Search results for: score prediction

Authors: Sudha T., Naveen C.

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Dengue is a serious public health issue that causes significant annual economic and welfare burdens on nations. However, enhanced optimization techniques and quantitative modeling approaches can predict the incidence of dengue. By advocating for a data-driven approach, public health officials can make informed decisions, thereby improving the overall effectiveness of sudden disease outbreak control efforts. The National Oceanic and Atmospheric Administration and the Centers for Disease Control and Prevention are two of the U.S. Federal Government agencies from which this study uses environmental data. Based on environmental data that describe changes in temperature, precipitation, vegetation, and other factors known to affect dengue incidence, many predictive models are constructed that use different machine learning methods to estimate weekly dengue cases. The first step involves preparing the data, which includes handling outliers and missing values to make sure the data is prepared for subsequent processing and the creation of an accurate forecasting model. In the second phase, multiple feature selection procedures are applied using various machine learning models and optimization techniques. During the third phase of the research, machine learning models like the Huber Regressor, Support Vector Machine, Gradient Boosting Regressor (GBR), and Support Vector Regressor (SVR) are compared with several optimization techniques for feature selection, such as Harmony Search and Genetic Algorithm. In the fourth stage, the model's performance is evaluated using Mean Square Error (MSE), Mean Absolute Error (MAE), and Root Mean Square Error (RMSE) as assistance. Selecting an optimization strategy with the least number of errors, lowest price, biggest productivity, or maximum potential results is the goal. In a variety of industries, including engineering, science, management, mathematics, finance, and medicine, optimization is widely employed. An effective optimization method based on harmony search and an integrated genetic algorithm is introduced for input feature selection, and it shows an important improvement in the model's predictive accuracy. The predictive models with Huber Regressor as the foundation perform the best for optimization and also prediction.

Keywords: deep learning model, dengue fever, prediction, optimization

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Authors: Vaibhavi Birle

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Posterior reversible encephalopathy syndrome is a rare clinic-radiological syndrome associated with acute changes in blood pressure during pregnancy. It is characterized symptomatically by headache, seizures, altered mental status, and visual blurring with radiological changes of white matter (vasogenic oedema) affecting the posterior occipital and parietal lobes of the brain. It is being increasingly recognized due to increased institutional deliveries and advances in imaging particularly magnetic resonance imaging (MRI). In spite of the increasing diagnosis the prediction of PRES and patient factors affecting susceptibility is still not clear. Hence, we conducted the retrospective study to analyse the factors associated with PRES at our tertiary centre.

Keywords: pres syndrome, eclampsia, maternal outcome, fetal outcome

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Authors: Sajad Khaliq Dar, Dipanjan Goswami, Arshad H. Khuroo, Mohd. Akhtar, Pulak Kumar Metia, Sudershan Kumar

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Background: Development of modified-release oral dosage formulations (OSD) like tacrolimus in narrow therapeutic categories, together with high levels of intra-individual variability, impose greater challenges. The risk assessment for bioequivalence studies requires developing a suitable design through pilot studies involving the comparison of multiple formulations of the same product with a marketed product to understand the in-vivo behaviour. These formulations could have varying coating levels and other minor quantitative differences to achieve the desired release rate for the final product. Although small-scale studies are critical before the conduct of full-scale Pharmacokinetic (PK) studies, regulatory agencies evaluate critical bioavailability attributes (CBA) before approving the submitted dossiers. Since Tacrolimus is a BCS Class II drug, therefore developing the extended-release formulation, in addition to associated challenges, provides an opportunity to present the In vitro-in vivo correlations (IVIVC) to regulatory agencies, not only to exhibit product quality but also to reduce the burden of additional human trials and cost involved to them for bringing the product to market. Objective: The objective of this study was to develop a Level-A In vitro - In vivo Correlation (IVIVC) model for Sun Pharma’s test formulation Tacrolimus ER tablet 4mg and extend its application to a widened dissolution window of 25% at 2.5 hours (critical release time) sampling time point. Experimental Procedure: Post the conduct of two in-vivo studies, a pilot study evaluating two test prototypes on 24 subjects (under fasting) and a pivotal study having 50 subjects (under fasting), the observed pharmacokinetic profile was used for IVIVC model development. The dissolution media used was 0.005% HPC + 0.25% SLS in Water 900 mL at pH 4.50 using USP II (Paddle) apparatus with alternative sinkers operated at 100 RPM. The sampling time points were chosen to mimic the drug absorption in vivo. The dissolution best fit to data was obtained using Makoid Banakar kinetics. Then deconvolution, anchoring to concepts of the single compartment by Wagner Nelson method was applied for tacrolimus slow-release formulation batch with film coating weight build-up of 5.4% (used in pilot bio study), medium release with Hypromellose (retard-release exhibit batch used in the pivotal study) and fast release formulation batch with film coating weight build-up of 5.05% (used in pilot bio study). Results and Conclusion: The results were deemed acceptable as prediction errors for internal and external validation were < 3% depicting in-vitro drug release mimics in-vivo absorption. Moreover, the prediction result for the Test/Reference ratio was <15% for all test formulations and widening dissolution (i.e., 39%-64% drug release at 2.5hrs) predictions were well within 80-125% when compared against Envarsus XR (reference drug). This IVIVC-validated model can be used in the futuristic exploration of dose titration with 1mg tacrolimus ER OSD as a surrogate for In-vivo bioequivalence trials.

Keywords: pharmacokinetics, BCS, oral dosage form, Bioavailability, intra-individual variability

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Authors: Ruchika Goyal, Ashwani Kumar, Sandeep Jain

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The experimental data for anticancer potential of curcumin nanoparticles was calculated by means of eclectic data. The optimal descriptors were examined using Monte Carlo method based CORAL SEA software. The statistical quality of the model is following: n = 14, R² = 0.6809, Q² = 0.5943, s = 0.175, MAE = 0.114, F = 26 (sub-training set), n =5, R²= 0.9529, Q² = 0.7982, s = 0.086, MAE = 0.068, F = 61, Av Rm² = 0.7601, ∆R²m = 0.0840, k = 0.9856 and kk = 1.0146 (test set) and n = 5, R² = 0.6075 (validation set). This data can be used to build predictive QSAR models for anticancer activity.

Keywords: anticancer potential, curcumin, model, nanoparticles, optimal descriptors, QSAR

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Authors: J. A. Marañón, L. Lozano C. De Los Santos, L. Martínez-Campesino, E. Caballero-Garrido, F. Galán-Estella

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Urinary incontinence (UI) is a significant health problem with considerable social and economic impact. An estimated 30% of women aged 30 to 60 years old have urinary incontinence (UI), while more than 50% of community-dwelling older women have the condition. Stress urinary incontinence and overactive bladder are the common types of incontinence The prevalence of stress and mixed (stress and urge) incontinence is higher than urge incontinence, but the latter is more likely to require treatment. In women, moderate and severe have a prevalence ranging from about 12% to 17% The objectives of this study was to examine the effect of the supplementation of tablets containing Dropsordry in women with urge urinary incontinence (UUI). Dropsordry is a novel active containing phytoestrogens from SOLGEN, the high genistin soy bean extract and pyrogallol plus polyphenols from standarized pumpkin seed extract,. The study was a single-center, not randomiized open prospective, study. 28 women with urinary incontinence ≥45 years were enrolled in this study (45-62 y. old age . Mean 52 y old). Items related to UI symptoms, were previously collected (T0) and these ítems were reviewed at the final of the study – 8 weeks. (T2). The presence of UI was previously diagnosed using the International Continence Society standards (ICS). Relationships between presence of UI and potential related factors as diabetes were also explored. Daily urinary test control was performed during the 8 weeks of treatment. Daily dosage was 1 g/ day (500 mg twice per day) from 0 to 4 week (T1), following a 500 mg/day daily intake from 4 to 8 week (T2). After eight weeks of treatment, the urgency grade score was reduced a 24,7%. The total urge episodes was reduced a 46%. Surprisingly there was no a significant change in daytime urinations (< 5%), however nocturia was reduced a 69,35%. Strenght Urinary Incontinence (SUI) was also tested showing a remarkably 52,17% reduction. Moreover the use of daily pantyliners was reduced a 66,25%. In addition, it was performed a panel test survey with quests when subjects of the study were enrolled (T0) and the same quests was performed after 8 weeks of supplementation (T2). 100% of the enrolled women fullfilled the ICIQ-SF quest (Spanish versión) and they were also questioned about the effects they noticed in response to taking the supplement and the change in quality of life. Interestingly no side effects were reported. There was a 96,2% of subjective satisfaction and a 85,8% objective score in the improvement of quality of life. CONCLUSION: the combination of High genistin isoflavones and pumpkin seed pyrogallol in Dropsordry tablets seems to be a safe and highly effective supplementation for the relieve of the urinary incontinence symptoms and a better quality of life in perimenopause women .

Keywords: isoflavones, pumpkin, menopause, incontinence, genistin

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Authors: Hieu Nguyen

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Performance management is the concern of any organizations in the context of increasing demand and fierce competition between education institution. This paper draws together the performance management concepts and focuses specifically to Balance Scorecard in the context of education. The study employs semi-structured in-depth interview to explore the measurement items for each of the sub-objectives in the four perspectives. Each of the perspectives’ explored measurement items will then be discussed the role and influence of them towards the perspective and how to improve the measurements to have improved performance management. Finally, the measurements will be put together as a suggested balanced scorecard framework in the case of International University.

Keywords: performance management, education institution, balance scorecard, measurement items, four perspectives, international univeristy

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Authors: Despoina Mouratidis, Katia Lida Kermanidis

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Machine translation (MT) is a very important task in Natural Language Processing (NLP). MT evaluation is crucial in MT development, as it constitutes the means to assess the success of an MT system, and also helps improve its performance. Several methods have been proposed for the evaluation of (MT) systems. Some of the most popular ones in automatic MT evaluation are score-based, such as the BLEU score, and others are based on lexical similarity or syntactic similarity between the MT outputs and the reference involving higher-level information like part of speech tagging (POS). This paper presents a language-independent machine learning framework for classifying pairwise translations. This framework uses vector representations of two machine-produced translations, one from a statistical machine translation model (SMT) and one from a neural machine translation model (NMT). The vector representations consist of automatically extracted word embeddings and string-like language-independent features. These vector representations used as an input to a multi-layer neural network (NN) that models the similarity between each MT output and the reference, as well as between the two MT outputs. To evaluate the proposed approach, a professional translation and a "ground-truth" annotation are used. The parallel corpora used are English-Greek (EN-GR) and English-Italian (EN-IT), in the educational domain and of informal genres (video lecture subtitles, course forum text, etc.) that are difficult to be reliably translated. They have tested three basic deep learning (DL) architectures to this schema: (i) fully-connected dense, (ii) Convolutional Neural Network (CNN), and (iii) Long Short-Term Memory (LSTM). Experiments show that all tested architectures achieved better results when compared against those of some of the well-known basic approaches, such as Random Forest (RF) and Support Vector Machine (SVM). Better accuracy results are obtained when LSTM layers are used in our schema. In terms of a balance between the results, better accuracy results are obtained when dense layers are used. The reason for this is that the model correctly classifies more sentences of the minority class (SMT). For a more integrated analysis of the accuracy results, a qualitative linguistic analysis is carried out. In this context, problems have been identified about some figures of speech, as the metaphors, or about certain linguistic phenomena, such as per etymology: paronyms. It is quite interesting to find out why all the classifiers led to worse accuracy results in Italian as compared to Greek, taking into account that the linguistic features employed are language independent.

Keywords: machine learning, machine translation evaluation, neural network architecture, pairwise classification

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Authors: Kweon Oh-Sang, Kim Heung-Youl

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Estimating the engineering properties of fires is important to be prepared for the complex and various fire risks of large-scale structures such as super-tall buildings, large stadiums, and multi-purpose structures. In this study, a mock-up of a compartment which was 2.4(L) x 3.6 (W) x 2.4 (H) meter in dimensions was fabricated at the 10MW LSC (Large Scale Calorimeter) and combustible office supplies were placed in the compartment for a real-scale fire test. Maximum heat release rate was 4.1 MW and total energy release obtained through the application of t2 fire growth rate was 6705.9 MJ.

Keywords: fire growth, fire experiment, t2 curve, large scale calorimeter

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Authors: Supatchalee Sirichokworrakit

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Fishbone of Nile tilapia (Tilapia nilotica), waste from the frozen Nile tilapia fillet factory, is one of calcium sources. In order to increase fish bone powder value, this study aimed to investigate the effect of tilapia bone flour (TBF) addition (5, 10, 15% by flour weight) on cooking quality, texture and sensory attributes of noodles. The results indicated that tensile strength, color value (a*) and water absorption of noodles significantly decreased (p≤0.05) as the levels of TBF increased from 0-15%. While cooking loss, cooking time and color values (L* and b*) of noodles significantly increased (p≤0.05). Sensory evaluation indicated that noodles with 5% TBF received the highest overall acceptability score.

Keywords: tilapia bone flour, noodles, cooking quality, calcium

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Authors: Fathi Alwafie

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In this paper we present the simulation of the propagation characteristics of the picocellular propagation channel environment. The first aim has been to find a correct description of the environment for received wave. The result of the first investigations is that the environment of the indoor wave significantly changes as we change the electric parameters of material constructions. A modified 3D ray tracing image method tool has been utilized for the coverage prediction. A detailed analysis of the dependence of the indoor wave on the wide-band characteristics of the channel: Root Mean Square (RMS) delay spread characteristics and mean excess delay, is also investigated.

Keywords: propagation, ray tracing, network, mobile computing

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Authors: Monika Dmitrzak-Weglarz, Aleksandra Rajewska-Rager, Maria Skibinska, Natalia Lepczynska, Piotr Sibilski, Joanna Pawlak, Pawel Kapelski, Joanna Hauser

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Epidermal growth factor (EGF) is a well-known neurotrophic factor that involves in neuronal growth and synaptic plasticity. The proteomic research provided in order to identify novel candidate biological markers for mood disorders focused on elevated EGF serum level in patients during depression episode. However, the EGF association with mood disorder spectrum among adolescents and young adults has not been studied extensively. In this study, we aim to investigate the serum levels of EGF in adolescents and young adults during hypo/manic, depressive episodes and in remission compared to healthy control group. In our study, we involved 80 patients aged 12-24 years in 2-year follow-up study with a primary diagnosis of mood disorder spectrum, and 35 healthy volunteers matched by age and gender. Diagnoses were established according to DSM-IV-TR criteria using structured clinical interviews: K-SADS for child and adolescents, and SCID for young adults. Clinical and biological evaluations were made at baseline and euthymic mood (at 3th or 6th month of treatment and after 1 and 2 years). The Young Mania Rating Scale and Hamilton Rating Scale for Depression were used for assessment. The study protocols were approved by the relevant ethics committee. Serum protein concentration was determined by Enzyme-Linked Immunosorbent Assays (ELISA) method. Human EGF (cat. no DY 236) DuoSet ELISA kit was used (R&D Systems). Serum EGF levels were analysed with following variables: age, age under 18 and above 18 years old, sex, family history of affective disorders, drug-free vs. medicated. Shapiro-Wilk test was used to test the normality of the data. The homogeneity of variance was calculated with Levene’s test. EGF levels showed non-normal distribution and the homogeneity of variance was violated. Non-parametric tests: Mann-Whitney U test, Kruskall-Wallis ANOVA, Friedman’s ANOVA, Wilcoxon signed rank test, Spearman correlation coefficient was applied in the analyses The statistical significance level was set at p<0.05. Elevated EGF level at baseline (p=0.001) and at month 24 (p=0.02) was detected in study subjects compared with controls. Increased EGF level in women at month 12 (p=0.02) compared to men in study group have been observed. Using Wilcoxon signed rank test differences in EGF levels were detected: decrease from baseline to month 3 (p=0.014) and increase comparing: month 3 vs. 24 (p=0.013); month 6 vs. 12 (p=0.021) and vs. 24 (p=0.008). EGF level at baseline was negatively correlated with depression and mania occurrence at 24 months. EGF level at 24 months was positively correlated with depression and mania occurrence at 12 months. No other correlations of EGF levels with clinical and demographical variables have been detected. The findings of the present study indicate that EGF serum level is significantly elevated in the study group of patients compared to the controls. We also observed fluctuations in EGF levels during two years of disease observation. EGF seems to be useful as an early marker for prediction of diagnosis, course of illness and treatment response in young patients during first episode od mood disorders, which requires further investigation. Grant was founded by National Science Center in Poland no 2011/03/D/NZ5/06146.

Keywords: biological marker, epidermal growth factor, mood disorders, prediction

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Authors: Alan Ruiz-Padilla, Brando Villalobos-Villalobos, Yeniley Ruiz-Noa, Claudia Mendoza-Macías, Claudia Palafox-Sánchez, Miguel Marín-Rosales, Álvaro Cruz, Rubén Rangel-Salazar

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Introduction: In patients with rheumatoid arthritis, resistance or poor response to disease modifying antirheumatic drugs (DMARD) may be a reflection of the increase in g-P. The expression of g-P may be important in mediating the effluence of DMARD from the cell. In addition, P-glycoprotein is involved in the transport of cytokines, IL-1, IL-2 and IL-4, from normal lymphocytes activated to the surrounding extracellular matrix, thus influencing the activity of RA. The involvement of P-glycoprotein in the transmembrane transport of cytokines can serve as a modulator of the efficacy of DMARD. It was shown that a number of lymphocytes with glycoprotein P activity is increased in patients with RA; therefore, P-glycoprotein expression could be related to the activity of RA and could be a predictor of poor response to therapy. Objective: To evaluate in RA patients, if the G2677T/A MDR1 polymorphisms is associated with differences in the rate of therapeutic response to disease-modifying antirheumatic agents in patients with rheumatoid arthritis. Material and Methods: A prospective cohort study was conducted. Fifty seven patients with RA were included. They had an active disease according to DAS-28 (score >3.2). We excluded patients receiving biological agents. All the patients were followed during 6 months in order to identify the rate of therapeutic response according to the American College of Rheumatology (ACR) criteria. At the baseline peripheral blood samples were taken in order to identify the G2677T/A MDR1 polymorphisms using PCR- Specific allele. The fragment was identified by electrophoresis in polyacrylamide gels stained with ethidium bromide. For statistical analysis, the genotypic and allelic frequencies of MDR1 gene polymorphism between responders and non-responders were determined. Chi-square tests as well as, relative risks with 95% confidence intervals (95%CI) were computed to identify differences in the risk for achieving therapeutic response. Results: RA patients had a mean age of 47.33 ± 12.52 years, 87.7% were women with a mean for DAS-28 score of 6.45 ± 1.12. At the 6 months, the rate of therapeutic response was 68.7 %. The observed genotype frequencies were: for G/G 40%, T/T 32%, A/A 19%, G/T 7% and for A/A genotype 2%. Patients with G allele developed at 6 months of treatment, higher rate for therapeutic response assessed by ACR20 compared to patients with others alleles (p=0.039). Conclusions: Patients with G allele of the - G2677T/A MDR1 polymorphisms had a higher rate of therapeutic response at 6 months with DMARD. These preliminary data support the requirement for a deep evaluation of these and other genotypes as factors that may influence the therapeutic response in RA.

Keywords: pharmacogenetics, MDR1, P-glycoprotein, therapeutic response, rheumatoid arthritis

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Authors: Prakash M.N, Mahesh G, Muhammed Rafi K.M, Shiju P. Nair

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Introduction: In launch vehicle missions, Reaction Control thrusters are being used for the three-axis stabilization of the vehicle during the coasting phases. A pressure-fed propulsion system is used for the operation of these thrusters due to its less complexity. In liquid stages, these thrusters are designed to draw propellant from the same tank used for the main propulsion system. So in order to regulate the propellant flow rates of these thrusters, flow control orifices are used in feed lines. These orifices are calibrated separately as per the flow rate requirement of individual thrusters for the nominal operating conditions. In some missions, it was observed that the thrusters were operated at higher thrust than nominal. This point was addressed through a series of cold flow and hot tests carried out in-ground and this paper elaborates the details of the same. Discussion: In order to find out the exact reason for this phenomenon, two flight configuration thrusters were identified and hot tested in the ground with calibrated orifices and feed lines. During these tests, the chamber pressure, which is directly proportional to the thrust, is measured. In both cases, chamber pressures higher than the nominal by 0.32bar to 0.7bar were recorded. The increase in chamber pressure is due to an increase in the oxidizer flow rate of both the thrusters. Upon further investigation, it is observed that the calibration of the feed line is done with ambient pressure downstream. But in actual flight conditions, the orifices will be subjected to operate with 10 to 11bar pressure downstream. Due to this higher downstream pressure, the flow through the orifices increases and thereby, the thrusters operate with higher chamber pressure values. Conclusion: As part of further investigatory tests, two numbers of fresh thrusters were realized. Orifice tuning of these thrusters was carried out in three different ways. In the first trial, the orifice tuning was done by simulating 1bar pressure downstream. The second trial was done with the injector assembled downstream. In the third trial, the downstream pressure equal to the flight injection pressure was simulated downstream. Using these calibrated orifices, hot tests were carried out in simulated vacuum conditions. Chamber pressure and flow rate values were exactly matching with the prediction for the second and third trials. But for the first trial, the chamber pressure values obtained in the hot test were more than the prediction. This clearly shows that the flow is detached in the 1st trial and attached for the 2nd & 3rd trials. Hence, the error in tuning the flow control orifices is pinpointed as the reason for this higher chamber pressure observed in flight.

Keywords: reaction control thruster, propellent, orifice, chamber pressure

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Authors: Simrin Kafle, Ulrika Enemark

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Catastrophic health expenditure (CHE) is a critical issue in low- and middle-income countries like Nepal, exacerbating financial hardship among vulnerable households. This study assesses the effectiveness of Nepal’s National Health Insurance Program (NHIP), launched in 2015, to reduce out-of-pocket (OOP) healthcare costs and mitigate CHE. Conducted in Pokhara Metropolitan City, the study used an analytical cross-sectional design, sampling 1276 households through a two-stage random sampling method. Data was collected via face-to-face interviews between May and October 2023. The analysis was conducted using SPSS version 29, incorporating propensity score matching to minimize biases and create comparable groups of enrolled and non-enrolled households in the NHIP. PSM helped reduce confounding effects by matching households with similar baseline characteristics. Additionally, a doubly robust methodology was employed, combining propensity score adjustment with regression modeling to enhance the reliability of the results. This comprehensive approach ensured a more accurate estimation of the impact of NHIP enrollment on CHE. Among the 1276 samples, 534 households (41.8%) were enrolled in NHIP. Of them, 84.3% of households renewed their insurance card, though some cited long waiting times, lack of medications, and complex procedures as barriers to renewal. Approximately 57.3% of households reported known diseases before enrollment, with 49.8% attending routine health check-ups in the past year. The primary motivation for enrollment was encouragement from insurance employees (50.2%). The data indicates that 12.5% of enrolled households experienced CHE versus 7.5% among non-enrolled. Enrollment into NHIP does not contribute to lower CHE (AOR: 1.98, 95% CI: 1.21-3.24). Key factors associated with increased CHE risk were presence of non-communicable diseases (NCDs) (AOR: 3.94, 95% CI: 2.10-7.39), acute illnesses/injuries (AOR: 6.70, 95% CI: 3.97-11.30), larger household size (AOR: 3.09, 95% CI: 1.81-5.28), and households below the poverty line (AOR: 5.82, 95% CI: 3.05-11.09). Other factors such as gender, education level, caste/ethnicity, presence of elderly members, and under-five children also showed varying associations with CHE, though not all were statistically significant. The study concludes that enrollment in the NHIP does not significantly reduce the risk of CHE. The reason for this could be inadequate coverage, where high-cost medicines, treatments, and transportation costs are not fully included in the insurance package, leading to significant out-of-pocket expenses. We also considered the long waiting time, lack of medicines, and complex procedures for the utilization of NHIP benefits, which might result in the underuse of covered services. Finally, gaps in enrollment and retention might leave certain households vulnerable to CHE despite the existence of NHIP. Key factors contributing to increased CHE include NCDs, acute illnesses, larger household sizes, and poverty. To improve the program’s effectiveness, it is recommended that NHIP benefits and coverage be expanded to better protect against high healthcare costs. Additionally, simplifying the renewal process, addressing long waiting times, and enhancing the availability of services could improve member satisfaction and retention. Targeted financial protection measures should be implemented for high-risk groups, and efforts should be made to increase awareness and encourage routine health check-ups to prevent severe health issues that contribute to CHE.

Keywords: catastrophic health expenditure, effectiveness, national health insurance program, Nepal

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Authors: Ahmed Jedidi, Mesfer Mohammed Alshamrani, Alwi Mohammad A. Bamhdi

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Optical performance monitoring and optical network management are essential in building a reliable, high-capacity, and service-differentiation enabled all-optical network. One of the serious problems in this network is the fact that optical crosstalk is additive, and thus the aggregate effect of crosstalk over a whole AON may be more nefarious than a single point of crosstalk. As results, we note a huge degradation of the Quality of Service (QoS) in our network. For that, it is necessary to identify and monitor the impairments in whole network. In this way, this paper presents new system to identify and monitor crosstalk in AONs in real-time fashion. particular, it proposes a new technique to manage intra-crosstalk in objective to relax QoS of the network.

Keywords: all-optical networks, optical crosstalk, optical cross-connect, crosstalk, monitoring crosstalk

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Authors: Jatziri Y. Moreno-Martinez, Arturo Galvan, Xavier Chavez Cardenas, Hiram Arroyo

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Several methods have been utilized to study the prediction of cracking of concrete structural under loading. The finite element analysis is an alternative that shows good results. The aim of this work was the numerical study of the width crack in reinforced concrete beams with dapped ends, these are frequently found in bridge girders and precast concrete construction. Properly restricting cracking is an important aspect of the design in dapped ends, it has been observed that the cracks that exceed the allowable widths are unacceptable in an aggressive environment for reinforcing steel. For simulating the crack width, the discrete crack approach was considered by means of a Cohesive Zone (CZM) Model using a function to represent the crack opening. Two cases of dapped-end were constructed and tested in the laboratory of Structures and Materials of Engineering Institute of UNAM. The first case considers a reinforcement based on hangers as well as on vertical and horizontal ring, the second case considers 50% of the vertical stirrups in the dapped end to the main part of the beam were replaced by an equivalent area (vertically projected) of diagonal bars under. The loading protocol consisted on applying symmetrical loading to reach the service load. The models were performed using the software package ANSYS v. 16.2. The concrete structure was modeled using three-dimensional solid elements SOLID65 capable of cracking in tension and crushing in compression. Drucker-Prager yield surface was used to include the plastic deformations. The reinforcement was introduced with smeared approach. Interface delamination was modeled by traditional fracture mechanics methods such as the nodal release technique adopting softening relationships between tractions and the separations, which in turn introduce a critical fracture energy that is also the energy required to break apart the interface surfaces. This technique is called CZM. The interface surfaces of the materials are represented by a contact elements Surface-to-Surface (CONTA173) with bonded (initial contact). The Mode I dominated bilinear CZM model assumes that the separation of the material interface is dominated by the displacement jump normal to the interface. Furthermore, the opening crack was taken into consideration according to the maximum normal contact stress, the contact gap at the completion of debonding, and the maximum equivalent tangential contact stress. The contact elements were placed in the crack re-entrant corner. To validate the proposed approach, the results obtained with the previous procedure are compared with experimental test. A good correlation between the experimental and numerical Load-Displacement curves was presented, the numerical models also allowed to obtain the load-crack width curves. In these two cases, the proposed model confirms the capability of predicting the maximum crack width, with an error of ± 30 %. Finally, the orientation of the crack is a fundamental for the prediction of crack width. The results regarding the crack width can be considered as good from the practical point view. Load-Displacement curve of the test and the location of the crack were able to obtain favorable results.

Keywords: cohesive zone model, dapped-end beams, discrete crack approach, finite element analysis

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Authors: Ricardo Avila, Gabriel Lopes, Vania Vidal, Jose Macedo

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This proposal aims for semantic enrichment between glossaries using the Simple Knowledge Organization System (SKOS) vocabulary to discover synonyms, hyponyms and hyperonyms semiautomatically, in Brazilian Portuguese, generating new semantic relationships based on WordNet. To evaluate the quality of this proposed model, experiments were performed by the use of two sets containing new relations, being one generated automatically and the other manually mapped by the domain expert. The applied evaluation metrics were precision, recall, f-score, and confidence interval. The results obtained demonstrate that the applied method in the field of Oil Production and Extraction (E&P) is effective, which suggests that it can be used to improve the quality of terminological mappings. The procedure, although adding complexity in its elaboration, can be reproduced in others domains.

Keywords: ontology matching, mapping enrichment, semantic web, linked data, SKOS

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Authors: Temitope O. Tokosi, Visvanathan Naicker

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Patient health records contain sensitive information for which an electronic patient record (EPR) system can safely secure and transmit amongst clinicians for use in improving health delivery. Clinician’s use of the behaviour of these systems is under scrutiny to assess their attributes towards health technology. South Africa (SA) clinicians responded to a pilot study survey to assess their understanding of EPR, what attributes are important towards technology use and more importantly streamlining the survey for a larger study. Descriptive statistics using mean scores was used because of the small sample size of 11 clinicians who completed the survey. Nine (9) constructs comprising 62 items were used and a Cronbach alpha score of 0.883 was obtained. Limitations and discussions conclude the study.

Keywords: EPR, clinicians, pilot study, South Africa

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Authors: Jiayue Guo, Lili You

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Background: Children and adolescent health are crucial for both personal well-being and the nation's future health landscape. Health Literacy (HL) is important in enabling adolescents to self-manage their health, a fundamental step towards health empowerment. However, there are limited tools for assessing HL among elementary and junior high school students. This study aims to construct and validate a test-based HL scale for Chinese students, offering a scientific reference for cross-cultural HL tool development. Methods: We conducted a cross-sectional online survey. Participants were recruited from a stratified cluster random sampling method, a total of 4189 Chinese in-school primary and secondary students. The development of the scale was completed by defining the concept of HL, establishing the item indicator system, screening items (7 health content dimensions), and evaluating reliability and validity. Delphi method expert consultation was used to screen items, the Rasch model was conducted for quality analysis, and Cronbach’s alpha coefficient was used to examine the internal consistency. Results: We developed four versions of the HL scale, each with a total score of 100, encompassing seven key health areas: hygiene, nutrition, physical activity, mental health, disease prevention, safety awareness, and digital health literacy. Each version measures four dimensions of health competencies: knowledge, skills, motivation, and behavior. After the second round of expert consultation, the average importance score of each item by experts is 4.5–5.0, and the coefficient of variation is 0.000–0.174. The knowledge and skills dimensions are judgment-based and multiple-choice questions, with the Rasch model confirming unidimensionality at a 5.7% residual variance. The behavioral and motivational dimensions, measured with scale-type items, demonstrated internal consistency via Cronbach's alpha and strong inter-item correlation with KMO values of 0.924 and 0.787, respectively. Bartlett's test of sphericity, with p-values <0.001, further substantiates the scale's reliability. Conclusions: The new test-based scale, designed to evaluate competencies within a multifaceted framework, aligns with current international adolescent literacy theories and China's health education policies, focusing not only on knowledge acquisition but also on the application of health-related thinking and behaviors. The scale can be used as a comprehensive tool for HL evaluation and a reference for other countries.

Keywords: adolescent health, Chinese, health literacy, rasch model, scale development

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Authors: Nataliya V. Dolgushina, Elena A. Gorodnova, Olga S. Beznoshenco, Andrey Yu Romanov, Irina V. Menzhinskaya, Lyubov V. Krechetova, Gennady T. Suchich

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In patients with COVID-19, generalized hypercoagulability can lead to the development of severe coagulopathy. This event is accompanied by the development of a pronounced inflammatory reaction. The observational prospective study included 39 patients with mild COVID-19 and 102 patients with moderate and severe COVID-19. Patients were then stratified into groups depending on the risk of venous thromboembolism. vWF to ADAMTS-13 concentrations and activity ratios were significantly higher in patients with a high venous thromboembolism risks in patients with moderate and severe forms COVID-19.

Keywords: ADAMTS-13, COVID-19, hypercoagulation, thrombosis, von Willebrand factor

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Authors: Hussain K. Chaiel

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The development in the field of the digital signal processing (DSP) and the microelectronics technology reduces the complexity of the iterative algorithms that need large number of arithmetic operations. Virtex-Field Programmable Gate Arrays (FPGAs) are programmable silicon foundations which offer an important solution for addressing the needs of high performance DSP designer. In this work, Virtex-7 FPGA technology is used to implement an iterative algorithm to estimate the earthquake location. Simulation results show that an implementation based on block RAMB36E1 and DSP48E1 slices of Virtex-7 type reduces the number of cycles of the clock frequency. This enables the algorithm to be used for earthquake prediction.

Keywords: DSP, earthquake, FPGA, iterative algorithm

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Authors: Stephen McCarthy, Joanne Gray, Esther Carr, Gerard Danjoux, Paul Baker, Rhiannon Hackett

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Background: The Go Well Health (GWH) platform is a web-based programme that allows patients to access personalised care plans and resources, aimed at prehabilitation prior to surgery. The online digital platform delivers essential patient education and support for patients prior to undergoing total hip replacements (THR) and total knee replacements (TKR). This study evaluated the impact of an online digital platform (ODP) in terms of functional health outcomes, health related quality of life and hospital length of stay following surgery. Methods: A retrospective cohort study comparing a cohort of patients who used the online digital platform (ODP) to deliver patient education and support (PES) prior to undergoing THR and TKR surgery relative to a cohort of patients who did not access the ODP and received usual care. Routinely collected Patient Reported Outcome Measures (PROMs) data was obtained on 2,406 patients who underwent a knee replacement (n=1,160) or a hip replacement (n=1,246) between 2018 and 2019 in a single surgical centre in the United Kingdom. The Oxford Hip and Knee Score and the European Quality of Life Five-Dimensional tool (EQ5D-5L) was obtained both pre-and post-surgery (at 6 months) along with hospital LOS. Linear regression was used to compare the estimate the impact of GWH on both health outcomes and negative binomial regressions were used to impact on LOS. All analyses adjusted for age, sex, Charlson Comorbidity Score and either pre-operative Oxford Hip/Knee scores or pre-operative EQ-5D scores. Fractional polynomials were used to represent potential non-linear relationships between the factors included in the regression model. Findings: For patients who underwent a knee replacement, GWH had a statistically significant impact on Oxford Knee Scores and EQ5D-5L utility post-surgery (p=0.039 and p=0.002 respectively). GWH did not have a statistically significant impact on the hospital length of stay. For those patients who underwent a hip replacement, GWH had a statistically significant impact on Oxford Hip Scores and EQ5D-5L utility post (p=0.000 and p=0.009 respectively). GWH also had a statistically significant reduction in the hospital length of stay (p=0.000). Conclusion: Health Outcomes were higher for patients who used the GWH platform and underwent THR and TKR relative to those who received usual care prior to surgery. Patients who underwent a hip replacement and used GWH also had a reduced hospital LOS. These findings are important for health policy and or decision makers as they suggest that prehabilitation via an ODP can maximise health outcomes for patients following surgery whilst potentially making efficiency savings with reductions in LOS.

Keywords: digital prehabilitation, online digital platform, orthopaedics, surgery

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Authors: Mohammad Ali Al Qatawneh, Bespalchuk Pavel Ivanovich

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Computer navigation has been introduced in total knee arthroplasty to improve the accuracy of the procedure. Computer navigation improves the accuracy of bone resection in the coronal and sagittal planes. It was also noted that it normalizes the rotational alignment of the femoral component and fully assesses and balances the deformation of soft tissues in the coronal plane. The work is devoted to the advantages of using computer navigation technology in total knee arthroplasty in 62 patients (11 men and 51 women) suffering from gonarthrosis, aged 51 to 83 years, operated using a computer navigation system, followed up to 3 years from the moment of surgery. During the examination, the deformity variant was determined, and radiometric parameters of the knee joints were measured using the Knee Society Score (KSS), Functional Knee Society Score (FKSS), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scales. Also, functional stress tests were performed to assess the stability of the knee joint in the frontal plane and functional indicators of the range of motion. After surgery, improvement was observed in all scales; firstly, the WOMAC values decreased by 5.90 times, and the median value to 11 points (p < 0.001), secondly KSS increased by 3.91 times and reached 86 points (p < 0.001), and the third one is that FKSS data increased by 2.08 times and reached 94 points (p < 0.001). After TKA, the axis deviation of the lower limbs of more than 3 degrees was observed in 4 patients at 6.5% and frontal instability of the knee joint just in 2 cases at 3.2%., The lower incidence of sagittal instability of the knee joint after the operation was 9.6%. The range of motion increased by 1.25 times; the volume of movement averaged 125 degrees (p < 0.001). Computer navigation increases the accuracy of the spatial orientation of the endoprosthesis components in all planes, reduces the variability of the axis of the lower limbs within ± 3 °, allows you to achieve the best results of surgical interventions, and can be used to solve most basic tasks, allowing you to achieve excellent and good outcomes of operations in 100% of cases according to the WOMAC scale. With diaphyseal deformities of the femur and/or tibia, as well as with obstruction of their medullary canal, the use of computer navigation is the method of choice. The use of computer navigation prevents the occurrence of flexion contracture and hyperextension of the knee joint during the distal sawing of the femur. Using the navigation system achieves high-precision implantation for the endoprosthesis; in addition, it achieves an adequate balance of the ligaments, which contributes to the stability of the joint, reduces pain, and allows for the achievement of a good functional result of the treatment.

Keywords: knee joint, arthroplasty, computer navigation, advantages

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Authors: Mohammad Safaeipour, Yousef Amer

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This study directs its focus on developing a conceptual model to offer a systematic and integrated method to weigh the related measures and evaluate a competence of hospitals and rank of the selected hospitals that involve and consider the stakeholders’ key performance indicators (KPI’s). The Analytical Hierarchy Process (AHP) approach will use to weigh the dimensions and related sub- components. The weights and performance scores will combine by using the Technique for Order Performance by Similarity to Ideal Solution (TOPSIS) and rank the selected hospitals. The results of this study provide interesting insight into the necessity of process improvement implementation in which hospital that received the lowest ranking score.

Keywords: performance measurement system, PMS, hospitals, AHP, TOPSIS

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Authors: Chung-Ming Lo, Chung-Chien Lee

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In many countries, the lifetime prevalence of shoulder pain is up to 70%. In America, the health care system spends 7 billion per year about the healthy issues of shoulder pain. With respect to the origin, up to 70% of shoulder pain is attributed to rotator cuff lesions This study proposed a computer-aided diagnosis (CAD) system to assist radiologists classifying rotator cuff lesions with less operator dependence. Quantitative features were extracted from the shoulder ultrasound images acquired using an ALOKA alpha-6 US scanner (Hitachi-Aloka Medical, Tokyo, Japan) with linear array probe (scan width: 36mm) ranging from 5 to 13 MHz. During examination, the postures of the examined patients are standard sitting position and are followed by the regular routine. After acquisition, the shoulder US images were drawn out from the scanner and stored as 8-bit images with pixel value ranging from 0 to 255. Upon the sonographic appearance, the boundary of each lesion was delineated by a physician to indicate the specific pattern for analysis. The three lesion categories for classification were composed of 20 cases of tendon inflammation, 18 cases of calcific tendonitis, and 18 cases of supraspinatus tear. For each lesion, second-order statistics were quantified in the feature extraction. The second-order statistics were the texture features describing the correlations between adjacent pixels in a lesion. Because echogenicity patterns were expressed via grey-scale. The grey-scale co-occurrence matrixes with four angles of adjacent pixels were used. The texture metrics included the mean and standard deviation of energy, entropy, correlation, inverse different moment, inertia, cluster shade, cluster prominence, and Haralick correlation. Then, the quantitative features were combined in a multinomial logistic regression classifier to generate a prediction model of rotator cuff lesions. Multinomial logistic regression classifier is widely used in the classification of more than two categories such as the three lesion types used in this study. In the classifier, backward elimination was used to select a feature subset which is the most relevant. They were selected from the trained classifier with the lowest error rate. Leave-one-out cross-validation was used to evaluate the performance of the classifier. Each case was left out of the total cases and used to test the trained result by the remaining cases. According to the physician’s assessment, the performance of the proposed CAD system was shown by the accuracy. As a result, the proposed system achieved an accuracy of 86%. A CAD system based on the statistical texture features to interpret echogenicity values in shoulder musculoskeletal ultrasound was established to generate a prediction model for rotator cuff lesions. Clinically, it is difficult to distinguish some kinds of rotator cuff lesions, especially partial-thickness tear of rotator cuff. The shoulder orthopaedic surgeon and musculoskeletal radiologist reported greater diagnostic test accuracy than general radiologist or ultrasonographers based on the available literature. Consequently, the proposed CAD system which was developed according to the experiment of the shoulder orthopaedic surgeon can provide reliable suggestions to general radiologists or ultrasonographers. More quantitative features related to the specific patterns of different lesion types would be investigated in the further study to improve the prediction.

Keywords: shoulder ultrasound, rotator cuff lesions, texture, computer-aided diagnosis

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Authors: Pellecchia M. T., Savarese G., Carpinelli L., Calabrese M.

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Introduction: Parkinson's disease (PD) is characterized by a progressive loss of autonomy which undoubtedly has a significant impact on the quality of life of caregivers, and parents are the main informal caregivers. Caring for a person with PD is associated with an increased risk of psychiatric morbidity and persistent anxiety-depressive distress. The aim of the study is to investigate the burden on caregivers of patients with PD, through the use of multidimensional scales and to identify their personological and environmental determinants. Methods: The study has been approved by the Ethic Committee of the University of Salerno and informed consent for participation to the study was obtained from patients and their caregivers. The study was conducted at the Neurology Department of the A.O.U. "San Giovanni di Dio and Ruggi D’Aragona" of Salerno between September 2020 and May 2021. Materials: The questionnaires used were: a) Caregiver Burden Inventory - CBI a questionnaire of 24 items that allow identifying five sub-categories of burden (objective, psychological, physical, social, emotional); b) Depression Anxiety Stress Scales Short Version - DASS-21 questionnaire consisting of 21 items and valid in examining three distinct but interrelated areas (depression, anxiety and stress); c) Family Strain Questionnaire Short Form - FSQ-SF is a questionnaire of 30 items grouped in areas of increasing psychological risk (OK, R, SR, U); d) Zarit Caregiver Burden Inventory - ZBI, consisting of 22 items based on the analysis of two main factors: personal stress and pressure related to his role; e) Life Satisfaction, a single item that aims to evaluate the degree of life satisfaction in a global way using a 0-100 Likert scale. Findings: N ° 29 caregivers (M age = 55.14, SD = 9.859; 69% F) participated in the study. 20.6% of the sample had severe and severe burden (CBI score = M = 26.31; SD = 22.43) and 13.8% of participants had moderate to severe burden (ZBI). The FSQ-SF highlighted a minority of caregivers who need psychological support, in some cases urgent (Area SR and Area U). The DASS-21 results show a prevalence of stress-related symptoms (M = 10.90, SD = 10.712) compared to anxiety (M = 7.52, SD = 10.752) and depression (M = 8, SD = 10.876). There are significant correlations between some specific variables and mean test scores: retired caregivers report higher ZBI scores (p = 0.423) and lower Life Satisfaction levels (p = -0.460) than working caregivers; years of schooling show a negative linear correlation with the ZBI score (p = -0.491). The T-Test indicates that caregivers of patients with cognitive impairment are at greater risk than those of patients without cognitive impairment. Conclusions: It knows the factors that affect the burden the most would allow for early recognition of risky situations and caregivers who would need adequate support.

Keywords: anxious-depressive axis, caregivers’ burden, Parkinson’ disease, psychological risks

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Authors: Parisa Mansour

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Introduction: Early diagnosis of coronavirus disease (COVID-19) is extremely important to isolate and treat patients in time, thus preventing the spread of the disease, improving prognosis and reducing mortality. High-resolution computed tomography (HRCT) chest imaging and artificial intelligence (AI)-based analysis of HRCT chest images can play a central role in the treatment of patients with COVID-19. Objective: To investigate different chest HRCT findings in different stages of COVID-19 pneumonia and to evaluate the potential role of artificial intelligence in the quantitative assessment of lung parenchymal involvement in COVID-19 pneumonia. Materials and Methods: This retrospective observational study was conducted between May 1, 2020 and August 13, 2020. The study included 2169 patients with COVID-19 who underwent chest HRCT. HRCT images showed the presence and distribution of lesions such as: ground glass opacity (GGO), compaction, and any special patterns such as septal thickening, inverted halo, mark, etc. HRCT findings of the breast at different stages of the disease (early: andlt) 5 days, intermediate: 6-10 days and late stage: >10 days). A CT severity score (CTSS) was calculated based on the extent of lung involvement on HRCT, which was then correlated with clinical disease severity. Use of artificial intelligence; Analysis of CT pneumonia and quot; An algorithm was used to quantify the extent of pulmonary involvement by calculating the percentage of pulmonary opacity (PO) and gross opacity (PHO). Depending on the type of variables, statistically significant tests such as chi-square, analysis of variance (ANOVA) and post hoc tests were applied when appropriate. Results: Radiological findings were observed in HRCT chest in 1438 patients. A typical pattern of COVID-19 pneumonia, i.e., bilateral peripheral GGO with or without consolidation, was observed in 846 patients. About 294 asymptomatic patients were radiologically positive. Chest HRCT in the early stages of the disease mostly showed GGO. The late stage was indicated by such features as retinal enlargement, thickening and the presence of fibrous bands. Approximately 91.3% of cases with a CTSS = 7 were asymptomatic or clinically mild, while 81.2% of cases with a score = 15 were clinically severe. Mean PO and PHO (30.1 ± 28.0 and 8.4 ± 10.4, respectively) were significantly higher in the clinically severe categories. Conclusion: Because COVID-19 pneumonia progresses rapidly, radiologists and physicians should become familiar with typical TC chest findings to treat patients early, ultimately improving prognosis and reducing mortality. Artificial intelligence can be a valuable tool in treating patients with COVID-19.

Keywords: chest, HRCT, covid-19, artificial intelligence, chest HRCT

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Authors: Kwok W. Mui, Ling T. Wong, Chin T. Cheung, Ho C. Yu

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Based on an indoor environmental quality (IEQ) index established by previous work that indicates the overall IEQ acceptance from the prospect of an occupant in residential buildings in terms of four IEQ factors - thermal comfort, indoor air quality, visual and aural comforts, this study develops a user-friendly IEQ calculator for iOS and Android users to calculate the occupant acceptance and compare the relative performance of IEQ in apartments. The calculator allows the prediction of the best IEQ scenario on a quantitative scale. Any indoor environments under the specific IEQ conditions can be benchmarked against the predicted IEQ acceptance range. This calculator can also suggest how to achieve the best IEQ acceptance among a group of residents.

Keywords: calculator, indoor environmental quality (IEQ), residential buildings, 5-star benchmarks

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Authors: Angela U. Makolo

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Protein-coding and Non-coding regions determine the biology of a sequenced transcriptome. Research advances have shown that Non-coding regions are important in disease progression and clinical diagnosis. Existing bioinformatics tools have been targeted towards Protein-coding regions alone. Therefore, there are challenges associated with gaining biological insights from transcriptome sequence data. These tools are also limited to computationally intensive sequence alignment, which is inadequate and less accurate to identify both Protein-coding and Non-coding regions. Alignment-free techniques can overcome the limitation of identifying both regions. Therefore, this study was designed to develop an efficient sequence alignment-free model for identifying both Protein-coding and Non-coding regions in sequenced transcriptomes. Feature grouping and randomization procedures were applied to the input transcriptomes (37,503 data points). Successive iterations were carried out to compute the gradient vector that converged the developed Protein-coding and Non-coding Region Identifier (PNRI) model to the approximate coefficient vector. The logistic regression algorithm was used with a sigmoid activation function. A parameter vector was estimated for every sample in 37,503 data points in a bid to reduce the generalization error and cost. Maximum Likelihood Estimation (MLE) was used for parameter estimation by taking the log-likelihood of six features and combining them into a summation function. Dynamic thresholding was used to classify the Protein-coding and Non-coding regions, and the Receiver Operating Characteristic (ROC) curve was determined. The generalization performance of PNRI was determined in terms of F1 score, accuracy, sensitivity, and specificity. The average generalization performance of PNRI was determined using a benchmark of multi-species organisms. The generalization error for identifying Protein-coding and Non-coding regions decreased from 0.514 to 0.508 and to 0.378, respectively, after three iterations. The cost (difference between the predicted and the actual outcome) also decreased from 1.446 to 0.842 and to 0.718, respectively, for the first, second and third iterations. The iterations terminated at the 390th epoch, having an error of 0.036 and a cost of 0.316. The computed elements of the parameter vector that maximized the objective function were 0.043, 0.519, 0.715, 0.878, 1.157, and 2.575. The PNRI gave an ROC of 0.97, indicating an improved predictive ability. The PNRI identified both Protein-coding and Non-coding regions with an F1 score of 0.970, accuracy (0.969), sensitivity (0.966), and specificity of 0.973. Using 13 non-human multi-species model organisms, the average generalization performance of the traditional method was 74.4%, while that of the developed model was 85.2%, thereby making the developed model better in the identification of Protein-coding and Non-coding regions in transcriptomes. The developed Protein-coding and Non-coding region identifier model efficiently identified the Protein-coding and Non-coding transcriptomic regions. It could be used in genome annotation and in the analysis of transcriptomes.

Keywords: sequence alignment-free model, dynamic thresholding classification, input randomization, genome annotation

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Authors: Saori Fujimoto, Hiromi Kawasaki, Mari Murakami, Yoko Ueno

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Background: Coronavirus disease (COVID-19) has been spreading throughout the world. In Japan, many nursing universities have conducted online clinical practices to secure students’ learning opportunities. In the field of women’s health nursing, even after the pandemic ended, it will be worthwhile to utilize online practice in declining birthrate and reducing the burden of mothers. This study examined the learning effects of conducting online visits for mothers with infants during the COVID-19 pandemic by nursing students to enhance the students’ ability to carry out the online practice even in ordinary times effectively. Methods: Students were divided into groups of three, and information on the mothers was assessed, and the visits were planned. After role-play was conducted by the students and teachers, an online visit was conducted. The analysis target was the self-evaluation score of nine students who conducted online visits in June 2020 and had consented to participate. The evaluation contents included three items for assessment, two items for planning, one item for ethical consideration, five items for nursing practice, and two items for evaluation. The self-evaluation score ranged from 4 (‘Can do with a little advice’) to 1 (‘Can’t do with a little advice’). A univariate statistical analysis was performed. This study was approved by the Ethical Committee for Epidemiology of Hiroshima University. Results: The items with the highest mean (standard deviation) scores were ‘advocates for the dignity and the rights of mothers’ (3.89 (0.31)) and ‘communication behavior needed to create a trusting relationship’ (3.89 (0.31)).’ Next were the ‘individual nursing practice tailored to mothers (3.78 (0.42))’ and ‘review own practice and work on own task (3.78 (0.42)).’ The mean (standard deviation) of the items by type were as follows: three assessment items, 3.26 (0.70), two planning items, 3.11 (0.49), one ethical consideration item, 3.89 (0.31), five nursing practice items, 3.56 (0.54), and two evaluation items, 3.67 (0.47). Conclusion: The highest self-evaluations were for ‘advocates for the dignity and the rights of mothers’ and ‘communication behavior needed to create a trusting relationship.’ These findings suggest that the students were able to form good relationships with the mothers by improving their ability to effectively communicate and by presenting a positive attitude, even when conducting health visits online. However, the self-evaluation scores for assessment and planning were lower than those of ethical consideration, nursing practice, and evaluation. This was most likely due to a lack of opportunities and time to gather information and the need to modify and add plans in a short amount of time during one online visit. It is necessary to further consider the methods used in conducting online visits from the following viewpoints: methods of gathering information and the ability to make changes through multiple visits.

Keywords: infants, learning effects, mothers, online visit practice

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