Search results for: healthcare supply chain

Authors: Sachin Kamble, Shradha Gawankar

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This paper presents the findings of successful implementation of Business Process Reengineering (BPR) of cement dispatch activities in a cement manufacturing plant located in India. Simulation model was developed for the purpose of identifying and analyzing the areas for improvement. The company was facing a problem of low throughput rate and subsequent forced stoppages of the plant leading to a high production loss of 15000MT per month. It was found from the study that the present systems and procedures related to the in-plant logistics plant required significant changes. The major recommendations included process improvement at the entry gate, reducing the cycle time at the security gate and installation of an additional weigh bridge. This paper demonstrates how BPR can be implemented for improving the in-plant logistics process. Various recommendations helped the plant to increase its throughput by 14%.

Keywords: in-plant logistics, cement logistics, simulation modelling, business process re-engineering, supply chain management

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Authors: Petronella Lunda, Catharina Susanna Minnie, Welma Lubbe

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Background This review aimed to provide healthcare professionals with a scientific summary of the best available research evidence on factors influencing respectful perinatal care. The review question was ‘What were the perceptions of midwives and doctors on factors that influence respectful perinatal care?’ Methods A detailed search was done on electronic databases: EBSCOhost: Medline, OAlster, Scopus, SciELO, Science Direct, PubMed, Psych INFO, and SocINDEX. The databases were searched for available literature using a predetermined search strategy. Reference lists of included studies were analysed to identify studies missing from databases. The phenomenon of interest was factors influencing maternity care practices according to midwives and doctors. Pre-determined inclusion and exclusion criteria were used during the selection of potential studies. In total, 13 studies were included in the data analysis and synthesis. Three themes were identified and a total of nine sub-themes. Results Studies conducted in various settings were included in the study. Multiple factors influencing respectful perinatal care were identified. During data synthesis, three themes emerged: healthcare institution, healthcare professionals, and women-related factors. Alongside the themes were sub-themes human resources, medical supplies, norms and practices, physical infrastructure, healthcare professional competencies and attributes, women’s knowledge, and preferences. The three factors influence the provision of respectful perinatal care; addressing them might improve the provision of the care. Conclusion Addressing factors that influence respectful perinatal care is vital towards the prevention of compromised patient care during the perinatal period as these factors have the potential to accelerate or hinder provision of respectful care.

Keywords: doctors, maternity care, midwives, obstetrician, perceptions, perinatal care, respectful care

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Authors: Bailey Hall, Athena Hoppe, Tevyn Kagele, Anna Nichols, Breeanna Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to people experiencing homelessness in Spokane, Washington. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to a largely underserved population. In this analysis, the SSM Program’s medical charts from street and shelter encounters in early 2021 were reviewed in order to identify illness and diseases in people experiencing homelessness in Spokane. More than half of the prescriptions written during these encounters were for either an antibacterial, an antibiotic, or an antifungal. Estimates of the cost to the local healthcare system are included. Initiating treatment for communicable diseases in people experiencing homelessness via street medicine efforts greatly reduces economic costs while improving health outcomes.

Keywords: ethical issues in public health, equity issues in public health, health economics, health disparities, healthcare costs, medical public health, public health ethics, street medicine

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Authors: Chi-Yuan Huang, Mei-Chuan Kuo, Ching-Yi Hsiao

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In this study, acids with various chain lengths (C₆, C₈, C₁₀ and C₁₂) modified by methane sulfonic acid (MSA) and temperature were used to modify tapioca starch (TPS), then the glycerol (GA) were added into modified starch, to prepare new blends. The mechanical properties, thermal properties and physical properties of blends were studied. This investigation was divided into two parts.  First, the biodegradable materials were used such as starch and glycerol with hexanedioic acid (HA), suberic acid (SBA), sebacic acid (SA), decanedicarboxylic acid (DA) manufacturing with different temperatures (90, 110 and 130 °C). And then, the solution was added into modified starch to prepare the blends by using single-screw extruder. The FT-IR patterns indicated that the characteristic peak of C=O in ester was observed at 1730 cm^-1. It is proved that different chain length acids (C₆, C₈, C₁₀ and C₁₂) reacted with glycerol by esterification and these are used to plasticize blends during extrusion. In addition, the blends would improve the hydrolysis and thermal stability. The water contact angle increased from 43.0° to 64.0°.  Second, the HA (110 °C), SBA (110 °C), SA (110 °C), and DA blends (130 °C) were used in study, because they possessed good mechanical properties, water resistances and thermal stability. On the other hand, the various contents (0, 0.005, 0.010, 0.020 g) of MSA were also used to modify the mechanical properties of blends. We observed that the blends were added to MSA, and then the FT-IR patterns indicated that the C=O ester appeared at 1730 cm^-1. For this reason, the hydrophobic blends were produced. The water contact angle of the MSA blends increased from 55.0° to 71.0°. Although break elongation of the MSA blends reduced from the original 220% to 128%, the stress increased from 2.5 MPa to 5.1 MPa. Therefore, the optimal composition of blends was the DA blend (130 °C) with adding of MSA (0.005 g).

Keywords: chain length acids, methane sulfonic acid, Tapioca starch (TPS), tensile stress

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Authors: Mayank Mishra

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Market Economy can be broadly defined as economic system where supply and demand regulate the economy and in which decisions pertaining to production, consumption, allocation of resources, price and competition are made by collective actions of individuals or organisations with limited government intervention. On the other hand Market Society is one where instead of the economy being embedded in social relations, social relations are embedded in the economy. A market economy becomes a market society when all of land, labour and capital are commodified. This transition also has effect on people’s attitude and values. Such a transition commence impacting the non-material aspect of life such as public education, public health and the like. The inception of neoliberal policies in non-market norms altered the nature of social goods like public health that raised the following questions. What impact would the transition to a market society make on people in terms of accessibility to public health? Is healthcare a commodity that can be subjected to a competitive market place? What kind of private investments are being made in public health and how do private investments alter the nature of a public good like healthcare? This research problem will employ empirical-analytical approach that includes deductive reasoning which will be using the existing concept of market economy and market society as a foundation for the analytical framework and the hypotheses to be examined. The research also intends to inculcate the naturalistic elements of qualitative methodology which refers to studying of real world situations as they unfold. The research will analyse the existing literature available on the subject. Concomitantly the research intends to access the primary literature which includes reports from the World Bank, World Health Organisation (WHO) and the different departments of respective ministries of the countries for the analysis. This paper endeavours to highlight how the issue of commodification of public health would lead to perpetual increase in its inaccessibility leading to stratification of healthcare services where one can avail the better services depending on the extent of one’s ability to pay. Since the fundamental maxim of private investments is to churn out profits, these kinds of trends would pose a detrimental effect on the society at large perpetuating the lacuna between the have and the have-nots.The increasing private investments, both, domestic and foreign, in public health sector are leading to increasing inaccessibility of public health services. Despite the increase in various public health schemes the quality and impact of government public health services are on a continuous decline.

Keywords: commodity, India and Pakistan, market society, public health

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Authors: Oluwatosin S. Adeoye

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The power quality issues in the world today are critical to the development of different nations. Prosperity of each nation depends on availability of constant power supply. Constant power supply is a major challenge in Africa particularly in Nigeria where the generated power is than thirty percent of the required power. The metrics of power quality are voltage dip, flickers, spikes, harmonics and interruptions. The level of interruptions in Ekiti State was examined through the investigation of the causes of power interruptions in the State. The method used was the collection of data from the Distribution Company, assessment through simple programming as a command for plotting the graphs through the use of MATLAB 2015 depicting the behavioural pattern of the interruption for a period of six months in 2016. The result shows that the interrelationship between the interruptions and development. Recommendations were suggested with the objective of solving the problems being set up by interruptions in the State and these include installation of reactors, automatic voltage regulators and effective tap changing system on the lines, busses and transformer substation respectively.

Keywords: development, frequency, interruption, power, quality

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Authors: Sonika Raj, Amarjeet Singh, Vijay Lakshmi Sharma

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Introduction: In 21st century, due to revolution in Information and Communication Technologies (ICTs), there has been phenomenal development in quality and quantity of knowledge in the field of medical science. So, the access to relevant information to physicians is critical to the delivery of effective healthcare services to patients. The study was conducted to assess the information needs and attitudes of the medical professionals; to determine the sources and channels of information used by them; to ascertain the current usage of ICTs and the barriers faced by them in utilization of ICTs in health information access. Methodology: This descriptive cross-sectional study was carried in 2015 on hundred medical professionals working in public and private sectors of Chandigarh. The study used both quantitative and qualitative method for data collection. A semi structured questionnaire and interview schedule was used to collect data on information seeking needs, access to ICTs and barriers to healthcare information access. Five Data analysis was done using SPSS-16 and qualitative data was analyzed using thematic approach. Results: The most preferred sources to access healthcare information were internet (85%), trainings (61%) and communication with colleagues (57%). They wanted information on new drug therapy and latest developments in respective fields. All had access to computer with but almost half assessed their computer knowledge as average and only 3% had received training regarding usage. Educational status (p=0.004), place of work (p=0.004), number of years in job (p=0.004) and sector of job (p=0.04) of doctors were found to be significantly associated with their active search for information. The major themes that emerged from in-views were need; types and sources of healthcare information; exchange of information among different levels of healthcare providers; usage of ICTs to obtain and share information; barriers to access of healthcare information and quality of health information materials and involvement in their development process Conclusion and Recommendations: The medical professionals need information in their in their due course of work. However, information needs of medical professionals were not being adequately met. There should be training of professional regarding internet skills and the course on bioinformatics should be incorporated in the curricula of medical students. The policy framework must be formulated that will encourage and promote the use of ICTs as tools for health information access and dissemination.

Keywords: health information, ICTs, medical professionals, qualitative

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Authors: Akshata Patel, Reenu Singh

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This paper focuses on current and upcoming fashion trends and global impact on the fashion industry due to the COVID-19 pandemic. The pandemic has had a major impact on the fashion industry worldwide. At the same time, the fashion market also faces challenges in consumer demand. As the supply chain and distribution channels are interconnected, this outbreak has a global impact due to travel restrictions and raw materials shortages. Given that this particular period represents an unprecedented market situation with almost no prior research on how the industry will recover from such a crisis and mold back to its original form, this research aims to propose new possibilities by evaluating the framework of specific segments. Based on the analysis and extensive literature review, the study develops a conceptual model that will illustrate the various connections among the different segments of the fashion industry. The findings provide actionable considerations for fashion industry pupils when implementing appropriate strategies to prevent unfavourable outcomes during times of crisis, such as the COVID-19 outbreak.

Keywords: COVID-19, fashion industry, global impact, new possibilities, pandemic

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Authors: Ramanpreet Kaur, Upasana Sharma

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The purpose of this paper is to address the challenges facing the water supply for the Machine Learning Database (MLDB) system at the piston foundry plant. In the MLDB system, one main unit, i.e., robotic, is connected by two sub-units. The functioning of the system depends on the robotic and water supply. Lack of water supply causes system failure. The system operates at full capacity with the help of two sub-units. If one sub-unit fails, the system runs at a low capacity. Reliability modeling is performed using semi-Markov processes and regenerative point techniques. Several system effects such as mean time to system failure, availability at full capacity, availability at reduced capacity, busy period for repair and expected number of visits have been achieved. Benefits have been analyzed. The graphical study is designed for a specific case using programming in C++ and MS Excel.

Keywords: MLDB system, robotic, semi-Markov process, regenerative point technique

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Authors: Mathias B. Michael, Esther T. Akinlabi, Tien-Chien Jen

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Thermal energy consumption in palm oil production plant comprises mainly of steam, hot water and hot air. In most efficient plants, hot water and air are generated from the steam supply system. Research has shown that thermal energy utilize in palm oil production plants is about 70 percent of the total energy consumption of the plant. In order to manage the plants’ energy efficiently, the energy systems are modelled and optimized. This paper aimed to present the model of steam supply systems of a typical palm oil production plant in Ghana. The models include exergy and energy models of steam boiler, steam turbine and the palm oil mill. The paper further simulates the virtual plant model to obtain the thermal energy performance of the plant under study. The simulation results show that, under normal operating condition, the boiler energy performance is considerably below the expected level as a result of several factors including intermittent biomass fuel supply, significant moisture content of the biomass fuel and significant heat losses. The total thermal energy performance of the virtual plant is set as a baseline. The study finally recommends number of energy efficiency measures to improve the plant’s energy performance.

Keywords: palm biomass, steam supply, exergy and energy models, energy performance benchmark

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Authors: Sudipto Shanker Dasgupta

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One of the largest mining companies wanted to look at health analytics for their driverless trucks. These trucks were the key to their supply chain logistics. The automated trucks had multi-level sub-assemblies which would send out sensor information. The use case that was worked on was to capture the sensor signal from the truck subcomponents and analyze the health of the trucks from repair and replacement purview. Open source software was used to stream the data into a clustered Hadoop setup in Amazon Web Services cloud and Apache Spark SQL was used to analyze the data. All of this was achieved through a 10 node amazon 32 core, 64 GB RAM setup real-time analytics was achieved on ‘300 million records’. To check the scalability of the system, the cluster was increased to 100 node setup. This talk will highlight how Open Source software was used to achieve the above use case and the insights on the high data throughput on a cloud set up.

Keywords: streaming analytics, data science, big data, Hadoop, high throughput, sensor data

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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: D. S. Gurjar, R. Kaur, K. P. Singh, R. Singh

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A greater volume of wastewater generate from urban areas in India. Due to the adequate availability, less energy requirement and nutrient richness, farmers of urban and peri-urban areas are deliberately using wastewater to grow high value vegetable crops. Wastewater contains pathogens and toxic pollutants, which can enter in the food chain system while using wastewater for irrigating vegetable crops. Hence, wastewater can use for growing commercial flower crops that may avoid food chain contamination. Tuberose (Polianthes tuberosa L.) is one of the most important commercially grown, cultivated over 30, 000 ha area, flower crop in India. Its popularity is mainly due to the sweet fragrance as well as the long keeping quality of the flower spikes. The flower spikes of tuberose has high market price and usually blooms during summer and rainy seasons when there is meager supply of other flowers in the market. It has high irrigation water requirement and fresh water supply is inadequate in tuberose growing areas of India. Therefore, wastewater may fulfill the water and nutrients requirements and may enhance the productivity of tuberose. Keeping in view, the present study was carried out at WTC farm of ICAR-Indian Agricultural Research Institute, New Delhi in 2014-15. Prajwal was the variety of test crop. The seven treatments were taken as T-1. Wastewater irrigation at 0.6 ID/CPE, T-2: Wastewater irrigation at 0.8 ID/CPE, T-3: Wastewater irrigation at 1.0 ID/CPE, T-4: Wastewater irrigation at 1.2 ID/CPE, T-5: Wastewater irrigation at 1.4 ID/CPE, T-6: Conjunctive use of Groundwater and Wastewater irrigation at 1.0 ID/CPE in cyclic mode, T-7: Control (Groundwater irrigation at 1.0 ID/CPE) in randomized block design with three replication. Wastewater and groundwater samples were collected on monthly basis (April 2014 to March 2015) and analyzed for different parameters of irrigation quality (pH, EC, SAR, RSC), pollution hazard (BOD, toxic heavy metals and Faecal coliforms) and nutrients potential (N, P, K, Cu, Fe, Mn, Zn) as per standard methods. After harvest of tuberose crop, soil samples were also collected and analyzed for different parameters of soil quality as per standard methods. The vegetative growth and flower parameters were recorded at flowering stage of tuberose plants. Results indicated that wastewater samples had higher nutrient potential, pollution hazard as compared to groundwater used in experimental crop. Soil quality parameters such as pH EC, available phosphorous & potassium and heavy metals (Cu, Fe, Mn, Zn, Cd. Pb, Ni, Cr, Co, As) were not significantly changed whereas organic carbon and available nitrogen were significant higher in the treatments where wastewater irrigations were given at 1.2 and 1.4 ID/CPE as compared to groundwater irrigations. Significantly higher plant height (68.47 cm), leaves per plant (78.35), spike length (99.93 cm), rachis length (37.40 cm), numbers of florets per spike (56.53), cut spike yield (0.93 lakh/ha) and loose flower yield (8.5 t/ha) were observed in the treatment of Wastewater irrigation at 1.2 ID/CPE. Study concluded that given quality of wastewater improves the productivity of tuberose without an adverse impact on soil quality/health. However, its long term impacts need to be further evaluated.

Keywords: conjunctive use, irrigation, tuberose, wastewater

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Authors: Omolara Lade, David Oloke

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Ibadan City suffers serious water supply problems; cases of dry taps are common in virtually every part of the City. The scarcity of piped water has made communities find alternative water sources; groundwater sources being a ready source. These wells are prone to pollution due to the close proximity of septic tanks to wells, disposal of solid or liquid wastes in pits, abandoned boreholes or even stream channels and landfills. Storms and floods in Ibadan have increased with consequent devastating effects claiming over 120 lives and displacing 600 people on August 2011 alone. In this study, an analysis of the water demand and sources of supply for the city was carried out through questionnaire survey and collection of data from City’s main water supply - Water Corporation of Oyo State (WCOS), groundwater sources were explored and 30 years rainfall data were collected from Meteorological station in Ibadan. 1067 questionnaire were administered at household level with a response rate of 86.7 %. A descriptive analysis of the survey revealed that 77.1 % of the respondents did not receive water at all from WCOS while 83.8 % depend on groundwater sources. Analysis of data from WCOS revealed that main water supply is inadequate as < 10 % of the population water demand was met. Rainfall intensity is highest in June with a mean value of 188 mm, which can be harvested at community—based level and used to complement the population water demand. Rainwater harvesting if planned, and managed properly will become a valuable alternative source of managing urban flood and alleviating water scarcity in the city.

Keywords: Ibadan, rainwater harvesting, sustainable water, urban flooding

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Authors: Lali Khurtsia, Vano Tsertsvadze

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Georgian drug policy is directed to reduce the supply of drugs. Retrospective analysis has shown that law enforcement activities have been followed by the expulsion of particular injecting drugs. The demand remains unchanged and drugs are substituted by the hand-made, even more dangerous homemade drugs entered the market. To find out expected new trends on the Georgian drug market, qualitative study was conducted with Georgian drug users to determine drug supply routes. It turned out that drug suppliers and consumers for safety reasons and to protect their anonymity, use Skype to make deals. IT in illegal drug trade is even more sophisticated in the worldwide. Trading with Bitcoins in the Darknet ensures high confidentiality of money transactions and the safe circulation of drugs. In 2014 largest Bitcoin mining enterprise in the world was built in Georgia. We argue that the use of Bitcoins and Darknet by Georgian drug consumers and suppliers will be an incentive to response adequately to the government's policy of restricting supply in order to satisfy market demand for drugs.

Keywords: bitcoin, darknet, drugs, policy

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Authors: M. Pramila Devi, J. Praveena

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In today’s industrial scenario, the expectations and demand of customers are reaching great heights. In order to satisfy the customer requirements the users are increasingly turning towards fourth party logistics (4PL) service providers to manage their total supply chain operations. In this present research, initially, the criteria for the selection of integrated service providers have been identified and an integrated modal based on their inter-relationship has been developed with help of shippers, with this idea of what factors to be considered and their inter-relationships while selecting integrated service provider. Later, various methods deriving the priority weights viz. Analytical Hierarchy Process (AHP) have been employed for 4PL service provider selection. The derived priorities of 4PL alternatives using methods have been critically analyzed and compared for effective selection. The use of the modal indicates that the computed quantitative evaluation can be applied to improve the precision of the selection.

Keywords: analytical hierarchy process, fourth party logistics, priority weight, criteria selection

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Authors: Jing Jiang, Yuguang Gao, Yang Yu

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Facing increasingly challenging insurance payment pressures, the Chinese healthcare system is undergoing significant transformations, akin to the implementation of DRG payment models by the United States' Medicare. Consequently, there is a pressing need for Chinese hospitals to establish optimizations in departmental operations tailored to the ongoing healthcare payment reforms. This abstract delineates the meticulous construction of a scientifically rigorous and comprehensive index system at the departmental level in China strategically aligned with the evolving landscape of healthcare payment reforms. Methodologically, it integrates key process areas and maturity assessment theories, synthesizing relevant literature and industry standards to construct a robust framework and indicator pool. Employing the Delphi method, consultations with 21 experts were conducted, revealing a collective demonstration of high enthusiasm, authority, and coordination in designing the index system. The resulting model comprises four primary indicators -technical capabilities, cost-effectiveness, operational efficiency, and disciplinary potential- supported by 14 secondary indicators and 23 tertiary indicators with varied coefficient adjustment for department types (platform or surgical). The application of this evaluation system in a Chinese hospital within the northeastern region yielded results aligning seamlessly with the actual operational scenario. In conclusion, the index system comprehensively considers the integrity and effectiveness of structural, process, and outcome indicators and stands as a comprehensive reflection of the collective expertise of the engaged experts, manifesting in a model designed to elevate the operational management of hospital departments. Its strategic alignment with healthcare payment reforms holds practical significance in guiding departmental development positioning, brand cultivation, and talent development.

Keywords: Chinese healthcare system, Delphi method, departmental management, evaluation indicators, hospital operations, weight coefficients

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Authors: Khaled Elbehiery, Hussam Elbehiery

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Smart cities are a framework of technologies along with sustainable infrastructure to provide their citizens an improved quality of life, safer environment, affordability, and more, which in turn helps with the society's economic growth. The proposed research will focus on the primary building block of the smart city; the infrastructure of the house itself. The traditional method of building houses has been, for a long time, nothing but a costly manufacturing process, and consequently, buying a house becomes not an option for everyone anymore. The smart cities' Modular Houses are not using traditional building construction materials; the design reduces the common lengthy construction times and associated high costs. The Modular Houses are technological homes, low-cost and customizable based on a family's requirements. In addition, the Modular Houses are environmentally friendly and healthy enough to assist with the pandemic situation.

Keywords: smart cities, modular houses, single-unit property, multi-unit property, mobility features, chain-supply, livable environment, carbon footprint

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Authors: R. Govender, T. C. Katsande, E. Madoroba, N. M. Thiebaut, D. Naidoo

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South African control over meat safety is managed by the Department of Agriculture, Forestry and Fisheries (DAFF). Veterinary services department in each of the nine provinces in the country is tasked with overseeing the farm and abattoir segments of the meat supply chain. Abattoirs are privately owned. The number of abattoirs over the years has increased. This increase has placed constraints on government resources required to monitor these abattoirs. This paper presents empirical research results on the hygienic processing of meat in high and low throughout abattoirs. This paper presents a case for the adoption of risk-based regulation as a method of government control over hygiene and safe meat processing at abattoirs in South Africa. Recommendations are made to the DAFF regarding policy considerations on risk-based regulation as a model of control in South Africa.

Keywords: risk-based regulation, abattoir, food control, meat safety

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Authors: Pedro M. Abreu, Bruno R. Mendes

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The management of pharmacotherapy and the process of dispensing medicines is becoming critical in clinical pharmacy due to the increase of incidence and prevalence of chronic diseases, the complexity and customization of therapeutic regimens, the introduction of innovative and more expensive medicines, the unbalanced relation between expenditure and revenue as well as due to the lack of rationalization associated with medication use. For these reasons, co-payments emerged in Europe in the 70s and have been applied over the past few years in healthcare. Co-payments lead to a rationing and rationalization of user’s access under healthcare services and products, and simultaneously, to a qualification and improvement of the services and products for the end-user. This analysis, under hospital practices particularly and co-payment strategies in general, was carried out on all the European regions and identified four reference countries, that apply repeatedly this tool and with different approaches. The structure, content and adaptation of European co-payments were analyzed through 7 qualitative attributes and 19 performance indicators, and the results expressed in a scorecard, allowing to conclude that the German models (total score of 68,2% and 63,6% in both elected co-payments) can collect more compliance and effectiveness, the English models (total score of 50%) can be more accessible, and the French models (total score of 50%) can be more adequate to the socio-economic and legal framework. Other European models did not show the same quality and/or performance, so were not taken as a standard in the future design of co-payments strategies. In this sense, we can see in the co-payments a strategy not only to moderate the consumption of healthcare products and services, but especially to improve them, as well as a strategy to increment the value that the end-user assigns to these services and products, such as medicines.

Keywords: clinical pharmacy, co-payments, healthcare, medicines

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Authors: Sisira Edirippulige

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Background: Digital health education and training (DHET) is imperative for preparing current and future clinicians to work competently in digitally enabled environments. Despite rapid integration of digital health in modern health services, systematic education and training opportunities for health workers is still lacking. Objectives: This study aimed to investigate healthcare professionals’ perspectives and expectations regarding the knowledge, skills and competency needs in digital health for current and future healthcare workforce. Methods: A qualitative study design with semi-structured individual interviews was employed. A purposive sample method was adopted to collect relevant information from the health workers. Inductive thematic analysis was used to analyse data. Interviews were audio-recorded and transcribed verbatim. Consolidated Criteria for Reporting Qualitative Research (COREQ) was followed when we reported this study. Results: Two themes emerged while analysing the data: (1) what to teach in DHET and (2) how to teach DHET. Overall, healthcare professionals agreed that DHET is important for preparing current and future clinicians for working competently in digitally enabled environments. Knowledge relating to what is digital health, types of digital health, use of technology and human factors in digital health were considered as important to be taught in DHET. Skills relating to digital health consultations, clinical information system management and remote monitoring were considered important to be taught. Blended learning which combined e-learning and classroom-based teaching, simulation sessions and clinical rotations were suggested by healthcare professionals as optimal approaches to deliver the above-mentioned content. Conclusions: This study is the first of its kind to investigate health professionals’ perspectives and expectations relating to the knowledge, skills and competency needs in digital health for current and future healthcare workforce. Healthcare workers are keen to acquire relevant knowledge, skills and competencies related to digital health. Different modes of education delivery is of interest to fit in with busy schedule of health workers.

Keywords: digital health, telehealth, telemedicine, education, curriculum

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Authors: Mohammad Al-Mousawi

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This academic article explores the indispensable role of critical thinking in the process of diagnosing diseases. Employing a multidisciplinary approach, we delve into the cognitive skills and analytical mindset that clinicians, researchers, and healthcare professionals must employ to navigate the complexities of disease identification. By examining the integration of critical thinking within the realms of medical education, diagnostic decision-making, and technological advancements, this article aims to underscore the significance of cultivating and applying critical thinking skills in the ever-evolving landscape of healthcare.

Keywords: critical thinking, medical education, diagnostic decision-making, fostering critical thinking

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Authors: Kazuhisa Koda, Tsutomu Kobayashi

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Laura Island, which is located about 50 km away from downtown, is a source of water supply in Majuro atoll, which is the capital of the Republic of the Marshall Islands. Low and flat Majuro atoll has neither river nor lake. It is very important for Majuro atoll to ensure the conservation of its water resources. However, up-coning, which is the process of partial rising of the freshwater-saltwater boundary near the water-supply well, was caused by the excess pumping from it during the severe drought in 1998. Up-coning will make the water usage of the freshwater lens difficult. Thus, appropriate water usage is required to prevent up-coning in the freshwater lens because there is no other water source during drought. Numerical simulation of water usage applying SEAWAT model was conducted at the central part of Laura Island, including the water-supply well, which was affected by up-coning. The freshwater lens was created as a result of infiltration of consistent average rainfall. The lens shape was almost the same as the one in 1985. 0 of monthly rainfall and variable daily pump discharge were used to calculate the sustainable pump discharge from the water-supply well. Consequently, the total amount of pump discharge was increased as the daily pump discharge was increased, indicating that it needs more time to recover from up-coning. Thus, a pump standard to reduce the pump intensity is being proposed, which is based on numerical simulation concerning the occurrence of the up-coning phenomenon in Laura Island during the drought.

Keywords: freshwater lens, islands, numerical simulation, sustainable water use

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Authors: Abdel-Aziz M. Mohamed

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This research proposes a methodology to estimate the customer order lead time in the supply chain based on the process capability index. The cases when the process output is normally distributed and when it is not are considered. The relationships between the system capability indices in both service and manufacturing applications, delivery system reliability and the percentages of orders delivered after their promised due dates are presented. The proposed method can be used to examine the current process capability to deliver the orders before the promised lead-time. If the system was found to be incapable, the method can be used to help revise the current lead-time to a proper value according to the service reliability level selected by the management. Numerical examples and a case study describing the lead time estimation methodology and testing the system capability of delivering the orders before their promised due date are illustrated.

Keywords: lead-time estimation, process capability index, delivery system reliability, statistical analysis, service achievement index, service quality

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Authors: John Pomerat, Aviv Segev

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Recently, deep learning has had many theoretical breakthroughs. For deep learning to be successful in the industry, however, there need to be practical algorithms capable of handling many real-world hiccups preventing the immediate application of a learning algorithm. Although AI promises to revolutionize the healthcare industry, getting access to patient data in order to train learning algorithms has not been easy. One proposed solution to this is data- sharing. In this paper, we propose an alternative protocol, based on multi-party computation, to train deep learning models while maintaining both the privacy and security of training data. We examine three methods of training neural networks in this way: Transfer learning, average ensemble learning, and series network learning. We compare these methods to the equivalent model obtained through data-sharing across two different experiments. Additionally, we address the security concerns of this protocol. While the motivating example is healthcare, our findings regarding multi-party computation of neural network training are purely theoretical and have use-cases outside the domain of healthcare.

Keywords: neural network aggregation, multi-party computation, transfer learning, average ensemble learning

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Authors: Elena Puica

Abstract:

This paper aims to investigate the impact of Supply Chain Management (SCM) on the environment by applying a Machine Learning model while pointing out the efficiency of the technology used. The Machine Learning model was used to derive the efficiency and optimization of technology used in SCM and the environmental impact of SCM processes. The model applied is a predictive classification model and was trained firstly to determine which stage of the SCM has more outputs and secondly to demonstrate the efficiency of using advanced technology in SCM instead of recuring to traditional SCM. The outputs are the emissions generated in the environment, the consumption from different steps in the life cycle, the resulting pollutants/wastes emitted, and all the releases to air, land, and water. This manuscript presents an innovative approach to applying advanced technology in SCM and simultaneously studies the efficiency of technology and the SCM's impact on the environment. Identifying the conceptual relationships between SCM practices and their impact on the environment is a new contribution to the research. The authors can take a forward step in developing recent studies in SCM and its effects on the environment by applying technology.

Keywords: machine-learning model in SCM, SCM processes, SCM and the environmental impact, technology in SCM

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Authors: Ezinne K. Okoro, Takahiko Katoh, Yoko Kawamura, Stanley C. Meribe

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HIV infection in children is largely as a result of vertical transmission (mother to child transmission [MTCT]). Thus, elimination of mother to child transmission of HIV/AIDS is critical in eliminating HIV infection in children. In Nigeria, drawbacks such as; limited pediatric screening, limited human capital, insufficient advocacy and poor understanding of ART guidelines, have impacted efforts at combating the disease, even as treatment services are free. Prevention of Mother to Child Transmission (PMTCT) program relies on health workers who not only counsel pregnant women on first contact but can competently provide HIV-positive pregnant women with accurate information about the PMTCT program such as feeding techniques and drug adherence. In developing regions like Nigeria where health care delivery faces a lot of drawbacks, it becomes paramount to address these issues of poor PMTCT coverage by conducting a baseline assessment of the knowledge, practices and perceptions related to HIV prevention amongst healthcare workers in Nigeria. A descriptive cross-sectional study was conducted amongst 250 health workers currently employed in health facilities in Abuja, Nigeria where PMTCT services were offered with the capacity to carry out early infant diagnosis testing (EID). Data was collected using a self-administered, pretested, structured questionnaire. This study showed that the knowledge of PMTCT of HIV was poor (30%) among healthcare workers who offer this service day-to-day to pregnant women. When PMTCT practices were analyzed in keeping with National PMTCT guidelines, over 61% of the respondents reported observing standard practices and the majority (58%) had good attitudes towards caring for patients with HIV/AIDS. Although 61% of the respondents reported being satisfied with the quality of service being rendered, 63% reported not being satisfied with their level of knowledge. Predictors of good knowledge were job designation and level of educational attainment. Health workers who were more satisfied with their working conditions and those who had worked for a longer time in the PMTCT service were more likely to observe standard PMTCT practices. With over 62% of the healthcare workers suggesting that more training would improve the quality of service being rendered, this is a strong pointer to stakeholders to consider a ‘healthcare worker-oriented approach’ when planning and conducting PMTCT training for healthcare workers. This in turn will increase pediatric ARV coverage, the knowledge and effectiveness of the healthcare workers in carrying out appropriate PMTCT interventions and culminating in the reduction/elimination of HIV transmission to newborns.

Keywords: attitudes, HIV/AIDS, healthcare workers, knowledge, mother to child transmission, Nigeria, perceptions

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Authors: Andrés I. Ávila, Patricia Aros, César San Martín, Elizabeth Kehr, Yovana Leal

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Planning models for fresh products is a very useful tool for improving the net profits. To get an efficient supply chain model, several functions should be considered to get a complete simulation of several operational units. We consider a linear programming model to help farmers to decide if it is convenient to choose what area should be planted for three kinds of export fruits considering their future investment. We consider area, investment, water, productivity minimal unit, and harvest restrictions to develop a monthly based model to compute the average income in five years. Also, conditions on the field as area, water availability, and initial investment are required. Using the Chilean costs and dollar-peso exchange rate, we can simulate several scenarios to understand the possible risks associated to this market. Also, this tool help to support decisions for government and individual farmers.

Keywords: mixed integer problem, fresh fruit production, support decision model, agricultural and biosystems engineering

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Authors: Garry A. Einicke, Langford B. White

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This paper describes an optimum filter and smoother for recovering a Markov process message from noisy measurements. The developments follow from an equivalence between a state space model and a hidden Markov chain. The ensuing filter and smoother employ transition probability matrices and approximate probability distribution vectors. The properties of the optimum solutions are retained, namely, the estimates are unbiased and minimize the variance of the output estimation error, provided that the assumed parameter set are correct. Methods for estimating unknown parameters from noisy measurements are discussed. Signal recovery examples are described in which performance benefits are demonstrated at an increased calculation cost.

Keywords: optimal filtering, smoothing, Markov chains

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Authors: Sriraman Kothuri, Komal Teja Mattupalli

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In this paper we proposed a novel algorithm for recognizing hulls in a hand written digits. This is an extension to the work on “Digit Recognition Using Freeman Chain code”. In order to find out the hulls in a user given digit it is necessary to follow three steps. Those are pre-processing, Boundary Extraction and at last apply the Hull Detection system in a way to attain the better results. The detection of Hull Regions is mainly intended to increase the machine learning capability in detection of characters or digits. This can also extend this in order to get the hull regions and their intensities in Black Holes in Space Exploration.

Keywords: chain code, machine learning, hull regions, hull recognition system, SASK algorithm

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