Search results for: FPGA tool

Authors: Borislava Dimitrova, Didem Kepir Savoly

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The movie analysis offers a dynamic and multifaceted lens in order to explore and understand various aspects of human behavior and relationship, emotion, and cognition. Cinema therapy can be an important tool for counselor education and counselors in therapy. Therefore, this paper aims to delve deeper into human relationships and individual behavior patterns and analyze some of their most vivid aspects in light of the transactional analysis and its main components. While describing certain human behaviors and emotional states in real life, sometimes it can be difficult even for mental health practitioners to become aware of the subtle social cues and hints that are being transmitted, often in a rushed and swift manner. To address this challenge, the current paper focuses on the relationship dynamics as conveyed through the plot of the movie “Sunset Boulevard”, and examines slightly exaggerated yet true-to-life examples. The movie was directed by Billy Wilder and written by Charles Brackett, Billy Wilder, and D.M. Marshman Jr. The scenes of interest were examined through Transactional Analysis concepts: the different ego states, strokes, the various kinds of transactions, the paradigm of games in transactional analysis, and lastly, with the help of the drama triangle. The addressed themes comprised mainly the way the main characters engaged in game playing, which eventually had a negative outcome on the sequences of interactions between the individuals and the desired payoffs that they craved as a result. Furthermore, counselor educators can use the result of this paper for educational purposes, such as for teaching theoretical knowledge about Transactional Analysis, and for utilizing characters’ interactions and behaviors as real-life situations that can serve as case studies and role-playing activities. Finally, the paper aims to foster the use of movies as materials for psychological analysis which can assist the teaching of new mental health professionals in the field.

Keywords: transactional analysis, movie analysis, drama triangle, games, ego-state

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Authors: Farheen Tabassum, Shoab Ahmed Khan

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The brutality of attacks on networks and decisive infrastructures are on the climb over recent years and appears to continue to do so. Distributed Denial of service attack is the most prevalent and easy attack on the availability of a service due to the easy availability of large botnet computers at cheap price and the general lack of protection against these attacks. Application layer DDoS attack is DDoS attack that is targeted on wed server, application server or database server. These types of attacks are much more sophisticated and challenging as they get around most conventional network security devices because attack traffic often impersonate normal traffic and cannot be recognized by network layer anomalies. Conventional techniques of single-hosted security systems are becoming gradually less effective in the face of such complicated and synchronized multi-front attacks. In order to protect from such attacks and intrusion, corporation among all network devices is essential. To overcome this issue, a collaborative intrusion detection system (CIDS) is proposed in which multiple network devices share valuable information to identify attacks, as a single device might not be capable to sense any malevolent action on its own. So it helps us to take decision after analyzing the information collected from different sources. This novel attack detection technique helps to detect seemingly benign packets that target the availability of the critical infrastructure, and the proposed solution methodology shall enable the incident response teams to detect and react to DDoS attacks at the earliest stage to ensure that the uptime of the service remain unaffected. Experimental evaluation shows that the proposed collaborative detection approach is much more effective and efficient than the previous approaches.

Keywords: Distributed Denial-of-Service (DDoS), Collaborative Intrusion Detection System (CIDS), Slowloris, OSSIM (Open Source Security Information Management tool), OSSEC HIDS

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Authors: Badrane Nohayla, Bamousse Zineb

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Financial crises, exchange rate volatility, fluctuations in commodity prices, increased competitive pressures, and environmental issues are all threats that businesses face. In light of these diverse challenges, proactive, agile, and innovative cash management becomes an indispensable financial shield, allowing companies to thrive despite the adverse conditions of the global environment. In the same spirit, uncertainty, turbulence, volatility, and competitiveness continue to disrupt economic environments, compelling companies to swiftly master innovative breakthroughs that provide added value. In such a context, innovation emerges as a catalytic vector for performance, aiming to reduce costs, strengthen growth, and ultimately ensure the sustainability of Moroccan companies in the national arena. Moreover, innovation in treasury management promises to be one of the key pillars of financial stability, enabling companies to navigate the tumultuous waters of a globalized environment. Therefore, the objective of this study is to better understand the impact of innovative treasury management on cost optimization and, by extension, performance improvement. To elucidate this relationship, we conducted an exploratory qualitative study with 20 large Moroccan companies operating in the Casablanca-Settat region. The results highlight that innovation at the heart of treasury management is a guarantee of sustainability against the risks of failure and stands as a true pivot of the performance of Moroccan companies, an important parameter of their financial balance and a catalytic vector of their growth in the national economic landscape. In this regard, the present study aims to explore the extent to which innovation at the core of the treasury function serves as an indispensable tool for boosting performance while optimising costs in large Moroccan companies.

Keywords: innovative cash management, artificial intelligence, financial performance, risk management, cost savings

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Authors: Manaf Bashir

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Corporate social responsibility (CSR) has become a tool for corporations to meet the expectations of different stakeholders about economic, social and environmental issues. It has become indispensable for an organization’s success, positive image and reputation. Equally important is how corporations communicate and report their CSR. Employing the stakeholder theory, the purpose of this research is to analyse CSR content of leading Kuwaiti corporations. No research analysis of CSR reporting has been conducted in Kuwait and this study is an attempt to redress in part this empirical deficit in the country and the region. It attempts to identify the issues and stakeholders of the CSR and if corporations are following CSR reporting standards. By analysing websites, annual and CSR reports of the top 100 Kuwaiti corporations, this study found low mentions of the CSR issues and even lower mentions of CSR stakeholders. Environmental issues were among the least mentioned despite an increasing global concern toward the environment. ‘Society’ was mentioned the most as a stakeholder and ‘The Environment’ was among the least mentioned. Cross-tabulations found few significant relationships between type of industry and the CSR issues and stakeholders. Independent sample t-tests found no significant difference between the issues and stakeholders that are mentioned on the websites and the reports. Only two companies from the sample followed reporting standards and both followed the Global Reporting Initiative. Successful corporations would be keen to identify the issues that meet the expectations of different stakeholders and address them through their corporate communication. Kuwaiti corporations did not show this keenness. As the stakeholder theory suggests, extending the spectrum of stakeholders beyond investors can open mutual dialogue and understanding between corporations and various stakeholders. However, Kuwaiti corporations focus on few CSR issues and even fewer CSR stakeholders. Kuwaiti corporations need to pay more attention to CSR and particularly toward environmental issues. They should adopt a strategic approach and allocate specialized personnel such as marketers and public relations practitioners to manage it. The government and non-profit organizations should encourage the private sector in Kuwait to do more CSR and meet the needs and expectations of different stakeholders and not only shareholders. This is in addition to reporting the CSR information professionally because of its benefits to corporate image, reputation, and transparency.

Keywords: corporate social responsibility, environmental responsibility, Kuwait, stakeholder theory

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Authors: Leo Laine, Morgan Johansson

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To meet the civilizations future needs for safe living and low environmental footprint, the engineers designing the complex systems of tomorrow will need efficient ways to model and optimize these systems for their intended purpose. For example, a civil defence shelter and its subsystem components needs to withstand, e.g. airblast and ground shock from decided design level explosion which detonates with a certain distance from the structure. In addition, the complex civil defence shelter needs to have functioning air filter systems to protect from toxic gases and provide clean air, clean water, heat, and electricity needs to also be available through shock and vibration safe fixtures and connections. Similar complex building systems can be found in any concentrated living or office area. In this paper, the authors use a multidomain modelling language called Modelica to model a concrete wall as a single degree of freedom (SDOF) system with elastoplastic properties with the implemented option of plastic hardening. The elastoplastic model was developed and implemented in the open source tool OpenModelica. The simulation model was tested on the case with a transient equivalent reflected pressure time history representing an airblast from 100 kg TNT detonating 15 meters from the wall. The concrete wall is approximately regarded as a concrete strip of 1.0 m width. This load represents a realistic threat on any building in a city like area. The OpenModelica model results were compared with an Excel implementation of a SDOF model with an elastic-plastic spring using simple fixed timestep central difference solver. The structural displacement results agreed very well with each other when it comes to plastic displacement magnitude, elastic oscillation displacement, and response times.

Keywords: airblast from explosives, elastoplastic spring model, Modelica modelling language, SDOF, structural response of concrete structure

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Authors: Bin Feng, Zhulin Zong

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Radar systems are critical in the modern military, aviation, and maritime operations, and their proper functioning is essential for the success of these operations. However, due to the complexity and sensitivity of radar systems, they are susceptible to various faults that can significantly affect their performance. Traditional radar fault diagnosis strategies rely on expert knowledge and rule-based approaches, which are often limited in effectiveness and require a lot of time and resources. Deep learning has recently emerged as a promising approach for fault diagnosis due to its ability to learn features and patterns from large amounts of data automatically. In this paper, we propose a radar fault diagnosis strategy based on deep learning that can accurately identify and classify faults in radar systems. Our approach uses convolutional neural networks (CNN) to extract features from radar signals and fault classify the features. The proposed strategy is trained and validated on a dataset of measured radar signals with various types of faults. The results show that it achieves high accuracy in fault diagnosis. To further evaluate the effectiveness of the proposed strategy, we compare it with traditional rule-based approaches and other machine learning-based methods, including decision trees, support vector machines (SVMs), and random forests. The results demonstrate that our deep learning-based approach outperforms the traditional approaches in terms of accuracy and efficiency. Finally, we discuss the potential applications and limitations of the proposed strategy, as well as future research directions. Our study highlights the importance and potential of deep learning for radar fault diagnosis. It suggests that it can be a valuable tool for improving the performance and reliability of radar systems. In summary, this paper presents a radar fault diagnosis strategy based on deep learning that achieves high accuracy and efficiency in identifying and classifying faults in radar systems. The proposed strategy has significant potential for practical applications and can pave the way for further research.

Keywords: radar system, fault diagnosis, deep learning, radar fault

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Authors: V. Pentland, S. Spilsbury, A. Biswas, M. F. Mottola, S. Paplinskie, M. S. Mitchell

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Postpartum depression (PPD) is a form of major depressive disorder that afflicts 10–22% of mothers worldwide. Rising demands for traditional PPD treatment options (e.g., psychiatry), especially in the context of the COVID-19 pandemic, are increasingly difficult to meet. More accessible treatment options (e.g., walking) are needed. The objective of this review is to determine the impact of walking on PPD severity. A structured search of seven electronic databases for randomised controlled trials published between 2000 and July 29, 2021, was completed. Studies were included if walking was the sole or primary aerobic exercise modality. A random-effects meta-analysis was conducted for studies reporting PPD symptoms measured using a clinically validated tool. A simple count of positive/null effect studies was undertaken as part of a narrative summary. Five studies involving 242 participants were included (mean age=~28.9 years; 100% with mild-to-moderate depression). Interventions were 12 (n=4) and 24 (n=1) weeks long. Each assessed PPD severity using the Edinburgh Postnatal Depression Scale (EPDS) and was included in the meta-analysis. The pooled effect estimate suggests that relative to controls, walking yielded clinically significant decreases in mean EPDS scores from baseline to intervention end (pooled MD=-4.01; 95% CI:-7.18 to -0.84, I2=86%). The narrative summary provides preliminary evidence that walking-only, supervised, and group-based interventions, including 90-120+ minutes/week of moderate-intensity walking, may produce greater EPDS reductions. While limited by a relatively small number of included studies, pooled effect estimates suggest walking may help mothers manage PPD. This is the first time walking as a treatment for PPD, an exercise modality that uniquely addresses many barriers faced by mothers has been summarized in a systematic way. Trial registration: PROSPERO (CRD42020197521) on August 16th, 2020

Keywords: postpartum, exercise, depression, walking

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Authors: Prathama Guha Chaudhuri, Arunima Datta, Ashis Mukhopadhyay

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Background: Visualization (guided imagery) is a set of techniques which induce relaxation and help people create positive mental images in order to reduce stress.It is relatively inexpensive and can even be practised by bed bound people. Studies have shown visualization to be an effective tool to improve cancer patients’ anxiety, depression and quality of life. The common images used with cancer patients in the developed world are those involving the individual’s body and its strengths. Since breast cancer patients in India are more family oriented and often their main concerns are the stigma of having cancer and subsequent isolation of their families, including their children, we figured that positive images involving acceptance and integration within family and society would be more effective for them. Method: Data was collected from 119 breast cancer patients on chemotherapy willing to undergo psychotherapy, with no history of past psychiatric illness. Their baseline stress, anxiety, depression and quality of life were assessed using validated tools. The participants were then randomly divided into three groups: a) those who received visualization therapy with standard imageries involving the body and its strengths (sVT), b) those who received visualization therapy using indigenous family oriented imageries (mVT) and c) a control group who received supportive therapy. There were six sessions spread over two months for each group. The psychological outcome variables were measured post intervention. Appropriate statistical analyses were done. Results:Both forms of visualization therapy were more effective than supportive therapy alone in reducing patients’ depression, anxiety and quality of life.Modified VT proved to be significantly more effective in improving patients’ anxiety and quality of life. Conclusion: Visualization is a valuable therapeutic option for reduction of psychological distress and improving quality of life of breast cancer patients.In order to be more effective, the images used need to be modified according to the sociocultural background and individual needs of the patients.

Keywords: breast cancer, visualization therapy, quality of life, anxiety, depression

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Authors: Rima A. Ajlouni

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The discovery of quasi-periodic structures in material science is revealing an exciting new class of symmetries, which has never been explored before. Due to their unique structural and visual properties, these symmetries are drawing interest from many scientific and design disciplines. Especially, in art and architecture, these symmetries can provide a rich source of geometry for exploring new patterns, forms, systems, and structures. However, the structural systems of these complicated symmetries are still posing a perplexing challenge. While much of their local order has been explored, the global governing system is still unresolved. Understanding their unique global long-range order is essential to their generation and application. The recent discovery of dodecagonal quasi-periodic patterns in historical Islamic architecture is generating a renewed interest into understanding the mathematical principles of traditional Islamic geometry. Astonishingly, many centuries before its description in the modern science, ancient artists, by using the most primitive tools (a compass and a straight edge), were able to construct patterns with quasi-periodic formations. These ancient patterns can be found all over the ancient Islamic world, many of which exhibit formations with 5, 8, 10 and 12 quasi-periodic symmetries. Based on the examination of these historical patterns and derived from the generating principles of Islamic geometry, a global multi-level structural model is presented that is able to describe the global long-range order of dodecagonal quasi-periodic formations in Islamic Architecture. Furthermore, this method is used to construct new quasi-periodic tiling systems as well as generating their deflation and inflation rules. This method can be used as a general guiding principle for constructing infinite patches of dodecagon-based quasi-periodic formations, without the need for local strategies (tiling, matching, grid, substitution, etc.) or complicated mathematics; providing an easy tool for scientists, mathematicians, teachers, designers and artists, to generate and study a wide range of dodecagonal quasi-periodic formations.

Keywords: dodecagonal, Islamic architecture, long-range order, quasi-periodi

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Authors: Prabesh Karki, Shyam Thapa Chettri, Bajarang Prasad Sah, Manoj Bhattarai, Sudeep Mishra

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Introduction: Frontal sinus is frequently described as the most difficult sinus to access surgically due to its proximity to the cribriform plate, orbit, and anterior ethmoid artery. Frontal sinus surgery requires a detailed understanding of the cellular structure and FSDP unique to each patient, making high-resolution CT scans an indispensable tool to assess the difficulty of planned sinus surgery. International Frontal Sinus Anatomy Classification (IFAC) was developed to provide a more precise nomenclature for cells in the frontal recess, classifying cells based on their anatomic origin. Objectives: To assess the proportion of frontal cell variants defined by IFAC, variation with respect to age and gender. Methods: 54 cases were enrolled after a detailed clinical history, thorough general and physical examinations, and CT a report ordered in a film. Assessment and tabulation of the presence of frontal cells according to the IFAC analyzed. The prevalence of each cell type was calculated, and data were entered in MS Excel and analyzed using Statistical Package for the Social Sciences (SPSS). Descriptive statistics and frequencies were defined for categorical and numerical variables. Frequency, percentage, the mean and standard deviation were calculated. Result: Among 54 patients, 30 (55.6%) were male and 24 (44.4%) were female. The patient enrolled ranged from 18 to 78 years. Majority33.3% (n=18) were in age group of >50 years.According to IFAC, Agger nasi cells (92.6%) were most common, whereas supraorbital ethmoidal cells were least common 16 (29.6%). Prevalence of other frontoethmoidal cells was SAC- 57.4%, SAFC- 38.9%, SBC- 74.1%, SBFC- 33.3%, FSC- 38.9% of 54 cases. Conclusion: IFAC is an international consensus document that describes an anatomically precise nomenclature for classifying frontoethmoidal cells' anatomy. This study has defined the prevalence, symmetry and reliability of frontoethmoidal cells as established by the IFAC system as in other parts of the world.

Keywords: frontal sinus, frontoethmoidal cells, international frontal sinus anatomy classification

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Authors: Aysel Mehdiyeva

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As a driving force of society, the role of teachers is important in inspiring, motivating, and encouraging the younger generation to protect the environment. In light of these, the study aims to explore teachers’ beliefs to understand teachers’ engagement with teaching about the environment. Though teachers’ beliefs about the environment have been explored by a number of researchers, the influence of these beliefs in their professional lives and in shaping their classroom instructions has not been widely investigated in Azerbaijan. To this end, this study aims to reveal the beliefs of secondary school geography teachers about the environment and find out the ways teachers’ beliefs of the environment are enacted in their classroom practice in Azerbaijan. Different frameworks have been suggested for measuring environmental beliefs stemming from well-known anthropocentric and biocentric worldviews. The study addresses New Ecological Paradigm (NEP) by Dunlap to formulate the interview questions as discussion with teachers around these questions aligns with the research aims serving to well-capture the beliefs of teachers about the environment. Despite the extensive applicability of the NEP scale, it has not been used to explore in-service teachers’ beliefs about the environment. Besides, it has been used as a tool for quantitative measurement; however, the study addresses the scale within the framework of the qualitative study. The research population for semi-structured interviews and observations was recruited via purposeful sampling. Teachers’ being a unit of analysis is related to the gap in the literature as to how teachers’ beliefs are related to their classroom instructions within the environmental context, as well as teachers’ beliefs about the environment in Azerbaijan have not been well researched. 6 geography teachers from 4 different schools were involved in the research process. The schools are located in one of the most polluted parts of the capital city Baku where the first oil well in the world was drilled in 1848 and is called “Black City” due to the black smoke and smell that covered that part of the city. Semi-structured interviews were conducted with the teachers to reveal their stated beliefs. Later, teachers were observed during geography classes to understand the overlap between teachers’ ideas presented during the interview and their teaching practice. Research findings aim to indicate teachers’ ecological beliefs and practice, as well as elaborate on possible causes of compatibility/incompatibility between teachers’ stated and observed beliefs.

Keywords: environmental education, anthropocentric beliefs, biocentric beliefs, new ecological paradigm

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Authors: Dmitry Aron

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Major radiation accidents carry not only the potential risks of negative consequences for public health due to exposure but also because of large-scale emergency measures were taken by authorities to protect the population, which can lead to unreasonable social and economic damage. It is technically difficult, as a rule, to assess the possible costs and damages from decisions on evacuation or resettlement of residents in the shortest possible time, since it requires specially prepared information systems containing relevant information on demographic, economic parameters and incoming data on radiation conditions. Foreign observers also face the difficulties in assessing the consequences of an accident in a foreign territory, since they usually do not have official and detailed statistical data on the territory of foreign state beforehand. Also, they can suppose the application of unofficial data from open Internet sources is an unreliable and overly labor-consuming procedure. This paper describes an approach to prompt creation of relational database that contains detailed actual data on economics, demographics and radiation situation at the Fukushima Prefecture during the Fukushima Daiichi NPP accident, received by the author from open Internet sources. This database was developed and used to assess the number of evacuated population, radiation doses, expected financial losses and other parameters of the affected areas. The costs for the areas with temporarily evacuated and long-term resettled population were investigated, and the radiological and economic effectiveness of the measures taken to protect the population was estimated. Some of the results are presented in the article. The study showed that such a tool for analyzing the consequences of radiation accidents can be prepared in a short space of time for the entire territory of Japan, and it can serve for the modeling of social and economic consequences for hypothetical accidents for any nuclear power plant in its territory.

Keywords: Fukushima, radiation accident, emergency measures, database

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Authors: Zeynep Yazicioglu

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Project development is a complex process where many stakeholders work together. Employers and main contractors are the base stakeholders, whereas designers, engineers, sub-contractors, suppliers, supervisors, and consultants are other stakeholders. A combination of the complexity of the building process with a large number of stakeholders often leads to time and cost overruns and irregular resource utilization. Failure to comply with the work schedule and inefficient use of resources in the construction processes indicate that it is necessary to accelerate production and increase productivity. The development of computer software called Building Information Modeling, abbreviated as BIM, is a major technological breakthrough in this area. The use of BIM enables architectural, structural, mechanical, and electrical projects to be drawn in coordination. BIM is a tool that should be considered by every stakeholder with the opportunities it offers, such as minimizing construction errors, reducing construction time, forecasting, and determination of the final construction cost. It is a process spreading over the years, enabling all stakeholders associated with the project and construction to use it. The main goal of this paper is to explore the problems associated with the adoption of BIM in multi-stakeholder projects. The paper is a conceptual study, summarizing the author’s practical experience with design offices and construction firms working with BIM. In the transition period to BIM, three of the challenges will be examined in this paper: 1. The compatibility of supplier companies with BIM, 2. The need for two-dimensional drawings, 3. Contractual issues related to BIM. The paper reviews the literature on BIM usage and reviews the challenges in the transition stage to BIM. Even on an international scale, the supplier that can work in harmony with BIM is not very common, which means that BIM's transition is continuing. In parallel, employers, local approval authorities, and material suppliers still need a 2-D drawing. In the BIM environment, different stakeholders can work on the same project simultaneously, giving rise to design ownership issues. Practical applications and problems encountered are also discussed, providing a number of suggestions for the future.

Keywords: BIM opportunities, collaboration, contract issues about BIM, stakeholders of project

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Authors: Kana Matsuyanagi

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Anorexia Nervosa (AN) is a psychiatric disorder characterized by a relentless pursuit of thinness and strict restriction of food. The current therapeutic approaches for AN predominantly revolve around outpatient psychotherapies, which create significant financial barriers for the majority of affected patients, hindering their access to treatment. Nonetheless, AN exhibit one of the highest mortality and relapse rates among psychological disorders, underscoring the urgent need to provide patients with an affordable self-treatment tool, enabling those unable to access conventional medical intervention to address their condition autonomously. To this end, a neurofeedback software, termed RelaxNeuron, was developed with the objective of providing an economical and portable means to aid individuals in self-managing AN. Electroencephalography (EEG) was chosen as the preferred modality for RelaxNeuron, as it aligns with the study's goal of supplying a cost-effective and convenient solution for addressing AN. The primary aim of the software is to ameliorate the negative emotional responses towards food stimuli and the accompanying aberrant eye-tracking patterns observed in AN patient, ultimately alleviating the profound fear towards food an elemental symptom and, conceivably, the fundamental etiology of AN. The core functionality of RelaxNeuron hinges on the acquisition and analysis of EEG signals, alongside an electrocardiogram (ECG) signal, to infer the user's emotional state while viewing dynamic food-related imagery on the screen. Moreover, the software quantifies the user's performance in accurately tracking the moving food image. Subsequently, these two parameters undergo further processing in the subsequent algorithm, informing the delivery of either negative or positive feedback to the user. Preliminary test results have exhibited promising outcomes, suggesting the potential advantages of employing RelaxNeuron in the treatment of AN, as evidenced by its capacity to enhance emotional regulation and attentional processing through repetitive and persistent therapeutic interventions.

Keywords: Anorexia Nervosa, fear conditioning, neurofeedback, BCI

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Authors: Nicholas Pearce, Eun-jin Kim

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Pathologies of the cardiovascular (CV) system remain a serious and deadly health problem for human society. Computational modelling provides a relatively accessible tool for diagnosis, treatment, and research into CV disorders. However, numerical models of the CV system have largely focused on the function of the ventricles, frequently overlooking the behaviour of the atria. Furthermore, in the study of the pressure-volume relationship of the heart, which is a key diagnosis of cardiac vascular pathologies, previous works often evoke popular yet questionable time-varying elastance (TVE) method that imposes the pressure-volume relationship instead of calculating it consistently. Despite the convenience of the TVE method, there have been various indications of its limitations and the need for checking its validity in different scenarios. A model of the combined left ventricle (LV) and left atrium (LA) is presented, which consistently considers various feedback mechanisms in the heart without having to use the TVE method. Specifically, a synergistic model of the left ventricle is extended and modified to include the function of the LA. The synergy of the original model is preserved by modelling the electro-mechanical and chemical functions of the micro-scale myofiber for the LA and integrating it with the microscale and macro-organ-scale heart dynamics of the left ventricle and CV circulation. The atrioventricular node function is included and forms the conduction pathway for electrical signals between the atria and ventricle. The model reproduces the essential features of LA behaviour, such as the two-phase pressure-volume relationship and the classic figure of eight pressure-volume loops. Using this model, disorders in the internal cardiac electrical signalling are investigated by recreating the mechano-electric feedback (MEF), which is impossible where the time-varying elastance method is used. The effects of AV node block and slow conduction are then investigated in the presence of an atrial arrhythmia. It is found that electrical disorders and arrhythmia in the LA degrade the CV system by reducing the cardiac output, power, and heart rate.

Keywords: cardiovascular system, left atrium, numerical model, MEF

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Authors: Corinne Kowalski, Lea de Jong, Rainer Sauerborn, Niamh Herlihy, Anneliese Depoux, Jale Tosun

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Climate change is considered one of the biggest threats to human health of the 21st century. The link between climate change and health has received relatively little attention in the media, in research and in policy-making. A long term and broad overview of how health is represented in the legislation on climate change is missing in the legislative literature. It is unknown if or how the argument for health is referred in legal clauses addressing climate change, in national and European legislation. Integrating scientific based evidence into policies regarding the impacts of climate change on health could be a key step to inciting the political and societal changes necessary to decelerate global warming. This may also drive the implementation of new strategies to mitigate the consequences on health systems. To provide an overview of this issue, we are analyzing the Global Climate Legislation Database provided by the Grantham Research Institute on Climate Change and the Environment. This institution was established in 2008 at the London School of Economics and Political Science. The database consists of (updated as of 1st January 2015) legislations on climate change in 99 countries around the world. This tool offers relevant information about the state of climate related policies. We will use the database to systematically analyze the 829 identified legislations to identify how health is represented as a relevant aspect of climate change legislation. We are conducting explorative research of national and supranational legislations and anticipate health to be addressed in various forms. The goal is to highlight how often, in what specific terms, which aspects of health or health risks of climate change are mentioned in various legislations. The position and recurrence of the mention of health is also of importance. Data will be extracted with complete quotation of the sentence which mentions health, which will allow for second qualitative stage to analyze which aspects of health are represented and in what context. This study is part of an interdisciplinary project called 4CHealth that confronts results of the research done on scientific, political and press literature to better understand how the knowledge on climate change and health circulates within those different fields and whether and how it is translated to real world change.

Keywords: climate change, explorative research, health, policies

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Authors: M. Miljkovic, A. Urakpo, M. Simic-Koumoutsaris

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Benefit-risk assessment (BRA) is a valuable tool that takes place in multiple stages during a medicine's lifecycle, and this assessment can be conducted in a variety of ways. The aim was to summarize current BRA methods used during approval decisions and in post-approval settings and to see possible future directions. Relevant reviews, recommendations, and guidelines published in medical literature and through regulatory agencies over the past five years have been examined. BRA implies the review of two dimensions: the dimension of benefits (determined mainly by the therapeutic efficacy) and the dimension of risks (comprises the safety profile of a drug). Regulators, industry, and academia have developed various approaches, ranging from descriptive textual (qualitative) to decision-analytic (quantitative) models, to facilitate the BRA of medicines during the product lifecycle (from Phase I trials, to authorization procedure, post-marketing surveillance and health technology assessment for inclusion in public formularies). These approaches can be classified into the following categories: stepwise structured approaches (frameworks); measures for benefits and risks that are usually endpoint specific (metrics), simulation techniques and meta-analysis (estimation techniques), and utility survey techniques to elicit stakeholders’ preferences (utilities). All these approaches share the following two common goals: to assist this analysis and to improve the communication of decisions, but each is subject to its own specific strengths and limitations. Before using any method, its utility, complexity, the extent to which it is established, and the ease of results interpretation should be considered. Despite widespread and long-time use, BRA is subject to debate, suffers from a number of limitations, and currently is still under development. The use of formal, systematic structured approaches to BRA for regulatory decision-making and quantitative methods to support BRA during the product lifecycle is a standard practice in medicine that is subject to continuous improvement and modernization, not only in methodology but also in cooperation between organizations.

Keywords: benefit-risk assessment, benefit-risk profile, product lifecycle, quantitative methods, structured approaches

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Authors: L. Kiefer, C. Richter, G. Reinhart

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The uprising complexity in production systems due to an increasing amount of variants up to customer innovated products leads to requirements that hierarchical control systems are not able to fulfil. Therefore, factory planners can install autonomous manufacturing systems. The fundamental requirement for an autonomous control is the identification of objects within production systems. In this approach an attribute-based identification is focused for avoiding dose-dependent identification costs. Instead of using an identification mark (ID) like a radio frequency identification (RFID)-Tag, an object type is directly identified by its attributes. To facilitate that it’s recommended to include the identification and the corresponding sensors within handling processes, which connect all manufacturing processes and therefore ensure a high identification rate and reduce blind spots. The presented methodology reduces the individual effort to integrate identification processes in handling systems. First, suitable object attributes and sensor systems for object identification in a production environment are defined. By categorising these sensor systems as well as handling systems, it is possible to match them universal within a compatibility matrix. Based on that compatibility further requirements like identification time are analysed, which decide whether the combination of handling and sensor system is well suited for parallel handling and identification within an autonomous control. By analysing a list of more than thousand possible attributes, first investigations have shown, that five main characteristics (weight, form, colour, amount, and position of subattributes as drillings) are sufficient for an integrable identification. This knowledge limits the variety of identification systems and leads to a manageable complexity within the selection process. Besides the procedure, several tools, as an example a sensor pool are presented. These tools include the generated specific expert knowledge and simplify the selection. The primary tool is a pool of preconfigured identification processes depending on the chosen combination of sensor and handling device. By following the defined procedure and using the created tools, even laypeople out of other scientific fields can choose an appropriate combination of handling devices and sensors which enable parallel handling and identification.

Keywords: agent systems, autonomous control, handling systems, identification

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Authors: A. Kourou, M. Panoutsopoulou

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Nowadays, disaster risk reduction requires innovative ways of working collaboratively, monitoring tools, management methods, risk communication, and knowledge, as key factors for decision-making actors. Experience has shown that the assessment of seismic risk and its effective management is still an important challenge. In Greece, Ionian Islands region is characterized as the most seismic area of the country and one of the most active worldwide. It is well known that in case of a disastrous earthquake the local authorities need to assess the situation in the affected area and coordinate the disaster response. In particular, the main outcomes of 'Telemachus' project are the development of an innovative operational system that hosts the needed data of seismic risk management in the Ionian Islands and the implementation of educational actions for the involved target groups. This project is funded in the Priority Axis 'Environmental Protection and Sustainable Development' of Operational Plan 'Ionian Islands 2014-2020'. EPPO is one of the partners of the project and it is responsible, among others, for the development of proper training material. This paper presents the training material of 'Telemachus' and its usage as a helpful, managerial tool in case of earthquake emergency. This material is addressed to different target groups, such as civil protection staff, people that involved with the tourism industry, educators of disabled people, etc. Very positive aspect of the project is the involvement of end-users that should evaluate the training products; test standards; clarify the personnel’s roles and responsibilities; improve interagency coordination; identify gaps in resources; improve individual performance; and identify opportunities for improvement. It is worth mentioning that even though the abovementioned material developed is useful for the training of specific target groups on emergency management issues within Ionian Islands Region, it could be used throughout Greece and other countries too.

Keywords: education of civil protection staff, Ionian Islands Region of Greece, seismic risk, training material

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Authors: Babatunde Dosumu, Obuks Ejohwomu, Akilu Yunusa-Kaltungo

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Cost estimation in construction is often difficult, particularly when dealing with risks and uncertainties, which are inevitable and peculiar to developing countries like Nigeria. Direct consequences of these are major deviations in cost, duration, and quality. The fundamental aim of this study is to develop a framework for assessing the impacts of risk on cost estimation, which in turn causes variabilities between contract sum and final account. This is very important, as initial estimates given to clients should reflect the certain magnitude of consistency and accuracy, which the client builds other planning-related activities upon, and also enhance the capabilities of construction industry professionals by enabling better prediction of the final account from the contract sum. In achieving this, a systematic literature review was conducted with cost variability and construction projects as search string within three databases: Scopus, Web of science, and Ebsco (Business source premium), which are further analyzed and gap(s) in knowledge or research discovered. From the extensive review, it was found that factors causing deviation between final accounts and contract sum ranged between 1 and 45. Besides, it was discovered that a cost estimation framework similar to Building Cost Information Services (BCIS) is unavailable in Nigeria, which is a major reason why initial estimates are very often inconsistent, leading to project delay, abandonment, or determination at the expense of the huge sum of money invested. It was concluded that the development of a cost estimation framework that is adjudged an important tool in risk shedding rather than risk-sharing in project risk management would be a panacea to cost estimation problems, leading to cost variability in the Nigerian construction industry by the time this ongoing Ph.D. research is completed. It was recommended that practitioners in the construction industry should always take into account risk in order to facilitate the rapid development of the construction industry in Nigeria, which should give stakeholders a more in-depth understanding of the estimation effectiveness and efficiency to be adopted by stakeholders in both the private and public sectors.

Keywords: cost variability, construction projects, future studies, Nigeria

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Authors: Shyamli Singh, Ishupinder Kaur, Vinod K. Sharma

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Climate Change refers to the change in climate for extended period of time. Climate is changing from the past history of earth but anthropogenic activities accelerate this rate of change and which is now being a global issue. Increase in greenhouse gas emissions is causing global warming and climate change related issues at an alarming rate. Increasing temperature results in climate variability across the globe. Changes in rainfall patterns, intensity and extreme events are some of the impacts of climate change. Rainfall variability refers to the degree to which rainfall patterns varies over a region (spatial) or through time period (temporal). Temporal rainfall variability can be directly or indirectly linked to climate change. Such variability in rainfall increases the vulnerability of communities towards climate change. Increasing urbanization and unplanned developmental activities, the air quality is deteriorating. This paper mainly focuses on the rainfall variability due to increasing level of greenhouse gases. Rainfall data of 65 years (1951-2015) of Safdarjung station of Delhi was collected from Indian Meteorological Department and analyzed using Mann-Kendall test for time-series data analysis. Mann-Kendall test is a statistical tool helps in analysis of trend in the given data sets. The slope of the trend can be measured through Sen’s slope estimator. Data was analyzed monthly, seasonally and yearly across the period of 65 years. The monthly rainfall data for the said period do not follow any increasing or decreasing trend. Monsoon season shows no increasing trend but here was an increasing trend in the pre-monsoon season. Hence, the actual rainfall differs from the normal trend of the rainfall. Through this analysis, it can be projected that there will be an increase in pre-monsoon rainfall than the actual monsoon season. Pre-monsoon rainfall causes cooling effect and results in drier monsoon season. This will increase the vulnerability of communities towards climate change and also effect related developmental activities.

Keywords: greenhouse gases, Mann-Kendall test, rainfall variability, Sen's slope

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Authors: Najeeb Hassan, Mahmudur Rahman

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Arial Khan River is one of the main south-eastward outlets of the River Padma. This river maintains a meander channel through its course and is erosional in nature. The specific objective of the research is to study and evaluate the hydrological characteristics in the form of assessing changes of cross-sections, discharge, water level and velocity profile in different stations and to create a hydrodynamic model of the Arial Khan River. Necessary data have been collected from Bangladesh Water Development Board (BWDB) and Center for Environment and Geographic Information Services (CEGIS). Satellite images have been observed from Google earth. In this study, hydrodynamic model of Arial Khan River has been developed using well known steady open channel flow code Hydrologic Engineering Centers and River Analysis System (HEC-RAS) using field surveyed geometric data. Cross-section properties at 22 locations of River Arial Khan for the years 2011, 2013 and 2015 were also analysed. 1-D HEC-RAS model has been developed using the cross sectional data of 2015 and appropriate boundary condition is being used to run the model. This Arial Khan River model is calibrated using the pick discharge of 2015. The applicable value of Mannings roughness coefficient (n) is adjusted through the process of calibration. The value of water level which ties with the observed data to an acceptable accuracy is taken as calibrated model. The 1-D HEC-RAS model then validated by using the pick discharges from 2009-2018. Variation in observed water level in the model and collected water level data is being compared to validate the model. It is observed that due to seasonal variation, discharge of the river changes rapidly and Mannings roughness coefficient (n) also changes due to the vegetation growth along the river banks. This river model may act as a tool to measure flood area in future. By considering the past pick flow discharge, it is strongly recommended to improve the carrying capacity of Arial Khan River to protect the surrounding areas from flash flood.

Keywords: BWDB, CEGIS, HEC-RAS

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Authors: M. P. Tripathi, Priti Tiwari

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Soil and Water Assessment Tool (SWAT) is a distributed parameter continuous time model and was tested on daily and fortnightly basis for a small agricultural watershed (Dhangaon) of Chhattisgarh state in India. The SWAT model recently interfaced with ArcGIS and called as ArcSWAT. The watershed and sub-watershed boundaries, drainage networks, slope and texture maps were generated in the environment of ArcGIS of ArcSWAT. Supervised classification method was used for land use/cover classification from satellite imageries of the years 2009 and 2012. Manning's roughness coefficient 'n' for overland flow and channel flow and Fraction of Field Capacity (FFC) were calibrated for monsoon season of the years 2009 and 2010. The model was validated on a daily basis for the years 2011 and 2012 by using the observed daily rainfall and temperature data. Calibration and validation results revealed that the model was predicting the daily surface runoff and sediment yield satisfactorily. Sensitivity analysis showed that the annual sediment yield was inversely proportional to the overland and channel 'n' values whereas; annual runoff and sediment yields were directly proportional to the FFC. The model was also tested (calibrated and validated) for the fortnightly runoff and sediment yield for the year 2009-10 and 2011-12, respectively. Simulated values of fortnightly runoff and sediment yield for the calibration and validation years compared well with their observed counterparts. The calibration and validation results revealed that the ArcSWAT model could be used for identification of critical sub-watershed and for developing management scenarios for the Dhangaon watershed. Further, the model should be tested for simulating the surface runoff and sediment yield using generated rainfall and temperature before applying it for developing the management scenario for the critical or priority sub-watersheds.

Keywords: watershed, hydrologic and water quality, ArcSWAT model, remote sensing, GIS, runoff and sediment yield

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Authors: Uche Lucy Onyekwelu, Uche B. Ugwuanyi

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Suffice to say that socio-economic disruptions of any form is likely to affect the wellbeing of the citizenry. The upsurge of social disequilibrium caused by the incessant disruptive tendencies exhibited by youths and some others in Nigeria are not helping matters. In Nigeria the social unrest has caused different forms of draw backs in Socio Economic Development. This study has empirically evaluated the impact of insecurity and insurgency on the Economic Development of Nigeria. The paper noted that the different forms of insecurity in Nigeria are namely: Insurgency and Banditry as witnessed in Northern Nigeria; Militancy: Niger Delta area and self-determination groups pursuing various forms of agenda such as Sit –at- Home Syndrome in the South Eastern Nigeria and other secessionist movements. All these have in one way or the other hampered Economic development in Nigeria. Data for this study were collected through primary and secondary sources using questionnaire and some existing documentations. Cost of investment in different aspects of security outfits in Nigeria represents the independent variable while the differentials in the Gross Domestic Product(GDP) and Human Development Index(HDI) are the measures of the dependent variable. Descriptive statistics and Simple Linear Regression analytical tool were employed in the data analysis. The result revealed that Insurgency/Insecurity negatively affect the economic development of the different parts of Nigeria. Following the findings, a model to analyse the effect of insecurity and insurgency was developed, named INSECUREDEVNIG. It implies that the economic development of Nigeria will continue to deteriorate if insurgency and insecurity continue. The study therefore recommends that the government should do all it could to nurture its human capital, adequately fund the state security apparatus and employ individuals of high integrity to manage the various security outfits in Nigeria. The government should also as a matter of urgency train the security personnel in intelligence cum Information and Communications Technology to enable them ensure the effectiveness of implementation of security policies needed to sustain Gross Domestic Product and Human Capital Index of Nigeria.

Keywords: insecurity, insurgency, gross domestic product, human development index, Nigeria

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Authors: Kung-Jen Tu, Danny Vernatha

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To assist individual departments within universities in their energy management tasks, this study explores the application of Building Information Modeling in establishing the ‘BIM based Energy Management Support System’ (BIM-EMSS). The BIM-EMSS consists of six components: (1) sensors installed for each occupant and each equipment, (2) electricity sub-meters (constantly logging lighting, HVAC, and socket electricity consumptions of each room), (3) BIM models of all rooms within individual departments’ facilities, (4) data warehouse (for storing occupancy status and logged electricity consumption data), (5) building energy management system that provides energy managers with various energy management functions, and (6) energy simulation tool (such as eQuest) that generates real time 'standard energy consumptions' data against which 'actual energy consumptions' data are compared and energy efficiency evaluated. Through the building energy management system, the energy manager is able to (a) have 3D visualization (BIM model) of each room, in which the occupancy and equipment status detected by the sensors and the electricity consumptions data logged are displayed constantly; (b) perform real time energy consumption analysis to compare the actual and standard energy consumption profiles of a space; (c) obtain energy consumption anomaly detection warnings on certain rooms so that energy management corrective actions can be further taken (data mining technique is employed to analyze the relation between space occupancy pattern with current space equipment setting to indicate an anomaly, such as when appliances turn on without occupancy); and (d) perform historical energy consumption analysis to review monthly and annually energy consumption profiles and compare them against historical energy profiles. The BIM-EMSS was further implemented in a research lab in the Department of Architecture of NTUST in Taiwan and implementation results presented to illustrate how it can be used to assist individual departments within universities in their energy management tasks.

Keywords: database, electricity sub-meters, energy anomaly detection, sensor

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Authors: Jonas A. R. H. Lima, Maria Antonia Carravilla

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As productivity concepts are widely related to industrial savings, it is becoming particularly important in a more and more competitive world, to really understand how productivity can be well used in industrial management techniques. Nowadays, consumers are no more willing to pay for mistakes and inefficiencies. Therefore, one way for companies to stay competitive is to control and increase their productivity. This study aims to define clearly the productivity concept, understand how a company can affect productivity, and, if possible, identify the relation between each identified productivity factor. This will help managers, by clarifying the main issues behind productivity concepts and proposing a methodology to measure, control and increase productivity. The main questions to be answered are: what is the importance of productivity for the Portuguese Wood Furniture Industry? Is it possible to control productivity internally, or is it a phenomenon external to companies, hard or even impossible to control? How to understand, control and adjust productivity performance? How to make productivity to become one main asset for maximizing the use of the available resources? This essay will follow a constructive approach mostly based in the research hypothesis mentioned above. For that, a literature review is being done to find the main conceptual frameworks and empirical studies that already exist, and by doing so, highlight eventual knowledge or conflicting research to be addressed in this work. We expect to build theoretical explanations and test theoretical predictions from participants understandings and own experiences, by elaborating field surveys and interviews, to select adjusted productivity indicators and analyze the productivity evolution according the adjustments on other variables. Its intended the conduction of an exploratory work that can simultaneous clarify productivity concepts, objectives, and define frameworks. This investigation intends to migrate from merely academic concepts to a daily basis operational reality of the companies from the Portuguese Wood Furniture Industry highlighting productivity increased importance within modern engineering and industrial management. The ambition is to clarify, systemize and develop a management tool that may not only control but positively influence the way resources are used.

Keywords: industrial management, motivation, productivity, performance indicators, reward management, wood furniture industry

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Authors: Elzyata Kuberlinova

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This study explores how the Kalmyk Buddhist sangha responded to the Russian empire’s administrative integration and how the Buddhist clerical institutions were shaped in the process of interaction with representatives of the predominantly Orthodox state. The eighteenth-nineteenth century Russian imperial regime adhered to a religion-centred framework to govern its diverse subjects. Within this framework, any form of religious authority was considered a useful tool in the imperial quest for legibility. As such, rather than imposing religious homogeneity, the Russian administration engineered a framework of religious toleration and integrated the non-Orthodox clerical institutions in the empire’s administration. In its attempt to govern the large body of Kalmyk Buddhist sangha, the Russian government had to incorporate the sangha into the imperial institutional establishment. To this end, the Russian government founded the Lamaist Spiritual Governing Board in 1834, which became a part of the civil administration, where the Kalmyk Buddhist affairs were managed under the supervision of the Russian secular authorities. In 1847 the Lamaist Spiritual Board was abolished and Buddhist religious authority was transferred to the Lama of the Kalmyk people. From 1847 until the end of the empire in 1917 the Lama was the manager and intermediary figure between the Russian authorities and the Kalmyks where religious affairs were concerned. Substantial evidence collected in archives in Elista, Astrakhan, Stavropol and St.Petersburg show that despite being on the government’s payroll, first the Lamaist Spiritual Governing Board and later on the Lama did not always serve the interests of the state, and did not always comply with the Russian authorities’ orders. Although being incorporated into the state administrative system the Lama often found ways to manoeuvre the web of the Russian imperial bureaucracy in order to achieve his own goals. The Lama often used ‘every-day forms of resistance’ such as feigned misinterpretation, evasion, false compliance, feigned ignorance, and sabotage in order to resist without directly confronting or challenging the state orders.

Keywords: Buddhist Sangha, intermediary, Kalmyks, Lama, legibility, resistance, reform, Russian empire

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Authors: Sita Lakshmi Thyagarajan

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Nanofibers will leave no field untouched by its scientific innovations; the medical field is no exception. Electrospinning has proven to be an excellent method for the synthesis of nanofibers which, have attracted the interest for many biomedical applications. The formation of biofilms in wounds often leads to chronic infections that are difficult to treat with antibiotics. In order to minimize the biofilms and enhance the wound healing, preparation of potential nanofibers was focused. In this study, siderophore incorporated nanofibers were electrospun using biocompatible polymers onto the collagen scaffold and were fabricated into a biomaterial suitable for the inhibition of biofilm formation. The purified microbial siderophore was blended with Poly-L-lactide (PLLA) and poly (ethylene oxide) PEO in a suitable solvent. Fabrication of siderophore blended nanofibers onto the collagen surface was done using standard protocols. The fabricated scaffold was subjected to physical-chemical characterization. The results indicated that the fabrication processing parameters of nanofiberous scaffold was found to possess the characteristics expected of the potential scaffold with nanoscale morphology and microscale arrangement. The influence of Poly-L-lactide (PLLA) and poly (ethylene oxide) PEO solution concentration, applied voltage, tip-to-collector distance, feeding rate, and collector speed were studied. The optimal parameters such as the ratio of Poly-L-lactide (PLLA) and poly (ethylene oxide) PEO concentration, applied voltage, tip-to-collector distance, feeding rate, collector speed were finalized based on the trial and error experiments. The fibers were found to have a uniform diameter with an aligned morphology. The overall study suggests that the prepared siderophore entrapped nanofibers could be used as a potent tool for wound dressing material for inhibition of biofilm formation.

Keywords: biofilms, electrospinning, nano-fibers, siderophore, tissue engineering scaffold

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Authors: S. Jabeen

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Though Pakistan has a rich cultural history and a diverse population; its global image is tarnished with labels of Muslim ‘fundamentalism’ and ‘extremism.’ Cultural policy is a tool that can be used by the government of Pakistan to ameliorate this image, but instead, this fundamentalist reputation is reinforced in the 2005 draft of Pakistan’s cultural policy. With its stern focus on a homogenized cultural identity, this 2005 draft bases itself largely on forced participation from the largely Muslim public and leaves little or no benefits to them or cultural minorities in Pakistan. The effects of this homogenized ‘Muslim’ identity linger ten years later where the study and celebration of the cultural heritage of Pakistan in schools and educational festivals focus entirely on creating and maintaining a singular ‘Islamic’ cultural identity. The current lack of inclusion has many adverse effects that include the breeding of extremist mindsets through the usurpation of minority rights and lack of safe cultural public spaces. This paper argues that Pakistan can improve social inclusivity and boost its global image through cultural policy. The paper sets the grounds for research by surveying the effectiveness of different cultural policies across nations with differing socioeconomic status. Then, by sampling two public literary festivals in Pakistan as case studies, the National Youth Peace Festival hosted with a nationalistic agenda using public funds and the Lahore Literary Festival (LLF) that aims to boost the cultural literacy scene of Lahore using both private and public efforts, this paper looks at the success of the private, more inclusive LLF. A revision of cultural policy is suggested that combines public and private efforts to host cultural festivals for the sake of cultural celebration and human development, without a set nationalistic agenda. Consequently, this comparison which is grounded in the human capabilities approach, recommends revising the 2005 draft of the Cultural Policy to improve human capabilities in order to support cultural diversity and ultimately contribute to economic growth in Pakistan.

Keywords: cultural policy, festivals, human capabilities, Pakistan

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Authors: Sania Bashir

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A promising approach to healthcare delivery, telemedicine makes use of communication technology to reach out to remote regions of the world, allowing for beneficial interactions between diabetic patients and healthcare professionals as well as the provision of affordable and easily accessible medical care. The emergence of contemporary care models, fueled by the pervasiveness of mobile devices, provides better information, offers low cost with the best possible outcomes, and is known as digital health. It involves the integration of collected data using software and apps, as well as low-cost, high-quality outcomes. The goal of this study is to assess how well telemedicine works for diabetic patients and how it impacts their HbA1c levels. A questionnaire-based survey of 300 diabetics included 150 patients in each of the groups receiving usual care and via telemedicine. A descriptive and observational study that lasted from September 2021 to May 2022 was conducted. HbA1c has been gathered for both categories every three months. A remote monitoring tool has been used to assess the efficacy of telemedicine and continuing therapy instead of the customary three monthly meetings like in-person consultations. The patients were (42.3) 18.3 years old on average. 128 men were outnumbered by 172 women (57.3% of the total). 200 patients (66.6%) have type 2 diabetes, compared to over 100 (33.3%) candidates for type 1. Despite the average baseline BMI being within normal ranges at 23.4 kg/m², the mean baseline HbA1c (9.45 1.20) indicates that glycemic treatment is not well-controlled at the time of registration. While patients who use telemedicine experienced a mean percentage change of 10.5, those who visit the clinic experienced a mean percentage change of 3.9. Changes in HbA1c are dependent on several factors, including improvements in BMI (61%) after 9 months of research and compliance with healthy lifestyle recommendations for diet and activity. More compliance was achieved by the telemedicine group. It is an undeniable reality that patient-physician communication is crucial for enhancing health outcomes and avoiding long-term issues. Telemedicine has shown its value in the management of diabetes and holds promise as a novel technique for improved clinical-patient communication in the twenty-first century.

Keywords: diabetes, digital health, mobile app, telemedicine

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