Search results for: clinical decision support systems

Authors: Khaldon Lweesy, Feryal Alskafi, Rabaa Hammad, Shaker Khanfar, Yara Alsukhni

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Electronic noses are devices designed to emulate the humane sense of smell by characterizing and differentiating odor profiles. In this study, we build a low-cost e-nose using an array module containing four different types of metal oxide semiconductor gas sensors. We used this system to create a profile for a meat specimen over three days. Then using a pattern recognition software, we correlated the odor of the specimen to its age. It is a simple, fast detection method that is both non-expensive and non-destructive. The results support the usage of this technology in food control management.

Keywords: e-nose, low cost, odor detection, food safety

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Authors: Elzbieta Sikorska-Simmons

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Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.

Keywords: advanced dementia, family caregiver, medical decision-making, symptom management

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Authors: Shaoyu Ye

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This study aims to investigate the relationship between international students’ (ISs) trust of others (Japanese people and other different-language speakers) and intercultural adaptation in Japan, controlling for the effects of language abilities (both Japanese and English) and their liking of Japanese students. A total of 206 ISs completed a questionnaire survey measuring their degree of liking of general Japanese students (JSs) and trust of others, their most frequently contact persons and their communication ways, their received social support from same-language speakers, Japanese native speakers and other different-language speakers, and their degree of feeling been accepted, and so on. The following results were observed. (a) Neither Japanese language nor English language had significant effects on their sense of acceptance, while their degree of liking of JSs and trust of others had significant positive effects on it; (b) ISs’ Japanese language, along with their trust of others, led them to receive more social support from Japanese people, which helped raise their sense of acceptance in Japan; (c) ISs’ English language and their trust of others helped them receive more social support from other different- language speakers, which led them to feel been accepted in Japan. The importance of distinguishing between the effects of trust of Japanese people on intercultural adaptation and the effects of trust of other different-language speakers on intercultural adaptation is discussed.

Keywords: international students in Japan, language abilities, social support, sense of acceptance, trust of others.

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Authors: Enva Doda

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Recent statistical analyses within the European Union (EU) underscore the enduring significance of the Gender Pay Gap in amplifying the Gender Pension Gap, a phenomenon resisting proportional reduction over time. This study meticulously calculates the Pension Gap, scrutinizing contributing variables within diverse pension systems. Furthermore, it investigates whether the "unexplained" segment of the Gender Gap correlates with political institutions, economic systems, historical events, or discrimination, utilizing quantitative methods and the Blinder-Oaxaca Decomposition Method to pinpoint potential discriminatory factors. The descriptive analysis reveals a conspicuous Gender Pension Gap across European nations, displaying notable variation. While an overall reduction in the Gender Gap is observed, the degree of improvement varies among countries. Subsequent analyses will delve into the specific reasons or variables influencing distinct Gender Gap percentages, forming the basis for nuanced policy recommendations. This comprehensive research enriches the ongoing discourse on gender equality and economic equity. By focusing on the root causes of the Pension Gap, the study has the potential to instigate policy adjustments, urging policymakers to reassess systemic structures and contribute to informed decision-making. Emphasizing gender equality as essential for a flourishing and resilient economy, the research aspires to drive positive change on academic and policy fronts.

Keywords: blinder Oaxaca decomposition method, discrimination, gender pension gap, quantitative methods, unexplained gender gap

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Authors: E. Koyuncu

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The problem of Order Acceptance and Scheduling (OAS) is defined as a joint decision of which orders to accept for processing and how to schedule them. Any linear programming model representing real-world situation involves the parameters defined by the decision maker in an uncertain way or by means of language statement. Fuzzy data can be used to incorporate vagueness in the real-life situation. In this study, a fuzzy mathematical model is proposed for a single machine OAS problem, where the orders are defined by their fuzzy due dates, fuzzy processing times, and fuzzy sequence dependent setup times. The signed distance method, one of the fuzzy ranking methods, is used to handle the fuzzy constraints in the model.

Keywords: fuzzy mathematical programming, fuzzy ranking, order acceptance, single machine scheduling

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Authors: Luis Javier Serrano Tamayo

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This research on technology makes a first approach to the selection of an amphibious landing ship with strategic capabilities, through the implementation of a multi-criteria model using Analytical Hierarchical Process (AHP), in which a significant group of alternatives of latest technology has been considered. The variables were grouped at different levels to match design and performance characteristics, which affect the lifecycle as well as the acquisition, maintenance and operational costs. The model yielded an overall measure of effectiveness and an overall measure of cost of each kind of ship that was compared each other inside the model and showed in a Pareto chart. The modeling was developed using the Expert Choice software, based on AHP method.

Keywords: analytic hierarchy process, multi-criteria decision-making, Pareto analysis, Colombian Marine Corps, projection operations, expert choice, amphibious landing ship

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Authors: Fuqiang Wang, Jun Liu, Liyan Cai

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This paper investigates the coordination of the conflicting two-stage low carbon supply chain consisting of upstream and downstream manufacturers. The conflict means that the upstream manufacturer takes action for carbon emissions reduction under carbon trading mechanism while the downstream manufacturer’s production cost rises. It assumes for the Stackelberg game that the upstream manufacturer plays as a leader and the downstream manufacturer does as a follower. Four kinds of the situation of decentralized decision making, centralized decision-making, the production cost sharing contract and the carbon emissions reduction revenue sharing contract under decentralized decision making are considered. The backward induction approach is adopted to solve the game. The results show that the more intense the conflict is, the lower the efficiency of carbon emissions reduction and the higher the retail price is. The optimal investment of the decentralized supply chain under the two contracts is unchanged and still lower than that of the centralized supply chain. Both the production cost sharing contract and the carbon emissions reduction revenue sharing contract cannot coordinate the supply chain, because that the sharing cost or carbon emissions reduction sharing revenue will transfer through the wholesale price mechanism. As a result, it requires more complicated contract forms to coordinate such a supply chain.

Keywords: cap-and-trade mechanism, carbon emissions reduction, conflict, supply chain coordination

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Authors: Fatemeh Sadeghi, Peyman Sheikhzadeh

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Introduction: Block Sequential Regularized Expectation Maximization (BSREM) reconstruction algorithm was recently developed to suppress excessive noise by applying a relative difference penalty. The aim of this study was to investigate the effect of various strengths of noise penalization factor in the BSREM algorithm under different acquisition duration and lesion sizes in order to determine an optimum penalty factor by considering both quantitative and qualitative image evaluation parameters in clinical uses. Materials and Methods: The NEMA IQ phantom and 15 clinical whole-body patients with prostate cancer were evaluated. Phantom and patients were injected withGallium-68 Prostate-Specific Membrane Antigen(68 Ga-PSMA)and scanned on a non-time-of-flight Discovery IQ Positron Emission Tomography/Computed Tomography(PET/CT) scanner with BGO crystals. The data were reconstructed using BSREM with a β-value of 100-500 at an interval of 100. These reconstructions were compared to OSEM as a widely used reconstruction algorithm. Following the standard NEMA measurement procedure, background variability (BV), recovery coefficient (RC), contrast recovery (CR) and residual lung error (LE) from phantom data and signal-to-noise ratio (SNR), signal-to-background ratio (SBR) and tumor SUV from clinical data were measured. Qualitative features of clinical images visually were ranked by one nuclear medicine expert. Results: The β-value acts as a noise suppression factor, so BSREM showed a decreasing image noise with an increasing β-value. BSREM, with a β-value of 400 at a decreased acquisition duration (2 min/ bp), made an approximately equal noise level with OSEM at an increased acquisition duration (5 min/ bp). For the β-value of 400 at 2 min/bp duration, SNR increased by 43.7%, and LE decreased by 62%, compared with OSEM at a 5 min/bp duration. In both phantom and clinical data, an increase in the β-value is translated into a decrease in SUV. The lowest level of SUV and noise were reached with the highest β-value (β=500), resulting in the highest SNR and lowest SBR due to the greater noise reduction than SUV reduction at the highest β-value. In compression of BSREM with different β-values, the relative difference in the quantitative parameters was generally larger for smaller lesions. As the β-value decreased from 500 to 100, the increase in CR was 160.2% for the smallest sphere (10mm) and 12.6% for the largest sphere (37mm), and the trend was similar for SNR (-58.4% and -20.5%, respectively). BSREM visually was ranked more than OSEM in all Qualitative features. Conclusions: The BSREM algorithm using more iteration numbers leads to more quantitative accuracy without excessive noise, which translates into higher overall image quality and lesion detectability. This improvement can be used to shorter acquisition time.

Keywords: BSREM reconstruction, PET/CT imaging, noise penalization, quantification accuracy

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Authors: Karla Lebedoff, Susan Walsh, Michelle Bain

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Eczema is a chronic atopy condition requiring long-term daily management in children. Written action plans for other chronic atopic conditions, such as asthma and food allergies, are widely recommended and distributed to pediatric patients' parents and caregivers, seeking to improve clinical outcomes and become empowered to manage the patient's ever-changing symptoms. Written action plans for eczema, referred to as "asthma of the skin," are not routinely used in practice. Parents of children suffering from eczema rarely receive a written action plan to follow, and commendations supporting eczema action plans are inconsistent. Pediatric patients between birth and 18 years old who were followed for eczema at an urban Midwest community hospital were eligible to participate in this quality improvement project. At the initial visit, parents received instructions on individualized eczema action plans for their child and completed two validated surveys: Health Confidence Score (HCS) and Patient-Oriented Eczema Measure (POEM). Pre- and post-survey responses were collected, and clinical symptom presentation at follow-up were outcome determinants. Project implementation was guided by Institute for Healthcare Improvement's Step-up Framework and the Plan-Do-Study-Act cycle. This project measured clinical outcomes and parent confidence in self-management of their child's eczema symptoms with the responses from 26 participant surveys. Pre-survey responses were collected from 36 participants, though ten were lost to follow-up. Average POEM scores improved by 53%, while average HCS scores remained unchanged. Of seven completed in-person follow-up visits, six clinical progress notes documented improvement. Individualized eczema action plans can be seamlessly incorporated into primary and specialty care visits for pediatric patients suffering from eczema. Following a patient-specific eczema action plan may lessen the daily physical and mental burdens of uncontrolled eczema for children and parents, managing symptoms that chronically flare and recede. Furthermore, incorporating eczema action plans into practice potentially reduces the likely underestimated $5.3 billion economic disease burden of eczema on the U.S. healthcare system.

Keywords: atopic dermatitis, eczema action plan, eczema symptom management, pediatric eczema

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Authors: Mai Kaneda, Sarah Feeney

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This study examined the association between adult attachment security and career decision-making self-efficacy (CDMSE) among college students in the United States. Previous studies show that attachment security is associated with levels of CDMSE among college students. Given that a majority of studies examining career development variables have used parental attachment measures, this study adds to understanding of this phenomenon by utilizing a broader measure of attachment. The participants included 269 college students (76% female) between the ages of 19-29. An anonymous survey was distributed online via social media as well as in hard copy format in classrooms. Multiple regression analyses were conducted to determine the relationship between anxious and avoidant attachment and CDMSE. Results revealed anxious attachment was a significant predictor of CDMSE (B = -.13, p = .01), such that greater anxiety in attachment was associated with lower levels of CDMSE. When accounting for anxious attachment, avoidant attachment was no longer significant as a predictor of CDMSE (B = -.12, p = .10). The variance in college CDMSE explained by the model was 7%, F(2,267) = 9.51, p < .001. Results for anxious attachment are consistent with existing literature that finds insecure attachment to be related to lower levels of CDMSE, however the non-significant results for avoidant attachment as a predictor of CDMSE suggest not all types of attachment insecurity are equally related to CDMSE. Future research is needed to explore the nature of the relationship between different dimensions of attachment insecurity and CDMSE.

Keywords: attachment, career decision-making, college students, self-efficacy

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Authors: Liane J. Ioannou, Jonathan Serpell, Cino Bendinelli, David Walters, Jenny Gough, Dean Lisewski, Win Meyer-Rochow, Julie Miller, Duncan Topliss, Bill Fleming, Stephen Farrell, Andrew Kiu, James Kollias, Mark Sywak, Adam Aniss, Linda Fenton, Danielle Ghusn, Simon Harper, Aleksandra Popadich, Kate Stringer, David Watters, Susannah Ahern

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BACKGROUND: There are significant variations in the management, treatment and outcomes of thyroid cancer, particularly in the role of: diagnostic investigation and pre-treatment scanning; optimal extent of surgery (total or hemi-thyroidectomy); use of active surveillance for small low-risk cancers; central lymph node dissections (therapeutic or prophylactic); outcomes following surgery (e.g. recurrent laryngeal nerve palsy, hypocalcaemia, hypoparathyroidism); post-surgical hormone, calcium and vitamin D therapy; and provision and dosage of radioactive iodine treatment. A proven strategy to reduce variations in the outcome and to improve survival is to measure and compare it using high-quality clinical registry data. Clinical registries provide the most effective means of collecting high-quality data and are a tool for quality improvement. Where they have been introduced at a state or national level, registries have become one of the most clinically valued tools for quality improvement. To benchmark clinical care, clinical quality registries require systematic measurement at predefined intervals and the capacity to report back information to participating clinical units. OBJECTIVE: The aim of this study was to develop a core set clinical indicators that enable measurement and reporting of quality of care for patients with thyroid cancer. We hypothesise that measuring clinical quality indicators, developed to identify differences in quality of care across sites, will reduce variation and improve patient outcomes and survival, thereby lessening costs and healthcare burden to the Australian community. METHOD: Preparatory work and scoping was conducted to identify existing high quality, clinical guidelines and best practice for thyroid cancer both nationally and internationally, as well as relevant literature. A bi-national panel was invited to participate in a modified Delphi process. Panelists were asked to rate each proposed indicator on a Likert scale of 1–9 in a three-round iterative process. RESULTS: A total of 236 potential quality indicators were identified. One hundred and ninety-two indicators were removed to reflect the data capture by the Australian and New Zealand Thyroid Cancer Registry (ANZTCR) (from diagnosis to 90-days post-surgery). The remaining 44 indicators were presented to the panelists for voting. A further 21 indicators were later added by the panelists bringing the total potential quality indicators to 65. Of these, 21 were considered the most important and feasible indicators to measure quality of care in thyroid cancer, of which 12 were recommended for inclusion in the final set. The consensus indicator set spans the spectrum of care, including: preoperative; surgery; surgical complications; staging and post-surgical treatment planning; and post-surgical treatment. CONCLUSIONS: This study provides a core set of quality indicators to measure quality of care in thyroid cancer. This indicator set can be applied as a tool for internal quality improvement, comparative quality reporting, public reporting and research. Inclusion of these quality indicators into monitoring databases such as clinical quality registries will enable opportunities for benchmarking and feedback on best practice care to clinicians involved in the management of thyroid cancer.

Keywords: clinical registry, Delphi survey, quality indicators, quality of care

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Authors: Annika Kjallman Alm, Ove Hellzen, Malin Rising-Holmstrom

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Worldwide, the number of people who are living with dementia is increasing because of an aging population, which leads to increased financial and social costs, including reduced quality of life for people with dementia and their care partners. Most people who have dementia reside in the community. Aging in place could be described as having the health and social supports and services you need to live safely and independently in your home or your society for as long as you wish and are able. People with dementia are not different than people without dementia where they want to remain at home, if possible, with a sense of familiarity and engagement in typical everyday activities. So how do persons with dementia or cognitive decline see their possibilities to be socially involved and experience support? The aim of this study was to explore persons with cognitive decline's sense of involvement and support living in the ordinary dwelling. The study was approved by the Ethical Review Authority in Sweden prior to the interviews. Interviews were conducted with 20 persons living at home, either alone or in a relationship. The persons had perceived cognitive decline; some were under investigation or already had a diagnose of early dementia. Thematic analysis was used to identify, analyze, and report patterns within the data. Researchers extracted three main themes through participants’ interviews: a) Importance of social involvement with family and friends. b) Hindrances for social involvement. c) Struggling mentally with a new life situation. Results found that going to activity centers, staying involved, and meeting friends and family enhanced the sense of involvement and support. There were also hindrances to a sense of involvement and support as they struggled with the diagnose and the changes in daily life, such as physical problems, mental problems, or economic issues. The mental struggle of accepting the cognitive decline and the changes in daily life it brought was also an issue for some of the participants. A multidimensional support should be provided by the community to enable persons with cognitive decline to stay involved in family and community in the comfort of their own homes.

Keywords: aging in place, cognitive decline, dementia, sense of involvement

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Authors: Camila Lima, Murilo Andrade Valle, Patrícia Teixeira Leite Asano

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The growth in demand for electricity, caused by human development, depletion and environmental impacts caused by traditional sources of electricity generation have made new energy sources are increasingly encouraged and necessary for companies in the electricity sector. Based on this scenario, this paper assesses the negative environmental impacts associated with thermoelectric power plants in Brazil, pointing out the importance of using renewable energy sources, reducing environmental aggression. This article points out the existence of an energy alternative, wind energy, of the municipalities of São Paulo, represented by georeferenced maps with the help of GIS, using as a premise the indicators of sustainability and multicriteria analysis in the decision-making process.

Keywords: GIS (geographic information systems), multicriteria analysis, sustainability, wind energy

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Authors: Shohreh Ghasemi

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Introduction: Melanoma is a complex disease with various clinical and histopathological features that impact prognosis and treatment decisions. Traditional methods of melanoma prognosis involve manual examination and interpretation of clinical and histopathological data by dermatologists and pathologists. However, the subjective nature of these assessments can lead to inter-observer variability and suboptimal prognostic accuracy. AI, with its ability to analyze vast amounts of data and identify patterns, has emerged as a promising tool for improving melanoma prognosis. Methods: A comprehensive literature search was conducted to identify studies that employed AI techniques for melanoma prognosis. The search included databases such as PubMed and Google Scholar, using keywords such as "artificial intelligence," "melanoma," and "prognosis." Studies published between 2010 and 2022 were considered. The selected articles were critically reviewed, and relevant information was extracted. Results: The review identified various AI methodologies utilized in melanoma prognosis, including machine learning algorithms, deep learning techniques, and computer vision. These techniques have been applied to diverse data sources, such as clinical images, dermoscopy images, histopathological slides, and genetic data. Studies have demonstrated the potential of AI in accurately predicting melanoma prognosis, including survival outcomes, recurrence risk, and response to therapy. AI-based prognostic models have shown comparable or even superior performance compared to traditional methods.

Keywords: artificial intelligence, melanoma, accuracy, prognosis prediction, image analysis, personalized medicine

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Authors: Ali Ulvi Uzer

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Data reduction is an important topic in the field of pattern recognition applications. The basic concept is the reduction of multitudinous amounts of data down to the meaningful parts. The Principal Component Analysis (PCA) method is frequently used for data reduction. The Support Vector Machine (SVM) method is a discriminative classifier formally defined by a separating hyperplane. In other words, given labeled training data, the algorithm outputs an optimal hyperplane which categorizes new examples. This study offers a hybrid approach that uses the PCA for data reduction and Support Vector Machines (SVM) for classification. In order to detect the accuracy of the suggested system, two boreholes taken from the soil sample was used. The classification accuracies for this dataset were obtained through using ten-fold cross-validation method. As the results suggest, this system, which is performed through size reduction, is a feasible system for faster recognition of dataset so our study result appears to be very promising.

Keywords: feature selection, sequential forward selection, support vector machines, soil sample

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Authors: Andrei Nosov

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This paper discusses the development directions of dialogue systems within the digitalisation of the railway industry, where technologies based on conversational AI are already potentially applied or will be applied. Conversational AI is one of the popular natural language processing (NLP) tasks, as it has great prospects for real-world applications today. At the same time, it is a challenging task as it involves many areas of NLP based on complex computations and deep insights from linguistics and psychology. In this review, we focus on dialogue systems and their implementation in the railway domain. We comprehensively review the state-of-the-art research results on dialogue systems and analyse them from three perspectives: type of problem to be solved, type of model, and type of system. In particular, from the perspective of the type of tasks to be solved, we discuss characteristics and applications. This will help to understand how to prioritise tasks. In terms of the type of models, we give an overview that will allow researchers to become familiar with how to apply them in dialogue systems. By analysing the types of dialogue systems, we propose an unconventional approach in contrast to colleagues who traditionally contrast goal-oriented dialogue systems with open-domain systems. Our view focuses on considering retrieval and generative approaches. Furthermore, the work comprehensively presents evaluation methods and datasets for dialogue systems in the railway domain to pave the way for future research. Finally, some possible directions for future research are identified based on recent research results.

Keywords: digitalisation, railway, dialogue systems, conversational AI, natural language processing, natural language understanding, natural language generation

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Authors: Danielle A. Walker, Kyle L. Johnson, Tara B. Thomas, Sandor Dorgo, Jacen S. Moore

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Approximately 37 million people worldwide are infected with the Human Immunodeficiency Virus (HIV), with the majority located in sub-Saharan Africa. The relationship existing between HIV incidence and socioeconomic inequity confirms the critical need for programs promoting HIV education, prevention and treatment access. This literature review analyzed 36 sources with a specific focus on the Democratic Republic of Congo, whose critically low socioeconomic status and education rate have resulted in a drastically high HIV rates. Relationships between HIV testing and treatment and barriers to care were explored. Cultural and religious considerations were found to be vital when creating and implementing HIV education and testing programs. Partnerships encouraging active support from community-based spiritual leaders to implement HIV educational programs were also key mechanisms to reach communities and individuals. Gender roles were highlighted as a key component for implementation of effective community trust-building and successful HIV education programs. The efficacy of added support by hospitals and clinics in rural areas to facilitate access to HIV testing and care for people living with HIV/AIDS (PLWHA) was discussed. This review highlighted the need for healthcare providers to provide a network of continued education for PLWHA in clinical settings during disclosure and throughout the course of treatment to increase retention in care and promote medication adherence for viral load suppression. Implementation of culturally sensitive models that rely on community familiarity with HIV educators such as ‘train-the-trainer’ were also proposed as efficacious tools for educating rural communities about HIV. Further research is needed to promote community partnerships for HIV education, understand the cultural context of gender roles as barriers to care, and empower local health care providers to be successful within the HIV Continuum of Care.

Keywords: cultural sensitivity, Democratic Republic of the Congo, education, HIV

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Authors: Semachew M. Kassa, Africa M Geremew, Tezera F. Azmatch, Nandyala Darga Kumar

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Frequency ratio (FR) and analytical hierarchy process (AHP) methods are developed based on past landslide failure points to identify the landslide susceptibility mapping because landslides can seriously harm both the environment and society. However, it is still difficult to select the most efficient method and correctly identify the main driving factors for particular regions. In this study, we used fourteen landslide conditioning factors (LCFs) and five soft computing algorithms, including Random Forest (RF), Support Vector Machine (SVM), Logistic Regression (LR), Artificial Neural Network (ANN), and Naïve Bayes (NB), to predict the landslide susceptibility at 12.5 m spatial scale. The performance of the RF (F1-score: 0.88, AUC: 0.94), ANN (F1-score: 0.85, AUC: 0.92), and SVM (F1-score: 0.82, AUC: 0.86) methods was significantly better than the LR (F1-score: 0.75, AUC: 0.76) and NB (F1-score: 0.73, AUC: 0.75) method, according to the classification results based on inventory landslide points. The findings also showed that around 35% of the study region was made up of places with high and very high landslide risk (susceptibility greater than 0.5). The very high-risk locations were primarily found in the western and southeastern regions, and all five models showed good agreement and similar geographic distribution patterns in landslide susceptibility. The towns with the highest landslide risk include Amhara Saint Town's western part, the Northern part, and St. Gebreal Church villages, with mean susceptibility values greater than 0.5. However, rainfall, distance to road, and slope were typically among the top leading factors for most villages. The primary contributing factors to landslide vulnerability were slightly varied for the five models. Decision-makers and policy planners can use the information from our study to make informed decisions and establish policies. It also suggests that various places should take different safeguards to reduce or prevent serious damage from landslide events.

Keywords: artificial neural network, logistic regression, landslide susceptibility, naïve Bayes, random forest, support vector machine

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Authors: Mir Mohammad Reza Hosseini

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In new years immune checkpoint inhibitors have gathered care as being one of the greatest talented kinds of immunotherapy on the prospect. There has been a specific emphasis on the immune checkpoint molecules, cytotoxic T-lymphocyte antigen-4 (CTLA-4) and programmed cell death protein 1 (PD-1). In 2011, ipilimumab, the primary antibody obstructive an immune checkpoint (CTLA4) was authorized. It is now documented that recognized tumors have many devices of overpowering the antitumor immune response, counting manufacture of repressive cytokines, staffing of immunosuppressive immune cells, and upregulation of coinhibitory receptors recognized as immune checkpoints. This was fast followed by the growth of monoclonal antibodies directing PD1 (pembrolizumab and nivolumab) and PDL1 (atezolizumab and durvalumab). Anti-PD1/PDL1 antibodies have developed some of the greatest extensively set anticancer therapies. We also compare and difference their present place in cancer therapy and designs of immune-related toxicities and deliberate the role of dual immune checkpoint inhibition and plans for the organization of immune-related opposing proceedings. In this review, the employed code and present growth of numerous immune checkpoint inhibitors are abridged, while the communicating device and new development of Immune checkpoint inhibitors in cancer therapy-based synergistic therapies with additional immunotherapy, chemotherapy, phototherapy, and radiotherapy in important and clinical educations in the historical 5 years are portrayed and tinted. Lastly, we disapprovingly measure these methods and effort to find their fortes and faintness based on pre-clinical and clinical information.

Keywords: checkpoint, cancer therapy, PD-1, PDL-1, CTLA4, immunosuppressive

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Authors: Tahmeena Ali, Andrew Francis, Keong Yap, Sharynn Schuster

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Social anxiety is a chronic and debilitating condition characterized by fear and avoidance of social situations. Several risk factors have emerged, which emphasize the role of early childhood experiences in the development of this condition. As such, the current study tested the hypothesis that early maladaptive schemas (EMSs) mediate the relationship between retrospectively reported parental criticism and social anxiety whilst controlling the effects of depression. Three hundred and thirty-four non-clinical participants completed an online questionnaire consisting of self-report measures of parental criticism, EMSs of disconnection and rejection, and symptoms of social anxiety and depression. The mediation analysis confirmed the hypothesized model, indicating that EMSs mediated the relationship between parental criticism and social anxiety symptoms when controlling for depression. Whilst the current study is limited due to its cross-sectional design, the findings lend support to the developmental formulations of social anxiety and have important therapeutic implications for treatment.

Keywords: early maladaptive schema, parental criticism, schema, social anxiety

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Authors: Daniel F. Bohorquez, Luis M. Agudelo, Henry H. León

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Heart rate variability (HRV) is defined as the temporary variation between heartbeats or RR intervals (distance between R waves in an electrocardiographic signal). This distance is currently a recognized biomarker. With the analysis of the distance, it is possible to assess the sympathetic and parasympathetic nervous systems. These systems are responsible for the regulation of the cardiac muscle. The analysis allows health specialists and researchers to diagnose various pathologies based on this variation. For the acquisition and analysis of HRV taken from a cardiac electrical signal, electronic equipment and analysis software that work independently are currently used. This complicates and delays the process of interpretation and diagnosis. With this delay, the health condition of patients can be put at greater risk. This can lead to an untimely treatment. This document presents a single portable device capable of acquiring electrocardiographic signals and calculating a total of 19 HRV metrics. This reduces the time required, resulting in a timelier intervention. The device has an electrocardiographic signal acquisition card attached to a microcontroller capable of transmitting the cardiac signal wirelessly to a mobile device. In addition, a mobile application was designed to analyze the cardiac waveform. The device calculates the RR and different metrics. The application allows a user to visualize in real-time the cardiac signal and the 19 metrics. The information is exported to a cloud database for remote analysis. The study was performed under controlled conditions in the simulated hospital of the Universidad de la Sabana, Colombia. A total of 60 signals were acquired and analyzed. The device was compared against two reference systems. The results show a strong level of correlation (r > 0.95, p < 0.05) between the 19 metrics compared. Therefore, the use of the portable system evaluated in clinical scenarios controlled by medical specialists and researchers is recommended for the evaluation of the condition of the cardiac system.

Keywords: biological signal análisis, heart rate variability (HRV), HRV metrics, mobile app, portable device.

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Authors: Mats Nilsson

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The European electricity markets have been changing from a regulated market, to in some places a deregulated market, and are now experiencing a strong influence of renewable support systems. Firm’s that rely on subsidies have a different business logic than firms acting in a market context. The article proposes that an offspring to the regular business models, the business-to-citizen, should be used. The case of the European electricity market frames the concept of a business-citizen business model, and a research agenda for this concept is outlined.

Keywords: business logic, business model, subsidies, business-to-citizen

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Authors: Takashi Shimizu, Tomoaki Hashimoto

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Controlling the flow of fluids is a challenging problem that arises in many fields. Burgers’ equation is a fundamental equation for several flow phenomena such as traffic, shock waves, and turbulence. The optimal feedback control method, so-called model predictive control, has been proposed for Burgers’ equation. However, the model predictive control method is inapplicable to systems whose all state variables are not exactly known. In practical point of view, it is unusual that all the state variables of systems are exactly known, because the state variables of systems are measured through output sensors and limited parts of them can be only available. In fact, it is usual that flow velocities of fluid systems cannot be measured for all spatial domains. Hence, any practical feedback controller for fluid systems must incorporate some type of state estimator. To apply the model predictive control to the fluid systems described by Burgers’ equation, it is needed to establish a state estimation method for Burgers’ equation with limited measurable state variables. To this purpose, we apply unscented Kalman filter for estimating the state variables of fluid systems described by Burgers’ equation. The objective of this study is to establish a state estimation method based on unscented Kalman filter for Burgers’ equation. The effectiveness of the proposed method is verified by numerical simulations.

Keywords: observer systems, unscented Kalman filter, nonlinear systems, Burgers' equation

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Authors: Toufic Sarieddine

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As the belt and road Initiative (henceforth, BRI) enters its 9th year, Iran and China are forging stronger ties on economic and military fronts, a development which has not only caused alarm in Washington but also risks staining China’s relationships with the oil-rich Gulf monarchies. World-systems theory has been used to examine the impact of the BRI on the current world order, with scholarship split on the capacity of China to emerge as a hegemon contending with the US or even usurping it. This paper argues the emergence of a new China-centered world-system comprised of states/areas and processes participating in the BRI and overlapping with the global world-system under (shaky) US hegemony. This world-system centers around China as core and hegemon via economic domination, capable new institutions (Shanghai Cooperation Council), legal modi operandi, the common goal of infrastructure development to rally support among developing states, and other indicators of hegemony outlined in world-systems theory. In this regard, while states like Pakistan could become peripheries to China in the BRI-bound world-system via large-scale projects such as the China-Pakistan Economic Corridor, Iran has greater capacities and influence in the Middle East, making it superior to a periphery. This paper thus argues that the increasing proximity between Iran and China sees the former becoming a semi-periphery with respect to China within the BRI-bound world-system, having economic dependence on its new core and hegemon while simultaneously wielding political and military influence on weaker states such as Iraq, Lebanon, Yemen, and Syria. The indicators for peripheralization as well as the characteristics of a semi-periphery outlined in world-systems theory are used to examine the current economic, political, and militaristic dimensions of Iran and China’s growing relationship, as well as the trajectory of these dimensions as part of the BRI-bound world-system.

Keywords: belt and road initiative, China, China-Middle East relations, Iran, world-systems analysis

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Authors: Mo Zhou, Samantha Ashby, Lyn Ebert

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In China, the changes that men experience in the perinatal period are not well researched. Men are also at risk of maladaptation to parenthood. The aim of this research is to review current studies regarding changes that Chinese men experience during transitioning to parenthood. 5 databases were employed to search relevant papers. The search found 128 articles. Based on the inclusion and exclusion criteria, 35 articles were included in this integrative review. Results showed the changes that Chinese fathers experienced during the transition to parenthood can be divided into two aspects: family relationships and mental problems. During transition to parenthood, fathers usually experienced an increase in their disappointment with marital conflict resolution and decreased sexual intimacy with their partner. Mental health declined, with fathers often feeling depressed and/or anxious during this time. Some men were diagnosed with clinical depression. The predictors of these changes included three domains: personal background (age and income), family background (gender of infant, relationship status and unplanned child) and cultural background (‘doing the month’, Confucianism, policy, social support).

Keywords: China, men, fatherhood, life change, postpartum

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Authors: M. Patterson, R. Bond, K. Cowan, M. Mulvenna, C. Reid, F. McMahon, P. McGowan, H. Cormican

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This paper outlines the design of a simulator to allow for the optimisation of clinical workflows through a pathology laboratory and to improve the laboratory’s efficiency in the processing, testing, and analysis of specimens. Often pathologists have difficulty in pinpointing and anticipating issues in the clinical workflow until tests are running late or in error. It can be difficult to pinpoint the cause and even more difficult to predict any issues which may arise. For example, they often have no indication of how many samples are going to be delivered to the laboratory that day or at a given hour. If we could model scenarios using past information and known variables, it would be possible for pathology laboratories to initiate resource preparations, e.g. the printing of specimen labels or to activate a sufficient number of technicians. This would expedite the clinical workload, clinical processes and improve the overall efficiency of the laboratory. The simulator design visualises the workflow of the laboratory, i.e. the clinical tests being ordered, the specimens arriving, current tests being performed, results being validated and reports being issued. The simulator depicts the movement of specimens through this process, as well as the number of specimens at each stage. This movement is visualised using an animated flow diagram that is updated in real time. A traffic light colour-coding system will be used to indicate the level of flow through each stage (green for normal flow, orange for slow flow, and red for critical flow). This would allow pathologists to clearly see where there are issues and bottlenecks in the process. Graphs would also be used to indicate the status of specimens at each stage of the process. For example, a graph could show the percentage of specimen tests that are on time, potentially late, running late and in error. Clicking on potentially late samples will display more detailed information about those samples, the tests that still need to be performed on them and their urgency level. This would allow any issues to be resolved quickly. In the case of potentially late samples, this could help to ensure that critically needed results are delivered on time. The simulator will be created as a single-page web application. Various web technologies will be used to create the flow diagram showing the workflow of the laboratory. JavaScript will be used to program the logic, animate the movement of samples through each of the stages and to generate the status graphs in real time. This live information will be extracted from an Oracle database. As well as being used in a real laboratory situation, the simulator could also be used for training purposes. ‘Bots’ would be used to control the flow of specimens through each step of the process. Like existing software agents technology, these bots would be configurable in order to simulate different situations, which may arise in a laboratory such as an emerging epidemic. The bots could then be turned on and off to allow trainees to complete the tasks required at that step of the process, for example validating test results.

Keywords: laboratory-process, optimization, pathology, computer simulation, workflow

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Authors: Erdinc Ozturk, Gizem Akcan

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The aim of this study was to determine some psychosocial variables that predict childhood trauma and dissociation in university students. These psychosocial variables were perceived social support, relationship status, gender and life satisfaction. 250 (125 males, 125 females) university students (bachelor, master and postgraduate degree) were enrolled in this study. They were chosen from universities in Istanbul at the education year of 2016-2017. Dissociative Experiences Scale (DES), Childhood Trauma Questionnaire (CTQ), Multidimensional Perceived Social Support Scale, Life Satisfaction Scale and Relationship Scales Questionnaire were used to assess related variables. Demographic information form was given to students in order to have their demographic information. Frequency distribution, multiple linear regression, and t-test analysis were used for statistical analysis. As together, perceived social support, relationship status and life satisfaction were found to have predictive value on trauma among university students. However, as together, these psychosocial variables did not have predictive value on dissociation. Only, trauma and relationship status had significant predictive value on dissociation. Moreover, there was significant difference between males and females in terms of trauma; however, dissociation scores of participants were not significantly different in terms of gender.

Keywords: childhood trauma, dissociation, perceived social support, relationship status, life satisfaction

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Authors: Felicia Segeth, Florian G. Klein, Lea Berger, Andreas Kolk, Per S. Holm

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The entry of oncolytic viruses (OVs) into clinical application opens groundbreaking changes in current and future treatment regimens. However, despite their potent anti-cancer activity in vitro, clinical studies revealed limitations of OVs as monotherapy. The same applies to CDK 4/6 inhibitors (CDK4/6i) targeting cell cycle as well as bromodomain and extra-terminal domain inhibitors (BETi) targeting gene expression. In this study, the anti-tumoral effect of XVir-N-31, an YB-1 dependent oncolytic adenovirus, was evaluated in combination with Ribociclib, a CDK4/6i, and JQ1, a BETi. The head and neck squamous cell carcinoma (HNSCC) cell lines Fadu, SAS, and Cal-33 were used. DNA replication and gene expression of XVir-N-31 was measured by RT-qPCR, protein expression by western blotting, and cell lysis by SRB assays. Treatment with CDK4/6i and BETi increased viral gene expression, viral DNA replication, and viral particle formation. The data show that the combination of oncolytic adenovirus XVir-N-31 with CDK4/6i & BETi acts highly synergistic in cancer cell lysis. Furthermore, additional molecular analyses on this subject demonstrate that the positive transcription elongation factor P-TEFb plays a decisive role in this regard, indicating an influence of the combinational therapy on gene transcription control. The combination of CDK4/6i & BETi and XVir-N-31 is an attractive strategy to achieve substantial cancer cell killing and is highly suitable for clinical testing.

Keywords: adenovirus, BET, CDK4/6, HNSCC, P-TEFb, YB-1

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Authors: Stephanie Giordano, Eric Lam, Rosa Plasencia

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An important piece of active aging is ensuring people have the right support to meet individual needs. Using NCI-AD data, we will look at measures of satisfaction with community access and needed services among people with physical disabilities receiving LTSS in the US. National Core Indicators—Aging and Disabilities (NCI-AD) is a voluntary effort by State Medicaid, aging, and disability agencies across the US to measure and track their own performance. NCI-AD uses a standardized survey – the Adult Consumer Survey (ACS), to hear directly from people receiving services about the quality of services and supports they receive. Data from the 2018-19 ACS found that compared to people without a physical disability, those with a physical disability were more likely to make choices about the services they receive, including when and how often they receive those services. Yet people with a physical disability were less likely to report they get enough assistance with everyday activities (e.g., shopping, housework, and taking medications) and self-care (e.g., dressing or bathing) and more likely to report that services and supports do not fully meet their needs and goals. A further breakdown by age shows that people 40-65 years old with a physical disability experienced even greater barriers to being as active in the community as they would like to be, indicating a need to better support people as they age with or into a disability. We will explore how these and other outcomes were affected by COVID-19, take a closer look at outcomes by demographics (e.g., race/ethnicity, gender, and mental health diagnoses) and discuss implications on the future needs of service systems.

Keywords: quality-of-life, long-term services and supports, person-centered, community

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Authors: Miloud Abid Brahim

Abstract:

Herpetic gingivostomatitis is a prevalent viral infection in children, predominantly caused by herpes simplex virus type 1 (HSV-1). This case report details the clinical presentation and management of a 9-year-old patient diagnosed with this condition. The child exhibited fever, oral pain, and vesicular lesions that progressed to painful erosions affecting the inner cheeks, tongue, lips, and gums. The diagnosis was established based on clinical findings. Treatment included symptomatic care with analgesics and antipyretics, antimicrobial therapy with antibiotics and antiseptics, and early administration of antiviral medication (aciclovir). The comprehensive approach led to complete resolution of symptoms within 10 days. This case underscores the significance of early recognition and prompt treatment to mitigate the impact of this condition on the patient’s quality of life and to prevent complications.

Keywords: gingivostomatitis, case report, pediatric oral health, herpes simplex virus (HSV-1)

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