Search results for: clinical decision support systems

Authors: Mahmoud Mohammad Salem Al-Suod, Ushkarenko O. Alexander, Dorogan I. Olga

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New algorithms using microprocessor systems have been proposed for protection the diesel-generator unit in autonomous power systems. The software structure is designed to enhance the control automata of the system, in which every protection module of diesel-generator encapsulates the finite state machine.

Keywords: diesel-generator unit, protection, state diagram, control system, algorithm, software components

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Authors: Maimona A. E. Elimam, Suhair Rehan, Miskelyemen A. Elmekki, Mogahid M. Elhassan

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Staphylococcus aureus (Staph. aureus), a major cause of potentially life-threatening infections acquired in healthcare and community settings, has developed resistance to most classes of antimicrobial agents as determined by the dramatic increase. The present study aimed to determine the prevalence of MRSA, and VRSA in patients with different clinical manifestations in Khartoum state. The study population (n, 426) were males and females with different age categories, suffering either from wound infections (105), ear infections (121), or UTI (101), in addition to nasal carriers of medical staff (100). Cultures, Gram staining, and other biochemical tests were performed for conventional identification. Modified Kirby-Bauer disk diffusion method was applied and DNA was extracted from MRSA and VRSA isolates and PCR was then performed for amplification of arc, mecA, VanA, and VanB genes. The results confirmed the existence of Staph. aureus in 49/426 (11.5%) cases among which MRSA were isolated from 34/49 (69.4%) when modified Kirby-Bauer disk diffusion method was applied. Ten out of these 34 MRSA were confirmed as VRSA by cultures on BHI agar containing 6μg/ml vancomycin according to NCCLS criteria. PCR revealed that out of the 34 MRSA isolates, 26 were mecA positive (76.5%) while 8 (23.5%) were arcC positive. No vanA or VanB genes were detected. Molecular method confirmed the results for MRSA through the presence of either arcC or mecA genes while it failed to approve the occurrence of VRSA since neither VanA or VanB genes were detected. Thus, VRSA may be attributed to other factors.

Keywords: antibiotic resistance, Staphylococcus aureus, VRSA, MRSA, Khartoum, Sudan

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Authors: Vasilis C. Hristidis, Ricardo Caceda, Ji Soo Kim, Brian Bronson, Emily A. Hill

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Objective: Leave passes to provide authorized leave for hospitalized patients from a psychiatric inpatient unit. Though providing day passes was once a relatively common practice, there is relatively little data describing their safety and efficacy. Methods: This descriptive study examines the use of leave passes in an adult inpatient unit at a university hospital between 2017 and 2021, with attention to reasons for granting the day pass, duration, and outcome of the pass. Results: During the study period, ten patients with primary psychotic or mood disorders received 12 passes for either housing coordination, COVID-19 vaccination, or major family events. There were no fatalities or elopements. One patient experienced severe agitation and engaged in non-suicidal self-injurious behavior. A second patient showed mild, redirectable psychomotor agitation upon return to the unit. The remaining 10 passes were uneventful. Conclusions: Our findings support the view that patients with diverse diagnoses can safely be provided leave from an inpatient setting with adequate planning and support, yielding a low incidence of adverse events.

Keywords: passes, inpatient, psychiatry, inpatient leave, outcome

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Authors: Nishant Rodrigues, Nicole Spanedda, Chilukuri K. Mohan, Arindam Chakraborty

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A crucial objective in quantum chemistry is the computation of the energy levels of chemical systems. This task requires electron-repulsion integrals as inputs, and the steep computational cost of evaluating these integrals poses a major numerical challenge in efficient implementation of quantum chemical software. This work presents a moment-based machine-learning approach for the efficient evaluation of electron-repulsion integrals. These integrals were approximated using linear combinations of a small number of moments. Machine learning algorithms were applied to estimate the coefficients in the linear combination. A random forest approach was used to identify promising features using a recursive feature elimination approach, which performed best for learning the sign of each coefficient but not the magnitude. A neural network with two hidden layers were then used to learn the coefficient magnitudes along with an iterative feature masking approach to perform input vector compression, identifying a small subset of orbitals whose coefficients are sufficient for the quantum state energy computation. Finally, a small ensemble of neural networks (with a median rule for decision fusion) was shown to improve results when compared to a single network.

Keywords: quantum energy calculations, atomic orbitals, electron-repulsion integrals, ensemble machine learning, random forests, neural networks, feature extraction

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Authors: Ki-Ro Kim, Seung-Jun Yu, Hyoung-Kyu Song

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Recently, the wireless communication systems are required to have high quality and provide high bit rate data services. Researchers have studied various multiple antenna scheme to meet the demand. In practical application, it is difficult to deploy multiple antennas for limited size and cost. Cooperative diversity techniques are proposed to overcome the limitations. Cooperative communications have been widely investigated to improve performance of wireless communication. Among diversity schemes, space-time block code has been widely studied for cooperative communication systems. In this paper, we propose a new cooperative scheme using pre-coding and space-time block code. The proposed cooperative scheme provides improved error performance than a conventional cooperative scheme using space-time block coding scheme.

Keywords: cooperative communication, space-time block coding, pre-coding

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Authors: Kongmeng Ly

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The management of transboundary river basins across developing countries, such as the Lower Mekong River Basin (LMB), is frequently challenging given the development and conservation divergences of the basin countries. Driven by needs to sustain economic performance and reduce poverty, the LMB countries (Cambodia, Lao PDR, Thailand, Viet Nam) are embarking on significant land use changes in the form hydropower dam, to fulfill their energy requirements. This pathway could lead to irreversible changes to the ecosystem of the Mekong River, if not properly managed. Given the uncertain trade-offs of hydropower development and operation, the Lower Mekong River Basin Countries through the technical support of the Mekong River Commission (MRC) Secretariat embarked on decade long the development of Technical Guidelines for Transboundary Environmental Impact Assessment. Through a series of workshops, seminars, national and regional consultations, and pilot studies and further development following the recommendations generated through legal and institutional reviews undertaken over two decades period, the LMB Countries jointly adopted the MRC Technical Guidelines for Transboundary Environmental Impact Assessment (TbEIA Guidelines). These guidelines were developed with particular regard to the experience gained from MRC supported consultations and technical reviews of the Xayaburi Dam Project, Don Sahong Hydropower Project, Pak Beng Hydropower Project, and lessons learned from the Srepok River and Se San River case studies commissioned by the MRC under the generous supports of development partners around the globe. As adopted, the TbEIA Guidelines have been designed as a supporting mechanism to the national EIA legislation, processes and systems in each Member Country. In recognition of the already agreed mechanisms, the TbEIA Guidelines build on and supplement the agreements stipulated in the 1995 Agreement on the Cooperation for the Sustainable Development of the Mekong River Basin and its Procedural Rules, in addressing potential transboundary environmental impacts of development projects and ensuring mutual benefits from the Mekong River and its resources. Since its adoption in 2022, the TbEIA Guidelines have already been voluntary implemented by Lao PDR on its underdevelopment Sekong A Downstream Hydropower Project, located on the Sekong River – a major tributary of the Mekong River. While this implementation is ongoing with results expected in early 2024, the implementation thus far has strengthened cooperation among concerned Member Countries with multiple successful open dialogues organized at national and regional levels. It is hope that lessons learnt from this application would lead to a wider application of the TbEIA Guidelines for future water resources development projects in the LMB.

Keywords: transboundary, EIA, lower mekong river basin, mekong river

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Authors: Warda Khan, Remo Lachmann, Adarsh S. Garakahally

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The increasing complexity of software and its applicability in a wide range of industries, e.g., automotive, call for enhanced quality assurance techniques. Test automation is one option to tackle the prevailing challenges by supporting test engineers with fast, parallel, and repetitive test executions. A high degree of test automation allows for a shift from mundane (manual) testing tasks to a more analytical assessment of the software under test. However, a high initial investment of test resources is required to establish test automation, which is, in most cases, a limitation to the time constraints provided for quality assurance of complex software systems. Hence, a computer-aided creation of automated test cases is crucial to increase the benefit of test automation. This paper proposes the application of machine learning for the generation of automated test cases. It is based on supervised learning to analyze test specifications and existing test implementations. The analysis facilitates the identification of patterns between test steps and their implementation with test automation components. For the test case generation, this approach exploits historical data of test automation projects. The identified patterns are the foundation to predict the implementation of unknown test case specifications. Based on this support, a test engineer solely has to review and parameterize the test automation components instead of writing them manually, resulting in a significant time reduction for establishing test automation. Compared to other generation approaches, this ML-based solution can handle different writing styles, authors, application domains, and even languages. Furthermore, test automation tools require expert knowledge by means of programming skills, whereas this approach only requires historical data to generate test cases. The proposed solution is evaluated using various multi-label evaluation criteria (EC) and two small-sized real-world systems. The most prominent EC is ‘Subset Accuracy’. The promising results show an accuracy of at least 86% for test cases, where a 1:1 relationship (Multi-Class) between test step specification and test automation component exists. For complex multi-label problems, i.e., one test step can be implemented by several components, the prediction accuracy is still at 60%. It is better than the current state-of-the-art results. It is expected the prediction quality to increase for larger systems with respective historical data. Consequently, this technique facilitates the time reduction for establishing test automation and is thereby independent of the application domain and project. As a work in progress, the next steps are to investigate incremental and active learning as additions to increase the usability of this approach, e.g., in case labelled historical data is scarce.

Keywords: machine learning, multi-class, multi-label, supervised learning, test automation

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Authors: Asma A. Alsufyani, Maram A. Alharthi, Maha J. Althobaiti, Manal S. Alharthi, Huda Rizq

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Twitter is one of the most popular microblogging sites that allows users to publish short text messages called 'tweets'. Increasing the number of accounts to follow (followings) increases the number of tweets that will be displayed from different topics in an unclassified manner in the timeline of the user. Therefore, it can be a vital solution for many Twitter users to have their tweets in a timeline classified into general categories to save the user’s time and to provide easy and quick access to tweets based on topics. In this paper, we developed a classifier for timeline tweets trained on a dataset consisting of 3600 tweets in total, which were collected from Saudi Twitter and annotated manually. We experimented with the well-known Bag-of-Words approach to text classification, and we used support vector machines (SVM) in the training process. The trained classifier performed well on a test dataset, with an average F1-measure equal to 92.3%. The classifier has been integrated into an application, which practically proved the classifier’s ability to classify timeline tweets of the user.

Keywords: corpus creation, feature extraction, machine learning, short text classification, social media, support vector machine, Twitter

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Authors: Ashima Sharma, Tapan K. Chaudhuri

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Human Serum Albumin (HSA) is one of the most demanded therapeutic protein with immense biotechnological applications. The current source of HSA is human blood plasma. Blood is a limited and an unsafe source as it possesses the risk of contamination by various blood derived pathogens. This issue led to exploitation of various hosts with the aim to obtain an alternative source for the production of the rHSA. But, till now no host has been proven to be effective commercially for rHSA production because of their respective limitations. Thus, there exists an indispensable need to promote non-animal derived rHSA production. Of all the host systems, Escherichia coli is one of the most convenient hosts which has contributed in the production of more than 30% of the FDA approved recombinant pharmaceuticals. E. coli grows rapidly and its culture reaches high cell density using inexpensive and simple substrates. The fermentation batch turnaround number for E. coli culture is 300 per year, which is far greater than any of the host systems available. Therefore, E. coli derived recombinant products have more economical potential as fermentation processes are cheaper compared to the other expression hosts available. Despite of all the mentioned advantages, E. coli had not been successfully adopted as a host for rHSA production. The major bottleneck in exploiting E. coli as a host for rHSA production was aggregation i.e. majority of the expressed recombinant protein was forming inclusion bodies (more than 90% of the total expressed rHSA) in the E. coli cytosol. Recovery of functional rHSA form inclusion body is not preferred because it is tedious, time consuming, laborious and expensive. Because of this limitation, E. coli host system was neglected for rHSA production for last few decades. Considering the advantages of E. coli as a host, the present work has targeted E. coli as an alternate host for rHSA production through resolving the major issue of inclusion body formation associated with it. In the present study, we have developed a novel and innovative method for enhanced soluble and functional production of rHSA in E.coli (~60% of the total expressed rHSA in the soluble fraction) through modulation of the cellular growth, folding and environmental parameters, thereby leading to significantly improved and enhanced -expression levels as well as the functional and soluble proportion of the total expressed rHSA in the cytosolic fraction of the host. Therefore, in the present case we have filled in the gap in the literature, by exploiting the most well studied host system Escherichia coli which is of low cost, fast growing, scalable and ‘yet neglected’, for the enhancement of functional production of HSA- one of the most crucial biomolecule for clinical and biotechnological applications.

Keywords: enhanced functional production of rHSA in E. coli, recombinant human serum albumin, recombinant protein expression, recombinant protein processing

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Authors: Risna Wijayanti, Sumiati, Hanif Iswari

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This study aims to analyze the role of financial risk attitude as a mediation between financial knowledge and business growth. The ability of human resources in managing capital (financial literacy) can be a major milestone for a company's business to grow and build its competitive advantage. This study analyzed the important role of financial risk attitude in bringing about financial knowledge on corporate growth. There have been many discussions arguing that financial knowledge is one of the main abilities of corporate managers in determining the success of managing a company. However, a contrary argument of other scholars also enlightened that financial knowledge did not have a significant influence on corporate growth. This study used literatures' review to analyze whether there is another variable that can mediate the effect of financial knowledge toward corporate growth. Research mapping was conducted to analyze the concept of risk tolerance. This concept was related to people's risk aversion effects when making a decision under risk and the role of financial knowledge on changes in financial income. Understanding and managing risks and investments are complicated, in particular for corporate managers, who are always demanded to maintain their corporate growth. Substantial financial knowledge is extremely needed to identify and take accurate information for corporate financial decision-making. By reviewing several literature, this study hypothesized that financial knowledge of corporate managers would be meaningless without manager's courage to bear risks for taking favorable business opportunities. Therefore, the level of risk aversion from corporate managers will determine corporate action, which is a reflection of corporate-level investment behavior leading to attain corporate success or failure for achieving the company's expected growth rate.

Keywords: financial knowledge, financial risk attitude, corporate growth, risk tolerance

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Authors: Alcardo Alex Barakabitze, Tan Xiaoheng

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Orthogonal Frequency Division Multiplexing (OFDM) is a special case of Multi-Carrier Modulation (MCM) technique which transmits a stream of data over a number of lower data rate subcarriers. OFDM splits the total transmission bandwidth into a number of orthogonal and non-overlapping subcarriers and transmit the collection of bits called symbols in parallel using these subcarriers. This paper explores the Peak to Average Power Reduction (PAPR) using the Partial Transmit Sequence technique. We provide the distribution analysis and the basics of OFDM signals and then show how the PAPR increases as the number of subcarriers increases. We provide the performance analysis of CCDF and PAPR expressed in decibels through MATLAB simulations. The simulation results show that, in PTS technique, the performance of PAPR reduction in OFDM systems improves significantly as the number of sub-blocks increases. However, by keeping the same number of sub-blocks variation, oversampling factor and the number of OFDM blocks’ iteration for generating the CCDF, the OFDM systems with 128 subcarriers have an improved performance in PAPR reduction compared to OFDM systems with 256, 512 or >512 subcarriers.

Keywords: OFDM, peak to average power reduction (PAPR), bit error rate (BER), subcarriers, wireless communications

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Authors: Reza Sedaghati

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The use of Flexible AC Transmission System (FACTS) devices in a power system can potentially overcome limitations of the present mechanically controlled transmission system. Also, the advance of technology makes possible to include new energy storage devices in the electrical power system. The integration of Superconducting Magnetic Energy Storage (SMES) into Static Synchronous Compensator (STATCOM) can lead to increase their flexibility in improvement of power system dynamic behaviour by exchanging both active and reactive powers with power grids. This paper describes structure and behaviour of SMES, specifications and performance principles of the STATCOM/SMES compensator. Moreover, the benefits and effectiveness of integrated SMES with STATCOM in power systems is presented. Also, the performance of the STATCOM/SMES compensator is evaluated using an IEEE 3-bus system through the dynamic simulation by PSCAD/EMTDC software.

Keywords: STATCOM/SMES compensator, chopper, converter, energy storage system, power systems

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Authors: Adandé Belarmain Fandohan

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Climate change has become a major concern globally, particularly in rural communities that have to find rapid coping solutions. Several vulnerability assessment approaches have been developed in the last decades. This comes along with a higher risk for different methods to result in different conclusions, thereby making comparisons difficult and decision-making non-consistent across areas. The effect of methods and computational approaches on estimates of people’s vulnerability was assessed using data collected from the Gambia. Twenty-four indicators reflecting vulnerability components: (exposure, sensitivity, and adaptive capacity) were selected for this purpose. Data were collected through household surveys and key informant interviews. One hundred and fifteen respondents were surveyed across six communities and two administrative districts. Results were compared over three computational approaches: the maximum value transformation normalization, the z-score transformation normalization, and simple averaging. Regardless of the approaches used, communities that have high exposure to climate change and extreme events were the most vulnerable. Furthermore, the vulnerability was strongly related to the socio-economic characteristics of farmers. The survey evidenced variability in vulnerability among communities and administrative districts. Comparing output across approaches, overall, people in the study area were found to be highly vulnerable using the simple average and maximum value transformation, whereas they were only moderately vulnerable using the z-score transformation approach. It is suggested that assessment approach-induced discrepancies be accounted for in international debates to harmonize/standardize assessment approaches to the end of making outputs comparable across regions. This will also likely increase the relevance of decision-making for adaptation policies.

Keywords: maximum value transformation, simple averaging, vulnerability assessment, West Africa, z-score transformation

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Authors: F. Guspi, E. García

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This exploratory study gives an overview of the evolution of the main financial and performance indicators of the Academic Spin-Off’s and High Growth Academic Spin-Off’s in year 3 and year 6 after its creation in the region of Catalonia in Spain. The study compares and evaluates results of these different measures of performance and the degree of success of these companies for each University. We found that the average Catalonian Academic Spin-Off is small and have not achieved the sustainability stage at year 6. On the contrary, a small group of High Growth Academic Spin-Off’s exhibit robust performance with high profits in year 6. Our results support the need to increase selectivity and support for these companies especially near year 3, because are the ones that will bring wealth and employment. University role as an investor has rigid norms and habits that impede an efficient economic return from their ASO investment. Universities with high performance on sales and employment in year 3 not always could sustain this growth in year 6 because their ASO’s are not profitable. On the contrary, profitable ASO exhibit superior performance in all measurement indicators in year 6. We advocate the need of a balanced growth (with profits) as a way to obtain subsequent continuous growth.

Keywords: Academic Spin-Off (ASO), university entrepreneurship, entrepreneurial university, high growth, New Technology Based Companies (NTBC), University Spin-Off

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Authors: Syeda Qamarunnisa, Ishrat Jamil, Abid Azhar, Zabta K. Shinwari, Syed Irtifaq Ali

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A phylogenetic analysis of family Solanaceae was conducted using sequence data from the chloroplast intergenic atpB-rbcL spacer. Sequence data was generated from 17 species representing 09 out of 14 genera of Solanaceae from Pakistan. Cladogram was constructed using maximum parsimony method and results indicate that Solanaceae is mainly divided into two subfamilies; Solanoideae and Cestroideae. Four major clades within Solanoideae represent tribes; Physaleae, Capsiceae, Datureae and Solaneae are supported by high bootstrap value and the relationships among them are not corroborating with the previous studies. The findings established that subfamily Cestroideae comprised of three genera; Cestrum, Lycium, and Nicotiana with high bootstrap support. Position of Nicotiana inferred with atpB-rbcL sequence is congruent with traditional classification, which placed the taxa in Cestroideae. In the current study Lycium unexpectedly nested with Nicotiana with 100% bootstrap support and identified as a member of tribe Nicotianeae. Expanded sampling of other genera from Pakistan could be valuable towards improving our understanding of intrafamilial relationships within Solanaceae.

Keywords: systematics, solanaceae, phylogenetics, intergenic spacer, tribes

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Authors: Anuradha Maharaj, Adrian Cashman

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The cross-cutting nature of water as a resource translates into the need for a better understanding of its movement, storage and loss at all points in the hydro-socioeconomic cycle. An integrated approach to addressing the issue of sustainability means quantitatively understanding: the linkages within this cycle, the role of water managers in resource allocation, and the critical factors influencing its scarcity. The Water Evaluation and Planning Tool (WEAP) is an integrative model that combines the catchment-scale hydrologic processes with a water management model, driven by environmental requirements and socioeconomic demands. The concept of demand priorities is included to represent the areas of greatest use within a given catchment. Located on Barbados’ West Coast, Speightstown and the surrounding areas encompass a well-developed tourist, residential and agricultural area. The main water resource for this area, and the rest of the island, is that of groundwater. The availability of groundwater in Barbados may be adversely affected by the projected changes in climate, such as reduced wet season rainfall. Economic development and changing sector priorities together with climate related changes have the potential to affect water resource abundance and by extension the allocation of resources for example in the Speightstown area. In order to investigate the potential impacts on the Speightstown area specifically, a WEAP Model of the study area was developed to estimate the present available water (baseline reference scenario 2000-2010). From this baseline scenario, it is envisioned that an exploration into projected changes in availability in the near term (2035-2045) and medium/long term (2065-2075) time frames will be undertaken. The generated estimations can assist water managers to better evaluate the status of and identify trends in water use and formulate adaptation measures to offset future deficits.

Keywords: water evaluation and planning system (WEAP), water availability, demand and supply, water allocation

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Authors: Baigts-Allende Diana, Klojdová Iveta, Kozlu Ali, Metri-ojeda Jorge

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Emulsion gels are constituted by a colloidal system (emulsion) stabilized by a polymeric gel matrix. These systems are more homogeneous and stable than conventional emulsions and can behave as either gel-like or soft-solid. Protein-based emulsion gels (PEG) have been used as carrier systems of bioactive compounds and as food structuring to improve the texture and consistency, mainly in producing low-fat content products. This work studied the effect of protein: polysaccharide ratio 0.75:1.25, 1:1, and 1.25:0.75 (levels -1, 0, and +1) and pH values (2-9) on the stability of protein-based emulsion gels using soy protein isolate and sodium alginate. Protein emulsion capacity was enhaced with increased pH (6,7,8 and 9) compared to acid pH values. The smaller particle size for PEG was at pH 9 (~23µm); however, with increasing protein ratio (level +1), higher particle size was observed (~23µm). The same trend was observed for rheological measurements; the consistency index (K) increased at pH 9 for level -1 (1.17) in comparison to level +1 (0.45). The studied PEG showed good thermal stability at neutral and pH 9 (~98 %) for all biopolymer ratios. Optimal conditions in pH and biopolymer ratios were determined for PEG using soy protein and sodium alginate ingredients with potential use in elaborating stable systems for broad application in the food sector.

Keywords: emulsion gels, food structuring, biopolymers, food systems

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Authors: Yang Xiong, Hua Cheng

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In this paper, for the basic problem of wireless sensor network topology control and deployment, the Roesser model in rectangular grid sensor networks is presented. In addition, a general constructive realization procedure will be proposed. The procedure enables a distributed implementation of linear systems on a sensor network. A non-trivial example is illustrated.

Keywords: grid sensor networks, Roesser model, state-space realization, multidimensional systems

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Authors: Shah Hussain Awan

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This study investigates the role of Business Incubation Centers (BICs) in fostering entrepreneurship in Pakistani universities. The high failure rate in new startups around the world has opened a challenging discussion. Though encouraging steps and strategies have been taken to overcome these challenges, still more aggressive action needs to be taken. However, Pakistan is one of the countries that promote entrepreneurship through BICs. The purpose of the present study is to develop a conceptual model that assesses the moderating impact of government policy on entrepreneurship development through business incubation centers of public and private universities. This area is under-researched, particularly in the context of Pakistan; therefore, this research may contribute to the existing body of knowledge to appraise the industry in Pakistan. The data collection procedure included a survey of stakeholders from private and public universities in Pakistan and was analyzed by SmartPLS 4.0. The findings show that Business incubation centers and government support have a significant impact on entrepreneurship development in Pakistan. Moderation analysis showed that for business incubation centers to be successful and effective, the government needs to implement efficient policies to inculcate entrepreneurship.

Keywords: business incubation centers, government support, policies, startup performance, entrepreneurship development

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Authors: Ashana Gupta

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Aim: In the UK, Botulinum Toxin (botox) is authorised for treating chronic myofascial pain secondary to masseter muscle hypertrophy (Fedorowicz et al. 2013). This audit aimed to ensure the Maxillofacial Unit is meeting the trust guidelines for the safe storage and disposal of botox. Method: The trust upholds a strict policy for botox handling. The audit was designed to optimise several elements including Staff awareness of regulations around botox handling A questionnaire was designed to test knowledge of advised storage temperatures, reporting of adverse events, disposal procedures and regulatory authorities. Steps taken to safely delivertoxin and eliminate unused toxin. A checklist was completed. These include marks for storagetemperature, identification checks, disposal of sharps, deactivation of toxin, and disposal. Results: All staff correctly stated storage requirements for toxin. 75% staff (n=8) were unsure about reporting and regulations. Whilst all staff knew how to dispose of vials, 0% staff showed awareness for the crucial step of deactivating toxin. All checklists (n=20) scored 100% for adequate storage, ID checks, and toxin disposal. However, there were no steps taken to deactivate toxin in any cases. Staff training took place with revision to clinical protocols. In line with Trust guidelines, an additional clinical step has been introduced including use of 0.5% sodium hypochlorite to deactivate botox. Conclusion: Deactivation is crucial to ensure residual toxin is not misused. There are cases of stolen botox within South-Tees Hospital (Woodcock, 2014). This audit was successful in increasing compliance to safe handling and disposal of botox by 100% and ensured our hospitalmeets Trust guidance.

Keywords: botulinum toxin, aesthetics, handling, disposal

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Authors: Ephrem Mebratu Dagnew, Mohammed Biset Ayalew, Gizework Alemnew Mekonnen, Alehegn Bishaw Geremew, Ousman Abubeker Abdela

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Objective: To assess the prevalence of drug-related problems and associated factors among adult psychiatric inpatients. Method: Hospital-based multicenter cross-sectional observational study was conducted from April to July 2021 at five randomly selected hospitals in North-west Ethiopia. A total of 325 consecutively sampled patients participated in the study. Clinical pharmacists assessed the DRPs based on clinical judgment supported by updated evidence-based diseases guidelines. A Medscape drug-interactions checker was used to check drug-drug interactions. The results were summarized using descriptive statistics, including frequency, mean, and standard deviation. Odds ratio (OR) with 95% confidence interval were also computed for each variable for the corresponding P-value. The value of P ≤ 0.05 was considered statistically significant. Result : From the total of 325 study participants, more than half of them (52.9%) were females and the mean age ± (standard deviation) was 30.8±11.3 years. At least one drug-related problem was recorded from 60.9%, 95% CI (55.7-65.8) of study participants with a mean of 0.6±0.49 per patient. Need additional drug therapy was the most common DRP (22.8%), followed by non-adherence to medicine (20.6%) and adverse drug reactions (11%), respectively. Factors independently associated with drug-related problems were rural residence [AOR=1.96,95%CI:1.01-2.84, P-value=0.046], self-employed [AOR=6.0 ,95% CI: 1.0-36.9, P-value=0.035] and alcohol drinkers [AOR=6.40,95%CI:1.12-37.5, p-value=0.034]. Conclusion: The prevalence of drug-related problems among adult psychiatric patients admitted to psychiatric wards was high. Healthcare providers give more attention to tackling these problems. Being a rural residence, self-employed, and Alcohol drinkers were associated with drug-related problems.

Keywords: psychiatric patients, drug-relatedproblems, multicenter, Ethiopia

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Authors: Fadwa Alhalaiqa, Othman Alfuqaha, Anas H. Khalifeh, Mahmoud Alsaraireh, Rami Masa’Deh, Natija S Manaa

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Background: Post-traumatic stress disorders (PTSD) usually occur after traumatic occurrences that exceed the range of common human experience. This study aimed to test the psychometric properties of PCL-5 checklist for the 20 PTSD symptoms from DSM-5 among Lebanese population and to identify the prevalence of PTSD. Methods: A cross sectional survey of PCL5 among 950 Lebanese using the online survey platform by Google form was conducted. Snowball recruitment was used to identify participants for the survey. STROBE guideline was used in reporting the current study. Results: Face content, construct, discriminant, and convergent validity had been accomplished of PCL-5. The reliability by Cronbach alpha, composite, and average variance extracted were set superior. We found also that more than half of the participants (55.6%) scored 33 or above, which is the cutoff score for a likely diagnosis of PTSD. Conclusion: The current study provides further support for the Arabic version PCL-5 validity and reliability among non-Western populations. This support using this tool in the screening of PTSD.

Keywords: post traumatic stress disorder, psychometric properties, stress, adult population

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Authors: Abdullah Nurus Salam Khan, Farhana Karim, Mohiuddin Ahsanul Kabir Chowdhury, S. Masum Billah, Nabila Zaka, Alexander Manu, Shams El Arifeen

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Globally, pre-eclampsia (PE) and ante-partum haemorrhage (APH) are two major causes of maternal mortality. Prompt identification and management of these conditions depend on competency of the birth attendants. Since these conditions are infrequent to be observed, clinical vignette based assessment could identify the extent of health worker’s competence in managing emergency obstetric care (EmOC). During June-August 2016, competence of 39 medical officers (MO) and 95 nurses working in obstetric ward of 15 government health facilities (3 district hospital, 12 sub-district hospital) was measured using clinical vignettes on PE and APH. The vignettes resulted in three outcome measures: total vignette scores, scores for diagnosis component, and scores for management component. T-test was conducted to compare mean vignette scores and linear regression was conducted to measure the strength and association of vignette scores with different cadres of health workers, facility’s readiness for EmOC and average annual utilization of normal deliveries after adjusting for type of health facility, health workers’ work experience, training status on managing maternal complication. For each of the seven component of EmOC items (administration of injectable antibiotics, oxytocic and anticonvulsant; manual removal of retained placenta, retained products of conception; blood transfusion and caesarean delivery), if any was practised in the facility within last 6 months, a point was added and cumulative EmOC readiness score (range: 0-7) was generated for each facility. The yearly utilization of delivery cases were identified by taking the average of all normal deliveries conducted during three years (2013-2015) preceding the survey. About 31% of MO and all nurses were female. Mean ( ± sd) age of the nurses were higher than the MO (40.0 ± 6.9 vs. 32.2 ± 6.1 years) and also longer mean( ± sd) working experience (8.9 ± 7.9 vs. 1.9 ± 3.9 years). About 80% health workers received any training on managing maternal complication, however, only 7% received any refresher’s training within last 12 months. The overall vignette score was 8.8 (range: 0-19), which was significantly higher among MO than nurses (10.7 vs. 8.1, p < 0.001) and the score was not associated with health facility types, training status and years of experience of the providers. Vignette score for management component (range: 0-9) increased with higher annual average number of deliveries in their respective working facility (adjusted β-coefficient 0.16, CI 0.03-0.28, p=0.01) and increased with each unit increase in EmOC readiness score (adjusted β-coefficient 0.44, CI 0.04-0.8, p=0.03). The diagnosis component of vignette score was not associated with any of the factors except it was higher among the MO than the nurses (adjusted β-coefficient 1.2, CI 0.13-2.18, p=0.03). Lack of competence in diagnosing and managing obstetric complication by the nurses than the MO is of concern especially when majority of normal deliveries are conducted by the nurses. Better EmOC preparedness of the facility and higher utilization of normal deliveries resulted in higher vignette score for the management component; implying the impact of experiential learning through higher case management. Focus should be given on improving the facility readiness for EmOC and providing the health workers periodic refresher’s training to make them more competent in managing obstetric cases.

Keywords: Bangladesh, emergency obstetric care, clinical vignette, competence of health workers

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Authors: Nirmani Wijenayake, Louise Lutze-Mann, Lucy Jo, John Wilson, Vivian Yeung, Dean Lovett, Kim Snepvangers

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Sessional academic staff at universities have the most influence and impact on student learning, engagement, and experience as they have the most direct contact with undergraduate students. A blended technology-enhanced program was created for the development and support of sessional staff to ensure adequate training is provided to deliver quality educational outcomes for the students. This program combines innovative mixed media educational modules, a peer-driven support forum, and face-to-face workshops to provide a comprehensive training and support package for staff. Additionally, the program encourages the development of learning communities and peer mentoring among the sessional staff to enhance their support system. In 2018, the program was piloted on 100 sessional staff in the School of Biotechnology and Biomolecular Sciences to evaluate the effectiveness of this model. As part of the program, rotoscope animations were developed to showcase ‘typical’ interactions between staff and students. These were designed around communication, confidence building, consistency in grading, feedback, diversity awareness, and mental health and wellbeing. When surveyed, 86% of sessional staff found these animations to be helpful in their teaching. An online platform (Moodle) was set up to disseminate educational resources and teaching tips, to host a discussion forum for peer-to-peer communication and to increase critical thinking and problem-solving skills through scenario-based lessons. The learning analytics from these lessons were essential in identifying difficulties faced by sessional staff to further develop supporting workshops to improve outcomes related to teaching. The face-to-face professional development workshops were run by expert guest speakers on topics such as cultural diversity, stress and anxiety, LGBTIQ and student engagement. All the attendees of the workshops found them to be useful and 88% said they felt these workshops increase interaction with their peers and built a sense of community. The final component of the program was to use an adaptive e-learning platform to gather feedback from the students on sessional staff teaching twice during the semester. The initial feedback provides sessional staff with enough time to reflect on their teaching and adjust their performance if necessary, to improve the student experience. The feedback from students and the sessional staff on this model has been extremely positive. The training equips the sessional staff with knowledge and insights which can provide students with an exceptional learning environment. This program is designed in a flexible and scalable manner so that other faculties or institutions could adapt components for their own training. It is anticipated that the training and support would help to build the next generation of educators who will directly impact the educational experience of students.

Keywords: designing effective instruction, enhancing student learning, implementing effective strategies, professional development

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Authors: Noor Ismael, Lisa Mische Lawson, Lauren Little, Murad Moqbel

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Background/Significance: Caregivers of children with Autism Spectrum Disorders (ASD) develop coping mechanisms to overcome daily challenges to successfully parent their child. There is variability in coping strategies used among caregivers of children with ASD. Capturing homogeneity among such variable groups may help elucidate targeted intervention approaches for caregivers of children with ASD. Study Purpose: This study aimed to identify groups of caregivers of children with ASD based on coping mechanisms, and to examine whether there are differences among these groups in terms of strain level. Methods: This study utilized a secondary data analysis, and included survey responses of 273 caregivers of children with ASD. Measures consisted of the COPE Inventory and the Caregiver Strain Questionnaire. Data analyses consisted of cluster analysis to group caregiver coping strategies, and analysis of variance to compare the caregiver coping groups on strain level. Results: Cluster analysis results showed four distinct groups with different combinations of coping strategies: Social-Supported/Planning (group one), Spontaneous/Reactive (group two), Self-Supporting/Reappraisal (group three), and Religious/Expressive (group four). Caregivers in group one (Social-Supported/Planning) demonstrated significantly higher levels than the remaining three groups in the use of the following coping strategies: planning, use of instrumental social support, and use of emotional social support, relative to the other three groups. Caregivers in group two (Spontaneous/Reactive) used less restraint relative to the other three groups, and less suppression of competing activities relative to the other three groups as coping strategies. Also, group two showed significantly lower levels of religious coping as compared to the other three groups. In contrast to group one, caregivers in group three (Self-Supporting/Reappraisal) demonstrated significantly lower levels of the use of instrumental social support and the use of emotional social support relative to the other three groups. Additionally, caregivers in group three showed more acceptance, positive reinterpretation and growth coping strategies. Caregivers in group four (Religious/Expressive) demonstrated significantly higher levels of religious coping relative to the other three groups and utilized more venting of emotions strategies. Analysis of Variance results showed no significant differences between the four groups on the strain scores. Conclusions: There are four distinct groups with different combinations of coping strategies: Social-Supported/Planning, Spontaneous/Reactive, Self-Supporting/Reappraisal, and Religious/Expressive. Each caregiver group engaged in a combination of coping strategies to overcome the strain of caregiving.

Keywords: autism, caregivers, cluster analysis, coping strategies

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Authors: Shabnam Sarwar, Franck Lacoeuille, Nadia Withofs, Roland Hustinx

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After the development of a potential surrogate of MAA, and its successful application for the diagnosis of pulmonary embolism in artificially embolized rats’ lungs, this microparticulate system were radiolabelled with gallium-68 to synthesize 68Ga-SBMP with high radiochemical purity >99%. As a prerequisite step of clinical trials, 68Ga- labelled starch based microparticles (SBMP) were analysed for their in-vivo behavior in small animals. The purpose of the presented work includes the ex-vivo biodistribution studies of 68Ga-SBMP in order to assess the activity uptake in target organs with respect to time, excretion pathways of the radiopharmaceutical, %ID/g in major organs, T/NT ratios, in-vivo stability of the radiotracer and subsequently the microparticles in the target organs. Radiolabelling of starch based microparticles was performed by incubating it with 68Ga generator eluate (430±26 MBq) at room temperature and pressure without using any harsh reaction condition. For Ex-vivo biodistribution studies healthy White Wistar rats weighing between 345-460 g were injected intravenously 68Ga-SBMP 20±8 MBq, containing about 2,00,000-6,00,000 SBMP particles in a volume of 700µL. The rats were euthanized at predefined time intervals (5min, 30min, 60min and 120min) and their organ parts were cut, washed, and put in the pre-weighed tubes and measured for radioactivity counts through automatic Gamma counter. The 68Ga-SBMP produced >99% RCP just after 10-20 min incubation through a simple and robust procedure. Biodistribution of 68Ga-SBMP showed that initially just after 5 min post injection major uptake was observed in the lungs following by blood, heart, liver, kidneys, bladder, urine, spleen, stomach, small intestine, colon, skin and skeleton, thymus and at last the smallest activity was found in brain. Radioactivity counts stayed stable in lungs with gradual decrease with the passage of time, and after 2h post injection, almost half of the activity were seen in lungs. This is a sufficient time to perform PET/CT lungs scanning in humans while activity in the liver, spleen, gut and urinary system decreased with time. The results showed that urinary system is the excretion pathways instead of hepatobiliary excretion. There was a high value of T/NT ratios which suggest fine tune images for PET/CT lung perfusion studies henceforth further pre-clinical studies and then clinical trials should be planned in order to utilize this potential lung perfusion agent.

Keywords: starch based microparticles, gallium-68, biodistribution, target organs, excretion pathways

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Authors: Ritu Rani

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In this paper, we apply minimalistically upheld linear semi-orthogonal B-spline wavelets, exceptionally developed for the limited interim to rough the obscure function present in the integral equations. Semi-orthogonal wavelets utilizing B-spline uniquely developed for the limited interim and these wavelets can be spoken to in a shut frame. This gives a minimized help. Semi-orthogonal wavelets frame the premise in the space L²(R). Utilizing this premise, an arbitrary function in L²(R) can be communicated as the wavelet arrangement. For the limited interim, the wavelet arrangement cannot be totally introduced by utilizing this premise. This is on the grounds that backings of some premise are truncated at the left or right end purposes of the interim. Subsequently, an uncommon premise must be brought into the wavelet development on the limited interim. These functions are alluded to as the limit scaling functions and limit wavelet functions. B-spline wavelet method has been connected to fathom linear and nonlinear integral equations and their systems. The above method diminishes the integral equations to systems of algebraic equations and afterward these systems can be illuminated by any standard numerical methods. Here, we have connected Newton's method with suitable starting speculation for solving these systems.

Keywords: semi-orthogonal, wavelet arrangement, integral equations, wavelet development

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Authors: Hesham Abd Elkhalek, Sherif M. Hafez, Yasser M. El Fahham

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Allocating limited budget to maintain bridge networks and selecting effective maintenance strategies for each bridge represent challenging tasks for maintenance managers and decision makers. In Egypt, bridges are continuously deteriorating. In many cases, maintenance works are performed due to user complaints. The objective of this paper is to develop a practical and reliable framework to manage the maintenance, repair, and rehabilitation (MR&R) activities of Bridges network considering performance and budget limits. The model solves an optimization problem that maximizes the average condition of the entire network given the limited available budget using Genetic Algorithm (GA). The framework contains bridge inventory, condition assessment, repair cost calculation, deterioration prediction, and maintenance optimization. The developed model takes into account multiple parameters including serviceability requirements, budget allocation, element importance on structural safety and serviceability, bridge impact on network, and traffic. A questionnaire is conducted to complete the research scope. The proposed model is implemented in software, which provides a friendly user interface. The framework provides a multi-year maintenance plan for the entire network for up to five years. A case study of ten bridges is presented to validate and test the proposed model with data collected from Transportation Authorities in Egypt. Different scenarios are presented. The results are reasonable, feasible and within acceptable domain.

Keywords: bridge management systems (BMS), cost optimization condition assessment, fund allocation, Markov chain

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Authors: Mmapula Petunia Tsweleng

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This qualitative study presents an exploration and findings thereof the quality of primary caregiving relationships between adolescents orphaned through Acquired Immune Deficiency Syndrome (AIDS) and their grandmothers. This exploration was based on in-depth narratives of 6 stakeholders who provided community-based psychosocial support services to children and families affected by AIDS. The narratives show that grandmothers provided high-quality parental care and support to the orphans. Furthermore, stakeholders categorised grandmother caregiving as genuine. Findings also show that the orphans thrived emotionally, socially, and cognitively and performed well academically. However, it was also identified that grandmothers’ caregiving had elements of overprotectiveness as well as susceptibility to manipulation -which appeared to be a threat to the positive development of the orphans. Relevant interventions, with a special focus on strengthening grandmother caregiving, are needed. Special attention should be on equipping grandmothers with a better understanding of adolescent behaviours and abilities to provide appropriate monitoring and supervision.

Keywords: adolescent orphans, AIDS, caregiving relationships, grandmothers

Procedia PDF Downloads 73

Authors: Rana Alaa El-Deen Ahmed, M. Elemam Shehab, Shereen Morsy, Nermeen Mekawie

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With the growing popularity and acceptance of e-commerce platforms, users face an ever increasing burden in actually choosing the right product from the large number of online offers. Thus, techniques for personalization and shopping guides are needed by users. For a pleasant and successful shopping experience, users need to know easily which products to buy with high confidence. Since selling a wide variety of products has become easier due to the popularity of online stores, online retailers are able to sell more products than a physical store. The disadvantage is that the customers might not find products they need. In this research the customer will be able to find the products he is searching for, because recommender systems are used in some ecommerce web sites. Recommender system learns from the information about customers and products and provides appropriate personalized recommendations to customers to find the needed product. In this paper eleven classification algorithms are comparatively tested to find the best classifier fit for consumer online shopping attitudes and behavior in the experimented dataset. The WEKA knowledge analysis tool, which is an open source data mining workbench software used in comparing conventional classifiers to get the best classifier was used in this research. In this research by using the data mining tool (WEKA) with the experimented classifiers the results show that decision table and filtered classifier gives the highest accuracy and the lowest accuracy classification via clustering and simple cart.

Keywords: classification, data mining, machine learning, online shopping, WEKA

Procedia PDF Downloads 354