Search results for: limitation of medical personnel

Authors: Ashlesha Khanapure, Harsh Kashyap, Abhinav Anand, Sanjana Habib, Anupama Bidargaddi

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Technologies that are developing quickly are being developed daily in a variety of disciplines, particularly the medical field. For the purpose of detecting bone fractures in X-ray pictures of different body segments, our work compares the ResNet-50 and MobileNetV3 architectures. It evaluates accuracy and computing efficiency with X-rays of the elbow, hand, and shoulder from the MURA dataset. Through training and validation, the models are evaluated on normal and fractured images. While ResNet-50 showcases superior accuracy in fracture identification, MobileNetV3 showcases superior speed and resource optimization. Despite ResNet-50’s accuracy, MobileNetV3’s swifter inference makes it a viable choice for real-time clinical applications, emphasizing the importance of balancing computational efficiency and accuracy in medical imaging. We created a graphical user interface (GUI) for MobileNet V3 model bone fracture detection. This research underscores MobileNetV3’s potential to streamline bone fracture diagnoses, potentially revolutionizing orthopedic medical procedures and enhancing patient care.

Keywords: CNN, MobileNet V3, ResNet-50, healthcare, MURA, X-ray, fracture detection

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Authors: Han Xiao

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The development of nanomedicines has recently achieved several breakthroughs in the field of cancer treatment; however, the biocompatibility and targeted burst release of these medications remain a limitation, which leads to serious side effects and significantly narrows the scope of their applications. The self-assembly of intermediate filament protein (IFP) peptides was triggered by a hydrophobic cation drug 7-amino actinomycin D (7-AAD) to synthesize pH-activatable nanoparticles (NPs) that could simultaneously locate tumors and produce antitumor effects. The designed IFP peptide included a target peptide (arginine–glycine–aspartate), a negatively charged region, and an α-helix sequence. It also possessed the ability to encapsulate 7-AAD molecules through the formation of hydrogen bonds and hydrophobic interactions by a one-step method. 7-AAD molecules with excellent near-infrared fluorescence properties could be target delivered into tumor cells by NPs and released immediately in the acidic environments of tumors and endosome/lysosomes, ultimately inducing cytotoxicity by arresting the tumor cell cycle with inserted DNA. It is noteworthy that the IFP/7-AAD NPs tail vein injection approach demonstrated not only high tumor-targeted imaging potential, but also strong antitumor therapeutic effects in vivo. The proposed strategy may be used in the delivery of cationic antitumor drugs for precise imaging and cancer therapy.

Keywords: 7-amino actinomycin D, intermediate filament protein, nanoparticle, tumor image

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Authors: Wu Liching

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Aim This case aims to discuss the pathogenesis, clinical manifestations and medical treatment of strokes caused by mitochondrial gene mutations. Methods Diagnosis of ischemic stroke caused by mitochondrial gene defect by means of "next-generation sequencing mitochondrial DNA gene variation detection", imaging examination, neurological examination, and medical history; this study took samples from the neurology ward of a medical center in northern Taiwan cases diagnosed with acute cerebral infarction as the research objects. Result This case is a 49-year-old married woman with a rare disease, mitochondrial gene mutation inducing ischemic stroke. She has severe hearing impairment and needs to use hearing aids, and has a history of diabetes. During the patient’s hospitalization, the blood test showed that serum Lactate: 7.72 mmol/L, Lactate (CSF) 5.9 mmol/L. Through the collection of relevant medical history, neurological evaluation showed changes in consciousness and cognition, slow response in language expression, and brain magnetic resonance imaging examination showed subacute bilateral temporal lobe infarction, which was an atypical type of stroke. The lineage DNA gene has m.3243A>G known pathogenic mutation point, and its heteroplasmic level is 24.6%. This pathogenic point is located in MITOMAP and recorded as Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes (MELAS) , Leigh Syndrome and other disease-related pathogenic loci, this mutation is located in ClinVar and recorded as Pathogenic (dbSNP: rs199474657), so it is diagnosed as a case of stroke caused by a rare disease mitochondrial gene mutation. After medical treatment, there was no more seizure during hospitalization. After interventional rehabilitation, the patient's limb weakness, poor language function, and cognitive impairment have all improved significantly. Conclusion Mitochondrial disorders can also be associated with abnormalities in psychological, neurological, cerebral cortical function, and autonomic functions, as well as problems with internal medical diseases. Therefore, the differential diagnoses cover a wide range and are not easy to be diagnosed. After neurological evaluation, medical history collection, imaging and rare disease serological examination, atypical ischemic stroke caused by rare mitochondrial gene mutation was diagnosed. We hope that through this case, the diagnosis of rare disease mitochondrial gene variation leading to cerebral infarction will be more familiar to clinical medical staff, and this case report may help to improve the clinical diagnosis and treatment for patients with similar clinical symptoms in the future.

Keywords: acute stroke, MELAS, lactic acidosis, mitochondrial disorders

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Authors: Olga Leontjeva

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In the age of Artificial Intelligence (AI), some organization management approaches need to be adapted or changed. Human Resource Management (HRM) is a part of organization management that is under the managers' focus nowadays, because AI integration into organization activities brings some HRM-connected challenges. The topic became more significant during the crises of many organizations in the world caused by the coronavirus pandemic (COVID-19). The paper presents an approach, which will be used for the study that is going to be focused on the various case analysis. The author of the future study will analyze the cases of the organizations from Latvia and Spain that are grouped by the size, type of activity and area of business. The information for the cases will be collected through structured interviews and online surveys. The main result presented is the questionnaire developed that will be used for the study as well as the definition and description of sampling. The first round of the survey will be based on convenience sampling that is the main limitation of the study. To conclude, the approach developed will help to collect valid data if the organizations participating in the survey are ready to share their cases in depth, so the researchers could draw the right conclusions and generalize compared organizations’ cases. The questionnaire developed for the survey is applicable for both written online data collection as well as for the interviews. The case analysis will help to identify some HRM challenges that are connected to AI integration into organization activities such as management of different generation employees and their training peculiarities.

Keywords: age of artificial intelligence, case analysis, generation Y and Z employees, human resource management

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Authors: Sheng-Hung Chen, Grace Mmametena Mahlangu, Hui-Cheng Wang

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This study aims to explore the trends of the Entrepreneurial Framework Conditions (EFCs) in the five African regions. The Global Entrepreneur Monitor (GEM) is the primary source of data. The data drawn were organized into a panel (2000-2021) and obtained from the National Expert Survey (NES) databases as harmonized by the (GEM). The Methodology used is descriptive and uses mainly charts and tables; this is in line with the approach used by the GEM. The GEM draws its data from the National Expert Survey (NES). The survey by the NES is administered to experts in each country. The GEM collects entrepreneurship data specific to each country. It provides information about entrepreneurial ecosystems and their impact on entrepreneurship. The secondary source is from the literature review. This study focuses on the following GEM indicators: Financing for Entrepreneurs, Government support and Policies, Taxes and Bureaucracy, Government programs, Basic School Entrepreneurial Education and Training, Post school Entrepreneurial Education and Training, R&D Transfer, Commercial And Professional Infrastructure, Internal Market Dynamics, Internal Market Openness, Physical and Service Infrastructure, and Cultural And Social Norms, based on GEM Report 2020/21. The limitation of the study is the lack of updated data from some countries. Countries have to fund their own regional studies; African countries do not regularly participate due to a lack of resources.

Keywords: trend analysis, entrepreneurial framework conditions (EFCs), African region, government programs

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Authors: Nalinee Sophatsathit

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The objectives of memorabilia of Suan Sunandha are to develop a general knowledge presentation about the historical royal garden through interactive graphic simulation technique and to employ high-functionality context in enhancing interactive user navigation. The approach infers non-intrusive display of relevant history in response to situational context. User’s navigation runs through the virtual reality campus, consisting of new and restored buildings. A flash back presentation of information pertaining to the history in the form of photos, paintings, and textual descriptions are displayed along each passing-by building. To keep the presentation lively, graphical simulation is created in a serendipity game play so that the user can both learn and enjoy the educational tour. The benefits of this human-computer interaction development are two folds. First, lively presentation technique and situational context modeling are developed that entail a usable paradigm of knowledge and information presentation combinations. Second, cost effective training and promotion for both internal personnel and public visitors to learn and keep informed of this historical royal garden can be furnished without the need for a dedicated public relations service. Future improvement on graphic simulation and ability based display can extend this work to be more realistic, user-friendly, and informative for all.

Keywords: interactive user navigation, high-functionality context, situational context, human-computer interaction

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Authors: Neha Sharma, Kanthi K. Kondepudi, Naveen Gupta

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Phytases are phytate specific phosphatases catalyzing the step-wise dephosphorylation of phytate, which acts as an anti-nutritional factor in food due to its strong binding capacity to minerals. In recent years microbial phytases have been explored for improving nutritional quality of food. But the major limitation is acceptability of phytases from these microorganisms. Therefore, efforts are being made to isolate organisms which are generally regarded as safe for human consumption such as Lactic Acid Bacteria (LAB). Phytases from these organisms will have an edge over other phytase sources due to its probiotic attributes. Only few LAB have been reported to give phytase activity that too is generally seen as intracellular. LAB producing extracellular phytase will be more useful as it can degrade phytate more effectively. Moreover, enzyme from such isolate will have application in food processing also. Only few species of Lactobacillus producing extracellular phytase have been reported so far. This study reports the isolation of a probiotic strain of Lactobacillus fermentum spp KA1 which produces extracellular phytase. Conditions for the optimal production of phytase have been optimized and the enzyme production resulted in an approximately 13-fold increase in yield. The phytate degradation potential of extracellular phytase in rice bran has been explored and conditions for optimal degradation were optimized. Under optimal conditions, there was 43.26% release of inorganic phosphate and 6.45% decrease of phytate content.

Keywords: Lactobacillus, phytase, phytate reduction, rice bran

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Authors: H. Jalahi, A. Yazdanpanah Nozari

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Background and Purpose: Assessment of learners’ performance is an important factors in teaching-learning process. When a factor is sensitive and has high influence on life, their assessment should be done precisely. Thinking dispositions are very important factors in medical education because of its specific condition. In this study a model is designed for fostering thinking dispositions of learners in which authentic assessment is an important element. Materials and Methods: Objective based research is developmental, and such a model was not designed for curricula. Data collection and comparing approaches about assessment and analyzing current assessments offered applied proposals. Results: Based on research findings, the current assessments are response-based, that is students instead of product of response, only offers the specific response which the teachers expects; but authentic assessment is a form of assessment in which students are asked to perform real-word tasks that demonstrate meaningful application of essential knowledge and skills. Conclusion: Because of the difficulties and unexpected problems in life and individuals needs to lifelong learning and conditions in medical course that require decision making in specific times, we must pay attention to reach thinking dispositions and it should be included in curriculum. Authentic assessment as an important aspect of curriculum can help fostering thinking dispositions of learners. Using this kind of assessments which focus on application of information and skills to solve real-word tasks have more important role in medical courses.

Keywords: assessment, authentic, medical courses, developmental

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Authors: Julia Wimmers-Klick

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In the contemporary study of anatomy, medical students utilize a diverse array of resources, including lab handouts, lectures, and, increasingly, digital media such as interactive anatomy apps and digital images. Notably, a significant shift has occurred, with fewer students possessing traditional anatomy atlases or books, reflecting a broader trend towards digital approaches like Virtual Reality, Augmented Reality, and web-based programs. This paper seeks to explore the evolution of anatomy education by contrasting current digital tools with historical resources, such as classical anatomical illustrations and atlases, to assess their relevance and potential benefits in modern medical education. Through a comprehensive literature review, the development of anatomical illustrations is traced from the textual descriptions of Galen to the detailed and artistic representations of Da Vinci, Vesalius, and later anatomists. The examination includes how the printing press facilitated the dissemination of anatomical knowledge, transforming covert dissections into public spectacles and formalized teaching practices. Historical illustrations, often influenced by societal, religious, and aesthetic contexts, not only served educational purposes but also reflected the prevailing medical knowledge and ethical standards of their times. Critical questions are raised about the place of historical illustrations in today's anatomy curriculum. Specifically, their potential to teach critical thinking, highlight the history of medicine, and offer unique insights into past societal conditions are explored. These resources are viewed in their context, including the lack of diversity and the presence of ethical concerns, such as the use of illustrations from unethical sources like Pernkopf’s atlas. In conclusion, while digital tools offer innovative ways to visualize and interact with anatomical structures, historical illustrations provide irreplaceable value in understanding the evolution of medical knowledge and practice. The study advocates for a balanced approach that integrates traditional and modern resources to enrich medical education, promote critical thinking, and provide a comprehensive understanding of anatomy. Future research should investigate the optimal combination of these resources to meet the evolving needs of medical learners and the implications of the digital shift in anatomy education.

Keywords: human anatomy, historical illustrations, historical context, medical education

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Authors: Maryam Solgi, Behzad Shahmohammadi, Morteza Raissi Dehkordi

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One of the main steps for seismic retrofitting of buildings is to determine the vulnerability of structures. While current procedures for evaluating existing buildings are complicated, and there is no limitation between short, middle-high, and tall buildings. This research utilizes a simplified method for assessing structures, which is adequate for existing reinforced concrete buildings. To approach this aim, Simple Lateral Mechanisms Analysis (SLaMA) procedure proposed by NZSEE (New Zealand Society for Earthquake Engineering) has been carried out. In this study, three RC moment-resisting frame buildings are determined. First, these buildings have been evaluated by inelastic static procedure (Pushover) based on acceptance criteria. Then, Park-Ang Damage Index is determined for the whole members of each building by Inelastic Time History Analysis. Next, the Simple Lateral Mechanisms Analysis procedure, a hand method, is carried out to define the capacity of structures. Ultimately, existing procedures are compared with Peak Ground Acceleration caused to fail (PGAfail). The results of this comparison emphasize that the Pushover procedure and SLaMA method define a greater value of PGAfail than the Park-Ang Damage model.

Keywords: peak ground acceleration caused to fail, reinforced concrete moment-frame buildings, seismic vulnerability analysis, simple lateral mechanisms analysis

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Authors: Amirreza Heidari, Akram Avami, Ehsan Heidari

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Evaporative cooling systems are known as energy efficient cooling systems, with much lower electricity consumption than conventional vapor compression systems. A serious limitation of these systems, however, is that they are not applicable in humid regions. Combining a desiccant wheel with these systems, known as desiccant-based evaporative cooling systems, makes it possible to use evaporative cooling in humid climates. This paper evaluates the performane of a cooling system combining desiccant wheel, direct and indirect evaporative coolers (called desiccant-based indirect-direct evaporative cooling (DIDE) system) and then evaluates the energy saving potential of this system over the conventional vapor compression cooling and drying system. To illustrate the system ability of providing comfort conditions, a dynamic hourly simulation of this system is performed for a typical 60 m² building in Sydney, Australia. To evaluate the energy saving potential of this system, a conventional cooling and drying system is also simulated for the same cooling capacity. It has been found that the DIE system is able to provide comfort temperature and relative humidity in a subtropical humid climate like Sydney. The electricity and natural gas consumption of this system are respectively 39.2% and 2.6% lower than that of conventional system over a week. As the research has demonstrated, the innovative DIDE system is an energy efficient cooling system for subtropical humid regions.

Keywords: desiccant, evaporative cooling, dehumidification, indirect evaporative cooler

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Authors: Siddhant Yadav, Ann Vincent, Sanjeev Nanda, Karen M. Fischer, Jessica A. Wright

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Statement of the Problem: Despite the growing popularity of cannabis in the general population, there are several unknowns regarding its use, specific reasons for use, patient’s choice of products, health benefits, and adverse effects. The aim of our study was to evaluate patient-reported information related to cannabis use that was recorded in the electronic medical records. Methodology & Theoretical Orientation: We manually reviewed the electronic medical records of cannabis users who were part of a large pharmacogenomic study. Data abstracted included demographics, level of education, concurrent alcohol and tobacco use, type of cannabis utilized, formulation, indication, symptomatic improvement, or adverse effects reported. Following this, we did a descriptive statistical analysis. Findings: Our sample of 164 cannabis users were predominantly female (73.2%); 66% of users reported using cannabis for medical indications. Of the 109 patients who recorded information pertaining to alcohol/tobacco use, two-thirds of cannabis users reported concurrent use of alcohol, and about half of them were former or current tobacco users. The mean age of cannabis use was 66 years. Regarding the type of cannabis, 34.1% reported using marijuana, 32.3% reported CBD use, 1.8% reported using THC, and 1.2% reported using Marinol. Oral formulations (capsules, oils, suspensions, brownies, cakes, and tea) were the most common route (44 %). Indications for use included chronic pain (n=76), anxiety (n=9), counteracting side effects of chemotherapy (n=4), and palliative reasons (n=2). Fifty-eight of the 76 users endorsed improvement in chronic pain (80%), 5 users reported improvement in anxiety, and 2 reported improvement in side effects of chemotherapy. Conclusion & Significance: The majority of our cannabis users were Caucasian females, and there was a high likelihood of coinciding use of alcohol/tobacco in patients using cannabis. Most of our patients used the oral formulation for chronic pain. Importantly, a considerable number of patients reported improvements in chronic pain, anxiety, and side effects of chemotherapy.

Keywords: cannabis use, adverse effects, medical practice, indications

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Authors: Brayden Mi

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Reverse time migration has been widely used in the Petroleum exploration industry to reveal subsurface images and to detect rock and fluid properties since the early 1980s. The seismic technology involves the construction of a velocity model through interpretive model construction, seismic tomography, or full waveform inversion, and the application of the reverse-time propagation of acquired seismic data and the original wavelet used in the acquisition. The methodology has matured from 2D, simple media to present-day to handle full 3D imaging challenges in extremely complex geological conditions. Conventional Ultrasound computed tomography (USCT) utilize travel-time-inversion to reconstruct the velocity structure of an organ. With the velocity structure, USCT data can be migrated with the “bend-ray” method, also known as migration. Its seismic application counterpart is called Kirchhoff depth migration, in which the source of reflective energy is traced by ray-tracing and summed to produce a subsurface image. It is well known that ray-tracing-based migration has severe limitations in strongly heterogeneous media and irregular acquisition geometries. Reverse time migration (RTM), on the other hand, fully accounts for the wave phenomena, including multiple arrives and turning rays due to complex velocity structure. It has the capability to fully reconstruct the image detectable in its acquisition aperture. The RTM algorithms typically require a rather accurate velocity model and demand high computing powers, and may not be applicable to real-time imaging as normally required in day-to-day medical operations. However, with the improvement of computing technology, such a computational bottleneck may not present a challenge in the near future. The present-day (RTM) algorithms are typically implemented from a flat datum for the seismic industry. It can be modified to accommodate any acquisition geometry and aperture, as long as sufficient illumination is provided. Such flexibility of RTM can be conveniently implemented for the application in USCT imaging if the spatial coordinates of the transmitters and receivers are known and enough data is collected to provide full illumination. This paper proposes an implementation of a full 3D RTM algorithm for USCT imaging to produce an accurate 3D acoustic image based on the Phase-shift-plus-interpolation (PSPI) method for wavefield extrapolation. In this method, each acquired data set (shot) is propagated back in time, and a known ultrasound wavelet is propagated forward in time, with PSPI wavefield extrapolation and a piece-wise constant velocity model of the organ (breast). The imaging condition is then applied to produce a partial image. Although each image is subject to the limitation of its own illumination aperture, the stack of multiple partial images will produce a full image of the organ, with a much-reduced noise level if compared with individual partial images.

Keywords: illumination, reverse time migration (RTM), ultrasound computed tomography (USCT), wavefield extrapolation

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Authors: Abhishek Kumar Jain, Anki Jain, Yuvraj Singh Dangi, Brajesh Kumar Tiwari

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The plant Eclipta alba Hassk. (Family: Compositae) contains coumestans (wedelolactone and demethyl wedelolactone) used in liver disorders. The objective of the present investigation was to develop a formulation of these coumestans in combination with the soya phosphatidylcholine (PC), in order to overcome the limitation of absorption and to investigate the protective effect of coumestans–phosphatidylcholine complex (C-PC) on carbon tetrachloride induced acute liver damage in rats. Methanolic extract (ME) of the whole plant of Eclipta alba was fractionated with water and then with ehylacetate. Coumestans were characterized in the ethylacetate fraction of methanolic extract (EFME). The C-PC was prepared by dissolving EFME and PC in 1:1 ratio in dichloromethane and heating at 60°C for 2 h. The C-PC was characterized by DSC and FTIR spectroscopy. In vitro drug release from EFME and C-PC through egg membrane was measured using UV-Visible spectrophotometer. The hepatoprotective activity of C-PC (equivalent to 5.35 and 10.7 mg/kg body weight of EFME), ME 250 mg/kg and EFME 5.35 mg/kg was evaluated by measuring various enzymes level. C-PC significantly provided better protection to the liver by restoring the enzyme levels of SGPT, SGOT, ALP and total billirubin with respect to carbon tetrachloride (CCl4) treated group (P < 0.001). Histopathological studies were also performed. The C-PC provided better protection to rat liver than ME and EFME at similar doses as well as shown significant regeneration of hepatocytes, central vein, intact cytoplasm, and nucleus.

Keywords: hepatotoxicity, wedelolactone, soya phosphatidylcholine, eclipta alba

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Authors: K. Chethana, A. S. Guru Prasad, S. N. Omkar, B. Vadiraj, S. Asokan

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This paper describes an ab-initio design, development and calibration results of an Optical Sensor Ground Reaction Force Measurement Platform (OSGRFP) for gait and geriatric studies. The developed system employs an array of FBG sensors to measure the respective ground reaction forces from all three axes (X, Y and Z), which are perpendicular to each other. The novelty of this work is two folded. One is in its uniqueness to resolve the tri axial resultant forces during the stance in to the respective pure axis loads and the other is the applicability of inherently advantageous FBG sensors which are most suitable for biomechanical instrumentation. To validate the response of the FBG sensors installed in OSGRFP and to measure the cross sensitivity of the force applied in other directions, load sensors with indicators are used. Further in this work, relevant mathematical formulations are presented for extracting respective ground reaction forces from wavelength shifts/strain of FBG sensors on the OSGRFP. The result of this device has implications in understanding the foot function, identifying issues in gait cycle and measuring discrepancies between left and right foot. The device also provides a method to quantify and compare relative postural stability of different subjects under test, which has implications in post surgical rehabilitation, geriatrics and optimizing training protocols for sports personnel.

Keywords: balance and stability, gait analysis, FBG applications, optical sensor ground reaction force platform

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Authors: Hyunsik Park

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As the rate of cerebrovascular disease increases in old populations, the prevalence rate of vascular dementia would be expected. Therefore, authors designed this study to find out the possibility of somatosensory evoked potentials(SSEP) as a parameter for early diagnosis and prognosis prediction of vascular dementia in cortical vascular dementia patients. 21 patients who met the criteria for vascular dementia according to DSM-IV,ICD-10and NINDS-AIREN with the history of recent cognitive impairment, fluctuation progression, and neurologic deficit. We subdivided these patients into two groups; a mild dementia and a severe dementia groups by MMSE and CDR score; and analysed comparison between normal control group and patient control group who have been cerebrovascular attack(CVA) history without dementia by using N20 latency and amplitude of median nerve. In this study, mild dementia group showed significant differences on latency and amplitude with normal control group(p-value<0.05) except patient control group(p-value>0.05). Severe dementia group showed significant differences both normal control group and patient control group.(p-value<0.05, <001). Since no significant difference has founded between mild dementia group and patient control group, SSEP has limitation to use for early diagnosis test. However, the comparison between severe dementia group and others showed significant results which indicate SSEP can predict the prognosis of vascular dementia in cortical vascular dementia patients.

Keywords: SSEP, cortical vascular dementia, N20 latency, N20 amplitude

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Authors: Osama Abaza, Tanay Datta Chowdhury

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As a driver's speed increases, so do the probability of an incident and likelihood of injury. The presence of equipment, personnel, and a changing landscape in construction zones create greater potential for incident. This is especially concerning in Alaska, where summer construction activity, coinciding with the peak annual traffic volumes, cannot be avoided. In order to reduce vehicular speeding in work zones, and therefore the probability of crash and incident occurrence, variable speed limit (VSL) systems can be implemented in the form of radar speed display trailers since the radar speed display trailers were shown to be effective at reducing vehicular speed in construction zones. Allocation of VSL not only help reduce the 85th percentile speed but also it will predominantly reduce mean speed as well. Total of 2147 incidents along with 385 crashes occurred only in one month around the construction zone in the Alaska which seriously requires proper attention. This research provided a thorough crash analysis to better understand the cause and provide proper countermeasures. Crashes were predominantly recoded as vehicle- object collision and sideswipe type and thus significant amount of crashes fall in the group of no injury to minor injury type in the severity class. But still, 35 major crashes with 7 fatal ones in a one month period require immediate action like the implementation of the VSL system as it proved to be a speed reducer in the construction zone on Alaskan roadways.

Keywords: speed, construction zone, crash, severity

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Authors: Sakul Jariyachansit

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The purposes of this research were to investigate and to compare the factors affecting the decision for Tourism in Thailand by ASEAN Tourists and among ASEAN community tourists. Samples in this research were 400 ASEAN Community Tourists who travel in Thailand at Suvarnabhumi Airport during November 2016 - February 2016. The researchers determined the sample size by using the formula Taro Yamane at 95% confidence level tolerances 0.05. The English questionnaire, research instrument, was distributed by convenience sampling, for gathering data. Descriptive statistics was applied to analyze percentages, mean and standard deviation and used for hypothesis testing. The statistical analysis by multiple regression analysis (Multiple Regression) was employed to prove the relationship hypotheses at the significant level of 0.01. The results showed that majority of the respondents indicated the factors affecting the decision for Tourism in Thailand by ASEAN Tourists, in general there were a moderate effects and the mean of each side is moderate. Transportation was the most influential factor for tourism in Thailand. Therefore, the mode of transport, information, infrastructure and personnel are very important to factor affecting decision making for tourism in Thailand by ASEAN tourists. From the hypothesis testing, it can be predicted that the decision for choosing Tourism in Thailand is at R2 = 0.449. The predictive equation is decision for choosing Tourism in Thailand = 1.195 (constant value) + 0.425 (tourist attraction) +0.217 (information received) and transportation factors, tourist attraction, information, human resource and infrastructure at the significant level of 0.01.

Keywords: factor, decision making, ASEAN tourists, tourism in Thailand

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Authors: Ziba R. Tehrani, Sanaz Moayer

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In the age of the knowledge-based economy, knowledge management has become a key factor in sustainable competitive advantage. Knowledge management is discovering, acquiring, developing, sharing, maintaining, evaluating, and using right knowledge in right time by right person in organization; which is accomplished by creating a right link between human resources, information technology, and appropriate structure, to achieve organisational goals. Studying knowledge management financial institutes shows the knowledge management in banking system is not different from other industries but because of complexity of bank’s environment, the implementation is more difficult. The bank managers found out that implementation of knowledge management will bring many advantages to financial institutes, one of the most important of which is reduction of threat to lose subsequent information of personnel job quit. Also Special attention to internal conditions and environment of the financial institutes and avoidance from copy-making in designing the knowledge management is a critical issue. In this paper, it is tried first to define knowledge management concept and introduce existing models of knowledge management; then some of the most important models which have more similarities with other models will be reviewed. In second step according to bank requirements with focus on knowledge management approach, most major objectives of knowledge management are identified. For gathering data in this stage face to face interview is used. Thirdly these specified objectives are analysed with the response of distribution of questionnaire which is gained through managers and expert staffs of ‘Karafarin Bank’. Finally based on analysed data, some features of exiting models are selected and a new conceptual model will be proposed.

Keywords: knowledge management, financial institute, knowledge management model, organisational knowledge

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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: Jeroen S. de Bruin, Karin Schindler, Christian Schuh

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With increasingly more mobile health applications appearing due to the popularity of smartphones, the possibility arises that these data can be used to improve the medical diagnostic process, as well as the overall quality of healthcare, while at the same time lowering costs. However, as of yet there have been no reports of a successful combination of patient-generated data from smartphones with data from clinical routine. In this paper, we describe how these two types of data can be combined in a secure way without modification to hospital information systems, and how they can together be used in a medical expert system for automatic nutritional classification and triage.

Keywords: mobile health, data integration, expert systems, disease-related malnutrition

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Authors: Prasanti Widyasih Sarli, Prayatni Soewondo

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Greater access to sanitation in developing countries is urgent. However even though sanitation is crucial, overall budget for sanitation is limited. With this budget limitation, it is important to (1) allocate resources strategically to maximize impact and (2) take into account communal agency to potentially be a source for sanitation improvements. The Jodipan and Kesatrian Project in Malang, Indonesia is an interesting alternative for solving the sanitation problem in which resources were allocated strategically and communal agency was also observed. Although the projects initial goal was only to improve visually the situation in the slums, it became a new tourist destination, and the economic benefit that came with it had an effect also on the change of behavior of the residents and the government towards sanitation. It also grew from only including the Kesatrian Village to expanding to the Jodipan Village in the course of less than a year. To investigate the success of this project, in this paper a descriptive model will be used and data will be drawn from intensive interviews with the initiators of the project, residents affected by the project and government officials. In this research it is argued that three points mark the success of the project: (1) the strategic initial impact due to choice of location, (2) the influx of tourists that triggered behavioral change among residents and, (3) the direct economic impact which ensured its sustainability and growth by gaining government officials support and attention for more public spending in the area for slum development and sanitation improvement.

Keywords: behaviour change, sanitation, slum, strategic thinking

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Authors: Goitom Molalign Takele, Tsegalem Hailemariam Ballo, Kiros Belay Gebrekidan, Birhan Gebresilassie Gebregiorgis

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Background: Emergency medical services (EMS) are services that provide out-of-hospital emergency medical care to injured or ill peoples, and transporting to definitive care. EMS is an integral part of the emergency medical system and has been associated with decreased morbidity and mortality related to emergency cases. The aim of this study was to assess the utilization, barriers, and determinants of EMS in Mekelle, Ethiopia. Methods: A community-based cross-sectional study was conducted in selected sub-cities of Mekelle. A multistage sampling method was employed to recruit study participants, and data were collected by trained data collectors using an interviewer-administered questionnaire. Multivariate logistic regression analysis was used to examine the statistical association of the determinants of EMS utilization. Results: Half (50.5%) of the respondents had experienced or witnessed an emergency incident in the past year. The common means of transportations used were Bajaj’s (39.2%) and ambulances (22.7%). Majority (88.1%) of the respondents did not knew the EMS access phone number of an ambulance. As their preferred mode of transportation in case of emergency conditions, 42.2% of the participants reported an ambulance, followed by Bajaj 33.7%. Where participants who had gynecologic emergencies were 9.4 times (AOR=9.4, 95% CI: 1.04, 85, p=0.046), and those who knew any ambulance numbers were 3.6 times (AOR=3.6, 95% CI: 1.22, 10.8, p=0.02) more likely to use ambulance services in case of emergencies. Conclusion: The ambulance utilization level in Mekelle city was low and victims of emergency conditions were being transported mainly using public transports such as Bajaj’s and taxis. Even though the perception of the public towards EMS services is favorable, lack of awareness of EMS access, and lack of integrated EMS system in the city are the barriers that may have contributed to the low utilization. Actions to improve EMS access and integrating the system are warranted to promote the services utilization.

Keywords: emergency medical services, utilization, Mekelle, barriers

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Authors: Monika Bansal

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Background: Placement of dental implant in narrow alveolar ridge is challenging to be treated. GBR procedure is currently most widely used to augment the deficient alveolar ridges and to treat the fenestration and dehiscence around dental implants. Thus, the objectives of the present study were to evaluate as well as compare the clinical performance of collagen membrane and titanium mesh for horizontal bone augmentation at dehisced implant sites. Methods and material: Total 12 single edentulous implant sites with buccal bone deficiency in 8 subjects were equally divided and treated simultaneously with either of the two membranes and DBBM(Bio-Oss) bone graft. Primary outcome measurements in terms of defect height and defect width were made using a calibrated plastic periodontal probe. Re-entry surgery was performed to remeasure the augmented site and to remove Ti-mesh at 6th month. Independent paired t-tests for the inter-group comparison and student-paired t-tests for the intra-group comparison were performed. The differences were considered to be significant at p ≤ 0.05. Results: Mean defect fill with respect to height and width was 3.50 ± 0.54 mm (87%) and 2.33 ± 0.51 mm (82%) for collagen membrane and 3.83 ± 0.75 mm (92%) and 2.50 ± 0.54 mm (88%) for Ti-mesh group respectively. Conclusions: Within the limitation of the study, it was concluded that mean defect height and width after 6 months were statistically significant within the group without significant difference between them, although defect resolution was better in Ti-mesh.

Keywords: collagen membrane, dehiscence, dental implant, horizontal bone, augmentation, ti-mesh

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Authors: Fatima Ghassan Al-Abtah, Naser Al-Huniti, Elsadig Mahdi

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As the lightest constructional metal on earth, magnesium alloys offer excellent potential for weight reduction in the transportation industry, and it was observed that some magnesium alloys exhibit superior ductility and superplastic behavior at high temperatures. The main limitation of the superplastic forming (SPF) includes the low production rate since it needs a long forming time for each part. Through this study, an SPF process that starts with a mechanical pre-forming stage is developed to promote formability and reduce forming time. A two-dimensional finite element model is used to simulate the process. The forming process consists of two steps. At the pre-forming step (deep drawing), the sheet is drawn into the die to a preselected level, using a mechanical punch, and at the second step (SPF) a pressurized gas is applied at a controlled rate. It is shown that a significant reduction in forming time and improved final thickness uniformity can be achieved when the hybrid forming technique is used, where the process achieved a fully formed part at 400°C. Investigation for the impact of different forming process parameters achieved by comparing forming time and the distribution of final thickness that were obtained from the simulation analysis. Maximum thinning decreased from over 67% to less than 55% and forming time significantly decreased by more than 6 minutes, and the required gas pressure profile was predicted for optimum forming process parameters based on the 0.001/sec target constant strain rate within the sheet.

Keywords: magnesium, plasticity, superplastic forming, finite element analysis

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Authors: Yao Fu, Xingli Zhang, Jiannong Shi

Abstract:

Visual working memory (VWM) capacity is the ability to maintain and manipulate short-term information which is not currently available. It is well known for its significance to form the basis of numerous cognitive abilities and its limitation in holding information. VWM span, the most popular measurable indicator, is found to reach the adult level (3-4 items) around 12-13 years’ old, while less is known about the precision development of the VWM capacity. By using simultaneously delayed responses paradigm, the present study investigates the development of VWM precision among 6-18-year-old children and young adults, besides its possible relationships with fluid intelligence and span. Results showed that precision and span both increased with age, and precision reached the maximum in 16-17 age-range. Moreover, when remembering 3 simultaneously presented items, the probability of remembering target item correlated with fluid intelligence and the probability of wrap errors (misbinding target and non-target items) correlated with age. When remembering more items, children had worse performance than adults due to their wrap errors. Compared to span, VWM precision was effective predictor of intelligence even after controlling for age. These results suggest that unlike VWM span, precision developed in a slow, yet longer fashion. Moreover, decreasing probability of wrap errors might be the main reason for the development of precision. Last, precision correlated more closely with intelligence than span in childhood and adolescence, which might be caused by the probability of remembering target item.

Keywords: fluid intelligence, precision, visual working memory, wrap errors

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Authors: Julius Steinkopf, Eric Rost, Aike Hessel, Sonia Lippke

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Objective: This study examined possible determinants of return to work (RTW) in individuals who participated in a medical rehabilitation program longitudinally over a time period of six months. Design/methodology/approach: N=1,044 rehabilitants were included in the baseline measurement in terms of completing a questionnaire during their medical rehabilitation. About 30% (n=350) have remained in the study in terms of participating in computer-assisted telephone interviewing (CATI) six months later. Frequency analyses and Regression analyses were run. Findings: About 70% of the rehabilitants returned to work six months after rehabilitation. Regression analyses revealed that the RTW rates were significantly predicted by gender (OR=0.12, men were more likely to return), perceived social support (OR=3.01) and current physical functioning (OR=1.25). Furthermore RTW motives, like expected monetary rewards (OR=25.2) and feelings of being needed (OR=0.18) same as motives for not returning to work (nRTW), like the wish to stop working in order to spend time with the spouse (OR=0.13) or a lack of enjoyment of work (OR=3.81), significantly predicted return to work rates. Life satisfaction, self-efficacy beliefs, mental health, current income, educational background or age did not significantly increase explained variance (all ps > .05). Practical implications: Taking theses predictors into account provides options to increase the effectiveness of interventions aiming at increasing RTW: Medical rehabilitations should not only aim at improving the physical functioning but also to enhance beneficial motives and social support as well as support women specifically in order to improve the effectiveness of medical rehabilitation and public health interventions. Originality/value: Illness-caused work absences are related to high financial costs and individual burden. Despite of the public health and societal implications, this is one of the very few studies investigating systematically fitness and health for the return to work.

Keywords: gender, fitness, health, physical functioning

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Authors: Ammar Ali Saleh Jaber, Amer Hayat Khan, Syed Azhar Syed Sulaiman

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Tuberculosis (TB) is considered as a major disease that affects daily activities and impairs health-related quality of life (HRQoL). The impact of TB on HRQoL can affect treatment outcome and may lead to treatment defaulting. Therefore, this study aims to evaluate the HRQoL of TB treatment lost to follow-up during and after treatment in Yemen. For this aim, this prospective study enrolled a total of 399 TB lost to follow-up patients between January 2011 and December 2015. By applying HRQoL criteria, only 136 fill the survey during treatment. Moreover, 96 were traced and fill out the HRQoL survey. All eight HRQol domains were categorized into the physical component score (PCS) and mental component score (MCS), which were calculated using QM scoring software. Results show that all lost to follow-up TB patients reported a score less than 47 for all eight domains, except general health (67.3) during their treatment period. Low scores of 27.9 and 29.8 were reported for emotional role limitation (RE) and mental health (MH), respectively. Moreover, the mental component score (MCS) was found to be only 28.9. The trace lost follow-up shows a significant improvement in all eight domains and a mental component score of 43.1. The low scores of 27.9 and 29.8 for role emotion and mental health, respectively, in addition to the MCS score of 28.9, show that severe emotional condition and reflect the higher depression during treatment period that can result to lost to follow-up. The low MH, RE, and MCS can be used as a clue for predicting future TB treatment lost to follow-up.

Keywords: Yemen, tuberculosis, health-related quality of life, Khat

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Authors: Alvarez Magañini, María Victoria-Rubbi, Lautaro Nahuel

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At present, we are facing an unstable international context, conditioned by a relative decline of the US power, primarily in the economic sphere and, to a lesser extent, in the military sphere. This scenario of multipolarity creates tension and uncertainty in the peripheral countries when the issue of their foreign policy arises. This paper presents an analysis of the bilateral relations that were maintained by the Argentine Republic, a peripheral country, along with the United States and China during the period of 2005-2015 in matters of defense in order to identify the empirical consequences resulted from the Argentine actions. Based on the conceptual framework of Peripheral Realism, we analyze indicators related to the weapon trade, defense loans, joint exercises, and personnel training, among others. There will also be a comparative analysis of the conventional military forces of the two powers in question, United States and China. As a conclusion, the cost of having closer relations with China instead of the United States in the defense agenda has been clearly higher than the benefits obtained. The conclusions drawn are empirically aligned with the theoretical paradigm of peripheral realism. Although there are certain conceptual and methodological digressions, these conclusions they could be useful to update and adapt the theory to the current complex international scenario.

Keywords: China, United States, Argentine, peripheral country, peripheral realism

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Authors: Khaled R. Khater

Abstract:

All civil engineering projects include excavation work and therefore need some retaining structures. Cantilever secant pile walls are an economical supporting system up to 5.0-m depths. The parameters controlling wall tip displacement are the focus of this paper. So, two analysis techniques have been investigated and arbitrated. They are the conventional method and finite element analysis. Accordingly, two computer programs have been used, Excel sheet and Plaxis-2D. Two soil models have been used throughout this study. They are Mohr-Coulomb soil model and Isotropic Hardening soil models. During this study, two soil densities have been considered, i.e. loose and dense sand. Ten wall rigidities have been analyzed covering ranges of perfectly flexible to completely rigid walls. Three excavation depths, i.e. 3.0-m, 4.0-m and 5.0-m were tested to cover the practical range of secant piles. This work submits beneficial hints about secant piles to assist designers and specification committees. Also, finite element analysis, isotropic hardening, is recommended to be the fair judge when two designs conflict. A rational procedure using empirical equations has been suggested to upgrade the conventional method to predict wall tip displacement ‘δ’. Also, a reasonable limitation of ‘δ’ as a function of excavation depth, ‘h’ has been suggested. Also, it has been found that, after a certain penetration depth any further increase of it does not positively affect the wall tip displacement, i.e. over design and uneconomic.

Keywords: design aids, numerical analysis, secant pile, Wall tip displacement

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