Search results for: healthcare regulations

Authors: Rajvir Kaur, Jeewani Anupama Ginige

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With recent trends in Big Data and advancements in Information and Communication Technologies, the healthcare industry is at the stage of its transition from clinician oriented to technology oriented. Many people around the world die of cancer because the diagnosis of disease was not done at an early stage. Nowadays, the computational methods in the form of Machine Learning (ML) are used to develop automated decision support systems that can diagnose cancer with high confidence in a timely manner. This paper aims to carry out the comparative evaluation of a selected set of ML classifiers on two existing datasets: breast cancer and cervical cancer. The ML classifiers compared in this study are Decision Tree (DT), Support Vector Machine (SVM), k-Nearest Neighbor (k-NN), Logistic Regression, Ensemble (Bagged Tree) and Artificial Neural Networks (ANN). The evaluation is carried out based on standard evaluation metrics Precision (P), Recall (R), F1-score and Accuracy. The experimental results based on the evaluation metrics show that ANN showed the highest-level accuracy (99.4%) when tested with breast cancer dataset. On the other hand, when these ML classifiers are tested with the cervical cancer dataset, Ensemble (Bagged Tree) technique gave better accuracy (93.1%) in comparison to other classifiers.

Keywords: artificial neural networks, breast cancer, classifiers, cervical cancer, f-score, machine learning, precision, recall

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Authors: Mohamed Salad Ahmed

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This study explores the impact of tax evasion and avoidance on the economy of Somalia. Somalia's economy is largely informal and cash-based, making it challenging to accurately assess the extent of tax evasion and avoidance. However, it is widely recognized that these practices have significant negative effects on the economy, including reduced government revenue, an uneven playing field for businesses, corruption, and a lack of access to international aid and investment. The study focuses on identifying strategies and solutions to reduce tax evasion and avoidance and increase revenue collection. This includes improving the government's capacity to enforce tax laws and regulations, creating a more transparent and accountable tax system, and increasing public awareness of the importance of paying taxes. By addressing these issues, Somalia can improve its economic stability and enhance its ability to provide essential public services, reduce poverty, and promote growth and development. Tax evasion and avoidance have a significant negative impact on the economy of Somalia. The informal nature of the country's economy and the difficulty in accurately assessing the extent of tax evasion and avoidance make it challenging to address these issues effectively. The lack of government revenue resulting from tax evasion and avoidance makes it difficult for the government to fund essential services, leading to a decline in the quality of public services and hindering economic growth. Tax evasion and avoidance also create an uneven playing field for businesses, discourage investment, contribute to corruption, and undermine the rule of law. Additionally, tax evasion and avoidance can make it more difficult for Somalia to access international aid and investment. Addressing these issues will require a concerted effort by the government to strengthen tax collection and enforcement, as well as by the international community to provide technical assistance and support. This abstract highlights the importance of addressing tax evasion and avoidance in Somalia and the potential benefits of doing so.

Keywords: tax evasion, tax avoidance, Somalia economy, revenue collection, informal economy, corruption economic growth, investment, tax policy, tax administration, governance, private sector

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Authors: Shivankar Agrawal, Indira Sarangthem

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Staphylococcus aureus and Methicillin-resistant Staphylococcus aureus (MRSA) remains one of the major causes of healthcare-associated and community-onset infections worldwide. Hence the search for non-toxic natural compounds having antibacterial activity has intensified for future drug development. The exploration of less studied niches of Earth can highly increase the possibility to discover novel bioactive compounds. Therefore, in this study, the cultivable fraction of fungi from the sediments of natural hot springs has been studied to mine potential fungal candidates with antibacterial activity against the human pathogen Staphylococcus aureus and Methicillin-resistant Staphylococcus aureus. We isolated diverse strains of thermophilic fungi from a collection of samples from sediment. Following a standard method, we isolated a promising thermophilic fungus strain IBSD19, identified as Acrophialophora levis, possessing the potential to produce an anti-Staphylococcus aureus agent. The growth conditions were optimized and scaled to fermentation, and its produced extract was subjected to chemical extraction. The ethyl acetate fraction was found to display significant activity against Staphylococcus aureus and MRSA with a minimum inhibitory concentration (MIC) of 0.5 mg/ml and 4 mg/ml, respectively. The cell membrane integrity assay and SEM suggested that the fungal metabolites cause bacteria clustering and further lysis of the cell.

Keywords: antibacterial activity, antioxidant, fungi, Staphylococcus aureus, MRSA, thermophiles

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Authors: Maher El-Masri, Jamie Crawley, Judy Bornais, Abeer Omar

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Background: Misuse of Emergency Department (ED) for non-urgent healthcare results in unnecessary crowdedness that can result in long ED waits and delays in treatment, diversion of ambulances to other hospitals, poor health outcomes for patients, and increased risk of death Objectives: The main purpose of this study was to explore the independent predictors of non-urgent ED visits in Erie St. Clair LHIN. Secondary purposes of the study include comparison of the rates of non-urgent ED visits between urban and rural hospitals Design: A secondary analysis of archived population-based data on 597,373 ED visits in southwestern Ontario Results The results suggest that older (OR = .992; 95% CI .992 – .993) and female patients (OR = .940; 95% CI .929 - .950) were less likely to visit ED for non-urgent causes. Non-urgent ED visits during the winter, spring, and fall were 13%, 5.8%, and 7.5%, respectively, lesser than they were during the summer time. The data further suggest that non-urgent visits were 19.6% and 21.3% less likely to occur in evening and overnight shifts compared to the day shift. Non-urgent visits were 2.76 times more likely to present to small community hospitals than large community hospitals. Health care providers were 1.92 times more likely to refer patients with non-urgent health problem to the ED than the decision taken by patients, family member or caretakers. Conclusion: In conclusion, our study highlights a number of important factors that are associated with inappropriate use of ED visits for non-urgent health problems. Knowledge of these factors could be used to address the issue of unnecessary ED crowdedness.

Keywords: emergency department, non-urgent visits, predictors, logistic regression

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Authors: Hanneke J. A. Smaling, Mandy Visser

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One way to reduce the risk of COVID-19 infection is by preventing close interpersonal contact with distancing measures. These social distancing measures presented challenges to the health and wellbeing of people with dementia and their informal and professional caregivers. This study describes the concerns and recommendations of informal and professional caregivers for COVID-19 policy for home care and long-term care for people with dementia during the first and second COVID-19 wave in the Netherlands. In this qualitative interview study, 20 informal caregivers and 20 professional caregivers from home care services and long-term care participated. Interviews were analyzed using an inductive thematic analysis approach. Both informal and professional caregivers worried about getting infected or infecting others with COVID-19, the consequences of the distancing measures, and quality of care. There was a general agreement that policy in the second wave was better informed compared to the first wave. At an organizational level, the policy was remarkably flexible. Recommendations were given for dementia care (need to offer meaningful activities, improve the organization of care, more support for informal caregivers), policy (national vs. locally organization, social isolation measures, visitor policy), and communication. Our study contributes to the foundation of future care decisions by (inter)national policymakers, politicians, and healthcare organizations during the course of the COVID-19 pandemic, underlining the need for balance between safety and autonomy for people with dementia.

Keywords: covid-19, dementia, home care, long-term care, policy

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Authors: Jyoti Rani, Ashima Anand, Shivendra Shivani

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In recent years, physiological signals obtained in telemedicine have been stored independently from patient information. In addition, people have increasingly turned to mobile devices for information on health-related topics. Major authentication and security issues may arise from this storing, degrading the reliability of diagnostics. This study introduces an approach to reversible watermarking, which ensures security by utilizing the electrocardiogram (ECG) signal as a carrier for embedding patient information. In the proposed work, Pan-Tompkins++ is employed to convert the 1D ECG signal into a 2D signal. The frequency subbands of a signal are extracted using RDWT(Redundant discrete wavelet transform), and then one of the subbands is subjected to MSVD (Multiresolution singular valued decomposition for masking. Finally, the encrypted watermark is embedded within the signal. The experimental results show that the watermarked signal obtained is indistinguishable from the original signals, ensuring the preservation of all diagnostic information. In addition, the DnCNN (Denoising convolutional neural network) concept is used to denoise the retrieved watermark for improved accuracy. The proposed ECG signal-based watermarking method is supported by experimental results and evaluations of its effectiveness. The results of the robustness tests demonstrate that the watermark is susceptible to the most prevalent watermarking attacks.

Keywords: ECG, VMD, watermarking, PanTompkins++, RDWT, DnCNN, MSVD, chaotic encryption, attacks

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Authors: Mohammad Tayefeh Norooz, Amirhossein Kargarzadeh

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Overweight and obesity as an abnormality are health threatening factors. Body mass index (BMI) above 25 is referred to as overweight and above 30 as obese. Apollo Endosurgery, Inc., a pioneering company in endoscopy surgeries, is poised to revolutionize patient care with its minimally invasive treatment options. Some product solutions are designed to improve patient outcomes and redefine the future of healthcare. Weight gain post-weight-loss surgery may stem from an enlarged stomach opening, reducing fullness and increasing food intake. Apollo Endosurgery's OverStitch system, a minimally invasive approach, addresses this by using sutures to reduce stomach opening size. This reflects Apollo's commitment to transformative improvements in healing endoscopy, emphasizing a shift towards minimally invasive options. The system's versatility and precision in full-thickness suturing offer treatment alternatives, exemplified in applications like Endoscopic Sleeve Gastroplasty for reshaping obesity management. Apollo’s dedication to pioneering advancements suggests ongoing breakthroughs in minimally invasive surgery, positioning the OverStitch systems as a testament to innovation in patient care.

Keywords: apollo endosurgery, endoscopic sleeve gastroplasty, weight loss system, overstitch endoscopic suturing system, therapeutic, perforations, fistula

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Authors: Feng-Ming Fan, Xiu-Hui Wen, Po-Feng Chen, Yi-Ching Tu

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Because of inborn natural conditions and man-made sabotage, the water resources insufficient phenomenon in Taiwan is a very important issue needed to face immediately. The regulations and law of water resources protection and recycling are gradually completed now but still lack of specific water recycling effectiveness checking method. The research focused on the industrial parks that already had been certificated with EIA to establish a professional checking system, carry through and forge ahead to contribute one’s bit in water resources sustainable usage. Taiwan Government Policies of Environmental Impact Assessment established in 1994, some development projects were requested to set certain water recycling ratio for water resources effective usage. The water covers and contains everything because all-inclusive companies enter and be stationed. For control the execution status of industrial park water and waste water recycling ratio about EIA commitment effectively, we invited experts and scholars in this filed to discuss with related organs to formulate the policy and audit plan. Besides, call a meeting to set public version water equilibrium diagrams and recycles parameter. We selected nine industrial parks that were requested set certain water recycling ratio in EIA examination stage and then according to the water usage quantity, we audited 340 factories in these industrial parks with spot and documents examination and got fruitful results – the average water usage of unit area per year of all these examined industrial parks is 31,000 tons/hectare/year, the value is just half of Taiwan industries average. It is obvious that the industrial parks with EIA commitment can decrease the water resources consumption effectively. Taiwan government policies of Environmental Impact Assessment took follow though tracking function into consideration at the beginning. The results of this research verify the importance of the implementing with water recycling to save water resources in EIA commitment. Inducing development units to follow EIA commitment to get the balance between environmental protection and economic development is one of the important EIA value.

Keywords: Taiwan government policies of environmental impact assessment, water recycling ratio of EIA commitment, water resources sustainable usage, water recycling

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Authors: Anushtha Saxena

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This paper examines the process of data monetisation bye-commerce companies operating in India. Data monetisation is collecting, storing, and analysing consumers’ data to use further the data that is generated for profits, revenue, etc. Data monetisation enables e-commerce companies to get better businesses opportunities, innovative products and services, a competitive edge over others to the consumers, and generate millions of revenues. This paper analyses the issues and challenges that are faced due to the process of data monetisation. Some of the issues highlighted in the paper pertain to the right to privacy, protection of data of e-commerce consumers. At the same time, data monetisation cannot be prohibited, but it can be regulated and monitored by stringent laws and regulations. The right to privacy isa fundamental right guaranteed to the citizens of India through Article 21 of The Constitution of India. The Supreme Court of India recognized the Right to Privacy as a fundamental right in the landmark judgment of Justice K.S. Puttaswamy (Retd) and Another v. Union of India . This paper highlights the legal issue of how e-commerce businesses violate individuals’ right to privacy by using the data collected, stored by them for economic gains and monetisation and protection of data. The researcher has mainly focused on e-commerce companies like online shopping websitesto analyse the legal issue of data monetisation. In the Internet of Things and the digital age, people have shifted to online shopping as it is convenient, easy, flexible, comfortable, time-consuming, etc. But at the same time, the e-commerce companies store the data of their consumers and use it by selling to the third party or generating more data from the data stored with them. This violatesindividuals’ right to privacy because the consumers do not know anything while giving their data online. Many times, data is collected without the consent of individuals also. Data can be structured, unstructured, etc., that is used by analytics to monetise. The Indian legislation like The Information Technology Act, 2000, etc., does not effectively protect the e-consumers concerning their data and how it is used by e-commerce businesses to monetise and generate revenues from that data. The paper also examines the draft Data Protection Bill, 2021, pending in the Parliament of India, and how this Bill can make a huge impact on data monetisation. This paper also aims to study the European Union General Data Protection Regulation and how this legislation can be helpful in the Indian scenarioconcerning e-commerce businesses with respect to data monetisation.

Keywords: data monetization, e-commerce companies, regulatory framework, GDPR

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Authors: Pachawo Bisani, Goodall Nyirenda

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The Malawi National Antiretroviral Therapy (NART) Electronic Medical Record (EMR) system was designed and developed with guidance from the Ministry of Health through the Department of HIV and AIDS (DHA) with the aim of supporting the management of HIV patient data and reporting in high prevalence ART clinics. As of 2021, the system has been scaled up to over 206 facilities across the country. The system is integrated with the clinical decision support system (CDSS) to assist healthcare providers in making a decision about an individual patient at a particular point in time. Despite NART EMR undergoing several evaluations and assessments, little has been done to evaluate the clinical decision support system in the NART EMR system. Hence, the study aimed to evaluate the use of CDSS in the NART EMR system in Malawi. The study adopted a mixed-method approach, and data was collected through interviews, observations, and questionnaires. The study has revealed that the CDSS tools were integrated into the ART clinic workflow, making it easy for the user to use it. The study has also revealed challenges in system reliability and information accuracy. Despite the challenges, the study further revealed that the system is effective and efficient, and overall, users are satisfied with the system. The study recommends that the implementers focus more on the logic behind the clinical decision-support intervention in order to address some of the concerns and enhance the accuracy of the information supplied. The study further suggests consulting the system's actual users throughout implementation.

Keywords: clinical decision support system, electronic medical record system, usability, antiretroviral therapy

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Authors: Srishti Sinha, Deepti Tikariha, Kallol K. Ghosh

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Over the past few decades protein-surfactant interactions have been a subject of extensive studies as they are of great importance in wide variety of industries, biological, pharmaceutical and cosmetic systems. Protein-surfactant interactions have been explored the effect of surfactants on structure of protein in the form of solubilization and denaturing or renaturing of protein. Globular proteins are frequently used as functional ingredients in healthcare and pharmaceutical products, due to their ability to catalyze biochemical reactions, to be adsorbed on the surface of some substance and to bind other moieties and form molecular aggregates. One of the most widely used globular protein is bovine serum albumin (BSA), since it has a well-known primary structure and been associated with the binding of many different categories of molecules, such as dyes, drugs and toxic chemicals. Protein−surfactant interactions are usually dependent on the surfactant features. Most of the research has been focused on single-chain surfactants. More recently, the binding between proteins and dimeric surfactants has been discussed. In present study interactions of one dimeric surfactant Butanediyl-1,4-bis (dimethylhexadecylammonium bromide) (16-4-16, 2Br-) and the corresponding single-chain surfactant cetyl trimethylammonium bromide (CTAB) with bovine serum albumin (BSA) have been investigated by surface tension and spectrofluoremetric methods. It has been found that the bindings of all gemini surfactant to BSA were cooperatively driven by electrostatic and hydrophobic interactions. The gemini surfactant carrying more charges and hydrophobic tails, showed stronger interactions with BSA than the single-chain surfactant.

Keywords: bovine serum albumin, gemini surfactants, hydrophobic interactions, protein surfactant interaction

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Authors: Inigo de Miguel Beriain

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Genetic data of deceased persons are of great interest for both biomedical research and clinical use. This is due to several reasons. On the one hand, many of our diseases have a genetic component; on the other hand, we share genes with a good part of our biological family. Therefore, it would be possible to improve our response considerably to these pathologies if we could use these data. Unfortunately, at the present moment, the status of data on the deceased is far from being satisfactorily resolved by the EU data protection regulation. Indeed, the General Data Protection Regulation has explicitly excluded these data from the category of personal data. This decision has given rise to a fragmented legal framework on this issue. Consequently, each EU member state offers very different solutions. For instance, Denmark considers the data as personal data of the deceased person for a set period of time while some others, such as Spain, do not consider this data as such, but have introduced some specifically focused regulations on this type of data and their access by relatives. This is an extremely dysfunctional scenario from multiple angles, not least of which is scientific cooperation at the EU level. This contribution attempts to outline a solution to this dilemma through an alternative proposal. Its main hypothesis is that, in reality, health data are, in a sense, a rara avis within data in general because they do not refer to one person but to several. Hence, it is possible to think that all of them can be considered data subjects (although not all of them can exercise the corresponding rights in the same way). When the person from whom the data were obtained dies, the data remain as personal data of his or her biological relatives. Hence, the general regime provided for in the GDPR may apply to them. As these are personal data, we could go back to thinking in terms of a general prohibition of data processing, with the exceptions provided for in Article 9.2 and on the legal bases included in Article 6. This may be complicated in practice, given that, since we are dealing with data that refer to several data subjects, it may be complex to refer to some of these bases, such as consent. Furthermore, there are theoretical arguments that may oppose this hypothesis. In this contribution, it is shown, however, that none of these objections is of sufficient substance to delegitimize the argument exposed. Therefore, the conclusion of this contribution is that we can indeed build a general framework on the processing of personal data of deceased persons in the context of the GDPR. This would constitute a considerable improvement over the current regulatory framework, although it is true that some clarifications will be necessary for its practical application.

Keywords: collective data conceptual issues, data from deceased people, genetic data protection issues, GDPR and deceased people

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Authors: Etaf Khlaed Haroun Alkhlaifat

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When doctors and patients do not share the same first language, language barriers may exist, which may have negative effects on the quality of communication and care provided. Doctors’ use of medical jargon and patients’ inability to fully express their illness, to a potential loss of relevant information can often create misunderstanding. This study sought to examine the extent to which a lack of “common” language represents one of the linguistic obstacles that may adversely influence the quality of healthcare services in Jordan. Communication Accommodation Theory (CAT) was used to interpret the phenomena under study. Doctors (n=9) and patients (n=18) were observed and interviewed in natural Jordanian medical settings. A thematic qualitative approach was employed to analyse the data. The preliminary findings of the study revealed that most doctors appeared to have a good sense of appropriate ways to break through communication barriers by changing medical terminologies or jargons into lay terms. However, for some, there were two main challenges: 1) the use of medical jargon in explaining medication and side effects and 2) the lack of patients’ knowledge in providing a full explanation about their illnesses. The study revealed that language barriers adversely affect health outcomes for patients with limited fluency in the English language. It argues that it is doctors’ responsibility to guarantee mutual understanding, educate patients on their condition and improve their health outcomes.

Keywords: communication accommodation theory, doctor-patient interaction, language barrier, medical jargon, misunderstanding

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Authors: Mitchell T. Grothaus, Cory Grigsby, Timothy S. Hare

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This study aims to determine if there is a relationship between elevated cancer risks in eastern Kentucky and the environmental effects of black shale. Previous research shows that black shale formations, such as those in eastern Kentucky contain high levels of toxic elements including arsenic and radon compared to average rocks and sediment. Similarly, the population of eastern Kentucky has higher rates of many health conditions, including lung cancer and cardiovascular disease, than surrounding regions. These poor health outcomes are typically explained in relation to social, economic, behavioral, and healthcare factors. The rates of many conditions, however, have not decreased as these factors improve with regional development. Black shale is known to affect environmental conditions such as by increasing radiation levels and heavy metal toxicity. We are mapping the effects of black shale through monitoring radiation, microbes, and chemical standards of water sources. In this presentation, we report on our measuring pH, dissolved oxygen, total dissolved solids, conductivity, temperature, and discharge and comparison with water quality standards from the Kentucky Department for Environmental Protection. The conditions of water sources combined with an environmental survey of the surrounding areas provide a greater understanding of why the people in eastern Kentucky face the current health issues.

Keywords: black shale, eastern Kentucky, environmental impact, water quality

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Authors: Omar Amoudi, Latifa Al Brashdi

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Construction projects are always subject to risks and uncertainties due to its unique and dynamic nature, outdoor work environment, the wide range of skills employed, various parties involved in addition to situation of construction business environment at large. Altogether, these risks and uncertainties affect projects objectives and lead to cost overruns, delay, and poor quality. Construction projects in Oman often experience cost overruns and delay. Managing these risks and reducing their impacts on construction cost requires firstly identifying these risks, and then analyzing their severity on project cost to obtain deep understanding about these risks. This in turn will assist construction managers in managing and tacking these risks. This paper aims to investigate the main risk factors that affect construction projects cost in the Sultanate of Oman. In order to achieve the main aim, literature review was carried out to identify the main risk factors affecting construction cost. Thirty-three risk factors were identified from the literature. Then, a questionnaire survey was designed and distributed among construction professionals (i.e., client, contractor and consultant) to obtain their opinion toward the probability of occurrence for each risk factor and its possible impact on construction project cost. The collected data was analyzed based on qualitative aspects and in several ways. The severity of each risk factor was obtained by multiplying the probability occurrence of a risk factor with its impact. The findings of this study reveal that the most significant risk factors that have high severity impact on construction project cost are: Change of Oil Price, Delay of Materials and Equipment Delivery, Changes in Laws and Regulations, Improper Budgeting, and Contingencies, Lack of Skilled Workforce and Personnel, Delays Caused by Contractor, Delays of Owner Payments, Delays Caused by Client, and Funding Risk. The results can be used as a basis for construction managers to make informed decisions and produce risk response procedures and strategies to tackle these risks and reduce their negative impacts on construction project cost.

Keywords: construction cost, construction projects, Oman, risk factors, risk management

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Authors: Ali Almadan, Anoop Krishnan, Ajita Rattani

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Facial recognition is a widely adopted technology in surveillance, border control, healthcare, banking services, and lately, in mobile user authentication with Apple introducing “Face ID” moniker with iPhone X. A lot of research has been conducted in the area of face recognition on datasets captured by surveillance cameras, DSLR, and mobile devices. Recently, face recognition technology has also been deployed on body-worn cameras to keep officers safe, enabling situational awareness and providing evidence for trial. However, limited academic research has been conducted on this topic so far, without the availability of any publicly available datasets with a sufficient sample size. This paper aims to advance research in the area of face recognition using body-worn cameras. To this aim, the contribution of this work is two-fold: (1) collection of a dataset consisting of a total of 136,939 facial images of 102 subjects captured using body-worn cameras in in-door and daylight conditions and (2) evaluation of various deep-learning architectures for face identification on the collected dataset. Experimental results suggest a maximum True Positive Rate(TPR) of 99.86% at False Positive Rate(FPR) of 0.000 obtained by SphereFace based deep learning architecture in daylight condition. The collected dataset and the baseline algorithms will promote further research and development. A downloadable link of the dataset and the algorithms is available by contacting the authors.

Keywords: face recognition, body-worn cameras, deep learning, person identification

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Authors: Rajendra Kumar Pandey

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Forest genetic resources not only represent regional biodiversity but also have immense value as the wealth for securing livelihood of poor people. These are vulnerable to ecological due to depletion/deforestation and /or impact of climate change. These resources of various plant categories are vulnerable on the floor of natural tropical forests, and leading to the threat on the growth and development of future forests. More than 170 species, including NTFPs, are in critical condition for their survival in natural tropical forests of Central India. Forest degradation, commensurate with biodiversity loss, is now pervasive, disproportionately affecting the rural poor who directly depend on forests for their subsistence. Looking ahead the interaction between forest and water, soil, precipitation, climate change, etc. and its impact on biodiversity of tropical forests, it is inevitable to develop co-operation policies and programmes to address new emerging realities. Forests ecosystem also known as the 'wealth of poor' providing goods and ecosystem services on a sustainable basis, are now recognized as a stepping stone to move poor people beyond subsistence. Poverty alleviation is the prime objective of the Millennium Development Goals (MDGs). However, environmental sustainability including other MDGs, is essential to ensure successful elimination of poverty and well being of human society. Loss and degradation of ecosystem are the most serious threats to achieving development goals worldwide. Millennium Ecosystem Assessment (MEA, 2005) was an attempt to identify provisioning and regulating cultural and supporting ecosystem services to provide livelihood security of human beings. Climate change may have a substantial impact on ecological structure and function of forests, provisioning, regulations and management of resources which can affect sustainable flow of ecosystem services. To overcome these limitations, policy guidelines with respect to planning and consistent research strategy need to be framed for conservation and sustainable development of forest genetic resources.

Keywords: climate change, forest ecosystem services, sustainable forest management, biodiversity conservation

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Authors: Cheryl Marie Cordeiro

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Although fisheries and aquaculture studies might seem marginal to international business (IB) studies in general, fisheries and aquaculture IB (FAIB) management is currently facing increasing pressure to meet global demand and consumption for fish in the next coming decades. In part address to this challenge, the purpose of this systematic review of literature (SLR) study is to investigate the use of the term ‘market access’ in its context of use in the generic literature and business sector discourse, in comparison to the more specific literature and discourse in fisheries, aquaculture and seafood. This SLR aims to uncover the knowledge/interest gaps between the academic subject discourses and business sector practices. Corpus driven in methodology and using a triangulation method of three different text analysis software including AntConc, VOSviewer and Web of Science (WoS) analytics, the SLR results indicate a gap in conceptual knowledge and business practices in how ‘market access’ is conceived and used in the context of the pharmaceutical healthcare industry and FAIB research and practice. While it is acknowledged that the product orientation of different business sectors might differ, this SLR study works with the assumption that both business sectors are global in orientation. These business sectors are complex in their operations from product to market. This SLR suggests a conceptual model in understanding the challenges, the potential barriers as well as avenues for solutions to developing market access for FAIB.

Keywords: market access, fisheries and aquaculture, international business, systematic literature review

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Authors: Cesar Augusto Hoil Rosas, José Luis Vázquez Burgos, José Juan Carbajal Hernandez

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White fish (Chirostoma estor estor) is an endemic species that habits in the Patzcuaro Lake, located in Michoacan, Mexico; being an important source of gastronomic and cultural wealth of the area. Actually, it have undergone an immense depopulation of individuals, due to the high fishing, contamination and eutrophication of the lake water, resulting in the possible extinction of this important species. This work proposes a new computational model for monitoring and assessment of critical environmental parameters of the white fish ecosystem. According to an Analytical Hierarchy Process, a mathematical model is built assigning weights to each environmental parameter depending on their water quality importance on the ecosystem. Then, a development of an advanced system for the monitoring, analysis and control of water quality is built using the virtual environment of LabVIEW. As results, we have obtained a global score that indicates the condition level of the water quality in the Chirostoma estor ecosystem (excellent, good, regular and poor), allowing to provide an effective decision making about the environmental parameters that affect the proper culture of the white fish such as temperature, pH and dissolved oxygen. In situ evaluations show regular conditions for a success reproduction and growth rates of this species where the water quality tends to have regular levels. This system emerges as a suitable tool for the water management, where future laws for white fish fishery regulations will result in the reduction of the mortality rate in the early stages of development of the species, which represent the most critical phase. This can guarantees better population sizes than those currently obtained in the aquiculture crop. The main benefit will be seen as a contribution to maintain the cultural and gastronomic wealth of the area and for its inhabitants, since white fish is an important food and economical income of the region, but the species is endangered.

Keywords: Chirostoma estor estor, computational system, lab view, white fish

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Authors: Débora C. Mendes, Matthias Eckert, Cláudia S. Moço, Hélio Martins, Jean-Pierre P. Gonçalves, Miguel Oliveira, José P. Da Silva

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Uncontrolled disposal of construction and demolition waste (C & DW) in embankments in the periphery of cities causes both environmental and social problems, namely erosion, deforestation, water contamination and human conflicts. One of the milestones of EU Horizon 2020 Programme is the management of waste as a resource. To achieve this purpose for C & DW, a detailed analysis of the properties of these materials should be done. In this work we report the physical, chemical and environmental properties of C & DW aggregates from 25 different origins. The results are compared with those of common natural aggregates used in construction. Assays were performed according to European Standards. Additional analysis of heavy metals and organic compounds such as polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls (PCBs), were performed to evaluate their environmental impact. Finally, properties of concrete prepared with C & DW aggregates are also reported. Physical analyses of C & DW aggregates indicated lower quality properties than natural aggregates, particularly for concrete preparation and unbound layers of road pavements. Chemical properties showed that most samples (80%) meet the values required by European regulations for concrete and unbound layers of road pavements. Analyses of heavy metals Cd, Cr, Cu, Pb, Ni, Mo and Zn in the C&DW leachates showed levels below the limits established by the Council Decision of 19 December 2002. Identification and quantification of PCBs and PAHs indicated that few samples shows the presence of these compounds. The measured levels of PCBs and PAHs are also below the limits. Other compounds identified in the C&DW leachates include phthalates and diphenylmethanol. In conclusion, the characterized C&DW aggregates show lower quality properties than natural aggregates but most samples showed to be environmentally safe. A continuous monitoring of the presence of heavy metals and organic compounds should be made to trial safe C&DW aggregates. C&DW aggregates provide a good economic and environmental alternative to natural aggregates.

Keywords: concrete preparation, construction and demolition waste, heavy metals, organic pollutants

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Authors: Sumia Fatima, Tayyaba Idrees

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Cardiac Arrest and Heart Failures are an important causes of mortality in developed and developing countries and even a second spent without Cardiopulmonary Resuscitation (CPR) increases the risk of mortality. Youngs doctors are expected to partake in CPR from the first day and if they are not taught basic life support (BLS) skills during their studies. They have next to no opportunity to learn them in clinical settings. To determine the exact level of knowledge of Basic Life Support among medical students. To compare the degree of knowledge among 1st and 2nd year medical students of RMU (Rawalpindi Medical University), using self-structured questionnaires. A cross sectional, qualitative primary study was conducted in March 2020 in order to analyse theoretical and practical knowledge of Basic Life Support among Medical Students of 1st and 2nd year MBBS. Self-Structured Questionnaires were distributed among 300 students, 150 from 1st year and 150 from 2nd year. Data was analysed using SPSS v 22. Chi Square test was employed. The results showed that only 13 (4%) students had received formal BLS training.129 (42%) students had encountered accidents in real life but had not known how to react. Majority responded that Basic Life Support should be made part of medical college curriculum (189 students), 194 participants (64%) had moderate knowledge of both theoretical and practical aspects of BLS. 75-80% students of both 1st and 2nd year had only moderate knowledge, which must be improved for them to be better healthcare providers in future. It was also found that male students had more practical knowledge than females, but both had almost the same proficiency in theoretical knowledge. The study concluded that the level of knowledge of BLS among the students was not up to the mark, and there is a dire need to include BLS training in the medical colleges’ curriculum.

Keywords: basic cardiac life support, cardiac arrest, awareness, medical students

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Authors: Hanen Khanchel, Karim Ben Kahla

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Pharmaceutical companies are facing competition. Indeed, the price differences between competing products can be such that it becomes difficult to compensate them by differences in value added. The conditions of competition are no longer homogeneous for the players involved. The price of a product is a given that puts a company and its customer face to face. However, price fixing obliges the company to consider internal factors relating to production costs and external factors such as customer attitudes, the existence of regulations and the structure of the market on which the firm evolved. In setting the selling price, the company must first take into account internal factors relating to its costs: costs of production fall into two categories, fixed costs and variable costs that depend on the quantities produced. The company cannot consider selling below what it costs the product. It, therefore, calculates the unit cost of production to which it adds the unit cost of distribution, enabling it to know the unit cost of production of the product. The company adds its margin and thus determines its selling price. The margin is used to remunerate the capital providers and to finance the activity of the company and its investments. Production costs are related to the quantities produced: large-scale production generally reduces the unit cost of production, which is an asset for companies with mass production markets. This shows that small and medium-sized companies with limited market segments need to make greater efforts to ensure their profit margins. As a result, and faced with high and low market prices for raw materials and increasing staff costs, the company must seek to optimize its production time in order to reduce loads and eliminate waste. Then, the customer pays only value added. Thus, and based on this principle we decided to create a project that deals with the problem of waste in our company, and having as objectives the reduction of production costs and improvement of performance indicators. This paper presents the implementation of the Value Stream Mapping (VSM) project in a pharmaceutical company. It is structured as follows: 1) determination of the family of products, 2) drawing of the current state, 3) drawing of the future state, 4) action plan and implementation.

Keywords: VSM, waste, production time, kaizen, cartography, improvement

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Authors: Blessings Masuku

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Background: Considering that Africa is urbanizing faster than any other region globally, managing cities in the global South has become the centerpiece for the New Urban Agenda (i.e., a shared vision of how we rethink, rebuild, and manage our cities for a better and more sustainable future). This study is centered on governance and planning of urban informality practices with particular reference to the relationship between the state, informal actors (e.g., informal traders and informal dwellers), and other city stakeholders who are public space users (commuters, businesses, and environmental activists), and how informal actors organize themselves to lobby the state and claim for their rights in the city, and how they navigate their everyday livelihood strategies. Aim: The purpose of this study is to examine and interrogate contemporary approaches, policy and regulatory frameworks to urban spatial planning and management of informality in one of South Africa’s busiest and major cities, Johannesburg. Setting: The study uses the metropolitan region of the city of Johannesburg, South Africa to understand how this contemporary industrial city manages urban informality practices, including the use of public space, land zoning and street life, and paying a closer look at what progress has been made and gaps in their inclusive urban policy frameworks. Methods: This study utilized a qualitative approach that includes surveys (open-ended questions), archival research (i., e policy and other key document reviews), and key interviews mainly with city officials, and informality actors. A thematic analysis was used to analyze the data collected. Contribution: This study contributes to large urban informality scholarship in the global South cities by exploring how major cities particularly in Africa regulate and manage informality patterns and practices in their quest to build “utopian” smart cities. This study also brings a different perspective on the hacking ways used by the informal actors to resist harsh regulations and remain invisible in the city, which is something that previous literature has barely delved in-depth.

Keywords: inclusive planning and governance, infrastructure systems, livelihood strategies urban informality, urban space

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Authors: Harsh Agarwal, Pratikkumar Patel, Maharshi Pathak

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Recently the low prices of Crude oil and increase in strict environmental regulations limit limits the use of diesel based muds as these muds are relatively costlier and toxic, as a result disposal of cuttings into the eco-system is a major issue faced by the drilling industries. To overcome these issues faced by the Oil Industry, an attempt has been made to develop oil-in-water emulsion mud system using nettlespurge oil. Nettlespurge oil could be easily available and its cost is around ₹30/litre which is about half the price of diesel in India. Oil-based mud (OBM) was formulated with Nettlespurge oil extracted from Nettlespurge seeds using the Soxhlet extraction method. The formulated nettlespurge oil mud properties were analysed with diesel oil mud properties. The compared properties were rheological properties, yield point and gel strength, and mud density and filtration loss properties, fluid loss and filter cake. The mud density measurement showed that nettlespurge OBM was slightly higher than diesel OBM with mud density values of 9.175 lb/gal and 8.5 lb/gal, respectively, at barite content of 70 g. Thus it has a higher lubricating property. Additionally, the filtration loss test results showed that nettlespurge mud fluid loss volumes, oil was 11 ml, compared to diesel oil mud volume of 15 ml. The filtration loss test indicated that the nettlespurge oil mud with filter cake thickness of 2.2 mm had a cake characteristic of thin and squashy while the diesel oil mud resulted in filter cake thickness of 2.7 mm with cake characteristic of tenacious, rubbery and resilient. The filtration loss test results showed that nettlespurge oil mud fluid loss volumes was much less than the diesel based oil mud. The filtration loss test indicated that the nettlespurge oil mud filter cake thickness less than the diesel oil mud filter cake thickness. So Low formation damage and the emulsion stability effect was analysed with this experiment. The nettlespurge oil-in-water mud system had lower coefficient of friction than the diesel oil based mud system. All the rheological properties have shown better results relative to the diesel based oil mud. Therefore, with all the above mentioned factors and with the data of the conducted experiment we could conclude that the Nettlespurge oil based mud is economically and well as eco-logically much more feasible than the worn out and shabby diesel-based oil mud in the Drilling Industry.

Keywords: economical feasible, ecological feasible, emulsion stability, nettle spurge oil, rheological properties, soxhlet extraction method

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Authors: Christin Koch, Andreas Winkel, Martin Kahlmeyer, Stefan Böhm

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Due to environmental regulations on greenhouse gas emissions and the depletion of fossil fuels, there is an increasing interest in electric vehicles.To maximize their driving range, batteries with high storage capacities are needed. In most electric cars, rechargeable lithium-ion batteries are used because of their high energy density. However, it has to be taken into account that these batteries generate a large amount of heat during the charge and discharge processes. This leads to a decrease in a lifetime and damage to the battery cells when the temperature exceeds the defined operating range. To ensure an efficient performance of the battery cells, reliable thermal management is required. Currently, the cooling is achieved by heat sinks (e.g., cooling plates) bonded to the battery cells with a thermally conductive adhesive (TCA) that directs the heat away from the components. Especially when large amounts of heat have to be dissipated spontaneously due to peak loads, the principle of heat conduction is not sufficient, so attention must be paid to the mechanism of heat storage. An efficient method to store thermal energy is the use of phase change materials (PCM). Through an isothermal phase change, PCM can briefly absorb or release thermal energy at a constant temperature. If the phase change takes place in the transition from solid to liquid, heat is stored during melting and is released to the ambient during the freezing process upon cooling. The presented work displays the great potential of thermally conductive adhesives filled with microencapsulated PCM to limit peak temperatures in battery systems. The encapsulation of the PCM avoids the effects of aging (e.g., migration) and chemical reactions between the PCM and the adhesive matrix components. In this study, microencapsulation has been carried out by in situ polymerization. The microencapsulated PCM was characterized by FT-IR spectroscopy, and the thermal properties were measured by DSC and laser flash method. The mechanical properties, electrical and thermal conductivity, and adhesive toughness of the TCA/PCM composite were also investigated.

Keywords: phase change material, microencapsulation, adhesive bonding, thermal management

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Authors: Chaliya Wamaloon, Malee Chaisaena, Nusara Prasertsri

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Informal caregivers providing home-based palliative and end-of-life (EOL) care to people with advanced cancer is needed, however, there has not been develop caregiver skills for the EOL in cancer patients. The aim of this research was to study the model development of caregiver skills for the EOL in cancer patients. Mixed methods research was conducted in 3 phases. All subjects were in Ubon Rathchathani Cancer Hospital including 30 EOL cancer patient caregivers, 30 EOL cancer patients, and 111 health care professionals who provided care for the EOL cancer patients and 30 EOL target participants who had been trained to be cancer patient caregivers. The research tools were questionnaires, semi structured interviews, and caregiver skills questionnaires. Data were analyzed by using percentage, mean, standard deviation, pair t-test, and content analysis. The result from this study showed the model development of caregiver skills for cancer patients consisted of 9 domains skills: 1. monitoring, 2. interpreting, 3. making decisions, 4. taking action, 5. making adjustments, 6. providing hands-on care, 7. accessing resources, 8. working together with the ill patients, and 9. navigating the healthcare system. The model composed of skills development curriculum for cancer patient caregivers, Manual of palliative care for caregivers, diary of health care records for cancer patients, and the evaluation model of development of caregiver skills for EOL cancer patients. The results of the evaluation in the development model of caregiver skills for EOL cancer patients showed that the caregivers were satisfied with the model of development for caregiver skills at a high level. The comparison of the caregiver skills before and after obtaining the development of caregivers skills revealed that it improved at a statistically significant level (p < 0.05).

Keywords: caregiver, caregiver skills, cancer patients, end of life

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Authors: Sulaiman Al-Hinai, Setyawan Widyarto

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The aim of this study is to identify the critically dominating factors on the delays of road constructions in the GCC countries and their effects on project delivery in Arab countries. Towards the achieved of the objectives the study used the empirical literature from the all relevant online sources and database as many as possible. The findings of this study have summarized and short listed of the success factors in the two categories such as internal and external factors have caused to be influenced to delay of road constructions in the Arab regions. However, in the category of internal factors, there are 63 factors short listed from seven group of factors which has revealed to effects on the delay of road constructions especially, the consultant related factors, the contractor related factors, designed related factors, client related factors, labor related factors, material related issues, equipment related issues respectively. Moreover, for external related factors are also considered to summarized especially natural disaster (flood, hurricanes and cyclone etc.), conflict, war, global financial crisis, compensation delay to affected property owner, price fluctuated, unexpected ground conditions (soil and high-water level), changing of government regulations and laws, delays in obtaining permission from municipality, loss of time by traffic control and restrictions at job site, problem with inhabitant of community, delays in providing service from utilities (water and electricity’s) and accident during constructions accordingly. The present study also concluded the effects of above factors which has delay road constructions through increasing of cost and overrun it, taken overtime, creating of disputes, going for lawsuits, finally happening of abandon of projects. Thus, the present study has given the following recommendations to overcome of above problems by increasing of detailed site investigations, ensure careful monitoring and regular meetings, effective site management, collaborative working and effective coordination’s, proper and comprehensive planning and scheduling and ensure full and intensive commitment from all parties accordingly.

Keywords: Arab GCC countries, critical success factors, road constructions delay, project management

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Authors: Sarmin, S., Ologuin, R.S.

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Background: Rapid population growth and land constraints in Singapore results in a possible situation in which we face a higher number of casualties and lack of operational space in healthcare facilities during disasters and HAZMAT events, collectively known as Civil Emergencies. This creates a need for available working space within hospital grounds to be amphibious or multi-functional, to ensure the institution’s capability to respond efficiently to Civil Emergencies. The Emergency Department (ED) mitigates this issue by converting the Ambulance Assembly Area used during peacetime into an Open Decontamination Facility (ODF) during Civil Emergency Response, for decontamination of casualties before they proceed to treatment areas into Ambulance Assembly Area used during peacetime. Aims: To effectively operationalize the Open Decontamination Facility (ODF) through the reduction of manual handling. Methods: From past experiences on Civil Emergency exercises, it was labor-intensive for staff to set up the Open Decontamination Facility (ODF). Manual handling to set up the Decontamination lanes by bringing down the curtains and supply of water was required to be turned on. Conclusion: The effectiveness of the design construction of an Open Decontamination Facility (ODF) is based on the use of automation of bringing down the curtains on the various lanes. The use of control panels for water supply to decontaminate patients. Safety within the ODF was considered with the installation of panic buttons, intercom for staff communication, and perimeter curtains were installed with stability arm to manage the condition with high wind velocity.

Keywords: civil emergencies, disaster, emergency department, Hazmat

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Authors: Atul Khurana, Rajul Rastogi, Hans-Joachim Gamperl

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The pharmaceutical companies are getting more inclined towards patient support programs (PSPs) which assist patients and/or healthcare professionals (HCPs) in more desirable disease management and cost-effective treatment. The utmost objective of these programs is patient care. The PSPs may include financial assistance to patients, medicine compliance programs, access to HCPs via phone or online chat centers, etc. The PSP has a crucial role in terms of customer acquisition and retention strategies. During the conduct of these programs, Marketing Authorisation Holder (MAH) may receive information related to concerned medicinal products, which is usually reported by patients or involved HCPs. This information may include suspected adverse reaction(s) during/after administration of medicinal products. Hence, the MAH should design PSP to comply with regulatory reporting requirements and avoid non-compliance during PV inspection. The emergence of wireless health devices is lowering the burden on patients to manually incorporate safety data, and building a significant option for patients to observe major swings in reference to drug safety. Therefore, to enhance the adoption of these programs, MAH not only needs to aware patients about advantages of the program, but also recognizes the importance of time of patients and commitments made in a constructive manner. It is indispensable that strengthening the public health is considered as the topmost priority in such programs, and the MAH is compliant to Pharmacovigilance (PV) requirements along with regulatory obligations.

Keywords: drug safety, good pharmacovigilance practice, patient support program, pharmacovigilance

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Authors: Joy Debski

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Due to the varying degrees of the problem posed by global warming, environmental sustainability dominates international discourse. International initiatives' aims and expectations have proven particularly challenging to put into practice in developing nations. To reduce human exploitation of the environment, stricter measures are urgently needed. However, putting them into practice has proven more difficult. Relatively recent information from the Climate Accountability Institute and academic researchers shows that fossil fuel companies are major contributors to the climate crisis. Host communities in oil and gas-producing areas, particularly in developing nations, have grown hostile toward both oil and gas companies and government policies. It is now essential that the three main stakeholders—government, the oil and gas sector, and host communities—cooperate to achieve the shared objective of environmental sustainability. This research, therefore, advocates a governance system for Nigeria that facilitates the achieving the goal of environmental sustainability. This objective is achieved by the research's examination of the main institutional framework for environmental sustainability, evaluation of the strategies used by major oil companies to increase stakeholder engagement in environmental sustainability, and examination of the involvement of host communities in environmental sustainability. The study reveals that while environmental sustainability is important to the identified stakeholders, it's challenging to accomplish without an informed synergy. Hence the research advocates the centralisation of CSR through a CSR commission for environmental sustainability. The commission’s mandate is to facilitate, partner with, and endorse companies. The commission is strongly advised to incorporate host community liaison offices into the process of negotiating contracts with oil and gas firms, as well as to play a facilitative role in helping firms adhere to both domestic and international regulations. The recommendations can benefit Nigerian policymakers in enhancing their unsuccessful efforts to pass CSR legislation. Through the research-proposed CSR department, which has competent training and stakeholder engagement strategies, oil and gas companies can enhance and centralise their goals for environmental sustainability. Finally, the CSR Commission's expertise would give host communities more leverage when negotiating their memorandum of understanding with oil and gas companies.

Keywords: environmental sustainability, corporate social responsibility, CSR, oil and gas, nigeria

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