Search results for: healthcare ecosystem

Authors: Syed Makhdoom Hussain, Muhammad Afzal, Farhat Jabeen, Arshad Javid, Tasneem Hameed

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A feeding trial was conducted with Cirrhinus mrigala fingerlings to study the effects of microbial phytase with graded levels (0, 500, 1000, 1500, and 2000 FTUkg-1) by sunflower meal based diet on growth performance and nutrient digestibility. The chromic oxide was added as an indigestible marker in the diets. Three replicate groups of 15 fish (Average wt 5.98 g fish-1) were fed once a day and feces were collected twice daily. The results of present study showed improved growth and feed performance of Cirrhinus mrigala fingerlings in response to phytase supplementation. Maximum growth performance was obtained by the fish fed on test diet-III having 1000 FTU kg-1 phytase level. Similarly, nutrient digestibility was also significantly increased (p<0.05) by phytase supplementation. Digestibility coefficients for sunflower meal based diet increased 15.76%, 17.70%, and 12.70% for crude protein, crude fat and apparent gross energy as compared to the reference diet, respectively at 1000 FTU kg-1 level. Again, maximum response of nutrient digestibility was recorded at the phytase level of 1000 FTU kg-1 diet. It was concluded that the phytase supplementation to sunflower meal based diet at 1000 FTU kg-1 level is optimum to release adequate chelated nutrients for maximum growth performance of C. mrigala fingerlings. Our results also suggested that phytase supplementation to sunflower meal based diet can help in the development of sustainable aquaculture by reducing the feed cost and nutrient discharge through feces in the aquatic ecosystem.

Keywords: sunflower meal, Cirrhinus mrigala, growth, nutrient digestibility, phytase

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Authors: P. S. Surya Meghana, K. Lingeshwaran, C. Kannan, V. Raghavendran, C. Priya

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One of the most basic and powerful tools in all of science and medicine is the light microscope, the fundamental device for laboratory as well as research purposes. With the improving technology, the need for portable, economic and user-friendly instruments is in high demand. The conventional microscope fails to live up to the emerging trend. Also, adequate access to healthcare is not widely available, especially in developing countries. The most basic step towards the curing of a malady is the diagnosis of the disease itself. The main aim of this paper is to diagnose Malaria with the most common device, cell phones, which prove to be the immediate solution for most of the modern day needs with the development of wireless infrastructure allowing to compute and communicate on the move. This opened up the opportunity to develop novel imaging, sensing, and diagnostics platforms using mobile phones as an underlying platform to address the global demand for accurate, sensitive, cost-effective, and field-portable measurement devices for use in remote and resource-limited settings around the world.

Keywords: cellular, hand-held, health care, image processing, malarial parasites, microscope

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Authors: Keyur Raval, Steffen Krohn, Bruno Moerschbacher

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Chitin, the biopolymer of the N-acetylglucosamine, is the most abundant biopolymer on the planet after cellulose. Industrially, chitin is isolated and purified from the shell residues of shrimps. A deacetylated derivative of chitin i.e. chitosan has more market value and applications owing to it solubility and overall cationic charge compared to the parent polymer. This deacetylation on an industrial scale is performed chemically using alkalis like sodium hydroxide. This reaction not only is hazardous to the environment owing to negative impact on the marine ecosystem. A greener option to this process is the enzymatic process. In nature, the naïve chitin is converted to chitosan by chitin deacetylase (CDA). This enzymatic conversion on the industrial scale is however hampered by the crystallinity of chitin. Thus, this enzymatic action requires the substrate i.e. chitin to be soluble which is technically difficult and an energy consuming process. We in this project wanted to address this shortcoming of CDA. In lieu of this, we have modeled a fusion protein with CDA and an auxiliary protein. The main interest being to increase the accessibility of the enzyme towards crystalline chitin. A similar fusion work with chitinases had improved the catalytic ability towards insoluble chitin. In the first step, suitable partners were searched through the protein data bank (PDB) wherein the domain architecture were sought. The next step was to create the models of the fused product using various in silico techniques. The models were created by MODELLER and evaluated for properties such as the energy or the impairment of the binding sites. A fusion PCR has been designed based on the linker sequences generated by MODELLER and would be tested for its activity towards insoluble chitin.

Keywords: chitin deacetylase, modeling, chitin binding domain, chitinases

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Authors: Areej Makeineldein Mustafa

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The study evaluates the management processes and healthcare provider compliance with the National Institute for Health and Care Excellence recommendations for constipation management. We aimed to evaluate the adherence to National Institute for Health and Care Excellence guidelines in the management of constipation during the period from February to June 2023. We collected data from a random sample ( 51 patients) over 4 months with inclusion criteria for patients above 60 who were just admitted to the care of the elderly department during this period. Patient age, sex, medical records for constipation, acute or chronic constipation, or opioid-induced constipation, and treatment options were used to identify constipation and the type of treatment given. Our findings indicate that there is a gap between practice and National Institute for Health and Care Excellence guideline steps; only 3 patient was given medications according to National Institute for Health and Care Excellence guidelines in order of combination or steps of escalation. Addressing these gaps could potentially lead to enhanced patient outcomes and an overall improvement in the quality of care provided to individuals suffering from constipation.

Keywords: constipation, elderly, management, patient

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Authors: Tarek M. Alguhane, Ayman H. Khalil, Nour M. Fayed, Ayman M. Ismail

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Early, pre-code, reinforced concrete structures present undetermined resistance to earthquakes. This situation is particularly unacceptable in the case of essential structures, such as healthcare structures and pilgrims' houses. Among these, existing old RC building in Madinah is seismically evaluated with and without infill wall and their dynamic characteristics are compared with measured values in the field using ambient vibration measurements (AVM). After, updating the mathematical models for this building with the experimental results, three dimensional pushover analysis (Nonlinear static analysis) was carried out using SAP 2000 software incorporating inelastic material properties for concrete, infill and steel. The purpose of this analysis is to evaluate the expected performance of structural systems by estimating, strength and deformation demands in design, and comparing these demands to available capacities at the performance levels of interest. The results are summarized and discussed.

Keywords: seismic assessment, pushover analysis ambient vibration, modal update

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Authors: Oluyemi O. Awolusi, Abimbola M. Enitan, Sheena Kumari, Faizal Bux

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Nitrification is essential to biological processes designed to remove ammonia and/or total nitrogen. It removes the excess nitrogenous compound in wastewater which could be very toxic to the aquatic fauna or cause a serious imbalance of such aquatic ecosystem. Efficient nitrification is linked to an in-depth knowledge of the structure and dynamics of the nitrifying community structure within the wastewater treatment systems. In this study, molecular technique was employed for characterizing the microbial structure of activated sludge [ammonia oxidizing bacteria (AOB) and nitrite oxidizing bacteria (NOB)] in a municipal wastewater treatment with intention of linking it to the plant efficiency. PCR-based phylogenetic analysis was also carried out for. The average operating and environmental parameters, as well as specific nitrification rate of a plant, was investigated during the study. During the investigation, the average temperature was 23±1.5oC. Other operational parameters such as mixed liquor suspended solids and chemical oxygen demand inversely correlated with ammonia removal. The dissolved oxygen level in the plant was constantly lower than the optimum (between 0.24 and 1.267 mg/l) during this study. The plant was treating wastewater with the influent ammonia concentration of 31.69 and 24.47 mg/l. The influent flow rates (ML/day) was 96.81 during the period. The dominant nitrifiers include: Nitrosomonas spp. Nitrobacter spp. and Nitrospira spp. The AOB had a correlation with nitrification efficiency and temperature. This study shows that the specific ammonia oxidizing rate and the specific nitrate formation rates can serve as a good indicator of the plant overall nitrification performance.

Keywords: Ammonia monooxygenase α-subunit gene, amoA, ammonia-oxidizing bacteria, AOB, nitrite-oxidizing bacteria, NOB, specific nitrification rate

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Authors: Jeter Canete, Noreen Joyce Estrella, Yedda Sachi Patrice Madelo

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Zooplankton plays a crucial role in aquatic ecosystems and a number of water parameters involved in it. Despite their relevance, there is inadequate information about zooplankton communities in Sarangani Bay, Sarangani Province: one of the most essential waterbodies in Mindanao. The aim of the present study was to determine the composition, abundance, and diversity of zooplankton as well as to provide more recent data about the physico-chemical characteristics of Sarangani Bay. Zooplankton samples were collected by vertical hauls using a zooplankton net (mouth diameter: 0.5m; mesh size opening: round, 350μm) in three stations in the coastal waters of Alabel, Malapatan, and Maasim during November 2018. A total of 74 species of zooplankton belonging mainly to Kingdom Protozoa, Phylum Arthropoda, Chaetognatha, and Chordata were identified. Results showed a total zooplankton abundance of 1,984,166 ind/m³ with the highest count recorded at Malapatan (717,169 ind/m³) and the lowest at Maasim (624,411 ind/m³). Among 22 zooplankton groups identified, subclass Copepoda was found to be the most dominant (73.10%), followed by Appendicularia (12.18%) and Vertebrata (3.54%). Diversity analysis revealed an even distribution of species and a diverse ecosystem in all stations sampled. Correlation analysis indicated a strong relationship between zooplankton abundance and physico-chemical parameters. Overall, the physico-chemical profile of Sarangani Bay did not differ from the standards set by DENR, and analysis of the zooplankton communities revealed that Sarangani Bay favorably supports marine organisms to flourish. The findings of this study provide useful knowledge on zooplankton communities and can be used to create management strategies to protect the aquatic biodiversity in Sarangani Bay.

Keywords: aquatic biomonitoring, biodiversity, physicochemical analysis, population survey, Sarangani Bay, Sarangani Province, zooplankton

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Authors: Marzieh Imani

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Antoni Gaudi and Santiago Calatrava have reputation for designing bio-inspired creative and technical buildings. Even though they have followed different independent approaches towards design, the source of bio-inspiration seems to be common. Taking a closer look at their projects reveals that Calatrava has been influenced by Gaudi in terms of interpreting nature and applying natural principles into the design process. This research firstly discusses the dialogue between Biomimicry and architecture. This review also explores human/nature discourse during the history by focusing on how nature revealed itself to the fine arts. This is explained by introducing naturalism and romantic style in architecture as the outcome of designers’ inclination towards nature. Reviewing the literature, theoretical background and practical illustration of nature have been included. The most dominant practical aspects of imitating nature are form and function. Nature has been reflected in architectural science resulted in shaping different architectural styles such as organic, green, sustainable, bionic, and biomorphic. By defining a set of common aspects of Gaudi and Calatrava‘s design approach and by considering biomimetic design categories (organism, ecosystem, and behaviour as the main division and form, function, process, material, and construction as subdivisions), Gaudi’s and Calatrava’s project have been analysed. This analysis explores if their design approaches are equivalent or different. Based on this analysis, Gaudi’s architecture can be recognised as biomorphic while Calatrava’s projects are literally biomimetic. Referring to these architects, this review suggests a new set of principles by which a bio-inspired project can be determined either biomorphic or biomimetic.

Keywords: biomimicry, Calatrava, Gaudi, nature

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Authors: Valmir Baloshi, Fran Gjoka, Nehat Çollaku, Elvin Toromani

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As a sediment production mechanism, soil erosion is the main environmental threat to the Bovilla watershed, including the decline of water quality of the Bovilla reservoir that provides drinking water to Tirana city (the capital of Albania). Therefore, an experiment with 25 erosion plots for soil erosion monitoring has been set up since June 2017. The aim was to determine the soil loss on plot and watershed scale in Bovilla watershed (Tirana region) for implementation of soil and water protection measures or payments for ecosystem services (PES) programs. The results of erosion monitoring for the period June 2017 - May 2018 showed that the highest values of surface runoff were noted in bare land of 38829.91 liters on slope of 74% and the lowest values in forest land of 12840.6 liters on slope of 64% while the highest values of soil loss were found in bare land of 595.15 t/ha on slope of 62% and lowest values in forest land of 18.99 t/ha on slope of 64%. These values are much higher than the average rate of soil loss in the European Union (2.46 ton/ha/year). In the same sloping class, the soil loss was reduced from orchard or bare land to the forest land, and in the same category of land use, the soil loss increased with increasing land slope. It is necessary to conduct chemical analyses of sediments to determine the amount of chemical elements leached out of the soil and end up in the reservoir of Bovilla. It is concluded that PES programs should be implemented for rehabilitation of sub-watersheds Ranxe, Vilez and Zall-Bastar of the Bovilla watershed with valuable conservation practices.

Keywords: ANOVA, Bovilla, land cover, slope, soil loss, watershed management

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Authors: Ronit Chakraborty, Sugata Banerji

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There has been a marked increase in the reported prevalence of Autism Spectrum Disorder (ASD) among children in the US over the past two decades. This research has analyzed the growth in state-level ASD prevalence against 45 different potentially explanatory factors, including socio-economic, demographic, healthcare, public policy, and political factors. The goal was to understand if these factors have adequate predictive power in modeling the differential growth in ASD prevalence across various states and if they do, which factors are the most influential. The key findings of this study include (1) the confirmation that the chosen feature set has considerable power in predicting the growth in ASD prevalence, (2) the identification of the most influential predictive factors, (3) given the nature of the most influential predictive variables, an indication that a considerable portion of the reported ASD prevalence differentials across states could be attributable to over and under diagnosis, and (4) identification of Florida as a key outlier state pointing to a potential under-diagnosis of ASD there.

Keywords: autism spectrum disorder, clustering, machine learning, predictive modeling

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Authors: Haitham Assiri, Priyadarsi Nanda

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The world is gradually entering the fourth industrial revolution. E-Government services are scaling government operations across the globe. However, as promising as an e-Government system would be, it is also susceptible to malicious attacks if not properly secured. This study found out that, in Saudi Arabia, the e-Government website, Yesser is vulnerable to external attacks. Obviously, this can lead to a breach of data integrity and privacy. In this paper, a Systematic Literature Review was conducted to explore possible ways the Kingdom of Saudi Arabia can take necessary measures to strengthen its e-Government system using Blockchain. Blockchain is one of the emerging technologies shaping the world through its applications in finance, elections, healthcare, etc. It secures systems and brings more transparency. A total of 28 papers were selected for this SLR, and 19 of the papers significantly showed that blockchain could enhance the security and privacy of Saudi’s e-government system. Other papers also concluded that blockchain is effective, albeit with the integration of other technologies like IoT, AI and big data. These papers have been analysed to sieve out the findings and set the stage for future research into the subject.

Keywords: blockchain, data integrity, e-government, security threats

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Authors: Ram Sharan Mehta

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Continuing changes in health and social care policy and practice have affected and changed the way in which nursing is practiced. One of the greatest challenges facing nursing today is to build on the essence of nursing as a caring profession whilst incorporating new technologies, ideas and approaches to future healthcare. The objective of this study was to find out the socio-demographic characteristics of the M.Sc. Nursing students and calculate the association between specialty subjects, caste, age group, and residence with SLC division, BN/BSN division, entrance score, and total nursing experience. Descriptive cross-sectional study design was used to conduct the study among all the 25 M.Sc. Nursing students studying at BPKIHS in 2012. Most of the students (56%) were of age group of 25-30 years, completed his academic courses with first division and succeeded in entrance test in first attempt (96%). Based on the results, it can conclude that most of the subjects were of young age, having high score achievers in SLC, I.Sc., CN, BN/BSN and Entrance test. The demographic characteristics do not influence in the academic scores of the students.

Keywords: profile, postgraduate nursing students, Nepal, influence

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Authors: Pronob Kumar Mozumder, M. Abdur Rob Mollah

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This research was conducted in two coastal locations of Bangladesh from February, 2013 to January, 2014.The objective of this research was to assess the potential vulnerabilities of climate change on local ecosystem and people and to identify and recommend local level adaptation strategies to climate change. Focus group discussions, participatory rural appraisal, interviewing local elderly people were conducted. Perceptions about climate change indicate that local people are experiencing impacts of climate change. According to local people, temperature, cyclone, rain, water-logging, siltation, salinity, erosion, and flash flood are increasing. Vulnerability assessment revealed that local people are variously affected by abnormal climate related disasters. This is jeopardizing their livelihoods, risking their lives, health, and their assets. This prevailing climatic situation in the area is also impacting their environmental conditions, biodiversity and natural resources, and their economic activities. The existing adaptation includes using traditional boat and mobile phone while fishing and making house on high land and lower height. Proposed adaptation for fishing boat are using more than 60 feet length with good timber, putting at least 3 longitudinal bar along upper side, using enough vertical side bars. The homestead measures include use of cross bracing of wall frame, roof tying with extra-post by ropes and plantation of timber tree against wind.

Keywords: community level vulnerabilities, climate change, Cox’s Bazar-Teknaf Coastal Area, Bangladesh

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Authors: Sabrina Neururer, Marco Schweitzer, Werner Hackl, Bernhard Tilg, Patrick Raudaschl, Andreas Huber, Bernhard Pfeifer

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History and the current outbreak of Covid-19 have shown the deadly potential of infectious diseases. However, infectious diseases also have a serious impact on areas other than health and healthcare, such as the economy or social life. These areas are strongly codependent. Therefore, disease control measures, such as social distancing, quarantines, curfews, or lockdowns, have to be adopted in a very considerate manner. Infectious disease modeling can support policy and decision-makers with adequate information regarding the dynamics of the pandemic and therefore assist in planning and enforcing appropriate measures that will prevent the healthcare system from collapsing. In this work, an agent-based simulation package named “survival” for simulating infectious diseases is presented. A special focus is put on SARS-Cov-2. The presented simulation package was used in Austria to model the SARS-Cov-2 outbreak from the beginning of 2020. Agent-based modeling is a relatively recent modeling approach. Since our world is getting more and more complex, the complexity of the underlying systems is also increasing. The development of tools and frameworks and increasing computational power advance the application of agent-based models. For parametrizing the presented model, different data sources, such as known infections, wastewater virus load, blood donor antibodies, circulating virus variants and the used capacity for hospitalization, as well as the availability of medical materials like ventilators, were integrated with a database system and used. The simulation result of the model was used for predicting the dynamics and the possible outcomes and was used by the health authorities to decide on the measures to be taken in order to control the pandemic situation. The survival package was implemented in the programming language Java and the analytics were performed with R Studio. During the first run in March 2020, the simulation showed that without measures other than individual personal behavior and appropriate medication, the death toll would have been about 27 million people worldwide within the first year. The model predicted the hospitalization rates (standard and intensive care) for Tyrol and South Tyrol with an accuracy of about 1.5% average error. They were calculated to provide 10-days forecasts. The state government and the hospitals were provided with the 10-days models to support their decision-making. This ensured that standard care was maintained for as long as possible without restrictions. Furthermore, various measures were estimated and thereafter enforced. Among other things, communities were quarantined based on the calculations while, in accordance with the calculations, the curfews for the entire population were reduced. With this framework, which is used in the national crisis team of the Austrian province of Tyrol, a very accurate model could be created on the federal state level as well as on the district and municipal level, which was able to provide decision-makers with a solid information basis. This framework can be transferred to various infectious diseases and thus can be used as a basis for future monitoring.

Keywords: modelling, simulation, agent-based, SARS-Cov-2, COVID-19

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Authors: Khachen Kongpakwattana, Nathorn Chaiyakunapruk

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Background: Decision-analytic models for Alzheimer’s disease (AD) have been advanced to discrete-event simulation (DES), in which individual-level modelling of disease progression across continuous severity spectra and incorporation of key parameters such as treatment persistence into the model become feasible. This study aimed to apply the DES to perform a cost-effectiveness analysis of treatment for AD in Thailand. Methods: A dataset of Thai patients with AD, representing unique demographic and clinical characteristics, was bootstrapped to generate a baseline cohort of patients. Each patient was cloned and assigned to donepezil, galantamine, rivastigmine, memantine or no treatment. Throughout the simulation period, the model randomly assigned each patient to discrete events including hospital visits, treatment discontinuation and death. Correlated changes in cognitive and behavioral status over time were developed using patient-level data. Treatment effects were obtained from the most recent network meta-analysis. Treatment persistence, mortality and predictive equations for functional status, costs (Thai baht (THB) in 2017) and quality-adjusted life year (QALY) were derived from country-specific real-world data. The time horizon was 10 years, with a discount rate of 3% per annum. Cost-effectiveness was evaluated based on the willingness-to-pay (WTP) threshold of 160,000 THB/QALY gained (4,994 US$/QALY gained) in Thailand. Results: Under a societal perspective, only was the prescription of donepezil to AD patients with all disease-severity levels found to be cost-effective. Compared to untreated patients, although the patients receiving donepezil incurred a discounted additional costs of 2,161 THB, they experienced a discounted gain in QALY of 0.021, resulting in an incremental cost-effectiveness ratio (ICER) of 138,524 THB/QALY (4,062 US$/QALY). Besides, providing early treatment with donepezil to mild AD patients further reduced the ICER to 61,652 THB/QALY (1,808 US$/QALY). However, the dominance of donepezil appeared to wane when delayed treatment was given to a subgroup of moderate and severe AD patients [ICER: 284,388 THB/QALY (8,340 US$/QALY)]. Introduction of a treatment stopping rule when the Mini-Mental State Exam (MMSE) score goes below 10 to a mild AD cohort did not deteriorate the cost-effectiveness of donepezil at the current treatment persistence level. On the other hand, none of the AD medications was cost-effective when being considered under a healthcare perspective. Conclusions: The DES greatly enhances real-world representativeness of decision-analytic models for AD. Under a societal perspective, treatment with donepezil improves patient’s quality of life and is considered cost-effective when used to treat AD patients with all disease-severity levels in Thailand. The optimal treatment benefits are observed when donepezil is prescribed since the early course of AD. With healthcare budget constraints in Thailand, the implementation of donepezil coverage may be most likely possible when being considered starting with mild AD patients, along with the stopping rule introduced.

Keywords: Alzheimer's disease, cost-effectiveness analysis, discrete event simulation, health technology assessment

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Authors: Rayan Elsiddig Eltaib, Yamanaka Norikazu, Mubarak Abdelrahman Abdalla

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This study investigated the effects of Acacia Senegal, Calotropis procera, Leptadenia pyrotechnica, Ziziphus spina Christi, Balanites aegyptiaca, Indigofera oblongigolia, Arachis hypogea and Sesimum indicum grown in the western region of White Nile State on soil properties of the 0-10, 10-30, 30-60 and 60-90 cm depths. Soil properties were: pH(paste), electrical conductivity of the saturation extract (ECe), total N (TN), organic carbon (OC), soluble K, available P, aggregate stability and water holding capacity. Triplicate Soil samples were collected after the end of the rainy season using 5 cm diameter auger. Results indicated that pH, ECe and TN were not significantly different among plant cover types. In the top 10-30 cm depth, OC under all types was significantly higher than the control (4.1 to 7.7 fold). The highest (0.085%) OC was found under the Z. spina Christi and A. Senegal whereas the lowest (0.045%) was reported under the A. hypogea. In the 10-30 cm depth, with the exception of A. hypogea, Z. spina christi and S. indicum, P content was almost similar but significantly higher than the control by 72 to 129%. In the 10-30 cm depth, K content under the S. indicum (0.46 meq/L) was exceptionally high followed by Z. spina christi (0.102 meq/L) as compared to the control (0.029 meq/L). Water holding capacity and aggregate stability of the top 0-10 cm depth were not significantly different among plant cover types. Based on the fact that accumulation of organic matter in the soil profile of any ecosystem is an important indicator of soil quality, results of this study may conclude that (1) cultivation of A.senegal, B.aegyptiaca and Z. spina Christi improved soil quality whereas (2) cultivation of A. hypogea or soil that is solely invaded with C. procera and L.pyrotechnica may induce soil degradation.

Keywords: canopy, crops, shrubs, soil properties, trees

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Authors: Nitish Suvarna, Anjali Awasthi

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In an era marked by rapid technological advancements, the integration of Autonomous Vehicles into supply chain networks represents a transformative shift, promising to redefine the paradigms of logistics and transportation. This thesis delves into a comprehensive assessment of the impact of autonomous vehicles on supply chain performance, with a particular focus on network design, operational efficiency, and environmental sustainability. Employing the advanced simulation capabilities of anyLogistix (ALX), the study constructs a digital twin of a conventional supply chain network, encompassing suppliers, production facilities, distribution centers, and customer endpoints. The research methodically integrates Autonomous Vehicles into this intricate network, aiming to unravel the multifaceted effects on transportation logistics including transit times, cost-efficiency, and sustainability. Through simulations and scenarios analysis, the study scrutinizes the operational resilience and adaptability of supply chains in the face of dynamic market conditions and disruptive technologies like Autonomous Vehicles. Furthermore, the thesis undertakes carbon footprint analysis, quantifying the environmental benefits and challenges associated with the adoption of Autonomous Vehicles in supply chain operations. The insights from this research are anticipated to offer a strategic framework for industry stakeholders, guiding the adoption of Autonomous Vehicles to foster a more efficient, responsive, and sustainable supply chain ecosystem. The findings aim to serve as a cornerstone for future research and practical implementations in the realm of intelligent transportation and supply chain management.

Keywords: autonomous vehicle, agri-food supply chain, ALX simulation, anyLogistix

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Authors: David Parmenter, Brian Millar

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Obstructive sleep apnoea is a common condition which is generally under-diagnosed. Poorly managed obstructive sleep apnoea carries serious health risks and can greatly impact on the sufferer's quality of life. This publication covers the aetiology, symptoms, and treatment of sleep apnoea. The treatment of Obstructive Sleep Apnoea is an emerging field, and the useful role of the Dental Team is relatively unknown, therefor this paper will highlight the role of the dental team in its treatment. The concept of mandibular advancement appliances, along with the clinical and laboratory stages for constructing them, are documented. It is the hope of the author that this publication will educate healthcare professionals on the role of dental practitioners in the multidisciplinary team for treating sleep apnoea. Objective: Individuals should be more aware of the demographic of patients at risk of sleep apnoea, how it is diagnosed and which group of sleep apnoea patients are suitable to refer for mandibular appliance therapy. Individuals should also be aware of what a mandibular advancement appliance is and how it helps treat obstructive sleep apnoea.

Keywords: sleep apnoea, snoring, sleep appliances, mandibular advancement appliance

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Authors: Veriko Jeladze, Besarion Partsvania, Levan Shoshiashvili

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This paper addresses a very topical issue today. The frequency range 2.5-100 GHz contains frequencies that have already been used or will be used in modern 5G technologies. The wavelengths used in 5G systems will be close to the body dimensions of small size biological objects, particularly insects. Because the body and body parts dimensions of insects at these frequencies are comparable with the wavelength, the high absorption of EMF energy in the body tissues can occur(body resonance) and therefore can cause harmful effects, possibly the extinction of some of them. An investigation into the impact of radio-frequency nonionizing electromagnetic field (EMF) utilized in the future 5G on insects is of great importance as a very high number of 5G network components will increase the total EMF exposure in the environment. All ecosystems of the earth are interconnected. If one component of an ecosystem is disrupted, the whole system will be affected (which could cause cascading effects). The study of these problems is an important challenge for scientists today because the existing studies are incomplete and insufficient. Consequently, the purpose of this proposed research is to investigate the possible hazardous impact of RF-EMFs (including 5G EMFs) on insects. The project will study the effects of these EMFs on various insects that have different body sizes through computer modeling at frequencies from 2.5 to 100 GHz. The selected insects are honey bee, wasp, and ladybug. For this purpose, the detailed 3D discrete models of insects are created for EM and thermal modeling through FDTD and will be evaluated whole-body Specific Absorption Rates (SAR) at selected frequencies. All these studies represent a novelty. The proposed study will promote new investigations about the bio-effects of 5G-EMFs and will contribute to the harmonization of safe exposure levels and frequencies of 5G-EMFs'.

Keywords: electromagnetic field, insect, FDTD, specific absorption rate (SAR)

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Authors: Shah Fahad

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Managing the Urban Heat Island (UHI) effects is a pressing concern for achieving sustainable urban development and ensuring thermal comfort in major cities of developing nations, such as Lahore, Pakistan. The current UHI effect is mostly triggered by climate change and rapid urbanization. This study explored UHI over the Lahore district and its adjoining urban and rural-urban fringe areas. Landsat satellite data was utilized to investigate spatiotemporal patterns of Land Use and Land Cover changes (LULC), Land Surface Temperature (LST), UHI, Normalized Difference Built-up Index (NDBI), Normalized Difference Vegetation Index (NDVI), and Urban Thermal Field Variance Index (UTFVI). The built-up area increased very fast, with a coverage of 22.99% in 2000, 36.06% in 2010, and 47.17% in 2020, while vegetation covered 53.21 % in 2000 and 46.16 % in 2020. It also revealed a significant increase in the mean LST, from 33°C in 2000 to 34.8°C in 2020. The results indicated a significantly positive correlation between LST and NDBI, a weak correlation was also observed between LST and NDVI. The study used scatterplots to show the correlation between NDBI and NDVI with LST, results revealed that the NDBI and LST had an R² value of 0.6831 in 2000 and 0.06541 in 2022, while NDVI and LST had an R² value of 0.0235 in 1998 and 0.0295 in 2022. Proper environmental planning is vital in specific locations to enhance quality of life, protect the ecosystem, and mitigate climate change impacts.

Keywords: land use land cover, spatio-temporal analysis, remote sensing, land surface temperature, urban heat island, lahore pakistan

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Authors: Mitsuo Yoshida

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A significant mercury contamination of soil/sediment was unveiled by an environmental monitoring program in a wetland along La Plata River, west to Montevideo City, Uruguay. The mercury contamination was caused by industrial wastewater discharged from a chlor-alkali plant using a mercury-cell process. The contamination level is above 60 mg/kg in soil/sediment. Most of mercury (Hg) in the environment is inorganic, but some fractions are converted by bacteria to methylmercury (MeHg), a toxic organic compound. MeHg biologically accumulates through a food-chain and become serious public health risk. In order to clarify the contaminated part for countermeasure operation, an intervention value of mercury contamination of sediment/soil was defined as 15 mg/kg (total Hg) by the authority. According to the intervention value, mercury contaminated area in the La Plata site is approximately 48,280 m² and estimated total volume of contaminated sediments/soils was around 18,750 m³. The countermeasures to contaminated zone were proposed in two stages; (i) mitigation of risks for public health and (ii) site remediation. The first stage is an installation of fens and net around the contamination zone, for mitigating risks of exposure, inhalation, and intake. The food chain among wetland-river ecosystem was also interrupted by the installation of net and fens. The state of mercury contamination in La Plata site and plan of countermeasure was disclosed to local people and the public, and consensus on setting off-limit area was successfully achieved. Mass media also contribute to share the information on the contamination site. The cost for countermeasures was borne by the industry under the polluter-pay-principle.

Keywords: chlor-alkali plant, mercury contamination, polluter pay principle, Uruguay, wetland

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Authors: Li Jiuen Ong, Magdalin Cheong, Sri Rahayu, Lek Alexander, Pei Ting Tan

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Background: Previous programme evaluations from the diabetes training programme conducted in Changi General Hospital revealed that healthcare professionals (HCPs) are keen to receive advance diabetes training and education, specifically in medical, nutritional therapy. HCPs also expressed a preference for interactive activities over didactic teaching methods to enhance their learning. Since the War on Diabetes was initiated by MOH in 2016, HCPs are challenged to be actively involved in continuous education to be better equipped to reduce the growing burden of diabetes. Hence, streamlining training to incorporate an element of fun is of utmost importance. Aim: The nutrition programme incorporates game play using an interactive board game that aims to provide a more conducive and less stressful environment for learning. The board game could be adapted for training of community HCPs, health ambassadors or caregivers to cope with the increasing demand of diabetes care in the hospital and community setting. Methodology: Stages for game’s conception (Jaffe, 2001) were adopted in the development of the interactive board game ‘Sweet Score™ ’ Nutrition concepts and topics in diabetes self-management are embedded into the game elements of varying levels of difficulty (‘Easy,’ ‘Medium,’ ‘Hard’) including activities such as a) Drawing/ sculpting (Pictionary-like) b)Facts/ Knowledge (MCQs/ True or False) Word definition) c) Performing/ Charades To study the effects of game play on knowledge acquisition and perceived experiences, participants were randomised into two groups, i.e., lecture group (control) and game group (intervention), to test the difference. Results: Participants in both groups (control group, n= 14; intervention group, n= 13) attempted a pre and post workshop quiz to assess the effectiveness of knowledge acquisition. The scores were analysed using paired T-test. There was an improvement of quiz scores after attending the game play (mean difference: 4.3, SD: 2.0, P<0.001) and the lecture (mean difference: 3.4, SD: 2.1, P<0.001). However, there was no significance difference in the improvement of quiz scores between gameplay and lecture (mean difference: 0.9, 95%CI: -0.8 to 2.5, P=0.280). This suggests that gameplay may be as effective as a lecture in terms of knowledge transfer. All the13 HCPs who participated in the game rated 4 out of 5 on the likert scale for the favourable learning experience and relevance of learning to their job, whereas only 8 out of 14 HCPs in the lecture reported a high rating in both aspects. 16. Conclusion: There is no known board game currently designed for diabetes training for HCPs.Evaluative data from future training can provide insights and direction to improve the game format and cover other aspects of diabetes management such as self-care, exercise, medications and insulin management. Further testing of the board game to ensure learning objectives are met is important and can assist in the development of awell-designed digital game as an alternative training approach during the COVID-19 pandemic. Learning through gameplay increases opportunities for HCPs to bond, interact and learn through games in a relaxed social setting and potentially brings more joy to the workplace.

Keywords: active learning, game, diabetes, nutrition

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Authors: Babalola Sunday Oyetayo, Igbinomwanhia Uyi Osamwonyi, Idowu T. O., Herbert Tata

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This paper explores the potential benefits of adopting blockchain technology in Nigeria's land administration systems while also addressing the challenges and implications of its implementation in the country's unique context. Through a comprehensive literature review and analysis of existing research, the paper delves into the key attributes of blockchain that can revolutionize land administration practices, with a particular focus on simplifying land registration procedures, expediting land title issuance, and enhancing data transparency and security. The decentralized and immutable nature of blockchain offers unique advantages, instilling trust and confidence in land transactions, which are especially crucial in Nigeria's land governance landscape. However, integrating blockchain in Nigeria's land administration ecosystem presents specific challenges, necessitating a critical evaluation of technical, socio-economic, and infrastructural barriers. These challenges encompass data privacy concerns, scalability, interoperability with outdated systems, and gaining acceptance from various stakeholders. By synthesizing these insights, the paper proposes strategies tailored to Nigeria's context to optimize the benefits of blockchain adoption while addressing the identified challenges. The research findings contribute significantly to the ongoing discourse on blockchain technology in Nigeria's land governance, offering evidence-based recommendations to policymakers, land administrators, and stakeholders. Ultimately, the paper aims to promote the effective utilization of blockchain, fostering efficiency, transparency, and trust in Nigeria's land administration systems to drive sustainable development and societal progress.

Keywords: block-chain, technology, stakeholders, land registration

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Authors: Sisira Edirippulige, Anthony C. Smith, Sumudu Wickramasinghe, Nigel R. Armfield

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Background: E-Health is steadily integrating into modern health services, making significant changes in the way health services are traditionally delivered. To work in this new environment, healthcare workers are required to have new knowledge, skills, and competencies specific to e-Health. The aim of this study was to understand the self-reported perceptions of graduates regarding the influence of an e-Health postgraduate program on their professional careers. Methods: All graduates from 2005 to 2015 were surveyed using an online questionnaire that consisted of a mixture of closed and open-ended questions. Results: The number of participants in the study was 32. Response rate was 62%. Graduates thought that the postgraduate e-Health program had an influence on their professional practice. The majority of the participants mentioned that they had worked in the e-Health field since their graduation. Their professional roles mainly involved implementation of e-Health in health service settings and the use of e-Health in clinical practice. Conclusions: While e-Health may be steadily integrating into modern health services, e-Health specific job opportunities are still relatively limited. E-Health workforce development must be given priority.

Keywords: e-health, postgraduate education, clinical practice, curriculum

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Authors: Feng Huang, Carlos G. Ochoa, Haitao Zhao

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Poyang Lake, the largest freshwater lake in China, is located at the middle-lower reaches of the Yangtze River basin. It has great value in socioeconomic development and is internationally recognized as an important lacustrine and wetland ecosystem with abundant biodiversity. Impacted by ongoing climate change and anthropogenic activities, especially the regulation of the Three Gorges Reservoir since 2003, Poyang Lake has experienced significant water regime evolution, resulting in challenges for the management of water resources and the environment. Quantifying the contribution of hydrologic and topographic changes to water regime alteration is necessary for policymakers to design effective adaption strategies. Long term hydrologic data were collected and the back-propagation neural networks were constructed to simulate the lake water level. The impacts of hydrologic and topographic changes were differentiated through scenario analysis that considered pre-impact and post-impact hydrologic and topographic scenarios. The lake water regime was characterized by hydrologic indicators that describe monthly water level fluctuations, hydrologic features during flood and drought seasons, and frequency and rate of hydrologic variations. The results revealed different contributions of hydrologic and topographic changes to different features of the lake water regime.Noticeable changes were that the water level declined dramatically during the period of reservoir impoundment, and the drought was enhanced during the dry season. The hydrologic and topographic changes exerted a synergistic effect or antagonistic effect on different lake water regime features. The findings provide scientific reference for lacustrine and wetland ecological protection associated with water regime alterations.

Keywords: back-propagation neural network, scenario analysis, water regime, Poyang Lake

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Authors: Rachel S. Chang, Samuel P. Massion, Alan Z. Grusky, Heather A. Ridinger

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Introduction Health advocacy is defined as activities that improve access to care, utilize resources, address health disparities, and influence health policy. Advocacy is increasingly being recognized as a critical component of a physician’s role, as understanding social determinants of health and improving patient care are important aspects within the American Medical Association’s Health Systems Science framework. However, despite this growing prominence, educational interventions that address advocacy topics are limited and variable across medical school curricula. Furthermore, few recent studies have evaluated attitudes toward health advocacy among physicians-in-training in the United States. This study examines medical student attitudes towards health advocacy, along with perceived knowledge, ability, and current level of engagement with health advocacy during their clerkships. Methods This study employed a cross-sectional survey design using a single anonymous, self-report questionnaire to all second-year medical students at Vanderbilt University School of Medicine (n=96) in December 2020 during clerkship rotations. The survey had 27 items with 5-point Likert scale (15), multiple choice (11), and free response questions (1). Descriptive statistics and thematic analysis were utilized to analyze responses. The study was approved by the Vanderbilt University Institutional Review Board. Results There was an 88% response rate among second-year clerkship medical students. A majority (83%) agreed that formal training in health advocacy should be a mandatory part of the medical student curriculum Likewise, 83% of respondents felt that acting as a health advocate or patients should be part of their role as a clerkship student. However, a minority (25%) felt adequately prepared. While 72% of respondents felt able to identify a psychosocial need, 18% felt confident navigating the healthcare system and only 9% felt able to connect a patient to a psychosocial resource to fill that gap. 44% of respondents regularly contributed to conversations with their medical teams when discussing patients’ social needs, such as housing insecurity, financial insecurity, or legal needs. On average, respondents reported successfully connecting patients to psychosocial resources 1-2 times per 8-week clerkship block. Barriers to participating in health advocacy included perceived time constraints, lack of awareness of resources, lower emphasis among medical teams, and scarce involvement with social work teams. Conclusions In this single-institutional study, second-year medical students on clerkships recognize the importance of advocating for patients and support advocacy training within their medical school curriculum. However, their perceived lack of ability to navigate the healthcare system and connect patients to psychosocial resources, result in students feeling unprepared to advocate as effectively as they hoped during their clerkship rotations. Our results support the ongoing need to equip medical students with training and resources necessary for them to effectively act as advocates for patients.

Keywords: clerkships, medical students, patient advocacy, social medicine

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Authors: Murad Almadani, Khalil Abu-Hantash, Xinyu Wang, Herbert Jelinek, Kinda Khalaf

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Gait analysis is used by healthcare professionals as a tool to gain a better understanding of the movement impairment and track progress. In most circumstances, monitoring patients in their real-life environments with low-cost equipment such as cameras and wearable sensors is more important. Inertial sensors, on the other hand, cannot provide enough information on angular dynamics. This research offers a method for tracking 2D joint coordinates using cutting-edge vision algorithms and a single RGB camera. We provide an end-to-end comprehensive deep learning pipeline for marker-less gait parameter estimation, which, to our knowledge, has never been done before. To make our pipeline function in real-time for real-world applications, we leverage the AlphaPose human posture prediction model and a deep learning transformer. We tested our approach on the well-known GPJATK dataset, which produces promising results.

Keywords: gait analysis, human pose estimation, deep learning, real time gait estimation, AlphaPose, transformer

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Authors: David Cook, Brynhildur Davidsdottir, Dadi. M. Kristofersson

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The approval of development projects with significant environmental impacts implies that the economic costs of the affected environmental resources must be less than the financial benefits, but such irreversible decisions are frequently made without ever attempting to estimate the monetary value of the losses. Due to this knowledge gap in the processes informing decision-making, development projects are commonly approved despite the potential for social welfare to be undermined. Heeding a repeated call by the OECD to commence economic accounting of environmental impacts as part of the cost-benefit analysis process for Icelandic energy projects, this paper sets out the results pertaining to the nation’s first two contingent valuation studies of geothermal areas likely to be developed in the near future. Interval regression using log-transformation was applied to estimate willingness to pay (WTP) for the preservation of the high-temperature Eldvörp and Hverahlíð fields. The estimated mean WTP was 8,333 and 7,122 ISK for Eldvörp and Hverahlíð respectively. Scaled up to the Icelandic population of national taxpayers, this equates to estimated total economic value of 2.10 and 1.77 billion ISK respectively. These results reinforce arguments in favour of accounting for the environmental impacts of Iceland’s future geothermal power projects as a mandatory component of the exploratory and production license application process. Further research is necessary to understand the economic impacts to specific ecosystem services associated with geothermal environments, particularly connected to changes in recreational amenity. In so doing, it would be possible to gain greater comprehension of the various components of total economic value, evolving understanding of why one geothermal area – in this case, Eldvörp – has a higher preservation value than another.

Keywords: decision-making, contingent valuation, geothermal energy, preservation

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Authors: Iis Diatin, Yani Hadiroseyani, Muhammad Mujahid, Ahmad Teduh, Juang R. Matangaran

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One of silica quarry managed by a mining company is located at Sukabumi District of West Java Province Indonesia with an area of approximately 70 hectares. Since 2013 this company stopped the mining activities. The company tries to restore the ecosystem post-mining with rehabilitation activities such as reclamation and revegetation of their ex-mining area. After three years planting the area the trees grown well. Not only planting some tree species but also some cover crop has covered the soil surface. There are two settling ponds located in the middle of the ex-mining area. Those settling pond were built in order to prevent the effect of acid mine drainage. Acid mine drainage (AMD) or the acidic water is created when sulphide minerals are exposed to air and water and through a natural chemical reaction produce sulphuric acid. AMD is the main pollutant at the open pit mining. The objective of the research was to analyze the effect of revegetation on water quality change at the settling pond. The physical and chemical of water quality parameter were measured and analysed at site and at the laboratory. Physical parameter such as temperature, turbidity and total organic matter were analyse. Also heavy metal and some other chemical parameter such as dissolved oxygen, alkalinity, pH, total ammonia nitrogen, nitrate and nitrite were analysed. The result showed that the acidity of first settling pond was higher than that of the second settling pond. Both settling pond water’s contained heavy metal. The turbidity and total organic matter were the parameter of water quality which become better after revegetation.

Keywords: acid mine drainage, ex-mining area, revegetation, settling pond, water quality

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Authors: Oluwaseun Adeleke, Grace Amarachi Omenife, Jennifer Adebambo, Mopelola Raji, Anthony Nwala, Mogbonjubade Adesulure

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Introduction: The incorporation of digital technology in healthcare systems is instrumental in transforming the delivery, management, and overall experience of healthcare and holds the potential to scale up access through over 200 million active mobile phones used in Nigeria. Digital tools enable increased access to care, stronger client engagement, progress in research and data-driven insights, and more effective promotion of self-care and do-it-yourself practices. The Delivering Innovation in Self-Care (DISC) project 2021 has played a pivotal role in granting women greater autonomy over their sexual and reproductive health (SRH) through a variety of approaches, including information and training to self-inject contraception (DMPA-SC). To optimize its outcomes, the project also leverages digital technology platforms like social media: Facebook, Instagram, and Meet Tina (Chatbot) via WhatsApp, Customer Relationship Management (CRM) applications Freshworks, and Viamo. Methodology: The project has been successful at optimizing in-person digital cyberspace interaction to sensitize individuals effectively about self-injection and provide linkages to SI services. This platform employs the Freshworks CRM software application, along with specially trained personnel known as Cyber IPC Agents and DHIS calling centers. Integration of Freshworks CRM software with social media allows a direct connection with clients to address emerging issues, schedule follow-ups, send reminders to improve compliance with self-injection schedules, enhance the overall user experience for self-injection (SI) clients, and generate comprehensive reports and analytics on client interactions. Interaction covers a range of topics, including – How to use SI, learning more about SI, side-effects and its management, accessing services, fertility, ovulation, other family planning methods, inquiries related to Sexual Reproductive Health as well as uses an address log to connect them with nearby facilities or online pharmaceuticals. Results: Between the months of March to September, a total of 5,403 engagements were recorded. Among these, 4,685 were satisfactorily resolved. Since the program's inception, digital advertising has created 233,633,075 impressions, reached 12,715,582 persons, and resulted in 3,394,048 clicks. Conclusion: Leveraging digital technology has proven to be an invaluable tool in client management and improving client experience. The use of Cyber technology has enabled the successful development and maintenance of client relationships, which have been effective at providing support, facilitating delivery and compliance with DMPA-SC self-injection services, and ensuring overall client satisfaction. Concurrently, providing qualitative data, including user experience feedback, has enabled the derivation of crucial insights that inform the decision-making process and guide in normalizing self-care behavior.

Keywords: selfcare, DMPA-SC self-injection, digital technology, cyber technology, freshworks CRM software

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