from various sources with different topics. The availability of this enormous data necessitates us to adopt effective computational tools to explore the data. This leads to an intense growing interest in the research community to develop computational methods focused on processing this text data. A line of study focused on condensing the text so that we are able to get a higher level of understanding in a shorter time. The two important tasks to do this are keyword extraction and text summarization. In keyword extraction, we are interested in finding the key important words from a text. This makes us familiar with the general topic of a text. In text summarization, we are interested in producing a short-length text which includes important information about the document. The TextRank algorithm, an unsupervised learning method that is an extension of the PageRank (algorithm which is the base algorithm of Google search engine for searching pages and ranking them), has shown its efficacy in large-scale text mining, especially for text summarization and keyword extraction. This algorithm can automatically extract the important parts of a text (keywords or sentences) and declare them as a result. However, this algorithm neglects the semantic similarity between the different parts. In this work, we improved the results of the TextRank algorithm by incorporating the semantic similarity between parts of the text. Aside from keyword extraction and text summarization, we develop a topic clustering algorithm based on our framework, which can be used individually or as a part of generating the summary to overcome coverage problems.

Keywords: keyword extraction, n-gram extraction, text summarization, topic clustering, semantic analysis

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Authors: Veenapani Rajeev Verma

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Context: Assessing facility readiness is paramount as it can indicate capacity of facilities to provide essential care for resilience to health challenges. In the context of decentralization, estimation of supply side readiness indices at sub national level is imperative for effective evidence based policy but remains a colossal challenge due to lack of dependable and representative data sources. Setting: District Poonch of Jammu and Kashmir was selected for this study. It is remote, rural district with unprecedented topographical barriers and is identified as high priority by government. It is also a fragile area as is bounded by Line of Control with Pakistan bearing the brunt of cease fire violations, military skirmishes and sporadic militant attacks. Hilly geographical terrain, rudimentary/absence of road network and impoverishment are quintessential to this area. Objectives: Objective of the study is to a) Evaluate the service readiness of health facilities and create a concise index subsuming plethora of discrete indicators and b) Ascertain supply side barriers in service provisioning via stakeholder’s analysis. Study also strives to expand analytical domain unravelling context and area specific intricacies associated with service delivery. Methodology: Mixed method approach was employed to triangulate quantitative analysis with qualitative nuances. Facility survey encompassing 90 Subcentres, 44 Primary health centres, 3 Community health centres and 1 District hospital was conducted to gauge general service availability and service specific availability (depth of coverage). Compendium of checklist was designed using Indian Public Health Standards (IPHS) in form of standard core questionnaire and scorecard generated for each facility. Information was collected across dimensions of amenities, equipment, medicines, laboratory and infection control protocols as proposed in WHO’s Service Availability and Readiness Assesment (SARA). Two stage polychoric principal component analysis employed to generate a parsimonious index by coalescing an array of tracer indicators. OLS regression method used to determine factors explaining composite index generated from PCA. Stakeholder analysis was conducted to discern qualitative information. Myriad of techniques like observations, key informant interviews and focus group discussions using semi structured questionnaires on both leaders and laggards were administered for critical stakeholder’s analysis. Results: General readiness score of health facilities was found to be 0.48. Results indicated poorest readiness for subcentres and PHC’s (first point of contact) with composite score of 0.47 and 0.41 respectively. For primary care facilities; principal component was characterized by basic newborn care as well as preparedness for delivery. Results revealed availability of equipment and surgical preparedness having lowest score (0.46 and 0.47) for facilities providing secondary care. Presence of contractual staff, more than 1 hr walk to facility, facilities in zone A (most vulnerable) to cross border shelling and facilities inaccessible due to snowfall and thick jungles was negatively associated with readiness index. Nonchalant staff attitude, unavailability of staff quarters, leakages and constraint in supply chain of drugs and consumables were other impediments identified. Conclusions/Policy Implications: It is pertinent to first strengthen primary care facilities in this setting. Complex dimensions such as geographic barriers, user and provider behavior is not under precinct of this methodology.

Keywords: effective coverage, principal component analysis, readiness index, universal health coverage

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Authors: Sameh Abaza, Mohamed Ibrahim, Tarek Mahmoud

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Due to the development in the digital image processing, its wide use in many applications such as medical, security, and others, the need for more accurate techniques that are reliable, fast and robust is vehemently demanded. In the field of security, in particular, speed is of the essence. In this paper, a pattern recognition technique that is based on the use of Hidden Markov Model (HMM), K-means and the Sobel operator method is developed. The proposed technique is proved to be fast with respect to some other techniques that are investigated for comparison. Moreover, it shows its capability of recognizing the normal face (center part) as well as face boundary.

Keywords: HMM, K-Means, Sobel, accuracy, face recognition

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Authors: Essam Mansour

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The key purpose of this study is to show information-seeking behaviour of Kuwaiti Judges (KJs). Being one of the few studies about the information needs and information-seeking behaviour conducted in Arab and developing countries, this study is a pioneer one among many studies conducted in information seeking, especially with this significant group of information users. The authors tried to investigate this seeking behavior in terms of KJs' thoughts, perceptions, motivations, techniques, preferences, tools and barriers met when seeking information. The authors employed a questionnaire, with a response rate 77.2 percent. This study showed that most of KJs were likely to be older, educated and with a work experience ranged from new to old experience. There is a statistically reliable significant difference between KJs' demographic characteristics and some sources of information, such as books, encyclopedias, references and mass media. KJs were using information moderately to make a decision, to be in line with current events, to collect statistics and to make a specific/general research. The office and home were the most frequent location KJs were accessing information from. KJs' efficiency level of the English language is described to be moderately good, and a little number of them confirmed that their efficiency level of French was not bad. The assistance provided by colleagues, followed by consultants, translators, sectaries and librarians were found to be most strong types of assistance needed when seeking information. Mobile apps, followed by PCs, information networks (the Internet) and information databases were the highest technology tool used by KJs. Printed materials, followed by non-printed and audiovisual materials were the most preferred information formats KJs use. The use of languages, the recency of information and the place of information, the deficit role of the library to deliver information were at least significant barriers to KJs when seeking information.

Keywords: information users, information-seeking behaviour, information needs, judges, Kuwait

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Authors: G. Salavwa, P. Erhijakpor Jr., H. Ukwu

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This study will explore child labour issues in Nigeria because it is capable of affecting the physical and general well-being of children who perform hazardous work. This feat will be achieved through qualitative research methodology. Data collection shall be elicited by oral interviews and documental content analysis to delve on the application of the Convention on the Rights of the Child (CRC), International Labour Organization ILO and Geneva Convention relating to child labour practices in Nigeria. This will include the relevance of present domestic laws relating to child labour as implemented in Nigeria, together with factors that contribute to the practice of child labour in the country. The oral interview data analysis will be performed by breaking the interview data into significant statements and themes. This shall be done by comparing and determining the commonalities that are prevalent in the participants’ views regarding child labour menace in Nigeria. Presumably, findings from this study shall unveil that a poor educational policy, a widespread poverty level which is mostly prevalent amongst families in the rural areas of the country, a lack of employment for adults, have led to the ineffectiveness of the local child labour laws in Nigeria. These has in turn culminated into a somewhat non-implementation of the international laws of the CRC, ILO and Geneva Declaration on child labour to which the Nigerian government is a signatory. Based on the finding, this study will calls on the government of Nigeria to extend its free educational policy from the elementary, secondary to tertiary educations. The government also has to ensure that offenders of children’s rights should face a severe punishment.

Keywords: commonalities, tertiary, constitution, qualitative

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Authors: Daniela Salih Khidir, Mohamed G. Al Kuwari, Mercia V. Walt, Izzeldin J. Ibrahim

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Background: University-based physical activity interventions aim to establish durable social patterns during the transition to adulthood. This study is a comprehensive evaluation of a 3-year intervention-based program to increase the culture of physical activity (PA) routine in Qatar campuses community, using a holistic approach. Methodology: General assessment methods: formative evaluation-SIH Campuses logic model design, stakeholders’ identification; process evaluation-members’ step counts analyze and qualitative Appreciative Inquiry session (4-D model); daily steps categorized as: ≤5,000, inactive; 5,000-7,499 low active; ≥7,500, physically active; outcome evaluation - records 3 years interventions. Holistic PA interventions methods: walking interventions - pedometers distributions and walking competitions for students and staff; educational interventions - in campuses implementation of bilingual educational materials, lectures, video related to PA in prevention of non-communicable diseases (NCD); articles published online; monthly emails and sms notifications for pedometer use; mass media campaign - radio advertising, yearly pre/post press releases; community stakeholders interventions-biyearly planning/reporting/achievements rewarding/ qualitative meetings; continuous follow-up communication, biweekly steps reports. Findings: Results formative evaluation - SIH in Campuses logic model identified the need of PA awareness and education within universities, resources, activities, health benefits, program continuity. Results process evaluation: walking interventions: Phase 1: 5 universities recruited, 2352 members, 3 months competition; Phase 2: 6 new universities recruited, 1328 members in addition, 4 months competition; Phase 3: 4 new universities recruited in addition, 1210 members, 6 months competition. Results phase 1 and 2: 1,299 members eligible for analyzes: 800 females (62%), 499 males (38%); 86% non-Qataris, 14% Qatari nationals, daily step count 5,681 steps, age groups 18–24 (n=841; 68%) students, 25–64; (n=458; 35.3%) staff; 38% - low active, 37% physically active and 25% inactive. The AI main themes engaging stakeholders: awareness/education - 5 points (100%); competition, multi levels of involvement in SIH, community-based program/motivation - 4 points each (80%). The AI points represent themes’ repetition within stakeholders’ discussions. Results education interventions: 2 videos implementation, 35 000 educational materials, 3 online articles, 11 walking benefits lectures, 40 emails and sms notifications. Results community stakeholders’ interventions: 6 stakeholders meetings, 3 rewarding gatherings, 1 focus meeting, 40 individual reports, 18 overall reports. Results mass media campaign: 1 radio campaign, 7 press releases, 52 campuses newsletters. Results outcome evaluation: overall 2013-2016, the study used: 1 logic model, 3 PA holistic interventions, partnerships 15 universities, registered 4890 students and staff (aged 18-64 years), engaged 30 campuses stakeholders and 14 internal stakeholders; Total registered population: 61.5% female (2999), 38.5% male (1891), 20.2% (988) Qatari nationals, 79.8% (3902) non-Qataris, 55.5% (2710) students aged 18 – 25 years, 44.5% (2180) staff aged 26 - 64 years. Overall campaign 1,558 members eligible for analyzes: daily step count 7,923; 37% - low active, 43% physically active and 20% inactive. Conclusion: The study outcomes confirm program effectiveness and engagement of young campuses community, specifically female, in PA. The authors recommend implementations of 'holistic PA intervention program approach in Qatar' aiming to impact the community at national level for PA guidelines achievement in support of NCD prevention.

Keywords: campuses, evaluation, Qatar, step-count

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Authors: Forrest Kaatz, Adhemar Bultheel

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We use an informational statistical mechanics approach to study the catalytic thermodynamics of platinum and palladium cuboctahedral nanoclusters. Nanoclusters and their adatoms are viewed as chemical graphs with a nearest neighbor adjacency matrix. We use the Morse potential to determine bond energies between cluster atoms in a coordination type calculation. We use adsorbate energies calculated from density functional theory (DFT) to study the adatom effects on the thermodynamic quantities, which are derived from a Hamiltonian. Oxygen radical and molecular adsorbates are studied on platinum clusters and hydrogen on palladium clusters. We calculate the entropy, free energy, and total energy as the coverage of adsorbates increases from bridge and hollow sites on the surface. Thermodynamic behavior versus adatom coverage is related to the structural distribution of adatoms on the nanocluster surfaces. The thermodynamic functions are characterized using a simple adsorption model, with linear trends as the coverage of adatoms increases. The data exhibits size effects for the measured thermodynamic properties with cluster diameters between 2 and 5 nm. Entropy and enthalpy calculations of Pt-O2 compare well with previous theoretical data for Pt(111)-O2, and our Pd-H results show similar trends as experimental measurements for Pd-H2 nanoclusters. Our methods are general and may be applied to wide variety of nanocluster adsorbate systems.

Keywords: catalytic thermodynamics, palladium nanocluster absorbates, platinum nanocluster absorbates, statistical mechanics

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Authors: Saleh Alumaran, Giampaolo Bella, Feng Chen

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The study of organisations’ information security cultures has attracted scholars as well as healthcare services industry to research the topic and find appropriate tools and approaches to develop a positive culture. The vast majority of studies in Saudi national health services are on the use of technology to protect and secure health services information. On the other hand, there is a lack of research on the role and impact of an organisation’s cultural dimensions on information security. This research investigated and analysed the role and impact of cultural dimensions on information security in Saudi Arabia health service. Hypotheses were tested and two surveys were carried out in order to collect data and information from three major hospitals in Saudi Arabia (SA). The first survey identified the main cultural-dimension problems in SA health services and developed an initial information security culture framework model. The second survey evaluated and tested the developed framework model to test its usefulness, reliability and applicability. The model is based on human behaviour theory, where the individual’s attitude is the key element of the individual’s intention to behave as well as of his or her actual behaviour. The research identified six cultural dimensions: Saudi national culture, Saudi health service leadership, employees’ trust, technology, multicultural interactions and employees’ job roles. The research also identified a set of cultural sub-dimensions. These include working values and norms, tribe values and norms, attitudes towards women, power sharing, vision, social interaction, respect and understanding, hospital intra-net, hospital employees’ language(s) used, multi-national culture, communication system, employees’ job satisfaction and job security. The research identified that (a) the human behaviour towards medical information in SA is one of the main threats to information security and one of the main challenges to SA health authority, (b) The current situation of SA hospitals’ IS cultures is falling short in protecting medical information due to the current value and norms towards information security, (c) Saudi national culture and employees’ job role are the main dimensions playing major roles in the employees’ attitude, and technology is the least important dimension playing a role in the employees’ attitudes.

Keywords: cultural dimension, electronic health record, information security, privacy

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Authors: Adesoji Tunbosun Jaiyeola, Josiah Adeyemo

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Sediment yield can be considered to be the total sediment load that leaves a drainage basin. The knowledge of the quantity of sediments present in a river at a particular time can lead to better flood capacity in reservoirs and consequently help to control over-bane flooding. Furthermore, as sediment accumulates in the reservoir, it gradually loses its ability to store water for the purposes for which it was built. The development of hydrological models to forecast the quantity of sediment present in a reservoir helps planners and managers of water resources systems, to understand the system better in terms of its problems and alternative ways to address them. The application of artificial intelligence models and technique to such real-life situations have proven to be an effective approach of solving complex problems. This paper makes an extensive review of literature relevant to the theories and applications of evolutionary algorithms, and most especially genetic programming. The successful applications of genetic programming as a soft computing technique were reviewed in sediment modelling and other branches of knowledge. Some fundamental issues such as benchmark, generalization ability, bloat and over-fitting and other open issues relating to the working principles of GP, which needs to be addressed by the GP community were also highlighted. This review aim to give GP theoreticians, researchers and the general community of GP enough research direction, valuable guide and also keep all stakeholders abreast of the issues which need attention during the next decade for the advancement of GP.

Keywords: benchmark, bloat, generalization, genetic programming, over-fitting, sediment yield

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Authors: Janis E. Campbell

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Most of what is known about complementary, alternative or traditional medicine (CATM) in the United States today is known from either the National Health Interview Survey a cross-sectional survey with a few questions or from small cross-sectional or cohort studies with specific populations. The broad geographical distribution in CATM use or providers is not known. For this project, we used geospatial cluster analysis to determine if there were clusters of CATM provider by county in the US. In this analysis, we used the National Provider Index to determine the geographic distribution of providers in the US. Of the 215,769 CAMT providers 211,603 resided in the contiguous US: Acupuncturist (26,563); Art, Poetry, Music and Dance Therapist (2,752); Chiropractor (89,514); Doula/Midwife (3,535); Exercise (507); Homeopath (380); Massage Therapist (36,540); Mechanotherapist (1,888); Naprapath (146); Naturopath (4,782); Nutrition (42,036); Reflexologist (522); Religious (2,438). ESRI® spatial autocorrelation was used to determine if the geographic location of CATM providers were random or clustered. For global analysis, we used Getis-Ord General G and for Local Indicators of Spatial Associations with an Optimized Hot Spot Analysis using an alpha of 0.05. Overall, CATM providers were clustered with both low and high. With Chiropractors, focusing in the Midwest, religious providers having very small clusters in the central US, and other types of CAMT focused in the northwest and west coast, Colorado and New Mexico, the great lakes areas and Florida. We will discuss some of the implications of this study, including associations with health, economic, social, and political systems.

Keywords: complementary medicine, alternative medicine, geospatial, United States

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Authors: Paola Causin, Andrea Aspri, Alessandro Benfenati

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Diffuse Optical Tomography (DOT) is an emergent medical imaging technique which employs NIR light to estimate the spatial distribution of optical coefficients in biological tissues for diagnostic purposes, in a noninvasive and non-ionizing manner. DOT reconstruction is a severely ill-conditioned problem due to prevalent scattering of light in the tissue. In this contribution, we present our research in adopting hybrid knowledgedriven/data-driven approaches which exploit the existence of well assessed physical models and build upon them neural networks integrating the availability of data. Namely, since in this context regularization procedures are mandatory to obtain a reasonable reconstruction [1], we explore the use of neural networks as tools to include prior information on the solution. 2. Materials and Methods The idea underlying our approach is to leverage neural networks to solve PDE-constrained inverse problems of the form 𝒒 ∗ = 𝒂𝒓𝒈 𝒎𝒊𝒏𝒒 𝐃(𝒚, 𝒚̃), (1) where D is a loss function which typically contains a discrepancy measure (or data fidelity) term plus other possible ad-hoc designed terms enforcing specific constraints. In the context of inverse problems like (1), one seeks the optimal set of physical parameters q, given the set of observations y. Moreover, 𝑦̃ is the computable approximation of y, which may be as well obtained from a neural network but also in a classic way via the resolution of a PDE with given input coefficients (forward problem, Fig.1 box ). Due to the severe ill conditioning of the reconstruction problem, we adopt a two-fold approach: i) we restrict the solutions (optical coefficients) to lie in a lower-dimensional subspace generated by auto-decoder type networks. This procedure forms priors of the solution (Fig.1 box ); ii) we use regularization procedures of type 𝒒̂ ∗ = 𝒂𝒓𝒈𝒎𝒊𝒏𝒒 𝐃(𝒚, 𝒚̃)+ 𝑹(𝒒), where 𝑹(𝒒) is a regularization functional depending on regularization parameters which can be fixed a-priori or learned via a neural network in a data-driven modality. To further improve the generalizability of the proposed framework, we also infuse physics knowledge via soft penalty constraints (Fig.1 box ) in the overall optimization procedure (Fig.1 box ). 3. Discussion and Conclusion DOT reconstruction is severely hindered by ill-conditioning. The combined use of data-driven and knowledgedriven elements is beneficial and allows to obtain improved results, especially with a restricted dataset and in presence of variable sources of noise.

Keywords: inverse problem in tomography, deep learning, diffuse optical tomography, regularization

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Authors: Xue Wang, Li-Wei Fan

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The technology innovation has become the driving force of social and economic development and transformation. The guidance and support of public policies is an important condition to promote the realization of technology innovation goals. Policy effectiveness evaluation is instructive in policy learning and adjustment. This paper reviews existing studies and systematically evaluates the effectiveness of policy-driven technological innovation. We used 167 articles from WOS and CNKI databases as samples to clarify the measurement of technological innovation indicators and analyze the classification and application of policy evaluation methods. In general, technology innovation input and technological output are the two main aspects of technological innovation index design, among which technological patents are the focus of research, the number of patents reflects the scale of technological innovation, and the quality of patents reflects the value of innovation from multiple aspects. As for policy evaluation methods, statistical analysis methods are applied to the formulation, selection and evaluation of the after-effect of policies to analyze the effect of policy implementation qualitatively and quantitatively. The bibliometric methods are mainly based on the public policy texts, discriminating the inter-government relationship and the multi-dimensional value of the policy. Decision analysis focuses on the establishment and measurement of the comprehensive evaluation index system of public policy. The economic analysis methods focus on the performance and output of technological innovation to test the policy effect. Finally, this paper puts forward the prospect of the future research direction.

Keywords: technology innovation, index, policy effectiveness, evaluation of policy, bibliometric analysis

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Authors: Sajed Yaghoubnezhad, Sedygheh Rezai

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Background and Aim: Since currently in Iran, students with learning disabilities are identified after entering school, and with the approach to the gap between IQ and academic achievement, the purpose of this study is to design and calculate the content validity of the pre-school screening checklist (5-7) exposed to learning difficulties. Methods: This research is a fundamental study, and in terms of data collection method, it is quantitative research with a descriptive approach. In order to design this checklist, after reviewing the research background and theoretical foundations, cognitive abilities (visual processing, auditory processing, phonological awareness, executive functions, spatial visual working memory and fine motor skills) are considered the basic variables of school learning. The basic items and worksheets of the screening checklist of pre-school students 5 to 7 years old with learning difficulties were compiled based on the mentioned abilities and were provided to the specialists in order to calculate the content validity ratio index. Results: Based on the results of the table, the validity of the CVR index of the background information checklist is equal to 0.9, and the CVR index of the performance checklist of preschool children (5 to7 years) is equal to 0.78. In general, the CVR index of this checklist is reported to be 0.84. The results of this study provide good evidence for the validity of the pre-school sieve screening checklist (5-7) exposed to learning difficulties.

Keywords: checklist, screening, preschoolers, learning difficulties

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