Search results for: clinical global impressions scale

Authors: Aamir Mubashar, Ibrahim Fiaz

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This research presents a three-dimensional finite element modelling strategy to simulate damage in a quasi-static three-point bending analysis of woven twill 2/2 type carbon fibre reinforced plastic (CFRP) composite on a micro-meso level using cohesive zone modelling technique. A meso scale finite element model comprised of a number of plies was developed in the commercial finite element code Abaqus/explicit. The interfaces between the plies were explicitly modelled using cohesive zone elements to allow for debonding by crack initiation and propagation. Load-deflection response of the CRFP within the quasi-static range was obtained and compared with the data existing in the literature. This provided validation of the model at the global scale. The outputs resulting from the global model were then used to develop a simulation model capturing the micro-meso scale material features. The sub-model consisted of a refined mesh representative volume element (RVE) modelled in texgen software, which was later embedded with cohesive elements in the finite element software environment. The results obtained from the developed strategy were successful in predicting the overall load-deflection response and the damage in global and sub-model at the flexure limit of the specimen. Detailed analysis of the effects of the micro-scale features was carried out.

Keywords: woven composites, multi-scale modelling, cohesive zone, finite element model

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Authors: Khan R. Rahaman, Quazi K. Hassan

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Global changes in climate, environment, economies, populations, governments, institutions, and cultures converge in localities. Changes at a local scale, in turn, contribute to global changes as well as being affected by them. Our hypothesis is built on a consideration that temperature does vary at local level (i.e., termed as local warming) in comparison to the predicted models at the regional and/or global scale. To date, the bulk of the research relating local places to global climate change has been top-down, from the global toward the local, concentrating on methods of impact analysis that use as a starting point climate change scenarios derived from global models, even though these have little regional or local specificity. Thus, our focus is to understand such trends over the southern Alberta, which will enable decision makers, scientists, researcher community, and local people to adapt their policies based on local level temperature variations and to act accordingly. Specific objectives in this study are: (i) to understand the local warming (temperature in particular) trend in context of temperature normal during the period 1961-2010 at point locations using meteorological data; (ii) to validate the data by using specific yearly data, and (iii) to delineate the spatial extent of the local warming trends and understanding influential factors to adopt situation by local governments. Existing data has brought the evidence of such changes and future research emphasis will be given to validate this hypothesis based on remotely sensed data (i.e. MODIS product by NASA).

Keywords: local warming, climate change, urban area, Alberta, Canada

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Authors: Vesile Unver, Tulay Basak, Hatice Ayhan, Ilknur Cinar, Emine Iyigun, Nuran Tosun

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The aim of this study is to analyze the effects of the hybrid simulation. In this simulation, types standardized patients and task trainers are employed simultaneously. For instance, in order to teach the IV activities standardized patients and IV arm models are used. The study was designed as a quasi-experimental research. Before the implementation an ethical permission was taken from the local ethical commission and administrative permission was granted from the nursing school. The universe of the study included second-grade nursing students (n=77). The participants were selected through simple random sample technique and total of 39 nursing students were included. The views of the participants were collected through a feedback form with 12 items. The form was developed by the authors and “Patient intervention self-confidence/competence scale”. Participants reported advantages of the hybrid simulation practice. Such advantages include the following: developing connections between the simulated scenario and real life situations in clinical conditions; recognition of the need for learning more about clinical practice. They all stated that the implementation was very useful for them. They also added three major gains; improvement of critical thinking skills (94.7%) and the skill of making decisions (97.3%); and feeling as if a nurse (92.1%). In regard to the mean scores of the participants in the patient intervention self-confidence/competence scale, it was found that the total mean score for the scale was 75.23±7.76. The findings obtained in the study suggest that the hybrid simulation has positive effects on the integration of theoretical and practical activities before clinical activities for the nursing students.

Keywords: hybrid simulation, clinical practice, nursing education, nursing students

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Authors: Kristen Erekson, Sarah Spendlove Caswell

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Nurse educators have the challenge of training future nurses that will provide compassionate care to an increasingly diverse population of patients in a culturally sensitive way. One approach to this challenge is an immersive public and global health experience as part of the nursing program curriculum. Undergraduate nursing students at our institution are required to participate in a Public and Global Health course. They participate in a didactic preparatory course followed by a 3-to-4-week program in one of the following locations: The Czech Republic, Ecuador, Finland/Poland, Ghana, India, Spain, Taiwan, Tonga, an Honor Flight to Washington D.C. with Veterans, or in local (Utah) communities working with marginalized populations (including incarcerated individuals, refugees, etc.). The students are required to complete 84 clinical hours and 84 culture hours (which involve exposure to local history, art, architecture, customs, etc.). As Faculty, we feel strongly that these public and global health experiences help cultivate cultural awareness in our students and prepare nurses who are better prepared to serve a diverse population of patients throughout their careers. This presentation will highlight our experiences and provide ideas for other nurse educators who have an interest in developing similar programs in their schools but do not know where to start. Suggestions about how to start building relationships that can lead to these opportunities, along with logistics for continuing the programs, will be highlighted.

Keywords: global health nursing, nursing education, clinical education, public health nursing

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Authors: K. Bourouni, M. Chacha, T. Jaber, A. Tchantchane

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In Multi-Effect Distillation (MED) desalination evaporators, the scale deposit outside the tubes presents a barrier to heat transfers reducing the global heat transfer coefficient and causing a decrease in water production; hence a loss of efficiency and an increase in operating and maintenance costs. Scale removal (by acid cleaning) is the main maintenance operation and constitutes the major reason for periodic plant shutdowns. A better understanding of scale deposition mechanisms will lead to an accurate determination of the variation of scale thickness around the tubes and an improved accuracy of the overall heat transfer coefficient calculation. In this paper, a coupled heat transfer-calcium carbonate scale deposition model on a horizontal tube bundle is presented. The developed tool is used to determine precisely the heat transfer area leading to a significant cost reduction for a given water production capacity. Simulations are carried to investigate the influence of different parameters such as water salinity, temperature, etc. on the heat transfer.

Keywords: multi-effect-evaporator, scale deposition, water desalination, heat transfer coefficient

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Authors: Mamdouh Milad Adly Morkos

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Despite having the greatest rates of mortality and morbidity in the world, low- and middle-income (LMIC) nations trail high-income nations in terms of the number of clinical trials, the number of qualified researchers, and the amount of research information specific to their people. Health inequities and the use of precision medicine may be hampered by a lack of local genomic data, clinical pharmacology and pharmacometrics competence, and training opportunities. These issues can be solved by carrying out health care infrastructure development, which includes data gathering and well-designed clinical pharmacology training in LMICs. It will be advantageous if there is international cooperation focused at enhancing education and infrastructure and promoting locally motivated clinical trials and research. This paper outlines various instances where clinical pharmacology knowledge could be put to use, including pharmacogenomic opportunities that could lead to better clinical guideline recommendations. Examples of how clinical pharmacology training can be successfully implemented in LMICs are also provided, including clinical pharmacology and pharmacometrics training programmes in Africa and a Tanzanian researcher's personal experience while on a training sabbatical in the United States. These training initiatives will profit from advocacy for clinical pharmacologists' employment prospects and career development pathways, which are gradually becoming acknowledged and established in LMICs. The advancement of training and research infrastructure to increase clinical pharmacologists' knowledge in LMICs would be extremely beneficial because they have a significant role to play in global health

Keywords: electromagnetic solar system, nano-material, nano pharmacology, pharmacovigilance, quantum theoryclinical simulation, education, pharmacology, simulation, virtual learning low- and middle-income, clinical pharmacology, pharmacometrics, career development pathways

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Authors: Mohammed Belloufi, Rachid Benzine, Badreddine Sellami

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Conjugate gradient methods is useful for solving large scale optimization problems in scientific and engineering computation, characterized by the simplicity of their iteration and their low memory requirements. It is well known that the search direction plays a main role in the line search method. In this paper, we propose a search direction with the Wolfe line search technique for solving unconstrained optimization problems. Under the above line searches and some assumptions, the global convergence properties of the given methods are discussed. Numerical results and comparisons with other CG methods are given.

Keywords: unconstrained optimization, conjugate gradient method, strong Wolfe line search, global convergence

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Authors: Intan Izafina Idrus, Mardina Abdullah, Alina Marie Hasbi, Asnawi Husin

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This paper presents the result of large-scale traveling ionospheric disturbance (LSTID) observation during moderate magnetic storm event on 25 October 2011 with SYM-H ~ -160 nT and Kp ~ 7 over Peninsular Malaysia at equatorial region using vertical total electron content (VTEC) from the Global Positioning System (GPS) observation measurement. The propagation of the LSTID signatures in the TEC measurements over Peninsular Malaysia was also investigated using VTEC map. The LSTID was found to propagate equator-ward during this event. The results showed that the LSTID propagated with an average phase velocity of 526.41 m/s and average periods of 140 min. The occurrence of this LSTID was also found to be the subsequent effects of substorm activities in the auroral region.

Keywords: Global Positioning System (GPS), large-scale traveling ionospheric disturbance (LSTID), moderate geomagnetic storm, vertical total electron content (VTEC)

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Authors: Kim Rod

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People whose chronic pain limits their independence are especially likely to become anxious and depressed. Mindfulness training has shown promise for stress-related disorders. Methods: Chronic pain patients who complained of anxiety and depression and who scored higher than moderate in Hamilton Depression Rating Scale (HDRS) and Hospital Anxiety and Depression Scale (HADS) as well as moderate in Quality of Life Scale (QOLS) were observed for eight weeks, three days a week for an hour of Mindfulness Meditation training with an hour daily home Mindfulness Meditation practice. Pain was evaluated on study entry and completion, and patients were given the Patients’ Global Impression of Change (PGIC) to score at the end of the training program. Results: Forty-seven patients (47) completed the Mindfulness Meditation Training program. Over the year-long observation, patients demonstrated noticeable improvement in depression, anxiety, pain, and global impression of change. Conclusion: Chronic pain patients who suffer with anxiety and depression may benefit from incorporating Mindfulness Meditation into their treatment plans.

Keywords: mindfulness, meditation, depression, anxiety, chronic pain

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Authors: Tadesse Melaku Abegaz

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Background: there was paucity of data on the self-reported adverse drug reactions (ADRs), level of adherence and clinical outcomes with antidepressants among major depressive disorder (MDD) patients in Ethiopia. Hence, the present study sought to determine the level of adherence for and clinical outcome with antidepressants and the magnitude of ADRs. Methods: A prospective cross-sectional study was employed on MDD patients from September 2016 to January 2017 at Gondar university hospital psychiatry clinic. All patients who were available during the study period were included under the study population. The Naranjo adverse drug reaction probability scale was employed to assess the adverse drug reaction. The rate of medication adherence was determined using morisky medication adherence measurement scale eight. Clinical Outcome of patients was measured by using patient health questionnaire. Multivariable logistic carried out to determine factors for adherence and patient outcome. Results: two hundred seventy patients were participated in the study. More than half of the respondents were males 122(56.2%). The mean age of the participants was 30.94 ± 8.853. More than one-half of the subjects had low adherence to their medications 124(57.1%). About 186(85.7%) of patients encountered ADR. The most common ADR was weight gain 29(13.2). Around 198(92.2%) ADRs were probable and 19(8.8%) were possible. Patients with long standing MDD had high risk of non-adherence COR: 2.458[4.413-4.227], AOR: 2.424[1.185-4.961]. More than one-half 125(57.6) of respondents showed improved outcome. Optimal level of medication adherence was found to be associated with reduced risk of progression of the diseases COR: 0.37[0.110-5.379] and AOR: 0.432[0.201-0.909]. Conclusion: Patient reported adverse drug reactions were more prevalent in major depressive disorder patients. Adherence to medications was very poor in the setup. However, the clinical outcome was relatively higher. Long standing depression was associated with non-adherence. In addition, clinical outcome of patients were affected by non-adherence. Therefore, adherence enhancing interventions should be provided to improve medication adherence and patient outcome.

Keywords: adverse drug reactions, clinical outcomes, Ethiopia, prospective study, medication adherence

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Authors: R. Hosny, Mahmoud F. Mubarak, Heba M. Salem, Asmaa A. Abdelrahman

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Oilfield scaling is a major problem in the oil and gas industry. Scale issues cost the industry millions of dollars in damage and lost production every year. One of the main causes of global production decline is scale. In this study, solid scale inhibitors based on silver tungstate loaded KIT-6 were synthesized and evaluated in both static and scale inhibition modeling. The silver tungstate loaded KIT-6 catalysts were synthesized via a simple impregnated method using 3D mesoporous KIT-6 as support. The synthesized materials were characterized using wide and low XRD, N2 adsorption–desorption analysis, TGA analysis, and FTIR, SEM, and XPS analysis. The scale inhibition efficiency of the synthesized materials was evaluated using a static scale inhibition test. The results of this study demonstrate the potential application of silver tungstate-loaded KIT-6 solid scale inhibitors for the oil and gas industry. The results of this study will contribute to the development of new and innovative solid scale inhibitors based on silver tungstate-loaded KIT-6. The inhibition efficiency of the scale inhibitor increases, and calcite scale inhibitor decreases with increasing pH (2 to8), it proposes that the scale inhibitor was more effective under alkaline conditions. An inhibition efficiency of 99% on calcium carbonate can be achieved at the optimal dosage of 7.5 ppm at 55oC, indicating that the scale inhibitor exhibits a relatively good inhibition performance on calcium carbonate. The use of these materials can potentially lead to more efficient and cost-effective solutions for scaling inhibition in various industrial processes.

Keywords: produced water treatment, solid scale inhibitors, calcite, silver tungestate, 3 D mesoporous KIT-6, oilfield scales, adsorption

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Authors: Nadereh Sohrabi Shegefti, Siamak Samani

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Level of adjustment is the first index to check mental health. The aim of this study was developing a valid and reliable Multidimensional Adjustment Scale (MAS). The sample consisted of 150 college students. Multidimensional adjustment scale and Depression, Anxiety, and stress scale (DASS) were used in this study. Principle factor analysis, Pearson correlation coefficient, and Cornbach's Alpha were used to check the validity and reliability of the MAS. Principle component factor analysis showed a 5 factor solution for the MAS. Alpha coefficients for the MAS sub scales were ranged between .69 to .83. Test-retest reliability for MAS was .88 and the mean of sub scales- total score correlation was .88. All these indexes revealed an acceptable reliability and validity for the MAS. The MAS is a short assessment instrument with good acceptable psychometric properties to use in clinical filed.

Keywords: psychological adjustment, psychometric properties, validity, Pearson correlation

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Authors: Zimu Li, Zheng Wan

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The Suez Canal plays an important role in global shipping networks and is one of the most frequently used waterways in the world. The 2021 canal obstruction by ship Ever Given in March 2021, however, completed blocked the Suez Canal for a week and caused significant disruption to world trade. Therefore, it is very important to quantitatively analyze the impact of the accident on the robustness of the global shipping network. However, the current research on maritime transportation networks is usually limited to local or small-scale networks in a certain region. Based on the complex network theory, this study establishes a global shipping complex network covering 2713 nodes and 137830 edges by using the real trajectory data of the global marine transport ship automatic identification system in 2018. At the same time, two attack modes, deliberate (Suez Canal Blocking) and random, are defined to calculate the changes in network node degree, eccentricity, clustering coefficient, network density, network isolated nodes, betweenness centrality, and closeness centrality under the two attack modes, and quantitatively analyze the actual impact of Suez Canal Blocking on the robustness of global shipping network. The results of the network robustness analysis show that Suez Canal blocking was more destructive to the shipping network than random attacks of the same scale. The network connectivity and accessibility decreased significantly, and the decline decreased with the distance between the port and the canal, showing the phenomenon of distance attenuation. This study further analyzes the impact of the blocking of the Suez Canal on Chinese ports and finds that the blocking of the Suez Canal significantly interferes withChina's shipping network and seriously affects China's normal trade activities. Finally, the impact of the global supply chain is analyzed, and it is found that blocking the canal will seriously damage the normal operation of the global supply chain.

Keywords: global shipping networks, ship AIS trajectory data, main channel, complex network, eigenvalue change

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Authors: Ryan Dale B. Elnar

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This study developed a multidimensional need assessment scale for college students called The University of Mindanao Needs Assessment Scale (UMNAS). Although there are context-specific instruments measuring the needs of clinical and non-clinical samples, literature reveals no standardized scales to measure the needs of the college students thus a four-phase item development process was initiated to support its content validity. Comprising seven broad facets namely spiritual-moral, intrapersonal, socio-personal, psycho-emotional, cognitive, physical and sexual, a pyramid model of college needs was deconstructed through FGD sample to support the literature review. Using various construct validity procedures, the model was further tested using a total of 881 Filipino college samples. The result of the study revealed evidences of the reliability and validity of the UMNAS. The reliability indices range from .929-.933. Exploratory and confirmatory factor analyses revealed a one-factor-six-dimensional instrument to measure the needs of the college students. Using multivariate regression analysis, year level and course are found predictors of students’ needs. Content analysis attested the usefulness of the instrument to diagnose students’ personal and academic issues and concerns in conjunction with other measures. The norming process includes 1728 students from the different colleges of the University of Mindanao. Further validation is recommended to establish a national norm for the instrument.

Keywords: needs assessment scale, validity, factor analysis, college students

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Authors: Abiola Falilat Ibraheem, Akinyimika Sowunmi, Valerie Otti

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Background: Introduction of innovative cancer clinical trials to Nigeria is a critical step in addressing global inequities of cancer burden. Low health and clinical trial literacy among Nigerian patients have been sighted as a significant barrier to ensuring that patients enrolled in clinical trials are truly informed. Video intervention has been shown to be the most proactive method to improving patient’s clinical trial knowledge. In the US, video interventions have been successful at improving education about cancer clinical trials among minority patients. Thus, this study aimed to apply and adapt video interventions addressing attitudinal barriers peculiar to Nigerian patients. Methods: A hospital-based representative mixed-method study was conducted at the Lagos State University Teaching Hospital (LASUTH) from July to December 2020, comprising of cancer patients aged 18 and above. Patients were randomly selected during every clinic day, of which 63 patients volunteered to participate in this study. We first administered a cancer literacy survey to determine patients’ knowledge about clinical trials. For patients who had prior knowledge, a pre-intervention test was administered, after which a 15-minute video (attitudes and intention to enroll in therapeutic clinical trials (AIET)) to improve patients’ knowledge, perception, and attitudes towards clinical trials was played, and then ended by administering a post-intervention test to the patients. For patients who had no prior knowledge, the AIET video was played for them, followed by the post-intervention test. Results: Out of 63 patients sampled, 43 (68.3%) had breast cancer. On average, patients agreed to understand their cancer diagnosis and treatment very well. 84.1% of patients had never heard about cancer clinical trials, and 85.7% did not know what cancer clinical trials were. There was a strong positive relationship (r=0.916) between the pretest and posttest, which means that the intervention improved patients’ knowledge, perception, and attitudes about cancer clinical trials. In the focus groups, patients recommended adapting the video in Nigerian settings and representing all religions in order to address trust in local clinical trialists. Conclusion: Due to the small size of patients, change in clinical trial knowledge was not statistically significant. However, there is a trend suggesting that culturally adapted video interventions can be used to improve knowledge and perception about cancer clinical trials.

Keywords: clinical trials, culturally targeted intervention, patient education, video intervention

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Authors: Mohamed Aly, Aliaa Rehan Youssef, Emad Sawerees, Mounir Guirgis

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Relevance: Osteoarthritis (OA) is the most common degenerative disease seen in all populations. It causes disability and substantial socioeconomic burden. Evidence supports that exercise are the most effective conservative treatment for patients with OA. Therapists experience and clinical judgment play major role in exercise prescription and scientific evidence for this regard is lacking. The development of clinical prediction rules to identify patients who are most likely benefit from exercise may help solving this dilemma. Purpose: This study investigated whether body mass index and functional ability at baseline can predict patients’ response to a selected exercise program. Approach: Fifty-six patients, aged 35 to 65 years, completed an exercise program consisting of open kinetic chain strengthening and passive stretching exercises. The program was given for 3 sessions per week, 45 minutes per session, for 6 weeks Evaluation: At baseline and post treatment, pain severity was assessed using the numerical pain rating scale, whereas functional ability was being assessed by step test (ST), time up and go test (TUG) and 50 feet time walk test (50 FTW). After completing the program, global rate of change (GROC) score of greater than 4 was used to categorize patients as successful and non-successful. Thirty-eight patients (68%) had successful response to the intervention. Logistic regression showed that BMI and 50 FTW test were the only significant predictors. Based on the results, patients with BMI less than 34.71 kg/m2 and 50 FTW test less than 25.64 sec are 68% to 89% more likely to benefit from the exercise program. Conclusions: Clinicians should consider the described strengthening and flexibility exercise program for patents with BMI less than 34.7 Kg/m2 and 50 FTW faster than 25.6 seconds. The validity of these predictors should be investigated for other exercise.

Keywords: clinical prediction rule, knee osteoarthritis, physical therapy exercises, validity

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Authors: N. W. Paul, M. Banerjee

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Discussing the nexus between global health policy and local practices, this article addresses the recent Ebola outbreak as a role model for narrative co-constructions of epidemic risk. We will demonstrate in how far a theory-driven and methodologically rooted analysis of narrativity can help to improve mechanisms of prevention and intervention whenever epidemic risk needs to be addressed locally in order to contribute to global health. Analyzing the narrative transformation of Ebola, we will also address issues of transcultural problem-solving and of normative questions at stake. In this regard, we seek to contribute to a better understanding of a key question of global health and justice as well as to the underlying ethical questions. By highlighting and analyzing the functions of narratives, this paper provides a translational approach to refine our practices by which we address epidemic risk, be it on the national, the transnational or the global scale.

Keywords: ebola, epidemic risk, medical ethics, medical humanities

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Authors: Ana Hol

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Study and work operations are being transformed with the uses of technologies and are consequently becoming global. This paper outlines lessons learned based on the international study tour that Australian Bachelor of Information Systems students undertook. This research identifies that for the study tour to be successful, students need to gain skills that global citizens require. For example, students will need to gain an understanding of local cultures, local customs and habits. Furthermore, students would also need to gain an understanding of how a field of their future career expertise operates in the host country, how study and business are conducted internationally, which tools and technologies are currently being utilized on a global scale, what trends drive future developments world-wide and how business negotiations and collaborations are being undertaken across borders. Furthermore, this research provides a guide to educators who are planning, guiding and running study tours as it outlines the requirements of having a pre-tour preparatory session, carefully planned and executed tour itineraries and post-tour sessions during which students can reflect on their experiences and lessons learned so that they can apply them to future international business visits and ventures.

Keywords: global education, international experiences, international study tours, students as global citizens, student centered education,

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Authors: Maide Yesilyurt, Saide Faydalı

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Patients experience pain at different intensities in postoperative. The diagnosis of the pain, the assessment and the success of the treatment and care make the measurement of this finding compulsory. The aim of the study is to determine the evaluation differences numeric pain scales. The descriptive study was conducted with 360 patients with in postoperative. The data were obtained from questionnaires related to six numeric pain scales most preferred in clinical use, and a face-to-face interview technique was used by the researcher. Regarding to numeric pain scale, questions include forth positive and one negative statement. In evaluating the data; chi-square and Pearson correlation tests were used. For the study, the patients’ informed consents, the institution and the ethics committee received permission. In this study, patients' ages are between 18-80, 95.8% of the patients were not informed about pain assessment. Patients evaluated the 5-item numeric scale as the easy, can be answered quickly, accurate, and appropriate for clinical use and the 101 items numeric scale as complex than other scales. Regarding to numeric pain scales with positive statements between age, marital status, educational status, previous surgery, having chronic disease and getting information about pain assessment significant difference has been detected. All numeric pain scales are correlated to each other. As a result, it was determined that as the items in the numerical scales decreased, the patients were able to perceive the scales better, and the items in the scales increased, the patients were in trouble to understand.

Keywords: numeric pain scales, nurse, pain assessment, patient

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Authors: Tsegay Giday Woldu, Haibin Zhang, Xin Zhang, Yemane Hailu Fissuh

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It is well known that nonlinear conjugate gradient method is one of the widely used first order methods to solve large scale unconstrained smooth optimization problems. Because of the low memory requirement, attractive theoretical features, practical computational efficiency and nice convergence properties, nonlinear conjugate gradient methods have a special role for solving large scale unconstrained optimization problems. Large scale optimization problems are with important applications in practical and scientific world. However, nonlinear conjugate gradient methods have restricted information about the curvature of the objective function and they are likely less efficient and robust compared to some second order algorithms. To overcome these drawbacks, the new modified nonlinear conjugate gradient method is presented. The noticeable features of our work are that the new search direction possesses the sufficient descent property independent of any line search and it belongs to a trust region. Under mild assumptions and standard Wolfe line search technique, the global convergence property of the proposed algorithm is established. Furthermore, to test the practical computational performance of our new algorithm, numerical experiments are provided and implemented on the set of some large dimensional unconstrained problems. The numerical results show that the proposed algorithm is an efficient and robust compared with other similar algorithms.

Keywords: conjugate gradient method, global convergence, large scale optimization, sufficient descent property

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Authors: Kingston Rajiah, Mari Kannan Maharajan, Si Jen Yeen, Sara Lew

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Parkinson’s disease (PD) is a progressive neurodegenerative disorder with evolving layers of complexity. Both motor and non-motor symptoms of PD may affect patients’ quality of life (QoL). Life expectancy for an individual with Parkinson’s disease depends on the level of care the individual has access to, can have a direct impact on length of life. Therefore, improvement of the QoL is a significant part of therapeutic plans. Patients with PD, especially those who are in advanced stages, are in great need of assistance, mostly from their family members or caregivers in terms of medical, emotional, and social support. The role of a caregiver becomes increasingly important with the progression of PD, the severity of motor impairment and increasing age of the patient. The nature and symptoms associated with PD can place significant stresses on the caregivers’ burden. As the prevalence of PD is estimated to more than double by 2030, it is important to recognize and alleviate the burden experienced by caregivers. This study focused on the impact of the clinical features on the QoL of PD patients, and of their caregivers. This study included PD patients along with their caregivers and was undertaken at the Malaysian Parkinson's Disease Association from June 2016 to November 2016. Clinical features of PD patients were assessed using the Movement Disorder Society revised Unified Parkinson Disease Rating Scale (MDS-UPDRS); the Hoehn and Yahr Staging of Parkinson's Disease were used to assess the severity and Parkinson's disease activities of daily living scale were used to assess the disability of Parkinson’s disease patients. QoL of PD patients was measured using the Parkinson's Disease Questionnaire-39 (PDQ-39). The revised version of the Zarit Burden Interview assessed caregiver burden. At least one of the clinical features affected PD patients’ QoL, and at least one of the QoL domains affected the caregivers’ burden. Clinical features ‘Saliva and Drooling’, and ‘Dyskinesia’ explained 29% of variance in QoL of PD patients. The QoL domains ‘stigma’, along with ‘emotional wellbeing’ explained 48.6% of variance in caregivers’ burden. Clinical features such as saliva, drooling and dyskinesia affected the QoL of PD patients. The PD patients’ QoL domains such as ‘stigma’ and ‘emotional well-being’ influenced their caregivers’ burden.

Keywords: carers, quality of life, clinical features, Malaysia

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Authors: Anila Xhahysa, Migena Ceyhan, Neki Kuka, Klajdi Qoshi, Damiano Koxhaj

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The seismic event catalog has been updated in the framework of a bilateral project supported by the Central European Investment Fund and with the extensive support of Global Earthquake Model Foundation to update Albania's national seismic hazard model. The earthquake catalogue prepared within this project covers the Western Balkan area limited by 38.0° - 48°N, 12.5° - 24.5°E and includes 41,806 earthquakes that occurred in the region between 510 BC and 2022. Since the moment magnitude characterizes the earthquake size accurately and the selected ground motion prediction equations for the seismic hazard assessment employ this scale, it was chosen as the uniform magnitude scale for the catalogue. Therefore, proxy values of moment magnitude had to be obtained by using new magnitude conversion equations between the local and other magnitude types to this unified scale. The Global Centroid Moment Tensor Catalogue was considered the most authoritative for moderate to large earthquakes for moment magnitude reports; hence it was used as a reference for calibrating other sources. The best fit was observed when compared to some regional agencies, whereas, with reports of moment magnitudes from Italy, Greece and Turkey, differences were observed in all magnitude ranges. For teleseismic magnitudes, to account for the non-linearity of the relationships, we used the exponential model for the derivation of the regression equations. The obtained regressions for the surface wave magnitude and short-period body-wave magnitude show considerable differences with Global Earthquake Model regression curves, especially for low magnitude ranges. Moreover, a conversion relation was obtained between the local magnitude of Albania and the corresponding moment magnitude as reported by the global and regional agencies. As errors were present in both variables, the Deming regression was used.

Keywords: regression, seismic catalogue, local magnitude, tele-seismic magnitude, moment magnitude

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Authors: Aybike Ayfer Karadağ

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Today, the amount of water available is decreasing day by day due to global warming, environmental problems and population increase. To protect water resources, it is necessary to take a lot of measures from the global scale to the local scale. Some of these measures are related to spatial planning studies. In this study, the impact of water process analysis was assessed in the development of spatial planning for water conservation. The study was conducted in the Kovada sub-watershed (Isparta, Turkey). By means of water process analysis, the way to reach underground water of surface water in the study area is mapped. In this context, plant cover, soil and rock permeability were evaluated holistically with geographic information systems technologies. Then, on the map, water permeability is classified and this is spatially expressed. The findings show that the permeability of the water is different in the study case. As a result, the water permeability map needs to be included in the planning for water conservation planning.

Keywords: water, conservation, spatial planning, water process analysis

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Authors: Janet D. Fish

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This paper will analyze how advanced information technology communications platform’s such as you tube, twitter, Facebook, and websites are being used in marketing cultural diversity on a global scale. The scope of this topic will encompass the use of marketing terror as a tool of educational understanding, accepting, and incorporating other ethnic groups into extremist Islamic cultural practices with an end goal of cultural assimilation. This paper will examine the impacts of various influences, such as globalism and technology on common public values and cultural diversity. Additionally, multiculturalism in public administration settings will be examined across cultures. Communications are a primary focus of review for this paper, the purpose of this review is to see how different technological platforms are currently being used as major tools of influence within the public sector. Technology and terror must become a primary concern for new public administrators in a modern world. While its existence is acknowledged, boundaries of legal recourse are currently few. Public administrators must understand the depth and reach of the future consequences of an unchecked process in the realm of technology and terror on a global scale.

Keywords: inclusionism, exclusionism, technology, terror

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Authors: Paria Baharvand, Mohammad Reza Abbasi, Soha Namazi

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Introduction: Uremic pruritus (UP) is one of the major complaints in hemodialysis patients. The aim of this randomized clinical trial study was the evaluation of the anti-pruritus effect of Melatonin on hemodialysis patients with UP. Methods: This multi-centered double, blinded randomized clinical trial study was conducted on hemodialysis patients with UP that referred to the dialysis department of Imam Khomeini Hospital, Labbafinezhad Hospital and Ghiasi Hospital in Tehran, Iran, in 2018. Forty participants were enrolled and block randomization was performed by using a randomized list and divided into 2 groups of twenty patients. Evaluation of the 12-Item Pruritus Severity Scale (12-PSS), Visual analog scale (VAS), and Calculation of the affected body surface area for pruritus extent (BSA %) was performed every week. The Melatonin group received a 10 mg soft gel capsule, and the placebo group received a soft gel capsule placebo after dinner. For statistical analysis used by SPSS version 21(IRCT20180714040462N1). Results: 38 hemodialysis patients enrolled in this study. The mean age in the placebo group and in the Melatonin group was 55.88 ± 11.70 and 54.52 ± 13.00 years (p> 0.05). Also, 46% of all participants were female. Aspartate transaminase, alanine transaminase and C-reactive protein have significant differences between the two groups (p< 0.05). VAS score reduction in the two groups had a statistically significant (CI 95% = -1.71, P= 0.015(.The results of BSA% showed Melatonin had a significant effect on the decrease of the pruritus extent compared to placebo (CI 95% = -22.82, P= 0.001(. Conclusion: According to the results of this study and the preliminary effects of Melatonin on uremic pruritus, we suggest performing advanced clinical trials studies.

Keywords: Melatonin, Uremic Pruritus, hemodialysis, anti-pruritus

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Authors: Mette Kjerholt, Thora Grothe Thomsen, Connie Bøttcher Berthelsen, Bibi Hølge Hazelton

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Academic nursing is a relatively new phenomenon in Denmark. Leadership and management training in nursing does not prepare Danish nurse leaders to become leaders for nurses with academic background, and some leaders may feel estranged with including this kind of nursing staff in clinical settings. Currently there is a debate regarding what academic nurses can contribute with in clinical practice, and some managers express concern regarding whether this will lead to less focus on clinical practice and more focus on theoretical issues that may not seem so relevant in a busy everyday clinical setting. The paper will present the experiences of integrating three advanced nurse practitioners with Ph.D. degrees (ANP) in three different clinical departments at a regional hospital in Denmark with no prior experiences with such profiles among its staff.

Keywords: leadership, advanced nurse practitioners, clinical practice, academic nursing

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Authors: Lan Luo, Jingjing Huang, Huafang Li

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Introduction: Distressing low sexual desire is common in China, while the lack of reliable and valid instruments to evaluate symptoms of hypoactive sexual desire disorder (HSDD) impedes related research and clinical services. Aim: This study aimed to validate the reliability and validity of the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale-Desire/Arousal/Orgasm (FSDS-DAO) in Chinese female HSDD patients. Methods: We administered FSFI and FSDS-DAO in a convenient sample of Chinese adult women. Participants were diagnosed by a psychiatrist according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR). Results: We had a valid analysis sample of 279 Chinese women, of which 107 were HSDD patients. The Cronbach's α of FSFI and FSDS-DAO were 0.947 and 0.956, respectively, and the intraclass correlation coefficients of which were 0.86 and 0.89, respectively (the interval was 13-15 days). The correlation coefficient between the Revised Adult Attachment Scale (RAAS) and FSFI (or FSDS-DAO) did not exceed 0.4; the area under the receiver operating characteristic (ROC) curve was 0. 83 when combined FSFI-d (the desire domain of FSFI) and FSDS-DAO to diagnose HSDD, which was significantly different from that of using these scales individually. FSFI-d of less than 2.7 (1.2-6) and FSDS-DAO of no less than 15 (0-60) (Sensitivity 65%, Specificity 83%), or FSFI-d of no more than 3.0 (1.2-6) and FSDS-DAO of no less than 14 (0-60) (Sensitivity 74%, Specificity 77%) can be used as cutoff scores in clinical research or outpatient screening. Clinical implications: FSFI (including FSFI-d) and FSDS-DAO are suitable for the screening and evaluation of Chinese female HSDD patients of childbearing age. Strengths and limitations: Strengths include a thorough validation of FSFI and FSDS-DAO and the exploration of the cutoff score combing FSFI-d and FSDS-DAO. Limitations include a small convenience sample and the requirement of being sexually active for HSDD patients. Conclusion: FSFI (including FSFI-d) and FSDS-DAO have good internal consistency, test-retest reliability, construct validity, and criterion validity in Chinese female HSDD patients of childbearing age.

Keywords: sexual desire, sexual distress, hypoactive sexual desire disorder, scale

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Authors: Kenneth Azaigba

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The history of post-colonial African States has been dubbed a history of endemic warfare in existing literature. Indeed, Africa political environment is characterized by a multiplicity of threats to peace and security. Africa's leading drivers of conflict include abundant (especially mineral) resources, personal rule and attendant political authoritarianism, manipulation of identity politics across ethnicity, marginalization of communities, as well as electoral mal-practices resulting in contested legitimacy and resultant violence. However, the character of armed conflicts in Africa is changing. This paper attempts to reconstruct the trajectory of armed conflicts in Africa and explain the changing pattern of armed conflict. The paper contends that large scale political violence in Africa is on the decline rendering the endemic thesis an inappropriate paradigm in explaining political conflicts in Africa. The paper also posits that though small scale conflicts are springing up and exhibiting trans-border dimensions, these patterns of armed conflicts are not peculiar to Africa but emerging waves of global conflicts. The paper explains that the shift in the scale of warfare in Africa is a function of a multiplicity of post-cold war global contradictions. Inclusive governance, social justice and economic security are articulated as workable panaceas for mitigating warfare in Africa.

Keywords: Africa, conflicts, pattern, war

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Authors: Khaled M. Alhawiti

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This paper investigates the future of medicine and the use of Natural language processing. The importance of having correct clinical information available online is remarkable; improving patient care at affordable costs could be achieved using automated applications to use the online clinical information. The major challenge towards the retrieval of such vital information is to have it appropriately coded. Majority of the online patient reports are not found to be coded and not accessible as its recorded in natural language text. The use of Natural Language processing provides a feasible solution by retrieving and organizing clinical information, available in text and transforming clinical data that is available for use. Systems used in NLP are rather complex to construct, as they entail considerable knowledge, however significant development has been made. Newly formed NLP systems have been tested and have established performance that is promising and considered as practical clinical applications.

Keywords: clinical information, information retrieval, natural language processing, automated applications

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Authors: Alexander S. Burnasov, Anatoly V. Stepanov, Maria Y. Ilyushkina

Abstract:

In the conditions of transition to the digital economy, the digital environment of the city becomes one of the key factors of its tourism attractiveness. Modern digital environment makes travelling more accessible, improves the quality of travel services and the attractiveness of many tourist destinations. The digitalization of the industry allows to use resources more efficiently, to simplify business processes, to minimize risks, and to improve travel safety. The city promotion as a tourist destination in the foreign market becomes decisive in the digital environment. Information technologies are extremely important for the functioning of not only any tourist enterprise but also the city as a whole. In addition to solving traditional problems, it is also possible to implement some innovations from the tourism industry, such as the availability of city services in international systems of booking tickets and booking rooms in hotels, the possibility of early booking of theater and museum tickets, the possibility of non-cash payment by cards of international payment systems, Internet access in the urban environment for travelers. The availability of the city's digital services makes it possible to reduce ordering costs, contributes to the optimal selection of tourist products that meet the requirements of the tourist, provides increased transparency of transactions. The users can compare prices, features, services, and reviews of the travel service. The ability to share impressions with friends thousands of miles away directly affects the image of the city. It is possible to promote the image of the city in the digital environment not only through world-scale events (such as World Cup 2018, international summits, etc.) but also through the creation and management of services in the digital environment aimed at supporting tourism services, which will help to improve the positioning of the city in the global tourism market.

Keywords: competitiveness, digital environment, travelling, Yekaterinburg

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