Search results for: medical technology

Authors: Kyung Min Kwom, Young Joo Lee

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Purpose: Up to 90% of pancreatic cancer patient suffer from neuropathic pain. In palliative care setting, pain control in a pancreatic cancer patient is one of the major goals. Ketamine is a NMDA receptor antagonist effective in neuropathic pain. Also, there have been studies about opioid sparing effect of ketamine. This study was held in palliative care unit among pancreatic cancer patients to find out the factors related to ketamine use and the opioid sparing effect. Methods: Medical records of pancreatic cancer patients admitted to St. Mary’s hospital palliative care unit from 2013.1 to 2014.12 were reviewed. Patients were divided into two categories according to ketamine use. Also, opioid use before and after ketamine use was compared in ketamine group. Results: Compared to non ketamine use group, patients in ketamine group required a higher dose of opioid. Total opioid dose, daily opioid dose, number of daily rescue medication, daily average rescue dose were statistically significantly higher in ketamine group. Opioid requirement was increased after ketamine administration. Conclusion: In this study, ketamine group required more opioid. Ketamine is frequently considered in patients with severe pain, requiring high amount of opioid. Also, ketamine did not have an opioid sparing effect. Future studies about palliative use of ketamine in a larger number of patients are required.

Keywords: ketamine, opioid sparing, palliative care, pancreatic cancer

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Authors: Rajashree Naik, Laxmi Kant Sharma

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Sambhar lake is the largest inland Salt Lake of India, declared as a Ramsar site on 23 March 1990. Due to high salinity and alkalinity condition its biodiversity richness is contributed by haloalkaliphilic flora and fauna along with the diverse land cover including waterbody, wetland, salt crust, saline soil, vegetation, scrub land and barren land which welcome large number of flamingos and other migratory birds for winter harboring. But with the gradual increase in the irrational salt extraction activities, the ecological diversity is at stake. There is an urgent need to assess the ecosystem. Advanced technology like remote sensing and GIS has enabled to look into the past, compare with the present for the future planning and management of the natural resources in a judicious way. This paper is a research work intended to present a vegetation in typical inland lake environment of Sambhar wetland using satellite data of NASA’s EO-1 Hyperion sensor launched in November 2000. With the spectral range of 0.4 to 2.5 micrometer at approximately 10nm spectral resolution with 242 bands 30m spatial resolution and 705km orbit was used to produce a vegetation map for a portion of the wetland. The vegetation map was tested for classification accuracy with a pre-existing detailed GIS wetland vegetation database. Though the accuracy varied greatly for different classes the algal communities were successfully identified which are the major sources of food for flamingo. The results from this study have practical implications for uses of spaceborne hyperspectral image data that are now becoming available. Practical limitations of using these satellite data for wetland vegetation mapping include inadequate spatial resolution, complexity of image processing procedures, and lack of stereo viewing.

Keywords: Algal community, NASA’s EO-1 Hyperion, salt-tolerant species, wetland vegetation mapping

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Authors: Sadeq Al Yaari, Fayza Alhammadi, Ayman Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Adham Al Yaari, Sajedah Al Yaari, Saleh Al Yami

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Background: A rapidly increasing number of studies that focus on the relationship between language and cortical (CD) and subcortical dementias (SCD) have recently shown that such correlation is existent. Mounting evidence suggests that cognitive impairments should be investigated against language disorders. Aims: This study aims at investigating how language is associated with dementia diseases namely CD &SCD in light of psychoneurolinguistic approach. Method: Data from multiple sources (e.g., theses, dissertations, articles, research, medical records, direct testing, staff reports, and client observations) have been integrated to provide a detailed analysis of the relationship between language and CD&SCD. The researchers identified over 20 most of dementia types, and described them. Having collected and described data, the researchers then analyzed these data independently to see to what extent CD&SCD are involved in matters concerning language. Results: Results of the present study demonstrate that language and CD&SCD are undoubtedly correlated with each other. The loss of the ability of some organs to perform certain functions (due to any of the dementia diseases) results in no way to the loss of some language aspects and /or speech skills. In clearer terms, it is rare to find a patient with dementia who is not suffering from partial or complete linguistic difficulties. Many deficits run through the current interpretation of linguistic disorders: language disorders, speech disorders, articulation disorders, or voice disorders.

Keywords: cortical dementia, subcortical dementia, diseases, psychoneurolinguistics, language, impairments, relationship

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Authors: Rafael Ricieri, Rogerio Barros

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Objective: This study is to report a case of massive necrotizing enterocolitis in a six-month-old patient, requiring ileostomy and protective jejunostomy as a damage control measure in the first exploratory laparotomy surgery in massive enterocolitis without a previous diagnosis. Methods: This study is a case report of success in making and closing a protective jejunostomy. However, the low number of publications on this staged and risky measure of surgical resolution encouraged the team to study the indication and especially the correct time for closing the patient's protective jejunostomy. The main study instrument will be the six-month-old patient's medical record. Results: Based on the observation of the case described, it was observed that the time for the closure of the described procedure (protective jejunostomy) varies according to the level of compromise of the health status of your patient and of an individual of each person. Early closure, or failure to close, can lead to a favorable problem for the patient since several problems can result from this closure, such as new intestinal perforations, hydroelectrolyte disturbances. Despite the risk of new perforations, we suggest closing the protective jejunostomy around the 14th day of the procedure, thus keeping the patient on broad-spectrum antibiotic therapy and absolute fasting, thus reducing the chances of new intestinal perforations. Associated with the closure of the jejunostomy, a gastric tube for decompression is necessary, and care in an intensive care unit and electrolyte replacement is necessary to maintain the stability of the case.

Keywords: jejunostomy, ileostomy, enterocolitis, pediatric surgery, gastric surgery

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Authors: Rodolfo Lorbieski, Silvia Modesto Nassar

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Many supervised machine learning tasks require decision making across numerous different classes. Multi-class classification has several applications, such as face recognition, text recognition and medical diagnostics. The objective of this article is to analyze an adapted method of Stacking in multi-class problems, which combines ensembles within the ensemble itself. For this purpose, a training similar to Stacking was used, but with three levels, where the final decision-maker (level 2) performs its training by combining outputs from the tree-based pair of meta-classifiers (level 1) from Bayesian families. These are in turn trained by pairs of base classifiers (level 0) of the same family. This strategy seeks to promote diversity among the ensembles forming the meta-classifier level 2. Three performance measures were used: (1) accuracy, (2) area under the ROC curve, and (3) time for three factors: (a) datasets, (b) experiments and (c) levels. To compare the factors, ANOVA three-way test was executed for each performance measure, considering 5 datasets by 25 experiments by 3 levels. A triple interaction between factors was observed only in time. The accuracy and area under the ROC curve presented similar results, showing a double interaction between level and experiment, as well as for the dataset factor. It was concluded that level 2 had an average performance above the other levels and that the proposed method is especially efficient for multi-class problems when compared to binary problems.

Keywords: stacking, multi-layers, ensemble, multi-class

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Authors: Anka Gorgiev, Chris Martin, Nikolaos Dimitriadis, Dimitrios V. Nikolaidis

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This paper is part of a doctoral research study aimed to identify behavioral indicators for the existence of the new marketing paradigm. Neuromarketing is becoming a growing trend in the marketing industry worldwide and it is capturing a lot of interest among the members of academia and the practitioner community. However, it is still not very clear how big of an impact neuromarketing might have in the following years. In an effort to get closer to an answer, this study investigates behavioral intentions and willingness to adopt neuromarketing and its practices by the marketing professionals, including academics, practitioners, students, researchers, experts and journal editors. The participants in the study include marketing professionals at different levels of neuromarketing fluency with residency in the United States of America and the South East Europe. The total of 19 participants participated in the interviews, all of whom belong to more than one group of marketing professionals. The authors use qualitative research approach and open-ended interview questions specifically developed to assess ideas, beliefs and opinions that marketing professionals hold towards neuromarketing. In constructing the interview questions, the authors have used the theory of planned behavior, the prototype willingness model and the technology acceptance model as a theoretical framework. Previous studies have not explicitly investigated the behavioral intentions of marketing professionals to engage in neuromarketing behavior, which is described here as a tendency to apply neuromarketing assumptions and tools in usual marketing practices. This study suggests that the marketing professionals believe that neuromarketing can contribute to the business in a positive way and outlines the main advantages and disadvantages of adopting neuromarketing as identified by the participants. In addition, the study reveals an emerging image of an exemplar company that is perceived to be using neuromarketing, including the most common characteristics and attributes. These findings are believed to be crucial in facilitating a way for neuromarketing field to have a broader impact than it currently does by recognizing and understanding the limitations that such exemplars imply and how that has an effect on the decision-making of marketing professionals.

Keywords: behavioral intentions, marketing paradigm, neuromarketing adoption, theory of planned behavior

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Authors: W. Thongkham, K. Sinthiptharakoon, K. Tantisantisom, A. Klamchuen, P. Khanchaitit, K. Jiramitmongkon, C. Lertsatitthanakorn, M. Liangruksa

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Due to demands of sustainable energy, thermoelectricity converting waste heat into electrical energy has become one of the intensive fields of worldwide research. However, such harvesting technology has shown low device performance in the temperature range below 150℃. In this work, a hybrid nanowire of inorganic bismuth telluride (Bi₂Te₃) and organic poly(3,4-ethylenedioxythiophene):polystyrenesulfonate (PEDOT:PSS) synthesized using a simple in-situ one-pot synthesis, enhancing efficiency of the nanowire-incorporated PEDOT:PSS-based thermoelectric converter is highlighted. Since the improvement is ascribed to the increased electrical conductivity of the thermoelectric host material, the individual hybrid nanowires are investigated using voltage-dependent conductive atomic force microscopy (CAFM) and spectroscopy (CAFS) considering that the electrical transport measurement can be performed either on insulating or conducting areas of the sample. Correlated with detailed chemical information on the crystalline structure and compositional profile of the nanowire core-shell structure, an electrical transporting pathway through the nanowire and the corresponding electronic-band structure have been determined, in which the native oxide layer on the Bi₂Te₃ surface is not considered, and charge conduction on the topological surface states of Bi₂Te₃ is suggested. Analyzing the core-shell nanowire synthesized using the conventional mixing of as-prepared Bi₂Te₃ nanowire with PEDOT:PSS for comparison, the oxide-removal effect of the in-situ encapsulating polymeric layer is further supported. The finding not only provides a structural information for mechanistic determination of the thermoelectricity, but it also encourages new approach toward more appropriate encapsulation and consequently higher efficiency of the nanowire-based thermoelectric generation.

Keywords: electrical transport measurement, hybrid Bi₂Te₃-PEDOT:PSS nanowire, nanoencapsulation, thermoelectricity, topological insulator

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Authors: Itamir de Morais Barroca Filho, Cephas A. S. Barreto, Ramon Malaquias, Cezar Miranda Paula de Souza, Arthur Costa Gorgônio, João C. Xavier-Júnior, Mateus Firmino, Fellipe Matheus Costa Barbosa

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Information and Communication Technologies (ICT) in healthcare are crucial for efficiently delivering medical healthcare services to patients. These ICTs are also known as e-health and comprise technologies such as electronic record systems, telemedicine systems, and personalized devices for diagnosis. The focus of e-health is to improve the quality of health information, strengthen national health systems, and ensure accessible, high-quality health care for all. All the data gathered by these technologies make it possible to help clinical staff with automated decisions using machine learning. In this context, we collected patient data, such as heart rate, oxygen saturation (SpO2), blood pressure, respiration, and others. With this data, we were able to develop machine learning models for patients’ risk of death and estimate the length of stay in ICU beds. Thus, this paper presents the methodology for applying machine learning techniques to develop these models. As a result, although we implemented these models on an IoT healthcare platform, helping clinical staff in healthcare in an ICU, it is essential to create a robust clinical validation process and monitoring of the proposed models.

Keywords: ICT, e-health, machine learning, ICU, healthcare

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Authors: Ai Serizawa, Kotaro Mori, Takahiro Ishizaki

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Al alloys have been used as advanced structural materials in automobile and railway industries because of excellent physical and mechanical properties such as low density, good heat conductivity, and high specific strength. Their low corrosion resistance, however, limits their use in the corrosive environment. To improve the corrosion resistance of the Al alloys, the development of a novel coating technology has been highly desirable. Chemical conversion methods using layered double hydroxide (LDH) have attracted much attention because the LDH can suppress corrosion reaction due to their trapping ability of corrosive anions such as Cl- between layers. In this presentation, we report on a novel preparation method of AlOOH film containing Mg-Al layered double hydroxide (LDH) on Al alloy by steam coating. The corrosion resistance of the composite film including LDH was especially focused. Al-Mg-Si alloy was used as the substrate. The substrates were ultrasonically cleaned in ethanol for 10 min. The cleaned substrates were set in the autoclave with a 100 mL capacity. 20 ml of ultrapure water was located at the bottom of the autoclave to produce steam. The autoclave was heated up to a temperature of 100 to 200 °C, and then held at this temperature for up to 48 h, and was subsequently cooled naturally to room temperature, resulting in the formation of anticorrosive films on Al alloys. The resultant films were characterized by XRD, FT-IR, FE-SEM and electrochemical measurements. FE-SEM image of film surface treated at 180 °C for 48 h demonstrated that needle-like nanostructure was densely formed on the surface. XRD patterns revealed that the film formed on the Al alloys by steam coating was composed of crystal AlOOH and Mg-Al LDH. The corrosion resistance of the film was evaluated using electrochemical measurements. The potentiodynamic polarization curves of the film coated and uncoated substrates of Al-Mg-Si alloy after immersion in the 5 wt% NaCl aqueous solution for 30 min revealed that the corrosion current density, jcorr, of the film coated sample decreased by more than two orders of magnitude as compared to the uncoated sample, indicating that the corrosion resistance of the substrates of Al-Mg-Si alloy were improved by the formation of the anticorrosive film via steam coating.

Keywords: aluminum alloy, boehmite, corrosion resistance, steam process

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Authors: Ayat E. Ali, Christeen R. Aziz, Merna A. Helmy, Mohammed M. Malek, Sherif H. El-Gohary

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Goal: Purpose of the project was to make a plastic surgery prediction by using pre-operative images for the plastic surgeries’ patients and to show this prediction on a screen to compare between the current case and the appearance after the surgery. Methods: To this aim, we implemented a software which used data from the internet for facial skin diseases, skin burns, pre-and post-images for plastic surgeries then the post- surgical prediction is done by using K-nearest neighbor (KNN). So we designed and fabricated a smart mirror divided into two parts a screen and a reflective mirror so patient's pre- and post-appearance will be showed at the same time. Results: We worked on some skin diseases like vitiligo, skin burns and wrinkles. We classified the three degrees of burns using KNN classifier with accuracy 60%. We also succeeded in segmenting the area of vitiligo. Our future work will include working on more skin diseases, classify them and give a prediction for the look after the surgery. Also we will go deeper into facial deformities and plastic surgeries like nose reshaping and face slim down. Conclusion: Our project will give a prediction relates strongly to the real look after surgery and decrease different diagnoses among doctors. Significance: The mirror may have broad societal appeal as it will make the distance between patient's satisfaction and the medical standards smaller.

Keywords: k-nearest neighbor (knn), face detection, vitiligo, bone deformity

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Authors: Mostosi C., Stéphenne J., Kempeneers E.

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Introduction: Refuellers from Brussels South Charleroi Airport (BSCA) expressed concerns about the risks involved in handling JET-A1 fuel. The HSE Manager of BSCA, in collaboration with the occupational physician and the industrial hygiene unit of the External Service of Occupational Medicine, decided to assess the toxicological exposure of these workers. Materials and methods: Two measurement methods were used. The first was to assay three types of metabolites in urine to highlight the exposure to xylenes, toluene, and benzene in aircraft fuels. Out of 32 refuellers in the department, 26 participated in the sampling, and 23 samples were exploited. The second method targeted the assessment of environmental exposure to certain potentially hazardous substances that refuellers are likely to breathe in work areas at the airport. It was decided to carry out two ambient air measurement campaigns, using static systems on the one hand and, on the other hand, using individual sensors worn by the refuellers at the level of the respiratory tract. Volatile organic compounds and diesel particles were analyzed. Results: Despite the fears that motivated these analyzes, the overall results showed low levels of exposure, far below the existing limit values, both in air quality and in urinary measurements. Conclusion: These results are comparable to a study carried out in several French airports. The staff could be reassured, and then the medical surveillance was modified by the occupational physician. With the aviation development at BSCA, equipment and methods are evolving. Their exposure will have to be reassessed.

Keywords: refuelling, airport, exposure, fuel, occupational health, air quality

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Authors: Tahsien Mohamed Okasha

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We hypothesized that Post cardiac arrest patients with Glasgow coma scale (GCS) score of less than (8) and who will be exposed to therapeutic hypothermia protocol will exhibit improvement in their neurological performance. Purposive sample of 17 patients who were fulfilling the inclusion criteria during one year collected. The study carried out using Quasi-experimental research design. Four Tools used for data collection of this study: Demographic and medical data sheet, Post cardiac arrest health assessment sheet, Bedside Shivering Assessment Scale (BSAS), and Glasgow Pittsburgh cerebral performance category scale (CPC). Result: the mean age was X̅ ± SD = 53 ± 8.122 years, 47.1% were arrested because of cardiac etiology. 35.3% with initial arrest rhythm ventricular tachycardia (VT), 23.5% with ventricular fibrillation (VF), and 29.4% with A-Systole. Favorable neurological outcome was seen among 70.6%. There was significant statistical difference in WBC, Platelets, blood gases value, random blood sugar. Also Initial arrest rhythm, etiology of cardiac arrest, and shivering status were significantly correlated with cerebral performance categories score. therapeutic hypothermia has positive effects on neurological performance among post cardiac arrest patients with GCS score of less than (8). replication of the study on larger probability sample, with randomized control trial design. Further study for suggesting nursing protocol for patients undergoing therapeutic hypothermia.

Keywords: therapeutic hypothermia, neurological performance, after resuscitation from cardiac arrest., resuscitation

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Authors: Sunglim Lee, Susumu Fujii, Koji Okamura

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Smart grid is a new approach for electric power grid that uses information and communications technology to control the electric power grid. Smart grid provides real-time control of the electric power grid, controlling the direction of power flow or time of the flow. Control devices are installed on the power lines of the electric power grid to implement smart grid. The number of the control devices should be determined, in relation with the area one control device covers and the cost associated with the control devices. One approach to determine the number of the control devices is to use the data on the surplus power generated by home solar generators. In current implementations, the surplus power is sent all the way to the power plant, which may cause power loss. To reduce the power loss, the surplus power may be sent to a control device and sent to where the power is needed from the control device. Under assumption that the control devices are installed on a lattice of equal size squares, our goal is to figure out the optimal spacing between the control devices, where the power sharing area (the area covered by one control device) is kept small to avoid power loss, and at the same time the power sharing area is big enough to have no surplus power wasted. To achieve this goal, a simulation using landscape ecology method is conducted on a sample area. First an aerial photograph of the land of interest is turned into a mosaic map where each area is colored according to the ratio of the amount of power production to the amount of power consumption in the area. The amount of power consumption is estimated according to the characteristics of the buildings in the area. The power production is calculated by the sum of the area of the roofs shown in the aerial photograph and assuming that solar panels are installed on all the roofs. The mosaic map is colored in three colors, each color representing producer, consumer, and neither. We started with a mosaic map with 100 m grid size, and the grid size is grown until there is no red grid. One control device is installed on each grid, so that the grid is the area which the control device covers. As the result of this simulation we got 350 m as the optimal spacing between the control devices that makes effective use of the surplus power for the sample area.

Keywords: landscape ecology, IT, smart grid, aerial photograph, simulation

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Authors: Kina Kim

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Background: There are two types of interferon-gamma release assays (IGRAs) in use for the detection of latent tuberculosis infection (LTBI), QuantiFERON-TB Gold In-tube (QFT-GIT) and T-SPOT.TB. There are some reports that IGRA results are affected by the patient's age. This study aims to compare the results of both IGRA tests according to age groups. Methods: We reviewed 54,882 samples referred to an independent reference laboratory (Seegene Medical Foundation, Seoul, Korea) for the diagnosis of LTBI from January 1, 2021, to December 31, 2021. This retrospective study enrolled 955 patients tested using QFT-GIT and 53,927 patients tested using T-SPOT.TB. The results of both IGRAs were divided in three age groups (0-9, 10-17, and ≥18-year old). The positive rates and the indeterminate rates between QFT-GIT and T-SPOT.TB were compared. We also evaluated the differences in positive and indeterminate rates by age-group. Results: The positive rate of QFT-GIT was 20.1% (192/955) and that of T-SPOT.TB was 8.7% (4704/53927) in overall patients. The positive rates of QFT-GIT in individuals aged 0-9, 10-17, and over 18-year old were 15.4%, 13.3%, and 22.0%, respectively. The positive rates of T-SPOT.TB were 8.9%, 2.0% and 8.8%,in each agegroup, respectively.The overall prevalence of indeterminate results was 2.1% (20/955) of QFT-GIT and 0.5% (270/53927) of T-SPOT.TB. The indeterminate rates of QFT-GIT in individuals aged 0-9, 10-17, and over 18 years were 0.4%, 6.7%, and 2.6%, respectively. The indeterminate rate of T-SPOT.TB were 0.5%, 0.7% and 0.5%,in each age group, respectively. Conclusion: Our findings suggest that T-SPOT.TB has a lower rate of positive results in overall patients and a lower rate of indeterminate results than those of QFT-GIT. The highest positive rate was found in the over 18 years group for QFT-GIT, but the positive rates of T-SPOT.TB was not significantly different among groups by age. QFT-GIT showed variable and higher indeterminate rates according to age group, but T-SPOT.TB showed lower rates in all age groups(<1%).

Keywords: LTBI, IGRA, QFT-GIT, T-SPOT. TB

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Authors: Yu-Chen Hsu, Kuang C. Lin

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The artificial lung called extracorporeal membrane oxygenation (ECMO) is an important medical machine that supports persons whose heart and lungs dysfunction. Previously, investigation of steady deoxygenated blood flows passing through hollow fibers for oxygen transport was carried out experimentally and computationally. The present study computationally analyzes the effect of biological pulsatile flow on the oxygen transport in blood. A 2-D model with a pulsatile flow condition is employed. The power law model is used to describe the non-Newtonian flow and the Hill equation is utilized to simulate the oxygen saturation of hemoglobin. The dimensionless parameters for the physical model include Reynolds numbers (Re), Womersley parameters (α), pulsation amplitudes (A), Sherwood number (Sh) and Schmidt number (Sc). The present model with steady-state flow conditions is well validated against previous experiment and simulations. It is observed that pulsating flow amplitudes significantly influence the velocity profile, pressure of oxygen (PO2), saturation of oxygen (SO2) and the oxygen mass transfer rates (m ̇_O2). In comparison between steady-state and pulsating flows, our findings suggest that the consideration of pulsating flow in the computational model is needed when Re is raised from 2 to 10 in a typical range for flow in artificial lung.

Keywords: artificial lung, oxygen transport, non-Newtonian flows, pulsating flows

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Authors: Suresh Lokiah

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The emerging trend of integrating robots into elderly care, particularly for assisting patients with dementia, holds the potential to greatly transform the sector. Assisted living facilities, which house a significant number of elderly individuals and dementia patients, constantly strive to engage their residents in stimulating activities. However, due to staffing shortages, they often rely on volunteers to introduce new activities. Despite the availability of social interaction, these residents, frequently overlooked in society, are in desperate need of additional support. Robots designed for elder care are categorized based on their design and functionality. These categories include companion robots, telepresence robots, health monitoring robots, and rehab robots. However, the integration of such robots raises significant ethical concerns, notably regarding privacy, autonomy, and the risk of dehumanization. Privacy issues arise as these robots may need to continually monitor patient activities. There is also a risk of patients becoming overly dependent on these robots, potentially undermining their autonomy. Furthermore, the replacement of human touch with robotic interaction may lead to the dehumanization of care. This paper delves into the ethical considerations of incorporating robotic assistance in eldercare. It proposes a series of guidelines and strategies to ensure the ethical deployment of these robots. These guidelines suggest involving patients in the design and development process of the robots and emphasize the critical need for human oversight to respect the dignity and rights of the elderly and dementia patients. The paper also recommends implementing robust privacy measures, including secure data transmission and data anonymization. In conclusion, this paper offers a thorough examination of the ethical implications of using robotic assistance in elder care. It provides a strategic roadmap to ensure this technology is utilized ethically, thereby maximizing its potential benefits and minimizing any potential harm.

Keywords: human-robot interaction, robots for eldercare, ethics, health, dementia

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Authors: Raj Chavan

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Currently, there are over 14,500 Water Resource Recovery Facilities (WRRFs) in the United States, with ~35% of them having some type of nutrient limits in place. These WRRFs account for about 1% of overall power demand and 2% of total greenhouse gas emissions (GHG) in the United States and contribute for 10 to 15% of the overall nutrient load to surface rivers in the United States. The evolution of densification technologies toward more compact and energy-efficient nutrient removal processes has been impacted by a number of factors. Existing facilities that require capacity expansion or biomass densification for higher treatability within the same footprint are being subjected to more stringent requirements relating to nutrient removal prior to surface water discharge. Densification of activated sludge has received recent widespread interest as a means for achieving process intensification and nutrient removal at WRRFs. At the core of the technology are the aerobic sludge granules where the biological processes occur. There is considerable interest in the prospect of producing granular sludge in continuous (or traditional) activated sludge processes (CAS) or densification of biomass by moving activated sludge flocs to a denser aggregate of biomass as a highly effective technique of intensification. This presentation will provide a fundamental understanding of densification by presenting insights and practical issues. The topics that will be discussed include methods used to generate and retain densified granules; the mechanisms that allow biological flocs to densify; the role that physical selectors play in the densification of biological flocs; some viable ways for managing biological flocs that have become densified; effects of physical selection design parameters on the retention of densified biological flocs and finally some operational solutions for customizing the flocs and granules required to meet performance and capacity targets. In addition, it will present some case studies where biological and physical parameters were used to generate aerobic granular sludge in the continuous flow system.

Keywords: densification, aerobic granular sludge, nutrient removal, intensification

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Authors: Vistorina Amputu, Katja Tielboerger, Nichola Knox

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Primary productivity in dry savannahs is constraint by moisture availability and under increasing anthropogenic pressure. Thus, considering climate change and the unprecedented pace and scale of rangeland deterioration, methods for assessing the status of such rangelands should be easy to apply, yield reliable and repeatable results that can be applied over large spatial scales. Global and local scale monitoring of rangelands through satellite data and labor-intensive field measurements respectively, are limited in accurately assessing the spatiotemporal heterogeneity of vegetation dynamics to provide crucial information that detects degradation in its early stages. Fortunately, newly emerging techniques such as unmanned aerial vehicles (UAVs), associated miniaturized sensors and improving digital photogrammetric software provide an opportunity to transcend these limitations. Yet, they have not been extensively calibrated in natural systems to encompass their complexities if they are to be integrated for long-term monitoring. Limited research using drone technology has been conducted in arid savannas, for example to assess the health status of this dynamic two-layer vegetation ecosystem. In our study, we fill this gap by testing the relationship between UAV-estimated cover of rangeland functional attributes and field data collected in discrete sample plots in a Namibian dryland savannah along a degradation gradient. The first results are based on a supervised classification performed on the ultra-high resolution multispectral imagery to distinguish between rangeland functional attributes (bare, non-woody, and woody), with a relatively good match to the field observations. Integrating UAV-based observations to improve rangeland monitoring could greatly assist in climate-adapted rangeland management.

Keywords: arid savannah, degradation gradient, field observations, narrow-band sensor, supervised classification

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Authors: Muhtasim Shafi Kader, Fizar Ahmed, Annesha Acharjee

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Machine learning and data mining are crucial in health care, as well as medical information and detection. Machine learning approaches are now being utilized to improve awareness of a variety of critical health issues, including diabetes detection, neuron cell tumor diagnosis, COVID 19 identification, and so on. Parkinson’s disease is basically a disease for our senior citizens in Bangladesh. Parkinson's Disease indications often seem progressive and get worst with time. People got affected trouble walking and communicating with the condition advances. Patients can also have psychological and social vagaries, nap problems, hopelessness, reminiscence loss, and weariness. Parkinson's disease can happen in both men and women. Though men are affected by the illness at a proportion that is around partial of them are women. In this research, we have to get out the accurate ML algorithm to find out the disease with a predictable dataset and the model of the following machine learning classifiers. Therefore, nine ML classifiers are secondhand to portion study to use machine learning approaches like as follows, Naive Bayes, Adaptive Boosting, Bagging Classifier, Decision Tree Classifier, Random Forest classifier, XBG Classifier, K Nearest Neighbor Classifier, Support Vector Machine Classifier, and Gradient Boosting Classifier are used.

Keywords: naive bayes, adaptive boosting, bagging classifier, decision tree classifier, random forest classifier, XBG classifier, k nearest neighbor classifier, support vector classifier, gradient boosting classifier

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Authors: Desmond Okorie, Emmanuel Prince

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Availability of portable water has been a global challenge especially to the developing continents/nations such as Africa/Nigeria. The World Health Organization WHO has produced the guideline for drinking water quality GDWQ which aims at ensuring water safety from source to consumer. Portable water parameters test include physical (colour, odour, temperature, turbidity), chemical (PH, dissolved solids) biological (algae, plytoplankton). This paper discusses the use of wireless sensor networks to monitor water quality using efficient and effective sensors that have the ability to sense, process and transmit sensed data. The integration of wireless sensor network to a portable sensing device offers the feasibility of sensing distribution capability, on site data measurements and remote sensing abilities. The current water quality tests that are performed in government water quality institutions in Benue State Nigeria are carried out in problematic locations that require taking manual water samples to the institution laboratory for examination, to automate the entire process based on wireless sensor network, a system was designed. The system consists of sensor node containing one PH sensor, one temperature sensor, a microcontroller, a zigbee radio and a base station composed by a zigbee radio and a PC. Due to the advancement of wireless sensor network technology, unexpected contamination events in water environments can be observed continuously. local area network (LAN) wireless local area network (WLAN) and internet web-based also commonly used as a gateway unit for data communication via local base computer using standard global system for mobile communication (GSM). The improvement made on this development show a water quality monitoring system and prospect for more robust and reliable system in the future.

Keywords: local area network, Ph measurement, wireless sensor network, zigbee

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Authors: G. Alex Ambrose, Melissa Paulsen, Abrar Fitwi, Masud Akbari

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In 2016, a U.S. business college was awarded a sub grant to work with FHI360, a nonprofit human development organization, to support a university in Afghanistan funded by the State Department’s U.S. Agency for International Development (USAID). A newly designed Master’s Degree in Finance and Accounting is being implemented to support Afghanistan’s goal of 20% females in higher education and industry by 2020 and to use finance and accounting international standards to attract capital investment for economic development. This paper will present a case study to describe the co-construction of an approach to an International Flipped Faculty Development Model grounded in blended learning theory. Like education in general, faculty development is also evolving from the traditional face to face environment and interactions to the fully online and now to a best of both blends. Flipped faculty development is both a means and a model for careful integration of the strengths of the synchronous and asynchronous dynamics and technologies with the combination of intentional sequencing to pre-online interactions that prepares and enhances the face to face faculty development and mentorship residencies with follow-up post-online support. Initial benefits from this model include giving the Afghan faculty an opportunity to experience and apply modern teaching and learning strategies with technology in their own classroom. Furthermore, beyond the technological and pedagogical affordances, the reciprocal benefits gained from the mentor-mentee, face-to-face relationship will be explored. Evidence to support this model includes: empirical findings from pre- and post-Faculty Mentor/ Mentee survey results, Faculty Mentorship group debriefs, Faculty Mentorship contact logs, and student early/end of semester feedback. In addition to presenting and evaluating this model, practical challenges and recommendations for replicating international flipped faculty development partnerships will be provided.

Keywords: educational development, faculty development, international development, flipped learning

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Authors: Marwa Al-Subhi, Eiman Al-Ajmi, Mallak Al-Maamari, Humood Al-Dhuhli, Srinivasa Rao

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The orbit and its contents are affected by various pathologies and craniofacial anomalies. Sound knowledge of the normal orbital dimensions is clinically essential for successful surgical outcomes and also in the field of forensic anthropology. Racial, ethnic, and regional variations in the orbital dimensions have been reported. This study sought to determine the orbital dimensions of Omani subjects who had been referred for computed tomography (CT) images at a tertiary care hospital. A total of 273 patients’ CT images were evaluated retrospectively by using an electronic medical records database. The orbital dimensions were recorded using both axial and sagittal planes of CT images. The mean orbital index (OI) was found to be 83.25±4.83 and the prevalent orbital type was categorized as mesoseme. The mean orbital index was 83.34±5.05 and 83.16±4.57 in males and females, respectively, with their difference being statistically not significant (p=0.76). A statistically significant association was observed between the right and left orbits with regard to horizontal distance (p<0.05) and vertical distance (p<0.01) of orbit and OI (p<0.05). No significant difference between the OI and age groups was observed in both males and females. The mean interorbital distance and interzygomatic distance were found to be 19.45±1.52 mm and 95.59±4.08 mm, respectively. Both of these parameters were significantly higher in males (p<0.05). Results of the present study provide reference values of orbital dimensions in Omani subjects. The prevalent orbital type of Omani subjects is mesoseme, which is a hallmark of the white race.

Keywords: orbit, orbital index, mesoseme, ethnicity, variation

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Authors: Abdul Nasir Zamir

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After the downfall of Ottoman Caliphate, it scattered into different small Muslim states. Muslim leaders, intellectuals, revivalists as well as modernists started trying to boost up their nation. Some Muslims are also trying to establish the caliphate. Every Muslim country has its own political system, i.e., kingship, dictatorship or democracy, etc. But these are not in their original forms as the historian or political science discussed in their studies. The laws and their practice are mixed, i.e., others with Islamic laws, e.g., Saudi Arabia (K.S.A) and the Islamic Republic of Pakistan, etc. There is great conflict among the revivalist Muslim parties (groups) and governments about political systems. The question is that the subject matter is Sharia or political system? Leaders of Modern Muslim states are alleged as disbelievers due to neglecting the revelation in their laws and decisions. There are two types of laws; Islamic laws and management laws. The conflict is that the non-Islamic laws are in practice in Muslim states. Non-Islamic laws can be gradually changed with Islamic laws with a legal and peaceful process according to the practice of former Muslim leaders and scholars. The bloodshed of Muslims is not allowed in any case. Weak Muslim state is a blessing than nothing. The political system after Muhammad and guided caliphs is considered as kingship. But during this period Muslims not only developed in science and technology but conquered many territories also. If the original aim is in practice, then the Modern Muslim states can be stabled with different political systems. Modern Muslim states are the hope of survival, stability, and development of Muslim Ummah. Islam does not allow arm clash with Muslim army or Muslim civilians. The caliphate is based on believing in one Allah Almighty and good deeds according to Quran and Sunnah. As faith became weak and good deeds became less from its standard level, caliphate automatically became weak and even ended. The last weak caliphate was Ottoman Caliphate which was a hope of all the Muslims of the world. There is no caliphate or caliph present in the world. But every Muslim country or state is like an Amarat (a part of caliphate or small and alternate form of the caliphate) of Muslims. It is the duty of all Muslims to stable these modern Muslim states with tolerance.

Keywords: caliphate, conflict resolution, modern Muslim state, political conflicts, political systems, tolerance

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Authors: Mohammad Mirwais Yusufi

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Skillful management is one of the most important success factors for today’s farms. When a farm is well managed, it can generate funds for its sustainability. Grape is one of the most diffused fruits in the world and one of the most important cash crops with high potential of production in Afghanistan as well. While there are several organizations intervening for improvement of this cash crop, the quality and quantity are still not satisfactory for producers and external markets. The situation has not changed over the years. Therefore, a survey was conducted in 2017 with 60 grape growers, supported by questionnaires in Mirbachakot, Kalakan and Shakardara districts of Kabul province. The purpose was to get an understanding of the current socio-demographic characteristics of farmers, management methods, constraints, farm size, yield and contribution of grape farming to household income. Findings indicate that grape farming was predominant 83.3% male, 16.6% female and small-scale farmers were the main grape producers, 60% < 1 ha of land under grape production. Likewise, 50% had more than > 10 years and 33.3% between 1-5 years’ experience in grape farming. The high level of illiteracy and diseases had significant digit effect on growth, yield and quality of grapes. The results showed that vineyard management operations to protect grapes from mechanical damage are very poor or completely absent. Comparing developed countries, table grape is one of the fruits with the highest input of technology, while in developing countries the cost of labor is low but the purchase of the equipment is very high due to financial situation. Hence the low quality and quantity of grape are influenced by poor management methods, such as non-availability of experts and lack of technical guidance in the study site. Thereby, the study suggested that improved agricultural extension services and managerial skills could contribute to addressing the problems.

Keywords: constraints, effect, management, Kabul

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Authors: Muhammad Jamil, Ning He, Wei Zhao

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It is a rough estimation that the aerospace companies received orders of 37000 new aircraft, including the air ambulances, until 2037. And titanium alloys have a 15% contribution in modern aircraft's manufacturing owing to the high strength/weight ratio. Despite their application in the aerospace and medical equipment manufacturing industry, still, their high-speed machining puts a challenge in terms of tool wear, heat generation, and poor surface quality. Among titanium alloys, Ti-6Al-4V is the major contributor to aerospace application. However, its poor thermal conductivity (6.7W/mK) accumulates shear and friction heat at the tool-chip interface zone. To dissipate the heat generation and friction effect, cryogenic cooling, Minimum quantity lubrication (MQL), nanofluids, hybrid cryogenic-MQL, solid lubricants, etc., are applied frequently to underscore their significant effect on improving the machinability of Ti-6Al-4V. Nowadays, hybrid lubri-cooling is getting attention from researchers to explore their effect regarding the hard-to-cut Ti-6Al-4V. Therefore, this study is devoted to exploring the effect of hybrid ethanol-ester oil MQL regarding the cutting temperature, surface integrity, and tool life. As the ethanol provides -OH group and ester oil of long-chain molecules provide a tribo-film on the tool-workpiece interface. This could be a green manufacturing alternative for the manufacturing industry.

Keywords: hybrid lubri-cooling, surface roughness, tool wear, MQL

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Authors: Sehrish Jalal, Choon-Mee Kim, Dong-Min Kim

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Background: Many pathogens causing hemorrhagic fevers of medical and veterinary importance have been identified and isolated from rodents in the Republic of Korea (ROK). Objective: We investigated the prevalence of emerging viruses causing hemorrhagic fevers, such as hemorrhagic fever with renal syndrome (HFRS), severe fever with thrombocytopenia syndrome (SFTS) and flaviviruses, from wild rodents. Methods: Striped field mice, Apodemus agrarius, (n=39) were captured during 2014-2015 in the south-west of ROK. Using molecular methods, lung samples were evaluated for SFTS virus, HFRS virus and flavivirus, and seropositivity was evaluated in the blood. Results: A high positive rate of Hantavirus (46.2%) was detected in A.agrarius lungs by reverse transcription-nested polymerase chain reaction (RT-N-PCR). The monthly prevalence of HFRS virus was 16.7% in October, 86.7% in November and 25% in August of the following year (p < 0.001). Moreover, 17.9% of blood samples were serologically positive for Hantavirus antibodies. The most prevalent strain in A. agrarius was Hantaan virus. All samples were positive for neither SFTS nor flavivirus. Conclusion: Hantan virus was detected in 86.7% of A. agrarius in November (autumn), and thus, virus shedding from A. agrarius can increase the risk of humans contracting HFRS. These findings may help to predict and prevent disease outbreaks in ROK.

Keywords: hemorrhagic fever virus, molecular diagnostic technique, rodents, Korea

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Authors: Deok Hyun Han

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Objective: To explore outcomes of UventaTM metallic ureteral stent between malignant and benign ureteral obstruction. Methods: We reviewed the medical records of 90 consecutive patients who underwent Uventa stent placement for benign or malignant ureteral obstruction from December 2009 to June 2013. We evaluated the clinical outcomes, complications, and reasons and results for unexpected stent removals. Results: The median follow-up was 10.7 (0.9 – 41) months. From a total of 125 ureter units, there were 24 units with benign obstructions and 101 units with malignant obstructions. Initial technical successes were achieved in all patients. The overall success rate was 70.8% with benign obstructions and 84.2% with malignant obstructions. The major reasons for treatment failure were stent migration (12.5%) in benign and tumor progression (11.9%) in malignant obstructions. The overall complication rate was similar between benign and malignant obstructions (58.3% and 42.6%), but severe complications, which are Clavien grade 3 or more, occurred in 41.7% of benign and 6.9% of malignant obstructions. The most common complications were stent migration (25.0%) in benign obstructions and persistent pain (14.9%) in malignant obstructions. The stent removal was done in 16 units; nine units that were removed by endoscopy and seven units were by open surgery. Conclusions: In malignant ureteral obstructions, the Uventa stent showed favorable outcomes with high success rate and acceptable complication rate. However, in benign ureteral obstructions, overall success rate and complication rate were less favorable. Malignant ureteral obstruction seems to be appropriate indication of Uventa stent placement. However, in chronic diffuse benign ureteral obstructions the decision of placement of Uventa stent has to be careful.

Keywords: cause, complication, ureteral obstruction, metal stent

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Authors: Poteet Frances, Glovinski Ira

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INTRODUCTION: The interoceptive nervous system continuously senses chemical and anatomical changes and helps you recognize, understand, and feel what’s going on inside your body so it is important for energy regulation, memory, affect, and sense of self. A newborn needs predictable routines rather than confusion/chaos to make connections between internal experiences and emotions. AIM: Current legal protocols of removing babies from drug-addicted mothers impact the critical window of bonding. The newborn’s brain is social and the attachment process influences a child’s development which begins immediately after birth through nourishment, comfort, and protection. DESCRIPTION: Our project aims to educate drug-addicted mothers, and medical, nursing, and social work professionals on interoceptive concepts and practices to sustain the mother/newborn relationship. A mother’s interoceptive knowledge predicts children’s emotion regulation and social skills in middle childhood. CONCLUSION: When mothers develop an awareness of their inner bodily sensations, they can self-regulate and be emotionally available to co-regulate (support their newborn during distressing emotions and sensations). Our project has enhanced relationship preservation (mothers understand how their presence matters) and the overall mother/newborn connection.

Keywords: drug-addiction, interoception, legal, mothers, newborn, self-regulation

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Authors: Mohammed Khamis Albalushi

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Background: Somatic symptoms disorders are usually comorbid with depressive disorders despite the fact that there is little evidence for effective treatment for it. Repetitive transcranial magnetic stimulation (rTMS) has been approved by the FDA for mildly resistant depression. From this point, we hypothesized that rTMS delivered over the prefrontal cortex (PFC) may be useful in somatic symptoms disorder. Therefore, in our case report, we want to shed light on the potential effectiveness of rTMS in somatic symptoms disorder. Case Report: A 65-year-old Omani female with multiple medical comorbidities on multiple medications. She presented complaining of multiple somatic complaints in the last 2 years after visiting multiple clinics and underwent several specialists’ examinations, investigations and procedures for somatic treatments; all of them were normal. Then patient was seen by a different psychiatric clinic; multiple anti-depressant and adjuvant anti-psychotic medications were tried, patient still did not improve. The patient was admitted to the hospital for observation and management. Initially, she was preoccupied with her somatic complaint and kept on Fluoxetine and Olanzapine along with that, topiramate was added, but still with minimal improvement. Then rTMS was added to her management plan following Intermittent theta burst (iTBS) rTMS protocol. After completing all sessions of rTMS, the patient was recovering from all her symptoms, and no complaints were reported from her. Conclusion: Our case highlights the importance of investigating more thoroughly in rTMS as a treatment option for Persistent Somatic symptoms Disorder.

Keywords: rTMS, somatic symptoms disorder, resistive cases, TMS

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Authors: Daisy Saikia

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Long-term maternal health issues with Caesarean section deliveries are significant. Thus, this study aims to investigate the prevalence of caesarean section deliveries in India and to comprehend its associated predictors in light of the high caesarean section delivery rate. The study uses data from the fifth National Family Health Surveys (NFHS-5) round. Specifically, live births to women aged 15-49 in the 5 years preceding the survey. Binary logistic regression was used to check the adjusted effects of the predictor variables on caesarean section delivery. STATA/SE v16.0 was used for the data analysis with a 5% significance level. Twenty-two per cent of the live births to women were delivered by caesarean section. There was socio-economic, demographic and geographical variation in the prevalence of caesarean section delivery in India. Increasing age, body mass index, marital status, mother’s occupation and education, birth order, place of delivery, full ANC, non-tribal status, wealth quintile and region are significantly associated with caesarean section deliveries in India. Caesarean section deliveries should only be performed when essential from a medical perspective, and regions, where the rate is too high, should follow the guidelines. Additionally, it needs to be investigated whether private hospitals compel patients to have caesarean section deliveries to increase their revenue. Thus, these unnecessary deliveries must be examined immediately for safe childbirth and the wellness of both mother and child.

Keywords: caesarean section, delivery, maternal health, India

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