Search results for: advanced care planning

Authors: Sapan Tiwari, Namrata Ghosh

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In urban mass transit, crew scheduling always plays a significant role. It deals with the formulation of work timetables for its staff so that an organization can meet the demand for its products or services. The efficient schedules of a specified timetable have an enormous impact on staff demand. It implies that an urban mass transit company's financial outcomes are strongly associated with planning operations in the region. The research aims to demonstrate the state of the crew scheduling studies and its practical implementation in mass transit businesses in metropolitan areas. First, there is a short overview of past studies in the field. Subsequently, the restrictions and problems with crew scheduling and some models, which have been developed to solve the related issues with their mathematical formulation, are defined. The comments are completed by a description of the solution opportunities provided by computer-aided scheduling program systems for operational use and exposures from urban mass transit organizations. Furthermore, Bus scheduling is performed using the Hungarian technique of problem-solving tasks and mathematical modeling. Afterward, the crew scheduling problem, which consists of developing duties using predefined tasks with set start and end times and places, is resolved. Each duty has to comply with a set line of work. The objective is to minimize a mixture of fixed expenses (number of duties) and varying costs. After the optimization of cost, the outcome of the research is that the same frequency can be provided with fewer buses and less workforce.

Keywords: crew scheduling, duty, optimization of cost, urban mass transit

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Authors: Paramvir Singh

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The locomotion of aquatic organisms has long fascinated biologists and engineers alike, with fish fins serving as a prime example of nature's remarkable adaptations for efficient underwater propulsion. This paper presents a comprehensive study focused on the hydrodynamic analysis of fish fin kinematics, employing an innovative approach that combines machine learning and image processing techniques. Through high-speed videography and advanced computational tools, we gain insights into the complex and dynamic motion of the fins of a Tilapia (Oreochromis Niloticus) fish. This study was initially done by experimentally capturing videos of the various motions of a Tilapia in a custom-made setup. Using deep learning and image processing on the videos, the motion of the Caudal and Pectoral fin was extracted. This motion included the fin configuration (i.e., the angle of deviation from the mean position) with respect to time. Numerical investigations for the flapping fins are then performed using a Computational Fluid Dynamics (CFD) solver. 3D models of the fins were created, mimicking the real-life geometry of the fins. Thrust Characteristics of separate fins (i.e., Caudal and Pectoral separately) and when the fins are together were studied. The relationship and the phase between caudal and pectoral fin motion were also discussed. The key objectives include mathematical modeling of the motion of a flapping fin at different naturally occurring frequencies and amplitudes. The interactions between both fins (caudal and pectoral) were also an area of keen interest. This work aims to improve on research that has been done in the past on similar topics. Also, these results can help in the better and more efficient design of the propulsion systems for biomimetic underwater vehicles that are used to study aquatic ecosystems, explore uncharted or challenging underwater regions, do ocean bed modeling, etc.

Keywords: biomimetics, fish fin kinematics, image processing, fish tracking, underwater vehicles

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Authors: Shahab Mirzaean Mahabadi, Elham Ebrahimi

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The urban development process in the historical urban context has predominately witnessed two main approaches: the first is the Preservation and conservation of the urban fabric and its value, and the second approach is urban renewal and redevelopment. The latter is generally supported by political and economic aspirations. These two approaches conflict evidently. The authors go through the history of urban planning in order to review the historical development of the mentioned approaches. In this article, various values which are inherent in the historical fabric of a city are illustrated by emphasizing on cultural identity and activity. In the following, it is tried to find an optimized plan which maximizes economic development and minimizes change in historical-cultural sites simultaneously. In the proposed model, regarding the decision maker’s intention, and the variety of functions, the selected zone is divided into a number of components. For each component, different alternatives can be assigned, namely, renovation, refurbishment, destruction, and change in function. The decision Variable in this model is to choose an alternative for each component. A set of decisions made upon all components results in a plan. A plan developed in this way can be evaluated based on the decision maker’s point of view. That is, interactions between selected alternatives can make a foundation for the assessment of urban context to design a historical-cultural landscape. A genetic algorithm (GA) approach is used to search for optimal future land use within the historical-culture landscape for a sustainable high-growth city.

Keywords: urban sustainability, green city, regeneration, genetic algorithm

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Authors: Mohammad Rahim Rahnama

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The study employs Monte Carlo method for simulation of rented housing in Mashhad second largest city in Iran. A total number of 334 rental residential units in Mashhad, including both apartments and houses (villa), were randomly selected from advertisements placed in Khorasan Newspapers during the months of July and August of 2015. In order to simulate the monthly rent price, the rent index was calculated through combining the mortgage and the rent price. In the next step, the relation between the variables of the floor area and that of the number of bedrooms for each unit, in both apartments and houses(villa), was calculated through multivariate regression using SPSS and was coded in XML. The initial model was called using simulation button in SPSS and was simulated using triangular and binominal algorithms. The findings revealed that the average simulated rental index was 548.5$ per month. Calculating the sensitivity of rental index to a number of bedrooms we found that firstly, 97% of units have three bedrooms, and secondly as the number of bedrooms increases from one to three, for the rent price of less than 200$, the percentage of units having one bedroom decreases from 10% to 0. Contrariwise, for units with the rent price of more than 571.4$, the percentage of bedrooms increases from 37% to 48%. In the light of these findings, it becomes clear that planning to build rental residential units, overseeing the rent prices, and granting subsidies to rental residential units, for apartments with two bedrooms, present a felicitous policy for regulating residential units in Mashhad.

Keywords: Mashhad, Monte Carlo, simulation, rent price, residential unit

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Authors: Giovanni Matheus Rech, Gilberto Zan, Filipe P. Aguiar

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The current pandemic scenario raises questions that many times would have previously gone unnoticed. One of these issues is the quality of the air we breathe in the most diverse environments in which we are inserted in an everyday. It is plausible to suppose that, at times like this, there is apprehension regarding the possibility of contamination by pathological agents such as viruses and bacterias through the airways. However, the renewal of indoor air, combined with a properly sanitized air conditioning system, are important tools for the prevention of viral diseases, as is the case with COVID-19. The bus is an example of an environment where renovation is applied to improve the quality of indoor air, helping to reduce the possibility of spreading pathological agents. Together with other care, such as an alcohol gel dispenser, curtains to separate the passengers, cleaning the environment more frequently, and mandatory use of masks, help to reduce the transmission of pathologies, such as COVID-19. Knowing the reality of a large part of the population regarding the need for public transport, there are standards and devices dedicated to promoting air quality, ensuring greater comfort and safety for users. This paper seeks to present such standards and recommendations to improve the quality of indoor air, as well as the equipment responsible for the renewal of the air in the body of a bus. Experimental measurement of the flow rates of the renewal devices present in the bus body allows quantifying the average volume of external air admitted in each type of body. This way, it was possible to compare, in terms of airflow per person, the values of a bus in relation to a series of other environments, using recommendations for air renewal are described through the Brazilian standard ABNT NBR 16401.

Keywords: air quality, air renewal, buses, Covid-19

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Authors: Wan Azuati Wan Omar, Selva Rani John Jasudass, Siti Rohaiza Md. Saad

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Introduction & objective: The objectives of this study were to assess patient’s knowledge of appropriate sublingual glyceryl trinitrate (GTN) use as well as to investigate how patients commonly store and carry their sublingual GTN tablets. Methodology: This was a cross-sectional survey, using a validated researcher-administered questionnaire. The study involved cardiac patients receiving sublingual GTN attending the outpatient and inpatient departments of Taiping Hospital, a non-academic public care hospital. The minimum calculated sample size was 92, but 100 patients were conveniently sampled. Respondents were interviewed on 3 areas, including demographic data, knowledge and use of sublingual GTN. Eight items were used to calculate each subject’s knowledge score and six items were used to calculate use score. Results: Of the 96 patients who consented to participate, majority (96.9%) were well aware of the indication of sublingual GTN. With regards to the mechanism of action of sublingual GTN, 73 (76%) patients did not know how the medication works. Majority of the patients (66.7%) knew about the proper storage of the tablet. In relation to the maximum number of sublingual GTN tablets that can be taken during each angina episode, 36.5% did not know that up to 3 tablets of sublingual GTN can be taken during each episode of angina. Fifty four (56.2%) patients were not aware that they need to replace sublingual GTN every 8 weeks after receiving the tablets. Majority (69.8%) of the patients demonstrated lack of knowledge with regards to the use of sublingual GTN as prevention of chest pain. Conclusion: Overall, patients’ knowledge regarding the self administration of sublingual GTN is still inadequate. The findings support the need for more frequent reinforcement of patient education, especially in the areas of preventive use, storage and drug stability.

Keywords: glyceryl trinitrate, knowledge, adherence, patient education

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Authors: Dimitris Kokkinos, Panagiotis Prinos

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In the last three decades, climate change has been studied extensively from scientific community, and its consequences are more than clear all around the world. Most countries have carried out a great effort to reduce global warming rates with the ratification and implementation of several international treaties. Moreover, many of them have already adopted national plans in order to adapt to climate change effects and mitigate human and economic losses. Coastal environments, with their inherent physical sensitivity, will face important challenges as a result of projected changes in climate conditions and hundreds of millions of people will be affected. Coastal zones are of high social and economic value and this research focuses on the Mediterranean basin, which is a densely populated and highly urbanized area. With 40% of its land used for human activity and the inevitability of the impacts of the climate change, it is obvious that some form of adaptation measures will be necessary. In this regard, the EU tools, policies and legislation concerning adaptation to climate change are presented. Additionally, the National Adaptation Strategies of State members of the Mediterranean basin are compared and analyzed concerning the coastal areas, along with an overview of projects and programs results focused on coastal issues at different spatial scales. The purpose of this research is to stress the differences between Mediterranean State members at methodologies implemented, to highlight the possible gaps in co-ordination and to emphasize on research initiatives that EU can build upon moving towards an integrated adaptation planning on a region-wide basis.

Keywords: coastal adaptation, Mediterranean Basin, climate change, coastal environments

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Authors: Mohammed Mustafa, Fatima Abusin, Mariam Abufatema

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Objective: This audit aims to evaluate the practices and outcomes of operative vaginal deliveries (OPVD) at Mayo University Hospital, focusing on identifying trends, complications, and adherence to clinical guidelines. Methods: A retrospective review was conducted on all cases of operative vaginal deliveries at Mayo University Hospital over one year. Data was collected from patient records, including demographics, OPVD indications, types of instruments used (forceps or vacuum), maternal and neonatal outcomes, and any associated complications. Statistical analyses were performed to assess the rates of successful and unsuccessful OPVDs and identify factors influencing outcomes. Results: The study included 159 [out of 174 total OPVD in 1 year] cases of operative vaginal deliveries. The indications predominantly consisted of the prolonged second stage of labor, fetal distress and suspicious CTG. The success rate of OVD was [97.5%]; maternal perineal tears [10 cases], hemorrhage[43 cases] and neonatal outcomes needed for SCBU admission[12 cases] were also assessed. Conclusion: This audit provides insights into the current practices and outcomes of operative vaginal deliveries at Mayo University Hospital. The findings underline the importance of adherence to clinical guidelines and highlight areas for potential improvement in practice

Keywords: OPVD operative vaginal delivery, GTG green top guidelines, PPH postpartum hemorrhage, SCBU special care baby unit

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Authors: Mais Nijim, Rama Devi Chennuboyina, Waseem Al Aqqad

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Advances in spatial and spectral resolution of satellite images have led to tremendous growth in large image databases. The data we acquire through satellites, radars and sensors consists of important geographical information that can be used for remote sensing applications such as region planning, disaster management. Spatial data classification and object recognition are important tasks for many applications. However, classifying objects and identifying them manually from images is a difficult task. Object recognition is often considered as a classification problem, this task can be performed using machine-learning techniques. Despite of many machine-learning algorithms, the classification is done using supervised classifiers such as Support Vector Machines (SVM) as the area of interest is known. We proposed a classification method, which considers neighboring pixels in a region for feature extraction and it evaluates classifications precisely according to neighboring classes for semantic interpretation of region of interest (ROI). A dataset has been created for training and testing purpose; we generated the attributes by considering pixel intensity values and mean values of reflectance. We demonstrated the benefits of using knowledge discovery and data-mining techniques, which can be on image data for accurate information extraction and classification from high spatial resolution remote sensing imagery.

Keywords: remote sensing, object recognition, classification, data mining, waterbody identification, feature extraction

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Authors: Taimaz Larimian

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During recent years, sustainable development has increasingly influenced urban policy, housing and planning in cities all over the world. Debates about sustainability no longer consider it solely as an environmental concern, but also incorporate social and economic dimensions. However, while a social dimension of sustainability is extensively accepted, the exact definition of the concept is still vague and unclear. This study is addressing this lack of specificity through a detailed exploration of social sustainability as the least studied pillar of sustainable development and sheds light on the debate over the definition of social sustainability through developing a measurement model of the constitutive dimensions of the concept. With this aim, a conceptual framework is developed based on the existing literature, determining seven main dimensions of the social sustainability concept namely: social interaction, safety and security, social equity, social participation, neighborhood satisfaction, housing satisfaction and sense of place. The validity and reliability of the model is then tested using exploratory and confirmatory factor analysis. In order to do so, five case study neighborhoods from Dunedin city with a range of urban forms and characters are investigated, to define social sustainability concept and its consisting dimensions from people’s perspective. The findings of this study present a clear definition of social sustainability at neighborhood scale and highlight all different dimensions of the concept in the context of New Zealand cities. According to the results, among the investigated dimensions, neighborhood satisfaction and safety and security had the most influence on people’s feeling of social sustainability in their neighborhood.

Keywords: social sustainability, factor analysis, neighborhood level, New Zealand cities

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Authors: Michael W. Markowitz, Jeffrey Gingerich

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The landscape of higher education in the United States has undergone significant changes in the last 25 years. What was once a domain of competition among prospective students for a limited number of college and university seats has become a marketplace in which institutions vie for the enrollment of educational consumers. A central figure in this paradigm shift has been the Chief Academic Officer (CAO), whose institutional role has also evolved beyond academics to include such disparate responsibilities as strategic planning, fiscal oversight, student recruitment, fundraising and personnel management. This paper explores the scope and impact of this transition by, first, explaining its context: the intersection of key social, economic and political factors in neo-conservative, late 20th Century America that redefined the value and accountability of institutions of higher learning. This context, in turn, is shown to have redefined the role and function of the CAO from a traditional academic leader to one centered on the successful application of corporate principles of organizational and fiscal management. Information gathered from a number of sitting Provosts, Vice-Presidents of Academic Affairs and Deans of Faculty is presented to illustrate the parameters of this change, as well as the extent to which today’s academic officers feel prepared and equipped to fulfill this broader institutional role. The paper concludes with a discussion of the impact of this transition on the American academy and whether it serves as a portend of change to come in higher education systems around the globe.

Keywords: academic administration, higher education, leadership, organizational management

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Authors: Ratna Kuswardani

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This paper aims to study the impact of recent Global Financial Crisis (GFC) on 6 selected emerging Asian economies (Indonesia, Malaysia, Thailand, Philippines, Singapore, and South Korea). We first figure out the contagion of GFC from the US and Europe to the selected emerging Asian countries by studying the tail dependence of market stock returns between those countries. We apply the concept of Extreme Value Theory (EVT) to model the dependence between multiple returns series of variables under examination. We explore the factors causing the contagion between the regions. We find dependencies between markets that are influenced by their size, especially for large markets in emerging Asian countries that tend to have a higher dependency to the market in the more advanced country such as the U.S. and some countries in Europe. The results also suggest that the dependencies between market returns and bank stock returns in the same region tend to be higher than dependencies between these returns across two different regions. We extend our analysis by studying the impact of GFC on the systemic in the banking system. We also find that larger institution has more dependencies with the market stock, suggesting that larger size bank can cause disruption in the market. Further, the higher probability of extreme loss can be seen during the crisis period, which is shown by the non-linear dependency between the pre-crisis and the post-crisis period. Finally, our analysis suggests that systemic risk appears in the domestic banking systems in emerging Asia, as shown by the extreme dependencies within banks in the system. Overall, our results provide caution to policy makers and investors alike on the possible contagion of the impact of global financial crisis across different markets.

Keywords: contagion, extreme value theory, global financial crisis, systemic risk

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Authors: D. S. Chakraborty, S. Ghosh, A. Hazra

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Objective: Medication errors are a reality in all settings where medicines are prescribed, dispensed and used. High Alert Medications (HAM) are those that bear a heightened risk of causing significant patient harm when used in error. We conducted a knowledge-attitude-practice survey, among residents working in a teaching hospital, to assess the ground situation with regard to the handling of HAM. Methods: We plan to approach 242 residents among the approximately 600 currently working in the hospital through purposive sampling. Residents in all disciplines (clinical, paraclinical and preclinical) are being targeted. A structured questionnaire that has been pretested on 5 volunteer residents is being used for data collection. The questionnaire is being administered to residents individually through face-to-face interview, by two raters, while they are on duty but not during rush hours. Results: Of the 156 residents approached so far, data from 140 have been analyzed, the rest having refused participation. Although background knowledge exists for the majority of respondents, awareness levels regarding HAM are moderate, and attitude is non-uniform. The number of respondents correctly able to identify most ( > 80%) HAM in three common settings– accident and emergency, obstetrics and intensive care unit are less than 70%. Several potential errors in practice have been identified. The study is ongoing. Conclusions: Situation requires corrective action. There is an urgent need for improving awareness regarding HAM for the sake of patient safety. The pharmacology department can take the lead in designing awareness campaign with support from the hospital administration.

Keywords: high alert medication, medication error, questionnaire, resident

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Authors: Kadiri Kayode Ibrahim

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Small and Medium Enterprises (SMEs) play significant roles in the economic development of Nigeria. However, the performance of these SMEs is influenced by various factors, including cultural factors. Keffi Local Government Area (LGA) in Nasarawa State, Nigeria, has a large number of registered SMEs. Understanding the impact of cultural factors on the performance of these SMEs in Keffi LGA is essential for their growth and sustainability. Therefore, this study aims to investigate the effect of cultural factors on the performance of selected SMEs in Keffi LGA, Nasarawa State. A cross-sectional survey research design was used to collect data from 165 purposefully selected SME owners out of the 283 registered SMEs in Keffi LGA. The data was collected using a questionnaire divided into three sections, and analysed using descriptive and ordinary least square regression (OLS). The results indicate that socio-cultural factors and ethical values have a positive and significant effect on the performance of SMEs in Keffi LGA, while attitude has a negative and significant effect on the performance of SMEs in Keffi LGA. Therefore, the study recommends that SMEs in Keffi LGA should understand the socio-cultural elements of their operating environment, adopt socio-cultural factors as elements to guide their planning and strategizing and take into consideration the ethical values of the business environment when offering new products or services. Additionally, SME Managers should take cognisance of people’s attitudes and use them to gauge their activities and ensure they support the overall performance of the business.

Keywords: cultural, factors, performance, SMEs

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Authors: N. Dlamini, Mpumelelo G. Ndlela, Philisiwe Dlamini, Nicholus Kisyeri, Bhekizitha Sithole

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Accessing health services during the COVID-19 pandemic have exacerbated scarcity to routine medication. To ensure continuous accessibility to services, Eswatini launched Community Health Commodities Distribution (CHCD). Eligible Antiretroviral Therapy(ART) stable clients (VL<1,000) and patients on Non-Communicable Disease (NCD) medications were attended at community pick up points (PUP) based on distance between clients’ residence and the public health facility. Services provided includes ART and Pre-Exposure prophylaxis (PrEP) refills and NCD drug refills). The number of community PUP was 14% higher than health facility visits. Among all medications and commodities distributed between April and October 2020 at the PUP, 64% were HIV-related (HIV rapid test, HIVST, VL test, PrEP meds), and 36% were NCD related. The rapid roll out of CHCD during COVID-19 pandemic reduced the risk of COVID-19 transmission to clients as travel to health facilities was eliminated. It Additionally increased access to commodities during COVID-19-driven lockdown, decongested health facilities, integrated model of care, and increase service coverage. It was also noted that CHCD added different curative and HIV related services based on client specific needs and availability of the commodities.

Keywords: community health commodities distribution, pick up points, antiretroviral therapy, pre-exposure prophylaxis

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Authors: Rachel M. Lørum, Henrik Eriksson, Frida Smith

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Purpose: In recent years, the use of benchmarks for the improvement of healthcare has become increasingly common. There has been an increasing interest in why improvement initiatives so often fail to eliminate the problems they aspire to solve. Benchmarking comes with its fair share of challenges and problems, such as capturing the dynamics and complexities of the care environments, among others. In this study, we demonstrate how learning-oriented, voluntary benchmarks in the complex environment of public healthcare could be designed. Findings: Our four most important findings were the following: first, important organizational learning (OL) regarding the complexity of the service and implications on how to design a benchmark for learning and improvement occurred during the process. Second, participation by a wide range of professionals and stakeholders was crucial for capturing the complexity of people and organizations and increasing the quality of the template. Third, the continuous dialogue between all organizations involved was an important tool for ongoing organizational learning throughout the process. The last important finding was the impact of the facilitator’s role through supporting progress, coordination, and dialogue. Design: We chose participatory design as the research design. Data were derived from written materials such as e-mails, protocols, observational notes, and reflection notes collected during a period of 1.5 years. Originality: Our main contributions are the identification of important strategies, initiatives, and actors to involve when designing voluntary benchmarks for learning and improvement.

Keywords: organizational learning, quality improvement, learning-oriented benchmark, healthcare, patient safety

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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: B. Adini, M. Oren

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Introduction: Communicable diseases and pandemics pose a growing threat to the well-being of the global population. A vital component of protecting the public health is the creation and sustenance of a continuous preparedness for such hazards. A joint Israeli-German task force was deployed in order to develop an advanced tool for self-evaluation of emergency preparedness for variable types of biological threats. Methods: Based on a comprehensive literature review and interviews with leading content experts, an evaluation tool was developed based on quantitative and qualitative parameters and indicators. A modified Delphi process was used to achieve consensus among over 225 experts from both Germany and Israel concerning items to be included in the evaluation tool. Validity and applicability of the tool for medical institutions was examined in a series of simulation and field exercises. Results: Over 115 German and Israeli experts reviewed and examined the proposed parameters as part of the modified Delphi cycles. A consensus of over 75% of experts was attained for 183 out of 188 items. The relative importance of each parameter was rated as part of the Delphi process, in order to define its impact on the overall emergency preparedness. The parameters were integrated in computerized web-based software that enables to calculate scores of emergency preparedness for biological events. Conclusions: The parameters developed in the joint German-Israeli project serve as benchmarks that delineate actions to be implemented in order to create and maintain an ongoing preparedness for biological events. The computerized evaluation tool enables to continuously monitor the level of readiness and thus strengths and gaps can be identified and corrected appropriately. Adoption of such a tool is recommended as an integral component of quality assurance of public health and safety.

Keywords: biological events, emergency preparedness, bioterrorism, natural biological events

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Authors: Navpreet Kaur, Randhir Singh

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Diabetic neuropathy is one of the most common microvascular complications of diabetes mellitus which affects more than 50% of diabetic patients. The present study targeted oxidative stress mediated nerve damage in diabetic rats using a hydro-alcohol extract of Cucurbita pepo L. (Family: Cucurbitaceae) and its potential in treatment of diabetic neuropathy. Diabetes neuropathy was induced in Wistar rats by injection of streptozotocin (65 mg/kg, i.p.) 15 min after Nicotinamide (230 mg/kg, i.p.) administration. Hydro-alcohol extract of C. pepo seeds was assessed by oral administration at 100, 200 and 400 mg/kg in STZ-nicotinamide induced diabetic rats. Thermal hyperalgesia (Eddy's hot plate and tail immersion), mechanical hyperalgesia (Randall-Selitto) and tactile allodynia (Von Frey hair tests) were evaluated in all groups of streptozotocin diabetic rats to assess the extent of neuropathy. Tissue (sciatic nerve) antioxidant enzymes (SOD, CAT, GSH and LPO) levels were measured along with the formation of AGEs in serum to assess the effect of hydro-alcohol extract of C. pepo in ameliorating oxidative stress. Diabetic rats exhibited significantly decreased tail-flick latency in the tail-immersion test and decreased paw withdrawal threshold in both Randall-Selitto and von-Frey hair test. A decrease in the nociceptive threshold was accompanied by significantly increased oxidative stress in sciatic nerve of diabetic rats. Treatment with the C. pepo hydro-alcohol extract significantly attenuated all the behavioral and biochemical alterations in a dose-dependent manner. C. pepo attenuated the diabetic condition and also reversed neuropathic pain through modulation of oxidative stress and thus it may find application as a possible therapeutic agent against diabetic neuropathy.

Keywords: advanced glycation end products, antioxidant enzymes, cucurbita pepo, hyperglycemia

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Authors: Pawan Kumar Gupta, Sumana Ghosh

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Parkinson's Disease (PD) is a long-term neurodegenerative movement disorder of the central nervous system with vast symptoms related to the motor system. The common symptoms of PD are tremor, rigidity, bradykinesia/akinesia, and postural instability, but the clinical symptom includes other motor and non‐motor issues. The motor symptoms of the disease are consequence of death of the neurons in a region of the midbrain known as substantia nigra pars compacta, leading to decreased level of a neurotransmitter known as dopamine. The cause of this neuron death is not clearly known but involves formation of Lewy bodies, an abnormal aggregation or clumping of the protein alpha-synuclein in the neurons. Unfortunately, there is no cure for PD, and the management of this disease is challenging. Therefore, it is critical for a patient to be diagnosed at early stages. A limited choice of drugs is available to improve the symptoms, but those become less and less effective over time. Apart from that, with rapid growth in the field of science and technology, other methods such as multi-area brain stimulation are used to treat patients. In order to develop advanced techniques and to support drug development for treating PD patients, an accurate mathematical model is needed to explain the underlying relationship of dopamine secretion in the brain with the hand tremors. There has been a lot of effort in the past few decades on modeling PD tremors and treatment effects from a computational point of view. These models can effectively save time as well as the cost of drug development for the pharmaceutical industry and be helpful for selecting appropriate treatment mechanisms among all possible options. In this review paper, an effort is made to investigate studies on PD modeling and analysis and to highlight some of the key advances in the field over the past centuries with discussion on the current challenges.

Keywords: Parkinson's disease, deep brain stimulation, tremor, modeling

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Authors: Gina Cynthia Raphita Hasibuan

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The housing sector in Indonesia is in critical condition where majority of low-income citizens live in substandard dwellings, and the number housing backlog is increasing every year. The housing problem becomes more urgent when the term 'sustainability' is considered, and sustainable affordable housing is yet to gain its successful implementation. Global urbanization develops fastest in developing countries like Indonesia where informal settlements are rapidly escalating, hence, making sustainable affordable housing strategies very critical in this context. The problem in developing countries like Indonesia lies on the institutional capacity of newly-established local governments having greater power to determine a development policy but apparently still lacking institutional capability and coordination with the central government and collaborative governance are still not established yet. The concept of upgrading informal settlements are seen changed over time and inconsistent. Despite much research on theme such as sustainable housing concept within Indonesian context, there has been a dearth of research examining the role of collaborative governance, as the current approach still shows fragmented approach between the stakeholders and the lack of community participation as the end user, and thus this research attempts to fill the gap on the aforementioned problems. By using case study with multi-methods conducted in Jakarta, this research has an overall aim to critically assess the role of collaborative governance in addressing sustainable affordable housing in Indonesia and to understand informal settlements and interventions in Indonesia rather than imposing a framework from western perspectives.

Keywords: affordable housing, collaborative governance, sustainability, urban planning

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Authors: Naveed Chughtai, Salman Atif, Azhar Ali Taj, Murtaza Asghar Bukhari

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Accessible transport systems play a crucial role in infrastructure management and ease of access to destinations. Thus, the necessity of knowledge of service coverage and service deprived areas is a prerequisite for devising policies. Integration of PTALs model with GIS network analysis models (Service Area Analysis, Closest Facility Analysis) facilitates the analysis of deprived areas. In this research, models presented determine the accessibility. The empirical evidence suggests that current bus network system caters only 18.5% of whole population. Using network analysis results as inputs for PTALs, it is seen that excellent accessibility indexed bands cover a limited areas, while 78.8% of area is totally deprived of any service. To cater the unserved catchment, new route alignments are proposed while keeping in focus the Socio-economic characteristics, land-use type and net population density of the deprived area. Change in accessibility with proposed routes show a 10% increment in service delivery and enhancement in terms of served population is up to 20.4%. PTALs result shows a decrement of 60 Km2 in unserved band. The result of this study can be used for planning, transport infrastructure management, allocation of new route alignments in combination with future land-use development and for adequate spatial distribution of service access points.

Keywords: GIS, public transport accessibility, PTALs, accessibility index, service area analysis, closest facility analysis

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Authors: Mehdi Khaki, Ehsan Forootan, Joseph Awange, Michael Kuhn

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Terrestrial water storage, as a source of freshwater, plays an important role in human lives. Hydrological models offer important tools for simulating and predicting water storages at global and regional scales. However, their comparisons with 'reality' are imperfect mainly due to a high level of uncertainty in input data and limitations in accounting for all complex water cycle processes, uncertainties of (unknown) empirical model parameters, as well as the absence of high resolution (both spatially and temporally) data. Data assimilation can mitigate this drawback by incorporating new sets of observations into models. In this effort, we use multi-mission satellite-derived remotely sensed observations to improve the performance of World-Wide Water Resources Assessment system (W3RA) hydrological model for estimating terrestrial water storages. For this purpose, we assimilate total water storage (TWS) data from the Gravity Recovery And Climate Experiment (GRACE) and surface soil moisture data from the Advanced Microwave Scanning Radiometer for the Earth Observing System (AMSR-E) into W3RA. This is done to (i) improve model estimations of water stored in ground and soil moisture, and (ii) assess the impacts of each satellite of data (from GRACE and AMSR-E) and their combination on the final terrestrial water storage estimations. These data are assimilated into W3RA using the Ensemble Square-Root Filter (EnSRF) filtering technique over Mississippi Basin (the United States) and Murray-Darling Basin (Australia) between 2002 and 2013. In order to evaluate the results, independent ground-based groundwater and soil moisture measurements within each basin are used.

Keywords: data assimilation, GRACE, AMSR-E, hydrological model, EnSRF

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Authors: Jamuna Rajeswaran

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In the past two decades, with a population of more than a billion. India is passing through a major socio-demographic and epidemiological transition with consequent changes in health scenario. TBI constitute significant burden on health care resources in India The impact on a person and family can be devastating. Patients with TBI experience persistent cognitive deficits, emotional changes, which contribute to the disruption of life activities. The recovery of TBI would be maximized by appropriate rehabilitation. Neurofeedback is an emerging neuroscience-based clinical application. Sixty patients were recruited for this study after obtaining informed consent. Rivermead Head Injury Follow-up Questionnaire, Rivermead Post Concussion Symptoms Questionnaire and Visual Analog Scale were used to assess the behavioral and symptomotolgy associated with post TBI. Neuropsychological assessment was carried out using NIMHANS neuropsychological battery 2004. The Intervention group received neurofeedback training and the waitlist group did not receive any treatment during this phase. Patients were allocated to intervention and waitlist group at random. There were 30 patients in each group. Patients were given 20 sessions of NFT Patients were trained on the O1 and O2 channels for alpha theta training. Each session was of 40 minutes duration with 5-6 sessions per week. The post-training assessment was carried out for the intervention group after 20 sessions of NFT. The waitlist group underwent assessment after one month. Results showed neurofeedback training is effective in ameliorating deficits in cognitive functions and quality of life in patients with TBI. Improvements were corroborated by the clinical interview with patients and significant others post NFT.

Keywords: assessment, rehabilitation, cognition, EEG neurofeedback

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Authors: Sudheer Moorkoth, Leslie Edward Lewis, Pragna Rao

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Newborn screening (NBS) is a part of routine newborn care in many countries worldwide to detect early any rare treatable conditions and inborn errors of metabolism (IEM). India has not started this program yet. In an attempt to understand the challenges in implementing a national newborn screening program in India, we initiated a pilot newborn screening project funded by the Government of Canada. Along with initiating the newborn screening at Kasturba Hospital, Manipal in South India, for screening six disorders (Congenital Hypothyroidism(CH), Congenital Adrenal Hyperplasia (CAH), Galactosemia, Biotinidase deficiency, Glucose-6-Phosphate Dehydrogenase deficiency (G-6PD) and Phenylketonurea), we also studied the awareness of various stakeholders on the newborn screening. In a period of nine months from August 2017 to March 2018 we could screen 1915 newborns (999 male and 916 female). The result showed that there were seven babies screened positive. This interim result points to an incidence rate of 1 in 270 children for these rare disorders collectively. This includes three confirmed cases of CH, two cases of G-6PD deficiency, and one case each for Galctosemia and CAH. A questionnaire based study to understand the awareness among various stakeholders revealed that there is little awareness among parents, adolescents and anganwadi workers (public health worker). The interim data points to the need for a national newborn screening programme in India. There is also an immediate need to undertake large-scale awareness programme to create knowledge on NBS among the various stakeholders.

Keywords: awareness, inborn errors of metabolism (IEM), newborn screening, rare disease

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Authors: Sanja Obradovic, Vladimir Stojanovic

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The purpose of this paper is to examine the attitudes of residents toward sustainable tourism development in the Bačko Podunavlje Biosphere Reserve (BPBR) in northwestern Serbia. BPBR is a part of 'the European Amazon', world's first five-country Transboundary UNESCO Biosphere Reserve 'Mura-Drava-Danube'. Sustainable tourism development requires the engagement of local residents. Within the initial stage of tourism development, it is important to address residents' attitudes from the early beginning, thus further involve the local community through all phases of development, which in return will largely influence overall success. Data were collected through in-person (face-to-face) questionnaire. The research also addresses the quality of the sustainable tourism attitude scale (SUS-TAS), perceived as an instrument to measure local communities' attitudes towards sustainable tourism development. SUS-TAS has seven variables, which are named as environmental sustainability, perceived social cost, long-term planning, perceived economic benefit, community center economy, ensuring visitor satisfaction, and maximizing community participation. Data were analyzed using SPSS. Findings indicate that residents have a positive attitude toward the development of sustainable tourism in the BPBR. They also recognized the importance of environmental sustainability and preservation for future generations. The study shows that BPBR has a very good community to support sustainable tourism activities in each area considered.

Keywords: biosphere reserve, local resident's attitude, sustainable tourism attitude scale, SUS-TAS, sustainable tourism

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Authors: Ikram Metalsi

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English as a Medium of Instruction known as (EMI) is expanding rapidly in the world. A growing volume of research has been dedicated to investigating its implementation. However, considerably less attention has been given to understanding EMI in a context where its implementation has been discussed but not yet put into practice. One such context is Algeria, where talks about a possible implementation of EMI have been going on for some time. The present study examines the current discourses and university lecturers’ attitudes towards the potential implementation of EMI as well as investigating the current implicit and explicit language policies in scientific courses in Algerian state universities. The focus is specifically on Engineering departments, as this field has gained worldwide importance in EMI research (Macaro et al. 2018), and, traditionally, French has been the MOI for Engineering in Algerian universities. Using the ROADMAPPING framework (Dafouz and Smit 2016) and the mixed method research approach, the present work explores the language in education policy (LEP) and planning situation in Algeria, the current media of instruction as well as the status and use of the English language in the scientific courses of the tertiary sector. Finally, the current study explores the perceived challenges and benefits of the implementation of EMI programmes from teachers’ perspectives with a particular focus on agency and how this potential policy implementation and teachers’ perceptions of agency around it may reflexively influence their professional identity.

Keywords: media of instruction, language in education policy, lecturers attitudes, teacher agency, professional identity

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Authors: Fatima M. Jadu, Asmaa A. Alzahrani, Maha A. Almutairi, Salma O. Al-Amoudi, Mawya A. Khafaji

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Introduction: Estimating the potential radiation risk for a widely used imaging technique such as cone beam CT (CBCT) is crucial. The aim of this study was to examine the effect of varying two CBCT technical factors, the voxel size (VOX) and the Field-of-View (FOV) centralization, on the radiation dose. Methodology: The head and neck slices of a RANDO® man phantom (Alderson Research Laboratories) were used with nanoDot™ OSLD dosimeters to measure the absorbed radiation dose at 25 predetermined sites. Imaging was done using the i-CAT® (Imaging Science International, Hatfield, PA, USA) CBCT unit. The VOX was changed for every three cycles of exposures from 0.2mm to 0.3mm and then 0.4mm. Then the FOV was centered on the maxilla and mandible alternatively while holding all other factors constant. Finally, the effective radiation dose was calculated for each view and voxel setting. Results: The effective radiation dose was greatest when the smallest VOX was chosen. When the FOV was centered on the maxilla, the highest radiation doses were recorded in the eyes and parotid glands. While on the mandible, the highest radiation doses were recorded in the sublingual and submandibular glands. Conclusion: Minor variations in the CBCT exposure factors significantly affect the effective radiation dose and thus the radiation risk to the patient. Therefore, extreme care must be taken when choosing these parameters especially for vulnerable patients such as children.

Keywords: CBCT, cone beam CT, effective dose, field of view, mandible, maxilla, resolution, voxel

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Authors: Nadya Patel, Jawn Lim

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Foresight 3.0 is a synergistic methodology that encompasses systems analysis, future studies, capacity building, and forward planning. These components are interconnected, fostering a collective anticipatory intelligence that promotes societal resilience (Ravetz, 2020). However, traditional applications of these strands can often fall short, leading to missed opportunities and narrow perspectives. Therefore, Foresight 3.0 champions a holistic approach to tackling complex issues, focusing on systemic transformations and power dynamics. Businesses are pivotal in preparing the workforce for an increasingly uncertain and complex world. This necessitates the adoption of innovative tools and methodologies, such as Foresight 3.0, that can better equip young employees to anticipate and navigate future challenges. Firstly, the incorporation of its methodology into workplace training can foster a holistic perspective among employees. This approach encourages employees to think beyond the present and consider wider social, economic, and environmental contexts, thereby enhancing their problem-solving skills and resilience. This paper discusses our research on integrating Foresight 3.0's transformative principles with a newly developed Critical Design Futures (CDF) framework to equip organisations with the ability to innovate for the world's most complex social problems. This approach is grounded in 'collective forward intelligence,' enabling mutual learning, co-innovation, and co-production among a diverse stakeholder community, where business transformation and innovation are achieved.

Keywords: business transformation, innovation, foresight, critical design

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Authors: Fauzik Lendriyono, Isbandi Rukminto Adi

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Muhammadiyah is an Islamic-based organization taking care to human suffering. The existence of Muhammadiyah organization is strong supported by its members. Muhammadiyah as the oldest Islamic organization in Indonesia, since its establishment has had main activities, such as in the fields of education, health, and social services, one of the form is Orphanage. However, at present, Muhammadiyah orphanage was in a dilemma because of differences in orientation and commitment of the caretaker-managers. This research on Muhammadiyah orphanage is very important because it is able to know the problem identification and to find the ideal concept for the better management of an orphanage in Muhammadiyah. This research is a phenomenology study by research subjects: caretaker of the orphanage in Muhammadiyah at Great Malang. The research data was obtained after the observation, in-depth interviews, review of documentation and the discussion focused. Data were analyzed with interpretative phenomenological analysis. Basic problems for causes of differences in orientation and commitment administrators of Muhammadiyah orphanage is the influence of organizational culture and organizational environment factors. Organizational culture factors include the Islamic-based value and organization ideology, so that the Islamic values and the values of Muhammadiyah are used as guidelines in the orphanage. Environmental factors include the demand for its organization sustainability as characterized by economically productive activities organized by Orphanage and a program to produce a cadre of Muhammadiyah. To support the social welfare of Muhammadiyah, the ideal Orphanage concept for Muhammadiyah is a missionary and self-sufficient orphanage.

Keywords: orphanage, Muhammadiyah, misionary, Great Malang

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