Search results for: nursing interventions classification

Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

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Obesity-related health conditions impose a substantial economic burden on payers due to increased healthcare use. Estimates of healthcare resource use and costs associated with obesity-related comorbidities are needed to inform policies and interventions targeting these conditions. Methods: Adults living with obesity were identified (a procedure-related body mass index code for class 2/3 obesity between 2012 and 2019 in Alberta, Canada; excluding those with bariatric surgery), and outcomes were compared over 1-year (2019/2020) between those who had and did not have specific obesity-related comorbidities. The probability of using a healthcare service (based on the odds ratio of a zero [OR-zero] cost) was compared; 95% confidence intervals (CI) were reported. Logistic regression and a generalized linear model with log link and gamma distribution were used for total healthcare cost comparisons ($CDN); cost ratios and estimated cost differences (95% CI) were reported. Potential socio-demographic and clinical confounders were adjusted for, and incremental cost differences were representative of a referent case. Results: A total of 220,190 adults living with obesity were included; 44% had hypertension, 25% had osteoarthritis, 24% had type-2 diabetes, 17% had cardiovascular disease, 12% had insulin resistance, 9% had chronic back pain, and 4% of females had polycystic ovarian syndrome (PCOS). The probability of hospitalization, ED visit, and ambulatory care was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (hospitalization: 1.8-times [OR-zero: 0.57 [0.55/0.59]] / ED visit: 1.9-times [OR-zero: 0.54 [0.53/0.56]] / ambulatory care visit: 2.4-times [OR-zero: 0.41 [0.40/0.43]]), cardiovascular disease (2.7-times [OR-zero: 0.37 [0.36/0.38]] / 1.9-times [OR-zero: 0.52 [0.51/0.53]] / 2.8-times [OR-zero: 0.36 [0.35/0.36]]), osteoarthritis (2.0-times [OR-zero: 0.51 [0.50/0.53]] / 1.4-times [OR-zero: 0.74 [0.73/0.76]] / 2.5-times [OR-zero: 0.40 [0.40/0.41]]), type-2 diabetes (1.9-times [OR-zero: 0.54 [0.52/0.55]] / 1.4-times [OR-zero: 0.72 [0.70/0.73]] / 2.1-times [OR-zero: 0.47 [0.46/0.47]]), hypertension (1.8-times [OR-zero: 0.56 [0.54/0.57]] / 1.3-times [OR-zero: 0.79 [0.77/0.80]] / 2.2-times [OR-zero: 0.46 [0.45/0.47]]), PCOS (not significant / 1.2-times [OR-zero: 0.83 [0.79/0.88]] / not significant), and insulin resistance (1.1-times [OR-zero: 0.88 [0.84/0.91]] / 1.1-times [OR-zero: 0.92 [0.89/0.94]] / 1.8-times [OR-zero: 0.56 [0.54/0.57]]). After fully adjusting for potential confounders, the total healthcare cost ratio was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (1.54-times [1.51/1.56]), cardiovascular disease (1.45-times [1.43/1.47]), osteoarthritis (1.36-times [1.35/1.38]), type-2 diabetes (1.30-times [1.28/1.31]), hypertension (1.27-times [1.26/1.28]), PCOS (1.08-times [1.05/1.11]), and insulin resistance (1.03-times [1.01/1.04]). Conclusions: Adults with obesity who have specific disease-related health conditions have a higher probability of healthcare use and incur greater costs than those without specific comorbidities; incremental costs are larger when other obesity-related health conditions are not adjusted for. In a specific referent case, hypertension was costliest (44% had this condition with an additional annual cost of $715 [$678/$753]). If these findings hold for the Canadian population, hypertension in persons with obesity represents an estimated additional annual healthcare cost of $2.5 billion among adults living with obesity (based on an adult obesity rate of 26%). Results of this study can inform decision making on investment in interventions that are effective in treating obesity and its complications.

Keywords: administrative data, healthcare cost, obesity-related comorbidities, real world evidence

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Authors: Gagnesh Kumar, Nitin Gupta

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Ternary Content Addressable Memory cells are mainly popular in network routers for packet forwarding and packet classification, but they are also useful in a variety of other applications that require high-speed table look-up. The main TCAM-design challenge is to decrease the power consumption associated with the large amount of parallel active circuitry, without compromising with speed or memory density. Furthermore, when the channel length decreases, leakage power becomes more significant, and it can even dominate dynamic power at lower technologies. In this paper, we propose a TCAM-design technique, called Virtual Power Supply technique that reduces the leakage by a substantial amount.

Keywords: match line (ML), search line (SL), ternary content addressable memory (TCAM), Leakage power (LP)

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Authors: Michel Kulhandjian, Dimitris A. Pados

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The objective of this work is to develop a theoretical framework for reliable digital recording system identification from digital audio files alone, for forensic purposes. A digital recording system consists of a microphone and a digital sound processing card. We view the cascade as a system of unknown transfer function. We expect same manufacturer and model microphone-sound card combinations to have very similar/near identical transfer functions, bar any unique manufacturing defect. Input voice (or other) signals are modeled as non-stationary processes. The technical problem under consideration becomes blind deconvolution with non-stationary inputs as it manifests itself in the specific application of digital audio recording equipment classification.

Keywords: blind system identification, audio fingerprinting, blind deconvolution, blind dereverberation

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Authors: Imalka Wasana Rathnayaka, Rasheda Khanam, Mohammad Mafizur Rahman

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TheCOVID-19 pandemic has created unprecedented challenges to both the health and economic states in countries around the world. This study aims to evaluate the effectiveness of governments' decisions to mitigate the risks of COVID-19 through proposing policy directions to reduce its magnitude. The study is motivated by the ongoing coronavirus outbreaks and comprehensive policy responses taken by countries to mitigate the spread of COVID-19 and reduce death rates. This study contributes to filling the knowledge by exploiting the long-term efficacy of extensive plans of governments. This study employs a Panel autoregressive distributed lag (ARDL) framework. The panels incorporate both a significant number of variables and fortnightly observations from22 countries. The dependent variables adopted in this study are the fortnightly death rates and the rates of the spread of COVID-19. Mortality rate and the rate of infection data were computed based on the number of deaths and the number of new cases per 10000 people.The explanatory variables are fortnightly values of indexes taken to investigate the efficacy of government interventions to control COVID-19. Overall government response index, Stringency index, Containment and health index, and Economic support index were selected as explanatory variables. The study relies on the Oxford COVID-19 Government Measure Tracker (OxCGRT). According to the procedures of ARDL, the study employs (i) the unit root test to check stationarity, (ii) panel cointegration, and (iii) PMG and ARDL estimation techniques. The study shows that the COVID-19 pandemic forced immediate responses from policymakers across the world to mitigate the risks of COVID-19. Of the four types of government policy interventions: (i) Stringency and (ii) Economic Support have been most effective and reveal that facilitating Stringency and financial measures has resulted in a reduction in infection and fatality rates, while (iii) Government responses are positively associated with deaths but negatively with infected cases. Even though this positive relationship is unexpected to some extent in the long run, social distancing norms of the governments have been broken by the public in some countries, and population age demographics would be a possible reason for that result. (iv) Containment and healthcare improvements reduce death rates but increase the infection rates, although the effect has been lower (in absolute value). The model implies that implementation of containment health practices without association with tracing and individual-level quarantine does not work well. The policy implication based on containment health measures must be applied together with targeted, aggressive, and rapid containment to extensively reduce the number of people infected with COVID 19. Furthermore, the results demonstrate that economic support for income and debt relief has been the key to suppressing the rate of COVID-19 infections and fatality rates.

Keywords: COVID-19, infection rate, deaths rate, government response, panel data

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Authors: Jialin Wu, Zhiwei Lian, Jieyu Tang, Jingyun Shen

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Tornado is a serious and unpredictable natural disaster, which has an important impact on people's production and life. The probability of being hit by tornadoes in China was analyzed considering the principles of tornado formation. Then some suggestions on layout and shapes for newly-built buildings were provided combined with the characteristics of tornado wind fields. Fuzzy clustering and inverse closeness methods were used to evaluate the probability levels of tornado risks in various provinces based on classification and ranking. GIS was adopted to display the results. Finally, wind field single-vortex tornado was studied to discuss the optimized design of rural low-rise houses in Yancheng, Jiangsu as an example. This paper may provide enough data to support building and urban design in some specific regions.

Keywords: tornado probability, computational fluid dynamics, fuzzy mathematics, optimal design

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Authors: Silvia Portarena, Chiara Anselmi, Chiara Baldacchini, Enrico Brugnoli

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Extra virgin olive oil (EVOO) is a complex matrix mainly composed by fatty acid and other minor compounds, among which carotenoids are well known for their antioxidative function that is a key mechanism of protection against cancer, cardiovascular diseases, and macular degeneration in humans. EVOO composition in terms of such constituents is generally the result of a complex combination of genetic, agronomical and environmental factors. To selectively improve the quality of EVOOs, the role of each factor on its biochemical composition need to be investigated. By selecting fruits from four different cultivars similarly grown and harvested, it was demonstrated that Raman spectroscopy, combined with chemometric analysis, is able to discriminate the different cultivars, also as a function of the harvest date, based on the relative content and composition of fatty acid and carotenoids. In particular, a correct classification up to 94.4% of samples, according to the cultivar and the maturation stage, was obtained. Moreover, by using gas chromatography and high-performance liquid chromatography as reference techniques, the Raman spectral features further allowed to build models, based on partial least squares regression, that were able to predict the relative amount of the main fatty acids and the main carotenoids in EVOO, with high coefficients of determination. Besides genetic factors, climatic parameters, such as light exposition, distance from the sea, temperature, and amount of precipitations could have a strong influence on EVOO composition of both major and minor compounds. This suggests that the Raman spectra could act as a specific fingerprint for the geographical discrimination and authentication of EVOO. To understand the influence of environment on EVOO Raman spectra, samples from seven regions along the Italian coasts were selected and analyzed. In particular, it was used a dual approach combining Raman spectroscopy and isotope ratio mass spectrometry (IRMS) with principal component and linear discriminant analysis. A correct classification of 82% EVOO based on their regional geographical origin was obtained. Raman spectra were obtained by Super Labram spectrometer equipped with an Argon laser (514.5 nm wavelenght). Analyses of stable isotope content ratio were performed using an isotope ratio mass spectrometer connected to an elemental analyzer and to a pyrolysis system. These studies demonstrate that RR spectroscopy is a valuable and useful technique for the analysis of EVOO. In combination with statistical analysis, it makes possible the assessment of specific samples’ content and allows for classifying oils according to their geographical and varietal origin.

Keywords: authentication, chemometrics, olive oil, raman spectroscopy

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Authors: Natalia Espinosa, Arthur Amorim, Rudolf Huebner

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Epilepsy is a chronic neural disease and around 50 million people in the world suffer from this disease, however, in many cases, the individual acquires resistance to the medication, which is known as drug-resistant epilepsy, where a detection system is necessary. This paper showed the development of an automatic system for seizure detection based on artificial neural networks (ANN), which are common techniques of machine learning. Discrete Wavelet Transform (DWT) is used for decomposing electroencephalogram (EEG) signal into main brain waves, with these frequency bands is extracted features for training a feedforward neural network with backpropagation, finally made a pattern classification, seizure or non-seizure. Obtaining 95% accuracy in epileptic EEG and 100% in normal EEG.

Keywords: Artificial Neural Network (ANN), Discrete Wavelet Transform (DWT), Epilepsy Detection , Seizure.

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Authors: Kaveh Shahi, Helmi Z. M. Shafri, Ebrahim Taherzadeh

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In remote sensing, shadow causes problems in many applications such as change detection and classification. It is caused by objects which are elevated, thus can directly affect the accuracy of information. For these reasons, it is very important to detect shadows particularly in urban high spatial resolution imagery which created a significant problem. This paper focuses on automatic shadow detection based on a new spectral index for multispectral imagery known as Shadow Detection Index (SDI). The new spectral index was tested on different areas of World-View 2 images and the results demonstrated that the new spectral index has a massive potential to extract shadows effectively and automatically.

Keywords: spectral index, shadow detection, remote sensing images, World-View 2

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Authors: Meenu S. Babu, K. Jayasankara Reddy

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Depression is a serious mental health concern that leads to significant distress and dysfunction in an individual. Due to the high physical, psychological, social, and economic burden it causes, it is important to study various bio-psycho-social factors that influence the onset, course, duration, intensity of depressive symptoms. The study aims to explore relationship between autobiographical memory (AM) functions, perceived control over stressful events and depressive symptoms. AM functions and perceived control were both found to be protective factors for individuals against depression and were both modifiable to predict better behavioral and affective outcomes. An extensive review of literatur, with a systematic search on Google Scholar, JSTOR, Science Direct and Springer Journals database, was conducted for the purpose of this review paper. These were used for all the aforementioned databases. The time frame used for the search was 2010-2021. An additional search was conducted with no time bar to map the development of the theoretical concepts. The relevant studies with quantitative, qualitative, experimental, and quasi- experimental research designs were included for the review. Studies including a sample with a DSM- 5 or ICD-10 diagnosis of depressive disorders were excluded from the study to focus on the behavioral patterns in a non-clinical population. The synthesis of the findings that were obtained from the review indicates there is a significant relationship between cognitive variables of AM functions and perceived control and depressive symptoms. AM functions were found to be have significant effects on once sense of self, interpersonal relationships, decision making, self- continuity and were related to better emotion regulation and lower depressive symptoms. Not all the components of AM function were equally significant in their relationships with various depressive symptoms. While self and directive functions were more related to emotion regulation, anhedonia, motivation and hence mood and affect, the social function was related to perceived social support and social engagement. Perceived control was found to be another protective cognitive factor that provides individuals a sense of agency and control over one’s life outcomes which was found to be low in individuals with depression. This was also associated to the locus of control, competency beliefs, contingency beliefs and subjective well being in individuals and acted as protective factors against depressive symptoms. AM and perceived control over stressful events serve adaptive functions, hence it is imperative to study these variables more extensively. They can be imperative in planning and implementing therapeutic interventions to foster these cognitive protective factors to mitigate or alleviate depressive symptoms. Exploring AM as a determining factor in depressive symptoms along with perceived control over stress creates a bridge between biological and cognitive factors underlying depression and increases the scope of developing a more eclectic and effective treatment plan for individuals. As culture plays a crucial role in AM functions as well as certain aspects of control such as locus of control, it is necessary to study these variables keeping in mind the cultural context to tailor culture/community specific interventions for depression.

Keywords: autobiographical memories, autobiographical memory functions, perceived control, depressive symptoms, depression, young adults

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Authors: Nadeesha Sewwandi, Dilini Shashikala, R. Kanapathy, S. Viyasan, R. M. S. Kumara, Duminda Guruge

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Early childhood development is important to the emotional, social, and physical development of young children and it has a direct effect on their overall development and on the adult they become. Play is so important to optimal child developments including skill development, social development, imagination, creativity and it fulfills a baby’s inborn need to learn. So, health promotion approach empowers people about the development of early childhood. Play area is a new concept and this study focus how this play areas helps to the development of early childhood of children in rural villages in Sri Lanka. This study was conducted with a children society in a rural village called Welankulama in Sri Lanka. Survey was conducted with children society about emotional, social and physical development of young children (Under age eight) in this village using questionnaires. It described most children under eight years age have poor level of emotional, social and physical development in this village. Then children society wanted to find determinants for this problem and among them they prioritized determinants like parental interactions, learning environment and social interaction and address them using an innovative concept called play area. In this village there is a common place as play area under a big tamarind tree. It consists of a playhouse, innovative playing toys, mobile library, etc. Twice a week children, parents, grandparents gather to this nice place. Collective feeding takes place in this area once a week and it was conducted by several mothers groups in this village. Mostly grandparents taught about handicrafts and this is a very nice place to share their experiences with all. Healthy competitions were conducted in this place through playing to motivate the children. Happy calendar (mood of the children) was marked by children before and after coming to the play area. In terms of results qualitative changes got significant place in this study. By learning about colors and counting through playing the thinking and reasoning skills got developed among children. Children were widening their imagination by means of storytelling. We observed there were good developments of fine and gross motor skills of two differently abled children in this village. Children learn to empathize with other people, sharing, collaboration, team work and following of rules. And also children gain knowledge about fairness, through role playing, obtained insight on the right ways of displaying emotions such as stress, fear, anger, frustration, and develops knowledge of how they can manage their feelings. The reading and writing ability of the children got improved by 83% because of the mobile library. The weight of children got increased by 81% in the village. Happiness was increased by 76% among children in the society. Playing is very important for learning during early childhood period of a person. Health promotion interventions play a major role to the development of early childhood and it help children to adjust to the school setting and even to enhance children’s learning readiness, learning behaviors and problem solving skills.

Keywords: early childhood development, health promotion approach, play and learning, working with children

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Authors: Alejandra Sierra, Gloria Valadez, Adriana Dávalos, Mirliana Ramírez

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For years, the Pan American Health Organization/World Health Organization and other organizations have made efforts to the improve access and the quality of prenatal care as part of comprehensive programs for maternal and neonatal health, the standards of care have been renewed in order to migrate from a medical perspective to a holistic perspective. However, despite the efforts currently antenatal care models have not been verified by a scientific evaluation in order to determine their effectiveness. The teenage pregnancy is considered as a very important phenomenon since it has been strongly associated with inequalities, poverty and the lack of gender quality; therefore it is important to analyze the antenatal care that’s been given, including not only the clinical intervention but also the activities surrounding the advertising and the health education. In this study, the objective was to describe if the previously established activities (on the prenatal care models) are being performed in the care of pregnant teenagers attending prenatal care in health institutions in two cities in México and Chile during 2013. Methods: Observational and descriptive study, of a transversal cohort. 170 pregnant women (13-19 years) were included in prenatal care in two health institutions (100 women from León-Mexico and 70 from Chile-Coquimbo). Data collection: direct survey, perinatal clinical record card which was used as checklists: WHO antenatal care model WHO-2003, Official Mexican Standard NOM-007-SSA2-1993 and Personalized Service Manual on Reproductive Process- Chile Crece Contigo; for data analysis descriptive statistics were used. The project was approved by the relevant ethics committees. Results: Regarding the fulfillment of interventions focused on physical, gynecological exam, immunizations, monitoring signs and biochemical parameters in both groups was met by more than 84%; the activities of guidance and counseling pregnant teenagers in Leon compliance rates were below 50%, on the other hand, although pregnant women in Coquimbo had a higher percentage of compliance, no one reached 100%. The topics that less was oriented were: family planning, signs and symptoms of complications and labor. Conclusions: Although the coverage of the interventions indicated in the prenatal care models was high, there were still shortcomings in the fulfillment of activities to orientation, education and health promotion. Deficiencies in adherence to prenatal care guidelines could be due to different circumstances such as lack of registration or incomplete filling of medical records, lack of medical supplies or health personnel, absences of people at prenatal check-up appointments, among many others. Therefore, studies are required to evaluate the quality of prenatal care and the effectiveness of existing models, considering the role of the different actors (pregnant women, professionals and health institutions) involved in the functionality and quality of prenatal care models, in order to create strategies to design or improve the application of a complete process of promotion and prevention of maternal and child health as well as sexual and reproductive health in general.

Keywords: adolescent health, health systems, maternal health, primary health care

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Authors: Carlos Huertas, Reyes Juarez-Ramirez

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Public health is one of the most critical issues today; therefore, there is great interest to improve technologies in the area of diseases detection. With machine learning and feature selection, it has been possible to aid the diagnosis of several diseases such as cancer. In this work, we present an extension to the Heat Map Based Feature Selection algorithm, this modification allows automatic threshold parameter selection that helps to improve the generalization performance of high dimensional data such as mass spectrometry. We have performed a comparison analysis using multiple cancer datasets and compare against the well known Recursive Feature Elimination algorithm and our original proposal, the results show improved classification performance that is very competitive against current techniques.

Keywords: biomarker discovery, cancer, feature selection, mass spectrometry

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Authors: C. M. Priesnitz, G. Zanandrea, J. P. Fabris, S. L. Russo, M. E. Camargo

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This study aimed to the prospection the physiotherapy area technological production registered with the National Intellectual Property Institute (INPI) in Brazil, for understand the evolution of the technological production in the country over time and visualize the distribution this production request in Brazil. There was an evolution in the technology landscape, where the average annual deposits had an increase of 102%, from 3.14 before the year 2004 to 6,33 after this date. It was found differences in the distribution of the number the deposits requested to each Brazilian region, being that of the 132 request, 68,9% were from the southeast region. The international patent classification evaluated the request deposits, and the more found numbers were A61H and A63B. So even with an improved panorama of technology production, this should still have incentives since it is an important tool for the development of the country.

Keywords: distribution, evolution, patent, physiotherapy, technological prospecting

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Authors: Daleesha M. Viswanathan, Sumam Mary Idicula

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Dynamic hand gestures are an intrinsic component in sign language communication. Extracting spatial temporal features of the hand gesture trajectory plays an important role in a dynamic gesture recognition system. Finding a discrete feature descriptor for the motion trajectory based on the orientation feature is the main concern of this paper. Kalman filter algorithm and Hidden Markov Models (HMM) models are incorporated with this recognition system for hand trajectory tracking and for spatial temporal classification, respectively.

Keywords: orientation features, discrete feature vector, HMM., Indian sign language

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Authors: Hannah M. Russell

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‘The Attach Project’ (TAP), is an educational intervention aimed at improving educational and socio-emotional outcomes for children who are looked after. TAP is underpinned by Attachment Theory and is adapted from Dyadic Developmental Psychotherapy (DDP), which is a treatment for children and young people impacted by complex trauma and disorders of attachment. TAP has been implemented in primary schools in Northern Ireland throughout the 2018/19 academic year. During this time, a design and implementation study has been conducted to assess the promise of effectiveness for the future dissemination and ‘scaling-up’ of the programme for a larger, randomised control trial. TAP has been designed specifically for implementation in a school setting and is comprised of a whole school element and a more individualised Key Adult-Key Child pairing. This design and implementation study utilises a mixed-methods research design consisting of quantitative, qualitative, and observational measures with stakeholder input and involvement being considered an integral component. The use of quantitative measures, such as self-report questionnaires prior to and eight months following the implementation of TAP, enabled the analysis of the strengths and direction of relations between the various components of the programme, as well as the influence of implementation factors. The use of qualitative measures, incorporating semi-structured interviews and focus groups, enabled the assessment of implementation factors, identification of implementation barriers, and potential methods of addressing these issues. Observational measures facilitated the continual development and improvement of ‘TAP training’ for school staff. Preliminary findings have provided evidence of promise for the effectiveness of TAP and indicate the potential benefits of introducing this type of attachment-based intervention across other educational settings. This type of intervention could benefit not only children who are looked after but all children who may be impacted by complex trauma or disorders of attachment. Furthermore, findings from this study demonstrate that it is possible for children to form a secondary attachment relationship with a significant adult in school. However, various implementation factors which should be addressed were identified throughout the study, such as the necessity of protected time being introduced to facilitate the development of a positive Key Adult- Key Child relationship. Furthermore, additional ‘re-cap’ training is required in future dissemination of the programme, to maximise ‘attachment friendly practice’ in the whole staff team. Qualitative findings have also indicated that there is a general opinion across school staff that this type of Key Adult- Key Child pairing could be more effective if it was introduced as soon as children begin primary school. This research has provided ample evidence for the need to introduce relationally based interventions in schools, to help to ensure that children who are looked after, or who are impacted by complex trauma or disorders of attachment, can thrive in the school environment. In addition, this research has facilitated the identification of important implementation factors and barriers to implementation, which can be addressed prior to the ‘scaling-up’ of TAP for a robust, randomised controlled trial.

Keywords: attachment, complex trauma, educational interventions, implementation

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Authors: Stephen Fanale

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Criminalization creates sizable barriers to housing and perpetuates the cycle of homelessness. Not only does criminalization leave people on the streets and in shelters indefinitely, but it also unnecessarily costs the taxpayers. Homelessness is a growing issue throughout the world, and criminalizing these human beings is a violation of basic human rights. While this may seem like an insurmountable obstacle, there is something that can be done while fighting that battle. While they are under-researched as a whole, specialty courts, specifically homeless courts, are a growing vessel that can address some of the barriers associated with the criminalization of homelessness. They divert individuals away from jail while connecting them to services that will help their situation instead of hindering it. The model being used in Salt Lake City, while similar to others throughout the United States, stands alone in its outreach efforts and should be paving the way for the rest of the world. The following will look at criminalization and different ways of addressing it, and, finally, Salt Lake City’s current operations, including the unique outreach court: Kayak Court.

Keywords: barriers to housing, criminalization, cycle of homelessness, homeless court, diversion, kayak court

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Authors: Muziwandile Luthuli

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Although numerous factors predicting adherence to antiretroviral therapy (ART) among people living with HIV/AIDS (PLWHA) have been broadly studied on both regional and global level, up-to-date adherence of patients to ART remains an overarching, dynamic and multifaceted problem that needs to be investigated over time and across various contexts. There is a rarity of empirical data in the literature on interactive mechanisms by which psychosocial factors influence adherence to ART among PLWHA within the South African context. Therefore, this study was designed to investigate the relationship between depression, HIV stigma, and adherence to ART among adult patients living with HIV at a tertiary hospital in Durban, South Africa, and the mediating roles of self-efficacy and social support. The health locus of control theory and the social support theory were the underlying theoretical frameworks for this study. Using a cross-sectional research design, a total of 201 male and female adult patients aged between 18-75 years receiving ART at a tertiary hospital in Durban, KwaZulu-Natal were sampled, using time location sampling (TLS). A self-administered questionnaire was employed to collect the data in this study. Data were analysed through SPSS version 27. Several statistical analyses were conducted in this study, namely univariate statistical analysis, correlational analysis, Pearson’s chi-square analysis, cross-tabulation analysis, binary logistic regression analysis, and mediational analysis. Univariate analysis indicated that the sample mean age was 39.28 years (SD=12.115), while most participants were females 71.0% (n=142), never married 74.2% (n=147), and most were also secondary school educated 48.3% (n=97), as well as unemployed 65.7% (n=132). The prevalence rate of participants who had high adherence to ART was 53.7% (n=108), and 46.3% (n=93) of participants had low adherence to ART. Chi-square analysis revealed that employment status was the only statistically significant socio-demographic influence of adherence to ART in this study (χ2 (3) = 8.745; p < .033). Chi-square analysis showed that there was a statistically significant difference found between depression and adherence to ART (χ2 (4) = 16.140; p < .003), while between HIV stigma and adherence to ART, no statistically significant difference was found (χ2 (1) = .323; p >.570). Binary logistic regression indicated that depression was statistically associated with adherence to ART (OR= .853; 95% CI, .789–.922, P < 001), while the association between self-efficacy and adherence to ART was statistically significant (OR= 1.04; 95% CI, 1.001– 1.078, P < .045) after controlling for the effect of depression. However, the findings showed that the effect of depression on adherence to ART was not significantly mediated by self-efficacy (Sobel test for indirect effect, Z= 1.01, P > 0.31). Binary logistic regression showed that the effect of HIV stigma on adherence to ART was not statistically significant (OR= .980; 95% CI, .937– 1.025, P > .374), but the effect of social support on adherence to ART was statistically significant, only after the effect of HIV stigma was controlled for (OR= 1.017; 95% CI, 1.000– 1.035, P < .046). This study promotes behavioral and social change effected through evidence-based interventions by emphasizing the need for additional research that investigates the interactive mechanisms by which psychosocial factors influence adherence to ART. Depression is a significant predictor of adherence to ART. Thus, to alleviate the psychosocial impact of depression on adherence to ART, effective interventions must be devised, along with special consideration of self-efficacy and social support. Therefore, this study is helpful in informing and effecting change in health policy and healthcare services through its findings

Keywords: ART adherence, depression, HIV/AIDS, PLWHA

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Authors: Jiangbo Li, Wenqian Huang

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Early detection of fungal infection in citrus fruit is one of the major problems in the postharvest commercialization process. The automatic and nondestructive detection of infected fruits is still a challenge for the citrus industry. At present, the visual inspection of rotten citrus fruits is commonly performed by workers through the ultraviolet induction fluorescence technology or manual sorting in citrus packinghouses to remove fruit subject with fungal infection. However, the former entails a number of problems because exposing people to this kind of lighting is potentially hazardous to human health, and the latter is very inefficient. Orange is used as a research object. This study would focus on this problem and proposed an effective method based on Vis-NIR hyperspectral imaging in the wavelength range of 400-1000 nm with a spectroscopic resolution of 2.8 nm. In this work, three normalization approaches are applied prior to analysis to reduce the effect of sample curvature on spectral profiles, and it is found that mean normalization was the most effective pretreatment for decreasing spectral variability due to curvature. Then, principal component analysis (PCA) was applied to a dataset composing of average spectra from decayed and normal tissue to reduce the dimensionality of data and observe the ability of Vis-NIR hyper-spectra to discriminate data from two classes. In this case, it was observed that normal and decayed spectra were separable along the resultant first principal component (PC1) axis. Subsequently, five wavelengths (band) centered at 577, 702, 751, 808, and 923 nm were selected as the characteristic wavelengths by analyzing the loadings of PC1. A multispectral combination image was generated based on five selected characteristic wavelength images. Based on the obtained multispectral combination image, the intensity slicing pseudocolor image processing method is used to generate a 2-D visual classification image that would enhance the contrast between normal and decayed tissue. Finally, an image segmentation algorithm for detection of decayed fruit was developed based on the pseudocolor image coupled with a simple thresholding method. For the investigated 238 independent set samples including infected fruits infected by Penicillium digitatum and normal fruits, the total success rate is 100% and 97.5%, respectively, and, the proposed algorithm also used to identify the orange infected by penicillium italicum with a 100% identification accuracy, indicating that the proposed multispectral algorithm here is an effective method and it is potential to be applied in citrus industry.

Keywords: citrus fruit, early rotten, fungal infection, hyperspectral imaging

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Authors: T. N. Goh, M. Hashmi, O. Hussain

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Temporomandibular joint (TMJ) dysfunction (TMD) is a condition that may affect patients via restricted mouth opening, significant pain during normal functioning, and/or reproducible joint noise. TMD includes myofascial pain, TMJ functional derangements (internal derangement, dislocation), and TMJ degenerative/inflammatory joint disease. Internal derangement (ID) is the most common cause of TMD-related clicking and locking. These patients are managed in a stepwise approach, from patient education (homecare advice and analgesia), splint therapy, physiotherapy, botulinum toxin treatment, to arthrocentesis. Arthrotomy is offered when the aforementioned treatment options fail to alleviate symptoms and improve quality of life. The aim of this prospective study was to review the outcomes of jaw joint open surgery in TMD patients. Patients who presented from 2015-2022 at the Oral and Maxillofacial Surgery Department in the Doncaster NHS Foundation Trust, UK, with a Wilkes classification of III -V were included. These patients underwent either i) discopexy with bone-anchoring suture (9); ii) intrapositional temporalis flap (ITF) with bone-anchoring suture (3); iii) eminoplasty and discopexy with suturing to the capsule (3); iii) discectomy + ITF with bone-anchoring suture (1); iv) discoplasty + bone-anchoring suture (1); v) ITF (1). Maximum incisal opening (MIO) was assessed pre-operatively and at each follow-up. Pain score, determined via the visual analogue scale (VAS, with 0 being no pain and 10 being the worst pain), was also recorded. A total of 18 eligible patients were identified with a mean age of 45 (range 22 - 79), of which 16 were female. The patients were scored by Wilkes Classification as III (14), IV (1), or V (4). Twelve patients had anterior disc displacement without reduction (66%) and six had degenerative/arthritic changes (33%) to the TMJ. The open joint procedure resulted in an increase in MIO and reduction in pain VAS and for the majority of patients, across all Wilkes Classifications. Pre-procedural MIO was 22.9 ± 7.4 mm and VAS was 7.8 ± 1.5. At three months post-procedure there was an increase in MIO to 34.4 ± 10.4 mm (p < 0.01) and a decrease in the VAS to 1.5 ± 2.9 (p < 0.01). Three patients were lost to follow-up prior to six months. Six were discharged at six month review and five patients were discharged at 12 months review as they were asymptomatic with good mouth opening. Four patients are still attending for annual botulinum toxin treatment. Two patients (Wilkes III and V) subsequently underwent TMJ replacement (11%). One of these patients (Wilkes III) had improvement initially to MIO of 40 mm, but subsequently relapsed to less than 20 mm due to lack of compliance with jaw rehabilitation device post-operatively. Clinical improvements in 89% of patients within the study group were found, with a return to near normal MIO range and reduced pain score. Intraoperatively, the operator found bone-anchoring suture used for discopexy/discoplasty more secure than the soft tissue anchoring suturing technique.

Keywords: bone anchoring suture, open temporomandibular joint surgery, temporomandibular joint, temporomandibular joint dysfunction

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Authors: Amr Mansour Mohsen, Hesham Ahmed Hassan, Amira M. Idrees

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Document Analysis is an important research field that aims to gather the information by analyzing the data in documents. As one of the important targets for many fields is to understand what people actually want, sentimental analysis field has been one of the vital fields that are tightly related to the document analysis. This research focuses on analyzing text documents to classify each document according to its opinion. The aim of this research is to detect the emotions from text documents based on enriching the lexicon with adapting their content based on semantic patterns extraction. The proposed approach has been presented, and different experiments are applied by different perspectives to reveal the positive impact of the proposed approach on the classification results.

Keywords: document analysis, sentimental analysis, emotion detection, WEKA tool, NRC lexicon

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Authors: Sukhvinder Kaur, Ashok Agarwal

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Background: For the first time in 2009, India was able to generate estimates of HIV incidence (the number of new HIV infections per year). Analysis of epidemic projections helped in revealing that the number of new annual HIV infections in India had declined by more than 50% during the last decade (GOI Ministry of Health and Family Welfare, 2010). Then, National AIDS Control Organisation (NACO) planned to scale up its efforts in generating projections through epidemiological analysis and modelling by taking recent available sources of evidence such as HIV Sentinel Surveillance (HSS), India Census data and other critical data sets. Recently, NACO generated current round of HIV estimates-2012 through globally recommended tool “Spectrum Software” and came out with the estimates for adult HIV prevalence, annual new infections, number of people living with HIV, AIDS-related deaths and treatment needs. State level prevalence and incidence projections produced were used to project consequences of the epidemic in spectrum. In presence of HIV estimates generated at state level in India by NACO, USIAD funded PIPPSE project under the leadership of NACO undertook the estimations and projections to district level using same Spectrum software. In 2011, adult HIV prevalence in one of the high prevalent States, Maharashtra was 0.42% ahead of the national average of 0.27%. Considering the heterogeneity of HIV epidemic between districts, two districts of Maharashtra – Thane and Mumbai were selected to estimate and project the number of People-Living-with-HIV/AIDS (PLHIV), HIV-prevalence among adults and annual new HIV infections till 2017. Methodology: Inputs in spectrum included demographic data from Census of India since 1980 and sample registration system, programmatic data on ‘Alive and on ART (adult and children)’,‘Mother-Baby pairs under PPTCT’ and ‘High Risk Group (HRG)-size mapping estimates’, surveillance data from various rounds of HSS, National Family Health Survey–III, Integrated Biological and Behavioural Assessment and Behavioural Sentinel Surveillance. Major Findings: Assuming current programmatic interventions in these districts, an estimated decrease of 12% points in Thane and 31% points in Mumbai among new infections in HRGs and migrants is observed from 2011 by 2017. Conclusions: Project also validated decrease in HIV new infection among one of the high risk groups-FSWs using program cohort data since 2012 to 2016. Though there is a decrease in HIV prevalence and new infections in Thane and Mumbai, further decrease is possible if appropriate programme response, strategies and interventions are envisaged for specific target groups based on this evidence. Moreover, evidence need to be validated by other estimation/modelling techniques; and evidence can be generated for other districts of the state, where HIV prevalence is high and reliable data sources are available, to understand the epidemic within the local context.

Keywords: HIV sentinel surveillance, high risk groups, projections, new infections

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Authors: Anna Veres

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People’s ability to adapt to a constantly changing environment is essential. Career adaptability is central to Career Construction Theory, where proper adaptation to new situations, changing environments, and jobs require adequate career development. Based on current career theories and the possibilities offered by digital technology, the primary goal of this study is to develop career adaptability through an online tool. Its secondary goal is to apply for an online career intervention program and explore its developmental possibilities. A total of 132 university students from the bachelor program took part in the study, from which 65 students received a four-week online career intervention, while 67 participants formed the control group. Based on the results, it can state that career adaptability can be developed, and there is a great demand and interest from university students to use career-related programs on online platforms. Career interventions should be performed online as well if there is suitable software and a well-constructed program. Limitations and further implications are discussed.

Keywords: career adaptability, career development, online career intervention, university students

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Authors: Ahmed Abdallatif

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Background: Patients with malignant germ cell tumors have age distribution in two peaks, with the first one during infancy and the second after the onset of puberty. Gonadal germ cell tumors are the most common malignant ovarian tumor in females aged below twenty years. Sacrococcygeal and retroperitoneal abdominal tumors usually presents in a large size before the onset of symptoms. Methods: Patients with pediatric germ cell tumors presenting to Children’s Cancer Hospital Egypt and National Cancer Institute Egypt from January 2008 to June 2011 Patients underwent stratification according to risk into low, intermediate and high risk groups according to children oncology group classification. Objectives: Assessment of the clinicopathologic features of all cases of pediatric germ cell tumors and classification of malignant cases according to their stage, and the primary site to low, intermediate and high risk patients. Evaluation of surgical management in each group of patients focusing on surgical approach, the extent of surgical resection according to each site, ability to achieve complete surgical resection and perioperative complications. Finally, determination of the three years overall and disease-free survival in different groups and the relation to different prognostic factors including the extent of surgical resection. Results: Out of 131 cases surgically explored only 26 cases had re exploration with 8 cases explored for residual disease 9 cases for remote recurrence or metastatic disease and the other 9 cases for other complications. Patients with low risk kept under follow up after surgery, out of those of low risk group (48 patients) only 8 patients (16.5%) shifted to intermediate risk. There were 20 patients (14.6%) diagnosed as intermediate risk received 3 cycles of compressed (Cisplatin, Etoposide and Bleomycin) and all high risk group patients 69patients (50.4%) received chemotherapy. Stage of disease was strongly and significantly related to overall survival with a poorer survival in late stages (stage IV) as compared to earlier stages. Conclusion: Overall survival rate at 3 three years was (76.7% ± 5.4, 3) years EFS was (77.8 % ±4.0), however 3 years DFS was much better (89.8 ± 3.4) in whole study group with ovarian tumors had significantly higher Overall survival (90% ± 5.1). Event Free Survival analysis showed that Male gender was 3 times likely to have bad events than females. Patients who underwent incomplete resection were 4 times more than patients with complete resection to have bad events. Disease free survival analysis showed that Patients who underwent incomplete surgery were 18.8 times liable for recurrence compared to those who underwent complete surgery, and patients who were exposed to re-excision were 21 times more prone to recurrence compared to other patients.

Keywords: extragonadal, germ cell tumors, gonadal, pediatric

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Authors: Shaukat Ali Shahee, Usha Ananthakumar

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A data set exhibits class imbalance problem when one class has very few examples compared to the other class, and this is also referred to as between class imbalance. The traditional classifiers fail to classify the minority class examples correctly due to its bias towards the majority class. Apart from between-class imbalance, imbalance within classes where classes are composed of a different number of sub-clusters with these sub-clusters containing different number of examples also deteriorates the performance of the classifier. Previously, many methods have been proposed for handling imbalanced dataset problem. These methods can be classified into four categories: data preprocessing, algorithmic based, cost-based methods and ensemble of classifier. Data preprocessing techniques have shown great potential as they attempt to improve data distribution rather than the classifier. Data preprocessing technique handles class imbalance either by increasing the minority class examples or by decreasing the majority class examples. Decreasing the majority class examples lead to loss of information and also when minority class has an absolute rarity, removing the majority class examples is generally not recommended. Existing methods available for handling class imbalance do not address both between-class imbalance and within-class imbalance simultaneously. In this paper, we propose a method that handles between class imbalance and within class imbalance simultaneously for binary classification problem. Removing between class imbalance and within class imbalance simultaneously eliminates the biases of the classifier towards bigger sub-clusters by minimizing the error domination of bigger sub-clusters in total error. The proposed method uses model-based clustering to find the presence of sub-clusters or sub-concepts in the dataset. The number of examples oversampled among the sub-clusters is determined based on the complexity of sub-clusters. The method also takes into consideration the scatter of the data in the feature space and also adaptively copes up with unseen test data using Lowner-John ellipsoid for increasing the accuracy of the classifier. In this study, neural network is being used as this is one such classifier where the total error is minimized and removing the between-class imbalance and within class imbalance simultaneously help the classifier in giving equal weight to all the sub-clusters irrespective of the classes. The proposed method is validated on 9 publicly available data sets and compared with three existing oversampling techniques that rely on the spatial location of minority class examples in the euclidean feature space. The experimental results show the proposed method to be statistically significantly superior to other methods in terms of various accuracy measures. Thus the proposed method can serve as a good alternative to handle various problem domains like credit scoring, customer churn prediction, financial distress, etc., that typically involve imbalanced data sets.

Keywords: classification, imbalanced dataset, Lowner-John ellipsoid, model based clustering, oversampling

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Authors: K. Y. Chen, Y. N. Jia, H. Chua, C. W. Kan

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In United States (US), the environmental policy went through two stages that are government control period and market mechanism period. In the government control period in the 1970s, environmental problems in U.S. are treated by mandatory direct control method, including promulgation of laws, formulation of emission standards and mandatory installation of pollution treatment equipment. After the 1980s, the environmental policy in U.S. went into the second stage, in which the government strengthened the incentives and coordination effects of market. Since then, environmental governance had been partially replaced by means of economic regulation of the market. Green Tax Policy and Marketable Pollution Permits are good examples of government's economic interventions. U.S. Federal Government regards environmental industry as high-tech industry which is promoted in this period. Therefore, in the paper, we aim to analyse the effect of environmental investment on the sustainable development in the US. Acknowledgment: Authors would like to thank the financial support from the Hong Kong Polytechnic University for this work.

Keywords: United States, public environmental investment, analysis, sustainable development

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Authors: Sabri Serkan Gulluoglu

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It is possible with Geographic Information Systems (GIS) that the information about all natural and artificial resources on the earth is obtained taking advantage of satellite images are obtained by remote sensing techniques. However, determination of unknown sources, mapping of the distribution and efficient evaluation of resources are defined may not be possible with the original image. For this reasons, some process steps are needed like transformation, pre-processing, image enhancement and classification to provide the most accurate assessment numerically and visually. Many studies which present the phases of obtaining and processing of the satellite images have examined in the literature study. The research showed that the determination of the process steps may be followed at this subject with the existence of a common whole may provide to progress the process rapidly for the necessary and possible studies which will be.

Keywords: remote sensing, satellite imaging, gis, computer science, information

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Authors: Mohammad Ahmad, Dayalan Kasilingam

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In this paper, a spectral domain implementation of the fast multipole method is presented. It is shown that the aggregation, translation, and disaggregation stages of the fast multipole method (FMM) can be performed using the spectral domain (SD) analysis. The spectral domain fast multipole method (SD-FMM) has the advantage of eliminating the near field/far field classification used in conventional FMM formulation. The study focuses on the application of SD-FMM to one-dimensional (1D) and two-dimensional (2D) electric field integral equation (EFIE). The case of perfectly conducting strip, circular and square cylinders are numerically analyzed and compared with the results from the standard method of moments (MoM).

Keywords: electric field integral equation, fast multipole method, method of moments, wave scattering, spectral domain

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Authors: Khaled Harrar, Rachid Jennane

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The purpose of this study is the discrimination of 28 postmenopausal with osteoporotic femoral fractures from an age-matched control group of 28 women using texture analysis based on fractals. Two pre-processing approaches are applied on radiographic images; these techniques are compared to highlight the choice of the pre-processing method. Furthermore, the values of the fractal dimension are compared to those of the fractal signature in terms of the classification of the two populations. In a second analysis, the BMD measure at proximal femur was compared to the fractal analysis, the latter, which is a non-invasive technique, allowed a better discrimination; the results confirm that the fractal analysis of texture on calcaneus radiographs is able to discriminate osteoporotic patients with femoral fracture from controls. This discrimination was efficient compared to that obtained by BMD alone. It was also present in comparing subgroups with overlapping values of BMD.

Keywords: osteoporosis, fractal dimension, fractal signature, bone mineral density

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Authors: Abdelaziz Moujane, Abedelali Boulli, Abdellah Ouigmane

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The present work focuses on the assessment of forestlandscape changes in the region of ZaouitAhansal, usingmultitemporal satellite images at high spatial resolution.Severalremotesensingmethodswereappliednamely: The supervised classification algorithm and NDVI whichwerecombined in a GIS environment to quantify the extent and change in density of forest stands (holmoak, juniper, thya, Aleppo pine, crops, and others).The resultsobtainedshowedthat the forest of ZaouitAhansal has undergonesignificantdegradationresulting in a decrease in the area of juniper, cedar, and zeenoak, as well as an increase in the area of baresoil and agricultural land. The remotesensing data providedsatisfactoryresults for identifying and quantifying changes in forestcover. In addition, thisstudycould serve as a reference for the development of management strategies and restoration programs.

Keywords: remote sensing, GIS, satellite image, NDVI, deforestation, zaouit ahansal

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Authors: Probuddha Mukhopadhyay

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The infiltration of key elements to the civil structure is foraying its way to reclaim, what is its own. The reclamation of lives and spaces, once challenged, becomes a consistent process of ingress, disguised as parallels to the moving city, disperses into discourses often unheard of and conveniently forgotten. In this age of 'hyper'-urbanization, there are solutions suggested to a plethora of issues faced by citizens, in improving their standards of living. Problems are ancillary to proposals that emerge out of the underlying disorders of the townscape. These interventions result in the formulation of urban policies, to consolidate and optimize, to regularize and to streamline resources. Policy and practice are processes where the politics in policies define the way in which urban solutions are prescribed. Social constraints, that formulate the various cycles of order and disorders within the urban realm, are the stigmas for such interventions. There is often a direct relation of policy to place, no matter how people-centric it may seem to be projected. How we live our lives depends on where we live our lives - a relative statement for urban problems, varies from city to city. Communal compositions, welfare, crisis, socio-economic balance, need for management are the generic roots for urban policy formulation. However, in reality, the gentry administering its environmentalism is the criterion, that shapes and defines the values and expanse of such policies. In relation to the psycho-spatial characteristic of urban spheres with respect to the other side of this game, there have been instances, where the associational values have been reshaped by interests. The public domain reclaimed for exclusivity, thus creating fortified neighborhoods. Here, the citizen cumulative is often drifted by proposals that would over time deplete such landscapes of the city. It is the organized rebellion that in turn formulates further inward looking enclaves of latent aggression. In recent times, it has been observed that the unbalanced division of power and the implied processes of regulating the weak, stem the rebellion who respond in kits and parts. This is a phenomenon that mimics the guerilla warfare tactics, in order to have systems straightened out, either by manipulations or by force. This is the form of the city determined by the various forms insinuated by the state of city wide decisions. This study is an attempt at understanding the way in which development is interpreted by the state and the civil society and the role that community driven processes undertake to reinstate their claims to the city. This is a charter of consolidated patterns of negotiations that tend to counter policies. The research encompasses a study of various contested settlements in two cities of India- Mumbai and Kolkata, tackling dissent through spatial order. The study has been carried out to identify systems - formal and informal, catering to the most challenged interests of the people with respect to their habitat, a model to counter the top-down authoritative framework challenging the legitimacy of such settlements.

Keywords: urban design, insurgence, tactical urbanism, urban governance, civil society, state

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