Search results for: disintegrated health system

Authors: Akhila Potluru

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Worldwide, more than 250 bodies of water are transboundary, meaning they cross the political boundaries of multiple countries. This creates a system of hydrological, economic, and social interdependence between communities reliant on these water sources. Transboundary water conflicts can occur as a result of this intense interdependence. Many factors contribute to the sparking of transboundary water conflicts, ranging from natural hydrological factors to hydro-political interactions. Previous attempts to predict transboundary water conflicts by analysing changes or trends in the contributing factors have typically failed because patterns in the data are hard to identify. However, there is potential for artificial intelligence and machine learning to fill this gap and identify future ‘hotspots’ up to a year in advance by identifying patterns in data where humans can’t. This research determines the extent to which AI can be used to predict and prevent transboundary water conflicts. This is done via a critical literature review of previous case studies and datasets where AI was deployed to predict water conflict. This research not only delivered a more nuanced understanding of previously undervalued factors that contribute toward transboundary water conflicts (in particular, culture and disinformation) but also by detecting conflict early, governance bodies can engage in processes to de-escalate conflict by providing pre-emptive solutions. Looking forward, this gives rise to significant policy implications and water-sharing agreements, which may be able to prevent water conflicts from developing into wide-scale disasters. Additionally, AI can be used to gain a fuller picture of water-based conflicts in areas where security concerns mean it is not possible to have staff on the ground. Therefore, AI enhances not only the depth of our knowledge about transboundary water conflicts but also the breadth of our knowledge. With demand for water constantly growing, competition between countries over shared water will increasingly lead to water conflict. There has never been a more significant time for us to be able to accurately predict and take precautions to prevent global water conflicts.

Keywords: artificial intelligence, machine learning, transboundary water conflict, water management

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Authors: Lakmali Anthony, Bushra Oathman, Anshini Jain, Raaj Chandra

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Introduction: Abscesses are traditionally treated by incision and drainage with the packing of the residual abscess cavity until healing. This method requires regular visits from community nurses for continuous wound packing upon discharge from the hospital and causes considerable patient discomfort. Whether abscess cavity packing offers any advantage over non-packing has not yet been adequately studied to the best of our knowledge. This study aims to determine if there are differences in clinical outcomes of time to healing, fistula formation and recurrence of abscess between abscess cavity packing vs. non-packing groups. Methods: This study was a single-center, single-blind, randomized controlled trial where patients were randomized into packing and non-packing arms. All patients over 18 years presenting to Eastern Health with an abscess requiring incision and drainage in the theatre were invited to participate. Those with underlying conditions that cause recurrent abscesses were excluded. Data were collected from December 2018 to April 2020. Results: There were 63 patients who had abscesses treated with incision and drainage that were enrolled in the study, 52 of which were suitable for analysis. Demographic characteristics were similar in both groups. The packing group had a significantly longer time to heal compared to the non-packing group. Rates of fistula formation and recurrence of abscess were low and there were no statistically significant differences between groups. The packing group had more patients with delayed healing (defined as >60 days) and required more follow-up visits compared to the non-packing group. Conclusion: This pilot study indicates that abscesses can not only be managed safely with incision and drainage alone without the need for continuous abscess cavity packing but also that non-packing may offer clinical benefits to patients with earlier healing of abscesses compared to continuous cavity packing.

Keywords: abscess packing, subcutaneous, perianal, pilonidal

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Authors: Sara Piccirillo

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The integrated urban regeneration represents a great opportunity to deliver correct management of the territory if implemented through the reuse, enhancement, and transformation of abandoned industrial areas, according to sustainability strategies. In environmental terms, recycling abandoned sites by demolishing buildings and regenerating the urban areas means promoting adaptation to climate change and a new sensitivity towards city living. The strategic vision of 'metabolism' can be implemented through diverse actions made on urban settlements, and planning certainly plays a primary role. Planning an urban transformation in a sustainable way is more than auspicable. It is necessary to introduce innovative urban soil management actions to mitigate the environmental costs associated with current land use and to promote projects for the recovery/renaturalization of urban or non-agricultural soils. However, by freeing up these through systematic demolition of the disused heritage, new questions open up in terms of environmental costs deriving from the inevitable impacts caused by the disposal of waste. The mitigation of these impacts involves serious reflection on the recycling supply chains aimed at the production and reuse of secondary raw materials in the construction industry. The recent developments in R&D of recycling materials are gradually becoming more and more pivotal in consideration of environmental issues such as increasing difficulties in exploiting natural quarries or strict regulations for the management and disposal of waste sites. Therefore, this contribution, set as a critical essay, presents the reconstruction outputs of the regulatory background on the material recycling chain up to the 'end of waste' stage, both at a national and regional scale. This extended approach to this urban design practice goes beyond the cultural dimension that has relegated urban regeneration to pure design only. It redefines its processes through an interdisciplinary system that affects human, environmental and financial resources.

Keywords: waste management, C&D waste, recycling, urban trasformation

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Authors: Londeka Ntuli, Frasia Oosthuizen

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Background: Tenefovir disiproxil fumarate (TDF) is a nephrotoxic drug and has been proven to contribute to renal insufficiency necessitating intensive monitoring and management of adverse effects arising from prolonged exposure to the drug. TDF is one of the preferred first-line drugs used in combination therapy in most regions. There are estimated 300 000 patients being initiated on the Efavirenz/TDF/Emtricitabine first-line regimen annually in South Africa. It is against this background that this study aims to investigate the effects of TDF on renal sufficiency of HIV positive patients. Methodology: A retrospective quantitative study was conducted, analysing clinical charts of HIV positive patient’s older than 18 years of age and on a TDF-containing regimen for more than 1 year. Data were obtained from the analysis of patient files and was transcribed into Microsoft® Excel® spreadsheet. Extracted data were coded, categorised and analysed using STATA®. Results: A total of 275 patient files were included in this study. Renal function started decreasing after 3 months of treatment (with 93.5% patients having a normal EGFR), and kept on decreasing as time progressed with only 39.6% normal renal function at year 4. Additional risk factors for renal insufficiency included age below 25, female gender, and additional medication. Conclusion: It is clear from this study that the use of TDF necessitates intensive monitoring and management of adverse effects arising from prolonged exposure to the drug. The findings from this study generated pertinent information on the safety profile of the drug TDF in a resource-limited setting of a public health institution. The appropriate management is of tremendous importance in the South African context where the majority of HIV positive individuals are on the TDF containing regimen; thus it is beneficial to ascertain the possible level of toxicities these patients may be experiencing.

Keywords: renal insufficiency, tenefovir, HIV, risk factors

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Authors: Ka Ho Yau, Jan Frederick Engels, Kwok Kei Lai, Reinhard Renneberg

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Lateral flow test is a prevalent technology in various sectors such as food, pharmacology and biomedical sciences. Colloidal gold (CG) is widely used as the signalling molecule because of the ease of synthesis, bimolecular conjugation and its red colour due to intrinsic SPRE. However, the production of colloidal gold is costly and requires vigorous conditions. The stability of colloidal gold are easily affected by environmental factors such as pH, high salt content etc. Silica nanoparticles are well known for its ease of production and stability over a wide range of solvents. Using reverse micro-emulsion (w/o), silica nanoparticles with different sizes can be produced precisely by controlling the amount of water. By incorporating different water-soluble dyes, a rainbow colour of the silica nanoparticles could be produced. Conjugation with biomolecules such as antibodies can be achieved after surface modification of the silica nanoparticles with organosilane. The optimum amount of the antibodies to be labelled was determined by Bradford Assay. In this work, we have demonstrated the ability of the dye-doped silica nanoparticles as a signalling molecule in lateral flow test, which showed a semi-quantitative measurement of the analyte. The image was further analysed for the LOD=10 ng of the analyte. The working range and the linear range of the test were from 0 to 2.15μg/mL and from 0 to 1.07 μg/mL (R2=0.988) respectively. The performance of the tests was comparable to those using colloidal gold with the advantages of lower cost, enhanced stability and having a wide spectrum of colours. The positives lines can be imaged by naked eye or by using a mobile phone camera for a better quantification. Further research has been carried out in multicolour detection of different biomarkers simultaneously. The preliminary results were promising as there was little cross-reactivity being observed for an optimized system. This approach provides a platform for multicolour detection for a set of biomarkers that enhances the accuracy of diseases diagnostics.

Keywords: colorimetric detection, immunosensor, paper-based biosensor, silica

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Authors: Zhaojun Wang, Zongdi Sun, Yongjie Chen, Manman Chen, Linghui Wang

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This paper uses the analytic hierarchy process to study the execution effect of the minimum purchase price of grain in different regions and various grain crops. Firstly, for different regions, five indicators including grain yield, grain sown area, gross agricultural production, grain consumption price index, and disposable income of rural residents were selected to construct an evaluation index system. We collect data of six provinces including Hebei Province, Heilongjiang Province and Shandong Province from 2006 to 2017. Then, the judgment matrix is constructed, and the hierarchical single ordering and consistency test are carried out to determine the scoring standard for the minimum purchase price of grain. The ranking of the execution effect from high to low is: Heilongjiang Province, Shandong Province, Hebei Province, Guizhou Province, Shaanxi Province, and Guangdong Province. Secondly, taking Shandong Province as an example, we collect the relevant data of sown area and yield of cereals, beans, potatoes and other crops from 2006 to 2017. The weight of area and yield index is determined by expert scoring method. And the average sown area and yield of cereals, beans and potatoes in 2006-2017 were calculated, respectively. On this basis, according to the sum of products of weights and mean values, the execution effects of different grain crops are determined. It turns out that among the cereals, the minimum purchase price had the best execution effect on paddy, followed by wheat and finally maize. Moreover, among major categories of crops, cereals perform best, followed by beans and finally potatoes. Lastly, countermeasures are proposed for different regions, various categories of crops, and different crops of the same category.

Keywords: analytic hierarchy process, grain yield, grain sown area, minimum grain purchase price

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Authors: Budi Purnomo, Karen M. Fernandez

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The creation of an ASEAN Community in 2015 is definitely one thing to look forward to. Integration may have birth pains in the beginning but at the end of the day, there are many opportunities that each member-state can take advantage that will benefit the people of ASEAN. Once fully integrated in 2015, ASEAN-certified tourism professionals who pass the common competency standards may find employment in various divisions of labor that are common across various sectors of tourism in member countries. At present, there are six labor divisions where tourism professionals may find employment in ASEAN member countries: namely Front Office; Housekeeping; Food Production; Food and Beverage Services (for Hotel Services); Travel Agency; and Tour Operations (for Travel Services Division). The study attempts to assess the readiness of Indonesian and Filipino students prospective skilled and educated tourism labors to work in ASEAN member countries by 2015. The data sources are obtained from a researcher-designed questionnaire and in-depth interview to reveal the interest of Indonesian and Filipino students to work in other ASEAN member states. The questionnaires were distributed to 240 third and fourth year students who are currently enrolled at the leading tourism institutes/universities in Indonesia and Philippines. The findings of the study will reveal the fulfillment of the requirements to work in ASEAN member-states, the comparison of existing tourism management curricula of Indonesia and Philippines to the Common ASEAN Curriculum (CATC) and Regional Qualifications Framework and Skills Recognition System (RQFSRS) which supports the policies of the Ministry of Tourism and Creative Economy of the Republic of Indonesia and the Department of Tourism and Department of Labor and Employment of the Republic of the Philippines.

Keywords: ASEAN economic community, prospective skilled and educated tourism labors, tourism labor movement, ASEAN certified-tourism professionals

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Authors: Naomi Huang Wenya, Xin Xiaohui, Vijaya Rao, Wong Ting Hway, Chow Kah Hoe Pierce, Tan Hiang Khoon

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Background: The majority of the cancelled elective surgeries caused by the COVID-19 pandemic globally were estimated to occur in low- and middle-income countries (LMICs), where surgical services had long been in short supply even before the pandemic. Therefore, minimising disruption to existing surgical care in LMICs is of crucial importance during a pandemic. This study aimed to explore contributory factors to the continuity of surgical care in LMICs, in the face of a pandemic. Methods: Semi-structured interviews were conducted over zoom, with surgical leaders of 25 tertiary hospitals from 11 LMICs in South and Southeast Asia, from September to October 2020. Key themes were subsequently identified from the interview transcripts, using Braun and Clarke's method of thematic analysis. Results: The COVID-19 pandemic affected all surgical services of participating institutions but to varying degrees. Overall, elective surgeries suffered the gravest disruption, followed by outpatient surgical care, and finally, emergency surgeries. Keeping healthcare workers safe and striving for continuity of essential surgical care emerged as notable response strategies observed across all participating institutions. Conclusion: This study suggested that four factors are important for the resilience of surgical care against COVID-19: adequate COVID-19 testing capacity and effective institutional infection control measures, designated COVID-19 treatment facilities, a whole-system approach to balancing pandemic response and meeting essential surgical needs, and active community engagement. These findings can inform healthcare institutions in other countries, especially LMICs, in their effort to tread a fine line between preserving healthcare capacity for pandemic response and protecting surgical services against pandemic disruption.

Keywords: COVID-19, pandemic, LMICs, continuity of surgical service

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Authors: Harley Stephens

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Although fiducial marker insertion is regarded as the ‘gold standard’ in terms of image guided radiotherapy (IGRT), its application must be considered carefully as the procedure can be invasive, time-consuming, and reliant on consultant expertise. Precision of the fiducials is dependent on these markers remaining in the same location and on the prostate not changing shape during the course treatment. To facilitate the acquirement of non-ionising IGRT and intra-fractional prostate tracking, Clarity TPUS was developed as an alternative imaging system. The main benefits of Clarity TPUS are that it is non-invasive, non-ionising and cost-effective. Other studies have compared fiducials to transabdominal ultrasound, which has since been proven to not be as accurate as trans-perineal imaging, as included in this study. CBCT fiducial translations and Clarity TPUS translations for 120 images as part of the PACE-C prostate SABR trial were retrospectively evaluated by three imaging specialists. Differences were analysed using correlation and Bland-Altman plots. Inter-observer matches agreed within 3mm 88.3 % of the time in left/right direction, 86.7 % of the time in in superior/inferior direction, and 91.7% of the time in ant/post direction. They agreed within 5mm more than 98.3 % of the time in all directions. The intra-class correlation co-efficient was calculated for each direction to show agreement between imaging specialist for inter-observer variability. Each was 0.95 or above, with 1 indicating perfect reliability. Agreement between observers was slightly higher for CBCT and fiducials at 98.7% agreement within 5 mm, compared to clarity TPUS where 96.7% agreement was seen within 5mm. Clarity TPUS has the benefit of no additional dose and intra-fractional monitoring, and results show a good correlation between the different modalities. Inter-observer variability is to be considered, and further research with a larger population would be of benefit.

Keywords: oncology, prostate radiotherapy, image guided radiotherapy, IGRT

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Authors: Avanika Gupta

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Education plays a significant and remedial role in balancing the socio-economic fabric of a country. Inclusive education is considered as the most appropriate mode of teaching students with hearing impairment (SwHI) by various national and international legislations. But inclusive education is still an evolving concept among the disability studies scholars and policy makers in India. The study aimed to examine accessibility of SwHI in mainstream schools if there are special provisions for SwHI. The study also intended to identify if the provisions are same for deaf and hard-of-hearing students. Using stratified random sampling technique, a school was selected from each of the six administrative zones of Nagpur city. All the selected schools had primary and secondary level education and were co-educational in nature. Interview with principals of these schools and focused-group- observation method showcased lack of accessibility for SwHI in attending schools. Not even a single school had a hearing impaired student, either deaf or hard-of-hearing depicting the double marginalization of SwHI. This is despite the fact that the right to education is a fundamental right in India, and national legislation on disability has special provisions for ensuring educational opportunities to SwHI. None of the schools even had an Indian Sign Language (ISL) instructor. Both observations seemed cause and effect of one another. One of the principals informed that they have seats for all students with disabilities but they usually lie vacant due to lack of awareness among the parents. One school had 2 students with locomotive impairment while another had a student with visual impairment. Principals of two special schools were also interviewed to understand the reason behind the low enrollment rate of SwHI in mainstream schools. Guardian preference, homogeneity, relatable faculty, familiar environment were some of the chief reasons mentioned. Few suggestions for the policymakers, teachers, guardians and the students are also recommended so that Indian education system could become inclusive in true sense.

Keywords: deaf, hard-of-hearing, inclusive education, India, Nagpur, students with hearing impairment

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Authors: Francesca di Donato, Sara Trucco

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Green accounting is a growing topic of interest. Indeed, nowadays, most firms affect the environment; therefore, companies are seeking the best way to disclose environmental information. Furthermore, companies are increasingly committed to improving the environment, and the topic is gaining more importance to the public, governments, and policymakers. Green accounting is a type of accounting that considers environmental costs and their impact on the financial performance of firms. Thus, the motivation of the current research is to investigate the state-of-the-art literature on the relationship between green accounting and firm performance since the birth of the topic of green accounting and to investigate gaps in the literature that represent fruitful terrain for future research. In doing so, this study provides a bibliometric literature review of existing evidence related to the link between green accounting and firm performance since 2000. The search, based on the most relevant databases for scientific journals (which are Scopus, Emerald, Web of Science, Google Scholar, and Econlit), returned 1917 scientific articles. The articles were manually reviewed in order to identify only the relevant studies in the field by excluding articles with titles and abstracts out of scope. The final sample was composed of 107 articles. A content analysis was carried out on the final sample of articles; in doing so, a classification system has been proposed. Findings show the most relevant environmental costs and issues considered in previous studies and how green accounting may be linked to the financial and non-financial performance of a firm. The study also offers suggestions for future research in this domain. This study has several practical implications. Indeed, the topic of green accounting may be applied to different sectors and different types of companies. Therefore, this study may help managers to better understand the most relevant environmental information to disclose and how environmental issues may be managed to improve the performance of the firms. Moreover, the bibliometric literature review may be of interest to those stakeholders who are interested in the historical evolution of the topic.

Keywords: bibliometric literature review, firm performance, green accounting, literature review

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Authors: Suneeta Gireesh Panicker

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Aim: Aminopeptidase P (APP) is an enzyme that has specificity for proline, can specifically cleave Xaa-Proline peptides and is a metallo-aminopeptidase. The bonds nearby to the imino acid proline are tough to cleave by many peptidases, but APP can specifically break peptide bonds engaged with proline. Membrane-bound form and a cytosolic form are the two forms in which this enzyme exists. The exact physiological function of APP remains unclear and hence the present work attempts to determine it. Methods: In the present study, the expression pattern of cytosolic Aminopeptidase P (DAP) was determined in all the embryonic stages and larval stages of wild-type Drosophila by using polyclonal monospecific antibodies. To show the presence of DAP RNA in embryonic and larval stages, RNA in situ hybridization was performed. DAP promoter-LacZ fusion reporter gene vector was used to construct transgenic embryos to study the regulation pattern of DAP. To study the DAP expression profile, a transgenic fly consisting of a DAP promoter with β-gal and GFP reporter genes in front of it was constructed. Results: DAP protein expression was observed in neuroectodermal cells, posterior midgut primordium, proctodeum, ventral neuroblast and primordial stomatogastric nervous system. It was observed in the ventral cord and midgut in stage 12. The completely developed embryos showed the intense occurrence of it in the ventral cord and gut region. The eye-antennal disc, wing disc and leg disc also showed the presence of DAP protein. LacZ expression in transgenic embryos also showed the same pattern. Conclusion: Similar to various known multiple-functional proteins, DAP could be one with different functions at different stages and in different cells. Data presented here designates DAP functions in the early embryonic and imaginal dics differentiation and development, suggesting that it may be required for the metabolism of proteins like neuropeptides and tachykinins.

Keywords: aminopeptidase P, in situ hybridization, transgenic fly, embryonic stages

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Authors: K. Drabczyk, Z. Starowicz, S. Maleczek, P. Zieba

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The army, police and fire brigade commonly use dedicated equipment based on special textile materials. The properties of these textiles should ensure human life and health protection. Equally important is the ability to use electronic equipment and this requires access to the source of electricity. Photovoltaic cells integrated with such textiles can be solution for this problem in the most of outdoor circumstances. One idea may be to laminate the cells to textile without changing their properties. The main goal of this work was analyzed lamination quality of special designed semi-flexible solar module with special textile materials as a backsheet. In the first step of investigation, the quality of lamination was determined using device equipped with dynamometer. In this work, the crystalline silicon solar cells 50 x 50 mm and thin chemical tempered glass - 62 x 62 mm and 0.8 mm thick - were used. The obtained results showed the correlation between breaking force and type of textile weave and fiber. The breaking force was in the ranges: 4.5-5.5 N, 15-20 N and 30-33 N depending on the type of wave and fiber type. To verify these observations the microscopic and FTIR analysis of fibers was performed. The studies showed the special textile can be used as a backsheet of semi-flexible solar modules. This work presents a new composition of solar module with special textile layer which, to our best knowledge, has not been published so far. Moreover, the work presents original investigations on adhesion of EVA (ethylene-vinyl acetate) polymer to textile with respect to fiber structure of laminated substrate. This work is realized for the GEKON project (No. GEKON2/O4/268473/23/2016) sponsored by The National Centre for Research and Development and The National Fund for Environmental Protection and Water Management.

Keywords: flexible solar modules, lamination process, solar cells, textile for photovoltaics

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Authors: Sylvester S. Horvey, Jones Mensah

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The growing complexities and dynamics in the business environment have led to a new approach to risk management, known as enterprise risk management (ERM). ERM is a system and an approach to managing the risks of an organization in an integrated manner to achieve the corporate goals and strategic objectives. Regardless of the diversities in the business environment, ERM has become an essential factor in managing individual and business risks because ERM is believed to enhance shareholder value and firm growth. Despite the growing number of literature on ERM, the question about what factors drives ERM remains limited. This study provides a comprehensive literature review of the main factors that contribute to ERM implementation. Google Scholar was the leading search engine used to identify empirical literature, and the review spanned between 2000 and 2020. Articles published in Scimago journal ranking and Scopus were examined. Thirteen firm characteristics and sixteen articles were considered for the empirical review. Most empirical studies agreed that firm size, institutional ownership, industry type, auditor type, industrial diversification, earnings volatility, stock price volatility, and internal auditor had a positive relationship with ERM adoption, whereas firm size, institutional ownership, auditor type, and type of industry were mostly seen be statistically significant. Other factors such as financial leverage, profitability, asset opacity, international diversification, and firm complexity revealed an inconclusive result. The growing literature on ERM is not without limitations; hence, this study suggests that further research should examine ERM determinants within a new geographical context while considering a new and robust way of measuring ERM rather than relying on a simple proxy (dummy) for ERM measurement. Other firm characteristics such as organizational culture and context, corporate scandals and losses, and governance could be considered determinants of ERM adoption.

Keywords: enterprise risk management, determinants, ERM adoption, literature review

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Authors: Merouane Salhi, Mohamed Roudane, Abdelkader Kirad

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In this work, we present a new form of characteristics method, which is a technique for solving partial differential equations. Typically, it applies to first-order equations; the aim of this method is to reduce a partial differential equation to a family of ordinary differential equations along which the solution can be integrated from some initial data. This latter developed under the real gas theory, because when the thermal and the caloric imperfections of a gas increases, the specific heat and their ratio do not remain constant anymore and start to vary with the gas parameters. The gas doesn’t stay perfect. Its state equation change and it becomes for a real gas. The presented equations of the characteristics remain valid whatever area or field of study. Here we need have inserted the developed Prandtl Meyer function in the mathematical system to find a new model when the effect of stagnation pressure is taken into account. In this case, the effects of molecular size and intermolecular attraction forces intervene to correct the state equation, the thermodynamic parameters and the value of Prandtl Meyer function. However, with the assumptions that Berthelot’s state equation accounts for molecular size and intermolecular force effects, expressions are developed for analyzing the supersonic flow for thermally and calorically imperfect gas. The supersonic parameters depend directly on the stagnation parameters of the combustion chamber. The resolution has been made by the finite differences method using the corrector predictor algorithm. As results, the developed mathematical model used to design 2D minimum length nozzles under effect of the stagnation parameters of fluid flow. A comparison for air with the perfect gas PG and high temperature models on the one hand and our results by the real gas theory on the other of nozzles shapes and characteristics are made.

Keywords: numerical methods, nozzles design, real gas, stagnation parameters, supersonic expansion, the characteristics method

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Authors: Amani Waheed, Adel Mishriky, Rasha Farouk, Essam Abdallah, Sarah Hussein

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Background: Occupational stress plays a crucial role in professional drivers' health. They are exposed to high workloads, low physical activity, high demand and low decisions as well as poor lifestyle factors including poor diet, sedentary work, and smoking. Dyslipidemia is a well-established modifiable cardiovascular risk factor. Occupational stress and other forms of chronic stress have been associated with raised levels of atherogenic lipids. Although stress management has some evidence in improving lipid profile, the association between occupational stress and dyslipidemia is not clear. Objectives: To assess the relational between occupational stress and lipid profile among professional drivers. Methodology: A cross-sectional study conducted at a large company in Ismailia City, Egypt, where, 131 professional drivers divided into 44 car drivers, 43 bus drivers, and 44 truck drivers were eligible after applying exclusion criteria. Occupational stress index (OSI), non-occupational risk factors of dyslipidemia were assessed using interview structured questionnaire. Blood pressure, body mass index (BMI) and lipid profile were measured. Results: The mean of total OSI score was 79.98 ± 6.14. The total OSI score is highest among truck drivers (82.16 ± 4.62), then bus drivers (80.26 ± 6.02) and lowest among car drivers (77.55 ± 6.79) with statistically significant. Eighty percent had Dyslipidemia. The duration of driving hours per day, exposure to passive smoking and increased BMI were the risk factors. No statistical significance between Total OSI score and dyslipidemia. Using, logistic regression analysis, occupational stress, duration of driving hours per day, and BMI were positive significant predictors for dyslipidemia. Conclusion: Professional drivers are exposed to occupational stress. A high proportion of drivers have dyslipidemia. Total OSI score doesn't have statistically significant relation with dyslipidemia.

Keywords: body mass index, dyslipidaemia, occupational stress, professional drivers

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Authors: Rui Wu

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In the volatile modern manufacturing environment, new orders randomly occur at any time, while the pre-emptive methods are infeasible. This leads to a real-time scheduling method that can produce a reasonably good schedule quickly. The dynamic Flexible Job Shop problem is an NP-hard scheduling problem that hybrid the dynamic Job Shop problem with the Parallel Machine problem. A Flexible Job Shop contains different work centres. Each work centre contains parallel machines that can process certain operations. Many algorithms, such as genetic algorithms or simulated annealing, have been proposed to solve the static Flexible Job Shop problems. However, the time efficiency of these methods is low, and these methods are not feasible in a dynamic scheduling problem. Therefore, a dynamic rule selection scheduling system based on the reinforcement learning method is proposed in this research, in which the dynamic Flexible Job Shop problem is divided into several parallel machine problems to decrease the complexity of the dynamic Flexible Job Shop problem. Firstly, the features of jobs, machines, work centres, and flexible job shops are selected to describe the status of the dynamic Flexible Job Shop problem at each decision point in each work centre. Secondly, a framework of reinforcement learning algorithm using a double-layer deep Q-learning network is applied to select proper composite dispatching rules based on the status of each work centre. Then, based on the selected composite dispatching rule, an available operation is selected from the waiting buffer and assigned to an available machine in each work centre. Finally, the proposed algorithm will be compared with well-known dispatching rules on objectives of mean tardiness, mean flow time, mean waiting time, or mean percentage of waiting time in the real-time Flexible Job Shop problem. The result of the simulations proved that the proposed framework has reasonable performance and time efficiency.

Keywords: dynamic scheduling problem, flexible job shop, dispatching rules, deep reinforcement learning

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Authors: Ákos Wolf, Richard P. Ray

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Due to the introduction of Eurocode 8, the structural design for seismic and dynamic effects has become more significant in Hungary. This has emphasized the need for more effort to describe the behavior of structures under these conditions. Soil conditions have a significant effect on the response of structures by modifying the stiffness and damping of the soil-structural system and by modifying the seismic action as it reaches the ground surface. Shear modulus (G) and shear wave velocity (v_s), which are often measured in the field, are the fundamental dynamic soil properties for foundation vibration problems, liquefaction potential and earthquake site response analysis. There are several laboratory and in-situ measurement techniques to evaluate dynamic soil properties, but unfortunately, they are often too expensive for general design practice. However, a significant number of correlations have been proposed to determine shear wave velocity or shear modulus from Cone Penetration Tests (CPT), which are used more and more in geotechnical design practice in Hungary. This allows the designer to analyze and compare CPT and seismic test result in order to select the best correlation equations for Hungarian soils and to improve the recommendations for the Hungarian geologic conditions. Based on a literature review, as well as research experience in Hungary, the influence of various parameters on the accuracy of results will be shown. This study can serve as a basis for selecting and modifying correlation equations for Hungarian soils. Test data are taken from seven locations in Hungary with similar geologic conditions. The shear wave velocity values were measured by seismic CPT. Several factors are analyzed including soil type, behavior index, measurement depth, geologic age etc. for their effect on the accuracy of predictions. The final results show an improved prediction method for Hungarian soils

Keywords: CPT correlation, dynamic soil properties, seismic CPT, shear wave velocity

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Authors: B. Fazekas, I. Korolov, K. Kutasi

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Plasma medicine, which involves the use of gas discharge plasmas for medical applications is a rapidly growing research field. The use of non-thermal atmospheric pressure plasmas in dermatology to assist tissue regeneration by improving the healing of infected and/or chronic wounds is a promising application. It is believed that plasma can activate cells, which are involved in the wound closure. Non-thermal atmospheric plasmas are rich in chemically active species (such as O and N-atoms, O2(a) molecules) and radiative species such as the NO, N2+ and N2 excited molecules, which dominantly radiate in the 200-500 nm spectral range. In order to understand the effect of plasma species, both of chemically active and radiative species on wound healing process, the interaction of physical plasma with the human skin cells is necessary. In order to clarify the effect of plasma radiation on the wound healing process we treated keratinocyte cells – that are one of the main cell types in human skin epidermis – covered with a layer of phosphate-buffered saline (PBS) with a low power atmospheric pressure plasma. For the generation of such plasma we have applied a plasma needle. Here, the plasma is ignited at the tip of the needle in flowing helium gas in contact with the ambient air. To study the effect of plasma radiation we used a plasma needle configuration, where the plasma species – chemically active radicals and charged species – could not reach the treated cells, but only the radiation. For the comparison purposes, we also irradiated the cells using a UV-B light source (FS20 lamp) with a 20 and 40 mJ cm-2 dose of 312 nm. After treatment the viability and the proliferation of the cells have been examined. The proliferation of cells has been studied with a real time monitoring system called Xcelligence. The results have indicated, that the 20 mJ cm-2 dose did not affect cell viability, whereas the 40 mJ cm-2 dose resulted a decrease in cell viability. The results have shown that the plasma radiation have no quantifiable effect on the cell proliferation as compared to the non-treated cells.

Keywords: UV radiation, non-equilibrium gas discharges (non-thermal plasmas), plasma emission, keratinocyte cells

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Authors: Jihuai Wu, Zeyu Song, Zhang Lan, Liuxue Sun

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Solar energy is clean, open, and infinite, but solar radiation on the earth is fluctuating, intermittent, and unstable. So, the sustainable utilization of solar energy requires a combination of high-efficient energy conversion and low-loss energy storage technologies. Hence, a photo capacitor integrated with photo-electrical conversion and electric-chemical storage functions in single device is a cost-effective, volume-effective and functional-effective optimal choice. However, owing to the multiple components, multi-dimensional structure and multiple functions in one device, especially the mismatch of the functional modules, the overall conversion and storage efficiency of the photocapacitors is less than 13%, which seriously limits the development of the integrated system of solar conversion and energy storage. To this end, two typical photocapacitors were studied. A three-terminal photocapacitor was integrated by using perovskite solar cell as solar conversion module and symmetrical supercapacitor as energy storage module. A function portfolio management concept was proposed the relationship among various efficiencies during photovoltaic conversion and energy storage process were clarified. By harmonizing the energy matching between conversion and storage modules and seeking the maximum power points coincide and the maximum efficiency points synchronize, the overall efficiency of the photocapacitor surpassed 18 %, and Joule efficiency was closed to 90%. A voltage adjustable hybrid supercapacitor (VAHSC) was designed as energy storage module, and two Si wafers in series as solar conversion module, a three-terminal photocapacitor was fabricated. The VAHSC effectively harmonizes the energy harvest and storage modules, resulting in the current, voltage, power, and energy match between both modules. The optimal photocapacitor achieved an overall efficiency of 15.49% and Joule efficiency of 86.01%, along with excellent charge/discharge cycle stability. In addition, the Joule efficiency (ηJoule) was defined as the energy ratio of discharge/charge of the devices for the first time.

Keywords: joule efficiency, perovskite solar cell, photocapacitor, silicon solar cell, supercapacitor

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Authors: Fabiha Tanzeem

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BACKGROUND: Osteoporosis is a skeletal disease that is associated with a reduction in bone mass and microstructures of the bone and deterioration of bone tissue. Fragility fracture due to osteoporosis is the most significant complication of osteoporosis. The increasing prevalence of fragility fractures presents a growing burden on the global economy. There is a rapidly evolving need to improve awareness of the costs associated with these types of fractures and to review current policies and practices for the prevention and management of the disease. This systematic review will identify and describe the direct and indirect costs associated with osteoporotic fragility fractures from a global perspective from the included studies. The review will also find out whether the costs required for the treatment of fragility fractures due to osteoporosis impose an economic burden on the global healthcare system. METHODS: Four major databases were systematically searched for direct and indirect costs of osteoporotic fragility fracture studies in the English Language. PubMed, Cochrane Library, Embase and Google Scholar were searched for suitable articles published between 1990 and July 2020. RESULTS: The original search yielded 1166 papers; from these, 27 articles were selected for this review according to the inclusion and exclusion criteria. In the 27 studies, the highest direct costs were associated with the treatment of pelvic fractures, with the majority of the expenditure due to hospitalization and surgical treatments. It is also observed that most of the articles are from developed countries. CONCLUSION: This review indicates the significance of the economic burden of osteoporosis globally, although more research needs to be done in developing countries. In the treatment of fragility fractures, direct costs were the main reported expenditure in this review. The healthcare costs incurred globally can be significantly reduced by implementing measures to effectively prevent the disease. Raising awareness in children and adults by improving the quality of the information available and standardising policies and planning of services requires further research.

Keywords: systematic review, osteoporosis, cost of illness

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Authors: Maulita Sari Hani, Abraham B. Sianipar, Jamaluddin Jompa, Natsir Nessa, Alan T. White

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Manta ray is an icon for tourism in Raja Ampat. The tourist volume has been increased for the past ten years which up to approximately 23,000 tourists in 2017. Since 2013, Conservation International Indonesia deployed satellite and acoustic tags on manta ray in Dampier strait to track the species and identify the aggregation areas. These findings encourage the government and the local community to boost conservation through the management of marine protected areas for tourism purposes. Community in Dampier strait including the village of Arborek, Kurkapa, Kapisawar, and Sawingray involved in variety of small scale tourism business including homestay, dive shop, tour operator, and crafts. Working groups of related local businesses were established to support the local community and to ensure the sustainability of the economic viability and environmental sustainability. In order to analyze the economic benefits of manta ray tourism, this study was conducted to identify the number of local business in Dampier Strait and the economic impacts in terms of local finance security, social, humanity, individual, and physical assets. The results of this study identify 30 homestays, 2 dive shops, 10 tour operators, 30 women involved in crafts, and about 50 villagers worked for dive resorts. In addition to community assets, we confirmed the welfare of community has been improved in terms of food security, households, education for children, savings, and health insurance.

Keywords: marine wildlife tourism, elasmobranch, conservation, ecotourism, co-management, economic viability, environmental sustainability

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Authors: Bo-Jian Wu, Si-Heng Wu

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Objectives: Frailty is a condition of a person who has chronic health problems complicated by a loss of physiological reserve and deteriorating functional abilities. The frailty syndrome was defined by Fried and colleagues, i.e., weight loss, fatigue, decreased grip strength, slow gait speed, and low physical activity. However, to our best knowledge, there have been rare studies exploring the prevalence of frailty and its association with falls in patients with schizophrenia. Methods: A total of 559 hospitalized patients were recruited from a public psychiatric hospital in 2013. The majority of the subjects were males (361, 64.6%). The average age was 53.5 years. All patients received the assessment of frailty status defined by Fried and colleagues. The status of a fall within one year after the assessment of frailty, clinical and demographic data was collected from medical records. Logistic regression was used to calculate the odds ratio of associated factors. Results : A total of 9.2% of the participants met the criteria of frailty. The percentage of patients having a fall was 7.2%. Age were significantly associated with frailty (odds ratio = 1.057, 95% confidence interval = 1.025-1.091); however, sex was not associated with frailty (p = 0.17). After adjustment for age and sex, frailty status was associated with a fall (odds ratio = 3.62, 95% confidence interval = 1.58-8.28). Concerning the components of frailty, decreased grip strength (odds ratio = 2.44, 95% confidence interval = 1.16-5.14), slow gait speed (odds ratio = 2.82, 95% confidence interval = 1.21-6.53), and low physical activity (odds ratio = 2.64, 95% confidence interval = 1.21-5.78) were found to be associated with a fall. Conclusions: Our findings suggest the prevalence of frailty was about 10% in hospitalized patients with chronic patients with schizophrenia, and frailty status was significant with a fall in this group. By using the status of frailty, it may be beneficial to potential target candidates having fallen in the future as early as possible. The effective intervention of prevention of further falls may be given in advance. Our results bridge this gap and open a potential avenue for the prevention of falls in patients with schizophrenia. Frailty is certainly an important factor for maintaining wellbeing among these patients.

Keywords: fall, frailty, schizophrenia, Taiwan

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Authors: Getinet Gezahegn Gebre

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The study examined the impact of gender differences on Crop productivity in Decha woreda of southwest Kafa zone, located 140 Km from Jimma Town and 460 km southwest of Addis Ababa, between Bonga town and Omo River. The specific objectives were to assess the extent to which the agricultural production system is gender oriented, to examine access and control over productive resources, and to estimate men’s and women’s productivity in agriculture. Cross-sectional data collected from a total of 140 respondents were used in this study, whereby 65 were female-headed and 75 were male-headed households. The data were analyzed by using Statistical Package for Social Science (SPSS). Descriptive statistics such as frequency, mean, percentage, t-test and chi-square were used to summarize and compare the information between the two groups. Moreover, Cobb-Douglas(CD) production function was used to estimate the productivity difference in agriculture between male and female-headed households. Results of the study showed that male-headed households (MHH) own more productive resources such as land, livestock, labor and other agricultural inputs as compared to female-headed households (FHH). Moreover, the estimate of CD production function shows that livestock, herbicide use, land size and male labor were statistically significant for MHH, while livestock, land size, herbicides use and female labor were significant variables for FHH. The crop productivity difference between MHH and FHH was about 68.83% in the study area. However, if FHH had equal access to the inputs as MHH, the gross value of the output would be higher by 23.58% for FHH. This might suggest that FHH would be more productive than MHH if they had equal access to inputs as MHH. Based on the results obtained, the following policy implication can be drawn: accessing FHH to inputs that increase the productivity of agriculture, such as herbicides, livestock and male labor; increasing the productivity of land; and introducing technologies that reduce the time and energy of women, especially for enset processing.

Keywords: gender difference, crop productivity, GDP, efficiency

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Authors: Mohd Zubairy Bin Shamsudin

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Work-related Musculoskeletal Disorder (WMSDs) is one of the occupational health problems encountered by workers over the world. In Malaysia, there is increasing in trend over the years, particularly in the manufacturing sectors. Current method to observe workplace WMSDs is self-report questionnaire, observation and direct measurement. Observational method is most frequently used by the researcher and practitioner because of the simplified, quick and versatile when it applies to the worksite. However, there are some limitations identified e.g. some approach does not cover a wide spectrum of biomechanics activity and not sufficiently sensitive to assess the actual risks. This paper elucidates the development of Work Movement Task Analysis (WMTA), which is an observational tool for industrial practitioners’ especially untrained personnel to assess WMSDs risk factors and provide a basis for suitable intervention. First stage of the development protocol involved literature reviews, practitioner survey, tool validation and reliability. A total of six themes/comments were received in face validity stage. New revision of WMTA consisted of four sections of postural (neck, back, shoulder, arms, and legs) and associated risk factors; movement, load, coupling and basic environmental factors (lighting, noise, odorless, heat and slippery floor). For inter-rater reliability study shows substantial agreement among rater with K = 0.70. Meanwhile, WMTA validation shows significant association between WMTA score and self-reported pain or discomfort for the back, shoulder&arms and knee&legs with p<0.05. This tool is expected to provide new workplace ergonomic observational tool to assess WMSDs for the next stage of the case study.

Keywords: assessment, biomechanics, musculoskeletal disorders, observational tools

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Authors: P. Gayathri, G. P. Jeyanthi

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The bark of Polyalthia longifolia is used in ayurvedic system of medicine for the manangement of various ailments including diabetes mellitus. The bark of P. longifolia extracts was extracted using various polar and non-polar solvents and tested for inhibition of alpha-amylase and alpha-glucosidase among which the ethanolic extracts were found to be more potent. The ethanolic extracts of the bark were tested for the in vitro inhibition of alpha-amylase using starch as substrate and alpha-glucosidase using p-nitro phenyl alpha-D-gluco pyranoside as substrate to establish its in vitro antidiabetic effect. The mechanism of inhibition was determined by Dixon plot and Cornish-Bowden plot. The cytotoxic effect of the extract was tested on L6 and Vero cell-lines. The extract was partially purified by TLC. The individual effect of the ethanolic extract, TLC fractions and its combinatorial effect with insulin and glibenclamide on glucose uptake by rat hemi-diaphragm were studied.Results revealed that the ethanolic extracts of Polyalthia longifolia bark exhibited competitive inhibition of alpha-amylase and alpha-glucosidase. The extracts were also found not to be cytotoxic at the highest dose of 1 mg/mL. Glucose uptake study revealed that the extract alone and when combined with insulin, decreased the glucose uptake when compared to insulin control, however the purified TLC fractions exhibited significantly higher (p<0.05) glucose uptake by the rat hemi-diaphragm when compared to insulin. The study shows various possible mechanism of in vitro antidiabetic effect of the P. longifolia bark.

Keywords: alpha-amylase, alpha-glucosidase, dixon, cornish-bowden, L6 , Vero cell-lines, glucose uptake, polyalthia longifolia bark, ethanolic extract, TLC fractions

Procedia PDF Downloads 468

Authors: Mohammadbagher Asghariaghamashhadi

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Internet users normally are automatically linked to an advertisement sponsored by a bidder when Internet users enter any trademarked keyword on a search engine. This advertisement appears beside the search results. Through the process of keyword advertising, advertisers can connect with many Internet users and let them know about their goods and services. This concept has generated heated disagreements among legal scholars, trademark proprietors, advertisers, search engine owners, and consumers. Therefore, use of trademarks in keyword advertising has been one of the most debatable issues in trademark law for several years. This entirely new way of using trademarks over the Internet has provoked a discussion concerning the core concepts of trademark law. In respect to legal issues, European Union (EU) trademark law is mostly governed by the Trademark Directive and the Community Trademark Regulation. Article 5 of the directive and Article 9 of the trademark regulation determine the circumstances in which a trademark owner holds the right to prohibit a third party’s use of his/her registered sign. Harmonized EU trademark law proved to be ambiguous on whether using of a trademark is amounted to trademark infringement or not. The case law of the European Court of Justice (ECJ), with reference to this legislation, is mostly unfavorable to trademark owners. This ambivalence was also exhibited by the case law of EU Member States. European keyword advertisers simply could not tell which use of a competitor‘s trademark was lawful. In recent years, ECJ has continuously expanded the scope and reach of trademark protection in the EU. It is notable that Inconsistencies in the Court’s system of infringement criteria clearly come to the fore and this approach has been criticized by analysts who believe that the Court should have adopted a more traditional approach to the analysis of trademark infringement, which was suggested by its Advocate General, in order to arrive at the same conclusion. Regarding case law of keyword advertising within Europe, one of the most disputable cases is Interflora vs. Marks and Spencer, which is still on-going. This study examines and critically analyzes the decisions of the ECJ, the high court of England, and the Court of Appeals of England and address critically keyword advertising issue within European trademark legislation.

Keywords: ECJ, Google, Interflora, keyword advertising, Marks and Spencer, trademark infringement

Procedia PDF Downloads 343

Authors: Ayse Pekrioglu Balkis, Sawash Mecid

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Due to continued growth and rapid development of road construction in worldwide, road sub-layers consist of soil layers, therefore, identification and recognition of type of soil and soil behavior in different condition help to us to select soil according to specification and engineering characteristic, also if necessary sometimes stabilize the soil and treat undesirable properties of soils by adding materials such as bitumen, lime, cement, etc. If the soil beneath the road is not done according to the standards and construction will need more construction time. In this case, a large part of soil should be removed, transported and sometimes deposited. Then purchased sand and gravel is transported to the site and full depth filled and compacted. Stabilization by cement or other treats gives an opportunity to use the existing soil as a base material instead of removing it and purchasing and transporting better fill materials. Classification of soil according to AASHTOO system and USCS help engineers to anticipate soil behavior and select best treatment method. In this study soil classification and the relation between soil classification and stabilization method is discussed, cement stabilization with different percentages have been selected for soil treatment based on NCHRP. There are different parameters to define the strength of soil. In this study, CBR will be used to define the strength of soil. Cement by percentages, 0%, 3%, 7% and 10% added to soil for evaluation effect of added cement to CBR of treated soil. Implementation of stabilization process by different cement content help engineers to select an economic cement amount for the stabilization process according to project specification and characteristics. Stabilization process in optimum moisture content (OMC) and mixing rate effect on the strength of soil in the laboratory and field construction operation have been performed to see the improvement rate in strength and plasticity. Cement stabilization is quicker than a universal method such as removing and changing field soils. Cement addition increases CBR values of different soil types by the range of 22-69%.

Keywords: California Bearing Ratio, cement stabilization, clayey soil, mechanical properties

Procedia PDF Downloads 394

Authors: Yu-Chieh Chen, Li-Yun Wang, Chi-Chih Chen, Huy Hùng Đào, Ya-Mei Chen, Ming-Chu Cheng, Wen-Bin Chung, Hso-Chi Chaung, Guan-Ming Ke

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Many recent researches have demonstrated that CD154, a protein primarily expressed on activated T cell molecules, has potentially acted as a molecular adjuvant to improve the immunogenicity of subunit vaccines against viral infections. Classical swine fever (CSF) affects the swine industry worldwide that is one of the most devastating and highly contagious pig diseases. It is listed by the World Organization for Animal Health (OIE) as an infectious animal disease that must be reported. Although pigs vaccinated with subunit vaccines can be differentially diagnosed from those infected animals, subunit vaccines usually need adjuvants to enhance and elicit immune responses. In this study, CD154 was linked with CSFV E2 sequences and then expressed in CHO cells to produce the fusion protein as E2-CD154. The porcine specific CpG adjuvant was also used in one of the formulations. The specific pathogen-free pigs (SPF) at the age of 4-week-old were randomly separated into four groups, vaccinated with E2-CpG, E2-CD154, E2-CD154-CpG or the commercial Bayovac® CSF-E2 vaccine and boosted two weeks after primary vaccination. The results showed that the percentages of CD4+ and CD4+IL2+ in peripheral blood mononuclear cells (PBMC) in E2-CD154 vaccinated piglets seven days after primary vaccination were gained by 1-5% relative to the control group. In addition, the percentages of CD4+IFNγ+ T cells had slightly edged up 0.1-0.3% compared with the control group. Also, increased E2-specific IFNγ levels had edged up CD4+CD8+ T cells found in E2-CD154 and E2-CD154-CpG groups, particularly in the E2-CD154-CpG group. These results implicate that CD154 may enhance cellular immunity and synergistically act with species-specific CpG adjuvant as a dual-phase adjuvant. Therefore, the CD154 may be beneficial as a promising adjuvant in subunit vaccines.

Keywords: CD154, CpG adjuvant, cellular immunity, subunit vaccine, pig

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Authors: Joshna Rani S., Ahmadi Banu

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Artificial Intelligence (AI) has a significant task to carry out in the medical care contributions of things to come. As AI, it is the essential capacity behind the advancement of accuracy medication, generally consented to be a painfully required development in care. Albeit early endeavors at giving analysis and treatment proposals have demonstrated testing, we anticipate that AI will at last dominate that area too. Given the quick propels in AI for imaging examination, it appears to be likely that most radiology, what's more, pathology pictures will be inspected eventually by a machine. Discourse and text acknowledgment are now utilized for assignments like patient correspondence and catch of clinical notes, and their utilization will increment. The best test to AI in these medical services areas isn't regardless of whether the innovations will be sufficiently skilled to be valuable, but instead guaranteeing their appropriation in day by day clinical practice. For far reaching selection to happen, AI frameworks should be affirmed by controllers, coordinated with EHR frameworks, normalized to an adequate degree that comparative items work likewise, instructed to clinicians, paid for by open or private payer associations, and refreshed over the long haul in the field. These difficulties will, at last, be survived, yet they will take any longer to do as such than it will take for the actual innovations to develop. Therefore, we hope to see restricted utilization of AI in clinical practice inside 5 years and more broad use inside 10 years. It likewise appears to be progressively evident that AI frameworks won't supplant human clinicians for a huge scope, yet rather will increase their endeavors to really focus on patients. Over the long haul, human clinicians may advance toward errands and work plans that draw on remarkably human abilities like sympathy, influence, and higher perspective mix. Maybe the lone medical services suppliers who will chance their professions over the long run might be the individuals who will not work close by AI

Keywords: artificial intellogence, health care, breast cancer, AI applications

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