Search results for: health information exchange (hie)

Authors: Harley Bray, Helen Pymar, Michelle Liu, Chau Pham, Tomislav Jelic, Fran Mulhall

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Background: Our study assesses the impact of the COVID-19 pandemic on early pregnancy assessment clinic (EPAC) referrals and the use of virtual consultation in Winnipeg, Manitoba. Our clinic expanded to accept referrals from all Winnipeg Emergency Department (ED)/Urgent Care (UC) sites beginning November 2019 to April 2020. By May 2020, the COVID-19 pandemic reached Manitoba and EPAC virtual care was expanded by performing hCG remotely and reviewing blood and ED/UC ultrasound results by phone. Methods: Emergency Department Information Systems (EDIS) and EPAC data reviewed ED/UC visits for pregnancy <20 weeks and vaginal bleeding 1-year pre-COVID (March 12, 2019, to March 11, 2020) and during COVID (March 12, 2020 (first case in Manitoba) to March 11, 2021). Results: There were fewer patient visits for vaginal bleeding or pregnancy of <20 weeks (4264 vs. 5180), diagnoses of threatened abortion (1895 vs. 2283), and ectopic pregnancy (78 vs. 97) during COVID compared with pre-COVID, respectively. ICD 10 codes were missing in 849 (20%) and 1183 (23%) of patients during COVID and pre-COVID, respectively. Wait times for all patient visits improved during COVID-19 compared to pre-COVID (5.1 ± 4.4 hours vs. 5.5 ± 3.8 hours), more patients received obstetrical ultrasounds, 761 (18%) vs. 787 (15%), and fewer patients returned within 30 days (1360 (32%) vs. 1848 (36%); p<0.01). EPAC saw 708 patients (218; 31% new ED/UC) during COVID-19 compared to 552 (37; 7% new ED/UC) pre-COVID. Fewer operative interventions for pregnancy loss (346 vs. 456) and retained products (236 vs. 272) were noted. Surgeries to treat ectopic pregnancy (106 vs 113) remained stable during the study time interval. Conclusion: Accurate identification of pregnancy complications was difficult, with over 20% missing ICD-10 diagnostic codes. There were fewer ED/UC visits and surgical management for threatened abortion during COVID-19, but ectopic pregnancy operative management remained unchanged.

Keywords: early pregnancy, ultrasound, COVID-19, obstetrics

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Authors: Yusuf Ulaş Kabukçu, Si̇nan Çeli̇k, Onur Salan, Mai̇de Altuntaş, Mert Can Dalkiran, Gökseni̇n Bozdağ, Metehan Bulut, Fati̇h Yaman

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This study presents a more compact implementation of the 2.4GHz MIT Coffee Can Doppler Radar for 2.6GHz operating frequency. The main difference of our prototype depends on the use of microstrip antennas which makes it possible to transport with a small robotic vehicle. We have designed our radar system with two different channels: Tx and Rx. The system mainly consists of Voltage Controlled Oscillator (VCO) source, low noise amplifiers, microstrip antennas, splitter, mixer, low pass filter, and necessary RF connectors with cables. The two microstrip antennas, one is element for transmitter and the other one is array for receiver channel, was designed, fabricated and verified by experiments. The system has two operation modes: speed detection and range detection. If the switch of the operation mode is ‘Off’, only CW signal transmitted for speed measurement. When the switch is ‘On’, CW is frequency-modulated and range detection is possible. In speed detection mode, high frequency (2.6 GHz) is generated by a VCO, and then amplified to reach a reasonable level of transmit power. Before transmitting the amplified signal through a microstrip patch antenna, a splitter used in order to compare the frequencies of transmitted and received signals. Half of amplified signal (LO) is forwarded to a mixer, which helps us to compare the frequencies of transmitted and received (RF) and has the IF output, or in other words information of Doppler frequency. Then, IF output is filtered and amplified to process the signal digitally. Filtered and amplified signal showing Doppler frequency is used as an input of audio input of a computer. After getting this data Doppler frequency is shown as a speed change on a figure via Matlab script. According to experimental field measurements the accuracy of speed measurement is approximately %90. In range detection mode, a chirp signal is used to form a FM chirp. This FM chirp helps to determine the range of the target since only Doppler frequency measured with CW is not enough for range detection. Such a FMCW Doppler radar may be used in border security of the countries since it is capable of both speed and range detection.

Keywords: doppler radar, FMCW, range detection, speed detection

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Authors: J. Y. Ijato, A. Adewumi, H. O Yakubu, O. O. Olajide, B. O. Ojo, B. A. Adanikin

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Post-harvest fruit rot pathogens are one of the major factors that are responsible for food security challenges in developing countries like Nigeria. These pathogens also cause fruit food poisoning. Biocidal effects of ethanolic extracts of Khaya grandifoliola, Hyptis suaveolens, Zingiber officinale, Calophyllum inophyllum, Datura stramonium on the mycelia growth of fungal rot pathogens of pineapple fruit was investigated, the ethanolic extracts of these test plants exhibited high significant inhibitory effects on the rot pathogens, the highest ethanolic extract inhibition of Zingiber officinale was on Aspergillus flavus (38.40%) at 1.0g/ml while the least inhibitory effect was on Aspergillus fumigatus (23.10%) at 1.0g/ml, the highest ethanol extract inhibition of Datura stramonium was on Aspergillus tubingensis (24.00%) at 1.0g/ml while the least inhibitory effect was 10.00% on Colletotrichum fruticola at 1.0g/ml, the highest ethanol extract inhibition of Calophyllum inophyllum was on Trichoderma harzianum (18.50%) at 1.0g/ml while the least inhibitory effect was on Aspergillus flavus (15.00%) at 1.0g/ml, the highest ethanol extract inhibition of Hyptis suaveolens was on Aspergillus fumigatus (35.00%) at 1.0g/ml while the least inhibitory effect was on Aspergillus niger (20.00%) at 1.0g/ml, the highest ethanol extract inhibition of Khaya grandifoliola was on Aspergillus flavus (35.00%) at 1.00g/ml while the least inhibitory effect was on Aspergillus fumigates (22.00%) at 1.0g/ml, the antifungal capacity of these test plant extracts on rot causing fungi on pineapple fruit reveals the possibility of their use by farmers and fruit traders as alternative to chemical fungicide that portends great threat to human and environmental health.

Keywords: fruit rot, pathogens, plant extracts, pineapple, food poisoning

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Authors: Kuei-Yu Chien, Hsiu-Yu Chiu, Chia-Nan Chen, Shu-Chen Chen

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Background: Frailty is associated with decreased physical performances that affect mobility of the elderly. Time up and go test (TUG) was the common method to evaluate mobility in the community. The purpose of this study was to compare the parameters in different stages of Time up and go test (TUG) and physical performance between pre-frail elderly (PFE) and non-frail elderly (NFE). We also investigated the relationship between TUG parameters and physical performance. Methods: Ninety-two community-dwelling older adults were as participants in this study. Based on Canadian Study of Health and Aging Clinical Frailty Scale, 22 older adults were classified as PFE (71.77 ± 6.05 yrs.) and 70 were classified as NFE (71.2 ± 5.02 yrs.). We performed body composition and physical performance, including balance, muscular strength/endurance, mobility, cardiorespiratory endurance, and flexibility. Results: Pre-frail elderly took significantly longer time than NFE in TUG test (p=.004). Pre-frail elderly had lower turning average angular velocity (p = .017), turning peak angular velocity (p = .041) and turning-stand to sit peak angular velocity (p = .037) than NFE. The turning related parameters related to open-eye stand on right foot, 30-second chair stand test, back scratch, and 2-min step tests. Conclusions: Turning average angular velocity, turning peak angular velocity and turning-stand to sit peak angular velocity mainly affected the TUG performance. We suggested that static/dynamic balance, agility, flexibility, and muscle strengthening of lower limbs exercise were important to PFE.

Keywords: mobility, aglity, active ageing, functional fitness

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Authors: Michael Ward, Eliana Kalakouti, Andrew Alabi

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Aim: The handover process is recognized as a vulnerable step in the patient care pathway where errors are likely to occur. As such, it is a major preventable cause of patient harm due to human factors of poor communication and systematic error. The aim of this study was to audit the general surgery department’s weekend handover process compared to the recommended criteria for safe handover as set out by the Royal College of Surgeons (RCS). Method: A retrospective audit of the General Surgery department’s Friday patient lists and patient medical notes used for weekend handover in a London-based District General Hospital (DGH). Medical notes were analyzed against RCS's suggested criteria for handover. A standardized paper weekend handover proforma was then developed in accordance with guidelines and circulated in the department. A post-intervention audit was then conducted using the same methods for cycle 1. For cycle 2, we introduced an electronic weekend handover tool along with Electronic Patient Records (EPR). After a one-month period, a second post-intervention audit was conducted. Results: Following cycle 1, the paper weekend handover proforma was only used in 23% of patient notes. However, when it was used, 100% of them had a plan for the weekend, diagnosis and location but only 40% documented potential discharge status and 40% ceiling of care status. Qualitative feedback was that it was time-consuming to fill out. Better results were achieved following cycle 2, with 100% of patient notes having the electronic proforma. Results improved with every patient having documented ceiling of care, discharge status and location. Only 55% of patients had a past surgical history; however, this was still an increase when compared to paper proforma (45%). When comparing electronic versus paper proforma, there was an increase in documentation in every domain of the handover outlined by RCS with an average relative increase of 1.72 times (p<0.05). Qualitative feedback was that the autofill function made it easy to use and simple to view. Conclusion: These results demonstrate that the implementation of an electronic autofill handover proforma significantly improved handover compliance with RCS guidelines, thereby improving the transmission of information from week-day to weekend teams.

Keywords: surgery, handover, proforma, electronic handover, weekend, general surgery

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Authors: Sonny Dewi Judiasih

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Every person retains the right to marry and starts a family through a legitimized marriage. Indonesian Marriage Act has regulated the minimum age for boys to marry is 19 while the girls is 16, with an exception that the parents could ask for an exemption to the court or to the authorized official. Despite the age limit is set by the Marriage Act, however, with the influences from adat law and islamic law which allows younger persons to marry, the child marriage phenomenon is inevitable to happen in Indonesia. Child marriages in Indonesia have shown such alarming fact where 4.8 percentage of total marriage number come from persons with the age of 10 to 14 years old. The percentage was the result from a research conducted by the National Population and Family Planning Board (BKKBN). The result shows 41.9 percent of child marriages was contributed by girls who marry in the age of 15 to 19, which mostly comes from villagers. Other fact shows 50 percent of child marriages end in divorce with grounds varied from the mental health of the children, economic situation, and so on. With more children committed early marriages, more babies will be borned from indebted families. Subsequently, the government’s program to alleviate poverty will be short of expectations. Other risk for child marriages includes death of the mother and the child after giving birth. The people have challenged the legality of child marriages through judicial review filed to the Constitutional Court. The Court decided to reinforce the age limitation previously set by the Marriage Act by issuing judicial decision no: 30-74/PUU-Xii/2014. The Court stated that changes to the age limit must be in conform with cultural and traditional situation. Further, it stated child marriages are allowed to be arranged as an “emergency exit” if the parents filed such request to an exemption on the grounds of coercive situation and after the court or the authorized officials issued its approval.

Keywords: child, marriage, court, Indonesia

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Authors: K. B. M. Islam, Syeeda Shiraj-Um-Mahmuda, Afroj Jahan, A. A. Bhuiyan

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In Bangladesh, the use of imported probiotics in poultry is gradually being increased. But surprisingly, no probiotic bacteria have been isolated yet in Bangladesh despite the existence of scavenging native poultry as potential source that is seemingly more resistant to GIT infection as well as other diseases. Therefore, the study was undertaken to isolate, identify and characterize the potential probiotic Lactobacillus and Bifidobacteria strains from Bangladeshi indigenous poultry, and to evaluate their suitability to use in poultry industry. Crop and cecal samples from 61 healthy indigenous birds were used to isolate potential probiotics strains following conventional cultural methods. A total of 216 isolates were identified following physical, biochemical and molecular methods that belonged to the genus Lactobacillus and Bifidobacteria. An auto-aggregation test was performed for 180 and 136 isolated lactobacilli and bifidobacteria strains, respectively. Twelve lactobacilli isolates and 7 bifidobacteria isolates were selected because of their convenient aggregation. In vitro tests including antibacterial activity, resistance to low pH, hemolytic activities etc. were performed for evaluation of probiotic potential of each strain. Under the in vitro conditions and with respects to the probiotic traits, three lactobacilli; LS16, LS45, LS133 and two bifidobacteria, BS21 and BS90 were found to be potential probiotic strains. Thus, they are proposed to be evaluated for their in vivo probiotic properties. If the proposed strains are found suitable as the probiotics to be used in commercial poultry industry, it is expected that the local probiotics would be more beneficial and would save the huge amount of money that Bangladesh spends every year for the importation of such materials from abroad.

Keywords: Bangladeshi poultry, gut microbiota, lactic acid bacteria, scavenging chicken, GIT health

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Authors: Asma Ahmed, Farah Khalid, Sahlah Sohail, Saira Banusokwalla, Sabiha Banu, Inaara Akbar, Safia Awan, Syed Iqbal Azam

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Background and Objectives: The level of knowledge regarding obesity as a disease condition and health-seeking behavior regarding its management is grossly lacking. We present data from our multidisciplinary obesity clinic at the large tertiary care facility in Karachi, Pakistan, to provide baseline profiles and outcomes of patients attending these clinics. Methods: 260 who attended the obesity clinic between June 2018 to March 2020 were enrolled in this study. The analysis included descriptive and ROC analysis to identify the best cut-offs of theanthropometric measurements to diagnose obesity-related comorbid conditions. Results: The majority of the studied population were women (72.3%) and employed(43.7%) with a mean age of 35.5 years. Mean BMIwas 37.4, waist circumference was 112.4 cm, visceral fat was 11.7%, and HbA1C was 6.9%. The most common comorbidities were HTN & D.M (33 &31%, respectively). The prevalence of MetS was 16.3% in patients and was slightly higher in males. Visceral fat was the main factor in predicting D.M (0.750; 95% CI: 0.665, 0.836) and MetS (0.709; 95% CI: 0.590, 0.838) compared to total body fat, waist circumference, and BMI. The risk of predicting DM &MetS for the visceral fat above 9.5% in women had the highest sensitivity (80% for D.M & 79% for MetS) and an NPV (92.75% for D.M & 95% for MetS). Conclusions: This study describes and establishes characteristics of these obese individuals, which can help inform clinical practices. These practices may involve using visceral fat for earlier identification and counseling-based interventions to prevent more severe surgical interventions down the line.

Keywords: obesity, metabolic syndrome, tertiary care facility, BMI, waist circumference, visceral fat

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Authors: Napasri Suwanajote

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The purposes of this research were to analyze and evaluate successful factors in OTOP production process for the developing of learning center on OTOP production process based on Sufficiency Economic Philosophy for sustainable life quality. The research has been designed as a qualitative study to gather information from 30 OTOP producers in Bangkontee District, Samudsongkram Province. They were all interviewed on 3 main parts. Part 1 was about the production process including 1) production, 2) product development, 3) the community strength, 4) marketing possibility, and 5) product quality. Part 2 evaluated appropriate successful factors including 1) the analysis of the successful factors, 2) evaluate the strategy based on Sufficiency Economic Philosophy, and 3) the model of learning center on OTOP production process based on Sufficiency Economic Philosophy for sustainable life quality. The results showed that the production did not affect the environment with potential in continuing standard quality production. They used the raw materials in the country. On the aspect of product and community strength in the past 1 year, it was found that there was no appropriate packaging showing product identity according to global market standard. They needed the training on packaging especially for food and drink products. On the aspect of product quality and product specification, it was found that the products were certified by the local OTOP standard. There should be a responsible organization to help the uncertified producers pass the standard. However, there was a problem on food contamination which was hazardous to the consumers. The producers should cooperate with the government sector or educational institutes involving with food processing to reach FDA standard. The results from small group discussion showed that the community expected high education and better standard living. Some problems reported by the community included informal debt and drugs in the community. There were 8 steps in developing the model of learning center on OTOP production process based on Sufficiency Economic Philosophy for sustainable life quality.

Keywords: production process, OTOP, sufficiency economic philosophy, language choice

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Authors: Mohsine Jebbour

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The ultimate aim of this study was to analyze a second-year baccalaureate textbook of English to see to what extent it includes elements of critical thinking. A further purpose was to assess the extent to which the teachers’ teaching practices help students develop some degree of critical thinking. The literature on critical thinking indicated that all the writers agree that critical thinking is skilled and dispositional oriented, and most of the definitions highlight the skill and disposition to select, collect, analyze and evaluate information effectively. In this study, two instruments were used, namely content analysis and questionnaire to ensure validity and reliability. The sample of this study, on the one hand, was a second year textbook of English, namely Ticket to English. The process of collecting data was carried out through designing a checklist to analyze the textbook of English. On the other hand, high school students (second baccalaureate grade) and teachers of English constituted the second sample. Two questionnaires were administered—One was completed by 28 high school teachers (18 males and10 females), and the other was completed by 51 students (26 males and 25 females) from Fez, Morocco. The items of the questionnaire tended to elicit both qualitative and quantitative data. An attempt was made to answer two research questions. One pertained to the extent to which the textbooks of English contain critical thinking elements (Critical thinking skills and dispositions, types of questions, language learning strategies, classroom activities); the second was concerned with whether the teaching practices of teachers of English help improve students’ critical thinking. The results demonstrated that the textbooks of English include elements of critical thinking, and the teachers’ teaching practices help the students develop some degree of critical thinking. Yet, the textbooks do not include problem-solving activities and media analysis and 86% of the teacher-respondents tended to skip activities in the textbooks, mainly the units dealing with Project Work and Study Skills which are necessary for enhancing critical thinking among the students. Therefore, the textbooks need to be designed around additional activities and the teachers are required to cover the units skipped so as to make the teaching of critical thinking effective.

Keywords: critical thinking, language learning strategies, language proficiency, teaching practices

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Authors: Sophia Shi

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Acute kidney injury (AKI) is the sudden onset of kidney damage in which the kidneys cannot filter waste from the blood, requiring emergency hospitalization. AKI patient mortality rate is high in the ICU and is virtually impossible for doctors to predict because it is so unexpected. Currently, there is no hybrid model predicting AKI that takes advantage of two types of data. De-identified patient data from the MIMIC-III database and de-identified kidney images and corresponding patient records from the Beijing Hospital of the Ministry of Health were collected. Using data features including serum creatinine among others, two numeric models using MIMIC and Beijing Hospital data were built, and with the hospital ultrasounds, an image-only model was built. Convolutional neural networks (CNN) were used, VGG and Resnet for numeric data and Resnet for image data, and they were combined into a hybrid model by concatenating feature maps of both types of models to create a new input. This input enters another CNN block and then two fully connected layers, ending in a binary output after running through Softmax and additional code. The hybrid model successfully predicted AKI and the highest AUROC of the model was 0.953, achieving an accuracy of 90% and F1-score of 0.91. This model can be implemented into urgent clinical settings such as the ICU and aid doctors by assessing the risk of AKI shortly after the patient’s admission to the ICU, so that doctors can take preventative measures and diminish mortality risks and severe kidney damage.

Keywords: Acute kidney injury, Convolutional neural network, Hybrid deep learning, Patient record data, ResNet, Ultrasound kidney images, VGG

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Authors: Martin Mensinger, Marjolaine Pfaffinger, Matthias Haslbeck

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The maintenance and expansion of the railway network represents a central task for transport planning in the future. In addition to the ultimate limit states, the aspects of resource conservation and sustainability are increasingly more necessary to include in the basic engineering. Therefore, as part of the AiF research project, ‘Integrated assessment of steel and composite railway bridges in accordance with sustainability criteria’, the entire lifecycle of engineering structures is involved in planning and evaluation, offering a way to optimize the design of steel bridges. In order to reduce the life cycle costs and increase the profitability of steel structures, it is particularly necessary to consider the demands on hanger connections resulting from fatigue. In order for accurate analysis, a number simulations were conducted as part of the research project on a finite element model of a reference bridge, which gives an indication of the internal forces of the individual structural components of a tied arch bridge, depending on the stress incurred by various types of trains. The calculations were carried out on a detailed FE-model, which allows an extraordinarily accurate modeling of the stiffness of all parts of the constructions as it is made up surface elements. The results point to a large impact of the formation of details on fatigue-related changes in stress, on the one hand, and on the other, they could depict construction-specific specifics over the course of adding stress. Comparative calculations with varied axle-stress distribution also provide information about the sensitivity of the results compared to the imposition of stress and axel distribution on the stress-resultant development. The calculated diagrams help to achieve an optimized hanger connection design through improved durability, which helps to reduce the maintenance costs of rail networks and to give practical application notes for the formation of details.

Keywords: fatigue, influence line, life cycle, tied arch bridge

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Authors: A. Lakshya

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The main aim of this paper is to interpret physical education for children from 5 to 18 years. Schools have the ability to promote positive mental health by developing physical education, which helps to build individual growth, goal setting, decision making, helps in muscular development, self-discipline, stresses relief, leadership qualities that can arise with new skills, prosocial behavior and problem-solving skills. But mostly the children at these early ages ought to hold the disorders as heart attack, diabetes and obesity disorders may increase in large number. The data of P.E has got a very least place, where children are with feeble minds and they acquired a state of inactiveness. Globally, 81% of adolescents aged 11-18 years were insufficiently physically active in the year 2016. Adolescent girls were less active than boys, with the percentage of 85% vs. 78% as well. A recent study of California schools found that students are sedentary most of the time during PE classes, with just four minutes of every half-hour spent in vigorous physical activity. Additionally, active PE time decreases with larger class sizes. Students in classes with more than forty-five students are half as active as students in smaller class sizes. The children in adolescence age they acquire more creative ideas hence they create new hairstyles, cooking styles and dressing styles. Instead, all the children are engaging themselves to TV (television) and video games. The development of physical quality not only improves students ’ physical fitness but is also conducive to the psychological development of the students. Physical education teaching should pay more attention to the training of physical quality in the future.

Keywords: physical education, prosocial behavior, leadership, goal setting

Procedia PDF Downloads 134

Authors: Suneet Jagdev, Siddharth Singhal, Dhrubajyoti Bordoloi, Peesari Vamshidhar Reddy

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There is no universally accepted definition of what constitutes a Smart City. It means different things to different people. The definition varies from place to place depending on the level of development and the willingness of people to change and reform. It tries to improve the quality of resource management and service provisions for the people living in the cities. Smart city is an urban development vision to integrate multiple information and communication technology (ICT) solutions in a secure fashion to manage the assets of a city. But most of these projects are misinterpreted as being technology projects only. Due to urbanization, a lot of informal as well government funded settlements have come up during the last few decades, thus increasing the consumption of the limited resources available. The people of each city have their own definition of Smart City. In the imagination of any city dweller in India is the picture of a Smart City which contains a wish list of infrastructure and services that describe his or her level of aspiration. The research involved a comparative study of the Smart City models in India and in China. Behavioral changes experienced by the people living in the pilot/first ever smart cities have been identified and compared. This paper discussed what is the target of the quality of life for the people in India and in China and how well could that be realized with the facilities being included in these Smart City projects. Logical and comparative analyses of important data have been done, collected from government sources, government papers and research papers by various experts on the topic. Existing cities with historically grown infrastructure and administration systems will require a more moderate step-by-step approach to modernization. The models were compared using many different motivators and the data is collected from past journals, interacting with the people involved, videos and past submissions. In conclusion, we have identified how these projects could be combined with the ongoing small scale initiatives by the local people/ small group of individuals and what might be the outcome if these existing practices were implemented on a bigger scale.

Keywords: behavior change, mission monitoring, pilot smart cities, social capital

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Authors: Tamas Molnar

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Electronic government systems are currently in the same development stage as e-commerce applications were about in the late 1990s. Wide adoption by the majority of population is near, as such services are not only more and more desired by the users, but also strongly advocated and pushed by the state, as a means to increase effectiveness and cut expenses at the same time. Diffusion is however hampered by the low motivation caused by usability issues which will cause more and more frustration as the general population ages. Usability centred design is essential when creating such services. Elderly users, who have statistically the least experience, have the most problems, and therefore reject unusable systems first. The goal of our research was to find a way to map the needs of the elderly and create guidelines for the design of electronic government systems which are usable for the whole population. The first phase of our research, started mid-2009, was centred on the idea to gather information about the needs of the target group, in both Germany and Hungary with over 70 participants. This was done with the help of scenarios, interviews and questionnaires. The supplied data enabled to choose an eGovernment system for tests on the target group. Tests conducted in Germany and Hungary were based on the design and functions of the German electronic ID card, in the native languages. Scenarios mirroring common, every day transactions requiring an identification procedure were used. The obtained results allowed us to develop a generalised solution, the IGUAN guideline. This guideline makes a standardised approach to the usability improvement process possible. It contains the special requirements of elderly users, and a catalogue of criteria, which helps to develop an application in line with the set requirements. The third phase of our research was used a proof of concept for the IGUAN. The guideline was evaluated and tested with an iterative prototyping. The successful completion of this phase indicates that the IGUAN can be used to measurably increase the acceptance of e-government systems by elderly users. We could therefore demonstrate that improvements in the interface make e-government application possible which are perceived useful and easy to use by elderly users. These improvements will measurably increase the user motivation and experience. This can however only be achieved with a structured design process, and requires a framework which takes the requirements of the elderly users into account.

Keywords: e-Government, usability, acceptance, guidelines

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Authors: Marjan Mahdavi-Roshan, Arsalan Salari, Mahbobeh Gholipour

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Hypertension is one of the important reasons of morbidity and mortality in countries, including Iran. It has been shown that hypertension is a consequence of the interaction of genetics and environment. Nutrients have important roles in the controlling of blood pressure. We assessed dietary habit and anthropometric status in patients with hypertension in the north of Iran, and that have special dietary habit and according to their culture. This study was conducted on 127 patients with newly recognized hypertension and the 120 normotensive participants. Anthropometric status was measured and demographic characteristics, and medical condition were collected by valid questionnaires and dietary habit assessment was assessed with 3-day food recall (two weekdays and one weekend). The mean age of participants was 58 ± 6.7 years. The mean level of energy intake, saturated fat, vitamin D, potassium, zinc, dietary fiber, vitamin C, calcium, phosphorus, copper and magnesium was significantly lower in the hypertensive group compared to the control (p < 0.05). After adjusting for energy intake, positive association was observe between hypertension and some dietary nutrients including; Cholesterol [OR: 1.1, P: 0.001, B: 0.06], fiber [OR: 1.6, P: 0.001, B: 1.8], vitamin D [OR: 2.6, P: 0.006, B: 0.9] and zinc [OR: 1.4, P: 0.006, B: 0.3] intake. Logistic regression analysis showed that there was not significant association between hypertension, weight and waist circumference. In our study, the mean intake of some nutrients was lower in the hypertensive individuals compared to the normotensive individual. Health training about suitable dietary habits and easier access to vitamin D supplementation in patients with hypertension are cost-effective tools to improve outcomes in Iran.

Keywords: hypertension, north of Iran, dietary intake, weight

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Authors: Ayesha Aihetasham, Najma Arshad, Sobia Khan

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Damage causes by subterranean termites are of major concern today. Termites majorly treated with pesticides resulted in several problems related to health and environment. For this reason, plant-derived natural products specifically essential oils have been evaluated in order to control termites. The aim of the present study was to investigate the antitermitic potential of six essential oils on Heterotermes indicola subterranean termite. No-choice bioassay was used to assess the termiticidal action of essential oils. Further, gut from each set of treated termite group was extracted and analyzed for reduction in number of protozoa and bacteria by protozoal count method using haemocytometer and viable bacterial plate count (dilution method) respectively. In no-choice bioassay it was found that Foeniculum vulgare oil causes high degree of mortality 90 % average mortality at 10 mg oil concentration (10mg/0.42g weight of filter paper). Least mortality appeared to be due to Citrus sinensis oil (43.33 % average mortality at 10 mg/0.42g). The highest activity verified to be of Foeniculum vulgare followed by Eruca sativa, Trigonella foenum-graecum, Peganum harmala, Syzygium cumini and Citrus sinensis. The essential oil which caused maximum reduction in number of protozoa was P. harmala followed by T. foenum-graecum and E. sativa. In case of bacterial count E. sativa oil indicated maximum decrease in bacterial number (6.4×10⁹ CFU/ml). It is concluded that F. vulgare, E. sativa and P. harmala essential oils are highly effective against H. indicola termite and its gut microflora.

Keywords: bacterial count, essential oils, Heterotermes indicola, protozoal count

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Authors: Zahra Asgharpour, Eric Renteria, Sebastian De Boodt

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There is a growing trend towards personalization of medical care, as evidenced by the emphasis on outcomes based medicine, the latest developments in CT and MR imaging and personalized treatment in a variety of surgical disciplines. 3D Printing has been introduced and applied in the medical field since 2000. The first applications were in the field of dental implants and custom prosthetics. According to recent publications, 3D printing in the medical field has been used in a wide range of applications which can be organized into several categories including implants, prosthetics, anatomical models and tissue bioprinting. Some of these categories are still in their infancy stage of the concept of proof while others are in application phase such as the design and manufacturing of customized implants and prosthesis. The approach of 3D printing in this category has been successfully used in the health care sector to make both standard and complex implants within a reasonable amount of time. In this study, some of the clinical applications of 3D printing in design and manufacturing of a patient-specific hip implant would be explained. In cases where patients have complex bone geometries or are undergoing a complex revision on hip replacement, the traditional surgical methods are not efficient, and hence these patients require patient-specific approaches. There are major advantages in using this new technology for medical applications, however, in order to get this technology widely accepted in medical device industry, there is a need for gaining more acceptance from the medical device regulatory offices. This is a challenge that is moving onward and will help the technology find its way at the end as an accepted manufacturing method for medical device industry in an international scale. The discussion will conclude with some examples describing the future directions of 3D Medical Printing.

Keywords: CT/MRI, image processing, 3D printing, medical devices, patient specific implants

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Authors: Andrej Kocjan

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Introduction: Mobility has been shown to play an important role of health and quality of life among older adults. Falls, which are often related to decreased mobility, as well as to neuromuscular deficits, represent the most common injury among older adults. Fall risk has been shown to increase with reduced lower extremity flexibility. The aim of the paper is to assess the importance of flexibility training on joint range of motion and functional performance among elderly population. Methods: We performed literature research on PubMed and evaluated articles published until 2000. The articles found in the search strategy were also added. The population of interest included older adults (≥ 65 years of age). Results: Flexibility training programs still represent an important part of several rehabilitation programs. Static stretching and proprioceptive neuromuscular facilitation are the most frequently used techniques to improve the length of the muscle-tendon complex. Although the effectiveness of type of stretching seems to be related to age and gender, static stretching is a more appropriate technique to enhance shoulder, hip, and ankle range of motion in older adults. Stretching should be performed in multiple sets with holds of more than 60 seconds for a single muscle group. Conclusion: The literature suggests that flexibility training is an effective method to increase joint range of motion in older adults. In the light of increased functional outcome, activities such as strengthening, balance, and aerobic exercises should be incorporated into a training program for older people. Due to relatively little published literature, it is still not possible to prescribe detailed recommendations regarding flexibility training for older adults.

Keywords: elderly, exercise, flexibility, falls

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Authors: Sandeep Mehmi, Harsh Verma, A. L. Sangal

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Ever since the idea of using computing services as commodity that can be delivered like other utilities e.g. electric and telephone has been floated, the scientific fraternity has diverted their research towards a new area called utility computing. New paradigms like cluster computing and grid computing came into existence while edging closer to utility computing. With the advent of internet the demand of anytime, anywhere access of the resources that could be provisioned dynamically as a service, gave rise to the next generation computing paradigm known as cloud computing. Today, cloud computing has become one of the most aggressively growing computer paradigm, resulting in growing rate of applications in area of IT outsourcing. Besides catering the computational and storage demands, cloud computing has economically benefitted almost all the fields, education, research, entertainment, medical, banking, military operations, weather forecasting, business and finance to name a few. Smart grid is another discipline that direly needs to be benefitted from the cloud computing advantages. Smart grid system is a new technology that has revolutionized the power sector by automating the transmission and distribution system and integration of smart devices. Cloud based smart grid can fulfill the storage requirement of unstructured and uncorrelated data generated by smart sensors as well as computational needs for self-healing, load balancing and demand response features. But, security issues such as confidentiality, integrity, availability, accountability and privacy need to be resolved for the development of smart grid cloud. In recent years, a number of intrusion prevention techniques have been proposed in the cloud, but hackers/intruders still manage to bypass the security of the cloud. Therefore, precise intrusion detection systems need to be developed in order to secure the critical information infrastructure like smart grid cloud. Considering the success of artificial neural networks in building robust intrusion detection, this research proposes an artificial neural network based model for detecting attacks in smart grid cloud.

Keywords: artificial neural networks, cloud computing, intrusion detection systems, security issues, smart grid

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Authors: Dileep Kumar Verma, Sunil Kumar Lal

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Influenza still remains one of the most challenging diseases posing significant threat to public health causing seasonal epidemics and pandemics. Influenza A Virus (IAV) surface protein hemagglutinin is known to play an important role in viral attachment to the host sialic acid receptors and concentrate in lipid rafts for efficient viral fusion. Selective nature of Influenza A virus to utilize rafts micro-domain for efficient virus assembly and budding has been explored in depth. However, the detailed mechanism of IAV binding to host cell membrane and entry into the host remains elusive. In the present study we investigated the role of lipid rafts in early life cycle events of IAV. Role of host lipid rafts was studied using raft disruption method by extraction of cholesterol by Methyl-β-Cyclodextrin. Using GM1, a well-known lipid raft marker, we were able to observe co-localization of IAV on lipid rafts on the host cell membrane. This experiment suggests a direct involvement of lipid rafts in the initiation of the IAV life cycle. Upon disruption of lipid rafts by Methyl-b-cyclodextrin, we observed a significant reduction in IAV binding on the host cell surface indicating a significant decrease in virus attachment to coherent membrane rafts. Our results provide proof that host lipid rafts and their constituents play an important role in the adsorption of IAV. This study opens a new avenues in IAV virus-host interactions to combat infection at a very early steps of the viral lifecycle.

Keywords: lipid raft, adsorption, cholesterol, methyl-β-cyclodextrin, GM1

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Authors: Muzamil Mahmood, Afshan Naseem, Muhammad Zeeshan Mirza, Yasir Ahmad, Masood Raza

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The purpose of this research is to analyze how aviation maintenance workers’ characteristics and work demand affect their development of work-related musculoskeletal disorders (WMSDs). Guided by literature on task characteristics, work demand, and WMSDs, data is collected from 128 aviation maintenance workers of private and public airlines. Data is then analyzed through descriptive and inferential statistics. It is found that task characteristics have a significant positive effect on WMSDs and an increase in tasks performed by aviation maintenance workers leads to increase in WMSDs. Work demand did not have a significant effect on WMSDs. The task characteristics of aviation maintenance workers moderates the relationship between their work demand and WMSDs. This reveals that task characteristics of aviation maintenance workers enhance the effect of work demand on WMSDs. The task characteristics of aviation maintenance workers are challenging and unpredictable. Subsequently, WMSDs are prevalent among aviation maintenance workers. The work demand of aviation maintenance workers does not influence their development of WMSDs. Pakistan Civil Aviation Authority should minimize the intensity of tasks assigned to aviation maintenance workers by introducing work dynamisms such as task sharing, job rotation, and probably teleworking to enhance flexibility. Human Resource and Recruitment Department need to consider the ability and fitness levels of potential aviation maintenance workers during recruitment. In addition, regular physical activities and ergonomic policies should be put in place by the management of the Pakistan Civil Aviation Authority to reduce the incidences of WMSDs.

Keywords: work related musculoskeletal disorders, ergonomics, occupational health and safety, human factors

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Authors: Sabah Khan

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The idea of universal Islam tends to exaggerate the extent of homogeneity in Islamic beliefs and practices across Muslim communities. In the age of migration, various Muslim communities are in diaspora. The immediate implication of this is what happens to Islam in diaspora? How Islam gets represented in new forms? Such pertinent questions need to be dealt with. This paper shall draw on the idea of religious transnationalism, primarily transnational Islam. There are multiple ways to conceptualize transnational phenomenon with reference to Islam in terms of flow of people, transnational organizations and networks; Ummah oriented solidarity and the new Muslim public sphere. This paper specifically deals with the new Muslim public sphere. It primarily refers to the space and networks enabled by new media and communication technologies, whereby Muslim identity and Islamic normativity are rehearsed, debated by people in different locales. A new sense of public is emerging across Muslim communities, which needs to be contextualized. This paper uses both primary and secondary data. Primary data elicited through content analysis of audio-visuals on social media and secondary sources of information ranging from books, articles, journals, etc. The basic aim of the paper is to focus on the emerging Muslim public sphere and the role of media in expanding public spheres of Islam. It also explores how Muslims in diaspora negotiate Islam and Islamic practices through media and the new Muslim public sphere. This paper cogently weaves in discussions firstly, of re-intellectualization of Islamic discourse in the public sphere. In other words, how Muslims have come to reimagine their collective identity and critically look at fundamental principles and authoritative tradition. Secondly, the emerging alternative forms of Islam by young Muslims in diaspora. In other words, how young Muslims search for unorthodox ways and media for religious articulation, including music, clothing and TV. This includes transmission and distribution of Islam in diaspora in terms of emerging ‘media Islam’ or ‘soundbite Islam’. The new Muslim public sphere has offered an arena to a large number of participants to critically engage with Islam, which leads not only to a critical engagement with traditional forms of Islamic authority but also emerging alternative forms of Islam and Islamic practices.

Keywords: Islam, media, Muslims, public sphere

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Authors: Anna Ching-Yu Wong

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This study aims to identify the quality and effectiveness of the adult programs provided by the public library using the ServQUAL Method and the National Library Public Programs Assessment guidelines (NIPPA, June 2019). ServQUAl covers several variables, namely: tangible, reliability, responsiveness, assurance, and empathy. NIPPA guidelines focus on program characteristics, particularly on the outcomes – the level of satisfaction from program participants. The reached populations were adults who participated in library adult programs at a small-town public library in Kansas. This study was designed as quantitative evaluative research which analyzed the quality and effectiveness of the library adult programs by analyzing the role of each factor based on ServQUAL and the NIPPA's library program assessment guidelines. Data were collected from November 2019 to January 2020 using a questionnaire with a Likert Scale. The data obtained were analyzed in a descriptive quantitative manner. The impact of this research can provide information about the quality and effectiveness of existing programs and can be used as input to develop strategies for developing future adult programs. Overall the result of ServQUAL measurement is in very good quality, but still, areas need improvement and emphasis in each variable: Tangible Variables still need improvement in indicators of the temperature and space of the meeting room. Reliability Variable still needs improvement in the timely delivery of the programs. Responsiveness Variable still needs improvement in terms of the ability of the presenters to convey trust and confidence from participants. Assurance Variables still need improvement in the indicator of knowledge and skills of program presenters. Empathy Variable still needs improvement in terms of the presenters' willingness to provide extra assistance. The result of program outcomes measurement based on NIPPA guidelines is very positive. Over 96% of participants indicated that the programs were informative and fun. They learned new knowledge and new skills and would recommend the programs to their friends and families. They believed that together, the library and participants build stronger and healthier communities.

Keywords: ServQual model, ServQual in public libraries, library program assessment, NIPPA library programs assessment

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Authors: Fahimeh Rafiezade, Fatemeh Kakoyi Dinaki, Maryam Soufi

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This research studies and identifies the important elements of the living style of the residents of one of the neighborhoods of Tehran. The study will also study the role, the degree, and extent of the influence of neighborhood trainings in the lives of these people. Saraymahaleh is one of the centers established by Tehran municipality in various neighborhoods of Tehran in order to provide educational, cultural, etc. services. We carried out our study according to demography, field study, observation, 30 interviews, and 2 focus group discussions (FGD) at Sahebalzaman neighborhood in district 18 of Tehran municipality. We interpreted our observations and interviews with the neighborhoods’ supervisors and city council assistants (Shorayar), supervisor of Saraymahaleh and people who refer to them. We used this information to study the citizens’ lifestyle, values, behavioral, motivational, and attitude preferences in their religious and environmental orientations, cultural consumptions, and spare times, and the influence of Saraymahaleh on these aspects according to specific economic, cultural, and ethnic characteristics. Sahebalzaman neighborhood is considered an underprivileged district in terms of economy, high illiteracy, and low but structured migration of young people. The interviews we made helped us classify the people referring to Saraymahaleh based on their demographic attributes and attitudes and the reason of referring and finally the influence of the rendered services on their lifestyles. The studies indicate that women made the most part of people referring to Saraymahaleh Sahebalzaman. They were mostly young, in their midlives, and generally unemployed without a specialized skill. People referred to Saraymahaleh Sahebalzaman mostly to receive services or for entertainment and recreation purposes, i.e. they did not take part actively. In addition to creating welfare and cultural facilities, Saraymahaleh increases the level of skill training, empowerment, innovation and creativity, and issues skill certificates and documents that helps to increase job and income producing opportunities for the neighborhood residents, improve the quality of their live, and increase their hope for life.

Keywords: lifestyle, living in neighborhood, Saraymahaleh, Tehran municipality, urban life, demography

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Authors: Meng-Huan Wu, Wei-Er Wang, Tsu-Nai Wang, Wei-Jian Hsu, Vincent Chin-Hung Chen

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Objective: Studies have reported a strong link between asthma and bipolar disorder. We conducted a 17-year community-based large cohort study to examine the relationship between asthma, early smoking initiation, and bipolar disorder during adolescence and early adulthood. Methods: A total of 162,766 participants aged 11–16 years were categorized into asthma and non-asthma groups at baseline and compared within the observation period. Covariates during late childhood or adolescence included parental education, cigarette smoking by family members of participants, and participant’s gender, age, alcohol consumption, smoking, and exercise habits. Data for urbanicity, prednisone use, allergic comorbidity, and Charlson comorbidity index were acquired from the National Health Insurance Research Database. The Cox proportional-hazards model was used to evaluate the association between asthma and bipolar disorder. Results: Our findings revealed that asthma increased the risk of bipolar disorder after adjustment for key confounders in the Cox proportional hazard regression model (adjusted HR: 1.31, 95% CI: 1.12-1.53). Hospitalizations or visits to the emergency department for asthma exhibited a dose–response effect on bipolar disorder (adjusted HR: 1.59, 95% CI: 1.22-2.06). Patients with asthma with onset before 20 years of age who smoked during late childhood or adolescence had the greatest risk for bipolar disorder (adjusted HR: 3.10, 95% CI: 1.29-7.44). Conclusions: Patients newly diagnosed with asthma had a 1.3 times higher risk of developing bipolar disorder. Smoking during late childhood or adolescence increases the risk of developing bipolar disorder in patients with asthma.

Keywords: adolescence, asthma, smoking, bipolar disorder, early adulthood

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Authors: Nardjes Hamini, Mohamed Bachir Yagoubi

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Precision agriculture has revolutionized farming by enabling farmers to monitor their crops remotely in real-time. By utilizing technologies such as sensors, farmers can detect the state of growth, hydration levels, and nutritional status and even identify diseases affecting their crops. With this information, farmers can make informed decisions regarding irrigation, fertilization, and pesticide application. Automated agricultural tasks, such as plowing, seeding, planting, and harvesting, are carried out by autonomous robots and have helped reduce costs and increase production. Despite the advantages of precision agriculture, its high cost makes it inaccessible to small and medium-sized farms. To address this issue, this paper presents an open-source guidance system for an autonomous planter robot. The system is composed of a Raspberry Pi-type nanocomputer equipped with Wi-Fi, a GPS module, a gyroscope, and a power supply module. The accompanying application allows users to enter and calibrate maps with at least four coordinates, enabling the localized contour of the parcel to be captured. The application comprises several modules, such as the mission entry module, which traces the planting trajectory and points, and the action plan entry module, which creates an ordered list of pre-established tasks such as loading, following the plan, returning to the garage, and entering sleep mode. A remote control module enables users to control the robot manually, visualize its location on the map, and use a real-time camera. Wi-Fi coverage is provided by an outdoor access point, covering a 2km circle. This open-source system offers a low-cost alternative for small and medium-sized farms, enabling them to benefit from the advantages of precision agriculture.

Keywords: autonomous robot, guidance system, low-cost, medium farms, open-source system, planter robot, precision agriculture, real-time monitoring, remote control, small farms

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Authors: Anargha A. Dhorde, Deshpande Gauri, Amit G. Dhorde

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Mula-Mutha basin is one of the speedily urbanizing watersheds, wherein two major urban centers, Pune and Pimpri-Chinchwad, have developed at a shocking rate in the last two decades. Such changing land use/land cover (LULC) is prone to hydrological problems and flash floods are a frequent, eventuality in the lower reaches of the basin. The present research brings out the impact of varying LULC, impervious surfaces on urban surface hydrology and generates storm-runoff scenarios for the hydrological units. The two multi-temporal satellite images were processed and supervised classification is performed with > 75% accuracy. The built-up has increased from 14.4% to 34.37% in the 28 years span, which is concentrated in and around the Pune-PCMC region. Impervious surfaces that were obtained by population calibrated multiple regression models. Almost 50% area of the watershed is impervious, which attribute to increase surface runoff and flash floods. The SCS-CN method was employed to calculate surface runoff of the watershed. The comparison between calculated and measured values of runoff was performed in a statistically precise way which shows no significant difference. Increasing built-up areas, as well as impervious surface areas due to rapid urbanization and industrialization, may lead to generating high runoff volumes in the basin especially in the urbanized areas of the watershed and along the major transportation arteries. Simulations generated with 50 mm and 100 mm rainstorm depth conspicuously noted that most of the changes in terms of increased runoff are constricted to the highly urbanized areas. Considering whole watershed area, the runoff values 39 m³ generated with 1'' rainfall whereas only urbanized areas of the basin (Pune and Pimpari-Chinchwad) were generated 11154 m³ runoff. Such analysis is crucial in providing information regarding their intensity and location, which proves instrumental in their analysis in order to formulate proper mitigation measures and rehabilitation strategies.

Keywords: land use/land cover, LULC, impervious surfaces, surface hydrology, storm-runoff scenarios

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Authors: Vladyslav Povoroznyuk, Tetiana Orlуk, Nataliia Dzerovych

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Introduction: Back pain is an extremely common health care problem worldwide. Many studies show a link between an obesity and risk of lower back pain. The aim is to study correlation and peculiarities of vertebral pain in women of different age depending on their anthropometric indicators. Materials: 1886 women aged 25-89 years were examined. The patients were divided into groups according to age (25-44, 45-59, 60-74, 75-89 years old) and body mass index (BMI: to 18.4 kg/m2 (underweight), 18.5-24.9 kg/m2 (normal), 25-30 kg/m2 (overweight) and more than 30.1 kg/m2 (obese). Methods: The presence and intensity of pain was evaluated in the thoracic and lumbar spine using a visual analogue scale (VAS). BMI is calculated by the standard formula based on body weight and height measurements. Statistical analysis was performed using parametric and nonparametric methods. Significant changes were considered as p <0.05. Results: The intensity of pain in the thoracic spine was significantly higher in the underweight women in the age groups of 25-44 years (p = 0.04) and 60-74 years (p=0.005). The intensity of pain in the lumbar spine was significantly higher in the women of 45-59 years (p = 0.001) and 60-74 years (p = 0.0003) with obesity. In the women of 45-74 years BMI was significantly positively correlated with the level of pain in the lumbar spine. Obesity significantly increases the relative risk of pain in the lumbar region (RR=0.07 (95% CI: 1.03-1.12; p=0.002)), while underweight significantly increases the risk of pain in the thoracic region (RR=1.21 (95% CI: 1.00-1.46; p=0.05)). Conclusion: In women, vertebral pain syndrome may be related to the anthropometric characteristics (e.g., BMI). Underweight may indirectly influence the development of pain in the thoracic spine and increase the risk of pain in this part by 1.21 times. Obesity influences the development of pain in the lumbar spine increasing the risk by 1.07 times.

Keywords: body mass index, age, pain in thoracic and lumbar spine, women

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Authors: Aziz Rezapour, Abdosaleh Jafari, Marziye Hadian, Elaheh Mazaheri

Abstract:

Introduction: Cardiac rehabilitation is an accurate educational and sporting program designed to help heart patients to increase their physical activities and reduce the risk factors that make their health worse and help to a healthier lifestyle so that they can return to their families and society with a better spirit. The aim of this study was to examine the cost-effectiveness and cost-utility of cardiac rehabilitation programs for patients with cardiovascular diseases. Methods: In the present review study, published articles related to cost-effectiveness and cost-utility of cardiac rehabilitation programs for patients with cardiovascular diseases within the time interval between 2004 and 2019 were searched using electronic databases. The methodological quality of the structure of articles was examined by Drummond’s standard checklist. Results: The results of reviewing studies showed that most of the studies related to the economic evaluation of cardiac rehabilitation programs in patients with cardiovascular disease were flawed in Drummond’s criteria, and only one study adhered to Drummond’s criteria. The results of the present study indicated use of cardiac rehabilitation programs in patients with cardiovascular disease was cost-effective. Conclusion: The results of this review study showed that although the results of the studies were different in terms of a number of aspects, such as the study perspective, the time horizons, and the costs of rehabilitation programs, they achieved a similar conclusion, they concluded that the use of cardiac rehabilitation programs in patients with cardiovascular diseases, leading to higher quality-adjusted life years (QALYs) and lower costs.

Keywords: economic evaluation, systematic review, cardiac rehabilitation, Drummond’s checklist

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