Search results for: healthcare technologies

Authors: Kristin Thooft

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— Increasing pressure to manage healthcare costs has resulted in shifting care towards ambulatory settings and is driving a focus on cost transparency. There are few nurse staffing to workload models developed for ambulatory settings, less for multi-specialty clinics. Of the existing models, few have been evaluated against outcomes to understand any impact. This evaluation took place after the AWARD model for nurse staffing to workload was implemented in a multi-specialty clinic at a regional healthcare system in the Midwest. The multi-specialty clinic houses 26 medical and surgical specialty practices. The AWARD model was implemented in two specialty practices in October 2020. Donabedian’s Structure-Process-Outcome (SPO) model was used to evaluate outcomes based on changes to the structure and processes of care provided. The AWARD model defined and quantified the processes, recommended changes in the structure of day-to-day nurse staffing. Cost of care per patient visit, total visits, a total nurse performed visits used as structural and process measures, influencing the outcomes of cost of care and access to care. Independent t-tests were used to compare the difference in variables pre-and post-implementation. The SPO model was useful as an evaluation tool, providing a simple framework that is understood by a diverse care team. No statistically significant changes in the cost of care, total visits, or nurse visits were observed, but there were differences. Cost of care increased and access to care decreased. Two weeks into the post-implementation period, the multi-specialty clinic paused all non-critical patient visits due to a second surge of the COVID-19 pandemic. Clinic nursing staff was re-allocated to support the inpatient areas. This negatively impacted the ability of the Nurse Manager to utilize the AWARD model to plan daily staffing fully. The SPO framework could be used for the ongoing assessment of nurse staffing performance. Additional variables could be measured, giving a complete picture of the impact of nurse staffing. Going forward, there must be a continued focus on the outcomes of care and the value of nursing

Keywords: ambulatory, clinic, evaluation, outcomes, staffing, staffing model, staffing to workload

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Authors: Andrew Thayer, Courtney Rondeau, Paraskevi Papadopoulou

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The Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) gene-editing technologies have generated considerable discussion about the applications and ethics of their use. However, no consistent guidelines for using CRISPR technologies have been developed -nor common legislation passed related to gene editing, especially as it is connected to genetically modified organisms (GMOs) in the European Union. The recent announcement that the first babies with CRISPR-edited genes were born, along with new studies exploring CRISPR’s applications in treating thalassemia, sickle-cell anemia, cancer, and certain forms of blindness, have demonstrated that the technology is developing faster than the policies needed to control it. Therefore, it can be seen that a reasonable and coherent regulatory framework for the use of CRISPR in human somatic and germline cells is necessary to ensure the ethical use of the technology in future years. The European Union serves as a unique region of interconnected countries without a standard set of regulations or legislation for CRISPR gene-editing. We posit that the EU would serve as a suitable model in comparing the legislations of its affiliated countries in order to understand the practicality and effectiveness of adopting majority-approved practices. Additionally, we present a proposed set of guidelines which could serve as a basis in developing a consistent regulatory framework for the EU countries to implement but also act as a good example for other countries to adhere to. Finally, an additional, multidimensional framework of smart solutions is proposed with which all stakeholders are engaged to become better-informed citizens.

Keywords: CRISPR, ethics, regulatory framework, European legislation

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Authors: Mehmet Balci, Sakir Tasdemir, Mustafa Altin, Ozlem Bozok

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Our globalizing world has become almost a small village and everyone can access any information at any time. Everyone lets each other know who does whatever in which place. We can learn which social events occur in which place in the world. From the perspective of education, the course notes that a lecturer use in lessons in a university in any state of America can be examined by a student studying in a city of Africa or the Far East. This dizzying communication we have mentioned happened thanks to fast developments in computer technologies and in parallel with this, internet technology. While these developments in the world, has a very large young population and a rapidly evolving electronic communications infrastructure Turkey has been affected by this situation. Researches has shown that almost all young people in Turkey has an account in a social network. Especially becoming common of mobile devices causes data traffic in social networks to increase. In this study, has been surveyed on students in the different age groups and at the Selcuk University Vocational School of Technical Sciences Department of Computer Technology. Student’s opinions about the use of internet and social media has been gotten. Using the Internet and social media skills, purposes, operating frequency, access facilities and tools, social life and effects on vocational education etc. have been explored. Both internet and use of social media positive and negative effects on this department students results have been obtained by the obtained findings evaluating from various aspects. Relations and differences have been found out with statistic.

Keywords: computer technologies, internet use, social network, higher vocational school

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Authors: Sean O'Callaghan

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Around 2011/2012, a whole new genre of Christian religious writing began to emerge, focused on the role of advanced technologies, particularly the GRIN technologies (Genetics, Robotics, Information Technology and Nanotechnology), in bringing about a techno-apocalypse, leading to catastrophic events which would usher in the end of the world. This genre, at first niche, has now begun to grow in significance in many quarters of the more fundamentalist and biblically literalist branches of evangelicalism. It approaches science and technology with more than extreme skepticism. It accuses transhumanists of being in league with satanic powers and a satanic agenda and contextualizes transhumanist scientific progress in terms of its service to what it believes to be a soon to come Antichrist figure. The genre has moved beyond literature and videos about its message can be found on YouTube and other forums, where many of the presentations there get well over a quarter of a million views. This paper will examine the genre and its genesis, referring to the key figures involved in spreading the anti-intellectualist and anti-scientific message. It will demonstrate how this genre of writing is similar in many respects to other forms of apocalyptic writing which have emerged in the twentieth and twenty-first centuries, all in response to both scientific and political events which are interpreted in the light of biblical prophecy. It will also set the genre in the context of a contemporary pre-occupation with conspiracy theory. The conclusions of the research conducted in this field by the author are that it does a grave disservice to both the scientific and Christian audiences which it targets, by misrepresenting scientific advances and by creating a hermeneutic of suspicion which makes it impossible for Christians to place their trust in scientific claims.

Keywords: antichrist, catastrophic, Christian, techno-apocalypse

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Authors: Shriya Chawla, Vinayak Malhotra

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Space exploration has noted an exponential rise in the past two decades. The world has started probing the alternatives for efficient and resourceful sustenance along with utilization of advanced technology viz., satellites on earth. Space propulsion forms the core of space exploration. Of all the issues encountered, space debris has increasingly threatened the space exploration and propulsion. The efforts have resulted in the presence of disastrous space debris fragments orbiting the earth at speeds up to several kilometres per hour. Debris are well known as a potential damage to the future missions with immense loss of resources, mankind, and huge amount of money is invested in active research on them. Appreciable work had been done in the past relating to active space debris-removal technologies such as harpoon, net, drag sail. The primary emphasis is laid on confined removal. In recently, remove debris spacecraft was used for servicing and capturing cargo ships. Airbus designed and planned the debris-catching net experiment, aboard the spacecraft. The spacecraft represents largest payload deployed from the space station. However, the magnitude of the issue suggests that active space debris-removal technologies, such as harpoons and nets, still would not be enough. Thus, necessitating the need for better and operative space debris removal system. Techniques based on diverting the path of debris or the spacecraft to avert damage have turned out minimal usage owing to limited predictions. Present work focuses on an active hybrid space debris removal system. The work is motivated by the need to have safer and efficient space missions. The specific objectives of the work are 1) to thoroughly analyse the existing and conventional debris removal techniques, their working, effectiveness and limitations under varying conditions, 2) to understand the role of key controlling parameters in coupled operation of debris capturing and removal. The system represents the utilization of the latest autonomous technology available with an adaptable structural design for operations under varying conditions. The design covers advantages of most of the existing technologies while removing the disadvantages. The system is likely to enhance the probability of effective space debris removal. At present, systematic theoretical study is being carried out to thoroughly observe the effects of pseudo-random debris occurrences and to originate an optimal design with much better features and control.

Keywords: space exploration, debris removal, space crafts, space accidents

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Authors: Dongwan Kang, Joohyung Oh, Chaetae Im

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Advancement of communication technologies and smart devices in the recent times is leading to changes into the integrated wired and wireless communication environments. Since early days, businesses had started introducing environments for mobile device application to their operations in order to improve productivity (efficiency) and the closed corporate environment gradually shifted to an open structure. Recently, individual user's interest in working environment using mobile devices has increased and a new corporate working environment under the concept of BYOD is drawing attention. BYOD (bring your own device) is a concept where individuals bring in and use their own devices in business activities. Through BYOD, businesses can anticipate improved productivity (efficiency) and also a reduction in the cost of purchasing devices. However, as a result of security threats caused by frequent loss and theft of personal devices and corporate data leaks due to low security, companies are reluctant about adopting BYOD system. In addition, without considerations to diverse devices and connection environments, there are limitations in detecting abnormal behaviors such as information leaks which use the existing network-based security equipment. This study suggests a method to detect abnormal behaviors according to individual behavioral patterns, rather than the existing signature-based malicious behavior detection and discusses applications of this method in BYOD environment.

Keywords: BYOD, security, anomaly behavior detection, security equipment, communication technologies

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Authors: Parvina Ismayilova

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Inclusion is like cultural diversity because, in the modern world, it is understood as everything that allows you to immerse yourself in the environment with the opportunity to expand your experience. In a narrow sense, inclusion is more associated with "inclusive education" and "inclusive technologies" - that is, it is a principle that allows people with disabilities to interact with the outside world. Technological progress allows people to unite, ensuring that they are seen and heard.

Keywords: diversity, disability, inclusivity, equality

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Authors: Truong H. Le, Ngoc M. To, Quang N. Tran, Luu T. Cao, Chi V. Le

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Introduction: In Vietnam, the current monitoring and treatment for ordinary diabetic patient mostly based on glucose monitoring with HbA1c test for every three months (recommended goal is HbA1c < 6.5%~7%). For diabetes in pregnant women or Gestational diabetes mellitus (GDM), glycemic control until the time of delivery is extremly important because it could reduce significantly medical implications for both the mother and the child. Besides, GDM requires continuos glucose monitoring at least every two weeks and therefore an alternative marker of glycemia for short-term control is considering a potential tool for the healthcare providers. There are published studies have indicated that the glycosylated serum protein is a better indicator than glycosylated hemoglobin in GDM monitoring. Based on the actual practice in Vietnam, this study was designed to evaluate the role of serum fructosamine as a monitoring tool in GDM treament and its correlations with fasting blood glucose (G0), 2-hour postprandial glucose (G2) and glycosylated hemoglobin (HbA1c). Methods: A cohort study on pregnant women diagnosed with GDM by the 75-gram oralglucose tolerance test was conducted at Endocrinology Department, Cho Ray hospital, Vietnam from June 2014 to March 2015. Cho Ray hospital is the final destination for GDM patient in the southern of Vietnam, the study population has many sources from other pronvinces and therefore researchers belive that this demographic characteristic can help to provide the study result as a reflection for the whole area. In this study, diabetic patients received a continuos glucose monitoring method which consists of bi-weekly on-site visit every 2 weeks with glycosylated serum protein test, fasting blood glucose test and 2-hour postprandial glucose test; HbA1c test for every 3 months; and nutritious consultance for daily diet program. The subjects still received routine treatment at the hospital, with tight follow-up from their healthcare providers. Researchers recorded bi-weekly health conditions, serum fructosamine level and delivery outcome from the pregnant women, using Stata 13 programme for the analysis. Results: A total of 500 pregnant women was enrolled and follow-up in this study. Serum fructosamine level was found to have a light correlation with G0 ( r=0.3458, p < 0.001) and HbA1c ( r=0.3544, p < 0.001), and moderately correlated with G2 ( r=0.4379, p < 0.001). During study timeline, the delivery outcome of 287 women were recorded with the average age of 38.5 ± 1.5 weeks, 9% of them have macrosomia, 2.8% have premature birth before week 35th and 9.8% have premature birth before week 37th; 64.8% of cesarean section and none of them have perinatal or neonatal mortality. The study provides a reference interval of serum fructosamine for GDM patient was 112.9 ± 20.7 μmol/dL. Conclusion: The present results suggests that serum fructosamine is as effective as HbA1c as a reflection of blood glucose control in GDM patient, with a positive result in delivery outcome (0% perinatal or neonatal mortality). The reference value of serum fructosamine measurement provided a potential monitoring utility in GDM treatment for hospitals in Vietnam. Healthcare providers in Cho Ray hospital is considering to conduct more studies to test this reference as a target value in their GDM treatment and monitoring.

Keywords: gestational diabetes mellitus, monitoring tool, serum fructosamine, Vietnam

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Authors: Anita Puspawati

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A failure in obtaining informed consent from patient occurs because there is not effective communication skill in doctors. Therefore, the language is very important in communication between doctor and patient. This study uses descriptive analysis method, that is a method used mainly in researching the status of a group of people, an object, a condition, a system of thought or a class of events in the present. The result of this study indicates that the communicative language between doctors and patients will increase the trust of patients to their doctors and accordingşy, patients will provide the informed consent voluntarily.

Keywords: communicative, language, doctor, patient

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Authors: Noorulain Khalid, Unsaar Hayat, Muhammad Chaudhary, Christos Iosifidis, Felipe Dhawahir-Scala, Fiona Carley

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Dry eye disease (DED) is a common condition seen in the emergency eye department (EED) at Manchester Royal Eye Hospital (MREH). However, there is variability in the prescription of lubricating eye drops among different healthcare providers. The aim of this study was to develop an up-to-date, standardized algorithm for the prescription of lubricating eye drops in the EED at MREH based on international and national guidelines. The study also aimed to assess the impact of implementing the guideline on the rate of inappropriate lubricant prescriptions. Primarily, the impact was to be assessed in the form of the appropriateness of prescriptions for patients’ DED. The impact was secondary to be assessed through analysis of the cost to the hospital. Data from 845 patients who attended the EED over a 3-month period were analyzed, and 157 patients met the inclusion and exclusion criteria. After conducting a review of the literature and collaborating with the corneal team, an algorithm for the prescription of lubricants in the EED was developed. Three plan-do-study-act (PDSA) cycles were conducted, with interventions such as emails, posters, in-person reminders, and education for incoming trainees. The appropriateness of prescriptions was evaluated against the guidelines. Data were collected from patient records and analyzed using statistical methods. The appropriateness of prescriptions was assessed by comparing them to the guidelines and by clinical correlation with a specialized registrar. The study found a substantial improvement in the number of appropriate prescriptions, with an increase from 55% to 93% over the three PDSA cycles. There was additionally a 51% reduction in expenditure on lubricant prescriptions, resulting in cost savings for the hospital (approximate saving of £50/week). Theoretical importance: Appropriate prescription of lubricating eye drops improves disease management for patients and reduces costs for the hospital. The development and implementation of a standardized guideline facilitate the achievement of these goals. Conclusion: This study highlights the inconsistent management of DED in the EED and the potential lack of training in this area for healthcare providers. The implementation of a standardized, easy-to-follow guideline for lubricating eye drops can help to improve disease management while also resulting in cost savings for the hospital.

Keywords: lubrication, dry eye disease, guideline, prescription

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Authors: M. A. Spielmann, L. Schebek

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In order to reach the long-term national climate goals of the German government for the building sector, substantial energetic measures have to be executed. Historically, those measures were primarily energetic efficiency measures at the buildings’ shells. Advanced technologies for the on-site generation of heat (or other types of energy) often are not feasible at this small spatial scale of a single building. Therefore, the present approach uses the spatially larger dimension of a quarter. The main focus of the present paper is the long-term economic-ecological assessment of available decentralized heat-generating (CHP power plants and electrical heat pumps) technologies at the quarter level for the German unrefurbished residential buildings. Three distinct terms have to be described methodologically: i) Quarter approach, ii) Economic assessment, iii) Ecological assessment. The quarter approach is used to enable synergies and scaling effects over a single-building. For the present study, generic quarters that are differentiated according to significant parameters concerning their heat demand are used. The core differentiation of those quarters is made by the construction time period of the buildings. The economic assessment as the second crucial parameter is executed with the following structure: Full costs are quantized for each technology combination and quarter. The investment costs are analyzed on an annual basis and are modeled with the acquisition of debt. Annuity loans are assumed. Consequently, for each generic quarter, an optimal technology combination for decentralized heat generation is provided in each year of the temporal boundaries (2016-2050). The ecological assessment elaborates for each technology combination and each quarter a Life Cycle assessment. The measured impact category hereby is GWP 100. The technology combinations for heat production can be therefore compared against each other concerning their long-term climatic impacts. Core results of the approach can be differentiated to an economic and ecological dimension. With an annual resolution, the investment and running costs of different energetic technology combinations are quantified. For each quarter an optimal technology combination for local heat supply and/or energetic refurbishment of the buildings within the quarter is provided. Coherently to the economic assessment, the climatic impacts of the technology combinations are quantized and compared against each other.

Keywords: building sector, economic-ecological assessment, heat, LCA, quarter level

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Authors: Xue Li, Hui Xu

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Mild cognitive impairment (MCI) is a clinical stage that occurs between normal aging and dementia. Although MCI increases the risk of developing dementia, individuals with MCI may maintain stable cognitive function and even recover to a typical cognitive state. An intervention to prevent or delay the progression to dementia in individuals with MCI may involve promoting social engagement. Social participation is the engagement in socially relevant social exchanges and meaningful activities. Older adults with MCI may encounter restricted cognitive abilities, mood changes, and behavioral difficulties during social participation, influencing their willingness to engage. Therefore, this study aims to employ qualitative research methods to gain an in-depth comprehension of the authentic social participation experiences of older adults with mild cognitive impairment, which will establish a foundation for designing appropriate intervention programs. A phenomenological research was conducted. The study participants were selected using the purposive sampling method in combination with the maximum differentiation sampling strategy. Face-to-face semistructured interviews were conducted among 12 elderly individuals suffering from mild cognitive impairment in a community in Zhengzhou City from May to July 2023. Colaizzi 7-step method was used to analyze the data and extract the theme. The real experience of social participation in older adults with mild cognitive impairment can be summarized into 3 themes: (1) a single social relationship but a strong desire to participate, (2) a dual experience of social participation with both positive and negative aspects, (3) multiple barriers to social participation, including impaired memory capacity, heavy family responsibilities and lack of infrastructure. The study found that elderly individuals with mild cognitive impairment and one social interaction display an increased desire to engage in society. To improve social participation levels and reduce cognitive function decline, healthcare providers should work with relevant government agencies and the community to create a comprehensive social participation system. It is important for healthcare providers to note the social participation status of the elderly with mild cognitive impairment.

Keywords: mild cognitive impairment, the elderly, social participation, qualitative research

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Authors: Sneha Shankar, Orlando Buendia, Will Evans

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Alpha-1 antitrypsin deficiency (AATD) is a rare, genetic, and multisystemic condition. Underdiagnosis is common, leading to chronic pulmonary and hepatic complications, increased resource utilization, and additional costs to the healthcare system. Currently, there is limited evidence of the direct medical costs of AATD diagnosis in the UK. This study explores the economic impact of AATD patients during the 3 years before diagnosis and to identify the major cost drivers using primary and secondary care electronic health record (EHR) data. The 3 years before diagnosis time period was chosen based on the ability of our tool to identify patients earlier. The AATD algorithm was created using published disease criteria and applied to 148 known AATD patients’ EHR found in a primary care database of 936,148 patients (413,674 Biobank and 501,188 in a single primary care locality). Among 148 patients, 9 patients were flagged earlier by the tool and, on average, could save 3 (1-6) years per patient. We analysed 101 of the 148 AATD patients’ primary care journey and 20 patients’ Hospital Episode Statistics (HES) data, all of whom had at least 3 years of clinical history in their records before diagnosis. The codes related to laboratory tests, clinical visits, referrals, hospitalization days, day case, and inpatient admissions attributable to AATD were examined in this 3-year period before diagnosis. The average cost per patient was calculated, and the direct medical costs were modelled based on the mean prevalence of 100 AATD patients in a 500,000 population. A deterministic sensitivity analysis (DSA) of 20% was performed to determine the major cost drivers. Cost data was obtained from the NHS National tariff 2020/21, National Schedule of NHS Costs 2018/19, PSSRU 2018/19, and private care tariff. The total direct medical cost of one hundred AATD patients three years before diagnosis in primary and secondary care in the UK was £3,556,489, with an average direct cost per patient of £35,565. A vast majority of this total direct cost (95%) was associated with inpatient admissions (£3,378,229). The DSA determined that the costs associated with tier-2 laboratory tests and inpatient admissions were the greatest contributors to direct costs in primary and secondary care, respectively. This retrospective study shows the role of EHRs in calculating direct medical costs and the potential benefit of new technologies for the early identification of patients with AATD to reduce the economic burden in primary and secondary care in the UK.

Keywords: alpha-1 antitrypsin deficiency, costs, digital health, early diagnosis

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Authors: Tolga Hayit, Ucman Ergun, Ugur Fidan

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Being healthy is undoubtedly an indispensable necessity for human life. With technological improvements, in the literature, various health monitoring and imaging systems have been developed to satisfy your health needs. In this context, the work of monitoring and recording the data of individual health monitoring data via wireless technology is also being part of these studies. Nowadays, mobile devices which are located in almost every house and which become indispensable of our life and have wireless technology infrastructure have an important place of making follow-up health everywhere and every time because these devices were using in the health monitoring systems. In this study, Arduino an open-source microcontroller card was used in which a sample sugar measuring device was connected in series. In this way, the glucose data (glucose ratio, time) obtained with the glucometer is transferred to the mobile device based on the Android operating system with the Bluetooth technology channel. A mobile application was developed using the Apache Cordova framework for listing data, presenting graphically and reading data over Arduino. Apache Cordova, HTML, Javascript and CSS are used in coding section. The data received from the glucometer is stored in the local database of the mobile device. It is intended that people can transfer their measurements to their mobile device by using wireless technology and access the graphical representations of their data. In this context, the aim of the study is to be able to perform health monitoring by using different wireless technologies in mobile devices that can respond to different wireless technologies at present. Thus, that will contribute the other works done in this area.

Keywords: Arduino, Bluetooth, glucose measurement, mobile health monitoring

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Authors: Rishi Prajapati

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3G is the abbreviation of third generation of wireless mobile telecommunication technologies. 3G is a mode that finds application in wireless voice telephony, mobile internet access, fixed wireless internet access, video calls and mobile TV. It also provides mobile broadband access to smartphones and mobile modems in laptops and computers. The first 3G networks were introduced in 1998, followed by 4G networks in 2008. 4G is the abbreviation of fourth generation of wireless mobile telecommunication technologies. 4G is termed to be the advanced form of 3G. 4G was firstly introduced in South Korea in 2007. Many abstracts have floated researches that depicted the diversity and similarity between the third and the fourth generation of wireless mobile telecommunications technology, whereas this abstract reflects the study that focuses on analyzing the preference between 3G versus 4G given by the elite group of the Indian society who are known as adolescents or the Millennial Generation aging from 18 years to 25 years. The Millennial Generation was chosen for this study as they have the easiest access to the latest technology. A sample size of 200 adolescents was selected and a structured survey was carried out which had several closed ended as well as open ended questions, to aggregate the result of this study. It was made sure that the effect of environmental factors on the subjects was as minimal as possible. The data analysis comprised of primary data collection reflecting it as quantitative research. The rationale behind this research is to give brief idea of how 3G and 4G are accepted by the Millennial Generation in India. The findings of this research would materialize a framework which depicts whether Millennial Generation would prefer 4G over 3G or vice versa.

Keywords: fourth generation, wireless telecommunication technology, Indian society, millennial generation, market research, third generation

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Authors: Tansel Comoglu

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Orally fast disintegrating tablets (FDTs or ODTs) have become popular during the last decade, and manufacturing of ODTs is getting a rapidly growing area in the pharmaceutical industry. The concept of ODTs has emerged from the desire to provide patients with more conventional means of taking their medication. Drugs, that have satisfactory absorption from the oral mucosa or aimed for immediate therapeutic activity can be formulated in ODTs. After placing the ODT into the mouth, these tablets dissolve or disintegrate in the mouth usullay less than a minute, in the absence of additional water. Even though the ODT technology has taken an important path, as proved by a large group of commercial products on the drug market, there are so many problems to be solved in ODT formulations such as; formulation of hydrophobic drugs is stil a challenge, especially when the amount of drug is high. As these tablets dissolve or disintegrate in the mouth without the need of additional water, taste masking of active ingredients becomes essential in these systems because the drug is entirely released in the mouth. In ODT technology, coping with the taste of drugs is still a challenge. Resins or sweeteners or other techniques are also used in the formulation to aid taste-masking of the API. Another important factor to consider is whether they can be manufactured using conventional equipment and processes, as this will have a positive influence on manufacturing costs. Some products, however, may require a more costly, special unitdose packaging if the dosage form is fragile. In this overview, benefits, various formulation technologies, clinical studies and some future research trends of ODTs will be discussed.

Keywords: orally fast disintegrating tablets, benefits, formulation technologies, future research trends

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Authors: Marco Lopes, Pedro D. Gaspar, Maria P. Simões

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This paper reviews the different concepts that have been investigated concerning the mechanization of fruit thinning as well as multiple working principles and solutions that have been developed for feature extraction of horticultural products, both in the field and industrial environments. The research should be committed towards selective methods, which inevitably need to incorporate some kinds of sensor technology. Computer vision often comes out as an obvious solution for unstructured detection problems, although leaves despite the chosen point of view frequently occlude fruits. Further research on non-traditional sensors that are capable of object differentiation is needed. Ultrasonic and Near Infrared (NIR) technologies have been investigated for applications related to horticultural produce and show a potential to satisfy this need while simultaneously providing spatial information as time of flight sensors. Light Detection and Ranging (LIDAR) technology also shows a huge potential but it implies much greater costs and the related equipment is usually much larger, making it less suitable for portable devices, which may serve a purpose on smaller unstructured orchards. Portable devices may serve a purpose on these types of orchards. In what concerns sensor methods, on-tree fruit detection, major challenge is to overcome the problem of fruits’ occlusion by leaves and branches. Hence, nontraditional sensors capable of providing some type of differentiation should be investigated.

Keywords: fruit thinning, horticultural field, portable devices, sensor technologies

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Authors: Xiao-Hua Zhu, Xin Yuan, Yi-Ran Zhao

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High-cadmium pollution in rice is a serious problem in many parts of China. Many kinds of remediation technologies have been tested and applied in many farmlands. Because of the productive function of the farmland, most technologies are inappropriate due to their destruction to the tillage soil layer. And the large labours and expensive fees of many technologies are also the restrictive factors for their applications. The conception of 'Root Micro-Geochemical Barrier' was proposed to reduce cadmium (Cd) bioavailability and the concentration of the cadmium in rice. Remediation and mitigation techniques were demonstrated on contaminated farmland in the downstream of some mine. According to the rule of rice growth, Cd would be absorbed by the crops in every growth stage, and the plant-absorb efficiency in the first stage of the tillering stage is almost the highest. We should create a method to protect the crops from heavy metal pollution, which could begin to work from the early growth stage. Many materials with repair property get our attention. The materials will create a barrier preventing Cd from being absorbed by the crops during all the growing process because the material has the ability to adsorb soil-Cd and making it losing its migration activity. And we should choose a good chance to put the materials into the crop-growing system cheaply as soon as early. Per plant, rice has a little root system scope, which makes the roots reach about 15cm deep and 15cm wide. So small root radiation area makes it possible for all the Cd approaching the roots to be adsorbed with a small amount of adsorbent. Mixing the remediation materials with the seed-raising soli and adding them to the tillage soil in the process of transplanting seedlings, we can control the soil-Cd activity in the range of roots to reduce the Cd-amount absorbed by the crops. Of course, the mineral materials must have enough adsorptive capacity and no additional pollution. More than 3000 square meters farmlands have been remediated. And on the application of root micro-geochemical barrier, the Cd-concentration in rice and the remediation-cost have been decreased by 90% and 80%, respectively, with little extra labour brought to the farmers. The Cd-concentrations in rice from remediated farmland have been controlled below 0.1 ppm. The remediation of one acre of contaminated cropland costs less than $100. The concept has its advantage in the remediation of paddy field contaminated by Cd, especially for the field with outside pollution sources.

Keywords: cadmium pollution, growth stage, cost, root micro-geochemistry barrier

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Authors: Saurabh Gupta, Vanshdeep Parmar, Sri Harsha Reddy Yelly, Michele Baker, Elizabeth Bigler, Kunhee Choi

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It is known that the adoption of solar powered LED highway lighting systems or sensory LED highway lighting systems can dramatically reduce energy consumption by 55 percent when compared to conventional on-grid High Pressure Sodium (HPS) lamps that are widely applied to most highways. However, an initial high installation cost for building the infrastructure of solar photovoltaic devices hampers a wider adoption of such technologies. This research aims to examine currently available state-of-the-art solar photovoltaic and sensory technologies, identify major obstacles, and analyze each technology to create a benchmarking metrics from the benefit-cost analysis perspective. The on-grid HPS lighting systems will serve as the baseline for this study to compare it with other lighting alternatives such as solar and sensory LED lighting systems. This research will test the validity of the research hypothesis that alternative LED lighting systems produce more favorable benefit-cost ratios and the added initial investment costs are recouped by the savings in the operation and maintenance cost. The payback period of the excess investment and projected savings over the life-cycle of the selected lighting systems will be analyzed by utilizing the concept of Net Present Value (NPV). Researchers believe that if this study validates the research hypothesis, it can promote a wider adoption of alternative lighting systems that will eventually save millions of taxpayer dollars in the long-run.

Keywords: lighting systems, sensory and solar PV, benefit cost analysis, net present value

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Authors: Eugene Wong, Felix Chan, Linsey Chen, Joey Cheung

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The widespread use of technologies and cyber/digital means for complex maritime operations have led to a sharp rise in global cyber-attacks. They have generated an increasing number of liability disputes, insurance claims, and legal proceedings. An array of antiquated case law, regulations, international conventions, and obsolete contractual clauses drafted in the pre-technology era have become grossly inadequate in addressing the contemporary challenges. This paper offers a critique of the ambiguity of cybersecurity liabilities under the obligation of seaworthiness entailed in the Hague-Visby Rules, which apply either by law in a large number of jurisdictions or by express incorporation into the shipping documents. This paper also evaluates the legal and technological criteria for assessing whether a vessel is properly equipped with the latest offshore technologies for navigation and cargo delivery operations. Examples include computer applications, networks and servers, enterprise systems, global positioning systems, and data centers. A critical analysis of the carriers’ obligations to exercise due diligence in preventing or mitigating cyber-attacks is also conducted in this paper. It is hoped that the present study will offer original and crucial insights to policymakers, regulators, carriers, cargo interests, and insurance underwriters closely involved in dispute prevention and resolution arising from cybersecurity liabilities.

Keywords: seaworthiness, cybersecurity, liabilities, risks, maritime, transport

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Authors: Matthew B. Davis, Amit Kumar

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With potentially dangerous impacts of climate change on the horizon, Canada has an opportunity to take a lead role on the international stage to demonstrate how energy use intensity and greenhouse gas emission intensity may be effectively reduced. Through bottom-up modelling of Canada’s energy sector using Long-range Energy Alternative Planning (LEAP) software, it can be determined where efforts should to be concentrated to produce the most positive energy management results. By analyzing a provincially integrated Canada, one can develop strategies to minimize the country’s economic downfall while transitioning to lower-emission energy technologies. Canada’s electricity sector plays an important role in accommodating these transitionary technologies as fossil-fuel based power production is prevalent in many parts of the country and is responsible for a large portion (17%) of Canada’s greenhouse gas emissions. Current findings incorporate an in-depth model of Canada’s current energy supply and demand sectors, as well as a business-as-usual scenario up to the year 2035. This allows for in-depth analysis of energy flow from resource potential, to extraction, to fuel and electricity production, to energy end use and emissions in Canada’s residential, transportation, commercial, institutional, industrial, and agricultural sectors. Bottom-up modelling techniques such as these are useful to critically analyze and compare the various possible scenarios of implementing sustainable energy measures. This work can aid government in creating effective energy and environmental policies, as well as guide industry to what technology or process changes would be most worthwhile to pursue.

Keywords: energy management, LEAP, energy end-use, GHG emissions

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Authors: Fatema Akram, Mohammad G. Rasul, M. Masud K. Khan, M. Sharif I. I. Amir

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Australia is a country of some 7,700 million square kilometres with a population of about 22.6 million. At present water security is a major challenge for Australia. In some areas the use of water resources is approaching and in some parts it is exceeding the limits of sustainability. A focal point of proposed national water conservation programs is the recycling of both urban storm-water and treated wastewater. But till now it is not widely practiced in Australia, and particularly storm-water is neglected. In Australia, only 4% of storm-water and rainwater is recycled, whereas less than 1% of reclaimed wastewater is reused within urban areas. Therefore, accurately monitoring, assessing and predicting the availability, quality and use of this precious resource are required for better management. As storm-water is usually of better quality than untreated sewage or industrial discharge, it has better public acceptance for recycling and reuse, particularly for non-potable use such as irrigation, watering lawns, gardens, etc. Existing storm-water recycling practice is far behind of research and no robust technologies developed for this purpose. Therefore, there is a clear need for using modern technologies for assessing feasibility of storm-water harvesting and reuse. Numerical modelling has, in recent times, become a popular tool for doing this job. It includes complex hydrological and hydraulic processes of the study area. The hydrologic model computes storm-water quantity to design the system components, and the hydraulic model helps to route the flow through storm-water infrastructures. Nowadays water quality module is incorporated with these models. Integration of Geographic Information System (GIS) with these models provides extra advantage of managing spatial information. However for the overall management of a storm-water harvesting project, Decision Support System (DSS) plays an important role incorporating database with model and GIS for the proper management of temporal information. Additionally DSS includes evaluation tools and Graphical user interface. This research aims to critically review and discuss all the aspects of storm-water harvesting and reuse such as available guidelines of storm-water harvesting and reuse, public acceptance of water reuse, the scopes and recommendation for future studies. In addition to these, this paper identifies, understand and address the importance of modern technologies capable of proper management of storm-water harvesting and reuse.

Keywords: storm-water management, storm-water harvesting and reuse, numerical modelling, geographic information system, decision support system, database

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Authors: Jaehyung An, Sungjoo Lee

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Patent documents constitute an up-to-date and reliable source of knowledge for reflecting technological advance, so patent analysis has been widely used for identification of technological trends and formulation of technology strategies. But, identifying technological information from patent data entails some limitations such as, high cost, complexity, and inconsistency because it rely on the expert’ knowledge. To overcome these limitations, researchers have applied to a quantitative analysis based on the keyword technique. By using this method, you can include a technological implication, particularly patent documents, or extract a keyword that indicates the important contents. However, it only uses the simple-counting method by keyword frequency, so it cannot take into account the sematic relationship with the keywords and sematic information such as, how the technologies are used in their technology area and how the technologies affect the other technologies. To automatically analyze unstructured technological information in patents to extract the semantic information, it should be transformed into an abstracted form that includes the technological key concepts. Specific sentence structure ‘SAO’ (subject, action, object) is newly emerged by representing ‘key concepts’ and can be extracted by NLP (Natural language processor). An SAO structure can be organized in a problem-solution format if the action-object (AO) states that the problem and subject (S) form the solution. In this paper, we propose the new methodology that can extract the SAO structure through technical elements extracting rules. Although sentence structures in the patents text have a unique format, prior studies have depended on general NLP (Natural language processor) applied to the common documents such as newspaper, research paper, and twitter mentions, so it cannot take into account the specific sentence structure types of the patent documents. To overcome this limitation, we identified a unique form of the patent sentences and defined the SAO structures in the patents text data. There are four types of technical elements that consist of technology adoption purpose, application area, tool for technology, and technical components. These four types of sentence structures from patents have their own specific word structure by location or sequence of the part of speech at each sentence. Finally, we developed algorithms for extracting SAOs and this result offer insight for the technology innovation process by providing different perspectives of technology.

Keywords: NLP, patent analysis, SAO, semantic-analysis

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Authors: H. Arzani, Z. Arzani

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Every piece of rangeland has a different set of physical and biological characteristics. This requires the manager to synthesis various information for regular monitoring to define changes trend to get wright decision for sustainable management. So range managers need to use computerized technologies to monitor rangeland, and select. The best management practices. There are four examples of computerized technologies that can benefit sustainable management: (1) Photographic method for cover measurement: The method was tested in different vegetation communities in semi humid and arid regions. Interpretation of pictures of quadrats was done using Arc View software. Data analysis was done by SPSS software using paired t test. Based on the results, generally, photographic method can be used to measure ground cover in most vegetation communities. (2) GPS application for corresponding ground samples and satellite pixels: In two provinces of Tehran and Markazi, six reference points were selected and in each point, eight GPS models were tested. Significant relation among GPS model, time and location with accuracy of estimated coordinates was found. After selection of suitable method, in Markazi province coordinates of plots along four transects in each 6 sites of rangelands was recorded. The best time of GPS application was in the morning hours, Etrex Vista had less error than other models, and a significant relation among GPS model, time and location with accuracy of estimated coordinates was found. (3) Application of satellite data for rangeland monitoring: Focusing on the long term variation of vegetation parameters such as vegetation cover and production is essential. Our study in grass and shrub lands showed that there were significant correlations between quantitative vegetation characteristics and satellite data. So it is possible to monitor rangeland vegetation using digital data for sustainable utilization. (4) Rangeland suitability classification with GIS: Range suitability assessment can facilitate sustainable management planning. Three sub-models of sensitivity to erosion, water suitability and forage production out puts were entered to final range suitability classification model. GIS was facilitate classification of range suitability and produced suitability maps for sheep grazing. Generally digital computers assist range managers to interpret, modify, calibrate or integrating information for correct management.

Keywords: computer, GPS, GIS, remote sensing, photographic method, monitoring, rangeland ecosystem, management, suitability, sheep grazing

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Authors: Ionel Botef

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Aerospace products operate in very aggressive environments characterized by high temperature, high pressure, large stresses on individual components, the presence of oxidizing and corroding atmosphere, as well as internally created or externally ingested particulate materials that induce erosion and impact damage. Consequently, during operation, the materials of individual components degrade. In addition, the impact of maintenance costs for both civil and military aircraft was estimated at least two to three times greater than initial purchase values, and this trend is expected to increase. As a result, for viable product realisation and maintenance, a spectrum of issues regarding novel processing technologies, innovation of new materials, performance, costs, and environmental impact must constantly be addressed. One of these technologies, namely the cold-gas dynamic-spray process has enabled a broad range of coatings and applications, including many that have not been previously possible or commercially practical, hence its potential for new aerospace applications. Therefore, the purpose of this paper is to summarise the state of the art of this technology alongside its theoretical and experimental studies, and explore how the cold-gas dynamic-spray process could be integrated within a framework that finally could lead to more efficient aircraft maintenance. Based on the paper's qualitative findings supported by authorities, evidence, and logic essentially it is argued that the cold-gas dynamic-spray manufacturing process should not be viewed in isolation, but should be viewed as a component of a broad framework that finally leads to more efficient aerospace operations.

Keywords: aerospace, aging aircraft, cold spray, materials

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Authors: Pakinee Pooprasert, Wanxin Wang, Tina Parmar, Dana Ahnood, Tafadzwa Young-Zvandasara, James Morgan

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Homelessness has been shown to be correlated to poor health outcomes, including increased visual health morbidity. Despite this, there are relatively few studies regarding visual health in the homeless population, especially in the UK. This research aims to investigate visual disability and access barriers prevalent in the homeless population in Cardiff, South Wales. Data was collected from 100 homeless participants in three different shelters. Visual outcomes included near and distance visual acuity as well as non-cycloplegic refraction. Qualitative data was collected via a questionnaire and included socio-demographic profile, ocular history, subjective visual acuity and level of access to healthcare facilities. Based on the participants’ presenting visual acuity, the total prevalence of myopia and hyperopia was 17.0% and 19.0% respectively based on spherical equivalent from the eye with the greatest absolute value. The prevalence of astigmatism was 8.0%. The mean absolute spherical equivalent was 0.841D and 0.853D for right and left eye respectively. The number of participants with sight loss (as defined by VA= 6/12-6/60 in the better-seeing eye) was 27.0% in comparison to 0.89% and 1.1% in the general Cardiff and Wales population respectively (p-value is < 0.05). Additionally, 1.0% of the homeless subjects were registered blind (VA less than 3/60), in comparison to 0.17% for the national consensus after age standardization. Most participants had good knowledge regarding access to prescription glasses and eye examination services. Despite this, 85.0% never had their eyes examined by a doctor and 73.0% had their last optometrist appointment in more than 5 years. These findings suggested that there was a significant disparity in ocular health, including visual acuity and refractive error amongst the homeless in comparison to the general population. Further, the homeless were less likely to receive the same level of support and continued care in the community due to access barriers. These included a number of socio-economic factors such as travel expenses and regional availability of services, as well as administrative shortcomings. In conclusion, this research demonstrated unmet visual health needs within the homeless, and that inclusive policy changes may need to be implemented for better healthcare outcomes within this marginalized community.

Keywords: homelessness, refractive error, visual disability, Wales

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Authors: Bernice Boafoaa Gyapong, Anne Jones, Sam Bassett, Janet Anderson

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Background: Maternal mortality and morbidity are global concerns, especially in sub-Saharan Africa (SSA). Most maternal mortalities occur at the time of birth. Quality intrapartum care is essential for improving maternal and newborn health outcomes. This scoping review aimed to assess and describe the quality of care during childbirth in SSA to provide an overview of the regional trend of the quality of intrapartum care, the challenges to quality care provision, and identify research gaps. Methods: A scoping review based on Arksey and O’Malley’s scoping review framework was conducted. Medline, CINAHL, PsycINFO, and maternal-infant databases were searched to identify the relevant studies for this review. A narrative summary was presented using themes based on the Donabedian structure, process, and outcome quality of care model. Results: A total of five hundred and forty-seven (547) publications were identified. Fifty-six (56) studies conducted in twenty (20) countries were included in the review. Thirty-four (34) were quantitative, sixteen (16) were qualitative, and six (6) were mixed methods. Most of the studies were related to the process component of quality of care. The provision of emergency obstetric care services, infrastructure, and availability of essential staff and equipment for perinatal care was inadequate in many facilities, particularly rural and peripheral health facilities. Many women experienced disrespectful care during childbirth. Routine care during labour and delivery was observed to be sub-optimal, yet some women reported high satisfaction with care. The use of health facilities for delivery was lower in health centres compared to hospitals. Conclusion: There are variations in the quality of maternity care provided in SSA. Intrapartum care quality is generally deficient in SSA, particularly in peripheral health facilities, health centres, and community clinics. Many of the quality-of-care issues identified are related to the structure component. Stakeholders must develop interventions that comprehensively address these interrelated issues to improve maternal healthcare quality, especially in primary healthcare facilities.

Keywords: quality of care, maternity health, Sub-Saharan Africa, intrapartum

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Authors: Kalpana Gupta

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Sexually transmitted infections (STIs) are infections that are spread primarily through sexual contact. In our daily practice, we see gonorrhea, chancroid, syphilis, and chlamydial infections that can be cured, as well as HIV, genital herpes, HPV, and hepatitis B infections that cannot be cured but can be managed with available treatments. Many people in India are infected with Sexually transmitted diseases (STDs), and the figures are quite high because of a lack of awareness and communication, as well as a taboo against these diseases. Numerous taboos and associated stigma shape patients’ lives and have a significant impact on health care policies, medical research, and current issues in medical ethics. Current statistics emphasize the importance of delivering sex education to this important demographic promptly. The long-standing tradition of girls marrying very young, especially in rural areas, and often too much older men, causes a slew of STIs. Stigma and HIV have a cyclical relationship; people who experience stigma and discrimination are marginalized and made more vulnerable to HIV/STDs, while those living with HIV are more vulnerable to stigma and discrimination. As urban pressures have grown, so have slums - and they have fast become ideal breeding grounds for STDs. In developed countries, strict laws have been enacted requiring people suffering from STDs to seek immediate treatment as well as contact the health department. Unfortunately, because of the stigma associated with the disease, patients in India are reluctant to reveal the source of infection. With various schemes, India is attempting to promote sex education and awareness. For example, the Ministry of Health and Family Welfare developed the National Adolescent Health Programme (also known as the Rashtriya Kishor Swasthya Karyakram) in partnership with the United Nations Population Fund (UNFPA). Whereas, National AIDS Control Organisation was set up so that every person living with HIV has access to quality care and is treated with dignity and breaking all taboos. It becomes clear that research and healthcare policies will not be effective in assisting patients with STDs unless these "nonscientific" elements are taken into account.

Keywords: sexually transmitted diseases, sexually transmitted infections, taboo, stigma, HIV/STDs, sex education and awareness, treatment, quality care, medications, healthcare policies

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Authors: Brogan Guest, Amy Donaldson-Perrott

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The Master’s of Physician Associate Studies (MPAS) programme at St George’s, University of London (SGUL), is an intensive two-year course that trains students to become physician associates (PAs). PAs are generalized healthcare providers who work in primary and secondary care across the UK. PA programmes face the difficult task of preparing students to become safe medical providers in two short years. Our goal is to teach students to develop clinical reasoning early on in their studies and historically, this has been done predominantly though problem-based learning (PBL). We have had an increase concern about student engagement in PBL and difficulty recruiting facilitators to maintain the low student to facilitator ratio required in PBL. To address this issue, we created ‘Clinical Application of Anatomy and Physiology (CAAP)’. These peer-led, interactive, problem-based, small group sessions were designed to facilitate students’ clinical reasoning skills. The sessions were designed using the concept of Team-Based Learning (TBL). Students were divided into small groups and each completed a pre-session quiz consisting of difficult questions devised to assess students’ application of medical knowledge. The quiz was completed in small groups and they were not permitted access of external resources. After the quiz, students worked through a series of openended, clinical tasks using all available resources. They worked at their own pace and the session was peer-led, rather than facilitator-driven. For a group of 35 students, there were two facilitators who observed the sessions. The sessions utilised an infinite space whiteboard software. Each group member was encouraged to actively participate and work together to complete the 15-20 tasks. The session ran for 2 hours and concluded with a post-session quiz, identical to the pre-session quiz. We obtained subjective feedback from students on their experience with CAAP and evaluated the objective benefit of the sessions through the quiz results. Qualitative feedback from students was generally positive with students feeling the sessions increased engagement, clinical understanding, and confidence. They found the small group aspect beneficial and the technology easy to use and intuitive. They also liked the benefit of building a resource for their future revision, something unique to CAAP compared to PBL, which out students participate in weekly. Preliminary quiz results showed improvement from pre- and post- session; however, further statistical analysis will occur once all sessions are complete (final session to run December 2022) to determine significance. As a post-graduate healthcare professional programme, we have a strong focus on self-directed learning. Whilst PBL has been a mainstay in our curriculum since its inception, there are limitations and concerns about its future in view of student engagement and facilitator availability. Whilst CAAP is not TBL, it draws on the benefits of peer-led, small group work with pre- and post- team-based quizzes. The pilot of these sessions has shown that students are engaged by CAAP, and they can make significant progress in clinical reasoning in a short amount of time. This can be achieved with a high student to facilitator ratio.

Keywords: problem based learning, team based learning, active learning, peer-to-peer teaching, engagement

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Authors: Adem Peker, Yüksel Eroğlu, İsmail Ay

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As the information and communication technologies have become embedded in everyday life of adolescents, both their possible benefits and risks to adolescents are being identified. The information and communication technologies provide opportunities for adolescents to connect with peers and to access to information. However, as with other social connections, users of information and communication devices have the potential to meet and interact with in harmful ways. One emerging example of such interaction is cyber bullying. Cyber bullying occurs when someone uses the information and communication technologies to harass or embarrass another person. Cyber bullying can take the form of malicious text messages and e-mails, spreading rumours, and excluding people from online groups. Cyber bullying has been linked to psychological problems for cyber bullies and victims. Therefore, it is important to determine how internet addiction contributes to cyber bullying. Building on this question, this study takes a closer look at the relationship between internet addiction and cyber bullying. For this purpose, in this study, based on descriptive relational model, it was hypothesized that loss of control, excessive desire to stay online, and negativity in social relationships, which are dimensions of internet addiction, would be associated positively with cyber bullying and victimization. Participants were 383 high school students (176 girls and 207 boys; mean age, 15.7 years). Internet addiction was measured by using Internet Addiction Scale. The Cyber Victim and Bullying Scale was utilized to measure cyber bullying and victimization. The scales were administered to the students in groups in the classrooms. In this study, stepwise regression analyses were utilized to examine the relationships between dimensions of internet addiction and cyber bullying and victimization. Before applying stepwise regression analysis, assumptions of regression were verified. According to stepwise regression analysis, cyber bullying was predicted by loss of control (β=.26, p<.001) and negativity in social relationships (β=.13, p<.001). These variables accounted for 9 % of the total variance, with the loss of control explaining the higher percentage (8 %). On the other hand, cyber victimization was predicted by loss of control (β=.19, p<.001) and negativity in social relationships (β=.12, p<.001). These variables altogether accounted for 8 % of the variance in cyber victimization, with the best predictor loss of control (7 % of the total variance). The results of this study demonstrated that, as expected, loss of control and negativity in social relationships predicted cyber bullying and victimization positively. However, excessive desire to stay online did not emerge a significant predictor of both cyberbullying and victimization. Consequently, this study would enhance our understanding of the predictors of cyber bullying and victimization since the results proposed that internet addiction is related with cyber bullying and victimization.

Keywords: cyber bullying, internet addiction, adolescents, regression

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