Search results for: electronic medical records

Authors: Leoni Van Der Merwe

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Historically, in South Africa, disability has been viewed as a dilemma of the individual. The discourse surrounding the definition of disability and applicable theories are as fluid as the differing needs of persons with disabilities within society. In 1997, the Office of the Deputy President published the White Paper on the Integrated National Disability Strategy (WPINDS) which sought to integrate disability issues in all governmental development strategies, planning and programs as well as to solidify the South African government’s stance that disability was to be considered according to the social model and not the, previously utilized, medical model of disability. The models of disability are conceptual frameworks for understanding disability and can provide some insight into why certain attitudes exist and how they are reinforced in society. Although the WPINDS was regarded as a critical milestone in the history of the disability rights struggle in South Africa; it has taken approximately twenty years for the publication of a similar document taking into account South Africa’s changing social, economic, political and technological dispensation. December 2015 marked the approval of the White Paper on the Rights of Persons with Disabilities (WPRPD) which seeks to update the WPINDS, integrate principles contained in international law instruments and endorse a mainstreaming trajectory for realizing the rights of persons with disabilities. While the WPINDS and the WPRPD were published two decades apart, both documents contain an emphasis on a transition from the medical model to the social model. Whereas, the medical model presupposes that disability is mainly a health and welfare matter and is focused on an individualistic and dependency-based approach; the social model requires a paradigm shift in the manner in which disability is constructed so as to highlight the shortcomings of society in respect of disability and to bring to the fore the capabilities of persons with disabilities. The social model has led to unmatched success in changing the perceptions surrounding disability. This article seeks to investigate the progress made in the implementation of the social model in South Africa by taking into account the effect of the diverse political and cultural landscape in promoting the historically entrenched medical model and the rise of disability activism prior to the new democratic dispensation as well as legislation, case law, policy documents and barriers in respect of persons with disabilities that are pervasive in South African society. The research paper will conclude that although numerous interventions have been identified and implemented to promote the consideration of disability within a social construct in South Africa, such interventions require increased national and international collaboration, resources and pace to ensure that the efforts made lead to sustainable results. For persons with disabilities, what remains to be seen is whether the proliferation of activism by interest groups, social awareness as well as the development of policy documents, legislation and case law will serve as the impetus to dissipate the view that disability is burden to be carried solely on the shoulders of the person with the disability.

Keywords: disability, medical model, social model, societal barriers, South Africa

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Authors: Stefanie Ficht, Lukas Schübel, Magdalena Kleybolte, Markus Eblenkamp, Jana Steger, Dirk Wilhelm, Petra Mela

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Although 3D printing as transformative technology has become of increasing interest in the medical field and the demand for biodegradable polymers has developed to a considerable extent, there are only a few additively manufactured, biodegradable implants on the market. Additionally, the sterilization of such implants and its side effects on degradation have still not been sufficiently studied. Within this work, thermosensitive poly p-dioxanone (PPDO) samples were printed with fused filament fabrication (FFF) and investigated. Subsequently, H₂O₂ plasma and gamma radiation were used as low-temperature sterilization techniques and compared among each other and the control group (no sterilization). In order to assess the effect of different sterilization on the degradation behavior of PPDO, the samples were immersed in phosphate-buffered solution (PBS) over 28 days, and surface morphology, thermal properties, molecular weight, inherent viscosity, and mechanical properties were examined at regular time intervals. The study demonstrates that PPDO was printed with great success and that thermal properties, molecular weight (Mw), and inherent viscosity (IV) were not significantly affected by the printing process itself. H₂O₂ plasma sterilization did not significantly harm the thermosensitive polymer, while gamma radiation lowered IV and Mw statistically significantly compared to the control group (p < 0.001). During immersion in PBS, a decrease in Mw and mechanical strength occurred for all samples. However, gamma sterilized samples were affected to a much higher extent compared to the two other sample groups both in final values and timeline. This was confirmed by scanning electron microscopy showing no changes of surface morphology of (non-sterilized) control samples, first microcracks appearing on plasma sterilized samples after two weeks while being present on gamma sterilized samples already immediately after radiation to then further deteriorate over immersion duration. To conclude, we demonstrated that FFF and H₂O₂ plasma sterilization are well suited for processing thermosensitive, biodegradable polymers used for the development of innovative short-term medical applications.

Keywords: additive manufacturing, sterilization, biodegradable, thermosensitive, medical application

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Authors: Domingos Vita, Patrick Brady

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Background: There is a tuberculosis (TB) epidemic in Angola that has been getting worse for more than a decade despite the active implementation of the DOTS strategy. The aim of this study was to directly interrogate healthcare workers involved in TB control on what they consider to be the drivers of the TB epidemic in Angola. Methods: Twenty four in-depth qualitative interviews were conducted with medical staff working in this field in the provinces of Luanda and Benguela. Results: The healthcare professionals see the migrant working poor as a particular problem for the control of TB. These migrants are constructed as ‘Rural People’ and are seen as non-compliant and late-presenting. This is a stigmatized and marginal group contending with the additional stigma associated with TB infection. The healthcare professionals interviewed also see the interruption of treatment and self medication generally as a better explanation for the TB epidemic than urbanization or lack of medication. Conclusions: The local narrative is in contrast to previous explanations used elsewhere in the developing world. To be effective policy must recognize the local issues of the migrant workforce, interruption of treatment and the stigma associated with TB in Angola.

Keywords: Africa, Angola, migrants, qualitative, research, tuberculosis

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Authors: Nagaraju Pendam, C. P. Vardhani

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A simple technology–compatible design of silicon-on-insulator based 1×2 optical power splitter is proposed. For developing large area Opto-electronic Silicon-on-Insulator (SOI) devices, the power splitter is a key passive device. The SOI rib- waveguide dimensions (height, width, and etching depth, refractive indices, length of waveguide) leading simultaneously to single mode propagation. In this paper a low loss optical power splitter is designed by using R Soft cad tool and simulated by Beam propagation method, here s-bend waveguides proposed. We concentrate changing the refractive index difference, branching angle, width of the waveguide, free space wavelength of the waveguide and observing transmitted power, effective refractive index in the designed waveguide, and choosing the best simulated results to be fabricated on silicon-on insulator platform. In this design 1550 nm free spacing are used.

Keywords: beam propagation method, insertion loss, optical power splitter, rib waveguide, transmitted power

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Authors: Chamseddine Barki, Salam Labidi, Hanen Boussi Rahmouni

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In this article, we present the principle and suitable methodology for the design of a medical ontology that highlights the radiological and dosimetric knowledge, applied in diagnostic radiology and radiation-therapy. Our ontology, which we named «Onto.Rap», is the subject of radiation protection in medical and radiology centers by providing a standardized regulatory oversight. Thanks to its added values of knowledge-sharing, reuse and the ease of maintenance, this ontology tends to solve many problems. Of which we name the confusion between radiological procedures a practitioner might face while performing a patient radiological exam. Adding to it, the difficulties they might have in interpreting applicable patient radioprotection standards. Here, the ontology, thanks to its concepts simplification and expressiveness capabilities, can ensure an efficient classification of radiological procedures. It also provides an explicit representation of the relations between the different components of the studied concept. In fact, an ontology based-radioprotection expert system, when used in radiological center, could implement systematic radioprotection best practices during patient exam and a regulatory compliance service auditing afterwards.

Keywords: knowledge, ontology, radiation protection, radiology

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Authors: Anastasia Constantinou, Stephen Morris

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Background: The adoption of synchronous and asynchronous telemedicine modalities for primary care consultations has exponentially increased since the COVID-19 pandemic. However, there is limited understanding of how virtual consultations influence healthcare resource utilization and other quality measures including safety, timeliness, efficiency, patient and provider satisfaction, cost-effectiveness and environmental impact. Aim: Quantify the rate of follow-up visits, emergency department visits, hospitalizations, request for investigations and prescriptions and comment on the effect on different quality measures associated with different telemedicine modalities used for primary care services and primary care referrals to secondary care Design and setting: Systematic review in primary care Methods: A systematic search was carried out across three databases (Medline, PubMed and Scopus) between August and November 2023, using terms related to telemedicine, general practice, electronic referrals, follow-up, use and efficiency and supported by citation searching. This was followed by screening according to pre-defined criteria, data extraction and critical appraisal. Narrative synthesis and metanalysis of quantitative data was used to summarize findings. Results: The search identified 2230 studies; 50 studies are included in this review. There was a prevalence of asynchronous modalities in both primary care services (68%) and referrals from primary care to secondary care (83%), and most of the study participants were females (63.3%), with mean age of 48.2. The average follow-up for virtual consultations in primary care was 28.4% (eVisits: 36.8%, secure messages 18.7%, videoconference 23.5%) with no significant difference between them or F2F consultations. There was an average annual reduction of primary care visits by 0.09/patient, an increase in telephone visits by 0.20/patient, an increase in ED encounters by 0.011/patient, an increase in hospitalizations by 0.02/patient and an increase in out of hours visits by 0.019/patient. Laboratory testing was requested on average for 10.9% of telemedicine patients, imaging or procedures for 5.6% and prescriptions for 58.7% of patients. When looking at referrals to secondary care, on average 36.7% of virtual referrals required follow-up visit, with the average rate of follow-up for electronic referrals being higher than for videoconferencing (39.2% vs 23%, p=0.167). Technical failures were reported on average for 1.4% of virtual consultations to primary care. When using carbon footprint estimates, we calculate that the use of telemedicine in primary care services can potentially provide a net decrease in carbon footprint by 0.592kgCO2/patient/year. When follow-up rates are taken into account, we estimate that virtual consultations reduce carbon footprint for primary care services by 2.3 times, and for secondary care referrals by 2.2 times. No major concerns regarding quality of care, or patient satisfaction were identified. 5/7 studies that addressed cost-effectiveness, reported increased savings. Conclusions: Telemedicine provides quality, cost-effective, and environmentally sustainable care for patients in primary care with inconclusive evidence regarding the rates of subsequent healthcare utilization. The evidence is limited by heterogeneous, small-scale studies and lack of prospective comparative studies. Further research to identify the most appropriate telemedicine modality for different patient populations, clinical presentations, service provision (e.g. used to follow-up patients instead of initial diagnosis) as well as further education for patients and providers alike on how to make best use of this service is expected to improve outcomes and influence practice.

Keywords: telemedicine, healthcare utilisation, digital interventions, environmental impact, sustainable healthcare

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Authors: Lukasz Szydlowski, Jiri Ehlich, Igor Goryanin

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We demonstrate a single chamber, 96-well-plated based Microbial Fuel Cell (MFC) with printed, electronic components. This invention is aimed at robust selection of electrogenic microbial community under specific conditions, e.g., electrode potential, pH, nutrient concentration, salt concentration that can be altered within the 96 well plate array. This invention enables robust selection of electrogenic microbial community under the homogeneous reactor, with multiple conditions that can be altered to allow comparative analysis. It can be used as a standalone technique or in conjunction with other selective processes, e.g., flow cytometry, microfluidic-based dielectrophoretic trapping. Mobile conductive elements, like carbon paper, carbon sponge, activated charcoal granules, metal mesh, can be inserted inside to increase the anode surface area in order to collect electrogenic microorganisms and to transfer them into new reactors or for other analytical works. An array of 96-well plate allows this device to be operated by automated pipetting stations.

Keywords: bioengineering, electrochemistry, electromicrobiology, microbial fuel cell

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Authors: Seyed Majid Alavi Shooshtari

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As a multi-layered prose piece of artistry and craftsmanship Charles de Secondat, baron de Montesquieu’s Persian Letters (1721) is a satirical work which records the experiences of two Persian noblemen, Usbek and Rica, traveling through France in the early eighteenth century. Montesquieu creates Persian Letters as a critique of the French society, a critical explanation of what was considered to be 'the Orient' in the period, and an invaluable historical document which illustrates the ways Europe and the East understood each other in the first half of the eighteenth century. However, Persian Letters is considered today, in part, an Orientalist text because of it presenting the culture of the East using stereotypical images. Although, when Montesquieu published Persian Letters, the term Orientalist was a harmless word for people who studied or took an interest in it, the ways in which this Western intellectual author exerts his critique of French social and political life through the eyes of Persian protagonists by placing the example of the Orient (the Other) at the service of an ongoing Eighteen century discourse does raise some Eastern eyebrows. The fact that Persian side of the novel is considered by some critics as a fanciful decor, and the letters sent home are seen as literary props, yet these Eastern men intelligently question the rationality of religious, state, military and cultural practices and uncover much of the absurdity, irrationality or frivolity of European life. By drawing on the insight that Montesquieu’s text problematizes the assumption that orientalism monolithically constructs the Orient as the Other, the present paper aims to examine how the innocent gaze of two Eastern travelers mirrors the ways Europe’s identity defines its-Self.

Keywords: montesquieu, persian letters, ‘the orint’, identity politics, self, the other

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Authors: Koteswara Rao Pagolu, Raghava Rao Tamanam

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In India, genetic disease is a disregarded service element in the community health- protection system. This study aims to gauge the accessibility of services for treating genetic disorders and also to evaluate the practices on deterrence and management services in the district health system. A cross-sectional survey of selected health amenities in the government health sector was conducted from 15 primary health centers (PHC’s), 4 community health centers (CHC’s), 1 district government hospital (DGH) and 3 referral hospitals (RH’s). From these, the existing manpower like 130 medical officers (MO’s), 254 supporting staff, 409 nursing staff (NS) and 45 lab technicians (LT’s) was examined. From the side of private health institutions, 25 corporate hospitals (CH’s), 3 medical colleges (MC’s) and 25 diagnostic laboratories (DL’s) were selected for the survey and from these, 316 MO’s, 995 NS and 254 LT’s were also reviewed. The findings show that adequate staff was in place at more than 70% of health centers, but none of the staff have obtained any operative training on genetic disease management. The largest part of the DH’s had rudimentary infrastructural and diagnostic facilities. However, the greater part of the CHC’s and PHC’s had inadequate diagnostic facilities related to genetic disease management. Biochemical, molecular, and cytogenetic services were not available at PHC’s and CHC’s. DH’s, RH’s, and all selected medical colleges were found to have offered the basic Biochemical genetics units during the survey. The district health care infrastructure in India has a shortage of basic services to be provided for the genetic disorder. With some policy resolutions and facility strengthening, it is possible to provide advanced services for a genetic disorder in the district health system.

Keywords: district health system, genetic disorder, infrastructural amenities, management practices

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Authors: Ivonne N. Pérez-Sánchez. María L. Rascón- Gasca, Angélica Riveros-Rosas, Rebeca Robles García

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Introduction: Primary caregivers of cancer patients have health problems related to their lack of time, stress, and fiscal strain. Their health problems could affect their patients’ health and also increase the expenses in public health. Aim: To describe self-care and risk behaviors in a sample of Mexican primary caregiver and the relation of these behaviors with emotional distress (caregiver burden, anxiety and depression symptoms), coping and sociodemographic variables. Method: Participated in this study 173 caregivers of a third level reference medical facility (age: M=49.4, SD=13.5) females 78%, males 22%, 57.5% were caregivers of patients with terminal cancer (CPTC), and 40.5% were caregivers of patients on oncology treatment (CPOT). Results: The 75.7% of caregivers reported to have had health problem in last six months as well as several symptoms which were related to emotional distress, these symptoms were more frequently between CPTC and female caregivers. A half (47.3%) of sample reported have had difficulties in caring their health; these difficulties were related to emotional distress and lower coping, more affected caregivers were who attend male patients and CPTC. The 76.8% of caregivers had health problems in last six months, but 26.5% of them waited to search medical care until they were very sick, and 11% didn't do it. Also, more than a half of sample (56.1%) admitted to have risk behaviors as drink alcohol, smoke or overeating for feeling well, these caregivers showed high emotional distress and lower coping. About caregivers healthy behaviors, 80% of them had a hobby; 27.2% do exercise usually and between 12% to 60% did medical checkups (glucose tests, blood pressure and cholesterol tests, eye exams and watched their weight), these caregivers had lower emotional distress and high coping, some variables related health behaviors were: care only one patient or a female patient and be a CPOT, social support, high educational level and experience as a caregiver in past. The half of caregivers were worrying to develop cancer in the future; this idea was 2.5 times more frequent in caregiver with problems to care their health. Conclusions: The results showed a big proportion of caregivers with medical problems. High emotional distress and low coping were related to physical symptoms, risk behaviors, and low self-care; poor self-care was frequently even in caregiver who have chronic illness.

Keywords: cancer, primary caregiver, risk behaviors, self-care

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Authors: Garima Singh, Kunal Malhotra

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Objective: The expansion of telehealth has been instrumental in increasing access to medical services, especially for underserved and rural communities. In 2020, 14 million patients received virtual care through telemedicine and the global telemedicine market is expected to reach up to $185 million by 2023. It provides a platform and allows a patient to receive primary care as well as specialized care using technology and the comfort of their homes. Telemedicine was particularly useful during COVID-pandemic and the number of telehealth visits increased by 5000% during that time. It continues to serve as a significant resource for patients seeking care and to bridge the gap between the disease and the treatment. Method: As per APA (American Psychiatric Association), Telemedicine is the process of providing health care from a distance through technology. It is a subset of telemedicine, and can involve providing a range of services, including evaluations, therapy, patient education and medication management. It can involve direct interaction between a physician and the patient. It also encompasses supporting primary care providers with specialist consultation and expertise. It can also involve recording medical information (images, videos, etc.) and sending this to a distant site for later review. Results: In our organization, we are using telepsychiatry and serving 25 counties and approximately 1.4 million people. We provide multiple services, including inpatient, outpatient, crisis intervention, Rehab facility, autism services, case management, community treatment and multiple other modalities. With project ECHO (Extension for Community Healthcare Outcomes) it has been used to advise and assist primary care providers in treating mental health. It empowers primary care providers to treat patients in their own community by sharing knowledge. Conclusion: Telemedicine has shown to be a great medium in meeting patients’ needs and accessible mental health. It has been shown to improve access to care in both urban and rural settings by bringing care to a patient and reducing barriers like transportation, financial stress and resources. Telemedicine is also helping with reducing ER visits, integrating primary care and improving the continuity of care and follow-up. There has been substantial evidence and research about its effectiveness and its usage.

Keywords: telehealth, telemedicine, access to care, medical technology

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Authors: E. G. Zaki, M. A. Migahed, A. M. Al-Sabagh, E. A. Khamis

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Inhibition effect of four novel nonionic surfactants based on sulphonamide, of linear alkyl benzene sulphonic acid (LABS), was reacted with 1 mole triethylenetetramine, tetraethylenepentamine then Ethoxylation of amide X 65 type carbon steel in oil wells formation water under H2S environment was investigated by electrochemical measurements. Scanning electron microscopy (SEM) and energy dispersion X-ray (EDX) were used to characterize the steel surface. The results showed that these surfactants act as a corrosion inhibitor in and their inhibition efficiencies depend on the ethylene oxide content in the system. The obtained results showed that the percentage inhibition efficiency (η%) was increased by increasing the inhibitor concentration until the critical micelle concentration (CMC) reached The quantum chemistry calculations were carried out to study the molecular geometry and electronic structure of obtained derivatives. The energy gap between the highest occupied molecular orbital and lowest unoccupied molecular orbital has been calculated using the theoretical computations to reflect the chemical reactivity and kinetic stability of compounds.

Keywords: corrosion, surfactants, steel surface, quantum

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Authors: M. A. Ferhat, M. N. Boukhatem, F. Chemat

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Microwave Clevenger or microwave accelerated distillation (MAD) is a combination of microwave heating and distillation, performed at atmospheric pressure without added any solvent or water. Isolation and concentration of volatile compounds are performed by a single stage. MAD extraction of orange essential oil was studied using fresh orange peel from Valencia late cultivar oranges as the raw material. MAD has been compared with a conventional technique, which used a Clevenger apparatus with hydro-distillation (HD). MAD and HD were compared in term of extraction time, yields, chemical composition and quality of the essential oil, efficiency and costs of the process. Extraction of essential oils from orange peels with MAD was better in terms of energy saving, extraction time (30 min versus 3 h), oxygenated fraction (11.7% versus 7.9%), product yield (0.42% versus 0.39%) and product quality. Orange peels treated by MAD and HD were observed by scanning electronic microscopy (SEM). Micrographs provide evidence of more rapid opening of essential oil glands treated by MAD, in contrast to conventional hydro-distillation.

Keywords: clevenger, microwave, extraction; hydro-distillation, essential oil, orange peel

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Authors: Yuguang Gao, Mingtao Deng

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The integration of independently operating hospitals into a unified healthcare service system has become a strategic imperative in the pursuit of hospitals’ high-quality development. Central to the concept of group governance over such transformation, exemplified by a collaborative medical alliance, is the delineation of shared value, vision, and goals. Given the inherent disparity in capabilities among hospitals within the alliance, particularly in the treatment of different diseases characterized by Disease Related Groups (DRG) in terms of effectiveness, efficiency and resource utilization, this study aims to address the centralized decision-making of intra-hospital patient referral within the medical alliance to enhance the overall production and quality of service provided. We first introduce the notion of production utility, where a higher production utility for a hospital implies better performance in treating patients diagnosed with that specific DRG group of diseases. Then, a Discrete-Event Simulation (DES) framework is established for patient referral among hospitals, where patient flow modeling incorporates a queueing system with fixed capacities for each hospital. The simulation study begins with a two-member alliance. The pivotal strategy examined is a "whether-to-refer" decision triggered when the bed usage rate surpasses a predefined threshold for either hospital. Then, the decision encompasses referring patients to the other hospital based on DRG groups’ production utility differentials as well as bed availability. The objective is to maximize the total production utility of the alliance while minimizing patients’ average length of stay and turnover rate. Thus the parameter under scrutiny is the bed usage rate threshold, influencing the efficacy of the referral strategy. Extending the study to a three-member alliance, which could readily be generalized to multi-member alliances, we maintain the core setup while introducing an additional “which-to-refer" decision that involves referring patients with specific DRG groups to the member hospital according to their respective production utility rankings. The overarching goal remains consistent, for which the bed usage rate threshold is once again a focal point for analysis. For the two-member alliance scenario, our simulation results indicate that the optimal bed usage rate threshold hinges on the discrepancy in the number of beds between member hospitals, the distribution of DRG groups among incoming patients, and variations in production utilities across hospitals. Transitioning to the three-member alliance, we observe similar dependencies on these parameters. Additionally, it becomes evident that an imbalanced distribution of DRG diagnoses and further disparity in production utilities among member hospitals may lead to an increase in the turnover rate. In general, it was found that the intra-hospital referral mechanism enhances the overall production utility of the medical alliance compared to individual hospitals without partnership. Patients’ average length of stay is also reduced, showcasing the positive impact of the collaborative approach. However, the turnover rate exhibits variability based on parameter setups, particularly when patients are redirected within the alliance. In conclusion, the re-structuring of diagnostic disease groups within the medical alliance proves instrumental in improving overall healthcare service outcomes, providing a compelling rationale for the government's promotion of patient referrals within collaborative medical alliances.

Keywords: collaborative medical alliance, disease related group, patient referral, simulation

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Authors: M. Kowalski, M. Brodowski, K. Dziabowska, E. Czaczyk, W. Bialobrzeska, N. Malinowska, S. Zoledowska, R. Bogdanowicz, D. Nidzworski

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Boron-doped-carbon nanowall (BCNW) electrodes are recently in much interest among scientists. BCNWs are good candidates for biosensor purposes as they possess interesting electrochemical characteristics like a wide potential range and the low difference between redox peaks. Moreover, from technical parameters, they are mechanically resistant and very tough. The production process of the microwave plasma-enhanced chemical vapor deposition (MPECVD) allows boron to build into the structure of the diamond being formed. The effect is the formation of flat, long structures with sharp ends. The potential of these electrodes was checked in the biosensing field. The procedure of simple carbon electrodes modification by antibodies was adopted to BCNW for specific antigen recognition. Surface protein D deriving from H. influenzae pathogenic bacteria was chosen as a target analyte. The electrode was first modified with the aminobenzoic acid diazonium salt by electrografting (electrochemical reduction), next anti-protein D antibodies were linked via 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride/N-hydroxysuccinimide (EDC/NHS) chemistry, and free sites were blocked by BSA. Cyclic voltammetry measurements confirmed the proper electrode modification. Electrochemical impedance spectroscopy records indicated protein detection. The sensor was proven to detect protein D in femtograms. This work was supported by the National Centre for Research and Development (NCBR) TECHMATSTRATEG 1/347324/12/NCBR/ 2017.

Keywords: anti-protein D antibodies, boron-doped carbon nanowall, impedance spectroscopy, Haemophilus influenzae.

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Authors: Atilla Evcin, Bahri Ersoy, Süleyman Akpınar, I. Sinan Atlı

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Ceramic, polymer and composite nanofibers are nowadays begun to be utilized in many fields of nanotechnology. By the means of dimensions, these fibers are as small as nano scale but because of having large surface area and microstructural characteristics, they provide unique mechanic, optical, magnetic, electronic and chemical properties. In terms of nanofiber production, electrospinning has been the most widely used technique in recent years. In this study, carbon nanofibers have been synthesized from solutions of Polyacrylonitrile (PAN)/ N,N-dimethylformamide (DMF) by electrospinning method. The carbon nanofibers have been stabilized by oxidation at 250 °C for 2 h in air and carbonized at 750 °C for 1 h in H2/N2. Images of carbon nanofibers have been taken with scanning electron microscopy (SEM). The images have been analyzed to study the fiber morphology and to determine the distribution of the fiber diameter using FibraQuant 1.3 software. Then polymer composites have been produced from mixture of carbon nanofibers and silicone polymer. The final polymer composites have been characterized by X-ray diffraction method and scanning electron microscopy (SEM) energy dispersive X-ray (EDX) measurements. These results have been reported and discussed. At result, homogeneous carbon nanofibers with 100-167 nm of diameter were obtained with optimized electrospinning conditions.

Keywords: electrospinning, characterization, composites, nanofiber

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Authors: William Michael Short

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Semantic Web’ technologies such as the Unified Medical Language System Metathesaurus, SNOMED-CT, and MeSH have been touted as transformational for the way users access online medical and health information, enabling both the automated analysis of natural-language data and the integration of heterogeneous healthrelated resources distributed across the Internet through the use of standardized terminologies that capture concepts and relationships between concepts that are expressed differently across datasets. However, the approaches that have so far characterized ‘semantic bioinformatics’ have not yet fulfilled the promise of the Semantic Web for medical and health information retrieval applications. This paper argues within the perspective of cognitive linguistics and cognitive anthropology that four features of human meaning-making must be taken into account before the potential of semantic technologies can be realized for this domain. First, many semantic technologies operate exclusively at the level of the word. However, texts convey meanings in ways beyond lexical semantics. For example, transitivity patterns (distributions of active or passive voice) and modality patterns (configurations of modal constituents like may, might, could, would, should) convey experiential and epistemic meanings that are not captured by single words. Language users also naturally associate stretches of text with discrete meanings, so that whole sentences can be ascribed senses similar to the senses of words (so-called ‘discourse topics’). Second, natural language processing systems tend to operate according to the principle of ‘one token, one tag’. For instance, occurrences of the word sound must be disambiguated for part of speech: in context, is sound a noun or a verb or an adjective? In syntactic analysis, deterministic annotation methods may be acceptable. But because natural language utterances are typically characterized by polyvalency and ambiguities of all kinds (including intentional ambiguities), such methods leave the meanings of texts highly impoverished. Third, ontologies tend to be disconnected from everyday language use and so struggle in cases where single concepts are captured through complex lexicalizations that involve profile shifts or other embodied representations. More problematically, concept graphs tend to capture ‘expert’ technical models rather than ‘folk’ models of knowledge and so may not match users’ common-sense intuitions about the organization of concepts in prototypical structures rather than Aristotelian categories. Fourth, and finally, most ontologies do not recognize the pervasively figurative character of human language. However, since the time of Galen the widespread use of metaphor in the linguistic usage of both medical professionals and lay persons has been recognized. In particular, metaphor is a well-documented linguistic tool for communicating experiences of pain. Because semantic medical knowledge-bases are designed to help capture variations within technical vocabularies – rather than the kinds of conventionalized figurative semantics that practitioners as well as patients actually utilize in clinical description and diagnosis – they fail to capture this dimension of linguistic usage. The failure of semantic technologies in these respects degrades the efficiency and efficacy not only of medical research, where information retrieval inefficiencies can lead to direct financial costs to organizations, but also of care provision, especially in contexts of patients’ self-management of complex medical conditions.

Keywords: ambiguity, bioinformatics, language, meaning, metaphor, ontology, semantic web, semantics

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Authors: Shveta Puri, Shiv Jyoti Pandey, G. M. Bhat, Neha Raina

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TheJammu and Kashmir region of the Northwest Himalaya had witnessed many devastating earthquakes in the recent past and has remained unexplored for any kind of seismic investigations except scanty records of the earthquakes that occurred in this region in the past. In this study, we have used local seismic data of year 2013 that was recorded by the network of Broadband Seismographs in J&K. During this period, our seismic stations recorded about 207 earthquakes including two moderate events of Mw 5.7 on 1st May, 2013 and Mw 5.1 of 2nd August, 2013.We analyzed the events of Mw 3-4.6 and the main events only (for minimizing the error) for source parameters, b value and sense of movement through waveform modeling for understanding seismotectonic and seismic hazard of the region. It has been observed that most of the events are bounded between 32.9° N – 33.3° N latitude and 75.4° E – 76.1° E longitudes, Moment Magnitude (Mw) ranges from Mw 3 to 5.7, Source radius (r), from 0.21 to 3.5 km, stress drop, from 1.90 bars to 71.1 bars and Corner frequency, from 0.39 – 6.06 Hz. The b-value for this region was found to be 0.83±0 from these events which are lower than the normal value (b=1), indicating the area is under high stress. The travel time inversion and waveform inversion method suggest focal depth up to 10 km probably above the detachment depth of the Himalayan region. Moment tensor solution of the (Mw 5.1, 02:32:47 UTC) main event of 2ndAugust suggested that the source fault is striking at 295° with dip of 33° and rake value of 85°. It was found that these events form intense clustering of small to moderate events within a narrow zone between Panjal Thrust and Kishtwar Window. Moment tensor solution of the main events and their aftershocks indicating thrust type of movement is occurring in this region.

Keywords: b-value, moment tensor, seismotectonics, source parameters

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Authors: Ngoc-Hieu Vu

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A study was conducted to estimate the record keeping, genetic selection, educational experience, and farm management effect on monthly milk yield per farm, average milk yield per cow, monthly milk revenue per farm, and monthly milk revenue per cow of dairy farms in the Southern region of Vietnam. The dataset contained 5448 monthly record collected from January 2013 to May 2015. Results showed that longer experience increased (P < 0.001) monthly milk yields and revenues. Better educated farmers produced more monthly milk per farm and monthly milk per cow and revenues (P < 0.001) than lower educated farmers. Farm that kept records on individual animals had higher (P < 0.001) for monthly milk yields and revenues than farms that did not. Farms that used hired people produced the highest (p < 0.05) monthly milk yield per farm, milk yield per cow and revenues, followed by farms that used both hire and family members, and lowest values were for farms that used family members only. Farms that used crosses Holstein in herd were higher performance (p < 0.001) for all traits than farms that used purebred Holstein and other breeds. Farms that used genetic information and phenotypes when selecting sires were higher (p < 0.05) for all traits than farms that used only phenotypes and personal option. Farms that received help from Vet, organization staff, or government officials had higher monthly milk yield and revenues than those that decided by owner. These findings suggest that dairy farmers should be training in systematic, must be considered and continuous support to improve farm milk production and revenues, to increase the likelihood of adoption on a sustainable way.

Keywords: dairy farming, education, milk yield, Southern Vietnam

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Authors: Shefali Nayak

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The architectural appeal, familiarity, and idiom of culturally significant structures are due to societal attachment to various movements, historical association or deviation. Generally, the urge to preserve a building in the northern part of India is driven either by emotional dogma or rational thinking, but, it is also influenced by traditional affinity. The northern region of India has an assortment of palaces and Havelis belonging to various time periods and families with vernacular yet signature style of architecture. Many of them are either successfully conserved by being put into adaptive reuse and some of them have been midst controversies and continued to remain in ruins. The research focuses on comparing successful examples of adaptive reuse such as Neemrana, Mehrangargh Fort palace with a few other merchant havelis converted into heritage hotels. Furthermore, evaluates the architectural aspects of structure, materials, plumbing and electrical installations, as well as specific challenges faced by heritage professionals practicing sustainability, while respecting traditional feelings of various stakeholders. This paper concludes through the analysis of the case study that, its highly unlikely for sustainable design cannot be used as a stand-alone application for heritage structures or cities, it needs the support of architecture conservation to be put into practice. However, it is often demanding to fit a new use of a building into an aged structure. This paper records modern-day generic requirements that reflect challenges faced by different architects, while conserving a heritage structure and retrofitting it into today's requisites. The research objective is to establish how conservation, restoration, and urban regeneration are closely related to sustainable architecture in historical cities.

Keywords: architecture conservation, architecture heritage, adaptive reuse, retrofitting, sustainability, urban regeneration

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Authors: S. I. Nwadioha, M. S. Odimayo, J. A. Omotayo, A. Olu Taiwo, O. E. Olabiyi

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The current study was conducted to determine the epidemiology and antibiotic sensitivity pattern of bacteria isolated from blood of septicemic patients for improved antibiotic therapy. A three-year descriptive study has been carried out at Microbiology Laboratory, Ekiti State University Teaching Hospital, Ado Ekiti, from April 2012 to April 2015. Information compiled from patients’ records includes age, sex, isolated organisms and antibiotic susceptibility patterns. Three hundred and thirteen blood cultures were collected from neonatology and pediatrics wards, Out Patients’ Department (OPD) and from other adult patients. Forty-one cultures yielded mono microbial growth (no polymicrobial growth), giving an incidence of 13.1% positive blood culture (N=41/313). There were 58.4% Gram-negative bacilli and 41.6% Gram-positive cocci in the microbial growth. Bacteria isolated were Staphylococcus aureus 34%(14/41), Klebsiella species22% (9/41), Enterococci 17%(7/41), Proteus species12%(5/41), Escherichia coli 7%(3/41) and Streptococcal pneumoniae 7%(3/41). There was a (35%) higher occurrence of septicemia in neonates than in any other age groups in the hospital. Bacterial sensitivity to 13 antibiotic agents was determined by antibiotics disc diffusion using modified Kirby Bauer’s method. Gram-positive organisms showed a higher antibiotic sensitivity ranging from 14- 100% than the Gram-negative bacteria (11-80%). Staphylococcus aureus and Klebsiella species are the most prevalent organisms. The third generation Cephalosporins (Ceftriaxone) and Floroquinolone(Levofloxacin, Ofloxacin) have proved reliable for management of these blood infections.

Keywords: blood cultures, septicemia, antibiogram, Nigeria

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Authors: Robin Ruowei Yang

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The Khitan-Liao dynasty (907-1125) was founded by the nomadic Khitan people and showed its peculiarities. This regime not only effectively ruled their own nomads, but also ruled the farming ethnic groups of the Han (漢) and others. It also controlled vast territories that included the northern border domains of China, East Asia, and even Central Asia. Different from the practice of other nomadic people, Khitan-Liao built settlement towns and cities on the Mongolia steppe from beginning of the dynasty, which made the politics, economy and culture of the steppe area develop significantly. In the process of cities’ construction, Khitan-Liao set up five capitals respectively. Except three of them were rebuilt or expanded based on existing cities in agricultural areas, two new capitals were built, namely up-capital (Shangjing) and middle-capital (Zhongjing) in the steppe area. This article takes the up-capital (Shangjing) as an example to investigate a special zone in the capital for settling movable tents which adapted Khitan nomads, especially its nomadic government officials to live in. By using primary Chinese historical records and newly archaeological excavations, this article examines how the special tent zone used by the Khitan rulers, discusses how the Khitan-Liao manifested its hybrid cultural characteristics in urban planning, and its implications in studying the history of Khitan-Liao. The information, discussion and argument presented in this article are also worth considering the influence of urbanization of Khitan-Liao’s urbaization on subsequent dynasties in pre-modern China and Inner Asia.

Keywords: cities on Steppe, special tent zone in cities, Khitan-Liao, hybrid culture

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Authors: Nuraisyah H. Zulkifley, Suriani Ismail, Rosliza Abdul Manaf, Poh Y. Lim

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Taking care of a person with dementia (PWD) is one of the most problematic and challenging caregiving situations. Without proper support, caregiver would need to deal with the impact of caregiving that would lead to caregiver burden. One of the most common tools used to measure caregiver burden among caregivers of PWD is Zarit Burden Interview (ZBI). A systematic review has been conducted through searching Medline, Science Direct, Cochrane Library, Embase, PsycINFO, ProQuest, and Scopus databases to identify relevant articles that elaborate on intervention and outcomes on ZBI among informal caregiver of PWD. The articles were searched in October 2019 with no restriction on language or publication status. Inclusion criteria are randomized control trial (RCT) studies, participants were informal caregivers of PWD, ZBI measured as outcomes, and intervention group was compared with no intervention control or usual care control. Two authors reviewed and extracted the data from the full-text articles. From a total of 344 records, nine studies were selected and included in this narrative review, and eight studies were included in the meta-analysis. The types of interventions that were implemented to ease caregiver burden are psychoeducation, physical activity, psychosocial, and computer-based intervention. The meta-analysis showed that there is a significant difference in the mean score of ZBI (p = 0.006) in the intervention group compared to the control group after implementation of intervention. In conclusion, interventions such as psychoeducation, psychosocial, and physical activity can help to reduce the burden experiencing by the caregivers of PWD.

Keywords: dementia, informal caregiver, randomized control trial, Zarit burden interview

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Authors: Mohamad Saab, Sidi Souvi

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In a major nuclear accident, the released fission products (FPs) and the structural materials are likely to influence the transport of iodine in the reactor coolant system (RCS) of a pressurized water reactor (PWR). So far, the thermodynamic data on cesium and silver species used to estimate the magnitude of FP release show some discrepancies, data are scarce and not reliable. For this reason, it is crucial to review the thermodynamic values related to cesium and silver materials. To this end, we have used state-of-the-art quantum chemical methods to compute the formation enthalpies and entropies of AgHMoO₄, CsHMoO₄, and AgCsMoO₄ in the gas phase. Different quantum chemical methods have been investigated (DFT and CCSD(T)) in order to predict the geometrical parameters and the energetics including the correlation energy. The geometries were optimized with TPSSh-5%HF method, followed by a single point calculation of the total electronic energies using the CCSD(T) wave function method. We thus propose with a final uncertainty of about 2 kJmol⁻¹ standard enthalpies of formation of AgHMoO₄, CsHMoO₄, and AgCsMoO₄.

Keywords: nuclear accident, ASTEC code, thermochemical database, quantum chemical methods

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Authors: Nidal F. Shilbayeh, Sameh T. Khuffash, Mohammad H. Allymoun, Reem Al-Saidi

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There is a real threat on the VIPs personal pages on the Social Network Sites (SNS). The real threats to these pages is violation of privacy and theft of identity through creating fake pages that exploit their names and pictures to attract the victims and spread of lies. In this paper, we propose a new secure architecture that improves the trusting and finds an effective solution to reduce fake pages and possibility of recognizing VIP pages on SNS. The proposed architecture works as a third party that is added to Facebook to provide the trust service to personal pages for VIPs. Through this mechanism, it works to ensure the real identity of the applicant through the electronic authentication of personal information by storing this information within content of their website. As a result, the significance of the proposed architecture is that it secures and provides trust to the VIPs personal pages. Furthermore, it can help to discover fake page, protect the privacy, reduce crimes of personality-theft, and increase the sense of trust and satisfaction by friends and admirers in interacting with SNS.

Keywords: social network sites, online social network, privacy, trust, security and authentication

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Authors: Vaibhav V. Dixit, Shubham Ajay Karwa

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Diabetic foot ulcers speak to a critical medical problem. Right now, clinicians and medical caretakers primarily construct their injury evaluation in light of visual examination of wound size and mending status, while the patients themselves rarely have a chance to play a dynamic part. Henceforth, love quantitative and practical examination technique that empowers the patients and their parental figures to take a more dynamic part in every day wound care possibly can quicken wound recuperating, spare travel cost and diminish human services costs. Considering the commonness of cell phones with a high-determination computerized camera, evaluating wounds by breaking down pictures of ceaseless foot ulcers is an alluring choice. In this paper, we propose a novel injury picture examination framework actualized using feature extraction and color segmentation. Here we are using the Normalized minimum distance classifier for classifying the output.

Keywords: diabetic, Gabor wavelet, normalized minimum distance classifier, quantiable parameters

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Authors: S. Kealy, J. Louys, S. O’Connor

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The island archipelago that stretches between the continents of Sunda (Southeast Asia) and Sahul (Australia - New Guinea) and comprising much of modern-day Indonesia as well as Timor-Leste, represents the biogeographic region of Wallacea. The islands of Wallaea are significant archaeologically as they have never been connected to the mainlands of either Sunda or Sahul, and thus the colonization by early modern humans of these islands and subsequently Australia and New Guinea, would have necessitated some form of water crossings. Accurate palaeogeographic reconstructions of the Wallacean Archipelago for this time are important not only for modeling likely routes of colonization but also for reconstructing likely landscapes and hence resources available to the first colonists. Here we present five digital reconstructions of coastal outlines of Wallacea and Sahul (Australia and New Guinea) for the periods 65, 60, 55, 50, and 45,000 years ago using the latest bathometric chart and a sea-level model that is adjusted to account for the average uplift rate known from Wallacea. This data was also used to reconstructed island areal extent as well as topography for each time period. These reconstructions allowed us to determine the distance from the coast and relative elevation of the earliest archaeological sites for each island where such records exist. This enabled us to approximate how much effort exploitation of coastal resources would have taken for early colonists, and how important such resources were. These reconstructions also allowed us to estimate visibility for each island in the archipelago, and to model how intervisible each island was during the period of likely human colonisation. We demonstrate how these models provide archaeologists with an important basis for visualising this ancient landscape and interpreting how it was originally viewed, traversed and exploited by its earliest modern human inhabitants.

Keywords: Wallacea, palaeogeographic reconstructions, islands, intervisibility

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Authors: Omer Zvi Shaked, Amir Tirosh

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Type 1 Diabetes (T1DM) is an incurable chronic illness with no known preventive measures. Excess to insulin therapy can lead to hypoglycemia with neuro-glycogenic symptoms such as shakiness, nausea, sweating, irritability, fatigue, excessive thirst or hunger, weakness, seizure, and coma. Severe Hypoglycemia (SH) is also considered a most aversive event since it may put patients at risk for injury and death, which matches the criteria of a traumatic event. SH has a ranging prevalence of 20%, which makes it a primary medical Issue. One of the results of SH is an intense emotional fear reaction resembling the form of post-traumatic stress symptoms (PTS), causing many patients to avoid insulin therapy and social activities in order to avoid the possibility of hypoglycemia. As a result, they are at risk for irreversible health deterioration and medical complications. Fear of Hypoglycemia (FOH) is, therefore, a major disturbance for T1DM patients. FOH differs from prevalent post-traumatic stress reactions to other forms of traumatic events since the threat to life continuously exists in the patient's body. That is, it is highly probable that orthodox interventions may not be sufficient for helping patients after SH to regain healthy social function and proper medical treatment. Accordingly, the current presentation will demonstrate the results of a study conducted among T1DM patients after SH. The study was designed in two stages. First, a preliminary qualitative phenomenological study among ten patients after SH was conducted. Analysis revealed that after SH, patients confuse between stress symptoms and Hypoglycemia symptoms, divide life before and after the event, report a constant sense of fear, a loss of freedom, a significant decrease in social functioning, a catastrophic thinking pattern, a dichotomous split between the self and the body, and internalization of illness identity, a loss of internal locus of control, a damaged self-representation, and severe loneliness for never being understood by others. The second stage was a two steps study of intervention among five patients after SH. The first part of the intervention included three months of therapeutic 3rd wave CBT therapy. The contents of the therapeutic process were: acceptance of fear and tolerance to stress; cognitive de-fusion combined with emotional self-regulation; the adoption of an active position relying on personal values; and self-compassion. Then, the intervention included a one-week practical real-time 24/7 support by trained medical personnel, alongside a gradual exposure to increased insulin therapy in a protected environment. The results of the intervention are a decrease in stress symptoms, increased social functioning, increased well-being, and decreased avoidance of medical treatment. The presentation will discuss the unique emotional state of T1DM patients after SH. Then, the presentation will discuss the effectiveness of the intervention for patients with chronic conditions after a traumatic event. The presentation will make evident the unique situation of illness-related PTSD. The presentation will also demonstrate the requirement for multi-professional collaboration between social work and medical care for populations with chronic medical conditions. Limitations of the study and recommendations for further research will be discussed.

Keywords: type 1 diabetes, chronic illness, post-traumatic stress, illness-related PTSD

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Authors: A. Shirazibeheshti, T. Radwan, A. Ettefaghian, G. Wilson, C. Luca, Farbod Khanizadeh

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Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature, which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on over 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. To further evaluate the performance of the model, any association between the average risk score within each group and other factors such as socioeconomic status (i.e., Index of Multiple Deprivation) and an index of health and disability were investigated. The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings also show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, indicating that females are more at risk from this kind of multiple medications. The risk may be monitored and controlled in well artificial intelligence-equipped healthcare management systems.

Keywords: anticholinergic medicines, clustering, deprivation, socioeconomic status

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Authors: Faisal Muhibuddin, Ani Dijah Rahajoe

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This in-depth exploration, through a systematic literature review, scrutinizes the nuanced role of data mining in the classification of criminal activities. The research focuses on investigating various methodological aspects and recent developments in leveraging data mining techniques to enhance the effectiveness and precision of crime categorization. Commencing with an exposition of the foundational concepts of crime classification and its evolutionary dynamics, this study details the paradigm shift from conventional methods towards approaches supported by data mining, addressing the challenges and complexities inherent in the modern crime landscape. Specifically, the research delves into various data mining techniques, including K-means clustering, Naïve Bayes, K-nearest neighbour, and clustering methods. A comprehensive review of the strengths and limitations of each technique provides insights into their respective contributions to improving crime classification models. The integration of diverse data sources takes centre stage in this research. A detailed analysis explores how the amalgamation of structured data (such as criminal records) and unstructured data (such as social media) can offer a holistic understanding of crime, enriching classification models with more profound insights. Furthermore, the study explores the temporal implications in crime classification, emphasizing the significance of considering temporal factors to comprehend long-term trends and seasonality. The availability of real-time data is also elucidated as a crucial element in enhancing responsiveness and accuracy in crime classification.

Keywords: data mining, classification algorithm, naïve bayes, k-means clustering, k-nearest neigbhor, crime, data analysis, sistematic literature review

Procedia PDF Downloads 65