Search results for: remote patient care

Authors: Si Mon Kueh, Tom J. Kazmierski

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There are about 1% of the world population suffering from the hidden disability known as epilepsy and major developing countries are not fully equipped to counter this problem. In order to reduce the inconvenience and danger of epilepsy, different methods have been researched by using a artificial neural network (ANN) classification to distinguish epileptic waveforms from normal brain waveforms. This paper outlines the aim of achieving massive ANN parallelization through a dedicated hardware using bit-serial processing. The design of this bit-serial Neural Processing Element (NPE) is presented which implements the functionality of a complete neuron using variable accuracy. The proposed design has been tested taking into consideration non-idealities of a hardware ANN. The NPE consists of a bit-serial multiplier which uses only 16 logic elements on an Altera Cyclone IV FPGA and a bit-serial ALU as well as a look-up table. Arrays of NPEs can be driven by a single controller which executes the neural processing algorithm. In conclusion, the proposed compact NPE design allows the construction of complex hardware ANNs that can be implemented in a portable equipment that suits the needs of a single epileptic patient in his or her daily activities to predict the occurrences of impending tonic conic seizures.

Keywords: Artificial Neural Networks (ANN), bit-serial neural processor, FPGA, Neural Processing Element (NPE)

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Authors: Sally Shepherd, Richard De Boer, Craig Murphy

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Background: Invasive lobular carcinoma (ILC) can metastasize to atypical sites within the peritoneal cavity, gastrointestinal, or genitourinary tract. Management varies depending on the symptom presentation, extent of disease burden, particularly if the primary disease is occult, and patient wishes. Case Series: 6 patients presented with general surgical presentations of ILC, including incomplete large bowel obstruction, cholecystitis, persistent lower abdominal pain, and faecal incontinence. 3 were diagnosed with their primary and metastatic disease in the same presentation, whilst 3 patients developed metastasis from 5 to 8 years post primary diagnosis of ILC. Management included resection of the metastasis (laparoscopic cholecystectomy), excision of the primary (mastectomy and axillary clearance), followed by a combination of aromatase inhibitors, biologic therapy, and chemotherapy. Survival post diagnosis of metastasis ranged from 3 weeks to 7 years. Conclusion: Metastatic ILC must be considered with any gastrointestinal or genitourinary symptoms in patients with a current or past history of ILC. Management may not be straightforward to chemotherapy if the acute pathology is resulting in a surgically resectable disease.

Keywords: breast cancer, gastrointestinal metastasis, invasive lobular carcinoma, metastasis

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Authors: Oluwaseun Adeleke, Samuel Ikan, Anthony Nwala, Mopelola Raji, Fidelis Edet

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Background: The risks associated with each pregnancy is carried almost entirely by a woman; however, the decision about whether and when to get pregnant is a subject that several others contend with her to make. The self-care concept offers women of reproductive age the opportunity to take control of their health and its determinants with or without the influence of a healthcare provider, family, and friends. DMPA-SC Self-injection (SI) is becoming the cornerstone of contraceptive self-care and has the potential to expand access and create opportunities for women to take control of their reproductive health. Methodology: To obtain insight into the influences that interfere with a woman’s capacity to make contraceptive choices independently, the Delivering Innovations in Selfcare (DISC) project conducted two intensive rounds of qualitative data collection and triangulation that included provider, client, and community mobilizer interviews, facility observations, and routine program data collection. Respondents were sampled according to a convenience sampling approach and data collected analyzed using a codebook and Atlas-TI. The research team members came together for participatory analysis workshop to explore and interpret emergent themes. Findings: Insights indicate that women are increasingly finding their voice and independently seek services to prevent a deterioration of their economic situation and achieve personal ambitions. Women who hold independent decision-making power still prefer to share decision making power with their male partners. Male partners’ influence on women’s use of family planning and self-inject was most dominant. There were examples of men’s support for women’s use of contraception to prevent unintended pregnancy, as well as men withholding support. Other men outrightly deny their partners from obtaining contraceptive services and their partners cede this sexual and reproductive health right without objection. A woman’s decision to initiate family planning is affected by myths and misconceptions, many of which have cultural and religious origins. Some tribes are known for their reluctance to use contraception and often associate stigma with the pursuit of family planning (FP) services. Information given by the provider is accepted, and, in many cases, clients cede power to providers to shape their SI user journey. A provider’s influence on a client’s decision to self-inject is reinforced by their biases and concerns. Clients are inhibited by the presence of peers during group education at the health facility. Others are motivated to seek FP services by the interest expressed by peers. There is also a growing trend in the influence of social media on FP uptake, particularly Facebook fora. Conclusion: The convenience of self-administration at home is a benefit for those that contend with various forms of social influences as well as covert users. Beyond increasing choice and reducing barriers to accessing Sexual and Reproductive Health (SRH) services, it can initiate the process of self-discovery and agency in the contraceptive user journey.

Keywords: selfcare, self-empowerment, agency, DMPA-SC, contraception, family planning, influences

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Authors: Carla Palencia-Aguilar

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Calculations of Net Carbon Balance can be obtained by means of Net Biome Productivity (NBP), Net Ecosystem Productivity (NEP), and Net Primary Production (NPP). The latter is an important component of the biosphere carbon cycle and is easily obtained data from MODIS MOD17A3HGF; however, the results are only available yearly. To overcome data availability, bands 33 to 36 from MODIS MYD021KM (obtained on a daily basis) were analyzed and compared with NPP data from the years 2000 to 2021 in 7 sites where surface mining takes place in the Colombian territory. Coal, Gold, Iron, and Limestone were the minerals of interest. Scales and Units as well as thermal anomalies, were considered for net carbon balance per location. The NPP time series from the satellite images were filtered by using two Matlab filters: First order and Discrete Transfer. After filtering the NPP time series, comparing the graph results from the satellite’s image value, and running a linear regression, the results showed R2 from 0,72 to 0,85. To establish comparable units among NPP and bands 33 to 36, the Greenhouse Gas Equivalencies Calculator by EPA was used. The comparison was established in two ways: one by the sum of all the data per point per year and the other by the average of 46 weeks and finding the percentage that the value represented with respect to NPP. The former underestimated the total CO2 emissions. The results also showed that coal and gold mining in the last 22 years had less CO2 emissions than limestone, with an average per year of 143 kton CO2 eq for gold, 152 kton CO2 eq for coal, and 287 kton CO2 eq for iron. Limestone emissions varied from 206 to 441 kton CO2 eq. The maximum emission values from unfiltered data correspond to 165 kton CO2 eq. for gold, 188 kton CO2 eq. for coal, and 310 kton CO2 eq. for iron and limestone, varying from 231 to 490 kton CO2 eq. If the most pollutant limestone site improves its production technology, limestone could count with a maximum of 318 kton CO2 eq emissions per year, a value very similar respect to iron. The importance of gathering data is to establish benchmarks in order to attain 2050’s zero emissions goal.

Keywords: carbon dioxide, NPP, MODIS, MINING

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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: Leonardo C. Pacheco-Londoño, Nataly J. Galan-Freyle, Lisandro Pacheco-Lugo, Antonio Acosta, Elkin Navarro, Gustavo Aroca-Martínez, Karin Rondón-Payares, Samuel P. Hernández-Rivera

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In our Life Science Research Center of the University Simon Bolivar (LSRC), one of the focuses is the diagnosis and prognosis of different diseases; we have been implementing the use of gold nanoparticles (Au-NPs) for various biomedical applications. In this case, Au-NPs were used for Surface-Enhanced Raman Spectroscopy (SERS) in different diseases' diagnostics, such as Lupus Nephritis (LN), hypertension (H), preeclampsia (PC), and others. This methodology is proposed for the diagnosis of each disease. First, good signals of the different metabolites by SERS were obtained through a mixture of urine samples and Au-NPs. Second, PLS-DA models based on SERS spectra to discriminate each disease were able to differentiate between sick and healthy patients with different diseases. Finally, the sensibility and specificity for the different models were determined in the order of 0.9. On the other hand, a second methodology was developed using machine learning models from all data of the different diseases, and, as a result, a discriminant spectral map of the diseases was generated. These studies were possible thanks to joint research between two university research centers and two health sector entities, and the patient samples were treated with ethical rigor and their consent.

Keywords: SERS, Raman, PLS-DA, diseases

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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: Emad Alenany, M. Adel El-Baz

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In this paper, the flow of different classes of patients into a hospital is modelled and analyzed by using the queueing network analyzer (QNA) algorithm and discrete event simulation. Input data for QNA are the rate and variability parameters of the arrival and service times in addition to the number of servers in each facility. Patient flows mostly match real flow for a hospital in Egypt. Based on the analysis of the waiting times, two approaches are suggested for improving performance: Separating patients into service groups, and adopting different service policies for sequencing patients through hospital units. The separation of a specific group of patients, with higher performance target, to be served separately from the rest of patients requiring lower performance target, requires the same capacity while improves performance for the selected group of patients with higher target. Besides, it is shown that adopting the shortest processing time and shortest remaining processing time service policies among other tested policies would results in, respectively, 11.47% and 13.75% reduction in average waiting time relative to first come first served policy.

Keywords: queueing network, discrete-event simulation, health applications, SPT

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Authors: Peregrine James Dalziel, Philip Vu Tran

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Objective / Introduction: Demand for radiology services from Emergency Departments (ED) continues to increase with greater demands placed on radiology staff providing reports for the management of complex cases. Queuing theory indicates that wide variability of process time with the random nature of request arrival increases the probability of significant queues. This can lead to delays in the time-to-availability of radiology reports (TTA-RR) and potentially impaired ED patient flow. In addition, greater “cognitive workload” of greater volume may lead to reduced productivity and increased errors. We sought to quantify the potential ED flow improvements obtainable from increased radiology providers serving 3 public hospitals in Melbourne Australia. We sought to assess the potential productivity gains, quality improvement and the cost-effectiveness of increased labor inputs. Methods & Materials: The Western Health Medical Imaging Department moved from single resident coverage on weekend days 8:30 am-10:30 pm to a limited period of 2 resident coverage 1 pm-6 pm on both weekend days. The TTA-RR for weekend CT scans was calculated from the PACs database for the 8 month period symmetrically around the date of staffing change. A multivariate linear regression model was developed to isolate the improvement in TTA-RR, between the two 4-months periods. Daily and hourly scan volume at the time of each CT scan was calculated to assess the impact of varying department workload. To assess any improvement in report quality/errors a random sample of 200 studies was assessed to compare the average number of clinically significant over-read addendums to reports between the 2 periods. Cost-effectiveness was assessed by comparing the marginal cost of additional staffing against a conservative estimate of the economic benefit of improved ED patient throughput using the Australian national insurance rebate for private ED attendance as a revenue proxy. Results: The primary resident on call and the type of scan accounted for most of the explained variability in time to report availability (R2=0.29). Increasing daily volume and hourly volume was associated with increased TTA-RR (1.5m (p<0.01) and 4.8m (p<0.01) respectively per additional scan ordered within each time frame. Reports were available 25.9 minutes sooner on average in the 4 months post-implementation of double coverage (p<0.01) with additional 23.6 minutes improvement when 2 residents were on-site concomitantly (p<0.01). The aggregate average improvement in TTA-RR was 24.8 hours per weekend day This represents the increased decision-making time available to ED physicians and potential improvement in ED bed utilisation. 5% of reports from the intervention period contained clinically significant addendums vs 7% in the single resident period but this was not statistically significant (p=0.7). The marginal cost was less than the anticipated economic benefit based assuming a 50% capture of improved TTA-RR inpatient disposition and using the lowest available national insurance rebate as a proxy for economic benefit. Conclusion: TTA-RR improved significantly during the period of increased staff availability, both during the specific period of increased staffing and throughout the day. Increased labor utilisation is cost-effective compared with the potential improved productivity for ED cases requiring CT imaging.

Keywords: workflow, quality, administration, CT, staffing

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Authors: Jake Tempo, Georgina Williams, Iain Robertson, Claire Pascoe, Darren Rama, Richard Cetti

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Introduction: The twelfth rib is commonly used as a landmark for surgery; however, its variability in length has not been formally studied. The highly variable rib length provides a challenge for urologists seeking a consistent landmark for percutaneous nephrolithotomy and retroperitoneoscopic surgery. Methods and materials: We analysed CT scans of 100 adults who had imaging between 23rd March and twelfth April 2020 at an Australian Hospital. We measured the distance from the mid-sagittal line to the twelfth rib tip in the axial plane as a surrogate for true rib length. We also measured the distance from the twelfth rib tip to the kidney, spleen, and liver. Results: Length from the mid-sagittal line to the right twelfth rib tip varied from 46 (percentile 95%CI 40 to 57) to 136mm (percentile 95%CI 133 to 138). On the left, the distances varied from 55 (percentile 95%CI 50 to 64) to 134mm (percentile 95%CI 131 to 135). Twenty-three percent of people had an organ lying between the tip of the twelfth rib and the kidney on the right, and 11% of people had the same finding on the left. Conclusion: The twelfth rib is highly variable in its length. Similar variability was recorded in the distance from the tip to intra-abdominal organs. Due to the frequency of organs lying between the tip of the rib and the kidney, it should not be used as a landmark for accessing the kidney without prior knowledge of an individual patient’s anatomy, as seen on imaging.

Keywords: PCNL, rib, anatomy, nephrolithotomy

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Authors: Harim Mohsin, Afshan Channa, Beena Saad

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The Kocher Debre Semelaigne Syndrome (KDSS) is known as cretinism muscular hypertrophy. It is an unusual presentation in intellectually deficit children, commonly associated with congenital or iatrogenic hypothyroidism. The creatinine phosphokinase (CPK) is usually elevated and it’s commonly found in males, consanguineous marriage and ages 18 months to 10 years. It might be misdiagnosed without the classical features of hypothyroidism at first presentation. We present a case of 15 year old intellectually deficit female with epilepsy managed on phenytoin. She had rigidity, myxedema, calf muscle hypertrophy and agitation. The patient was managed as Neuroleptic Malignant Syndrome due to raised CPK of 40,680 IU/L and mixed presentation. Nevertheless, no improvement was noticed and thyroid profile was done to exclude alternative resources. Thyroid stimulating hormone (TSH) was 74.5 IU, Free T3 1.22 ng/dl, and Free T4 0.43 ng/dl. Thyroxine was started along with change in antiepileptic leading to recovery. This case report highlights the inconsistent finding of KDSS. The female gender, non-consanguineous marriage, delayed onset with primarily neuromuscular symptoms, and raised CPK is a rare demonstration in KDSS. Additionally, thyroid profile is not routinely done, which can lead to misdiagnosis and mismanagement.

Keywords: cretinism, hypothyroidism, intellectual deficit, KDSS

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Authors: Ahmed Stifi, Sascha Gentes

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The German nuclear industry, while implementing the German policy, believes that the journey towards the green-field, namely phasing out of nuclear energy, should be achieved through green techniques. The most important techniques required for the wide range of decommissioning activities are decontamination techniques, cutting techniques, radioactivity measuring techniques, remote control techniques, techniques for worker and environmental protection and techniques for treating, preconditioning and conditioning nuclear waste. Many decontamination techniques are used for removing contamination from metal, concrete or other surfaces like the scales inside pipes. As the pipeline system is one of the important components of nuclear power plants, the process of decontamination in tubing is of more significance. The development of energy sectors like oil sector, gas sector and nuclear sector, since the middle of 20th century, increased the pipeline industry and the research in the decontamination of tubing in each sector is found to serve each other. The extraction of natural products and material through the pipeline can result in scale formation. These scales can be radioactively contaminated through an accumulation process especially in the petrochemical industry when oil and gas are extracted from the underground reservoir. The radioactivity measured in these scales can be significantly high and pose a great threat to people and the environment. At present, the decontamination process involves using high pressure water jets with or without abrasive material and this technology produces a high amount of secondary waste. In order to overcome it, the research team within Karlsruhe Institute of Technology developed a new sustainable method to carry out the decontamination of tubing without producing any secondary waste. This method is based on vibration technique which removes scales and also does not require any auxiliary materials. The outcome of the research project proves that the vibration technique used for decontamination of tubing is environmental friendly in other words a sustainable technique.

Keywords: sustainable technologies, decontamination, pipeline, nuclear industry

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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: Cindy de Frias, Erum Whyne

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Objectives: The current study examined whether the link between stress and health-related quality of life was buffered by protective factors, namely mindfulness, in a sample of middle-aged and older adults. Method: In this cross-sectional study, 134 healthy, community-dwelling adults (aged 50–85 years) were recruited from Dallas, Texas. The participants were screened for depressive symptoms and severity (using the Patient Health Questionnaire [PHQ-9]). All participants completed measures of self-reported health status (i.e., SF-36v2: mental and physical health composites), life stress (using the Elder’s Life Stress Inventory [ELSI]), and trait mindfulness (i.e., Mindful Attention Awareness Scale). Results: Hierarchical regressions (covarying for age, gender, and education) showed that life stress was inversely related to physical and mental health. Mindfulness was positively related to mental health. The negative effect of life stress on mental health was weakened for those individuals with greater trait mindfulness. Discussion: The results suggest that mindfulness is a powerful, adaptive strategy that may protect middle-aged and older adults from the well-known harmful effects of stress on healthy aging.

Keywords: health, stress, mindfulness, aging

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Authors: Jong Yeop Kim, Jong Bum Choi, Hyun Jeong Kwak, Sook Young Lee

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Background: Each supraglottic airway requires different anesthetic depth because it has a specific structure and different compressive force in the oropharyngeal cavity. We designed the study to investigate remifentanil effect-site concentration (Ce) in 50% of patients (EC50) for successful insertion of i- gel, and to compare it with that for laryngeal mask airway (LMA) insertion during propofol target-controlled infusion (TCI). Methods: Forty-one female patients were randomized to the i-gel group (n=20) or the LMA group (n=21). Anesthesia induction was performed using propofol Ce of 5 μg/ml and the predetermined remifentanil Ce, and i-gel or LMA insertion was attempted 5 min later. The remifentanil Ce was estimated by modified Dixon's up-and-down method (initial concentration: 3.0 ng/ml, step size: 0.5 ng/ml). The patient’s response to device insertion was classified as either ‘success (no movement)’ or ‘failure (movement)’. Results: Using the Dixon’s up and down method, EC50 of remifentanil Ce for i-gel (1.58 ± 0.41 ng/ml) was significantly lower than that for LMA (2.25 ± 0.55 ng/ml) (p=0.038). Using isotonic regression, EC50 (83% CI) of remifentanil in the i-gel group [1.50 (1.37-1.80) ng/ml] was statistically lower than that in the LMA group [2.00 (1.82-2.34) ng/ml]. EC95 (95% CI) of remifentanil in the i-gel group [2.38 (1.48-2.50) ng/ml] was statistically lower than that in the LMA group [3.35 (2.58-3.48) ng/ml]. Conclusion: We found that EC50 of remifentanil Ce for i-gel insertion (1.58 ng/ml) was significantly lower than that for LMA insertion (2.25 ng/ml), in female patients during propofol TCI without neuromuscular blockade.

Keywords: i-gel, laryngeal mask airway, propofol, remifentanil

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Authors: Kayode Fatokun, Nozipho N. Motsa

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Field experiments were carried out during the summer/autumn (first trial) and winter/spring (second trial) seasons of 2019 and 2021 inDlangubo, Ngwelezane, and Mtubatubaareas of KwaZulu-Natal Province of South Africa to study the drought amelioration effects and impact of 2 locally available organic wastes [filter cake (FC) and macadamia husk compost (MHC)] on the productivity, and physiological responses of 4 orange-fleshed sweet potato cultivars (Buregard cv., Impilo, W-119 and 199062.1). The effects of FC and MHC were compared with that of inorganic fertilizer (IF) [2:3:2 (30)], FC+IF, MHC+IF, and control. The soil amendments were applied in the first trials only. Climatic data such as humidity, temperature, and rainfall were taken via remote sensing. The results of the first trial indicated that filter cake and IF significantly performed better than MHC. While the strength of filter cake may be attributable to its rich array of mineral nutrients such as calcium, magnesium, potassium, sodium, zinc, copper, manganese, iron, and phosphorus. The little performance from MHC may be attributable to its water holding capacity. Also, a positive correction occurred between the yield of the test OFSP cultivars and climatic factors such as rainfall, NDVI, and NDWI values. Whereas the inorganic fertilizer did not have any significant effect on the growth and productivity of any of the tested sweet potato cultivars in the second trial; FC, and MHC largely maintained their significant performances. In conclusion, the use of FC is highly recommended in the production of the test orange-fleshed sweet potato cultivars. Also, the study indicated that both FC and MHC may not only supply the needed plant nutrients but has the capacity to reduce the impact of drought on the growth of the test cultivars. These findings are of great value to farmers, especially the resource-poorones.

Keywords: amendments, drought, filter cake, macadamia husk compost, sweet potato

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Authors: Luís Miguel Estevão Cristóvão, Constâncio Augusto Machanguana, Fernando Chichango, Salvador Grande

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Sub-Saharan African nations depend greatly on agriculture, a sector mainly marked by low production. Most of the farmers live in rural areas and employ basic labor-intensive technologies that lead to time inefficiencies and low overall effectiveness. Even with attempts to enhance farmers’ welfare through improved seeds and fertilizers, meaningful outcomes are yet to be achieved due to huge amounts of post-harvest losses. Such losses significantly endanger food security, economic stability, and result in unsustainable agricultural practices because more land, water, labor, energy, fertilizer, and other inputs must be used to produce more food. Drying, as a critical post-harvest process involving simultaneous heat and mass transfer, deserves attention. Among alternative green-energy sources, solar energy-based drying garners attention, particularly for small-scale farmers in remote communities. However, the intermittent nature of solar radiation poses challenges. To address this, energy storage solutions like rock-based thermal energy storage offer cost-effective solutions tailored to the needs of farmers. Methodologically, three solar dryers were constructed of metal, wood, and clay brick. Several tests were carried out with and without energy storage material. Notably, it has been demonstrated that soapstone stands out as a promising material due to its affordability and high specific energy capacity. By implementing these greener technologies, Sub-Saharan African countries could mitigate post-harvest losses, enhance food availability, improve nutrition, and promote sustainable resource utilization.

Keywords: energy storage, food security, post-harvest, solar dryer

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Authors: Tigabu Dagne Akal

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Electronic health records (EHRs) can help to store, maintain, and make the appropriate handling of patient histories for proper treatment and decision. Merging the EHRs with big data analytics (BDA) capabilities enable healthcare stakeholders to provide effective and efficient treatments for chronic diseases. Though there are huge opportunities and efforts that exist in the deployment of EMRs and the development of BDA, there are challenges in addressing resources and organizational capabilities that are required to achieve the competitive advantage and sustainability of EHRs and BDA. The resource-based view (RBV), information system (IS), and non- IS theories should be extended to examine organizational capabilities and resources which are required for successful data analytics in the healthcare industries. The main purpose of this study is to develop a conceptual framework for the development of healthcare BDA capabilities based on past works so that researchers can extend. The research question was formulated for the search strategy as a research methodology. The study selection was made at the end. Based on the study selection, the conceptual framework for the development of BDA capabilities in the healthcare settings was formulated.

Keywords: EHR, EMR, Big data, Big data analytics, resource-based view

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Authors: David A. Padilla, Rodolfo Villamizar

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In recent years, closed loop control strategies have been developed in order to establish a healthy glucose profile in type 1 diabetic mellitus (T1DM) patients. However, the controller itself is unable to define a suitable reference trajectory for glucose. In this paper, a control strategy Is proposed where the shape of the reference trajectory is generated bases in the amount of carbohydrates present during the digestive process, due to the effect of carbohydrate intake. Since there no exists a sensor to measure the amount of carbohydrates consumed, an estimator is proposed. Thus this paper presents the entire process of designing a carbohydrate estimator, which allows estimate disturbance for a predictive controller (MPC) in a T1MD patient, the estimation will be used to establish a profile of reference and improve the response of the controller by providing the estimated information of ingested carbohydrates. The dynamics of the diabetic model used are due to the equations described by the UVA/Padova model of the T1DMS simulator, the system was developed and simulated in Simulink, taking into account the noise and limitations of the glucose control system actuators.

Keywords: estimation, glucose control, predictive controller, MPC, UVA/Padova

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Authors: Fadwa Alhalaiqa, Ahmad Al-Nawafleh, Abdul-Monim Batiha, Rami Masadeh, Aida Abd Alrazek

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Healthy lifestyle recommendations (e.g. physical inactivity, unhealthy diet, increased cholesterol levels, obesity, and poor stress management) play an important role in controlling BP. This study aimed to assess lifestyle modification factors among patient diagnosed with hypertension. Methods and materials: A cross section-survey design was used. Data was collected by four questionnaires one was the beliefs about medication (BMQ) and rest were developed to collect data about demographics and clinical characteristics and lifestyle modification factors. Results: Total 312 questionnaires had been completed. The participants had a mean age of 57.6 years (SD =11.8). The results revealed that our participants did not follow healthy lifestyle recommendations; for example the means BS level, BMI, and cholesterol levels were 155 mg/dl (SD= 71.9), 29 kg/2m (SD= 5.4) and 197 mg/dl (SD= 86.6) respectively. A significant correlation was shown between age and BP (P= 0.000). Increase in DBP correlates with a significant increase in cholesterol level (P= .002) and BMI (P= .006). Conclusion: Hypertensive patients did not adhere to healthy lifestyle modification factors. Therefore, an urgent action by addressing behavioral risk factors has a positive impact on preventing and controlling hypertension.

Keywords: adherence, healthy lifestyle, hypertension, patients

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Authors: Kiara Lawrence, Robynne Hansmann, Clive Greentsone

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Geographic Information Systems (GIS) are used to store, analyze, visualize, capture and monitor geographic data. Built environment professionals as well as urban planners specifically, need to possess GIS skills to effectively and efficiently plan spaces. GIS application extends beyond the production of map artifacts and can be applied to relate to spatially referenced, real time data to support spatial visualization, analysis, community engagement, scenarios, and so forth. Though GIS has been used in the built environment for a few decades, its use in education has not been researched enough to draw conclusions on the trends in the last 20 years. The study looks to discover current and emerging trends of GIS in built environment education. A bibliometric review analysis methodology was carried out through exporting documents from Scopus and Web of Science using keywords around "Geographic information systems" OR "GIS" AND "built environment" OR “geography” OR "architecture" OR "quantity surveying" OR "construction" OR "urban planning" OR "town planning" AND “education” between the years 1994 to 2024. A total of 564 documents were identified and exported. The data was then analyzed using VosViewer software to generate network analysis and visualization maps on the co-occurrence of keywords, co-citation of documents and countries and co-author network analysis. By analyzing each aspect of the data, deeper insight of GIS within education can be understood. Preliminary results from Scopus indicate that GIS research focusing on built environment education seems to have peaked prior to 2014 with much focus on remote sensing, demography, land use, engineering education and so forth. This invaluable data can help in understanding and implementing GIS in built environment education in ways that are foundational and innovative to ensure that students are equipped with sufficient knowledge and skills to carry out tasks in their respective fields.

Keywords: architecture, built environment, construction, education, geography, geographic information systems, quantity surveying, town planning, urban planning

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Authors: David J. Thomson, Joshua C. J. Chew

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Background: Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT) is a rare complication of lithium toxicity that typically causes irreversible cerebellar dysfunction. These patients may require hemodialysis and extensive supports in the intensive care. Methods: A review was performed on the available literature of SILENT with a focus on current pathophysiological hypotheses and advances in treatment. Articles were restricted to the English language. Results: Although the exact mechanism is unclear, CNS demyelination, especially in the cerebellum, was seen on the brain biopsies of a proportion of patients. There is no definitive management of SILENT but instead current management is focused on primary and tertiary prevention – detection of those at risk, and rehabilitation post onset of neurological deficits. Conclusions: This review draws conclusions from a limited amount of available literature, most of which are isolated case reports. Greater awareness of SILENT and further investigation into the risk factors and pathogenesis are required so this serious and irreversible syndrome may be avoided.

Keywords: lithium toxicity, pathogenesis, SILENT, syndrome of irreversible lithium-effectuated neurotoxicity

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Authors: Alexis D'Agostino, Celeste Sununtunasuk, Jack Fiedler

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Background: Iron-folic acid (IFA) supplementation during antenatal care (ANC) has existed in many countries for decades. Despite this, low national coverage persists and women do not often consume appropriate amounts during pregnancy. USAID’s SPRING Project investigated pregnant women’s access to, and consumption of, IFA tablets through ANC. Cross-country analysis provided a global picture of the state of IFA-supplementation, while country-specific results noted key contextual issues, including geography, wealth, and ANC attendance. The analysis can help countries prioritize strategies for systematic performance improvements within one of the most common micronutrient supplementation programs aimed at reducing maternal anemia. Methodology: Using falter point analysis on Demographic and Health Survey (DHS) data collected from 162,958 women across 22 countries, SPRING identified four sequential falter points (ANC attendance, IFA receipt or purchase, IFA consumption, and number of tablets taken) where pregnant women fell out of the IFA distribution structure. SPRING analyzed data on IFA intake from DHS surveys with women of reproductive age. SPRING disaggregated these data by ANC participation during the most recent pregnancy, residency, and women’s socio-economic status. Results: Average sufficient IFA tablet use across all countries was only eight percent. Even in the best performing countries, only about one-third of pregnant women consumed 180 or more IFA tablets during their most recent pregnancy. ANC attendance was an important falter point for a quarter of women across all countries (with highest falter rates in Democratic Republic of the Congo, Nigeria, and Niger). Further analysis reveals patterns, with some countries having high ANC coverage but low IFA provision during ANC (DRC and Haiti), others having high ANC coverage and IFA provision but few women taking any tablets (Nigeria and Liberia), and countries that perform well in ANC, supplies, and initial consumption but where very few women consume the recommended 180 tablets (Malawi and Cambodia). Country-level analysis identifies further patterns of supplementation. In Indonesia, for example, only 62% of women in the poorest quintile took even one IFA tablet, while 86% of the wealthiest women did. This association between socioeconomic status and IFA intake held across nearly all countries where these data are available and was also visible in rural/urban comparisons. Analysis of ANC attendance data also suggests that higher numbers of ANC visits are associated with higher tablet intake. Conclusions: While it is difficult to disentangle which specific aspects of supply or demand cause the low rates of consumption, this tool allows policy-makers to identify major bottlenecks to scaling-up IFA supplementation during ANC. In turn, each falter point provides possible explanations of program performance and helps strategically identify areas for improved IFA supplementation. For example, improving the delivery of IFA supplementation in Ethiopia relies on increasing access to ANC, but also on identifying and addressing program gaps in IFA supply management and health workers’ practices in order to provide quality ANC services. While every country requires a customized approach to improving IFA supplementation, the multi-country analysis conducted by SPRING is a helpful first step in identifying country bottlenecks and prioritizing interventions.

Keywords: iron and folic acid, supplementation, antenatal care, micronutrient

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Authors: Ram Sharan Mehta

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Continuing changes in health and social care policy and practice have affected and changed the way in which nursing is practiced. One of the greatest challenges facing nursing today is to build on the essence of nursing as a caring profession whilst incorporating new technologies, ideas and approaches to future healthcare. The objective of this study was to find out the socio-demographic characteristics of the M.Sc. Nursing students and calculate the association between specialty subjects, caste, age group, and residence with SLC division, BN/BSN division, entrance score, and total nursing experience. Descriptive cross-sectional study design was used to conduct the study among all the 25 M.Sc. Nursing students studying at BPKIHS in 2012. Most of the students (56%) were of age group of 25-30 years, completed his academic courses with first division and succeeded in entrance test in first attempt (96%). Based on the results, it can conclude that most of the subjects were of young age, having high score achievers in SLC, I.Sc., CN, BN/BSN and Entrance test. The demographic characteristics do not influence in the academic scores of the students.

Keywords: profile, postgraduate nursing students, Nepal, influence

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Authors: Ilham Akbar Rahman, Aflah Dhea Bariz Yasta, Iin Fadhilah Utami Tamasse, Devina Juanita

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Meningioma is adult brain tumors originating from the meninges covering the brain and spinal cord. The females have approximately twice higher 2:1 than male in the incidence of meningioma. This study aimed to analyze the histopathological grading and clinical aspect in predicting the prognosis of meningioma patients. An observational study with cross sectional design was used on 53 meningioma patients treated at Dr. Wahidin Sudirohusodo hospital in 2016. The data then were analyzed using SPSS 20.0. Of 53 patients, mostly 41 (77,4%) were female and 12 (22,6%) were male. The distribution of histopathology patients showed the meningothelial meningioma of 18 (43,9%) as the most type found. Fibroplastic meningioma were 8 (19,5%), while atypical meningioma and psammomatous meningioma were 6 (14,6%) each. The rest were malignant meningioma and angiomatous meningioma which found in respectively 2 (4,9%) and 1 (2,4%). Our result found significant finding that mostly male were fibroblastic meningioma (50%), however meningothelial meningioma were found in the majority of female (54,8%) and also seizure comprised only in higher grade meningioma. On the outcome of meningioma patient treated operatively, histopathological grade remained insignificant (p > 0,05). This study can be used as prognostic value of meningioma patients based on gender, histopathological grade, and clinical manifestation. Overall, the outcome of the meningioma’s patients is good and promising as long as it is well managed.

Keywords: meningioma, prognostic value, histopathological grading, clinical manifestation

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Authors: Dana Gabriková, Martin Mistrík, Jarmila Bernasovská, Iveta Tóthová, Jana Kisková

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The Roma (Gypsies) is a transnational minority with a high degree of consanguineous marriages. Similar to other genetically isolated founder populations, the Roma harbor a number of unique or rare genetic disorders. This paper discusses about a rare form of Charcot-Marie-Tooth disease – type 4G (CMT4G), also called Hereditary Motor and Sensory Neuropathy type Russe, an autosomal recessive disease caused by mutation private to Roma characterized by abnormally increased density of non-myelinated axons. CMT4G was originally found in Bulgarian Roma and in 2009 two putative causative mutations in the HK1 gene were identified. Since then, several cases were reported in Roma families mainly from Bulgaria and Spain. Here we present a Slovak Roma family in which CMT4G was diagnosed on the basis of clinical examination and genetic testing. This case is a further proof of the role of the HK1 gene in pathogenesis of the disease. It confirms that mutation in the HK1 gene is a common cause of autosomal recessive CMT disease in Roma and should be considered as a common part of a diagnostic procedure.

Keywords: gypsies, HK1, HSMN-Russe, rare disease

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Authors: Adolfo Cangas, Noelia Navarro

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The current study shows the assessment made by university students of a video game entitled Stigma-Stop where the characters present different mental disorders. The objective is that players have more real information about mental disorders and empathize with them and thus reduce stigma. The sample consisted of 169 university students studying degrees related to education, social care and welfare (i.e., Social Education, Psychology, Early Childhood Education, Special Education, and Social Work). The participants valued the video game positively, especially in relation to utility, being somewhat lower the score awarded to the degree of entertainment. They detect the disorders and point out that in many occasions they felt the same (particularly in the case of depression, being lower in agoraphobia and bipolar disorder, and even lower in the case of schizophrenia), most students recommend the use of the video game. They emphasize that Stigma-Stop offers intervention strategies, information regarding the symptomatology and sensitizes against stigma.

Keywords: schizophrenia, social stigma, students, mental health

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Authors: Rajesh Kumar, Roopali Dogra, Puneet Aggarwal

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In the era of technological advancement, use of computer technology has become inevitable. Hence it has become the need of the hour to integrate software methods in engineering curriculum as a part to boost pedagogy techniques. Simulations software is a great help to graduates of disciplines such as electrical engineering. Since electrical engineering deals with high voltages and heavy instruments, extra care must be taken while operating with them. The viable solution would be to have appropriate control. The appropriate control could be well designed if engineers have knowledge of kind of waveforms associated with the system. Though these waveforms can be plotted manually, but it consumes a lot of time. Hence aid of simulation helps to understand steady state of system and resulting in better performance. In this paper computer, aided teaching of transformer is carried out using MATLAB/Simulink. The test carried out on a transformer includes open circuit test and short circuit respectively. The respective parameters of transformer are then calculated using the values obtained from open circuit and short circuit test respectively using Simulink.

Keywords: computer aided teaching, open circuit test, short circuit test, simulink, transformer

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Authors: G. Magalhães-Mota, C. Magro, S. Sério, E. Mateus, P. A. Ribeiro, A. B. Ribeiro, M. Raposo

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Triclosan [5-chloro-2-(2,4-dichlorophenoxy) phenol], belonging to the class of Pharmaceuticals and Personal Care Products (PPCPs), is a broad-spectrum antimicrobial agent and bactericide. Because of its antimicrobial efficacy, it is widely used in personal health and skin care products, such as soaps, detergents, hand cleansers, cosmetics, toothpastes, etc. However, it has been considered to disrupt the endocrine system, for instance, thyroid hormone homeostasis and possibly the reproductive system. Considering the widespread use of triclosan, it is expected that environmental and food safety problems regarding triclosan will increase dramatically. Triclosan has been found in river water samples in both North America and Europe and is likely widely distributed wherever triclosan-containing products are used. Although significant amounts are removed in sewage plants, considerable quantities remain in the sewage effluent, initiating widespread environmental contamination. Triclosan undergoes bioconversion to methyl-triclosan, which has been demonstrated to bio accumulate in fish. In addition, triclosan has been found in human urine samples from persons with no known industrial exposure and in significant amounts in samples of mother's milk, demonstrating its presence in humans. The action of sunlight in river water is known to turn triclosan into dioxin derivatives and raises the possibility of pharmacological dangers not envisioned when the compound was originally utilized. The aim of this work is to detect low concentrations of triclosan in an aqueous complex matrix through the use of a sensor array system, following the electronic tongue concept based on impedance spectroscopy. To achieve this goal, we selected the appropriate molecules to the sensor so that there is a high affinity for triclosan and whose sensitivity ensures the detection of concentrations of at least nano-molar. Thin films of organic molecules and oxides have been produced by the layer-by-layer (LbL) technique and sputtered onto glass solid supports already covered by gold interdigitated electrodes. By submerging the films in complex aqueous solutions with different concentrations of triclosan, resistance and capacitance values were obtained at different frequencies. The preliminary results showed that an array of interdigitated electrodes sensor coated or uncoated with different LbL and films, can be used to detect TCS traces in aqueous solutions in a wide range concentration, from 10⁻¹² to 10⁻⁶ M. The PCA method was applied to the measured data, in order to differentiate the solutions with different concentrations of TCS. Moreover, was also possible to trace a curve, the plot of the logarithm of resistance versus the logarithm of concentration, which allowed us to fit the plotted data points with a decreasing straight line with a slope of 0.022 ± 0.006 which corresponds to the best sensitivity of our sensor. To find the sensor resolution near of the smallest concentration (Cs) used, 1pM, the minimum measured value which can be measured with resolution is 0.006, so the ∆logC =0.006/0.022=0.273, and, therefore, C-Cs~0.9 pM. This leads to a sensor resolution of 0.9 pM for the smallest concentration used, 1pM. This attained detection limit is lower than the values obtained in the literature.

Keywords: triclosan, layer-by-layer, impedance spectroscopy, electronic tongue

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Authors: M. V. Chidananda Murthy, M. Z. Kurian, H. S. Guruprasad

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Super-resolution is the technique of intelligently upscaling images, avoiding artifacts or blurring, and deals with the recovery of a high-resolution image from one or more low-resolution images. Single-image super-resolution is a process of obtaining a high-resolution image from a set of low-resolution observations by signal processing. While super-resolution has been demonstrated to improve image quality in scaled down images in the image domain, its effects on the Fourier-based technique remains unknown. Super-resolution substantially improved the spatial resolution of the patient LGE images by sharpening the edges of the heart and the scar. This paper aims at investigating the effects of single image super-resolution on Fourier-based and image based methods of scale-up. In this paper, first, generate a training phase of the low-resolution image and high-resolution image to obtain dictionary. In the test phase, first, generate a patch and then difference of high-resolution image and interpolation image from the low-resolution image. Next simulation of the image is obtained by applying convolution method to the dictionary creation image and patch extracted the image. Finally, super-resolution image is obtained by combining the fused image and difference of high-resolution and interpolated image. Super-resolution reduces image errors and improves the image quality.

Keywords: image dictionary creation, image super-resolution, LGE images, patch extraction

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