Search results for: healthcare evaluation

Authors: Yu-Chieh Chen, Kuei-Feng Shen, Chia-Ling Chao

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The purpose of this report was to present the nursing experience and case of an unexpected cerebellar hemorrhagic stroke with acute hydrocephalus patient after lumbar spine surgery. The patient had been suffering from an emergent external ventricular drainage and stayed in the Surgical Intensive Care Unit from July 8, 2016, to July 22, 2016. During the period of the case, the data were collected for attendance, evaluation, observation, interview, searching medical record, etc. An integral evaluation of the patient's physiological 'psychological' social and spiritual states was also noted. The author noticed the following major nursing problems including ineffective cerebral perfusion 'physical activity dysfunction' family resource preparation for disability. The author provided nursing care to maintain normal intracranial pressure, along with a well-therapeutic relationship and applied interdisciplinary medical/nursing team to draft an individualized and appropriate nursing plan for them to face the psychosocial impact of the patient disabilities. We also actively participated in the rehabilitation treatments to improve daily activity and confidence. This was deemed necessary to empower them to a more positive attitude in the future.

Keywords: family resourace preparation inability, hemorrhagic sroke, ineffective tissue cerebral perfusion, lumbar spine surgery

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Authors: Dongjoo Chin

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The purpose of this study was to investigate the effectiveness of an Early Intensive Behavioral Intervention (EIBI) program on infants with autism spectrum disorder (ASD) and to explore the factors predicting the effectiveness of the program, focusing on the infant's age, language ability, problem behaviors, and parental stress. 19 pairs of infants aged between 2 and 5 years who have had been diagnosed with ASD, and their parents participated in an EIBI program at a clinic providing evidence-based treatment based on applied behavior analysis. The measurement tools which were administered before and after the EIBI program and compared, included PEP-R, a curriculum evaluation, K-SIB-R, K-Vineland-II, K-CBCL, and PedsQL for the infants, and included PSI-SF and BDI-II for the parents. Statistical analysis was performed using a sample t-test and multiple regression analysis and the results were as follows. The EIBI program showed significant improvements in overall developmental age, curriculum assessment, and quality of life for infants. There was no difference in parenting stress or depression. Furthermore, measures for both children and parents at the start of the program predicted neither PEP-R nor the degree of improvement in curriculum evaluation measured six months later at the end of the program. Based on these results, the authors suggest future directions for developing an effective intensive early intervention (EIBI) program for infants with ASD in Korea, and discuss the implications and limitations of this study.

Keywords: applied behavior analysis, autism spectrum disorder, early intensive behavioral intervention, parental stress

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Authors: Mihika Shivkumar, Krishna Kumar, C. Perisamy

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3D printing is a method of manufacturing wherein materials, such as plastic or metal, are deposited in layers one on top of the other to produce a three dimensional object. 3D printing is most commonly associated with creating engineering prototypes. However, its applications in the field of human health care have been frequently disregarded. Medical applications for 3D printing are expanding rapidly and are envisaged to revolutionize health care. Medical applications for 3D printing, both present and its potential, can be categorized broadly, including: creation of customized prosthetics tissue and organ fabrication; creation of implants, and anatomical models and pharmaceutical research regarding drug dosage forms. This piece breaks down bioprinting in the healthcare sector. It focuses on the better subtle elements of every particular point, including how 3D printing functions in the present, its impediments, and future applications in the health care sector.

Keywords: bio-printing, prototype, drug delivery, organ regeneration

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Authors: Stephan Schiffer, Andreas Kain, Philipp Wilde, Maximilian Helbing, Bernard Bäker

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Automobile manufacturers progressively focus on a downsizing strategy to meet the EU's CO2 requirements concerning type-approval consumption cycles. The reduction in naturally aspirated engine power is compensated by increased levels of turbocharging. By downsizing conventional engines, CO2 emissions are reduced. However, it also implicates major challenges regarding longitudinal dynamic characteristics. An example of this circumstance is the delayed turbocharger-induced torque reaction which leads to a partially poor response behavior of the vehicle during acceleration operations. That is why it is important to focus conventional drive train design on real customer driving again. The currently considered dynamic maneuvers like the acceleration time 0-100 km/h discussed by journals and car manufacturers describe longitudinal dynamics experienced by a driver inadequately. For that reason we present the realization and evaluation of a comprehensive proband study. Subjects are provided with different vehicle concepts (electrified vehicles, vehicles with naturally aspired engines and vehicles with different concepts of turbochargers etc.) in order to find out which dynamic criteria are decisive for a subjectively strong acceleration and response behavior of a vehicle. Subsequently, realistic acceleration criteria are derived. By weighing the criteria an evaluation metric is developed to objectify customer-oriented transient dynamics. Fully-electrified vehicles are the benchmark in terms of customer-oriented longitudinal dynamics. The electric machine provides the desired torque almost without delay. This advantage compared to combustion engines is especially noticeable at low engine speeds. In conclusion, we will show the degree to which extent customer-relevant longitudinal dynamics of conventional vehicles can be approximated to electrified vehicle concepts. Therefore, various technical measures (turbocharger concepts, 48V electrical chargers etc.) and drive train designs (e.g. varying the final drive) are presented and evaluated in order to strengthen the vehicle’s customer-relevant transient dynamics. As a rating size the newly developed evaluation metric will be used.

Keywords: 48V, customer-oriented driving dynamics, electric charger, electrified vehicles, vehicle concepts

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Authors: Giada Feletti, Daniela Tedesco, Paolo Trucco

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The present study aims to develop a dashboard of Key Performance Indicators (KPI) to enhance information and predictive capabilities in Emergency Medical Services (EMS) systems, supporting both operational and strategic decisions of different actors. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning the indicators currently used for the performance measurement of EMS systems. From this literature analysis, it emerged that current studies focus on two distinct perspectives: the ambulance service, a fundamental component of pre-hospital health treatment, and the patient care in the Emergency Department (ED). The perspective proposed by this study is to consider an integrated view of the ambulance service process and the ED process, both essential to ensure high quality of care and patient safety. Thus, the proposal focuses on the entire healthcare service process and, as such, allows considering the interconnection between the two EMS processes, the pre-hospital and hospital ones, connected by the assignment of the patient to a specific ED. In this way, it is possible to optimize the entire patient management. Therefore, attention is paid to the dependency of decisions that in current EMS management models tend to be neglected or underestimated. In particular, the integration of the two processes enables the evaluation of the advantage of an ED selection decision having visibility on EDs’ saturation status and therefore considering the distance, the available resources and the expected waiting times. Starting from a critical review of the KPIs proposed in the extant literature, the design of the dashboard was carried out: the high number of analyzed KPIs was reduced by eliminating the ones firstly not in line with the aim of the study and then the ones supporting a similar functionality. The KPIs finally selected were tested on a realistic dataset, which draws us to exclude additional indicators due to the unavailability of data required for their computation. The final dashboard, which was discussed and validated by experts in the field, includes a variety of KPIs able to support operational and planning decisions, early warning, and citizens’ awareness of EDs accessibility in real-time. By associating each KPI to the EMS phase it refers to, it was also possible to design a well-balanced dashboard covering both efficiency and effective performance of the entire EMS process. Indeed, just the initial phases related to the interconnection between ambulance service and patient’s care are covered by traditional KPIs compared to the subsequent phases taking place in the hospital ED. This could be taken into consideration for the potential future development of the dashboard. Moreover, the research could proceed by building a multi-layer dashboard composed of the first level with a minimal set of KPIs to measure the basic performance of the EMS system at an aggregate level and further levels with KPIs that can bring additional and more detailed information.

Keywords: dashboard, decision support, emergency medical services, key performance indicators

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Authors: A. M. Raseona, D. M. Barry, T. L. Nedambale

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Preservation of semen is an important process to ensure that semen quality is sufficient for assisted reproductive technology. This study evaluated the effectiveness of different extenders to preserve Nguni bull semen stored at controlled room temperature 24 °C for three days, as an alternative to frozen-thawed semen straws used for artificial insemination. Semen samples were collected from two Nguni bulls using an electro-ejaculator and transported to the laboratory for evaluation. Pooled semen was aliquot into three extenders Triladyl, Ham’s F10 and M199 at a dilution ratio of 1:4 then stored at controlled room temperature 24 °C. Sperm motility was analysed after 0, 24, 48 and 72 hours. Morphology and viability were analysed after 72 hours. The study was replicated four times and data was analysed by analysis of variance (ANOVA). Triladyl showed higher viability percentage and consistent total motility for three days. Ham’s F10 showed higher progressive motility compared to the other extenders. There was no significant difference in viability between Ham’s F10 and M199. No significant difference was also observed in total abnormality between the two Nguni bulls. In conclusion, Nguni semen can be preserved in Triladyl or Ham’s F10 and M199 culture media stored at 24 °C and stay alive for three days. Triladyl proved to be the best extender showing high viability and consistency in total motility as compared to Ham’s F10 and M199.

Keywords: bull semen, artificial insemination, Triladyl, Ham’s F10, M199, viability

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Authors: Youngmok Yun, Bosung Kim, Sungho Lee, Kyeongsu Jeon, Hyunwook Hwangbo, Byounggun Choi

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A betavoltaic battery converts nuclear energy released as beta particles (β-) directly into electrical energy. Betavoltaic cells are analogous to photovoltaic cells. The beta particle’s kinetic energy enters a p-n junction and creates electron-hole pairs. Subsequently, the built-in potential of the p-n junction accelerates the electrons and ions to their respective collectors. The major challenges are electrical conversion efficiencies and exact evaluation. In this study, the performance of betavoltaic battery was evaluated. The betavoltaic cell was evaluated in the same condition as radiation from radioactive isotope using by FE-SEM(field emission scanning electron microscope). The average energy of the radiation emitted from the Ni-63 radioisotope is 17.42 keV. FE-SEM is capable of emitting an electron beam of 1-30keV. Therefore, it is possible to evaluate betavoltaic cell without radioactive isotopes. The betavoltaic battery consists of radioisotope that is physically connected on the surface of Si-based PN diode. The performance of betavoltaic battery can be estimated by the efficiency of PN diode unit cell. The current generated by scanning electron microscope with fixed accelerating voltage (17keV) was measured by using faraday cup. Electrical characterization of the p-n junction diode was performed by using Nano Probe Work Station and I-V measurement system. The output value of the betavoltaic cells developed by this research team was 0.162 μw/cm2 and the efficiency was 1.14%.

Keywords: betavoltaic, nuclear, battery, Ni-63, radio-isotope

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Authors: Ruth Green, Samantha Milton, Rinal Desai

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Background/Aims: Eye pain/swelling/redness is a common presentation to Barnet General Hospital (a district general hospital), pediatric emergency department, and is managed by both the pediatric and emergency teams. The management of each child differs dramatically depending on the healthcare professional who reviews them. There also appears to be confusion in diagnosis between periorbital cellulitis, pre-septal cellulitis, and orbital cellulitis. Pre septal cellulitis refers to an inflammation of the eyelids and soft tissue anterior to the orbital septum. In contrast, orbital cellulitis is a serious, rapidly progressive infection of soft tissues located posterior to the orbital septum. Pre-septal cellulitis is more prevalent and less serious than orbital cellulitis, although it may be part of a continuous spectrum if untreated. Pre-septal cellulitis should there be diagnosed and treated urgently to prevent spread to the septum. For the purpose of the audit, the term periorbital cellulitis has been used as an umbrella term for all spectrums of this infection. The audit aimed to look at, how as a whole, the department is diagnosing and managing orbital and pre-septal cellulitis. Gold Standard: Patients of the same age and diagnosis should be treated with the same medication, advice, and follow-up. Method: Data was collected retrospectively from pediatric patients ( < 18years) who attended the emergency department from June 2019 to February 2020 who had been coded as pre-septal cellulitis, periorbital cellulitis, orbital cellulitis, or eye pain/swelling/redness. Demographics, signs and symptoms, management, and follow-up were recorded for all patients with any of the diagnoses of pre-septal, periorbital, or orbital cellulitis. A Microsoft Excel spreadsheet was used to record the anonymised data. Results: There were vast discrepancies in the diagnosis, management, and follow-up of patients with periorbital cellulitis. Conclusion/Discussion: The audit concluded there is no uniform approach to managing periorbital cellulitis in Barnet General Hospital Paediatric Emergency Department. Healthcare professionals misdiagnosed conjunctivitis as periorbital cellulitis, and adequate steps did not appear to be documented on excluding red flag signs and symptoms of patients presenting. There was no consistency in follow-up, with some patients having timely phone reviews or clinical reviews for mild symptoms. Advice given by the staff was appropriate, and patients did return when symptoms got worse and were treated accordingly. Plan: Given the inconsistency, a gold standard care pathway or local easily accessible clinical guideline can be developed to help with the diagnosis and management of periorbital cellulitis. Along with this, a teaching session can be carried out for the staff of the pediatric team and emergency department to disseminate the teaching. Following the introduction of a guideline and teaching sessions, patients notes can be re-reviewed to check improvement in patient care.

Keywords: periorbital cellulitis, preseptal cellulitis, orbital cellulitis, erythematous eyelid

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Authors: Piotr Prewysz-Kwinto, Grazyna Voss

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In June 2013, the European Parliament and the Council adopted a directive on financial reporting (Directive 2013/34/EU). The main objective was to simplify the principles of the preparation of financial statements, including the principles of the presentation and disclosures of financial information by adapting reporting burdens to the type and size of an undertaking. Therefore, the Directive introduced a classification of all undertakings into five groups, i.e. micro, small, medium-sized, large and public-interest entities, and defined in detail the classification criteria. The principles of the preparation of financial statements and the presentation of financial information as well as applicable simplifications were defined for each group. The EU Member States had to implement the provisions of Directive 34 relating to accounting and financial reporting into domestic norms until January 1, 2016. In Poland, the provisions of Directive 34 were implemented into domestic accounting norms specified in the Polish Accounting Act on a gradual basis. On July 11, 2014, the Polish Parliament adopted an amendment to the Act, introducing the Directive's solutions for micro-undertakings and on July 23, 2015, for the remaining undertakings. The aim of this paper is to present Polish solutions relating to financial reporting after the implementation of Directive 34 and the results of the survey conducted among accountants regarding the evaluation of the implemented simplifications for micro and small undertakings.

Keywords: accounting standards, financial reporting, financial statement, simplification

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Authors: Bu Kyung Park

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Background: The survival rate of pediatric cancer patients has been increased. Thus, the needs of long-term management and follow-up education after discharge continue to grow. Purpose: The purpose of this study was to explore the experiences of pediatric cancer patients and their families from first diagnosis to returning their social life. The ultimate goal of this study was to assess which information and intervention did pediatric cancer patients and their families required and needed, so that this could provide fundamental information for developing educational content of web-based intervention program for pediatric cancer patients. Research Approach: This study was based on a descriptive qualitative research design using semi-structured focus group interview. Participants: Twelve pediatric cancer patients and 12 family members participated in a total six focus group interview sessions. Methods: All interviews were audiotaped after obtaining participants’ approval. The recordings were transcribed. Qualitative Content analysis using the inductive coding approach was performed on the transcriptions by three coders. Findings: Eighteen categories emerged from the six main themes: 1) Information needs, 2) Support system, 3) Barriers to treatment, 4) Facilitators to treatment, 5) Return to social life, 6) Healthcare system issues. Each theme had both pediatric cancer patients’ codes and their family members’ codes. Patients and family members had high information needs through the whole process of treatment, not only the first diagnosis but also after completion of treatment. Hospitals provided basic information on chemo therapy, medication, and various examinations. However, they were more likely to rely on information from other patients and families by word of mouth. Participants’ information needs were different according to their treatment stage (e.g., first admitted patients versus cancer survivors returning to their social life). Even newly diagnosed patients worried about social adjustment after completion of all treatment, such as return to school and diet and physical activity at home. Most family members had unpleasant experiences while they were admitted in hospitals and concerned about healthcare system issues, such as medical error and patient safety. Conclusions: In conclusion, pediatric cancer patients and their family members wanted information source which can provide tailored information based on their needs. Different information needs with patients and their family members based on their diagnosis, progress, stage of treatment were identified. Findings from this study will be used to develop a patient-centered online health intervention program for pediatric cancer patients. Pediatric cancer patients and their family members had variety fields of education needs and soak the information from various sources. Web-based health intervention program for them is required to satisfy their inquiries to provide reliable information.

Keywords: focus group interview, family caregivers, pediatric cancer patients, qualitative content analysis

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Authors: M. Javanmard

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This study was aimed at analyzing the effects of packaging (MAP) and preservation conditions on the packaged fresh walnut kernel quality. The central composite plan was used for evaluating the effect of oxygen (0–10%), carbon dioxide (0-10%), and temperature (4-26 °C) on qualitative characteristics of walnut kernels. Also, the response level technique was used to find the optimal conditions for interactive effects of factors, as well as estimating the best conditions of process using least amount of testing. Measured qualitative parameters were: peroxide index, color, decreased weight, mould and yeast counting test, and sensory evaluation. The results showed that the defined model for peroxide index, color, weight loss, and sensory evaluation is significant (p < 0.001), so that increase of temperature causes the peroxide value, color variation, and weight loss to increase and it reduces the overall acceptability of walnut kernels. An increase in oxygen percentage caused the color variation level and peroxide value to increase and resulted in lower overall acceptability of the walnuts. An increase in CO₂ percentage caused the peroxide value to decrease, but did not significantly affect other indices (p ≥ 0.05). Mould and yeast were not found in any samples. Optimal packaging conditions to achieve maximum quality of walnuts include: 1.46% oxygen, 10% carbon dioxide, and temperature of 4 °C.

Keywords: shelled walnut, MAP, quality, storage temperature

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Authors: Pedro Dias, Lurdes Verissimo, Maria Joao Baptista, Ana Pinheiro, Patricia Oliveira-Silva, Sofia Serra, Daniela Coimbra

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To achieve a high standard in performance, a musician must be well in all aspects of health (physical, mental and social). Anxiety in performance is related to the high level of coordination and skill needed in performance, as well as to the public evaluation of the performer. It affects some key elements of performance, such as concentration, memory, motor coordination, and relaxation. This work presents two studies focused on the adaptation and evaluation of the psychometric properties of the Music Performance Anxiety Inventory (MPAI-A) in young Portuguese music students. The first study was conducted with a sample of 161 adolescent music students, who responded to the Portuguese version of this instrument, and to the State-Trait Anxiety Inventory for Children (STAIC-c2). Validity and reliability were examined, and this measure revealed robust psychometric properties in this sample. The second study aimed to adapt the MPAI to a younger population (one hundred 8-10 years-old music students). Again, the MPAI and the STAIC c-2 were used in this study. Exploratory factor analysis, correlations, and internal consistency were used to evaluate the final children version of the instrument (MPAI-C), presenting a different factor structure compared to the adolescent version (10 items organized in 2 factors) and high levels of reliability and convergent validity.

Keywords: anxiety, assessment, children and adolescents, music performance

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Authors: Sutida Maneeanakekul, Dusit Wechakit, Somsak Piriyayota

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Coastal erosion is a major problem in Thailand, in both the Gulf of Thailand and the Andaman Sea coasts. According to the Department of Marine and Coastal Resources, land erosion occurred along the 200 km coastline with an average rate of 5 meters/year. Coastal erosion affects public and government properties, as well as the socio-economy of the country, including emigration in coastal communities, loss of habitats, and decline in fishery production. To combat the problem of coastal erosion, projects utilizing bamboo sticks for coastal defense against erosion were carried out in 5 areas beginning in November, 2010, including: Pak Klong Munharn- Samut Songkhram Province; Ban Khun Samutmaneerat, Pak Klong Pramong and Chao Matchu Shrine-Samut Sakhon Province,and Pak Klong Hongthong – Chachoengsao Province by Marine and Coastal Resources Department. In 2012, an evaluation of the effectiveness of solving the problem of coastal erosion by using bamboo stick was carried out, with a focus on three aspects. Firstly, the change in physical and biological features after using the bamboo stick technique was assessed. Secondly, participation of people in the community in the way of managing the problem of coastal erosion were these aspects evaluated as part of the study. The last aspect that was evaluated is the satisfaction of the community toward this technique. The results of evaluation showed that the amounts of sediment have dramatically changed behind the bamboo sticks lines. The increase of sediment was found to be about 23.50-56.20 centimeters (during 2012-2013). In terms of biological aspect, there has been an increase in mangrove forest areas, especially at Bang Ya Prak, Samut Sakhon Province. Average tree density was found to be about 4,167 trees per square meter. Additionally, an increase in production of fisheries was observed. Presently, the change in the evaluated physical features tends to increase in every aspect, including the satisfaction of people in community toward the process of solving the erosion problem. People in the community are involved in the preparatory, operation, monitoring and evaluation process to resolve the problem in the medium levels.

Keywords: bamboo sticks, coastal erosion, rehabilitate, Thailand sustainable development approach

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Authors: Mehdi Moayyedian, Kazem Abhary, Romeo Marian

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This paper presents an evaluation of a plastic defect in injection molding before it occurs in the process; it is known as the short shot defect. The evaluation of different parameters which affect the possibility of short shot defect is the aim of this paper. The analysis of short shot possibility is conducted via SolidWorks Plastics and Taguchi method to determine the most significant parameters. Finite Element Method (FEM) is employed to analyze two circular flat polypropylene plates of 1 mm thickness. Filling time, part cooling time, pressure holding time, melt temperature and gate type are chosen as process and geometric parameters, respectively. A methodology is presented herein to predict the possibility of the short-shot occurrence. The analysis determined melt temperature is the most influential parameter affecting the possibility of short shot defect with a contribution of 74.25%, and filling time with a contribution of 22%, followed by gate type with a contribution of 3.69%. It was also determined the optimum level of each parameter leading to a reduction in the possibility of short shot are gate type at level 1, filling time at level 3 and melt temperature at level 3. Finally, the most significant parameters affecting the possibility of short shot were determined to be melt temperature, filling time, and gate type.

Keywords: injection molding, plastic defects, short shot, Taguchi method

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Authors: Ahmed Soliman Nagiub, Mahmoud Fayez, Heba Khaled, Said Ghoniemy

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Accurate perception is a critical component in enabling autonomous vehicles to understand their driving environment. The acquisition of 3D information about objects, including their location and pose, is essential for achieving this understanding. This survey paper presents a comprehensive review of 3D object detection techniques specifically tailored for autonomous vehicles. The survey begins with an introduction to 3D object detection, elucidating the significance of the third dimension in perceiving the driving environment. It explores the types of sensors utilized in this context and the corresponding data extracted from these sensors. Additionally, the survey investigates the different types of datasets employed, including their formats, sizes, and provides a comparative analysis. Furthermore, the paper categorizes and thoroughly examines the perception methods employed for 3D object detection based on the diverse range of sensors utilized. Each method is evaluated based on its effectiveness in accurately detecting objects in a three-dimensional space. Additionally, the evaluation metrics used to assess the performance of these methods are discussed. By offering a comprehensive overview of 3D object detection techniques for autonomous vehicles, this survey aims to advance the field of perception systems. It serves as a valuable resource for researchers and practitioners, providing insights into the techniques, sensors, and evaluation metrics employed in 3D object detection for autonomous vehicles.

Keywords: computer vision, 3D object detection, autonomous vehicles, deep learning

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Authors: Josif Figueroa, Kush Bubbar, Greg Young-Morris

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The reliability evaluation of composite generation and bulk transmission systems is crucial for ensuring a reliable supply of electrical energy to significant system load points. However, evaluating adequacy indices using probabilistic methods like sequential Monte Carlo Simulation can be computationally expensive. Despite this, it is necessary when time-varying and interdependent resources, such as renewables and energy storage systems, are involved. Recent advances in solving power network optimization problems and parallel computing have improved runtime performance while maintaining solution accuracy. This work introduces CompositeSystems, an open-source Composite System Reliability Evaluation tool developed in Julia™, to address the current deficiencies of commercial and non-commercial tools. This work introduces its design, validation, and effectiveness, which includes analyzing two different formulations of the Optimal Power Flow problem. The simulations demonstrate excellent agreement with existing published studies while improving replicability and reproducibility. Overall, the proposed tool can provide valuable insights into the performance of transmission systems, making it an important addition to the existing toolbox for power system planning.

Keywords: open-source software, composite system reliability, optimization methods, Monte Carlo methods, optimal power flow

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Authors: Ilham Zaidi, P. Sankara Sarma, Quazi Taufique Ahmed, V. Raman Kutty, Khalid Umer Khayyam, Gurpreet Singh, Abhishek Royal

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Introduction: Tuberculosis is a global public health emergency, but it is particularly acute in India, which has the world's highest tuberculosis burden. Due to overpopulation, lack of sanitation, malnutrition, low living standards, and poor socioeconomic status, among other factors, it is India's most common infectious disease. The long period of treatment is one of the main reasons for considering it as a public health emergency. Consequently, there is an increase in patient noncompliance, which leads to treatment failure, adverse treatment outcomes, and deaths. This could lead to the growth of anti-TB drug resistance. According to the WHO, approximately 558 thousand new cases of Multi-Drug Resistance Tuberculosis were diagnosed worldwide, with 8.5 percent developed Extensively Drug Resistance Tuberculosis. Methodology: This study is a program-based cross-sectional descriptive survey of adult tuberculosis patients enrolled in the Delhi-based Revised National Tuberculosis Program. The study setting was 27 NTEP districts of Delhi. (N=65,893) and Sample size- was 200; the sampling method which is used in the study was the systemic random sampling method. Results: Most of the demographic factors (age, gender, residence, and family type) were not significantly associated with adherence; marital status was found statistically significant with the treatment compliance. Hesitation while telling people about the disease and motivation to strictly follow drug schedule by healthcare workers were other factors where a significant association with drug adherence was observed. The study findings also suggest that provision of food, minimal financial and other moral support from family, counseling, discussion and politeness by healthcare providers might also facilitate adherence. Discussion and Conclusions: For TB treatment, adherence, age, sex, socioeconomic status, types of accommodations, malnutrition, and personal hygiene should all be considered; similar results were observed in previous studies. In the care of TB patients, DOTS services, health workers, and family support play a significant role. According to the country's National Strategic Plan, the Indian government has set a goal of eliminating tuberculosis by 2025 and patients' compliance with TB care and treatment adherence is very crucial to achieve this aim. A cohort study will be able to give a better understanding of factors associated with adherence since this study may have missed some defaulters who were absconding and could not be reached. Important Terms: RNTCP, NTEP, DOTS, DS-TB, DR-TB, RR-TB, MDR-TB, XDR-TB, Treatment failure, Treatment relapse, Treatment adherence.

Keywords: treatment adherence, treatment relapse, treatment failure, drug resistance tuberculosis

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Authors: Lyka Selene Magnayi, Marcos Vinas, Roseanne Ramos

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As the real estate industry continually grows in the Philippines, Geographic Information Systems (GIS) provide advantages in generating spatial databases for efficient delivery of information and services. The real estate sector is not only providing qualitative data about real estate properties but also utilizes various spatial aspects of these properties for different applications such as hazard mapping and assessment. In this study, a three-dimensional (3D) model and a spatial database of real estate properties in Fort Bonifacio, Taguig City are developed using GIS and SketchUp. Spatial datasets include political boundaries, buildings, road network, digital terrain model (DTM) derived from Interferometric Synthetic Aperture Radar (IFSAR) image, Google Earth satellite imageries, and hazard maps. Multiple model layers were created based on property listings by a partner real estate company, including existing and future property buildings. Actual building dimensions, building facade, and building floorplans are incorporated in these 3D models for geovisualization. Hazard model layers are determined through spatial overlays, and different scenarios of hazards are also presented in the models. Animated maps and walkthrough videos were created for company presentation and evaluation. Model evaluation is conducted through client surveys requiring scores in terms of the appropriateness, information content, and design of the 3D models. Survey results show very satisfactory ratings, with the highest average evaluation score equivalent to 9.21 out of 10. The output maps and videos obtained passing rates based on the criteria and standards set by the intended users of the partner real estate company. The methodologies presented in this study were found useful and have remarkable advantages in the real estate industry. This work may be extended to automated mapping and creation of online spatial databases for better storage, access of real property listings and interactive platform using web-based GIS.

Keywords: geovisualization, geographic information systems, GIS, real estate, spatial database, three-dimensional model

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Authors: Nicolas D. Norboge

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Purchasers of municipal bonds in primary and secondary markets are increasingly expecting issuers to disclose environmental, social, and governance factors (ESG) inissuance and continuing disclosure documents. U.S. tolling authorities are slowly catching up with other transportation sectors, such as public transit, in integrating ESG factors into their bond disclosure documents. A systematic mixed-methods evaluation of publicly available bond disclosure documents from 2010-2022 suggest that only a small number of U.S. tolling authorities disclosedall ESG factors; however, the pace has accelerated significantly from 2020-2022. Because many tolling authorities have a direct financial stake in the growth of passenger vehicle miles traveled on their toll facilities, and in turn the burning of more climate-warming fossil fuels, one crucial questionthat remains is how bond purchasers will view increasedESG transparency. Recent moves by large institutional investors, credit rating agencies, and regulators suggestan expectation of ESG disclosure is a trend likely to endure. This researchsuggests tolling authorities will need to proactively consider these emerging trends and carefully adapt their disclosure practiceswhere possible. Building on these findings, this research also provides a basic sketch framework for how issuers can responsibly position themselves within the changing global municipal debt marketplace.

Keywords: debt policy, ESG, municipal bonds, public-private partnerships, public tolling authorities, transportation finance, and policy

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Authors: Ju-Chun Chien

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Rapid aging and depopulation could lead to serious problems, including workforce shortages and health expenditure costs. The current and predicted future LTC workforce shortages could be a real threat to Taiwan’s society. By means of comparison of data from 144 nursing aide trainees and 727 general public, the main purpose of the present study was to determine whether there were any notable differences between the two groups toward engaging in LTC services. Moreover, this study focused on recognizing the attributes of the general public who had the willingness to take LTC jobs but continue to ride the fence. A self-developed questionnaire was designed based on Ajzen’s Theory of Planned Behavior model. After conducting exploratory factor analysis (EFA) and reliability analysis, the questionnaire was a reliable and valid instrument for both nursing aide trainees and the general public. The main results were as follows: Firstly, nearly 70% of nursing aide trainees showed interest in LTC jobs. Most of them were middle-aged female (M = 46.85, SD = 9.31), had a high school diploma or lower, had unrelated work experience in healthcare, and were mostly unemployed. The most common reason for attending the LTC training program was to gain skills in a particular field. The second most common reason was to obtain the license. The third and fourth reasons were to be interested in caring for people and to increase income. The three major reasons that might push them to leave LTC jobs were physical exhaustion, payment is bad, and being looked down on. Secondly, the variables that best-predicted nursing aide trainees’ intention to engage in LTC services were having personal willingness, perceived behavior control, with high school diploma or lower, and supported from family and friends. Finally, only 11.80% of the general public reported having interest in LTC jobs (the disapproval rating was 50% for the general public). In comparison to nursing aide trainees who showed interest in LTC settings, 64.8% of the new workforce for LTC among the general public was male and had an associate degree, 54.8% had relevant healthcare experience, 67.1% was currently employed, and they were younger (M = 32.19, SD = 13.19) and unmarried (66.3%). Furthermore, the most commonly reason for the new workforce to engage in LTC jobs were to gain skills in a particular field. The second priority was to be interested in caring for people. The third and fourth most reasons were to give back to society and to increase income, respectively. The top five most commonly reasons for the new workforce to quitting LTC jobs were listed as follows: physical exhaustion, being looked down on, excessive working hours, payment is bad, and excessive job stress.

Keywords: long-term care services, nursing aide trainees, Taiwanese people, theory of planned behavior

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Authors: Bakhtiar Azadbakht, Karim Adinehvand, Amin Sahebnasagh

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The purpose of this study was to evaluate dependence of PAGAT polymer gel dosimeter 1/T2 on different electron and photon energies as well as on different mean dose rates for a standard clinically used Co-60 therapy unit and an ELECTA linear accelerator. A multi echo sequence with 32 equidistant echoes was used for the evaluation of irradiated polymer gel dosimeters. The optimal post-manufacture irradiation and post imaging times were both determined to be one day. The sensitivity of PAGAT polymer gel dosimeter with irradiation of photon and electron beams was represented by the slope of calibration curve in the linear region measured for each modality. The response of PAGAT gel with photon and electron beams is very similar in the lower dose region. The R2-dose response was linear up to 30Gy. In electron beams the R2-dose response for doses less than 3Gy is not exact, but in photon beams the R2-dose response for doses less than 2Gy is not exact. Dosimeter energy dependence was studied for electron energies of 4, 12 and 18MeV and photon energies of 1.25, 4, 6 and 18MV. Dose rate dependence was studied in 6MeV electron beam and 6MV photon beam with the use of dose rates 80, 160, 240, 320, 400, and 480cGy/min. Evaluation of dosimeters were performed on Siemens Symphony, Germany 1.5T Scanner in the head coil. In this study no trend in polymer-gel dosimeter 1/T2 dependence was found on mean dose rate and energy for electron and photon beams.

Keywords: polymer gels, PAGAT gel, electron and photon beams, MRI

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Authors: Naruemon Phongaksorn

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The biofuel consumption has increased significantly over the decade resulting in the increasing request on agricultural land for biofuel feedstocks. However, the biofuel feedstocks are already stressed of having low productivity owing to inappropriate agricultural practices without considering suitability of crop land. This research evaluates the land suitability using GIS-integrated Analytic Hierarchy Processing (AHP) of biofuel crops: cassava, at Chachoengsao province, in Thailand. AHP method that has been widely accepted for land use planning. The objective of this study is compared between AHP method and the most limiting group of land characteristics method (classical approach). The reliable results of the land evaluation were tested against the crop performance assessed by the field investigation in 2015. In addition to the socio-economic land suitability, the expected availability of raw materials for biofuel production to meet the local biofuel demand, are also estimated. The results showed that the AHP could classify and map the physical land suitability with 10% higher overall accuracy than the classical approach. The Chachoengsao province showed high and moderate socio-economic land suitability for cassava. Conditions in the Chachoengsao province were also favorable for cassava plantation, as the expected raw material needed to support ethanol production matched that of ethanol plant capacity of this province. The GIS integrated AHP for biofuel crops land suitability evaluation appears to be a practical way of sustainably meeting biofuel production demand.

Keywords: Analytic Hierarchy Processing (AHP), Cassava, Geographic Information Systems, Land suitability

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Authors: Mohammad Mirzaei

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The term "modernism" is at the heart of debates about 20th-century literature and critical theory. Astradur Eysteinsson argues here that the notion of modernity does not emerge directly from the literature it encompasses but is actually a product of critical practices related to non-traditional literature. By intervening in and relating them to modernist works and contemporary literary theories, Esteinsson takes a comprehensive look at the idea of modernity. Eysteinsson critically examines various expressions of modernism in the rich spectrum of American, British, and European literature, criticism, and theory. He first explored a number of modernist paradigms and found a conflict between modernism's potential for cultural subversion and its relatively conservative status as a formalist project. In turn, he sees these paradigms as interpretations and inventions of literary history. Seen in this way, modernism presents both a historical change in the literary scene and the context of this change. Imbued with the connotations of tradition and modernity, modernity fulfills its primary function. Highlights and defines the complex relationship between history and post-realist literature. Eysteinsson focuses on how concepts of modernism guide our understanding of literature and literary history and how they influence the evaluation of experimental and 3post realist works in literature and art. He discusses in detail the relationship between modernism and the key terms postmodernism, avant-garde, and realism. In staging a crisis of subject and reference, modernity is not a form of discourse but its subversion, the "other" that may reveal important aspects of our social and linguistic experience in Western culture.

Keywords: literature, modernism, western cultures, postmodernism

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Authors: Temesgen Geremew Tefery

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Nanomaterials, due to their unique properties, have revolutionized the field of biosensing. Their functionalization, or modification with specific molecules, is crucial for enhancing their biocompatibility, selectivity, and sensitivity. This review explores recent advancements in nanomaterial functionalization for biosensing applications. We discuss various strategies, including covalent and non-covalent modifications, and their impact on biosensor performance. The use of biomolecules like antibodies, enzymes, and nucleic acids for targeted detection is highlighted. Furthermore, the integration of nanomaterials with different sensing modalities, such as electrochemical, optical, and mechanical, is examined. The future outlook for nanomaterial-based biosensing is promising, with potential applications in healthcare, environmental monitoring, and food safety. However, challenges related to biocompatibility, scalability, and cost-effectiveness need to be addressed. Continued research and development in this area will likely lead to even more sophisticated and versatile biosensing technologies.

Keywords: biosensing, nanomaterials, biotechnology, nanotechnology

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Authors: Niu Shu Fen

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Sleep disturbance is highly prevalent among shift-working nurses. We aimed to evaluate whether aerobic exercise (i.e., walking combined with jogging) improves objective Sleepparameters among female nurses at the end of an 8-week exercise program and 4 weeks after study completion. This single-blinded, parallel design, randomized controlled trial was conducted in the floor classroom of a would-be medical center in northern Taiwan. Sixtyeligible female nurses were randomly assigned to either aerobic exercise (n = 30) or usual care (n = 30) group. The moderate-intensity aerobic exercise program was performed over 5days (60 min per day) a week for 8 weeks after work hours. Objective sleep outcomes including total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), and sleep efficiency (SE), were retrieved using an Actigraph device. A generalized estimated equation model was used for data analyses. The aerobic exercise group had significant improvements in TST and SE at 4 weeks and 8 weeks compared with baseline evaluation(TST: B = 70.49 and 55.96, both p < 0.001; SE: B = 5.21 and 3.98, p < 0.001 and 0.002).Significant between-group differences were observed in SOL and WASO at 4 weeks but not8 weeks compared with the baseline evaluation (SOL: B = −7.18, p = 0.03; WASO: B =−11.38, p = 0.008). The positive lasting effects for TST were observed only until the 4-week follow-up. To improve sleep quality and quantity, we encourage female nurses to regularly perform moderate-intensity aerobic exercise.

Keywords: sleep quality, aerobic exercise, nurses, shift work

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Authors: Kemkanit Sanyanunthana

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The purpose of this research is to study the management system of information technology which supports the education of five private universities in Thailand, according to the case studies which have been developing their qualities and standards of management and education by service provision of information technology to support the excellence performance. The concept to connect information technology with a suitable system has been created by information technology administrators for development, as a system that can be used throughout the organizations to help reach the utmost benefits of using all resources. Hence, the researcher as a person who has been performing these duties within higher education is interested to do this research by selecting the Control Objective for Information and Related Technology 5 (COBIT 5) for the Malcolm Baldrige National Quality Award (MBNQA) of America, or the National Award which applies the concept of Total Quality Management (TQM) to the organization evaluation. Such evaluation is called the Education Criteria for Performance Excellence (EdPEx) focuses on studying and comparing education quality development for excellent performance using COBIT 5 in terms of information technology to study the problems and obstacles of the investigation process for an information technology system, which is considered as an instrument to drive all organizations to reach the excellence performance of the information technology, and to be the model of evaluation and analysis of the process to be in accordance with the strategic plans of the information technology in the universities. This research is conducted in the form of descriptive and survey research according to the case studies. The data collection were carried out by using questionnaires through the administrators working related to the information technology field, and the research documents related to the change management as the main study. The research can be concluded that the performance based on the APO domain process (ALIGN, PLAN AND ORGANISE) of the COBIT 5 standard frame, which emphasizes concordant governance and management of strategic plans for the organizations, could reach only 95%. This might be because of some restrictions such as organizational cultures; therefore, the researcher has studied and analyzed the management of information technology in universities as a whole, under the organizational structures, to reach the performance in accordance with the overall APO domain which would affect the determined strategic plans to be able to develop based on the excellence performance of information technology, and to apply the risk management system at the organizational level into every performance process which would develop the work effectiveness for the resources management of information technology to reach the utmost benefits. 

Keywords: COBIT5, APO, EdPEx Criteria, MBNQA

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Authors: Arpit Patil, Atharav Bhagwat, Rajas Bhope, Pramod Bide

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This research integrates IoT and ML to predict heart failure risks, utilizing the Framingham dataset. IoT devices gather real-time physiological data, focusing on heart rate dynamics, while ML, specifically Random Forest, predicts heart failure. Rigorous feature selection enhances accuracy, achieving over 90% prediction rate. This amalgamation marks a transformative step in proactive healthcare, highlighting early detection's critical role in cardiovascular risk mitigation. Challenges persist, necessitating continual refinement for improved predictive capabilities.

Keywords: cardiovascular diseases, internet of things, machine learning, cardiac risk assessment, heart failure prediction, early detection, cardio data analysis

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Authors: M. G. N. A. S. Fernando

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This study uses a researchable framework to improve the quality of ICT education and the Teaching Learning Assessment/ Evaluation (TLA/TLE) process. It utilizes existing resources while improving the methodologies along with pedagogical techniques and e-Learning approaches used in the secondary schools of Sri Lanka. The study was carried out in two phases. Phase I focused on investigating the factors which affect the quality of ICT education. Based on the key factors of phase I, the Phase II focused on the design of an Experimental Application Model with 6 activity levels. Each Level in the Activity Model covers one or more levels in the Revised Bloom’s Taxonomy. Towards further enhancement of activity levels, other pedagogical techniques (activity based learning, e-learning techniques, problem solving activities and peer discussions etc.) were incorporated to each level in the activity model as appropriate. The application model was validated by a panel of teachers including a domain expert and was tested in the school environment too. The validity of performance was proved using 6 hypotheses testing and other methodologies. The analysis shows that student performance with problem solving activities increased by 19.5% due to the different treatment levels used. Compared to existing process it was also proved that the embedded techniques (mixture of traditional and modern pedagogical methods and their applications) are more effective with skills development of teachers and students.

Keywords: activity models, Bloom’s taxonomy, ICT education, pedagogies

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Authors: M. Yadegari

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The thyroid gland is the largest classic endocrine organ that effects many organs of the body and plays a significant role in the process of Metabolism in animals. The aim of this study was to investigate the prevalence of thyroid disorders diagnosed by ultrasound and microscopic Lesions of the thyroid during the slaughter of apparently healthy One Humped Camels (Camelus dromedarius) in Iran. Randomly, 520 male camels (With an age range of 4 to 8 years), were studied in 2012 to 2013. The Camels’ thyroid glands were evaluated by sonographic examination. In both longitudinal and transverse view and then tissue sections were provide and stained with H & E and finally examined by light microscopy. The results obtained indicated the following: hyperplastic goiter (21%), degenerative changes (12%), follicular cysts (8%), follicular atrophy (4%), nodular hyperplasia (3%), adenoma (1%), carcinoma (1%) and simple goiter colloid (1%). Ultrasound evaluation of thyroid gland in adenoma and carcinoma showed enlargement and irregular of the gland, decreased echogenicity, and the heterogeneous thyroid parenchyma. Also, in follicular cysts were observed in the enlarged gland with no echo structures of different sizes and decreased echogenicity as a local or general. In nodular hyperplasia, increase echogenicity and heterogeneous parenchymal were seen. These findings suggest the use of Ultrasound as a screening test in the diagnosis of complications of thyroid disorders. Pathology also to be used for the diagnosis of thyroid problems and other side effects.

Keywords: thyroid gland, one humped camel, sonography, pathology

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Authors: J. Vasauskaite

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From the perspective of Lithuanian furniture enterprises, the role of energy efficiency is significant as it leads to direct economic benefits, increased competitiveness and higher productivity. There are various possible improvements in energy efficiency in industry: changes in the production process, investment in R&D, implementation of energy-saving technologies or energy management systems. The research aims to contribute the understanding of energy efficiency importance in industry by presenting possible improvements of energy use in different manufacturing process of enterprises. The evaluation methodology included quantitative and qualitative research methods: the comparative and statistical analysis of primary and secondary sources of information. This paper provides the detailed analysis of the energy efficiency development opportunities and challenges in Lithuanian furniture industry. The results of the study show the importance of technological innovations, energy efficiency policies and environmental management strategies in developing energy efficiency within the wood and furniture industry. The analysis of energy efficiency development in Lithuanian furniture industry showed that the industrial activities are influenced by various internal and external factors such as increasing flows of products, human resources and overall management decisions; dynamic growth and increasing competition; emerging need for environmental information. In the light of these factors, Lithuanian furniture industry has undergone significant changes – restructuring, technological advances and business model innovations, allowing it to be more export-oriented and focus on upgrading quality, design and innovation.

Keywords: energy efficiency, energy policy, furniture industry, technological innovation

Procedia PDF Downloads 510