Search results for: integrated clinical environment

Authors: Niloufar Yadgari

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GANs are a potent form of deep learning models that have found success in various fields. They are part of the larger group of generative techniques, which aim to produce authentic data using a probabilistic model that learns distributions from actual samples. In clinical settings, GANs have demonstrated improved abilities in capturing spatially intricate, nonlinear, and possibly subtle disease impacts in contrast to conventional generative techniques. This review critically evaluates the current research on how GANs are being used in imaging studies of different neurological conditions like Alzheimer's disease, brain tumors, aging of the brain, and multiple sclerosis. We offer a clear explanation of different GAN techniques for each use case in neuroimaging and delve into the key hurdles, unanswered queries, and potential advancements in utilizing GANs in this field. Our goal is to connect advanced deep learning techniques with neurology studies, showcasing how GANs can assist in clinical decision-making and enhance our comprehension of the structural and functional aspects of brain disorders.

Keywords: GAN, pathology, generative adversarial network, neuro imaging

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Authors: Mustapha Ouardouz, Mina Amharref, Abdessamed Bernoussi

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The future energy, for limited energy resources countries, goes through renewable energies (solar, wind etc.). The renewable energies constitute a major component of the energy strategy to cover a substantial part of the growing needs and contribute to environmental protection by replacing fossil fuels. Indeed, sustainable development involves the promotion of renewable energy and the preservation of the environment by the use of clean energy technologies to limit emissions of greenhouse gases and reducing the pressure exerted on the forest cover. So the impact studies, of the energy use on the environment and farm-related risks are necessary. For that, a global approach integrating all the various sectors involved in such project seems to be the best approach. In this paper we present an approach based on the multi criteria analysis and the realization of one pilot to achieve the development of an innovative geo-intelligent environmental platform. An implementation of this platform will collect, process, analyze and manage environmental data in connection with the nature of used energy in the studied region. As an application we consider a region in the north of Morocco characterized by intense agricultural and industrials activities and using diverse renewable energy. The strategic goals of this platform are; the decision support for better governance, improving the responsiveness of public and private companies connected by providing them in real time with reliable data, modeling and simulation possibilities of energy scenarios, the identification of socio-technical solutions to introduce renewable energies and estimate technical and implantable potential by socio-economic analyzes and the assessment of infrastructure for the region and the communities, the preservation and enhancement of natural resources for better citizenship governance through democratization of access to environmental information, the tool will also perform simulations integrating environmental impacts of natural disasters, particularly those linked to climate change. Indeed extreme cases such as floods, droughts and storms will be no longer rare and therefore should be integrated into such projects.

Keywords: renewable energies, decision aided tool, environment, simulation

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Authors: H. Zidoum, A. AlShareedah, S. Al Sawafi, A. Al-Ansari, B. Al Lawati

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Systemic lupus erythematosus (SLE) is an autoimmune disease with genetic and environmental components. SLE is characterized by a wide variability of clinical manifestations and a course frequently subject to unpredictable flares. Despite recent progress in classification tools, the early diagnosis of SLE is still an unmet need for many patients. This study proposes an interpretable disease classification model that combines the high and efficient predictive performance of CatBoost and the model-agnostic interpretation tools of Shapley Additive exPlanations (SHAP). The CatBoost model was trained on a local cohort of 219 Omani patients with SLE as well as other control diseases. Furthermore, the SHAP library was used to generate individual explanations of the model's decisions as well as rank clinical features by contribution. Overall, we achieved an AUC score of 0.945, F1-score of 0.92 and identified four clinical features (alopecia, renal disorders, cutaneous lupus, and hemolytic anemia) along with the patient's age that was shown to have the greatest contribution on the prediction.

Keywords: feature selection, classification, systemic lupus erythematosus, model interpretation, SHAP, Catboost

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Authors: Gerhard Peter

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In this paper, we present an integrated framework that governs the introduction of social media into enterprises and its evaluation. It is argued that the framework should address the following issues: (1) the contribution of social media for increasing efficiency and improving the quality of working life; (2) the level on which this contribution happens (i.e., individual, team, or organisation); (3) a description of the processes for implementing and evaluating social media; and the role of (4) organisational culture and (5) management. We also report the results of a case study where the framework has been employed to introduce a social networking platform at a German enterprise. This paper only considers the internal use of social media.

Keywords: case study, enterprise 2.0, framework, introducing and evaluating social media, social media

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Authors: Jungbin Lim, Bohee Kang, Heelim Lee, Sunjin Kim, GeumHee Choi, Jae-Suk Jung, Suk Ji

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Nonsurgical periodontal therapies have, for several decades, been the basis of periodontal treatment concepts. The aim of this paper is to investigate the effectiveness of non-surgical periodontal therapy according to the severity of periodontitis disease. Methods: Retrospective data of patients who visited Department of periodontics in Ajou University Medical Center from 2016 to 2022 were collected. Among the patients, those who took full mouth examination of clinical parameters and non-surgical periodontal therapy were chosen for this study. Selected patients were divided into initial, moderate, and severe periodontitis based on severity and complexity of management (2018 World Workshop EFP/AAP consensus). Recall visits with clinical periodontal examination were scheduled for 1,2,3 months or 1,3,6 months after the treatment. The results were evaluated by recordings of mean probing pocket depth (mean PD), mean clinical attachment levels (mean CAL), bleeding on probing (BOP%), mean gingival index (mean GI), mean regression, mean sulcus bleeding index (mean SBI), mean plaque scores (mean PI). All statistical analyses were performed with R software, version 4.3.0. A level of significance, P<0.05, was considered to be statistically significant. Results: A total of 92 patients were included in this study. 15 patients were diagnosed as initial periodontitis, 14 moderate periodontitis, and 63 severe periodontitis. The all parameters except for mean recession decreased over time in all groups. The amount of mean PD decreased were the greatest in severe periodontitis group followed by moderate and initial, which was found to be statistically significant. The changes of mean PD were 0.15±0.05 mm, 0.37±0.06 mm, and 1.01±0.07 mm (initial, moderate, and severe, respectively, P<0.001). When comparing before and after treatment, the reductions in BOP(%), mean GI, mean SBI, and mean PI were statistically significant. Conclusion: All patients who received non-surgical periodontal therapy showed periodontal healing in terms of improvements in clinical parameters, and it was greater in the severe group.

Keywords: periodontology, clinical periodontology, oral treatment, comprehensive preventive dentistry, non-surgical periodontal therapy

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Authors: G. Martino, F. Silva, E. Marchal

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The control over delivered iron ore blend characteristics is one of the most important aspects of the mining business. The iron ore price is a function of its composition, which is the outcome of the beneficiation process. So, end-to-end integrated planning of mine operations can reduce risks of penalties on the iron ore price. In a standard iron mining company, the production chain is composed of mining, ore beneficiation, and client supply. When mine planning and client supply decisions are made uncoordinated, the beneficiation plant struggles to deliver the best blend possible. Technological improvements in several fields allowed bridging the gap between departments and boosting integrated decision-making processes. Clusterization and classification algorithms over historical production data generate reasonable previsions for quality and volume of iron ore produced for each pile of run-of-mine (ROM) processed. Mathematical modeling can use those deterministic relations to propose iron ore blends that better-fit specifications within a delivery schedule. Additionally, a model capable of representing the whole production chain can clearly compare the overall impact of different decisions in the process. This study shows how flexibilization combined with a planning optimization model between the mine and the ore beneficiation processes can reduce risks of out of specification deliveries. The model capabilities are illustrated on a hypothetical iron ore mine with magnetic separation process. Finally, this study shows ways of cost reduction or profit increase by optimizing process indicators across the production chain and integrating the different plannings with the sales decisions.

Keywords: clusterization and classification algorithms, integrated planning, mathematical modeling, optimization, penalty minimization

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Authors: Karl Owen L. Suan, Juliet Marie S. Lambayan, Floramay P. Salo-Curato

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Objective: To predict the outcome among patients admitted with community-acquired pneumonia (ages 3 months to 59 months old) admitted in Visayas Community Medical Center using the Respiratory Index of Severity in Children (RISC). Design: A cross-sectional study design was used. Setting: The study was done in Visayas Community Medical Center, which is a private tertiary level in Cebu City from January-June 2013. Patients/Participants: A total of 72 patients were initially enrolled in the study. However, 1 patient transferred to another institution, thus 71 patients were included in this study. Within 24 hours from admission, patients were assigned a RISC score. Statistical Analysis: Cohen’s kappa coefficient was used for inter-rater agreement for categorical data. This study used frequency and percentage distribution for qualitative data. Mean, standard deviation and range were used for quantitative data. To determine the relationship of each RISC score parameter and the total RISC score with the outcome, a Mann Whitney U Test and 2x2 Fischer Exact test for testing associations were used. A p value less of than 0.05 alpha was considered significant. Results: There was a statistical significance between RISC score and clinical outcome. RISC score of greater than 4 was correlated with intubation and/or mortality. Conclusion: The RISC scoring system is a simple combination of clinical parameters and a reliable tool that will help stratify patients aged 3 months to 59 months in predicting clinical outcome.

Keywords: RISC, clinical outcome, community-acquired pneumonia, patients

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Authors: Eimar Yadir Quintero Tapias

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Background: Science is not generally self-correcting; many clinical studies end with the same conclusion "more research is needed." This study hypothesizes that first, we need a better appraisal of the available (and unavailable) evidence instead of creating more of the same false inquiries. Methods: Systematic review of ClinicalTrials.gov study records using the following Boolean operators: (food OR nut OR milk OR egg OR shellfish OR wheat OR peanuts) AND (allergy OR allergies OR hypersensitivity OR hypersensitivities). Variables included the status of the study (e g., active and completed), availability of results, sponsor type, sample size, among others. To determine the rates of non-publication in journals indexed by PubMed, an advanced search query using the specific Number of Clinical Trials (e.g., NCT000001 OR NCT000002 OR...) was performed. As a prophylactic measure to prevent P-hacking, data analyses only included descriptive statistics and not inferential approaches. Results: A total of 2092 study records matched the search query described above (date: September 13, 2019). Most studies were interventional (n = 1770; 84.6%) and the remainder observational (n = 322; 15.4%). Universities, hospitals, and research centers sponsored over half of these investigations (n = 1208; 57.7%), 308 studies (14.7%) were industry-funded, and 147 received NIH grants; the remaining studies got mixed sponsorship. Regarding completed studies (n = 1156; 55.2%), 248 (21.5%) have results available at the registry site, and 417 (36.1%) matched NCT numbers of journal papers indexed by PubMed. Conclusions: The internal and external validity of human research is critical for the appraisal of medical evidence. It is imperative to analyze the entire dataset of clinical studies, preferably at a patient-level anonymized raw data, before rushing to conclusions with insufficient and inadequate information. Publication bias and non-registration of clinical trials limit the evaluation of the evidence concerning therapeutic interventions for food allergy, such as oral and sublingual immunotherapy, as well as any other medical condition. Over half of the food allergy human research remains unpublished.

Keywords: allergy, clinical trials, immunology, systematic reviews

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Authors: Yasir Memon

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The complexity and challenges in the offshore industry are increasing more than the past. The oil and gas industry is expanding every day by accomplishing these challenges. More challenging wells such as longer and deeper are being drilled in today’s environment. Blowout prevention phenomena hold a worthy importance in oil and gas biosphere. In recent, so many past years when the oil and gas industry was growing drilling operation were extremely dangerous. There was none technology to determine the pressure of reservoir and drilling hence was blind operation. A blowout arises when an uncontrolled reservoir pressure enters in wellbore. A potential of blowout in the oil industry is the danger for the both environment and the human life. Environmental damage, state/country regulators, and the capital investment causes in loss. There are many cases of blowout in the oil the gas industry caused damage to both human and the environment. A huge capital investment is being in used to stop happening of blowout through all over the biosphere to bring damage at the lowest level. The objective of this study is to promote safety and good resources to assure safety and environmental integrity in all operations during drilling. This study shows that human errors and management failure is the main cause of blowout therefore proper management with the wise use of precautions, prevention methods or controlling techniques can reduce the probability of blowout to a minimum level. It also discusses basic procedures, concepts and equipment involved in well control methods and various steps using at various conditions. Furthermore, another aim of this study work is to highlight management role in oil gas operations. Moreover, this study analyze the causes of Blowout of Macondo well occurred in the Gulf of Mexico on April 20, 2010, and deliver the recommendations and analysis of various aspect of well control methods and also provides the list of mistakes and compromises that British Petroleum and its partner were making during drilling and well completion methods and also the Macondo well disaster happened due to various safety and development rules violation. This case study concludes that Macondo well blowout disaster could be avoided with proper management of their personnel’s and communication between them and by following safety rules/laws it could be brought to minimum environmental damage.

Keywords: energy, environment, oil and gas industry, Macondo well accident

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Authors: Sonia Alberti

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The Regional Conference to Restructure Psychiatric Care in Latin America, convened by the Pan American Health Organization (PAHO) in 1990, oriented the Brazilian Federal Act in 2001 that stipulated the psychiatric reform which requires deinstitutionalization and community-based treatment. Since then, the 15 years’ experience of different working teams in mental health led an academic working group – supervisors from personal practices, professors and researchers – to discuss certain clinical issues, as well as supervisions, and to organize colloquia in different cities as a methodology. These colloquia count on the participation of different working teams from the cities in which they are held, with team members with different levels of educational degrees and prior experiences, in order to increase dialogue right where it does not always appear to be possible. The principal aim of these colloquia is to gain interlocution between practitioners and academics. Working with the theory of case constructions, this methodology revealed itself helpful in unfolding new solutions. The paper also observes that there is not always harmony between what the psychiatric reform demands and clinical ethics.

Keywords: mental health, supervision, clinical cases, Brazilian experience

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Authors: Lim Chen Kim, Tan Kian Lam, Chan Yi Chee

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This research presents a multi-modal simulation in the reconstruction of the past and the construction of present in digital cultural heritage on mobile platform. In bringing the present life, the virtual environment is generated through a presented scheme for rapid and efficient construction of 360° panoramic view. Then, acoustical heritage model and crowd model are presented and improvised into the 360° panoramic view. For the reconstruction of past life, the crowd is simulated and rendered in an old trading port. However, the keystone of this research is in a virtual walkthrough that shows the virtual present life in 2D and virtual past life in 3D, both in an environment of virtual heritage sites in George Town through mobile device. Firstly, the 2D crowd is modelled and simulated using OpenGL ES 1.1 on mobile platform. The 2D crowd is used to portray the present life in 360° panoramic view of a virtual heritage environment based on the extension of Newtonian Laws. Secondly, the 2D crowd is animated and rendered into 3D with improved variety and incorporated into the virtual past life using Unity3D Game Engine. The behaviours of the 3D models are then simulated based on the enhancement of the classical model of Boid algorithm. Finally, a demonstration system is developed and integrated with the models, techniques and algorithms of this research. The virtual walkthrough is demonstrated to a group of respondents and is evaluated through the user-centred evaluation by navigating around the demonstration system. The results of the evaluation based on the questionnaires have shown that the presented virtual walkthrough has been successfully deployed through a multi-modal simulation and such a virtual walkthrough would be particularly useful in a virtual tour and virtual museum applications.

Keywords: Boid Algorithm, Crowd Simulation, Mobile Platform, Newtonian Laws, Virtual Heritage

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Authors: Muhammad Haseeb

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It is crucial to have a balanced approach to food's energy and nutritional content in a world with limited resources. The preservation of the environment is vital, and both the agrifood-making and food service sectors will be requested to use fewer resources to produce a wider range of existing foods and develop imaginative foods that are physiologically appropriate for a better sense of good health, have long shelf lives and are conveniently transportable. Delivering healthy diets that satisfy consumer expectations from robust and sustainable agrifood systems is necessary in a world that is changing and where natural resources are running out. Across the whole food supply chain, an integrated multi-sectoral approach is needed to alleviate global food and nutrition insecurity.

Keywords: health, food, nutrition, supply chain

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Authors: Diana Meeks

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The use of a virtual learning environment (VLE), via the Second Life Platform has been a positive experience to enhance critical thinking, for executive graduate nursing practicum students. Due to the interest of faculty and students, the opportunity to immerse students via a virtual learning environment to enhance critical thinking related to the nurse executive role was explored. The College of Nursing realized the potential to enhance critical thinking and incorporated the Second Life, virtual learning environment platform into their graduate nursing program within their executive practicum course. The results from students and faculty regarding this experience have been positive. Students state the VLE platform has enhanced their critical thinking and interaction with peers. To date, course refinement incorporating a Second Life, virtual learning environment for the nurse executive practicum students continues. As a result, a designated subject matter expert has been designated for this course. The development and incorporation of the VLE approach will be presented.

Keywords: nursing, virtual learning environment, critical thinking, VLE

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Authors: M. Yakubu, M. B. Isah, S. Bako

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This paper presents the findings of a research which sought to investigate the readiness to integrate sustainable construction principles into curriculum design for built environment professional programs in the Nigerian Universities. Developing the knowledge and understanding that construction professionals acquire of sustainable construction practice leads to considerable improvement in the environmental performance of the construction sector. Integrating sustainable environmental issues within the built environment education curricula provide the basis of this research. An integration of sustainable development principles into the universities built environment professional programmes are carried out with a view of finding solutions to the key issues identified. The perspectives of academia have been assessed and findings tested for validity through the analysis of primary quantitative data that has been collected. The secondary data generated has shown that there are significant differences in the approach to curriculum design within the built environment professional programmes, and this reveals that there is no ‘best practice’ that is clearly identifiable. Sequel to the above, this research reveals that engaging all stakeholders would be a useful component of built environment curriculum development, and that the curriculum be negotiated with interested parties. These parties have been identified as academia, government, construction industry and built environment professionals.

Keywords: built environment, curriculum development, sustainable construction, sustainable development

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Authors: Francimar Alves, Marcos Castro, Marllus Lustosa

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In the context of the teaching of computer programming, the choice of tool to use is very important in the initiation and continuity of learning a programming language. The literature tools do not always provide usability and pedagogical dynamism clearly and accurately for effective learning. This hypothesis implies fall in productivity and difficulty of learning a particular programming language by students. The integrated development environments (IDEs) Dev-C ++ and Code :: Blocks are widely used in introductory courses for undergraduate courses in Computer Science for learning C and C ++ languages. However, after several years of discontinuity maintaining the source code of Dev-C ++ tool, the continued use of the same in the teaching and learning process of the students of these institutions has led to difficulties, mainly due to the lack of update by the official developers, which resulted in a sequence of problems in using it on educational settings. Much of the users, dissatisfied with the IDE Dev-C ++, migrated to Code :: Blocks platform targeting the more dynamic range in the learning process of the C and C ++ languages. Nevertheless, there is still the need to create a tool that can provide the resources of most IDE's software development literature, however, more interactive, simple, accurate and efficient. This motivation led to the creation of Falcon C ++ tool, IDE that brings with features that turn it into an educational platform, which focuses primarily on increasing student learning index in the early disciplines of programming and algorithms that use the languages ​​C and C ++ . As a working methodology, a field research to prove the truth of the proposed tool was used. The test results and interviews with entry-level students and intermediate in a postsecondary institution gave basis for the composition of this work, demonstrating a positive impact on the use of the tool in teaching programming, showing that the use of Falcon C ++ software is beneficial in the teaching process of the C and C ++ programming languages.

Keywords: ide, education, learning, development, language

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Authors: Narottam Puri, Bishnu Panigrahi, Narayan Pendse

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Background: Clinical Outcomes are the globally agreed upon, evidence-based measurable changes in health or quality of life resulting from the patient care. Reporting of outcomes and its continuous monitoring provides an opportunity for both assessing and improving the quality of patient care. In 2012, International Consortium Of HealthCare Outcome Measurement (ICHOM) was founded which has defined global Standard Sets for measuring the outcome of various treatments. Method: Monitoring of Clinical Outcomes was identified as a pillar of Fortis’ core value of Patient Centricity. The project was started as an in-house developed Clinical Outcomes Reporting Portal by the Fortis Medical IT team. Standard sets of Outcome measurement developed by ICHOM were used. A pilot was run at Fortis Escorts Heart Institute from Aug’13 – Dec’13.Starting Jan’14, it was implemented across 11 hospitals of the group. The scope was hospital-wide and major clinical specialties: Cardiac Sciences, Orthopedics & Joint Replacement were covered. The internally developed portal had its limitations of report generation and also capturing of Patient related outcomes was restricted. A year later, the company provisioned for an ICHOM Certified Software product which could provide a platform for data capturing and reporting to ensure compliance with all ICHOM requirements. Post a year of the launch of the software; Fortis Healthcare has become the 1st Healthcare Provider in Asia to publish Clinical Outcomes data for the Coronary Artery Disease Standard Set comprising of Coronary Artery Bypass Graft and Percutaneous Coronary Interventions) in the public domain. (Jan 2016). Results: This project has helped in firmly establishing a culture of monitoring and reporting Clinical Outcomes across Fortis Hospitals. Given the diverse nature of the healthcare delivery model at Fortis Network, which comprises of hospitals of varying size and specialty-mix and practically covering the entire span of the country, standardization of data collection and reporting methodology is a huge achievement in itself. 95% case reporting was achieved with more than 90% data completion at the end of Phase 1 (March 2016). Post implementation the group now has one year of data from its own hospitals. This has helped identify the gaps and plan towards ways to bridge them and also establish internal benchmarks for continual improvement. Besides the value created for the group includes: 1. Entire Fortis community has been sensitized on the importance of Clinical Outcomes monitoring for patient centric care. Initial skepticism and cynicism has been countered by effective stakeholder engagement and automation of processes. 2. Measuring quality is the first step in improving quality. Data analysis has helped compare clinical results with best-in-class hospitals and identify improvement opportunities. 3. Clinical fraternity is extremely pleased to be part of this initiative and has taken ownership of the project. Conclusion: Fortis Healthcare is the pioneer in the monitoring of Clinical Outcomes. Implementation of ICHOM standards has helped Fortis Clinical Excellence Program in improving patient engagement and strengthening its commitment to its core value of Patient Centricity. Validation and certification of the Clinical Outcomes data by an ICHOM Certified Supplier adds confidence to its claim of being leaders in this space.

Keywords: clinical outcomes, healthcare delivery, patient centricity, ICHOM

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Authors: S. S. Rwanga, J. M. Ndambuki

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Groundwater quantification needs a method which is not only flexible but also reliable in order to accurately quantify its spatial and temporal variability. As groundwater is dynamic and interdisciplinary in nature, an integrated approach of remote sensing (RS) and GIS technique is very useful in various groundwater management studies. Thus, the GIS water balance model (WetSpass) together with remote sensing (RS) can be used to quantify groundwater recharge. This paper discusses the concept of WetSpass in combination with GIS on the quantification of recharge with a view to managing water resources in an integrated framework. The paper presents the simulation procedures and expected output after simulation. Preliminary data are presented from GIS output only.

Keywords: groundwater, recharge, GIS, WetSpass

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Authors: Ilma Robo, Saimir Heta, Rialda Xhizdari, Kers Kapaj

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Background: The ideal disinfectant for surfaces, instruments, air, skin, both in dentistry and in the fields of medicine, does not exist.This is for the sole reason that all the characteristics of the ideal disinfectant cannot be contained in one; these are the characteristics that if one of them is emphasized, it will conflict with the other. A disinfectant must be stable, not be affected by changes in the environmental conditions where it stands, which means that it should not be affected by an increase in temperature or an increase in the humidity of the environment. Both of these elements contradict the other element of the idea of an ideal disinfectant, as they disrupt the solubility ratios of the base substance of the disinfectant versus the diluent. Material and methods: The study aims to extract the constant of each disinfectant/antiseptic used during dental disinfection protocols, accompanied by the side effects of the surface of the skin or mucosa where it is applied in the role of antiseptic. In the end, attempts were made to draw conclusions about the best possible combination for disinfectants after a dental procedure, based on the data extracted from the basic literature required during the development of the pharmacology module, as a module in the formation of a dentist, against data published in the literature. Results: The sensitivity of the disinfectant to changes in the atmospheric conditions of the environment where it is kept is a known fact. The care against this element is always accompanied by the advice on the application of the specific disinfectant, in order to have the desired clinical result. The constants of disinfectants according to the classification based on the data collected and presented are for alcohols 70-120, glycols 0.2, aldehydes 30-200, phenols 15-60, acids 100, povidone iodine halogens 5-75, hypochlorous acid halogens 150, sodium hypochlorite halogens 30-35, oxidants 18-60, metals 0.2-10. The part of halogens should be singled out, where specific results were obtained according to the representatives of this class, since it is these representatives that find scope for clinical application in dentistry. Conclusions: The search for the "ideal", in the conditions where its defining criteria are also established, not only for disinfectants but also for any medication or pharmaceutical product, is an ongoing search, without any definitive results. In this mine of data in the published literature if there is something fixed, calculable, such as the specific constant for disinfectants, the search for the ideal is more concrete. During the disinfection protocols, different disinfectants are applied since the field of action is different, including water, air, aspiration devices, tools, disinfectants used in full accordance with the production indications.

Keywords: disinfectant, constant, ideal, side effects

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Authors: Polina Prokopovich

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Disease-modifying osteoarthritis drugs (DMOADs) are a new therapeutic class for OA, preventing or inhibiting OA development. Unfortunately, none of the DMOADs have been clinically approved due to their poor therapeutic effects in clinical trials. The joint environment has played a role in the poor clinical performance of these drugs by limiting the amount of drug effectively delivered as well as the time that the drug spends within the joint space. The current study aims to enhance the cartilage uptake and retention time of the DMOADs-model (licofelone), which showed a significant therapeutic effect against OA progression and is currently in phase III. Licofelone will be covalently conjugated to the hydrolysable, cytocompatible, and cationic poly beta-amino ester polymers (PBAE). The cationic polymers (A16 and A87) can be electrostatically attached to the negatively charged cartilage component (glycosaminoglycan), which will increase the drug penetration through the cartilage and extend the drug time within the cartilage. In the cartilage uptake and retention time studies, an increase of 18 to 37 times of the total conjugated licofelone to A87 and A16 was observed when compared to the free licofelone. Furthermore, the conjugated licofelone to A87 was detectable within the cartilage at 120 minutes, while the free licofelone was not detectable after 60 minutes. Additionally, the A87-licofelone conjugate showed no effect on the chondrocyte viability. In conclusion, the cationic A87 and A16 polymers increased the percentage of licofelone within the cartilage, which could potentially enhance the therapeutic effect and pharmacokinetic performance of licofelone or other DMOADs clinically.

Keywords: PBAE, cartilage., osteoarthritis, injectable biomaterials, drug delivery

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Authors: G. Ghamrawi, Y. Abunnasr, M. Fawaz, S. Yazigi

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Coastal cities are constantly exposed to environmental degradation and economic regression fueled by rapid and uncontrolled urban growth as well as continuous resource depletion. This is the case of the City of Mina in Tripoli (Lebanon), where lack of awareness to preserve social, ecological, and historical assets, coupled with the increasing development pressures, are threatening the socioeconomic status of the city residents, the quality of life and accessibility to the coast. To address these challenges, a holistic coastal urban design and planning approach was developed to analyze the environmental, political, legal, and socioeconomic context of the city. This approach aims to investigate the potential of balancing urban development with the protection and enhancement of cultural, ecological, and environmental assets under an integrated coastal zone management approach (ICZM). The analysis of Mina's different sectors adopted several tools that include direct field observation, interviews with stakeholders, analysis of available data, historical maps, and previously proposed projects. The findings from the analysis were mapped and graphically represented, allowing the recognition of character zones that become the design intervention units. Consequently, the thesis proposes an urban, city-scale intervention that identifies 6 different character zones (the historical fishing port, Abdul Wahab island, the abandoned Port Said, Hammam el Makloub, the sand beach, and the new developable area) and proposes context-specific design interventions that capitalize on the main characteristics of each zone. Moreover, the intervention builds on the institutional framework of ICZM as well as other studies previously conducted for the coast and adopts nature-based solutions with hybrid systems for providing better environmental design solutions for developing the coast. This enables the realization of an all-inclusive, well-connected shoreline with easy and free access towards the sea; a developed shoreline with an active local economy, and an improved urban environment.

Keywords: blue green infrastructure, coastal cities, hybrid solutions, integrated coastal zone management, sustainable development, urban planning

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Authors: M. Crozet, D. Roudil, T. Branger, S. Boden, P. Peerani, B. Russell, M. Herranz, L. Aldave de la Heras

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The EURATOM work program project INSIDER (Improved Nuclear Site Characterization for Waste minimization in Decommissioning under Constrained Environment) was launched in June 2017. This 4-year project has 18 partners and aims at improving the management of contaminated materials arising from decommissioning and dismantling (D&D) operations by proposing an integrated methodology of characterization. This methodology is based on advanced statistical processing and modelling, coupled with adapted and innovative analytical and measurement methods, with respect to sustainability and economic objectives. In order to achieve these objectives, the approaches will be then applied to common case studies in the form of Inter-laboratory comparisons on matrix representative reference samples and benchmarking. Work Package 6 (WP6) ‘Performance analysis and overall uncertainty’ is in charge of the analysis of the benchmarking on real samples, the organisation of inter-laboratory comparison on synthetic certified reference materials and the establishment of overall uncertainty budget. Assessment of the outcome will be used for providing recommendations and guidance resulting in pre-standardization tests.

Keywords: decommissioning, sampling strategy, research and development, characterization, European project

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Authors: Othman Maklouf, Abdunnaser Tresh

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GPS and inertial navigation system (INS) have complementary qualities that make them ideal use for sensor fusion. The limitations of GPS include occasional high noise content, outages when satellite signals are blocked, interference and low bandwidth. The strengths of GPS include its long-term stability and its capacity to function as a stand-alone navigation system. In contrast, INS is not subject to interference or outages, have high bandwidth and good short-term noise characteristics, but have long-term drift errors and require external information for initialization. A combined system of GPS and INS subsystems can exhibit the robustness, higher bandwidth and better noise characteristics of the inertial system with the long-term stability of GPS. The most common estimation algorithm used in integrated INS/GPS is the Kalman Filter (KF). KF is able to take advantages of these characteristics to provide a common integrated navigation implementation with performance superior to that of either subsystem (GPS or INS). This paper presents a simplified KF algorithm for land vehicle navigation application. In this integration scheme, the GPS derived positions and velocities are used as the update measurements for the INS derived PVA. The KF error state vector in this case includes the navigation parameters as well as the accelerometer and gyroscope error states.

Keywords: GPS, INS, Kalman filter, inertial navigation system

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Authors: S. B. V. S. P. Sastry, V. V. S. Kesava Rao

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In this paper, x-ray impact of Taguchi method and design of experiment philosophy to project relationship between various factors leading to output yield strength of rebar is studied. In bar mill of an integrated steel plant, there are two production lines called as line 1 and line 2. The metallic properties e.g. yield strength of finished product of the same material is varying for a particular grade material when rolled simultaneously in both the lines. A study has been carried out to set the process parameters at optimal level for obtaining equal value of yield strength simultaneously for both lines.

Keywords: bar mill, design of experiment, taguchi, yield strength

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Authors: T. S. Sowmya Bhaskaran, Shekhar Seshadri

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This study aims to study the clinical features of with a history of Child Sexual Abuse (CSA). A chart review of 40 children (<16 years) with history of CSA evaluated at the Department of Child and Adolescent Psychiatry of NIMHANS during a two year period was performed. Results:The most common form of abuse was contact penetrative abuse (65%) followed by non-contact penetrative abuse (32.5%). 75% (N=30) had a psychiatric diagnosis at baseline. 50% of these children had one or more psychiatric comorbidities. Anxiety disorder was the most common diagnosis (27.5%) which included PTSD (11%) followed by Depressive disorder (25.2%). Children abused by multiple perpetrators were found to be more likely to have depression, to having a comorbid psychiatric disorder and more prone to exhibit sexualized behaviour. Children who also experienced physical violence at home were more likely to develop psychiatric illness following child sexual abuse. Psychiatric morbidity is high in clinic population of children with history of CSA. It is important to increase the awareness regarding the consequences of CSA in order to increase help seeking.

Keywords: child sexual abuse, India, tertiary care centre, clinical characteristics

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Authors: Bollu Mounica

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Background: Nowadays drug related problems were seen very commonly within the health care practice. These could result in the medication errors, adverse events, drug interactions and harm to patients. Pharmacist has an identified role in minimizing and preventing such type of problems. Objectives: To detect the incidence of drug related problems for the hospitalized patient, and to analyze the clinical pharmacist interventions performed during the review of prescription orders of the general medicine, psychiatry, surgery, pediatrics, gynaecology units of a large tertiary care teaching hospital. Methods: It was a retrospective, observational and interventional study. The analysis took place daily with the following parameters: dose, rate of administration, presentation and/or dosage form, presence of inappropriate/unnecessary drugs, necessity of additional medication, more proper alternative therapies, presence of relevant drug interactions, inconsistencies in prescription orders, physical-chemical incompatibilities/solution stability. From this evaluation, the drug therapy problems were classified, as well as the resulting clinical interventions. For a period starting November 2012 until December 2014, the inpatient medication charts and orders were identified and rectified by ward and practicing clinical pharmacists within the inpatient pharmacy services in a tertiary care teaching hospital on routine daily activities. Data was collected and evaluated. The causes of this problem were identified. Results: A total of 360 patients were followed. Male (71.66%) predominance was noted over females (28.33%). Drug related problems were more commonly seen in patients aged in between 31-60. Most of the DRP observed in the study resulted from the dispensing errors (26.11%), improper drug selection (17.22%), followed by untreated indications (14.4%) Majority of the clinical pharmacist recommendations were on need for proper dispensing (26.11%), and drug change (18.05%). Minor significance of DRPs were noted high (41.11 %), whereas (35.27 %) were moderate and (23.61 %) were major. The acceptance rate of intervening clinical pharmacist recommendation and change in drug therapy was found to be high (86.66%). Conclusion: Our study showed that the prescriptions reviewed had some drug therapy problem and the pharmacist interventions have promoted positive changes needed in the prescriptions. In this context, routine participation of clinical pharmacists in clinical medical rounds facilitates the identification of DRPs and may prevent their occurrence.

Keywords: drug related problems, clinical pharmacist, drug prescriptions, drug related problems, intervention

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Authors: P. Bharathiraja

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Computer Aided decision making system is used to enhance diagnosis and prognosis of diseases and also to assist clinicians and junior doctors in clinical decision making. Medical Data used for decision making should be definite and consistent. Data Mining and soft computing techniques are used for cleaning the data and for incorporating human reasoning in decision making systems. Fuzzy rule based inference technique can be used for classification in order to incorporate human reasoning in the decision making process. In this work, missing values are imputed using the mean or mode of the attribute. The data are normalized using min-ma normalization to improve the design and efficiency of the fuzzy inference system. The fuzzy inference system is used to handle the uncertainties that exist in the medical data. Equal-width-partitioning is used to partition the attribute values into appropriate fuzzy intervals. Fuzzy rules are generated using Class Based Associative rule mining algorithm. The system is trained and tested using heart disease data set from the University of California at Irvine (UCI) Machine Learning Repository. The data was split using a hold out approach into training and testing data. From the experimental results it can be inferred that classification using fuzzy inference system performs better than trivial IF-THEN rule based classification approaches. Furthermore it is observed that the use of fuzzy logic and fuzzy inference mechanism handles uncertainty and also resembles human decision making. The system can be used in the absence of a clinical expert to assist junior doctors and clinicians in clinical decision making.

Keywords: decision making, data mining, normalization, fuzzy rule, classification

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Authors: Nonso Ochinanwata, Patrick Oseloka Ezepue

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This paper explores challenges and prospects in Nigerian higher education. The paper develops an integrated business model that aimed to innovate Nigeria higher education system. A survey and semi-structured interview among Nigerian higher education academics, students and graduates are used to explore the challenges and prospects. The study provides a comparison between lecturers, students and graduates opinions to evaluate challenges and prospects in Nigerian higher institutions. The study found to achieve efficient and effectiveness innovation in Nigerian higher education, there is a need for higher institutions to collaborate with industry professionals and other stakeholders such as company management, and government policy makers in designing higher education institutions curricula. The study found that the curriculum design and delivery need to blend theoretical understanding and real-life experience from industry, and with social cultural influences related to Nigerian environment. This will enable lecturers to organise their teaching and assessments such that students can learn around theoretical and practical study themes. The curriculum design and delivery need to link the core ideas to challenging problems in society, nationally and globally. Hence, this approach will support business start-ups and social entrepreneurship which resolve key societal problems. The study suggests that higher education executives, directors, deans, head of departments, and even individual academics need to emulate innovative business managers to create value-adding products and services from innovative research and academic work.

Keywords: higher education, curriculum innovation, business model innovation, teaching and research excellence, economic development

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Authors: Dalia Perkumiene

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The process of globalization has several unforeseen negative effects on the quality of the environment, including increased pollution, climate change, and the depletion and destruction of natural resources. The impact of these processes makes it difficult to guarantee citizens' rights to a clean environment, and complex legal solutions are needed to implement this right. In order to implement human rights in a clean and safe environment, international legal documents and court rulings are analyzed. It is important to find a balance between the legal context: the right to a clean environment and environmental challenges such as climate change and global warming. Research Methods: The following methods were used in this study: analytical, analysis, and synthesis of scientific literature and legal documents, comparative analysis of legal acts, and generalization. Major Findings: It is difficult to implement the right to a clean, safe and sustainable environment. The successful implementation of this right depends on the application of various complex ideas and rational, not only legal solutions. Legislative measures aim to maximize the implementation of citizens' rights in the face of climate change and other environmental challenges. This area remains problematic, especially in international law. Concluding Statement: The right to a clean environment should allow a person to live in a harmonious system, where environmental factors do not pose a risk to human health and well-being.

Keywords: clean and safe and clean environmen, environmen, persons’ rights, right to a clean and safe and clean environment

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Authors: Jakub Młoźniak, Adam Szymański, Gabriela Stondzik, Dagny Krankowska, Tomasz Mikuła

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Nontuberculous mycobacteria (NTM) are bacterial species that cause diversely manifesting diseases mainly in immunocompromised patients. In people with HIV, NTM infection is an AIDS-defining disease and usually appears when the lymphocyte T CD4 count is below 50 cells/μl. The usage of antiretroviral therapy has decreased the prevalence of NTM among people with HIV, but the disease can still be observed especially among patients with late HIV diagnosis. Common presence in environment, human colonization, clinical similarity with tuberculosis and slow growth on culture makes NTM especially hard to diagnose. The study aimed to analyze the epidemiology and clinical course of NTM among patients with HIV. This study included patients with NTM and HIV admitted to our department between 2017 and 2023. Medical records of patients were analyzed and data on age, sex, median time from HIV diagnosis to identification of NTM infection, median CD4 count at NTM diagnosis, methods of determining NTM infection, type of species of mycobacteria identified, clinical symptoms and treatment course were gathered. Twenty-four patients (20 men, 4 women) with identified NTM were included in this study. Among them, 20 were HIV late presenters. The patients' median age was 40. The main symptoms which patients presented were fever, weight loss and cough. Pulmonary disease confirmed with positive cultures from sputum/bronchoalveolar lavage was present in 18 patients. M. avium was the most common species identified. M. marinum caused disseminated skin lesions in 1 patient. Out of all, 5 people were not treated for NTM caused by lack of symptoms and suspicion of colonization with mycobacterium. Concomitant tuberculosis was present in 6 patients. The median diagnostic time from HIV to NTM infections was 3.5 months. The median CD4 count at NTM identification was 69.5 cells/μl. Median NTM treatment time was 16 months but 7 patients haven’t finished their treatment yet. The most commonly used medications were ethambutol and clarithromycin. Among analyzed patients, 4 of them have died. NTM infections are still an important disease among patients who are HIV late presenters. This disease should be taken into consideration during the differential diagnosis of fever, weight loss and cough in people with HIV with lymphocyte T CD4 count <100 cells/μl. Presence of tuberculosis does not exclude nontuberculous mycobacterium coinfection.

Keywords: mycobacteriosis, HIV, late presenter, epidemiology

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Authors: Leila Goosen, Toppie N. Mukasa-Lwanga

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The purpose of this paper relates to exploring academics’ use of distance education technologies for empowerment and equity in an Information Technology environment. Literature was studied on academics’ technology use towards effective teaching and meaningful learning in a distance education Information Technology environment. Main arguments presented center on formulating and situating significant concepts within an appropriate theoretical and conceptual framework, including those related to distance education, throughput and other measures of academic efficiency. The research design, sampling, data collection instrument and the validity and reliability thereof, as well as the data analysis method used is described. The paper discusses results related to academics’ use of technology towards effective teaching and meaningful learning in a distance education Information Technology environment. Conclusions are finally presented on the way in which this paper makes a significant and original contribution regarding academics’ use of technology towards effective teaching and meaningful learning in a distance education Information Technology environment.

Keywords: distance, education, technologies, Information Technology Environment

Procedia PDF Downloads 524