Search results for: geological setting

Authors: Lucie Litvack, Malaz Elsaddig, Kevin Jones

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There is strong evidence to support the efficacy of the World Health Organization (WHO) Surgical Safety Checklist in improving patient safety; however, its use can be associated with difficulties. This study uses qualitative data collected in Kitovu Healthcare Complex, a rural Ugandan hospital, to identify factors that may influence the use of the checklist in a low-income setting. Potential barriers to and motivators for the hospital’s use of this checklist are identified and explored through observations of current patient safety practices; semi-structured interviews with theatre staff; a focus group with doctors; and trial implementation of the checklist. Barriers identified include the institutional context; knowledge and understanding; patient safety culture; resources and checklist contents. Motivators for correct use include prior knowledge; team attitudes; and a hospital advocate. Challenges are complex and unique to this socioeconomic context. Stepwise change to improve patient safety practices, local champions, whole team training, and checklist modification may assist the implementation and sustainable use of the checklist in an effective way.

Keywords: anaesthesia, patient safety, Uganda, WHO surgical safety checklist

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Authors: M. Trousselard, D. Steiler, C. Drogou, P. van-Beers, G. Lamour, S. N. Crosnier, O. Bouilland, P. Dubost, M. Chennaoui, D. Léger

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According to published data, undersea navigation for long periods (nuclear-powered ballistic missile submarine, SSBN) constitutes an extreme environment in which crews are subjected to multiple stresses, including the absence of natural light, illuminance below 1,000 lux, and watch schedules that do not respect natural chronobiological rhythms, for a period of 60-80 days. These stresses seem clearly detrimental to the submariners’ sleep, with consequences for their affective (seasonal affective disorder-like) and cognitive functioning. In the long term, there are abundant publications regarding the consequences of sleep disruption for the occurrence of organic cardiovascular, metabolic, immunological or malignant diseases. It seems essential to propose countermeasures for the duration of the patrol in order to reduce the negative physiological effects on the sleep and mood of submariners. Light therapy, the preferred treatment for dysfunctions of the internal biological clock and the resulting seasonal depression, cannot be used without data to assist knowledge of submariners’ chronobiology (melatonin secretion curve) during patrols, given the unusual characteristics of their working environment. These data are not available in the literature. The aim of this project was to assess, in the course of two studies, the benefits of two environmental techniques for managing chronobiological stress: techniques for optimizing potential (TOP; study 1)3, an existing programme to help in the psychophysiological regulation of stress and sleep in the armed forces, and dawn and dusk simulators (DDS, study 2). For each experiment, psychological, physiological (sleep) or biological (melatonin secretion) data were collected on D20 and D50 of patrol. In the first experiment, we studied sleep and depressive distress in 19 submariners in an operational setting on board an SSBM during a first patrol, and assessed the impact of TOP on the quality of sleep and depressive distress in these same submariners over the course of a second patrol. The submariners were trained in TOP between the two patrols for a 2-month period, at a rate of 1 h of training per week, and assigned daily informal exercises. Results show moderate disruptions in sleep pattern and duration associated with the intensity of depressive distress. The use of TOP during the following patrol improved sleep and depressive mood only in submariners who regularly practiced the techniques. In light of these limited benefits, we assessed, in a second experiment, the benefits of DDS on chronobiology (daily secretion of melatonin) and depressive distress. Ninety submariners were randomly allocated to two groups, group 1 using DDS daily, and group 2 constituting the control group. Although the placebo effect was not controlled, results showed a beneficial effect on chronobiology and depressive mood for submariners with a morning chronotype. Conclusions: These findings demonstrate the difficulty of practicing the tools of psychophysiological management in real life. They raise the question of the subjects’ autonomy with respect to using aids that involve regular practice. It seems important to study autonomy in future studies, as a cognitive resource resulting from the interaction between internal positive resources and “coping” resources, to gain a better understanding of compliance problems.

Keywords: chronobiology, light therapy, seasonal affective disorder, sleep, stress, stress management, submarine

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Authors: Sreejith Gopinath, Aspen Olmsted

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This paper is based on our previous work that proposed a risk-transference-based architecture for healthcare systems to store sensitive data outside the system boundary, rendering the system unattractive to would-be bad actors. This architecture also allows a compromised system to be abandoned and a new system instance spun up in place to ensure business continuity without paying a ransom or engaging with a bad actor. This paper delves into the details of various attacks we simulated against the prototype system. In the paper, we discuss at length the time and computational costs associated with storing and retrieving data in the prototype system, abandoning a compromised system, and setting up a new instance with existing data. Lastly, we simulate some analytical workloads over the data stored in our specialized data storage system and discuss the time and computational costs associated with running analytics over data in a specialized storage system outside the system boundary. In summary, this paper discusses the total costs of data storage, access, and analytics incurred with the proposed architecture.

Keywords: cybersecurity, healthcare, ransomware, resilience, risk transference

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Authors: Javed Khan, Aamir Saeed Malik, Nidal Kamel, Sarat Chandra Dass, Azura Mohd Affandi

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Low contrast images can result from the wrong setting of image acquisition or poor illumination conditions. Such images may not be visually appealing and can be difficult for feature extraction. Contrast enhancement of color images can be useful in medical area for visual inspection. In this paper, a new technique is proposed to improve the contrast of color images. The RGB (red, green, blue) color image is transformed into normalized RGB color space. Adaptive histogram equalization technique is applied to each of the three channels of normalized RGB color space. The corresponding channels in the original image (low contrast) and that of contrast enhanced image with adaptive histogram equalization (AHE) are morphed together in proper proportions. The proposed technique is tested on seventy color images of acne patients. The results of the proposed technique are analyzed using cumulative variance and contrast improvement factor measures. The results are also compared with decorrelation stretch. Both subjective and quantitative analysis demonstrates that the proposed techniques outperform the other techniques.

Keywords: contrast enhacement, normalized RGB, adaptive histogram equalization, cumulative variance.

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Authors: Lee Bih Ni, Kiu Su Na

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This paper discusses the Chinese Language Teaching as a Second Language by focusing on Immersion Teaching. Researchers used narrative literature review to describe the current states of both art and science in focused areas of inquiry. Immersion teaching comes with a standard that teachers must reliably meet. Chinese language-immersion instruction consists of language and content lessons, including functional usage of the language, academic language, authentic language, and correct Chinese sociocultural language. Researchers used narrative literature reviews to build a scientific knowledge base. Researchers collected all the important points of discussion, and put them here with reference to the specific field where this paper is originally based on. The findings show that Chinese Language in immersion teaching is not like standard foreign language classroom; immersion setting provides more opportunities to teach students colloquial language than academic. Immersion techniques also introduce a language’s cultural and social contexts in a meaningful and memorable way. It is particularly important that immersion teachers connect classwork with real-life experiences. Immersion also includes more elements of discovery and inquiry based learning than do other kinds of instructional practices. Students are always and consistently interpreted the conclusions and context clues.

Keywords: a second language, Chinese language teaching, immersion teaching, instructional strategies

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Authors: Dave Kenneth Tayao Cayado, Carlo P. Magno, Venice Cristine Dangaran

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The present study determines whether there will be differences in the self-regulation dispositions that learners utilize when writing different types of composition. There were 7 self-regulation factors that were used to develop a scale in this study such as memory strategy, goal setting, self-evaluation, seeking assistance, learning responsibility, environmental structuring, and organizing. The scale was made specific for writing a composition. The researcher-made scale was administered to 150 participants who all came from a university in the Philippines. The participants were asked to write two compositions namely opinion essay and research introduction/review of related literature. The zero-order correlation revealed that all the factors of self-regulation are correlated with one another. However, only seeking assistance and self-evaluation are correlated with opinion essay and technical writing is not correlated to any of the self-regulation factors. However, when path analysis was used, it was shown that seeking assistance can predict opinion essay scores whereas memory strategy, self-evaluation, and organizing can predict technical writing scores.

Keywords: opinion essay, self-regulation, technical writing, writing skills

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Authors: Ciaran Friel, Jerry Suls, Patrick Robles, Frank Vicari, Joan Duer-Hefele, Karina W. Davidson

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Physical activity guidelines focus on increasing moderate intensity activity for older adults, but adherence to recommendations remains low. This is despite the fact that scientific evidence supports that any increase in physical activity is positively correlated with health benefits. Behavior change techniques (BCTs) have demonstrated effectiveness in reducing sedentary behavior and promoting physical activity. This pilot study uses a Personalized Trials (N-of-1) design to evaluate the efficacy of using four BCTs to promote an increase in low-intensity physical activity (2,000 steps of walking per day) in adults aged 45-75 years old. The 4 BCTs tested were goal setting, action planning, feedback, and self-monitoring. BCTs were tested in random order and delivered by text message prompts requiring participant response. The study recruited health system employees in the target age range, without mobility restrictions and demonstrating interest in increasing their daily activity by a minimum of 2,000 steps per day for a minimum of five days per week. Participants were sent a Fitbit Charge 4 fitness tracker with an established study account and password. Participants were recommended to wear the Fitbit device 24/7, but were required to wear it for a minimum of ten hours per day. Baseline physical activity was measured by the Fitbit for two weeks. Participants then engaged with a clinical research coordinator to review comprehension of the text message content and required actions for each of the BCTs to be tested. Participants then selected a consistent daily time in which they would receive their text message prompt. In the 8 week intervention phase of the study, participants received each of the four BCTs, in random order, for a two week period. Text message prompts were delivered daily at a time selected by the participant. All prompts required an interactive response from participants and may have included recording their detailed plan for walking or daily step goal (action planning, goal setting). Additionally, participants may have been directed to a study dashboard to view their step counts or compare themselves with peers (self-monitoring, feedback). At the end of each two week testing interval, participants were asked to complete the Self-Efficacy for Walking Scale (SEW_Dur), a validated measure that assesses the participant’s confidence in walking incremental distances and a survey measuring their satisfaction with the individual BCT that they tested. At the end of their trial, participants received a personalized summary of their step data in response to each individual BCT. Analysis will examine the novel individual-level heterogeneity of treatment effect made possible by N-of-1 design, and pool results across participants to efficiently estimate the overall efficacy of the selected behavioral change techniques in increasing low-intensity walking by 2,000 steps, 5 days per week. Self-efficacy will be explored as the likely mechanism of action prompting behavior change. This study will inform the providers and demonstrate the feasibility of N-of-1 study design to effectively promote physical activity as a component of healthy aging.

Keywords: aging, exercise, habit, walking

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Authors: Emad Amar, Tawfik Khattab, Fatma Zada

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Predicting earthquakes is an important issue in the study of geography. Accurate prediction of earthquakes can help people to take effective measures to minimize the loss of personal and economic damage, such as large casualties, destruction of buildings and broken of traffic, occurred within a few seconds. United States Geological Survey (USGS) science organization provides reliable scientific information of Earthquake Existed throughout history & Preliminary database from the National Center Earthquake Information (NEIC) show some useful factors to predict an earthquake in a seismic area like Aleutian Arc in the U.S. state of Alaska. The main advantage of this prediction method that it does not require any assumption, it makes prediction according to the future evolution of object's time series. The article compares between simulation data result from trained BP and RBF neural network versus actual output result from the system calculations. Therefore, this article focuses on analysis of data relating to real earthquakes. Evaluation results show better accuracy and higher speed by using radial basis functions (RBF) neural network.

Keywords: BP neural network, prediction, RBF neural network, earthquake

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Authors: Hafez Abdo, Rob Ackrill

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Renewable energy (RE) promotion in the UK relies on multiple policy instruments, which are required to overcome the path dependency pressures favouring fossil fuels. These instruments include targeted funding schemes and economy-wide instruments embedded in the tax code. The resulting complexity of incentives raises important questions around the coherence and effectiveness of these instruments for RE generation. This complexity is exacerbated by UK RE policy being nested within EU policy in a multi-level governance (MLG) setting. To gain analytical traction on such complexity, this study will analyse policies promoting the on-farm generation of energy for heat and power, from farm and food waste, via anaerobic digestion. Utilising both primary and secondary data, it seeks to address a particular lacuna in the academic literature. Via a localised, in-depth investigation into the complexity of policy instruments promoting RE, this study will help our theoretical understanding of the challenges that MLG and path dependency pressures present to policymakers of multi-dimensional policies.

Keywords: anaerobic digestion, energy, green, policy, renewable, tax, UK

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Authors: Mohammad Reza Esmaili

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After the occurrence of blackouts, the most important subject is how fast the electric service is restored. Power system restoration is an immensely complex issue and there should be a plan to be executed within the shortest time period. This plan has three main stages of black start, network reconfiguration and load restoration. In the black start stage, operators and experts may face several problems, for instance, the unsuccessful connection of the long high-voltage transmission line connected to the electrical source. In this situation, the generator may be tripped because of the unsuitable setting of its line charging mode or high absorbed reactive power. In order to solve this problem, the line charging process is defined as a nonlinear programming problem, and it is optimized by using GAMS software in this paper. The optimized process is performed on a grid that includes a 250 MW hydroelectric unit and a 400 KV transmission system. Simulations and field test results show the effectiveness of optimal planning.

Keywords: power system restoration, black start, line charging mode, nonlinear programming

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Authors: K. C. Surekha

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The natural habitat forms the setting for every urban development. The tangible and intangible characteristics of the site contributed to the sustenance of various urban dimensions of early civilizations. However, as the towns were continuously evolving and developing, the attitude towards the natural habitat changed. The after effects of this self-centered attitude resulted in various natural and manmade catastrophes. At the same time the social habitat, cities and new towns were increasingly over-populated; and will become even more numerous and crowded in the future. The coexistence of natural and urban components is necessary for a sustainable future and preserving the region’s unique features. Therefore, there is an urgent need to rethink actively on alternative development paradigms to achieve sustenance of all living forms on the planet in a more sustainable way. The main aim of this paper is to understand bioregionalism as an alternative development paradigm, its theory, concepts as well as the key aspects of bioregional planning. The paper will try to understand the concept of bioregionalism theoretically and take case studies. The critical interpretation of theory and analysis of case studies will be used to form a set of design parameters which can be physically implemented from an urban design and planning standpoint.

Keywords: bioregion, bioregionalism, holistic, sustainable

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Authors: Dewi Fatmaningrum, Ade Wiradnyani

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Background: Optimal feeding, include optimal micronutrient intake, becomes one of the ways to overcome the long-term consequences of undernutrition. Macronutrient and micronutrient intake were important for rapid growth and development of the children. Objectives: To assess macro and micronutrient intake of children aged 12-23 months old and nutrients inadequacy from intake of children aged 12-23 months old. Methods: This survey was a cross-sectional study, simple random sampling was performed to select respondents. Total sample of this study was 83 children aged 12-23 months old in Paseban Village, Senen Sub-district, Central Jakarta. The data was collected via interview and hemoglobin measurement of children. Results: The highest prevalence of inadequacy was iron intake (52.4%) compared to other micronutrients, 11.98% children had inadequate energy intake. There were 62.6% anemic children in the study area in which divided into anemic (37.3%) and severe anemic (25.3%). Conclusion: Micronutrient inadequacy occurred more frequently than macronutrient inadequacy in the study area. The higher the percentage of iron inadequacy gets, the higher the percentage of anemia among children is observed.

Keywords: micronutrient, macronutrient, children under five, urban setting

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Authors: Ahasanul Haque, Noor Hazilah Abd Manaf, Zohurul Anis, Tarekol Islam

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Sustainable community health (SCH) is an example of a new healthcare concept formed from applying the Maqasid al-Shariah principle to hospital management and delivery services. Because the idea is novel, it needs comprehensive and ongoing investigation to be improved. However, there is a lack of research on the necessity of developing sustainable community health (SCH), particularly its organizational structure. Furthermore, there is a misconception about the order of components in Maqasid al-Shariah, particularly in a hospital setting. Furthermore, the use of medicines and treatment by conventional recommendations to carry out the treatment by the Maqasid al Shariah. As such, this study focuses on the essential prerequisite for establishing a sustainable community health system based on Maqasid al-Shariah. This study discusses the use of Maqasid al-Shariah in administration and treatment. In this qualitative research approach, a literature search and interviews with specialists are conducted. The gathered data is examined using content analysis, emphasizing inductive and deductive reasoning. The research reveals that the Shariah Advisory Council and Shariah Critical Point are necessary for sustainable community health. In conclusion, by discussing the causes for each instance, this research adds to the creation of methods for determining the level of Maasid al-Shariah in-hospital care.

Keywords: empowering, sustainability, community health, maqasid al shariah, hospital and malaysia

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Authors: Georges F. Hatoum, Thomas H. Temple, Silvio Garcia, Xiaodong Wu

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Soft Tissue Sarcomas (STS) represent a diverse group of malignancies with heterogeneous clinical and pathological features. The treatment of extremity STS aims to achieve optimal local tumor control, improved survival, and preservation of limb function. The National Comprehensive Cancer Network guidelines, based on the cumulated clinical data, recommend radiation therapy (RT) in conjunction with limb-sparing surgery for large, high-grade STS measuring greater than 5 cm in size. Such treatment strategy can offer a cure for patients. However, when recurrence occurs (in nearly half of patients), the prognosis is poor, with a median survival of 12 to 15 months and with only palliative treatment options available. The spatially-fractionated-radiotherapy (SFRT), with a long history of treating bulky tumors as a non-mainstream technique, has gained new attention in recent years due to its unconventional therapeutic effects, such as bystander/abscopal effects. Combining single fraction of GRID, the original form of SFRT, with conventional RT was shown to have marginally increased the rate of pathological necrosis, which has been recognized to have a positive correlation to overall survival. In an effort to consistently increase the pathological necrosis rate over 90%, multiple fractions of Lattice RT (LRT), a newer form of 3D SFRT, interdigitated with the standard RT as neoadjuvant therapy was conducted in a preliminary clinical setting. With favorable results of over 95% of necrosis rate in a small cohort of patients, a Phase I/II clinical study was proposed to exam the safety and feasibility of this new strategy. Herein the design of the clinical study is presented. In this single-arm, two-stage phase I/II clinical trial, the primary objectives are >80% of the patients achieving >90% tumor necrosis and to evaluation the toxicity; the secondary objectives are to evaluate the local control, disease free survival and overall survival (OS), as well as the correlation between clinical response and the relevant biomarkers. The study plans to accrue patients over a span of two years. All patient will be treated with the new neoadjuvant RT regimen, in which one of every five fractions of conventional RT is replaced by a LRT fraction with vertices receiving dose ≥10Gy while keeping the tumor periphery at or close to 2 Gy per fraction. Surgical removal of the tumor is planned to occur 6 to 8 weeks following the completion of radiation therapy. The study will employ a Pocock-style early stopping boundary to ensure patient safety. The patients will be followed and monitored for a period of five years. Despite much effort, the rarity of the disease has resulted in limited novel therapeutic breakthroughs. Although a higher rate of treatment-induced tumor necrosis has been associated with improved OS, with the current techniques, only 20% of patients with large, high-grade tumors achieve a tumor necrosis rate exceeding 50%. If this new neoadjuvant strategy is proven effective, an appreciable improvement in clinical outcome without added toxicity can be anticipated. Due to the rarity of the disease, it is hoped that such study could be orchestrated in a multi-institutional setting.

Keywords: lattice RT, necrosis, SFRT, soft tissue sarcoma

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Authors: Manoja Rajalakshmi Aravindakshana, Devleena Ghosha, Chittaranjan Mandala, K. V. Venkateshb, Jit Sarkarc, Partha Chakrabartic, Sujay K. Maity

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Oral Glucose Tolerance Test (OGTT) is the primary test used to diagnose type 2 diabetes mellitus (T2DM) in a clinical setting. Analysis of OGTT data using the Oral Minimal Model (OMM) along with the rate of appearance of ingested glucose (Ra) is performed to study differences in model parameters for control and T2DM groups. The differentiation of parameters of the model gives insight into the behaviour and physiology of T2DM. The model is also studied to find parameter differences among obese and non-obese T2DM subjects and the sensitive parameters were co-related to the known physiological findings. Sensitivity analysis is performed to understand changes in parameter values with model output and to support the findings, appropriate statistical tests are done. This seems to be the first preliminary application of the OMM with obesity as a distinguishing factor in understanding T2DM from estimated parameters of insulin-glucose model and relating the statistical differences in parameters to diabetes pathophysiology.

Keywords: oral minimal model, OGTT, obese and non-obese T2DM, mathematical modeling, parameter estimation

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Authors: Motlatjo Ntatamala, Natasha Ravyse, Michael Laubsher

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As much as students are being assessed through reflective activities, it is important to examine and check if those very same activities really assist in influencing and shaping both their writing and critical thinking skills. The skills which students will acquire from the reflective activities will not only be beneficial for the present or immediate moment, but they will also carry them over to their 4th year of writing a mini dissertation and in future for those who would want to explore their post-graduate studies. Thus, the only way to source the reliable and raw feedback on whether students think the reflective activities help them think about their writing and critical thinking skills is to get a direct students’ perspective by analysing their submitted reflective activities. Writing a research proposal implies that critical thinking is a talent that will grow in a holistic manner, as evidenced by previous studies. However, no research has been conducted to investigate the impact of critical thinking on legal writing skills in the South African setting. This study seeks to examine the effectiveness of the reflective activities in 3rd years’ students’ writing and towards their critical thinking. The proposed paper aims to examine the effectiveness of the reflection activities as an encouragement and motivation to their both writing and thinking skills. The paper will make use of students’ activities as a means of data collection and the activities will thus be analysed.

Keywords: reflection activities, writing skills, critical thinking skills, reflective thinking

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Authors: Aaminah Hassan

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Advertisements carry a great potential to influence our lives because they are crafted to meet particular ends. Stereotypical representation in advertisements is capable of forming unconscious attitudes among people towards any gender and their abilities. This study focuses on gender representation in Pakistani prime time advertisements. For this purpose, 13 advertisements were selected from three different categories of foods and beverages, cosmetics, cell phones and cellular networks from the prime time slots of one of the leading Pakistani entertainment channel, ‘Urdu 1’. Both quantitative and qualitative analyses are carried out for range of variables like gender, age, roles, activities, setting, appearance and voice overs. The results revealed that gender representation in advertisements is stereotypical. Moreover, in few instances, the portrayal of women is not only culturally inappropriate but is demeaning to the image of women as well. Their bodily charm is used to promote products. Comparing different entertainment channels for their prime time advertisements and broadening the scope of this research will yield greater implications for the researchers who want to carry out the similar research. It is hoped that the current study would help in the promotion of media literacy among the viewers and media authorities in Pakistan.

Keywords: Advertisements, Content Analysis, Gender, Prime time

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Authors: Neil Singla, Derek Muse, Karen DiDonato, Pamela Palmer

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Introduction: Pain is the most common reason people visit emergency rooms. Studies indicate however, that Emergency Department (ED) physicians often do not provide adequate analgesia to their patients as a result of gender and age bias, opiophobia and insufficient knowledge of and formal training in acute pain management. Novel classes of analgesics have recently been introduced, but many patients suffer from acute pain in settings where the availability of intravenous (IV) access may be limited, so there remains a clinical need for rapid-acting, potent analgesics that do not require an invasive route of delivery. A sublingual sufentanil tablet (SST), dispensed using a single-dose applicator, is in development for treatment of moderate-to-severe acute pain in a medically-supervised setting. Objective: The primary objective of this study was to demonstrate the repeat-dose efficacy, safety and tolerability of sufentanil 20 mcg and 30 mcg sublingual tablets compared to placebo for the management of acute pain as determined by the time-weighted sum of pain intensity differences (SPID) to baseline over the 12-hour study period (SPID12). Key secondary efficacy variables included SPID over the first hour (SPID1), Total pain relief over the 12-hour study period (TOTPAR12), time to perceived pain relief (PR) and time to meaningful PR. Safety variables consisted of adverse events (AE), vital signs, oxygen saturation and early termination. Methods: In this Phase 2, double-blind, dose-finding study, an equal number of male and female patients were randomly assigned in a 2:2:1 ratio to SST 20 mcg, SS 30 mcg or placebo, respectively, following bunionectomy. Study drug was dosed as needed, but not more frequently than hourly. Rescue medication was available as needed. The primary endpoint was the Summed Pain Intensity Difference to baseline over 12h (SPIDI2). Safety was assessed by continuous oxygen saturation monitoring and adverse event reporting. Results: 101 patients (51 Male/50 Female) were randomized, 100 received study treatment (intent-to-treat [ITT] population), and 91 completed the study. Reasons for early discontinuation were lack of efficacy (6), adverse events (2) and drug-dosing error (1). Mean age was 42.5 years. For the ITT population, SST 30 mcg was superior to placebo (p=0.003) for the SPID12. SPID12 scores in the active groups were superior for both male (ANOVA overall p-value =0.038) and female (ANOVA overall p-value=0.005) patients. Statistically significant differences in favour of sublingual sufentanil were also observed between the SST 30mcg and placebo group for SPID1(p<0.001), TOTPAR12(p=0.002), time to perceived PR (p=0.023) and time to meaningful PR (p=0.010). Nausea, vomiting and somnolence were more frequent in the sufentanil groups but there were no significant differences between treatment arms for the proportion of patients who prematurely terminated due to AE or inadequate analgesia. Conclusions: Sufentanil tablets dispensed sublingually using a single-dose applicator is in development for treatment of patients with moderate-to-severe acute pain in a medically-supervised setting where immediate IV access is limited. When administered sublingually, sufentanil’s pharmacokinetic profile and non-invasive delivery makes it a useful alternative to IM or IV dosing.

Keywords: acute pain, pain management, sublingual, sufentanil

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Authors: Argyro-Maria Skourmalla

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Today’s reality is characterized by diversity in different levels and aspects of everyday life. Focusing on the aspect of language and communication in Higher Education (HE), the present paper draws on the example of the University of Luxembourg as a multilingual and international setting. The University of Luxembourg, which is located between France, Germany, and Belgium, adopted its new multilingualism policy in 2020, establishing English, French, German, and Luxembourgish as the official languages of the Institution. In addition, with around 10.000 students and staff coming from various countries around the world, linguistic diversity in this university is seen as both a resource and a challenge that calls for an inclusive and multilingual approach. The present paper includes data derived from semi-structured interviews with lecturing staff from different disciplines and an online survey with undergraduate students at the University of Luxembourg. Participants shared their experiences and point of view regarding linguistic diversity in this context. Findings show that linguistic diversity in this university is seen as an asset but comes with challenges, and even though there is progress in the use of multilingual practices, a lot needs to be done towards the recognition of staff and students’ linguistic repertoires for inclusion and education equity.

Keywords: linguistic diversity, higher education, Luxembourg, multilingual practices, teaching, learning

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Authors: Swarna Pundir, Prabuddha Hans

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As AI has already stepped into the daily life of human society, one cannot be ignorant about the data it collects and used it to provide a quality of services depending up on the individuals’ choices. It also helps in giving option for making decision Vs choice selection with a calculation based on the history of our search criteria. Over the past decade or so, the way Artificial Intelligence (AI) has impacted society is undoubtedly large.AI has changed the way we shop, the way we entertain and challenge ourselves, the way information is handled, and has automated some sections of our life. We have answered as to what AI is, but not why one may see it as useful. AI is useful because it is capable of learning and predicting outcomes, using Machine Learning (ML) and Deep Learning (DL) with the help of Artificial Neural Networks (ANN). AI can also be a system that can act like humans. One of the major impacts be Joblessness through automation via AI which is seen mostly in manufacturing sectors, especially in the routine manual and blue-collar occupations and those without a college degree. It raises some serious concerns about AI in regards of less employment, ethics in making moral decisions, Individuals privacy, human judgement’s, natural emotions, biased decisions, discrimination. So, the question is if an error occurs who will be responsible, or it will be just waved off as a “Machine Error”, with no one taking the responsibility of any wrongdoing, it is essential to form some rules for using the AI where both machines and humans are involved.

Keywords: AI, ML, DL, ANN

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Authors: Mehaiguene Madjid, Touhari Fadhila, Meddi Mohamed

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The Cheliff basin offers a good hydrological example for the possibility of studying the problem which elucidated in the future, because of the unclearity in several aspects and hydraulic installation. Thus, our study of the Cheliff basin is divided into two principal parts: The spatial evaluation of the precipitation: also, the understanding of the modes of the reconstitution of the resource in water supposes a good knowledge of the structuring of the precipitation fields in the studied space. In the goal of a good knowledge of revitalizes them in water and their management integrated one judged necessary to establish a precipitation card of the Cheliff basin for a good understanding of the evolution of the resource in water in the basin and that goes will serve as basis for all study of hydraulic planning in the Cheliff basin. Then, the establishment of the precipitation card of the Cheliff basin answered a direct need of setting to the disposition of the researchers for the region and a document of reference that will be completed therefore and actualized. The hydrological study, based on the statistical hydrometric data processing will lead us to specify the hydrological terms of the assessment hydrological and to clarify the fundamental aspects of the annual flow, seasonal, extreme and thus of their variability and resources surface water.

Keywords: hydrological assessment, surface water resources, Cheliff, Algeria

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Authors: Chico A. E. Hindarto

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Knowledge management practices are more contextual when they combine with the corporate culture. Each entity has a specific cultural climate that enables knowledge sharing in both functional and individual levels. The interactions between people within organization can be influenced by the culture and how the knowledge is transmitted. On the other hand, these interactions have impacts in culture modification as well. Storytelling is one of the methods in delivering the knowledge throughout the organization. This paper aims to explore the possibility in using a quasi-folklore in the family-based business. Folklore is defined as informal tradition culture that spreading through a word-of-mouth, without knowing the source of the story. In this paper, the quasi-folklore term is used to differentiate it with the original term of folklore. The story is created by somebody in the organization, not like the folklore with unknown source. However, the source is not disclosed, in order to avoid the predicted interest from the story origin. The setting of family-based business is deliberately chosen, since the kinship is considerably strong in this type of entity. Through a thorough literature review that relates to knowledge management, storytelling, and folklore, this paper determines how folklore can be an option for knowledge sharing within the organization.

Keywords: folklore, family business, organizational culture, knowledge management, storytelling

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Authors: Gamith Mendis

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Even though the doctors are knowledgeable, there's a gap between knowing and being ethical. This is a barrier to establish an ethical doctor-patient relationship. Current health system has oriented in a way that gives a meaning to both the doctor and the patient through intermediate entities. For the doctor, the meaning of the doctor-patient relationship is given through the financial benefits, promotions, and social status. For the patient, the meaning is given through curing of the disease. It is obvious that both are independent entities between the doctor and the patient. As the philosophers like Husserl and Heidegger have pointed out, our subjective world will give the immediate meaningfulness to us. We should seek this immediate meaningfulness of the doctor-patient relationship. The present research has used the existential methodology as guided self-reflections on the lived experiences of a doctor and his students. In this approach, two important aspects have been understood. The first is, establishing the fact that being ethical is itself giving meaningfulness to the doctor’s being without any mediate entities. Simply, it is enjoying being an honest being. The second is by being-with-the-patient while treating the disease; both the doctor and the patient can enjoy the meaningfulness of their human relationship. The medical students and the doctors should focus on this meaningfulness. For that, this discussion should be actively incorporated into the medical curriculum with programs of practical guidance to medical students and should be discussed in patient-care reviews in the health setting within a satisfactory framework.

Keywords: doctor-patient relationship, medical education, medical ethics, medical humanities, qualitative health research

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Authors: Syamimi Shamsuddin, Hanafiah Yussof, Fazah Akhtar Hanapiah, Salina Mohamed, Nur Farah Farhan Jamil, Farhana Wan Yunus

Abstract:

Robot-based intervention for children with autism is an evolving research niche in human-robot interaction (HRI). Recent studies in this area mostly covered the role of robots in the clinical and experimental setting. Our previous work had shown that interaction with a robot pose no adverse effects on the children. Also, the presence of the robot, together with specific modules of interaction was associated with less autistic behavior. Extending this impact on school-going children, interactions that are in-tune with special education lessons are needed. This methodological paper focuses on how a robot can be incorporated in a current learning environment for autistic children. Six interaction scenarios had been designed based on the existing syllabus to teach communication skills, using the Applied Behavior Analysis (ABA) technique as the framework. Development of the robotic experience in class also covers the required set-up involving participation from teachers. The actual research conduct involving autistic children, teachers and robot shall take place in the next phase.

Keywords: autism spectrum disorder, ASD, humanoid robot, communication skills, robot-assisted learning

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Authors: Valentina Zhang

Abstract:

While facial expression is a complex and individualized behavior, all facial emotion recognition (FER) systems known to us rely on a single facial representation and are trained on universal data. We conjecture that: (i) different facial representations can provide different, sometimes complementing views of emotions; (ii) when employed collectively in a discussion group setting, they enable more accurate emotion reading which is highly desirable in autism care and other applications context sensitive to errors. In this paper, we first study FER using pixel-based DL vs semantics-based DL in the context of deepfake videos. Our experiment indicates that while the semantics-trained model performs better with articulated facial feature changes, the pixel-trained model outperforms on subtle or rare facial expressions. Armed with these findings, we have constructed an adaptive FER system learning from both types of models for dyadic or small interacting groups and further leveraging the synthesized group emotions as the ground truth for individualized FER training. Using a collection of group conversation videos, we demonstrate that FER accuracy and personalization can benefit from such an approach.

Keywords: neurodivergence care, facial emotion recognition, deep learning, ground truth for supervised learning

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Authors: Rubaiat S. Ahmed, Jemer Garrido, Sergey M. Motov

Abstract:

Clinical informatics (CI) enables the transformation of data into a systematic organization that improves the quality of care and the generation of positive health outcomes.Innovative technology through informatics that compiles accurate data on analgesic utilization in the emergency department can enhance pain management in this important clinical setting. We aim to establish a simplified reporting system through CI to examine and assess the analgesic prescribing practices in the EDthrough executing a U.S. federal grant project on opioid reduction initiatives. Queried data points of interest from a level-one trauma ED’s electronic medical records were used to create data sets and develop informational/visual reporting dashboards (on Microsoft Excel and Google Sheets) concerning analgesic usage across several pre-defined parameters and performance metrics using CI. The data was then qualitatively analyzed to evaluate ED analgesic prescribing trends by departmental clinicians and leadership. During a 12-month reporting period (Dec. 1, 2020 – Nov. 30, 2021) for the ongoing project, about 41% of all ED patient visits (N = 91,747) were for pain conditions, of which 81.6% received analgesics in the ED and at discharge (D/C). Of those treated with analgesics, 24.3% received opioids compared to 75.7% receiving opioid alternatives in the ED and at D/C, including non-pharmacological modalities. Demographics showed among patients receiving analgesics, 56.7% were aged between 18-64, 51.8% were male, 51.7% were white, and 66.2% had government funded health insurance. Ninety-one percent of all opioids prescribed were in the ED, with intravenous (IV) morphine, IV fentanyl, and morphine sulfate immediate release (MSIR) tablets accounting for 88.0% of ED dispensed opioids. With 9.3% of all opioids prescribed at D/C, MSIR was dispensed 72.1% of the time. Hydrocodone, oxycodone, and tramadol usage to only 10-15% of the time, and hydromorphone at 0%. Of opioid alternatives, non-steroidal anti-inflammatory drugs were utilized 60.3% of the time, 23.5% with local anesthetics and ultrasound-guided nerve blocks, and 7.9% with acetaminophen as the primary non-opioid drug categories prescribed by ED providers. Non-pharmacological analgesia included virtual reality and other modalities. An average of 18.5 ED opioid orders and 1.9 opioid D/C prescriptions per 102.4 daily ED patient visits was observed for the period. Compared to other specialties within our institution, 2.0% of opioid D/C prescriptions are given by ED providers, compared to the national average of 4.8%. Opioid alternatives accounted for 69.7% and 30.3% usage, versus 90.7% and 9.3% for opioids in the ED and D/C, respectively.There is a pressing need for concise, relevant, and reliable clinical data on analgesic utilization for ED providers and leadership to evaluate prescribing practices and make data-driven decisions. Basic computer software can be used to create effective visual reporting dashboards with indicators that convey relevant and timely information in an easy-to-digest manner. We accurately examined our ED's analgesic prescribing practices using CI through dashboard reporting. Such reporting tools can quickly identify key performance indicators and prioritize data to enhance pain management and promote safe prescribing practices in the emergency setting.

Keywords: clinical informatics, dashboards, emergency department, health informatics, healthcare informatics, medical informatics, opioids, pain management, technology

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Authors: Chatarina Muryani, Sarwono, Sugiyanto Heribentus

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Major part of Grobogan District, Central Java Province, Indonesia, always suffers from drought every year. The drought has implications toward almost all of the community activities, both domestic, agriculture, livestock, and industrial. The aim of this study was to determine (1) the drought distribution area in Grobogan District in 2015; (2) the impact of drought; and (3) the community adaptation toward the drought. The subject of the research was people who were impacted by the drought, purposive sampling technique was used to draw the sample. The data collection method was using field observation and in-depth interview while the data analysis was using descriptive analysis. The results showed that (1) in 2015, there were 14 districts which were affected by the drought and only 5 districts which do not suffer from drought, (2) the drought impacted to the reduction of water for domestic compliance, reduction of agricultural production, reduction of public revenue, (3) community adaptation to meet domestic water need was by making collective deep-wells and building water storages, adaptation in agriculture was done by setting the cropping pattern, while adaptation on economics was by allocating certain amount of funds for the family in anticipation of drought, which was mostly to purchase water.

Keywords: adaptation, distribution, drought, impacts

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Authors: Iqra Khan, Ghousia Saeed, Salman Jamil

Abstract:

Fashion is the soul of styles. People of all times want to look trendy, eye catching and unique among all. For this reason, people always adopt different flairs in their outfits including their clothes, shoes, bags and other accessories. However, unfortunately, there is lack of opportunity for accommodating the fashion exposure activities expressed with the folk dances of different regions so as to exhibit the fashion of Pakistan to the world. The paper focuses on the vibrant setting of the whole building according to the social patterns, folk and local trends and existing environment of Lahore. This is done by studying each of the aspect obtained from objectives through research questions evolved from the objectives. The answers to these questions are found through case studies and the existing theories in the world in relevance to the topic. The paper finds out how the geometry of dance works with design principles to create transparent geometry of fashion building. This all creates the fiesta environment taken from the locality of the region from the local and cultural lifestyles of the locals and then assembling it together to create a full festivity experience throughout the building.

Keywords: fashion, folk dance, geometry, local trends, social patterns, transparent

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Authors: M. Akhlaque Ahmed, Maliha Afshan Siddiqui

Abstract:

A study has been carried out to see the prospect of wind power potential of southern Sindh namely Karachi, Hawksbay, Norriabad, Hyderabad, Ketibander and Shahbander using local wind speed data. The monthly average wind speed for these area ranges from 4.5m/sec to 8.5m/sec at 30m height from ground. Extractable wind power, wind energy and Weibul parameter for above mentioned areas have been examined. Furthermore, the power output using fast and slow wind machine using different blade diameter along with the 4Kw and 20 Kw aero-generator were examined to see the possible use for deep well pumping and electricity supply to remote villages. The analysis reveals that in this wind corridor of southern Sindh Hawksbay, Ketibander and Shahbander belongs to wind power class-3 Hyderabad and Nooriabad belongs to wind power class-5 and Karachi belongs to wind power class-2. The result shows that the that higher wind speed values occur between June till August. It was found that considering maximum wind speed location, Hawksbay,Noriabad are the best location for setting up wind machines for power generation.

Keywords: wind energy generation, Southern Sindh, seasonal change, Weibull parameter, wind machines

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Authors: Devam Sheth

Abstract:

Nuclear imaging with stress myocardial perfusion (stress test) is the preferred first line investigation for noninvasive evaluation of ischaemic heart condition. The sensitivity of this test is close to 90 % making it a very reliable test. However, rarely it gives a false negative result which can be explained by the phenomenon termed as “balanced ischaemia”. We present the case of a 78 year Caucasian female without any significant past cardiac history, who presents with chest pain and shortness of breath since one day. The initial ECG and cardiac enzymes were non-impressive. Few hours later, she had some substernal chest pain along with some ST segment depression in the lateral leads. Stress test comes back negative for any significant perfusion defects. However, given her typical symptoms, she underwent a cardiac catheterization which revealed significant triple vessel disease mandating her to get a bypass surgery. This unusual phenomenon of false nuclear stress test in the setting of positive ECG changes can be explained only by balanced ischemia wherein due to global myocardial ischemia, the stress test fails to reveal relative perfusion defects in the affected segments.

Keywords: balanced, false positive, ischemia, myocardial perfusion imaging

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