Search results for: early mobilisation in intensive care (ICU)

Authors: Pablo Cid Galache, Laura Zamorano Bonilla

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Mauriac syndrome (MS) is a rare complication of type 1 diabetes mellitus (DM1). It is rela-ted to low insulin concentrations. Therefore is a complication mainly found in developing countries. The main clinical features are hepatomegaly, edema, growth and puberty delay, and the presence of elevated transaminases and serum lipids. The MS incidence is de-creasing due to the new types of insulin and intensive glycemic control. Therefore is a rare diagnosis in Europe nowadays, being described mainly in developing countries or with so-cioeconomic limitations to guarantee an adequate management of diabetes. Edema secondary to fluid retention is a rare complication of insulin treatment, especially in young patients. Its severity is variable and is mainly related to the start of a proper treatment and the improvement in glycemic control after diagnosis or after periods of poor metabolic control. Edema resolves spontaneously without requiring treatment in most cases. The Pediatric Endocrinology Unit of Hospital Motril could diagnose a 14-year-old girl who presented very poor metabolic control during the last 3 years as a consequence of the socioeconomic conditions of the country of origin during the last years. Presents up to 4 admissions for ketoacidosis during the last 12 months. After the family moved to Spain our patient began to be followed up in our Hospital. Initially presented glycated hemoglobin figures of 11%. One week after the start of treatment, the patient was admitted in the emergency room due to the appearance of generalized edema and pain in the limbs. The main laboratory abnormalities include: blood glucose 225mg/dl; HbA1C 10.8% triglycerides 543 mg/dl, total cholesterol 339 mg/dl (LDL 225) GOT 124 U/l, GPT 89U/l. Abdominal ultrasound shows mild hepatomegaly and no signs of ascites were shown. The patient presented a progressive improvement with resolution of the edema and analitical abnormalities during the next two weeks. During admission, the family received diabetes education, achieving adequate glycemic control at discharge. Nowadays the patient has a good glycemic control having glycated hemoglobin levels around 7%.

Keywords: Mauriac, diabetes, complication, developing countries

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Authors: Tan G. K. Y., Chew M. S. J., Sajeev S., Vellasamy A.

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Injuries of the extensor hallucis longus (EHL) tendon are a rare phenomenon, with most occurring due to lacerations or penetrating injuries. Closed traumatic ruptures of the EHL are described as “Mallet injuries of the toe”. These can be classified as bony or soft mallet injuries depending on the presence or absence of a fracture at the insertion site of the EHL tendon in the distal phalanx. We present a case of a 33-year-old woman who presented with a hyperflexion injury to the left big toe with an inability to extend the big toe. Ultrasound showed a complete rupture of the EHL tendon with retraction proximal to the hallucal interphalangeal joint of the big toe. The patient was treated through transarticular pinning and repair using the Arthrex Mini Bio-Suture Tak with a 2-0 fibre wire. Six months postoperatively, the patient had symmetrical EHL power and full range of motion of the toe. The lessons to be drawn from this case report are that isolated hallux mallet injuries are rare and can be easily missed in the absence of penetrating wounds. Patients who have such injuries should be investigated early with the appropriate imaging techniques, such as ultrasound or MRI, and treated surgically.

Keywords: hallux mallet, extensor hallucis longus tendon, extensor hallucis longus

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Authors: Saba. T. Suliman, Alaa. H. Osman, Sara. T. Ahmed, Zeinab. A. Mustafa, Akram. I. Omara, Banazier. A. Ibraheem

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Diagnosis by sweat is one of the emerging methods whereby sweat can identify many diseases in the human body. Sweat contains many elements that help in the diagnostic process. In this research, we analyzed sweat samples by using a Colorimeter device to identify the disease of kidney failure in its various stages. This analysis is a non-invasive method where the sample is collected from outside the body, and then this sample is analyzed. Urea refers to the disease of kidney failure when its quantity is high in the blood and then in the sweat, and by experience, we found that the amount of urea for males differs from its quantity for females, where there is a noticeable increase for males in normal and pathological cases. In this research, we took many samples from a normal group that does not suffer from renal failure and another who suffers from the disease to compare the percentage of urea, and after analysis, we found that the urea percentage is high in people with kidney failure disease. with an accuracy of results of 85%.

Keywords: sweat analysis, kidney failure, urea, non-invasive, eccrine glands, mineral composition, sweat test

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Authors: Mohd. Akram, A. A. M. Saeed

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Surfactants are widely used in our daily life either directly in household and personal care products or indirectly in the industrial processes. The kinetics of the interaction of glycyl-DL-aspartic acid (Gly-DL-Asp) with ninhydrin has been investigated spectrophotometrically in aqueous and organic-solvent media in the absence and presence of cationic surfactant of tetradecyltrimethylammonium bromide (TTAB). The study was carried out under different experimental conditions. The first and fractional order-rate were observed for [Gly-DL-Asp] and [ninhydrin], respectively. The reaction was enhanced about four-fold by TTAB micelles. The effect of organic solvents was studied at a constant concentration of TTAB and showed an increase in the absorbance as well as the rate constant for the formation of product (Ruhemann's purple). The results obtained in micellar media are treated quantitatively in terms of pseudo-phase and Piszkiewicz cooperativity models. The Arrhenius and Eyring equations are valid for the reaction over the range of temperatures used and different activation parameters (Ea, ∆H#, ∆S#, and ∆G#) have been evaluated.

Keywords: glycyl-DL-aspartic acid, ninhydrin, organic solvents, TTAB

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Authors: Yihao Kuang, Bowen Ding

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With the increasing scale and complexity of knowledge graph, modern knowledge graph contains more and more types of entity, relationship, and attribute information. Therefore, in recent years, it has been a trend for knowledge graph inference to use reinforcement learning to deal with large-scale, incomplete, and noisy knowledge graphs and improve the inference effect and interpretability. The Proximal Policy Optimization (PPO) algorithm utilizes a near-end strategy optimization approach. This allows for more extensive updates of policy parameters while constraining the update extent to maintain training stability. This characteristic enables PPOs to converge to improved strategies more rapidly, often demonstrating enhanced performance early in the training process. Furthermore, PPO has the advantage of offline learning, effectively utilizing historical experience data for training and enhancing sample utilization. This means that even with limited resources, PPOs can efficiently train for reinforcement learning tasks. Based on these characteristics, this paper aims to obtain a better and more efficient inference effect by introducing PPO into knowledge inference technology.

Keywords: reinforcement learning, PPO, knowledge inference

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Authors: Elmo Thiago Lins Cöuras Ford, Valentina Alessandra Carvalho do Vale

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With the evolution of the productive processes, demonstrated mainly by the presence every time larger of the irrigation and to crescent it disputes for water, accompanied by your shortage (distances every time larger), there is need to project facilities that can provide supply of water with larger speed and efficiency. Being like this, the presence of hydraulic pumps in an irrigation project or water supply for small communities, is of highest importance, and the knowledge of the fundamental parts to your good operation it deserves the due attention and care. Hydraulic pumps are machines of flow, whose function is to supply energy for the water, in order to press down her, through the conversion of mechanical energy of your originating from rotor a motor the combustion or of an electric motor. This way, the hydraulic pumps are had as generating hydraulic machines. The objective of this work was to project and to build a radial centrifugal pump for agricultural application in small communities.

Keywords: centrifuge pump, hydraulic energy, agricultural applications, irrigation

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Authors: Isaura Esther Solano Núñez, David Suarez

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The main purpose of this research is to discover what causes death in children of the Wayuu community, and deeply analyze those results in order to take corrective measures to properly control infant mortality. We consider important to determine the reasons that are producing early death in this specific type of population, since they are the most vulnerable to high risk environmental conditions. In this way, the government, through competent authorities, may develop prevention policies and the right measures to avoid an increase of this tragic fact. The methodology used to develop this investigation is data mining, which consists in gaining and examining large amounts of data to produce new and valuable information. Through this technique it has been possible to determine that the child population is dying mostly from malnutrition. In short, this technique has been very useful to develop this study; it has allowed us to transform large amounts of information into a conclusive and important statement, which has made it easier to take appropriate steps to resolve a particular situation.

Keywords: malnutrition, data mining, analytical, descriptive, population, Wayuu, indigenous

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Authors: Gabriela Prins, Quinette Louw, Dawn Ernstzen

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Background: Access to rehabilitation services is a major challenge globally, especially in low-and-middle income countries (LMICs) where resources and infrastructure are extremely limited. Telerehabilitation (TR) has emerged in recent decades as a highly promising method to dramatically expand accessibility to rehabilitation services globally. TR provides rehabilitation care remotely using communication technologies such as video conferencing, smartphones, and internet-connected devices. This boosts accessibility to underprivileged regions and allows for greater flexibility for patients. Despite this, TR is hindered by several factors, including limited technological resources, high costs, lack of digital access, and the unavailability of healthcare systems, which are major barriers to widespread adoption among LMIC patients. These barriers have collectively hindered the potential implementation and adoption of TR services in LMICs healthcare settings. Adoption of TR will also require the buy-in of end users and limited information is known on the perspectives of the SA population. Aim: The study aimed to understand patients' perspectives regarding the use of digital technology as part of their OA rehabilitation at a public community healthcare centre in the Cape Metropole Area. Methods: A qualitative descriptive study design was used on 10 OA patients from a public community rehabilitation centre in South Africa. Data collection included semi-structured interviews and patient-reported outcome measures (PSFS, ASES-8, and EuroQol EQ-5D-5L) on functioning and quality of life. Transcribed interview data were coded in Atlas.ti. 22.2 and analyzed using thematic analysis. The results were narratively documented. Results: Four themes arose from the interviews. The themes were Telerehabilitation awareness (Use of Digital Technology Information Sources and Prior Experience with Technology /TR), Telerehabilitation Benefits (Access to healthcare providers, Access to educational information, Convenience, Time and Resource Efficiency and Facilitating Family Involvement), Telerehabilitation Implementation Considerations (Openness towards TR Implementation, Learning about TR and Technology, Therapeutic relationship, and Privacy) and Future use of Telerehabilitation (Personal Preference and TR for the next generation). The ten participants demonstrated limited awareness and exposure to TR, as well as minimal digital literacy and skills. Skepticism was shown when comparing the effectiveness of TR to in-person rehabilitation and valued physical interactions with health professionals. However, some recognized potential benefits of TR for accessibility, convenience, family involvement and improving community health in the long term. Willingness existed to try TR with sufficient training. Conclusion: With targeted efforts addressing identified barriers around awareness, technological literacy, clinician readiness and resource availability, perspectives on TR may shift positively from uncertainty towards endorsement of this expanding approach for simpler rehabilitation access in LMICs.

Keywords: digital technology, osteoarthritis, primary health care, telerehabilitation

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Authors: P. S. Surya Meghana, K. Lingeshwaran, C. Kannan, V. Raghavendran, C. Priya

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One of the most basic and powerful tools in all of science and medicine is the light microscope, the fundamental device for laboratory as well as research purposes. With the improving technology, the need for portable, economic and user-friendly instruments is in high demand. The conventional microscope fails to live up to the emerging trend. Also, adequate access to healthcare is not widely available, especially in developing countries. The most basic step towards the curing of a malady is the diagnosis of the disease itself. The main aim of this paper is to diagnose Malaria with the most common device, cell phones, which prove to be the immediate solution for most of the modern day needs with the development of wireless infrastructure allowing to compute and communicate on the move. This opened up the opportunity to develop novel imaging, sensing, and diagnostics platforms using mobile phones as an underlying platform to address the global demand for accurate, sensitive, cost-effective, and field-portable measurement devices for use in remote and resource-limited settings around the world.

Keywords: cellular, hand-held, health care, image processing, malarial parasites, microscope

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Authors: Ahmad Al Aboudi

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The Department of Archaeology at King Saud University conduct a long Term excavations since 2004 at the archaeological site of (Qurh) in Al-Ula area. The history of the site goes back to the eighth century AD. The main aim of the excavations is the training of the students on the archaeological field work associated with the scientific skills of exploring, surveying, classifying, documentations and other necessary in the field archaeology. During the 12th Season of Excavations, an area of 20 × 40 m2 of the site was excavated. The depth of the excavating the site was reached to 2-3 m. Many of the architectural features of a residential area in the northern part of the site were excavated this season. Circular walls made of mud-brick and a brick column drums and tiles made of clay were revealed this season. Additionally, lots of findings such as Gemstones, jars, ceramic plates, metal, glass, and fabric, as well as some jewelers and coins were discovered. This paper will deal with the main results of this field project including the architectural features and phenomena and their interpretations, the classification of excavated material culture remains and stratigraphy.

Keywords: Islamic architecture, Islamic art, excavations, early Islamic city

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Authors: Bahadir Aydin

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Today it is difficult to reach accurate knowledge because of mass data. This huge data makes the environment more and more caotic. Data is a main piller of intelligence. There is a close tie between knowledge and intelligence. Information gathered from different sources can be modified, interpreted and classified by using knowledge development process. This process is applied in order to attain intelligence. Within this process the effect of knowledge is crucial. Knowledge is classified as explicit and tacit knowledge. Tacit knowledge can be seen as "only the tip of the iceberg”. This tacit knowledge accounts for much more than we guess in all intelligence cycle. If the concept of intelligence scrutinized, it can be seen that it contains risks, threats as well as success. The main purpose for all organization is to be succesful by eliminating risks and threats. Therefore, there is a need to connect or fuse existing information and the processes which can be used to develop it. By the help of process the decision-maker can be presented with a clear holistic understanding, as early as possible in the decision making process. Planning, execution and assessments are the key functions that connects to information to knowledge. Altering from the current traditional reactive approach to a proactive knowledge development approach would reduce extensive duplication of work in the organization. By new approach to this process, knowledge can be used more effectively.

Keywords: knowledge, intelligence cycle, tacit knowledge, KIDW

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Authors: Shannon L. Stewart, Ashley Toohey, Natalia Lapshina

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There is a well-established relationship between childhood maltreatment and negative outcomes (e.g., physical and mental health problems, social skill deficits, poor quality of life). The goal of this study was to examine the relationship between polyvictimization (multiple types of trauma) and risk of harm to self and others, taking into account possible age and sex differences. A total of 8980 children and youth were recruited from over 50 mental health facilities across Ontario, Canada. Among this sample, 29% of children and youth had experienced polyvictimization. Results showed that female children and youth who had experienced trauma were at greater risk of harm to themselves, while their male counterparts were at greater risk of harming others. Further, findings from this study highlight that experiencing polyvictimization, regardless of age or sex, increased the risk of harm to self and others. These findings add to extant literature as to the cumulative relationship between polyvictimization and risk in relation to harming oneself or others. Further, results from this study have significant implications for assessment and care-planning for those children and youth presenting with a trauma background.

Keywords: children's mental health, polyvictimization, risk of harm, sex differences

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Authors: Thomas Monahan, Nicolas Gorius, Thanh Nguyen

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Exoplanet atmospheric parameters retrieval is a complex, computationally intensive, inverse modeling problem in which an exoplanet’s atmospheric composition is extracted from an observed spectrum. Traditional Bayesian sampling methods require extensive time and computation, involving algorithms that compare large numbers of known atmospheric models to the input spectral data. Runtimes are directly proportional to the number of parameters under consideration. These increased power and runtime requirements are difficult to accommodate in space missions where model size, speed, and power consumption are of particular importance. The use of traditional Bayesian sampling methods, therefore, compromise model complexity or sampling accuracy. The Atmospheric Retrievals conditional Generative Adversarial Network (ARcGAN) is a deep convolutional generative adversarial network that improves on the previous model’s speed and accuracy. We demonstrate the efficacy of artificial intelligence to quickly and reliably predict atmospheric parameters and present it as a viable alternative to slow and computationally heavy Bayesian methods. In addition to its broad applicability across instruments and planetary types, ARcGAN has been designed to function on low power application-specific integrated circuits. The application of edge computing to atmospheric retrievals allows for real or near-real-time quantification of atmospheric constituents at the instrument level. Additionally, edge computing provides both high-performance and power-efficient computing for AI applications, both of which are critical for space missions. With the edge computing chip implementation, ArcGAN serves as a strong basis for the development of a similar machine-learning algorithm to reduce the downlinked data volume from the Compact Ultraviolet to Visible Imaging Spectrometer (CUVIS) onboard the DAVINCI mission to Venus.

Keywords: deep learning, generative adversarial network, edge computing, atmospheric parameters retrieval

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Authors: Vaisnavy Govindasamy, Saba Ishrat

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Introduction: The Dexamethasone Intravitreal Implant 0.7 mg (OzurdexTM, Allergan®) is a biodegradable corticosteroid implant approved by the FDA for managing diabetic macular edema (DMO), macular edema following branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO), and posterior segment non-infectious uveitis. This implant can release dexamethasone over a six-month period, exhibiting peak effectiveness between 60 and 90 days post-administration. The intravitreal injection should be performed under sterile conditions. At James Cook University Hospital (JCUH), Ozurdex injections are currently administered in the Vitreo-Retinal (VR) theatre. This study aimed to evaluate the feasibility and potential advantages of establishing a dedicated clinic for Ozurdex administration separate from the VR theatre setting. Method: Retrospectively, data of all Ozurdex injections administered between October 2021 to October 2022 was collected from operating theatre registers at JCUH. Data pertaining to the indications for Ozurdex; waiting times from referral date to date of injection; duration of theatre time consumed; and post-injection complications were collected from electronic notes. The resources needed to establish a dedicated Ozurdex clinic were evaluated. Over a six-month period from October 2023 to March 2024, we gathered data on utilization of theatre 28. Results: A total of 135 Ozurdex injections were administered. Among the indications, uveitis represented 47.3% of cases, DMO with 23.6% and RVO with 22.9%. Remaining cases lacked sufficient data. Each Ozurdex injection procedure consumed 15 minutes in the VR theatre list. Complications arose in 5% of injections, totaling 7 cases. These included glaucoma, ocular hypertension, subconjunctival haemorrhage and implant migration. Waiting times averaged 6 weeks from date for referral to procedure date. We also found that, on an average theatre 28 was offered but remained unused for 4 days, totalling eight sessions in a month. Analysis: Establishing a sperate Ozurdex clinic would improve the quality of patient care in following ways: 1.Decrease injection waiting times (currently averaging 6 weeks), leading to better visual outcomes. 2.Free up approximately three hours of theatre time in Vitreo-Retina theatres each month, allowing for 3-4 additional surgeries. Reduce waiting times for critical retinal surgeries and enhance visual outcomes. 3.Provide additional training opportunities for trainees and retina fellows, improving their skills. 4.Optimize the use of empty theatre slots (theatre 28) currently experiencing underutilization of resources. Conclusion: These findings support the implementation of a separate clinic for administering Ozurdex injections at JCUH. It is evident that introducing a dedicated clinic will enhance operational efficiency, optimise resource utilsation, and improve overall quality of care for patients undergoing this treatment.

Keywords: opthalmology, ozurdex, efficiency, complication

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Authors: Atefeh Ahmadi, Mohamed Sharif Mustaffa

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Mental health problems that children introspect them are hardly identified. The internalizing nature of Anxiety Disorders as the most prevalent psychological diseases, make them been under recognized by parents and teachers and so become under attended by school counsellors and subsequently under referred to clinicians. The aim of this study is to investigate the level of Anxiety Disorders to clarify if it is necessary to run screening programs in rural educational settings. Spence children anxiety scale-malay-child for the first time in Malaysia distributed among 640 Malay rural primary school students aged from 9-11 years old. Cut-off score was considered one standard deviation more than the mean of all students’ scores. The results of descriptive analyses revealed the mean for scores of SCAS was 32.84 and 15.6% of students had high level of anxiety. In addition, the level and prevalence of six types of anxiety disorders based on SCAS were described. In regards to the study outcomes, screening for anxiety disorders in academic settings could prevent and reduce their side effects by early identification.

Keywords: anxiety disorders, primary schools, SCAS, screening

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Authors: Abdullah Alyoussef

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Folliculitis decalvans is a rare inflammatory scalp disorder. This paper gives an update to patient management and treatment modalities. Folliculitis decalvans is classified as primary neutrophilic cicatricial alopecia and predominantly occurs in middle-aged adults. The cause of folliculitis decalvans (FD) remains unknown. Staphylococcus aureus and a deficient host immune response seem to play an important role in the development of this disfiguring scalp disease. Lesions occur mainly in the vertex and occipital area. Clinically, the lesions present with follicular pustules, lack of ostia, diffuse and perifollicular erythema, follicular tufting, and, oftentimes, hemorrhagic crusts and erosions. Histology displays a mainly neutrophilic inflammatory infiltrate in early lesions and additionally lymphocytes and plasma cells in advanced lesions. Treatment is focused on the eradication of S. aureus and anti-inflammatory agents. Although the etiology of FD is unclear, S. aureus is almost always isolated from affected areas, and eradication is an important part of therapeutic management, in combination with systemic and ⁄ or topical anti-inflammatory treatment.

Keywords: cicatricial alopecia, folliculitis decalvans, tufted folliculitis, erosion

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Authors: Hafiz Khubaib Ur Rehman Awan

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Education used to play a central role in the formation and transfiguration of society since early times, owing in part to the centrality of scripture and its study in the human circles. According to the Islamic purpose of education, its pivotal contribution in the society is to produce a balanced growth of the entire persona of an individual through training the spirit, intellect, rational self, feelings, and bodily senses such that faith is infused into the whole personality. The purpose of this study is to attempt the exploration of the development of the Islamic religious curriculum in the Islamic world with an emphasis on Pakistan because this homeland came into existence under the name of Islam. This study persists of necessary historical background on the curricular reform of religious education in Pakistan and their impact on it and the suburban countries. However, the mainstay of this paper bases on reform in the religious education curriculum and the challenges faced by Pakistan and the Islamic world. Some suggestions are positioned at the end for areas of Islamic religious education and the improvement of Islamic curricular reform, especially in Pakistan and generally in Muslim countries.

Keywords: curricula, religious educational institutions, Pakistan, Muslim world, educational, religious , curricula

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Authors: Ahmad Masduki Bin Selamat

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Malaysia is becoming a developed country by the year 2020, the problem is that little is known about the perceptions and curricular values of Malaysian high school students who have taken Living Skills as a subject in the regular public school. How these students perceive technology in their daily lives, in the country’s development and in global context, is not known. The study involved form 4 students from four public schools in Petaling District. The study found that the Petaling District students’ knowledge of technology were good, where 76.6 % of them scored 50% marks and above during the achievement test. In addition, it was also found that only excellent and squatter students perceived technology education as important as a school subject, compared to those students from the urban area. It was found that students preferred business and entrepreneurship topics rather than the other Living Skills curriculum. The study suggests that students should be exposed to technology education from the early years of schooling (preschool to secondary). In addition, the acquisition of skills, the evaluation, revision and modification of the instruction as well as the curriculum should be enforced.

Keywords: technology education, living skills, curricular values, public schools

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Authors: Clarissa Delariarte

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With the aim of helping the poorest of the poor achieve quality education, Psychology students supported and served as teacher assistants to its Early Childhood Education Center in two barangays since the program began in 1999. Making use of qualitative approach, the impact of the program to 29 alumni who served as teacher assistants between 2000-2014 was assessed. Results show that the impact to the alumni is in cognitive as well as social-emotional in terms of feelings of deep satisfaction and sense of volunteerism which is being carried out in their respective workspaces. They also expressed positive feelings of inspiration, gratefulness and happiness. A wider perspective in life, being confident, creative and resourceful was also articulated as concrete impacts. It is concluded that the program had an impact on helping the helper and is a concrete manifestation of the academe being successful in its commitment of forming individuals into becoming integrated and compassionate in the service of the Church and Society. It implies that more opportunities of helping others be provided to students since, in the final analysis, is actually an opportunity of helping the helper be of better service to others.

Keywords: applied psychology, life skill, qualitative research, quality education

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Authors: Yiding Qu, Svetlana V. Komarova

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Chemokines acting through their cognate chemokine receptors guide the directional migration of the cell along the chemokine gradient. Several chemokine receptors were recently identified as non-signaling (decoy), based on their ability to bind the chemokine but produce no measurable signal in the cell. The function of these decoy receptors is not well understood. We examined the expression of a decoy receptor CCRL1 and a signaling receptor that binds to the same ligands, CCR7, in prostate cancer using publically available microarray data (www.oncomine.org). The expression of both CCRL1 and CCR7 increased in an approximately half of prostate carcinoma samples and the majority of metastatic cancer samples compared to normal prostate. Moreover, the expression of CCRL1 positively correlated with the expression of CCR7. These data suggest that CCR7 and CCRL1 can be used as clinical markers for the early detection of transformation from carcinoma to metastatic cancer. In addition, these data support our hypothesis that the non-signaling chemokine receptors actively stimulate cell migration.

Keywords: bioinformatics, cell migration, decoy receptor, meta-analysis, prostate cancer

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Authors: Sıdıka Kaya, Gülay Sain Güven, Seda Karsavuran, Onur Toka

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This study is part of an ongoing research project supported by the Scientific and Technological Research Council of Turkey (TUBITAK) under Project Number 114K404, and participation to this conference was supported by Hacettepe University Scientific Research Coordination Unit under Project Number 10243. Evaluation of hospital readmissions is gaining importance in terms of quality and cost, and is becoming the target of national policies. In Turkey, the topic of hospital readmission is relatively new on agenda and very few studies have been conducted on this topic. The aim of this study was to determine 30-day readmission rates and risk factors for readmission. Whether readmission was planned, related to the prior admission and avoidable or not was also assessed. The study was designed as a ‘prospective cohort study.’ 472 patients hospitalized in internal medicine departments of a university hospital in Turkey between February 1, 2015 and April 30, 2015 were followed up. Analyses were conducted using IBM SPSS Statistics version 22.0 and SPSS Modeler 16.0. Average age of the patients was 56 and 56% of the patients were female. Among these patients 95 were readmitted. Overall readmission rate was calculated as 20% (95/472). However, only 31 readmissions were unplanned. Unplanned readmission rate was 6.5% (31/472). Out of 31 unplanned readmission, 24 was related to the prior admission. Only 6 related readmission was avoidable. To determine risk factors for readmission we constructed Chi-square automatic interaction detector (CHAID) decision tree algorithm. CHAID decision trees are nonparametric procedures that make no assumptions of the underlying data. This algorithm determines how independent variables best combine to predict a binary outcome based on ‘if-then’ logic by portioning each independent variable into mutually exclusive subsets based on homogeneity of the data. Independent variables we included in the analysis were: clinic of the department, occupied beds/total number of beds in the clinic at the time of discharge, age, gender, marital status, educational level, distance to residence (km), number of people living with the patient, any person to help his/her care at home after discharge (yes/no), regular source (physician) of care (yes/no), day of discharge, length of stay, ICU utilization (yes/no), total comorbidity score, means for each 3 dimensions of Readiness for Hospital Discharge Scale (patient’s personal status, patient’s knowledge, and patient’s coping ability) and number of daycare admissions within 30 days of discharge. In the analysis, we included all 95 readmitted patients (46.12%), but only 111 (53.88%) non-readmitted patients, although we had 377 non-readmitted patients, to balance data. The risk factors for readmission were found as total comorbidity score, gender, patient’s coping ability, and patient’s knowledge. The strongest identifying factor for readmission was comorbidity score. If patients’ comorbidity score was higher than 1, the risk for readmission increased. The results of this study needs to be validated by other data–sets with more patients. However, we believe that this study will guide further studies of readmission and CHAID is a useful tool for identifying risk factors for readmission.

Keywords: decision tree, hospital, internal medicine, readmission

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Authors: Ahmad Khoirul Umam

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This paper investigates the role of vested interests and its impacts on anti-corruption agenda in Indonesia following the collapse of authoritarian regime in 1998. A pervasive and rampant corruption has been believed as the main cause of the state economy’s fragility. Hence, anti-corruption measures were implemented by applying democratization and market liberalization since the establishment of a consolidated democracy which go hand in hand with a liberal market economy is convinced to be an efficacious prescription for effective anti-corruption. The reform movement has also mandated the establishment of the independent, neutral and professional special anti-corruption agency namely Corruption Eradication Commission (KPK) to more intensify the fight against the systemic corruption. This paper will examine whether these anti-corruption measures have been effective to combat corruption, and investigate to what extend have the anti-corruption efforts, especially those conducted by KPK, been impeded by the emergence of a nexus of vested interests as the side-effect of democratization and market liberalization. Based on interviews with key stakeholders from KPK, other law enforcement agencies, government, prominent scholars, journalists and NGOs in Indonesia, it is found that since the overthrow of Soeharto, anti-corruption movement in the country have become more active and serious. After gradually winning the hearth of people, KPK successfully touched the untouchable corruption perpetrators who were previously protected by political immunity, legal protection and bureaucratic barriers. However, these changes have not necessarily reduced systemic and structural corruption practices. Ironically, intensive and devastating counterattacks were frequently posed by the alignment of business actors, elites of political parties, government, and also law enforcement agencies by hijacking state’s instruments to make KPK deflated, powerless, and surrender. This paper concludes that attempts of democratization, market liberalization and the establishment of anti-corruption agency may have helped Indonesia to reduce corruption. However, it is still difficult to imply that such anti-corruption measures have fostered the more effective anti-corruption works in the newly democratized and weakly regulated liberal economic system.

Keywords: vested interests, democratization, market liberalization, anti-corruption, Indonesia

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Authors: Uma Maheshwari V., Rajanikanth Aluvalu, Kumar Gautam

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The COVID-19 disease is a highly contagious viral infection with major worldwide health implications. The global economy suffers as a result of COVID. The spread of this pandemic disease can be slowed if positive patients are found early. COVID-19 disease prediction is beneficial for identifying patients' health problems that are at risk for COVID. Deep learning and machine learning algorithms for COVID prediction using X-rays have the potential to be extremely useful in solving the scarcity of doctors and clinicians in remote places. In this paper, a convolutional neural network (CNN) with deep layers is presented for recognizing COVID-19 patients using real-world datasets. We gathered around 6000 X-ray scan images from various sources and split them into two categories: normal and COVID-impacted. Our model examines chest X-ray images to recognize such patients. Because X-rays are commonly available and affordable, our findings show that X-ray analysis is effective in COVID diagnosis. The predictions performed well, with an average accuracy of 99% on training photographs and 88% on X-ray test images.

Keywords: deep CNN, COVID–19 analysis, feature extraction, feature map, accuracy

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Authors: Elnaz Kanani-Kuchesfehani, Andrea Schiffauerova

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Due to the novelty of the nanotechnology science, its highly knowledge intensive content, and its invaluable application in almost all technological fields, the close interaction between university and industry is essential. A possible gap between academic strengths to generate good nanotechnology ideas and industrial capacity to receive them can thus have far-reaching consequences. In order to be able to enhance the collaboration between the two parties, a better understanding of knowledge transfer within the university-industry relationship is needed. The objective of this research is to investigate the research collaboration between academia and industry in Canadian nanotechnology and to propose the best cooperative strategy to maximize the quality of the produced knowledge. First, a network of all Canadian academic and industrial nanotechnology inventors is constructed using the patent data from the USPTO (United States Patent and Trademark Office), and it is analyzed with social network analysis software. The actual level of university-industry collaboration in Canadian nanotechnology is determined and the significance of each group of actors in the network (academic vs. industrial inventors) is assessed. Second, a novel methodology is proposed, in which the network of nanotechnology inventors is assessed from a game theoretic perspective. It involves studying a cooperative game with n players each having at most n-1 decisions to choose from. The equilibrium leads to a strategy for all the players to choose their co-worker in the next period in order to maximize the correlated payoff of the game. The payoffs of the game represent the quality of the produced knowledge based on the citations of the patents. The best suggestion for the next collaborative relationship is provided for each actor from a game theoretic point of view in order to maximize the quality of the produced knowledge. One of the major contributions of this work is the novel approach which combines game theory and social network analysis for the case of large networks. This approach can serve as a powerful tool in the analysis of the strategic interactions of the network actors within the innovation systems and other large scale networks.

Keywords: cooperative strategy, game theory, industry-university collaboration, knowledge production, social network analysis

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Authors: Riyad Awad, Abdulmohsen Alghadeer, Meshari Otaibi

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Proper operation and maintenance (O&M) activities of high voltage equipment can lead to an increased asset lifecycle and maintain its integrity and reliability. Such a vital process is important to be proactively considered during equipment design and manufacturing phases by removing and eliminating any obstacles in the equipment which adversely affect the (O&M) activities. This paper presents a gap analysis pertaining to difficulties in performing operations and maintenance (O&M) high voltage electrical equipment, includes power transformers, switch gears, motor control center, disconnect switches and circuit breakers. The difficulties are gathered from field personnel, equipment design review comments, quality management system, and lessons learned database. The purpose of the gap analysis is to mitigate and prevent the (O&M) difficulties as early as possible in the design stage of the equipment lifecycle. The paper concludes with several recommendations and corrective actions for all identified gaps in order to reduce the cost (O&M) difficulties and improve the equipment lifecycle.

Keywords: operation and maintenance, high voltage equipment, equipment lifecycle, reduce the cost of maintenance

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Authors: Jessica Maiuolo, Irene Bava, Micaela Gliozzi, Vincenzo Mollace

Abstract:

Doxorubicin is an anthracycline that is commonly used as a chemotherapy drug due to its cytotoxic effects. The clinical use of doxorubicin is limited due to its known cardiotoxic effects. Polyphenols have a wide range of beneficial properties, and particular importance is given to Oleuropein, one of the main polyphenolic compounds of olive oil. The biological mechanisms involved and the role of the endoplasmic reticulum were examined. Olive oil extract and Oleuropein were able to decrease the damage induced by exposure to doxorubicin. In particular, this natural compound was found to reduce cell mortality and oxidative damage, increase lipid content, and decrease the concentration of calcium ions that escaped from the endoplasmic reticulum. In addition, the direct involvement of this cellular organelle was demonstrated by silencing the ATF6 arm of the Unfolded Protein Response, which was activated after treatment with doxorubicin. The protection afforded by pre-treatment with the natural compound of interest, following the early damage induced by DOXO, provided valuable information regarding the potential use of these substances along with chemotherapy treatment.

Keywords: Olea europea L., oleuropein, doxorubicin, endoplasmic reticulum, nutraceutical support

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Authors: Mannan Malik Muhammad Naeem, Jeong Myung Yung

Abstract:

Functional near infrared spectroscopy (fNIRS) has a favorable position in non-invasive brain imaging techniques. The concentration change of oxygenated hemoglobin and de-oxygenated hemoglobin during particular cognitive activity is the basis for this neuro-imaging modality. Two wavelengths of near-infrared light can be used with modified Beer-Lambert law to explain the indirect status of neuronal activity inside brain. The temporal resolution of fNIRS is very good for real-time brain computer-interface applications. The portability, low cost and an acceptable temporal resolution of fNIRS put it on a better position in neuro-imaging modalities. In this study, an optimization model for impulse response function has been used to estimate/predict initial dip using fNIRS data. In addition, the activity strength parameter related to motor based cognitive task has been analyzed. We found an initial dip that remains around 200-300 millisecond and better localize neural activity.

Keywords: fNIRS, brain-computer interface, optimization algorithm, adaptive signal processing

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Authors: Liu Ying-jie, Lu Wen-bo, Peng Cheng-jian

Abstract:

With the development of the automotive technology and electric vehicle, the contribution of the wind noise on the interior noise becomes the main source of noise. The main transfer path which the exterior excitation is transmitted through is the greenhouse panels and side windows. Simulating the wind noise transmitted into the vehicle accurately in the early development stage can be very challenging. The basic methodologies of this study were based on the Lighthill analogy; the exterior flow field around a passenger car was computed using unsteady Computational Fluid Dynamics (CFD) firstly and then a Finite Element Method (FEM) was used to compute the interior acoustic response. The major findings of this study include: 1) The Sound Pressure Level (SPL) response at driver’s ear locations is mainly induced by the turbulence pressure fluctuation; 2) Peaks were found over the full frequency range. It is found that the methodology used in this study could predict the interior wind noise induced by the exterior aerodynamic excitation in industry.

Keywords: wind noise, computational fluid dynamics, finite element method, passenger car

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Authors: Ahmed H. Abdullah, Pavel Kroupa

Abstract:

Globular clusters (GC) are important objects for tracing the early evolution of a galaxy. We study the correlation between the cluster population and the global properties of the host galaxy. We found that the correlation between cluster population (NGC) and the baryonic mass (Mb) of the host galaxy are best described as 10 −5.6038Mb. In order to understand the origin of the U -shape relation between the GC specific frequency (SN) and Mb (caused by the high value of SN for dwarfs galaxies and giant ellipticals and a minimum SN for intermediate mass galaxies≈ 1010M), we derive a theoretical model for the specific frequency (SNth). The theoretical model for SNth is based on the slope of the power-law embedded cluster mass function (β) and different time scale (Δt) of the forming galaxy. Our results show a good agreement between the observation and the model at a certain β and Δt. The model seems able to reproduce higher value of SNth of β = 1.5 at the midst formation time scale.

Keywords: galaxies: dwarf, globular cluster: specific frequency, number of globular clusters, formation time scale

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Authors: Rhaed Khiati, Muhammad Hanif

Abstract:

In the past decade, smart healthcare systems have been on an ascendant drift, especially with the evolution of hospitals and their increasing reliance on bioinformatics and software specializing in healthcare. Doctors have become reliant on technology more than ever, something that in the past would have been looked down upon, as technology has become imperative in reducing overall costs and improving the quality of patient care. With patient-doctor interactions becoming more necessary and more complicated than ever, systems must be developed while taking into account costs, patient comfort, and patient data, among other things. In this work, we proposed a smart hospital bed, which mixes the complexity and big data usage of traditional healthcare systems with the comfort found in soft beds while taking certain concerns like data confidentiality, security, and maintaining SLA agreements, etc. into account. This research work potentially provides users, namely patients and doctors, with a seamless interaction with to their respective nurses, as well as faster access to up-to-date personal data, including prescriptions and severity of the condition in contrast to the previous research in the area where there is lack of consideration of such provisions.

Keywords: big data, smart healthcare, distributed systems, bioinformatics

Procedia PDF Downloads 202