Search results for: access improvement

Authors: Hsiao-Chuan Huang, King-Lung Kuo, Mei-Hsin Lo, Hsiao-Yun Chou, Yusen Lin

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The most robust and economical method for laboratory diagnosis of TB is to identify mycobacterial bacilli (AFB) under acid-fast staining despite its disadvantages of low sensitivity and labor-intensive. Though digital pathology becomes popular in medicine, an automated microscopic system for microbiology is still not available. A new AI-assisted automated microscopic system, consisting of a microscopic scanner and recognition program powered by big data and deep learning, may significantly increase the sensitivity of TB smear microscopy. Thus, the objective is to evaluate such an automatic system for the identification of AFB. A total of 5,930 smears was enrolled for this study. An intelligent microscope system (TB-Scan, Wellgen Medical, Taiwan) was used for microscopic image scanning and AFB detection. 272 AFB smears were used for transfer learning to increase the accuracy. Referee medical technicians were used as Gold Standard for result discrepancy. Results showed that, under a total of 1726 AFB smears, the automated system's accuracy, sensitivity and specificity were 95.6% (1,650/1,726), 87.7% (57/65), and 95.9% (1,593/1,661), respectively. Compared to culture, the sensitivity for human technicians was only 33.8% (38/142); however, the automated system can achieve 74.6% (106/142), which is significantly higher than human technicians, and this is the first of such an automated microscope system for TB smear testing in a controlled trial. This automated system could achieve higher TB smear sensitivity and laboratory efficiency and may complement molecular methods (eg. GeneXpert) to reduce the total cost for TB control. Furthermore, such an automated system is capable of remote access by the internet and can be deployed in the area with limited medical resources.

Keywords: TB smears, automated microscope, artificial intelligence, medical imaging

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Authors: S. Archsana, Vajira Balasuriya

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In Trincomalee of Sri Lanka, a post-conflict area, resettlement projects and policy initiatives are taking place to improve the wealth of the rural communities through promoting economic activities by way of encouraging the rural women to opt to commence and operate Micro and Small Scale (MSS) businesses. This study attempts to identify the manner in which the institutional environment could facilitate these MSS businesses owned and operated by women in the rural environment. The respondents of this study are the beneficiaries of the Divi Neguma Development Training Program (DNDTP); a project designed to aid women owned MSS businesses, in Trincomalee district. 96 women business operators, who had obtained financing facilities from the DNDTP, are taken as the sample based on fixed interval random sampling method. The study reveals that primary challenges encountered by 82% of the women business operators are lack of initial capital followed by 71% initial market finding and 35% access to technology. The low level of education and language barriers are the constraints in accessing support agencies/service providers. Institutional support; specifically management and marketing services, have a significant relationship with wealth augmentation. Institutional support at the setting-up stage of businesses are thin whereas terms and conditions of the finance facilities are perceived as ‘too challenging’. Although diversification enhances wealth of the rural women business operators, assistance from the institutional framework to prepare financial reports that are required for business expansion is skinny. The study further reveals that institutional support is very much weak in terms of providing access to new technology and identifying new market networks. A mechanism that could facilitate the institutional framework to support the rural women business operators to access new technology and untapped market segments, and assistance in preparation of legal and financial documentation is recommended.

Keywords: business facilitation, institutional support, rural women business operators, wealth augmentation

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Authors: Elham Azimzadeh, Fahimeh Khorshidi, Alireza Farsi

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Balance impairment and fear of falling in older adults may reduce their quality of life. Reactive balance training could improve rapid postural responses and fall prevention in the elderly during daily tasks. Performing postural training and simultaneously cognitive dual tasks could be similar to the daily circumstances. Purpose: This study aimed to determine the effect of balance training on stable and unstable surfaces under dual cognitive task conditions on postural control and fear of falling in the elderly. Methods: Thirty non-fallers of older adults (65-75 years) were randomly assigned to two training groups: stable-surface (n=10), unstable-surface (n=10), or a control group (n=10). The intervention groups underwent six weeks of balance training either on a stable (balance board) or an unstable (wobble board) surface while performing a cognitive dual task. The control group received no balance intervention. COP displacements in the anterioposterior (AP) and mediolateral (ML) directions using a computerized balance board, functional balance using TUG, and fear of falling using FES-I were measured in all participants before and after the interventions. Summary of Results: Mixed ANOVA (3 groups * 2 times) with repeated measures and post hoc test showed a significant improvement in both intervention groups in AP index (F= 11/652, P= 0/0002) and functional balance (F= 9/961, P= 0/0001). However, the unstable surface training group had more improvement. However, the fear of falling significantly improved after training on an unstable surface (p= 0/035). All groups had no significant improvement in the ML index (p= 0/817). In the present study, there was an improvement in the AP index after balance training. Conclusion: Unstable surface training may reduce reaction time in posterior ankle muscle activity. Furthermore, focusing attention on cognitive tasks can lead to maintaining balance unconsciously. Most of the daily activities need attention distribution among several activities. So, balance training concurrent to a dual cognitive task is challenging and more similar to the real world. According to the specificity of the training principle, it may improve functional independence and fall prevention in the elderly.

Keywords: cognitive dual task, elderly, fear of falling, postural control, unstable surface

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Authors: Akor Omachile Opaluwah

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Entrepreneurs are heralded as a very vital force in the growth of economies. This is because they create businesses, employ people, have direct access to the local consumer, and primarily utilize local sources of raw materials, have an understanding of the immediate need of consumers, and they have the capacity to keep in motion the economy. The rise of social enterprises takes these advantages further beyond the business and economic benefits. These Social enterprises help address developmental issues in the society while maintaining a profit for their investors and shareholders. These combined roles create a unique synergy between the civil society and the market, therefore placing the social enterprise in a position where they can access directly, the benefits of the market while meeting the needs of the citizens and their environment. With such a unique position, social enterprises hold a place in the development discourse that has previously been left unexplored. This hybridisation of the functions of civil societies and the market can provide to development, practices, and benefits that have previously been only available in trace amounts. It, therefore, is imperative to understand the efficacy of social enterprises. With the discourse of social enterprises still in its early stages. This paper looks at selected social enterprise cases in Nigeria and analyses their approach and contribution to development.

Keywords: business, civil society, development, entrepreneurs, innovation, market, Nigeria, social enterprise

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Authors: M. G. Cattaneo

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The non-effectiveness of certain codified human rights is particularly apparent with reference to the lack of access to essential drugs in developing countries, which represents a breach of the human right to receive adequate health assistance. This paper underlines the conflict and the legal contradictions between human rights, namely health rights, international Intellectual Property Rights, in particular patent law, as well as international trade law. The paper discusses the crucial links between R&D costs for innovation, patents and new medical drugs, with the goal of reformulating the hierarchies of priorities and of interests at stake in the international intellectual property (IP) law system. Different from what happens today, International patent law should be a legal instrument apt at rebalancing an axiological asymmetry between the (conflicting) needs at stake The core argument in the paper is the proposal of an alternative pathway, namely a feasible proposal for a patent law reform. IP laws tend to balance the benefits deriving from innovation with the costs of the provided monopoly, but since developing countries and industrialized countries are in completely different political and economic situations, it is necessary to (re)modulate such exchange according to the different needs. Based on this critical analysis, the paper puts forward a proposal, called Trading Time for Space (TTS), whereby a longer time for patent exclusive life in western countries (Time) is offered to the patent holder company, in exchange for the latter selling the medical drug at cost price in developing countries (Space). Accordingly, pharmaceutical companies should sell drugs in developing countries at the cost price, or alternatively grant a free license for the sale in such countries, without any royalties or fees. However, such social service shall be duly compensated. Therefore, the consideration for such a service shall be an extension of the temporal duration of the patent’s exclusive in the country of origin that will compensate the reduced profits caused by the supply at the price cost in developing countries.

Keywords: global health, global justice, patent law reform, access to drugs

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Authors: Muhammad Danyal Khan

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The standards of patentability are drawing a great impact upon medicine industry of Pakistan which is indirectly troubling the right to health of ordinary citizen. Globalization of intellectual property laws is directly impacting access to medicine for population in Pakistan. Pakistan has enacted Patent Ordinance 2000 to develop the standards of Patent laws in consonance with international commitments. Moreover, Pakistan is signatory to UN Millennium Development Goals (2000-2015), and three of them directly put stress upon the health standards. This article will provide a critical brief about implications of TRIPS Agreement on standards of health in Pakistan and will also propose a futuristic approach for the pharmaceutical industry. This paper will define the paradox of globalization and national preparedness on pharmaceutical patents utilizing industry statistics and case laws from Pakistan. Moreover, this work will contribute towards debate on access to medicine at legislative and interpretative levels that will further help development of equilibrium between pharmaceutical patents and right to health.

Keywords: TRIPS (Trade Related Intellectual Property Rights), patents, compulsory licensing, patent, lifesaving drugs, WTO, infringement

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Authors: Stephen Bahooshy

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Co-producing services with the people that access them is considered best practice in the United Kingdom, with the Care Act 2014 arguing that people who access services and their carers should be involved in the design, commissioning and delivery of services. Co-production is a way of working with the community, breaking down barriers of access and providing meaningful opportunity for people to engage. Unfortunately, owing to a number of reported factors such as time constraints, practitioner experience and departmental budget restraints, this process is not always followed. In 2019, in a south London borough, d/Deaf people who access services were engaged in the design, commissioning and delivery of an information and advice service that would support their community to access local government services. To do this, sensory impairment social workers and commissioners collaborated to host a series of engagement events with the d/Deaf community. Interpreters were used to enable communication between the commissioners and d/Deaf participants. Initially, the community’s opinions, ideas and requirements were noted. This was then summarized and fed back to the community to ensure accuracy. Subsequently, a service specification was developed which included performance metrics, inclusive of qualitative and quantitative indicators, such as ‘I statements’, whereby participants respond on an adapted Likert scale how much they agree or disagree with a particular statement in relation to their experience of the service. The service specification was reviewed by a smaller group of d/Deaf residents and social workers, to ensure that it met the community’s requirements. The service was then tendered using the local authority’s e-tender process. Bids were evaluated and scored in two parts; part one was by commissioners and social workers and part two was a presentation by prospective providers to an evaluation panel formed of four d/Deaf residents. The internal evaluation panel formed 75% of the overall score, whilst the d/Deaf resident evaluation panel formed 25% of the overall tender score. Co-producing the evaluation panel with social workers and the d/Deaf community meant that commissioners were able to meet the requirements of this community by developing evaluation questions and tools that were easily understood and use by this community. For example, the wording of questions were reviewed and the scoring mechanism consisted of three faces to reflect the d/Deaf residents’ scores instead of traditional numbering. These faces were a happy face, a neutral face and a sad face. By making simple changes to the commissioning and tender evaluation process, d/Deaf people were able to have meaningful involvement in the design and commissioning process for a service that would benefit their community. Co-produced performance metrics means that it is incumbent on the successful provider to continue to engage with people accessing the service and ensure that the feedback is utilized. d/Deaf residents were grateful to have been involved in this process as this was not an opportunity that they had previously been afforded. In recognition of their time, each d/Deaf resident evaluator received a £40 gift voucher, bringing the total cost of this co-production to £160.

Keywords: co-production, community engagement, deaf and hearing impaired, service design

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Authors: Ahmed Amin Mousa, M. Abd El-Salam

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This study discusses a simple solution for the problem of shortage in learning resources for kindergarten teachers. Occasionally, kindergarten teachers cannot access proper resources by usual search methods as libraries or search engines. Furthermore, these methods require a long time and efforts for preparing. The study is expected to facilitate accessing learning resources. Moreover, it suggests a potential direction for using QR code inside the classroom. The present work proposes that QR code can be used for digitizing kindergarten curriculums and accessing various learning resources. It investigates using QR code for saving information related to the concepts which kindergarten teachers use in the current educational situation. The researchers have established a guide for kindergarten teachers based on the Egyptian official curriculum. The guide provides different learning resources for each scientific and mathematical concept in the curriculum, and each learning resource is represented as a QR code image that contains its URL. Therefore, kindergarten teachers can use smartphone applications for reading QR codes and displaying the related learning resources for students immediately. The guide has been provided to a group of 108 teachers for using inside their classrooms. The results showed that the teachers approved the guide, and gave a good response.

Keywords: kindergarten, child, learning resources, QR code, smart phone, mobile

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Authors: Prem Bahadur Giri

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The nationalization of forests during the early 1960s had become counterproductive for the conservation of forests in Nepal. Realizing this fact, the Government of Nepal initiated a paradigm shift from a government-controlled forestry system to people’s direct participation in managing forestry, conceptualizing a community forest approach in the early 1980s. The community forestry approach is expected to promote sustainable forest management, restoring degraded forests to enhance the forest condition on the one hand, and on the other, improvement of livelihoods, particularly of low-income people and forest-dependent communities, as well as promoting community ownership of a forest. As a result, the establishment of community forests started and had taken faster momentum in Nepal. Of the total land in Nepal, forest occupies 6.5 million hectares which are around 45 percent of the forest area. Of the total forest area, 1.8 million hectares have been handed over to community management. A total of 19,361 ‘community forest users groups’ are already created to manage the community forest. To streamline the governance of community forests, the enactment of ‘The Forest Act 1993’ provides a clear legal basis for managing community forests in Nepal. This article is based on an in-depth study taking the case of Tarpakha Community Forest (TCF) located in Siranchok Rural Municipality of Gorkha District in Nepal. It mainly discusses the extent to which the TCF is able to achieve the twin objectives of this community forest for catalyzing socio-economic improvement of the targeted community and conservation of the forest. The primary information was generated through in-depth interviews along with group discussions with members, the management committee, and other relevant stakeholders. The findings reveal that there is a significant improvement in the regeneration of the forest and also changes in the socio-economic status of the local community. However, coordination with local municipalities and forest governing entities is still weak.

Keywords: community forest, socio-economic benefit, sustainable forest management, Nepal

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Authors: Tamara Jimah, Priscilla Kehoe, Pamela Pimentel, Amir Rahmani, Nikil Dutt, Yuqing Guo

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Ensuring equitable access to maternal health care is critical for public health. Particularly for underserved women, community health workers (CHWs) have been invaluable in providing support through health education and strategies for improved maternal self-care management. Our research aimed to assess the acceptance of technology by CHWs and perinatal women to promote healthy pregnancy and postpartum wellness. This pilot study was conducted at a local community organization in Orange County, California, where CHWs play an important role in supporting low-income women through home visitations. Questionnaires were administered to 14 CHWs and 114 pregnant and postpartum women, literate in English and/or Spanish. CHWs tested two wearable devices (Galaxy watch and Oura ring) and shared their user experience, including potential reception by the perinatal women they served. In addition, perinatal women provided information on access to a smart phone and the internet, as well as their interest in using wearable devices to self-monitor personal health with guidance from a CHW. Over 85% of CHWs agreed that it was useful to track pregnancy with the smart watch and ring. The majority of perinatal women owned a smartphone (97.4%), had access to the internet (80%) and unlimited data plans (78%), expressed interest in using the smart wearable devices to self-monitor health, and were open to receiving guidance from a CHW (87%). Community health workers and perinatal women embraced the use of wearable technology to monitor maternal health. These preliminary findings have formed the basis of an ongoing research study that integrates CHW guidance and technology (i.e., smart watch, smart ring, and a mobile phone app) to promote self-efficacy and self-management among underserved perinatal women.

Keywords: community health workers, health promotion and education, health equity, maternal and child health, technology

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Authors: Irfan Khan, Chiemeka David Ekene Arize, Hilly Swami

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Mental health care access and stigma present global challenges, with disparities significantly influenced by economic, cultural, and societal factors. This paper focuses on the mental health care systems of South Asia and the United States, comparing how cultural norms, infrastructure, and policy affect mental health care accessibility and effectiveness in both regions. In South Asia, mental health care is hindered by a combination of underfunding, a critical shortage of professionals, and deeply ingrained cultural stigmas that deter help-seeking. Traditional beliefs often link mental disorders to supernatural causes, and women face additional barriers due to gender disparities. Despite recent policy reforms, implementation remains a challenge, particularly in rural areas. In contrast, the U.S. has a more developed healthcare infrastructure but continues to grapple with stigma, particularly within professional settings like law enforcement. Interventions such as the use of community health workers (CHWs) and collaborative care models have improved access, especially among underserved populations. However, the U.S. still faces disparities in care for minority groups, where cultural competence and stigma reduction are critical for improving outcomes. The paper’s comparative analysis identifies transferable strategies from the U.S. that could be adapted to South Asia’s context, such as integrating mental health care into primary care and using digital interventions to bridge the treatment gap in rural areas. Additionally, South Asia's community-centered approaches offer insights that could enhance the cultural adaptability of interventions in the U.S., particularly for ethnic minorities and immigrant populations. Through a systematic review, this paper examines intervention strategies, stigma, policy support, and the cultural and social determinants of mental health in both regions. The findings emphasize the need for culturally tailored mental health interventions and policy reforms that promote access and reduce stigma. Recommendations include enhancing public awareness, integrating mental health services into primary care, expanding community-based programs, and leveraging digital health interventions. This research contributes to the global discourse on mental health by highlighting culturally sensitive approaches that can be adapted to improve mental health care access and outcomes in both South Asia and the United States.

Keywords: mental health stigma South Asia, mental health care accessibility South Asia, cultural influences mental health South Asia, mental health interventions USA, cross-cultural mental health care

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Authors: Jorge Urrutia-Mosquera, Luz Flórez-Calderón, Yasna Cortés

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We assessed the state of progress in terms of urban sustainability indicators and studied the impact of current land use conditions and the level of spatial accessibility to basic urban amenities on travel patterns and sustainable mobility in Santiago de Chile. We determined the spatial impact of urban facilities on sustainable travel patterns through the statistical analysis, data visualisation, and weighted regression models. The results show a need to diversify land use in more than 60% of the communes, although in 85% of the communes, accessibility to public spaces is guaranteed. The findings also suggest improving access to early education facilities, as only 26% of the communes meet the sustainability standard, negatively impacting travel in sustainable modes. It is also observed that the level of access to urban facilities generates spatial heterogeneity in the city, which negatively affects travel patterns in terms of time over 60 minutes and modes of travel in private vehicles. The results obtained allow us to identify opportunities for public policy intervention to promote and adopt sustainable mobility.

Keywords: land use, urban sustainability, travel patterns, spatial heterogeneity, GWR model, sustainable mobility

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Authors: S. Sarumathi, C. Deepadharani, Garimella Archana, S. Dakshayani, D. Logeshwaran, D. Jayakumar, Vijayarangan Natarajan

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The need of the hour for the customers who use a dial-up or a low broadband connection for their internet services is to access HD video data. This can be achieved by developing a new video format using H. 265. This is the latest video codec standard developed by ISO/IEC Moving Picture Experts Group (MPEG) and ITU-T Video Coding Experts Group (VCEG) on April 2013. This new standard for video compression has the potential to deliver higher performance than the earlier standards such as H. 264/AVC. In comparison with H. 264, HEVC offers a clearer, higher quality image at half the original bitrate. At this lower bitrate, it is possible to transmit high definition videos using low bandwidth. It doubles the data compression ratio supporting 8K Ultra HD and resolutions up to 8192×4320. In the proposed model, we design a new video format which supports this H. 265 standard. The major areas of applications in the coming future would lead to enhancements in the performance level of digital television like Tata Sky and Sun Direct, BluRay Discs, Mobile Video, Video Conferencing and Internet and Live Video streaming.

Keywords: access HD video, H. 265 video standard, high performance, high quality image, low bandwidth, new video format, video streaming applications

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Authors: Ayoub Kafyulilo, Petra Fisser, Joke Voogt

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This study was conducted to assess the continuation of the use of technology in science and mathematics teaching of the pre-service and in-service teachers who attended the professional development programme. It also assessed professional development, personal, institutional, and technological factors contributing to the continuous use of technology in teaching. The study involved 42 teachers, thirteen pre-service teachers, and twenty-nine in-service teachers. A mixed-method research approach was used to collect data for this study. Findings showed that the continuous use of technology in teaching after the termination of the professional development arrangement was high among the pre-service teachers, and differed for the in-service teachers. The regression model showed that knowledge and skills, access to technology and ease of use were strong predictors (R2 = 55.3%) of the teachers’ continuous use of technology after the professional development arrangement. The professional development factor did not have a direct effect on the continuous use of technology, rather had an influence on personal factors (knowledge and skills). In turn, the personal factors had influence on the institutional factors (access to technology) and technological factors (ease of use), which together had an effect on the teachers’ continuous use of technology in teaching.

Keywords: technology, professional development, teachers, science and mathematics

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Authors: Kristine Kalnica-Dorosenko, Aiga Svede

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Amblyopia or 'lazy eye' is impaired or dim vision without obvious defect or change in the eye. It is often associated with abnormal visual experience, most commonly strabismus, anisometropia or both, and form deprivation. The main task of amblyopia treatment is to ameliorate etiological factors to create a clear retinal image and, to ensure the participation of the amblyopic eye in the visual process. The treatment of amblyopia and eccentric fixation is usually associated with problems in the therapy. Eccentric fixation is present in around 44% of all patients with amblyopia and in 30% of patients with strabismic amblyopia. In Latvia, amblyopia is carefully treated in various clinics, but eccentricity diagnosis is relatively rare. Conflict which has developed relating to the relationship between the visual disorder and the degree of eccentric fixation in amblyopia should to be rethoughted, because it has an important bearing on the cause and treatment of amblyopia, and the role of the eccentric fixation in this case. Visuoscopy is the most frequently used method for determination of eccentric fixation. With traditional visuoscopy, a fixation target is projected onto the patient retina, and the examiner asks to look straight directly at the center of the target. An optometrist then observes the point on the macula used for fixation. This objective test provides clinicians with direct observation of the fixation point of the eye. It requires patients to voluntarily fixate the target and assumes the foveal reflex accurately demarcates the center of the foveal pit. In the end, by having a very simple method to evaluate fixation, it is possible to indirectly evaluate treatment improvement, as eccentric fixation is always associated with reduced visual acuity. So, one may expect that if eccentric fixation in amlyopic eye is found with visuoscopy, then visual acuity should be less than 1.0 (in decimal units). With occlusion or another amblyopia therapy, one would expect both visual acuity and fixation to improve simultaneously, that is fixation would become more central. Consequently, improvement in fixation pattern by treatment is an indirect measurement of improvement of visual acuity. Evaluation of eccentric fixation in the child may be helpful in identifying amblyopia in children prior to measurement of visual acuity. This is very important because the earlier amblyopia is diagnosed – the better the chance of improving visual acuity.

Keywords: amblyopia, eccentric fixation, visual acuity, visuoscopy

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Authors: Kim Quy Le, Duan Fei, Jia Wei Chew, Jun Zeng, Maria Fabiola Leyva

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In line with the sustainable development goal, molded fiber products play important roles in reducing plastic-based packaging. To fabricate molded fiber products, besides using conventional meshing tools, 3D printing is employed to manufacture the molded fiber screen. 3D printing technique allows printing molded fiber screens with complex geometry, flexible in pore size and shape. The 3D printed molded fiber screens are in the progress of investigation to improve the de-watering efficiency, fiber collection, mechanical strength, etc. In addition, the fiber distribution on the screen is also necessary to access the quality of the screen. Besides using experimental methods to capture the fiber distribution on screen, simulation also offers using tools to access the uniformity of fiber. In this study, the fiber was simulated using the multi-sphere model to simulate the fibers. The interaction of the fibers was able to mimic by employing the discrete element method. The fiber distribution was captured and compared to the experiment. The simulation results were able to reveal the fiber deposition layer upon layer and explain the formation of uneven thickness on the tilted area of molded fiber screen.

Keywords: 3D printing, multi-jet fusion, molded fiber screen, discrete element method

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Authors: Harshkumar K. Desai, Anuj K. Desai, Jay P. Patel, Snehal V. Trivedi, Yogendrasinh Parmar

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The need of continuous improvement in a product or process in this era of global competition leads to apply value engineering for functional and aesthetic improvement in consideration with economic aspect too. Solar industries located at G.I.D.C., Makarpura, Vadodara, Gujarat, India; a manufacturer of variety of CNC Machines had a challenge to analyze the structural design of column, base, carriage and table of CNC Milling Machine in the account of reduction of overall weight of a machine without affecting the rigidity and accuracy at the time of operation. The identified task is the first attempt to validate and optimize the proposed design of ribbed structure statically using advanced modeling and analysis tools in a systematic way. Results of stress and deformation obtained using analysis software are validated with theoretical analysis and found quite satisfactory. Such optimized results offer a weight reduction of the final assembly which is desired by manufacturers in favor of reduction of material cost, processing cost and handling cost finally.

Keywords: CNC milling machine, optimization, finite element analysis (FEA), weight reduction

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Authors: Umang H. Gajjar, K. M. Khambholja, R. K. Patel

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Semecarpus anacardium shows the presence of bioflavonoids, phenolic compounds, bhilawanols, minerals, vitamins and amino acids. Detoxified S. anacardium and its oils are considered to have anti-inflammatory properties and used in nervous debility, neuritis, rheumatism and leprous modules. S. anacardium if used without purification causes toxic skin inflammation problem because it contains toxic phenolic oil. During this Shodhana Process - An ayurvedic purification method, toxic phenolic oil was removed, have marked effect on the concentration of the phytoconstituent & antioxidant activity of S. anacardium. Total phenolic content decreased up to 70 % (from 28.9 %w/w to 8.94 %w/w), while there is a negligible effect on the concentration of total flavonoid (7.51 %w/w to 7.43 %w/w) and total carbohydrate (0.907 %w/w to 0.853 % w/w) content. IC50& EC50 value of extract of S. anacardium before and after purification are 171.7 & 314.3 while EC50values are 280.μg/ml & 304. μg/ml, shows that antioxidant activity of S. anacardium is decreased but the safety profile of the drug is increased as the toxic phenolic oil was removed during Shodhana - An ayurvedic purification method.

Keywords: Semecarpus anacardium, Shodhana process, safety profile, improvement

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Authors: H. Ashrafi, S. Ebrahimi, H. Kamalzadeh

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With the development of business competition, it is important for healthcare providers to improve their service qualities. In order to improve service quality of a clinic, four important dimensions are defined: tangibles, responsiveness, empathy, and reliability. Moreover, there are several service stages in hospitals such as financial screening and examination. One of the most challenging limitations for improving service quality is budget which impressively affects the service quality. In this paper, we present an approach to address budget uncertainty and provide guidelines for service resource allocation. In this paper, a service quality improvement approach is proposed which can be adopted to multistage service processes to improve service quality, while controlling the costs. A multi-objective function based on the importance of each area and dimension is defined to link operational variables to service quality dimensions. The results demonstrate that our approach is not ultra-conservative and it shows the actual condition very well. Moreover, it is shown that different strategies can affect the number of employees in different stages.

Keywords: allocation, budget uncertainty, healthcare resource, service quality assessment, robust optimization

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Authors: Ginés Hernández-Cánovas, Mª Camino Ramón-Llorens, Johanna Koëter-Kant

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This paper uses a survey data-set of 837 Spanish SMEs to analyze the association between borrower discouragement and prior firm´s strategic decisions, while controlling for firm and owner characteristics. While existing literature has neglected factors limiting the demand for resources by an overreliance on arguments which attempt to explain the existence of discouraged borrowers solely in terms of lack of access to supply of credit. The objective of this paper is to show that factors limiting the demand for resources and, therefore, reducing the availability of funds, can be traced back to the firm manager´s decision. Our hypothesis is that managers that undertake strategic decisions seeking growth or improvement in their business performance participate more in the banking market than those showing contentment with their current business situation. Our results shows that SMEs that undertake an active role in research and development activities and that achieve improvements in the operating performance of their business are less likely to be discouraged from applying for a loan. Who needs credit and who applies for credit is important for firms, prospective lenders and policymakers interested in the financial health of these firms. Credit constrained firms are less likely to invest in R&D and to introduce new products, possibly harming long-term economic growth. Knowing how important borrower discouragement is in Europe, is important for judging the priority which should be attached to government policies aimed at reducing its effects. For example, policy makers could encourage the transparency about credit eligibility and conditions in order to reduce discouragement.

Keywords: discouragement, financial constraints, SMEs financing

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Authors: Shyamlal Kumawat

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Cloud computing is shifting the approach IT capital are utilized. Cloud computing dynamically delivers convenient, on-demand access to shared pools of software resources, platform and hardware as a service through internet. The cloud computing model—made promising by sophisticated automation, provisioning and virtualization technologies. Users want the ability to access these services including infrastructure resources, how and when they choose. To accommodate this shift in the consumption model technology has to deal with the security, compatibility and trust issues associated with delivering that convenience to application business owners, developers and users. Absent of these issues, trust has attracted extensive attention in Cloud computing as a solution to enhance the security. This paper proposes a trusted computing technology through Standard Resource parameter Based Trust Model in Cloud Computing to select the appropriate cloud service providers. The direct trust of cloud entities is computed on basis of the interaction evidences in past and sustained on its present performances. Various SLA parameters between consumer and provider are considered in trust computation and compliance process. The simulations are performed using CloudSim framework and experimental results show that the proposed model is effective and extensible.

Keywords: cloud, Iaas, Saas, Paas

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Authors: Alvaro Quino, Roger Trejo, Gary Duran, Jordy Viso

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This article presents a study on the lightening and improvement of properties of soil extracted in the province of Talara in the department of Piura -Peru, to be used in filling in the construction of embankments for roads. This soft soil has a high percentage of elastic settlement and consolidation settlement. Currently, there are different methods that seek to mitigate the impact of this problem, which have achieved favorable results. As a contribution to these investigations, we propose the use of two lightening materials to be used in the filling of embankments; these materials are expanded polystyrene beads (EPS) and rice husk ash (RHA). Favorable results were obtained, such as a reduction of 14.34% of the volumetric weight, so the settlement will be reduced. In addition, it is observed that as the RHA dosage increases, the shear resistance increases. In this article, soil mechanics tests were performed to determine the effectiveness of this method in lightening and improving properties for the soil under study.

Keywords: sandy clay soils, rice husk ash, expanded polystyrene, soft soils

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Authors: Liudmila Garzanova, Lidia Ananyeva, Olga Koneva, Olga Ovsyannikova, Oxana Desinova, Mayya Starovoytova, Rushana Shayahmetova, Anna Khelkovskaya-Sergeeva

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Objectives. There is very few data on changes of the musculoskeletal manifestations (artritis, arthralgia, muscle weakness, etc.) in systemic sclerosis (SSc) on rituximab (RTX) therapy. The aim of our study was to assess the severity of the musculoskeletal involvement in SSc patients (pts) and its changes during RTX therapy. Methods. Our study included 103 pts with SSc. The mean followup period was 12.6±10.7 months. The mean age was 47±12.9 years, female-87 pts (84%), the diffuse cutaneous subset of the disease had 55 pts (53%). The mean disease duration was 6.2±5.5 years. All pts had interstitial lung disease (ILD) and were positive for ANA, 67% of them were positive for antitopoisomerase-1. All patients received prednisolone at a dose of 11.3±4.5 mg/day, immunosuppressants at inclusion received 47% of them. Pts received RTX due to the ineffectiveness of previous therapy for ILD. The cumulative mean dose of RTX was 1.7±0.6 grams. Arthritis was observed in 22 pts (21%), arthralgias in 47 pts (46%). Muscle weakness was observed in 17 pts (17%). Tendon friction rubs was established in 7 pts (7%). The results at baseline and at the end of the follow up are presented in the form of mean values. Results. There was an improvement of all outcome parameters and musculoskeletal manifestations on RTX therapy. There was a decrease in the number of pts with arthritis from 22 (21%) to 10 (9%), a decrease in the number of pts with arthralgias from 47 (46%) to 31 (30%). The number of pts with muscle weakness decreased from 17 (17%) to 7 (7%). The number of pts with tendon friction rubs decreased from 7 (7%) to 3 (3%). The creatine phosphokinase decreased from 365.5±186 to 70.8±50.4 (p=0.00006). The C-reactive protein (CRP) decreased from 23.2±31.3 to 8.62±7.4 (p=0.001). The dose of prednisolone was reduced from 11.3±4.5 to 9.8±3.5 mg/day (p=0.0004). Conclusion. In our study, musculoskeletal involvement was detected in almost half of the patients with SSc-ILD. There was an improvement of musculoskeletal manifestations despite a small cumulative dose of RTX. We also managed to reduce the dose of glucocorticosteroids. The improvement of musculoskeletal manifestations was accompanied by a decrease in laboratory parameters - creatine phosphokinase and CRP. RTX is effective option for treatment of musculoskeletal manifestations in SSc.

Keywords: arthritis, musculoskeletal involvement, systemic sclerosis, rituximab

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Authors: Mario Robinson, Moe Rabea

Abstract:

This research examines the effects of heat treatment processes on the mechanical properties and corrosion resistanceof1045 and 4140 Steel Alloysfor industrial applications. Heat treatment processes of full annealing, normalizing, quenching, and tempering are carried out on the alloy samples. The mechanical and corrosion resistance tests of the heat treated samples are carried out, and the results obtained are related to their SEMmorphologies analysis. The results show that the heat treatment processes have an effect on the tensile strength, impact, and a significant effect on the corrosion resistance of the alloy samples. With respect to the strain characteristics, significant improvement in the ductility of the samples is recorded in the full annealing and alloy tempered samples. Thus, for application requiring strength and ductility, such as in aerospace industries, this tempered heat treated alloy could be used. In addition, the quenched sample shows a significant improvement in hardness.

Keywords: heat treatment, corrosion resistance, steel, industrial appilcations

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Authors: Ntandoyenkosi Moyo

Abstract:

Majority of rural Eastern Cape villages of South Africa households do not have access to safe water supply. Due to changes in climatic conditions for example higher temperatures, these sources become not reliable in supplying adequate and safe water to the population. These rural populations due to the drying up of water resources have to find other alternative ways to get water. Climate change has an impact on the reliability of water resources and this has an impact on rural communities. This study seeks to establish what alternative ways do people use when affected by unfavorable conditions like less rainfall and increased temperatures. The study also seeks to investigate any local and provincial intervention in the provision of water to the village. Interventions can be in the form of programmes or initiatives that involve water supply strategies. The community should participate fully in making sure that their place is serviced. The study will identify households with improved sources (JOJO tanks) and those with unimproved sources (rivers) and investigate what alternatives they resort to when their sources dry up. The study also investigates community views on whether they have any challenges of water supply (reliability and adequacy) as required by section 27(1) (b) of the constitution which states that everyone should have access to safe and clean water.

Keywords: rural water resources, temperature, improved sources, unimproved sources

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Authors: Jiri F. Urbanek, Jiri Barta, Oldrich Svoboda, Jiri J. Urbanek

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The organizations of European and Czech critical infrastructure have specific position, mission, characteristics and behaviour in European Union and Czech state/ business environments, regarding specific requirements for regional and global security environments. They must respect policy of national security and global rules, requirements and standards in all their inherent and outer processes of supply-customer chains and networks. A controlling is generalized capability to have control over situational policy. This paper aims and purposes are to introduce the controlling as quite new necessary process attribute providing for critical infrastructure is environment the capability and profit to achieve its commitment regarding to the effectiveness of the quality management system in meeting customer/ user requirements and also the continual improvement of critical infrastructure organization’s processes overall performance and efficiency, as well as its societal security via continual planning improvement via DYVELOP modelling.

Keywords: added value, DYVELOP, controlling, environments, process approach

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Authors: Pornwipa Daoduong, Jairak Loysongkroa, Napaphan Viriyautsahakul, Wachira Pengjuntr

Abstract:

Obesity is on of serious health problem in many countries including Thailand where the prevalence of childhood obesity has increased from 8.8 % in 2014 to 9.5 % in 2015 and 12.9 % in 2016. The Ministry of Public Health’s objective is to reduce prevalence of childhood Obesity to 10% or lower in 2017, by implementing the measure in relation to nutrition, physical activity (PA) and environment in 6,405 targeted school with proportion of school children with obesity is higher than 10 %. Smart Kids Coacher (SKC)” is a new innovative intervention created by Department of Health and consists of 252 regional and provincial officers. The SKC aims to train the super trainers about food and nutrition.PA and emotional control through implementing three learning activities including 1) Food for Fun is about Nutrition flag, Nutrition label, food portion and Nutrition surveillance; 2) Fun for Fit includes intermediated- and advanced level workouts within 60 minutes such as kangaroo dance, Chair stretching; and 3) Control emotional is about to prevent probability of access to unhealthy food, to ensure for having meal in appropriate time, and to recruit peers and family member to increase awareness among target groups. Apart from providing SKC lesson for 3,828 officers at district level, a number of students (2,176) as role model are selected through implementing “Smart Kids Leader: (SKL)”.Consequently. The SKC lowers proportion of childhood obesity from 17% in 2012 to 12.9% in 2016. Further, the SKC coverage should be expanded to other setting. Policy maker should be aware of the important of reduction of the prevalence of childhood obesity, and it’s related risk. Network and Collaboration between stakeholders are essential as well as an improvement of holistic intervention and knowledge “NuPETHS” for kids in the future.

Keywords: childhood obesity, model, obesity, smart kids coacher

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Authors: Mathieu Audet, Monica Soliman, Emilie Eve Gravel, Rebecca Friesdorf

Abstract:

Access to higher education is critical for reducing social inequalities. The Canada Learning Bond (CLB) is a government savings incentive aimed at increasing higher education access for children of low income families by providing money toward a Registered Education Savings Plan. To better understand the educational and financial decision-making of low income families, Employment Social Development Canada conducted qualitative fieldwork with eligible parents and children, teachers, and community organizations promoting the Bond. Insights from this fieldwork were then used to develop letters to better target the needs and experiences of eligible families. In the present study, we conducted a randomized controlled trial with children ages 12 to 13, the oldest cohort of eligible children, to test the effectiveness of the new letters. Parents or caregivers of 150,088 eligible children were assigned to one of five letter conditions promoting the Bond or to a control condition that did not receive a letter. The letter conditions were: (a) the standard letter from past outreach, (b) a letter presenting the exact amount the child was eligible to receive, enhancing the salience of benefits, (c) a letter with a social norm, (d) a letter with an image emphasizing the feasibility of higher education by presenting the diversity of options (i.e., college, trade schools, apprenticeships) – many participants interviewed viewed that university was unfeasible, and (e) a letter minimizing references to 'saving' (i.e., not framing the Bond explicitly as a savings incentive) – a concept that did not resonate with low income families who felt they could not afford to save. The exact amount was also presented in letters (c) through (e). The letter minimizing references to 'saving' and presenting the exact amount had the highest net take-up rate at 6.6%, compared to 3.5% for the standard letter group. Furthermore, this trial’s BI-informed letters showed the largest impact on take-up so far, with a net take-up of 5.7% compared to 3.0% and 3.9% in the first two trials. This research highlights the value of mixed-method approaches combining qualitative and behavioural insights methods for developing context-sensitive interventions for social programs. By gaining a deeper understanding of the needs and experiences of program users through qualitative fieldwork, and then integrating these insights into behaviourally informed communications, we were able to increase take-up of an education savings program, which may ultimately improve access to higher education in children of low income families.

Keywords: access to higher education, behavioral insights, government, innovation, mixed-methods, social programs

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Authors: Faeze omid, Morteza Banakar

Abstract:

Background: The COVID-19 pandemic has had a significant impact on global health and healthcare systems, including oral health. The lockdown measures implemented in many countries have led to changes in oral health behaviors, access to dental care, and the delivery of dental services. However, the extent of these changes and their effects on oral health outcomes remains unclear. This systematic review aims to synthesize the available evidence on the state of oral health after the COVID-19 lockdown. Methods: We conducted a systematic search of electronic databases (PubMed, Embase, Scopus, and Web of Science) and grey literature sources for studies reporting on oral health outcomes after the COVID-19 lockdown. We included studies published in English between January 2020 and March 2023. Two reviewers independently screened the titles, abstracts, and full texts of potentially relevant articles and extracted data from included studies. We used a narrative synthesis approach to summarize the findings. Results: Our search identified 23 studies from 12 countries, including cross-sectional surveys, cohort studies, and case reports. The studies reported on changes in oral health behaviors, access to dental care, and the prevalence and severity of dental conditions after the COVID-19 lockdown. Overall, the evidence suggests that the lockdown measures had a negative impact on oral health outcomes, particularly among vulnerable populations. There were decreases in dental attendance, increases in dental anxiety and fear, and changes in oral hygiene practices. Furthermore, there were increases in the incidence and severity of dental conditions, such as dental caries and periodontal disease, and delays in the diagnosis and treatment of oral cancers. Conclusion: The COVID-19 pandemic and associated lockdown measures have had significant effects on oral health outcomes, with negative impacts on oral health behaviors, access to care, and the prevalence and severity of dental conditions. These findings highlight the need for continued monitoring and interventions to address the long-term effects of the pandemic on oral health.

Keywords: COVID-19, oral health, systematic review, dental public health

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Authors: Johana Jaramillo, Robin Kalfat, Dmitriy A. Dikin

Abstract:

The cement production process is one of the major sources of carbon dioxide (CO₂), a potent greenhouse gas. Indeed, as a result of its cement manufacturing process, concrete contributes approximately 8% of global greenhouse gas emissions. In addition to environmental concerns, concrete also has a low tensile and ductility strength, which can lead to cracks. Graphene nanoplatelets (GNPs) have proven to be an eco-friendly solution for improving the mechanical and durability properties of concrete. The current research investigates the effects of preparing concrete enhanced with GNPs by using different wet dispersions techniques and mixing methods on its mechanical properties. Concrete specimens were prepared with 0.00 wt%, 0.10 wt%, 0.20 wt%, 0.30 wt% and wt% GNPs. Compressive and flexural strength of concrete at age 7 days were determined. The results showed that the maximum improvement in mechanical properties was observed when GNPs content was 0.20 wt%. The compressive and flexural were improved by up to 17.5% and 8.6%, respectively. When GNP dispersions were prepared by the combination of a drill and an ultrasonic probe, mechanical properties experienced maximum improvement.

Keywords: concrete, dispersion techniques, graphene nanoplatelets, mechanical properties, mixing methods

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