Search results for: Pediatric intensive care unit

Authors: Zachary Bernard, Dorothy Dillard

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Background: Haitian Creole women in Sussex County, Delaware, experience significant disparities in breast cancer outcomes, exacerbated by cultural, linguistic, and socioeconomic barriers. The Chanpyons Credible Messenger Intervention was developed to address these disparities through culturally tailored education, logistical support, and the engagement of trusted community members as credible messengers. Method: This mixed-methods study combined quantitative analysis of screening rates pre- and post-intervention, using demographic data from 85 participants, with qualitative interviews to explore participants' perceptions, barriers, and experiences. Results: Of the participants, 22.35% had received a mammogram before the program, compared to 50.59% after its implementation, marking a significant increase in screening rates. Women with private insurance had higher up-to-date screening rates (78.95%) compared to uninsured women (36.36%). Qualitative findings revealed that credible messengers effectively built trust, addressed cultural misconceptions, and alleviated fear, empowering women to prioritize preventive care. Conclusion: The study demonstrates the success of culturally specific interventions in increasing breast cancer screening rates and reducing health disparities. The Chanpyons model highlights the importance of integrating community-driven approaches in public health programs, offering a replicable framework for addressing similar challenges in underserved populations.

Keywords: breast cancer, community engagement, Haitian Creole women, credible messengers, health disparities, preventive care

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Authors: Morgan Dempsey, Sam Lewis, Maggie Pierce, Alex Goodman

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This research investigates the impact of equine-assisted therapy programs on occupational engagement for children with intellectual and developmental disabilities. There is a general lack of evidence for equine-based services for this population, so this research aims to decrease gaps in the current literature. To gain comprehensive insight, data will be collected from both the child and their caregiver. This study takes a qualitative approach utilizing online surveys and in-person guided interviews. The participants are individuals ages 4-17 with a diagnosed intellectual or developmental disability who are currently participating in a PATH int. certified equine-assisted therapy program. Also, caregivers of individuals who meet this criterion are included. This study decreases gaps in the literature by providing comprehensive data regarding the impacts of these services on occupational engagement. The addressed domains are physical, behavioral, emotional, and social functioning, as well as overall activity engagement and impacts in everyday life. With a better understanding of how equine-assisted therapy affects relevant outcomes for children with disabilities, an increased number of occupational therapists can implement these uniquely effective services while adhering to standards of evidence-based practice. Ultimately, this research strives to contribute to generalizable data in occupational therapy by supporting the implementation of equine-assisted services for children with intellectual and/or developmental disabilities and their caregivers/families.

Keywords: occupational therapy, pediatric, rehabilitation, hippotherapy

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Authors: Emmanuel Mkambankhani, Tiwonge Manda

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Software platform architecture includes system components, their relationships, and design, as well as evolution principles. Software architecture and documentation affect a platform's customizability and openness to external innovators, thus affecting developer productivity. Malawi Point of Care (POC) Electronic Medical Records System (EMRS) follows some architectural design standards, but it lacks third-party innovators and is difficult to customize as compared to CommCare and District Health Information System 2 (DHIS2). Improving software architecture and documentation for the Malawi POC will increase productivity and third-party contributions. A conceptual framework based on Generativity and Boundary Resource Model (BRM) was used to compare the three platforms. Interviews, observations, and document analysis were used to collect primary and secondary data. Themes were found by analyzing qualitative and quantitative data, which led to the following results. Configurable, flexible, and cross-platform software platforms and the availability of interfaces (Boundary Resources) that let internal and external developers interact with the platform's core functionality, hence boosting developer productivity. Furthermore, documentation increases developer productivity, while its absence inhibits the use of resources. The study suggests that the architecture and openness of the Malawi POC EMR software platform will be improved by standardizing web application program interfaces (APIs) and making interfaces that can be changed by the user. In addition, increasing the availability of documentation and training will improve the use of boundary resources, thus improving internal and third-party development productivity.

Keywords: health systems, configurable platforms, software architecture, software documentation, software development productivity

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Authors: Kachout Mnaouer, Bel Hadj Tahar Jamel, Choubani Fethi

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In this paper, three electric equivalent models to evaluate crosstalk between three-conductor transmission lines are proposed. First, electric equivalent models for three-conductor transmission lines are presented. Secondly, rigorous equations to calculate the per-unit length inductive and capacitive parameters are developed. These models allow us to calculate crosstalk between conductors. Finally, to validate the presented models, we compare the theoretical results with simulation data. Obtained results show that proposed models can be used to predict crosstalk performance.

Keywords: near-end crosstalk, inductive parameter, L, Π, T models

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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: P. Shahabi

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The increase in average human life expectancy has led to a growing elderly population. This demographic shift has brought forth various challenges related to the mental and physical well-being of the elderly, often resulting in a lack of dignity and respect for this valuable segment of society. These emerging social issues have cast a shadow on the lives of families, prompting the need for innovative solutions to enhance the lives of the elderly. In this study, within the context of architecture, we aim to create a pleasant and nurturing environment that combines traditional Iranian and modern architectural elements to cater to the unique needs of the elderly. Our primary research objectives encompass the following: Recognizing the societal demand for nursing homes due to the increasing elderly population, addressing the need for a conducive environment that promotes physical and mental well-being among the elderly, developing spatial designs that are specifically tailored to the elderly population, ensuring their comfort and convenience. To achieve these objectives, we have undertaken a comprehensive exploration of the challenges and issues faced by the elderly. We have also laid the groundwork for the architectural design of nursing homes, culminating in the presentation of an architectural plan aimed at minimizing the difficulties faced by the elderly and enhancing their quality of life. It is noteworthy that many of the existing nursing homes in Iran lack the necessary welfare and safety conditions required for the elderly. Hence, our research aims to establish comprehensive and suitable criteria for the optimal design of nursing homes. We believe that through optimal design, we can create spaces that are not only diverse, attractive, and dynamic but also significantly improve the quality of life for the elderly. We hold the hope that these homes will serve as beacons of hope and tranquility for all individuals in their later years.

Keywords: care home, elderly, optimum design, support

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Authors: Cachanda K. Orellana

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This study examined preservice teachers’ perceptions of their role in digital citizenship education. Data was gathered via surveys and coursework from the preservice teachers’ instructional technology course. Pre-service teachers were asked about their role in digital citizenship education during a unit on digital dilemmas. Findings suggest that teacher education programs should consider digital citizenship education as more than the acquisition of a set of skills and behaviors and prepare preservice teachers to support students’ ability to engage in ethical decision-making in digital spaces.

Keywords: digital citizenship, digital dilemmas, pre-service teachers, teacher education

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Authors: M. S. Raza, A. Kapil, Sonu Tyagi, H. Gautam, S. Mohapatra, R. Chaudhry, S. Sood, V. Goyal, R. Lodha, V. Sreenivas, B. K. Das

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Background: Acute bacterial meningitis remains the major cause of mortality and morbidity. More than half of the survivors develop the significant lifelong neurological abnormalities. Diagnosis of the hospital acquired acute bacterial meningitis (HAABM) is challenging as it appears either in the post operative patients or patients acquire the organisms from the hospital environment. In both the situations, pathogens are exposed to high dose of antibiotics. Chances of getting multidrug resistance organism are very high. We have performed this experiment to find out the etiological agents of HAABM and its antibiotics susceptibility pattern. Methodology: A perspective study was conducted at the Department of Microbiology, All India Institute of Medical Sciences, New Delhi. From March 2015 to April 2018 total 400 Cerebro spinal fluid samples were collected aseptically. Samples were processed for cell count, Gram staining, and culture. Culture plates were incubated at 37°C for 18-24 hours. Organism grown on blood and MacConkey agar were identified by MALDI-TOF Vitek MS (BioMerieux, France) and antibiotic susceptibility tests were performed by Kirby Bauer disc diffusion method as per CLSI 2015 guideline. Results: Of the 400 CSF samples processed, 43 (10.75%) were culture positive for different bacteria. Out of 43 isolates, the most prevalent Gram-positive organisms were S. aureus 4 (9.30%) followed by E. faecium 3 (6.97%) & CONS 2 (4.65%). Similarly, E. coli 13 (30.23%) was the commonest Gram-negative isolates followed by A. baumannii 12 (27.90%), K. pneumonia 5 (11.62%) and P. aeruginosa 4(9.30%). Most of the antibiotics tested against the Gram-negative isolates were resistance to them. Colistin was most effective followed by Meropenem and Imepenim for all Gram-negative HAABM isolates. Similarly, most of antibiotics tested were susceptible to S. aureus and CONS. However, E. faecium (100%) were only susceptible to vancomycin and teicoplanin. Conclusion: Hospital acquired acute bacterial meningitis (HAABM) is becoming the emerging challenge as most of isolates are showing resistance to commonly used antibiotics. Gram-negative organisms are emerging as the major player of HAABM. Great care needs to be taken especially in tertiary care hospitals. Similarly, antibiotic stewardship should be followed and antibiotic susceptibility test (AST) should be performed regularly to update the antibiotic patter and to prevent from the emergence of resistance. Updated information of the AST will be helpful for the better management of the meningitis patient.

Keywords: CSF, MALDI-TOF, hospital acquired acute bacterial meningitis, AST

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Authors: Brogan Guest, Amy Donaldson-Perrott

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The Master’s of Physician Associate Studies (MPAS) programme at St George’s, University of London (SGUL), is an intensive two-year course that trains students to become physician associates (PAs). PAs are generalized healthcare providers who work in primary and secondary care across the UK. PA programmes face the difficult task of preparing students to become safe medical providers in two short years. Our goal is to teach students to develop clinical reasoning early on in their studies and historically, this has been done predominantly though problem-based learning (PBL). We have had an increase concern about student engagement in PBL and difficulty recruiting facilitators to maintain the low student to facilitator ratio required in PBL. To address this issue, we created ‘Clinical Application of Anatomy and Physiology (CAAP)’. These peer-led, interactive, problem-based, small group sessions were designed to facilitate students’ clinical reasoning skills. The sessions were designed using the concept of Team-Based Learning (TBL). Students were divided into small groups and each completed a pre-session quiz consisting of difficult questions devised to assess students’ application of medical knowledge. The quiz was completed in small groups and they were not permitted access of external resources. After the quiz, students worked through a series of openended, clinical tasks using all available resources. They worked at their own pace and the session was peer-led, rather than facilitator-driven. For a group of 35 students, there were two facilitators who observed the sessions. The sessions utilised an infinite space whiteboard software. Each group member was encouraged to actively participate and work together to complete the 15-20 tasks. The session ran for 2 hours and concluded with a post-session quiz, identical to the pre-session quiz. We obtained subjective feedback from students on their experience with CAAP and evaluated the objective benefit of the sessions through the quiz results. Qualitative feedback from students was generally positive with students feeling the sessions increased engagement, clinical understanding, and confidence. They found the small group aspect beneficial and the technology easy to use and intuitive. They also liked the benefit of building a resource for their future revision, something unique to CAAP compared to PBL, which out students participate in weekly. Preliminary quiz results showed improvement from pre- and post- session; however, further statistical analysis will occur once all sessions are complete (final session to run December 2022) to determine significance. As a post-graduate healthcare professional programme, we have a strong focus on self-directed learning. Whilst PBL has been a mainstay in our curriculum since its inception, there are limitations and concerns about its future in view of student engagement and facilitator availability. Whilst CAAP is not TBL, it draws on the benefits of peer-led, small group work with pre- and post- team-based quizzes. The pilot of these sessions has shown that students are engaged by CAAP, and they can make significant progress in clinical reasoning in a short amount of time. This can be achieved with a high student to facilitator ratio.

Keywords: problem based learning, team based learning, active learning, peer-to-peer teaching, engagement

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Authors: Maryna Barushka, Aleh Meshyk

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The research analyzes absolute maximum soil temperatures registered at 36 gauge stations in Belarus from 1950 to 2013. The main method applied in the research is cartographic, in particular, trend surface analysis. Warming that had never been so long and intensive before started in 1988. The average temperature in January and February of that year exceeded the norm by 7-7.5 С, in March and April by 3-5С. In general, that year, as well as the year of 2008, happened to be the hottest ones in the whole period of instrumental observation. Yearly average air temperature in Belarus in those years was +8.0-8.2 С, which exceeded the norm by 2.0 – 2.2 С. The warming has been observed so far. The only exception was in 1996 when the yearly average air temperature in Belarus was below normal by 0.5 С. In Belarus the value of trend line of standard temperature deviation in the warmest months (July-August) has been positive for the past 25 years. In 2010 absolute maximum air and soil temperature exceeded the norm at 15 gauge stations in Belarus. The structure of natural processes includes global, regional, and local constituents. Trend surface analysis of the investigated characteristics makes it possible to determine global, regional, and local components. Linear trend surface shows the occurrence of weather deviations on a global scale, outside Belarus. Maximum soil temperature appears to be growing in the south-west direction with the gradient of 5.0 С. It is explained by the latitude factor. Polynomial trend surfaces show regional peculiarities of Belarus. Extreme temperature regime is formed due to some factors. The prevailing one is advection of turbulent flow of the ground layer of the atmosphere. In summer influence of the Azores High producing anticyclones is great. The Gulf Stream current forms the values of temperature trends in a year period. The most intensive flow of the Gulf Stream in the second half of winter and the second half of summer coincides with the periods of maximum temperature trends in Belarus. It is possible to estimate a local component of weather deviations in the analysis of the difference in values of the investigated characteristics and their trend surfaces. Maximum positive deviation (up to +4 С) of averaged soil temperature corresponds to the flat terrain in Pripyat Polesie, Brest Polesie, and Belarusian Poozerie Area. Negative differences correspond to the higher relief which partially compensates extreme heat regime of soils. Another important factor for maximum soil temperature in these areas is peat-bog soils with the least albedo of 8-15%. As yearly maximum soil temperature reaches 40-60 С, this could be both negative and positive factors for Belarus’s environment and economy. High temperature causes droughts resulting in crops dying and soil blowing. On the other hand, vegetation period has lengthened thanks to bigger heat resources, which allows planting such heat-loving crops as melons and grapes with appropriate irrigation. Thus, trend surface analysis allows determining global, regional, and local factors in accumulating heat in the soils of Belarus.

Keywords: soil, temperature, trend surface analysis, warming

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Authors: Wei Liu, Shuquan Wang, Yang Gao

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Microgravity Science Experiment Rack (MSER) will be onboard TianHe (TH) spacecraft planned to be launched in 2018. TH is one module of Chinese Space Station. Microgravity Vibration Isolation System (MVIS), which is MSER’s core part, is used to isolate disturbance from TH and provide high-level microgravity for science experiment payload. MVIS is two stage vibration isolation system, consisting of Follow Unit (FU) and Experiment Support Unit (ESU). FU is linked to MSER by umbilical cables, and ESU suspends within FU and without physical connection. The FU’s position and attitude relative to TH is measured by binocular vision measuring system, and the acceleration and angular velocity is measured by accelerometers and gyroscopes. Air-jet thrusters are used to generate force and moment to control FU’s motion. Measurement module on ESU contains a set of Position-Sense-Detectors (PSD) sensing the ESU’s position and attitude relative to FU, accelerometers and gyroscopes sensing ESU’s acceleration and angular velocity. Electro-magnetic actuators are used to control ESU’s motion. Firstly, the linearized equations of FU’s motion relative to TH and ESU’s motion relative to FU are derived, laying the foundation for control system design and simulation analysis. Subsequently, two control schemes are proposed. One control scheme is that ESU tracks FU and FU tracks TH, shorten as E-F-T. The other one is that FU tracks ESU and ESU tracks TH, shorten as F-E-T. In addition, motion spaces are constrained within ±15 mm、±2° between FU and ESU, and within ±300 mm between FU and TH or between ESU and TH. A Proportional-Integrate-Differentiate (PID) controller is designed to control FU’s position and attitude. ESU’s controller includes an acceleration feedback loop and a relative position feedback loop. A Proportional-Integrate (PI) controller is designed in the acceleration feedback loop to reduce the ESU’s acceleration level, and a PID controller in the relative position feedback loop is used to avoid collision. Finally, simulations of E-F-T and F-E-T are performed considering variety uncertainties, disturbances and motion space constrains. The simulation results of E-T-H showed that control performance was from 0 to -20 dB for vibration frequency from 0.01 to 0.1 Hz, and vibration was attenuated 40 dB per ten octave above 0.1Hz. The simulation results of T-E-H showed that vibration was attenuated 20 dB per ten octave at the beginning of 0.01Hz.

Keywords: microgravity science experiment rack, microgravity vibration isolation system, PID control, vibration isolation performance

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Authors: P. Singh, S. Mittal

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Stability of slope in Chamoli Distt. near River Alaknanda in Uttarakhand is essential to safeguard the infrastructure of the slope where a dam is proposed to be built near this slope. Every year the areas near the slope have been facing severe landslides (small or big) due to intensive precipitation inflicting substantial damages as per Geological Survey of India records. The stability analysis of the slope under static and pseudo static conditions are presented in this study by using FEM software PHASE2. As per the earthquake zonation map of India, the slope is found in zone V, and hence, pseudo static stability of slope has been performed considering pseudo static analysis. For analysing the slope Mohr-Coulomb shear strength criteria is adopted for soil material and self-drilling anchors are modelled as bolts with parameters like modulus of elasticity, diameter of anchors and peak pull-out resistance of the anchors with the soil present there. The slope is found to be unstable under pseudo static conditions with computed factor of safety= 0.93. Stability is provided to the slope by using Self Drilling Anchors (SDA) which gives factor of safety= 1.15 under pseudo static condition.

Keywords: FEM, pseudo static, self-drilling anchors, slope stability

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Authors: Rozafa Shala

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Development of preschool education in Kosovo has passed through several periods. The period after the 1999 war was very intensive period when preschool education started to change. Step-by-step program was one of the programs which were very well extended during the period after the 1999 war until now. The aim of this study is to present the impact of the step-by-step program in the preschool education. This research is based on the hypothesis that: Step-by-step program continues to be present with its elements, in all other programs that the teachers can use. For data collection a questionnaire is constructed which was distributed to 25 teachers of preschool education who work in public preschool institutions. All the teachers have finished the training for step by step program. To support the data from the questionnaire a focus group is also organized with whom the critical issues of the program were discussed. From the results obtained we can conclude that the step-by-step program has a very strong impact in the preschool level. Many specific elements such as: circle time, weather calendar, environment inside the class, portfolios and many other elements are present in most of the preschool classes. The teacher's approach also has many elements of the step-by-step program.

Keywords: preschool education, step-by-step program, impact, teachers

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Authors: Peggy M. Randon, Lisa Randon

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Introduction: The post-COVID-19 era has presented unique challenges for addressing complex mental health issues, particularly due to exacerbated stress, increased social isolation, and disrupted continuity of care. This article outlines relevant health disparities and policy implications within the context of the United States while maintaining international relevance. Methods: A comprehensive literature review (including studies, reports, and policy documents) was conducted to examine concerns related to childhood-onset schizophrenia and the impact on patients and their families. Qualitative and quantitative data were synthesized to provide insights into the complex etiology of schizophrenia, the effects of the pandemic, and the challenges faced by socioeconomically disadvantaged populations. Case studies were employed to illustrate real-world examples and areas requiring policy reform. Results: Early intervention in childhood is crucial for preventing or mitigating the long-term impact of complex psychotic disorders, particularly schizophrenia. A comprehensive understanding of the genetic, environmental, and physiological factors contributing to the development of schizophrenia is essential. The COVID-19 pandemic worsened symptoms and disrupted treatment for many adolescent patients with schizophrenia, emphasizing the need for adaptive interventions and the utilization of virtual platforms. Health disparities, including stigma, financial constraints, and language or cultural barriers, further limit access to care, especially for socioeconomically disadvantaged populations. Policy implications: Current US health policies inadequately support patients with schizophrenia. The limited availability of longitudinal care, insufficient resources for families, and stigmatization represent ongoing policy challenges. Addressing these issues necessitates increased research funding, improved access to affordable treatment plans, and cultural competency training for healthcare providers. Public awareness campaigns are crucial to promote knowledge, awareness, and acceptance of mental health disorders. Conclusion: The unique challenges faced by children and families in the US affected by schizophrenia and other psychotic disorders have yet to be adequately addressed on institutional and systemic levels. The relevance of findings to an international audience is emphasized by examining the complex factors contributing to the onset of psychotic disorders and their global policy implications. The broad impact of the COVID-19 pandemic on mental health underscores the need for adaptive interventions and global responses. Addressing policy challenges, improving access to care, and reducing the stigma associated with mental health disorders are crucial steps toward enhancing the lives of adolescents and young adults with schizophrenia and their family members. The implementation of virtual platforms can help overcome barriers and ensure equitable access to support and resources for all patients, enabling them to lead healthy and fulfilling lives.

Keywords: childhood, schizophrenia, policy, United, States, health, disparities

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Authors: Asharaf Abdul Salam

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Arabian Gulf countries have norms and rules different from others: having an exodus of male immigrant labor contract holders of age 20-60 years as a floating population. Such a demographic scenario camouflages population ageing. However, it is observed on examining vigilantly, not only in the native population but also in the general population. This research on population ageing in the Arabian Gulf examines ageing scenario and concerns through analyses of international databases (US Census Bureau and United Nations) and national level databases (Censuses and Surveys) apart from a review of published research. Transitions in demography and epidemiology lead to gains in life expectancy and thereby reductions in fertility, leading to ageing of the population in the region. Even after bringing adult immigrants, indices and age pyramids show an increasing ageing trend in the total population, demonstrating an ageing workforce. Besides, the exclusive native population analysis reveals a trend of expansive pyramids (pre-transitional stage) turning to constrictive (transition stage) and cylindrical (post-transition stage) shapes. Age-based indices such as the index of ageing, age dependency ratio, and median age confirm this trend. While the feminine nature of ageing is vivid, gains in life expectancy and causes of death in old age, indicating co-morbidity compression, are concerns to ageing. Preparations are in demand to cope with ageing from different dimensions, as explained in the United Nations Plans of Action. A strategy of strengthening informal care with supportive semi-formal and supplementary formal care networks would alleviate this crisis associated with population ageing.

Keywords: total versus native population, indices of ageing, age pyramids, feminine nature, comorbidity compression, strategic interventions

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Authors: Ajay Kumar Sinha, Sharad Singh, Anukriti Sinha

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Passive energy dissipation method for earthquake protection of structures is undergoing developments for improved performance. Combined use of different types of damping mechanisms has shown positive results in the near past. Different supplemental damping methods like viscous damping, frictional damping and metallic damping are being combined together for optimum performance. The conventional method of connecting passive dampers to structures is a parallel connection between the damper unit and structural member. Researchers are investigating coupling effect of different types of dampers. The most popular choice among the research community is coupling of viscous dampers and frictional dampers. The series and parallel coupling of these damping units are being studied for relative performance of the coupled system on response control of structures against earthquake. In this paper an attempt has been made to couple Fluid Viscous Dampers and Frictional Dampers in series and parallel to form a single unit of damping system. The relative performance of the coupled units has been studied on three dimensional reinforced concrete framed structure. The current theories of structural dynamics in practice for viscous damping and frictional damping have been incorporated in this study. The time history analysis of the structural system with coupled damper units, uncoupled damper units as well as of structural system without any supplemental damping has been performed in this study. The investigations reported in this study show significant improved performance of coupled system. A higher natural frequency of the system outside the forcing frequency has been obtained for structural systems with coupled damper units as against the other cases. The structural response of the structure in terms of storey displacement and storey drift show significant improvement for the case with coupled damper units as against the cases with uncoupled units or without any supplemental damping. The results are promising in terms of improved response of the structure with coupled damper units. Further investigations in this regard for a comparative performance of the series and parallel coupled systems will be carried out to study the optimum behavior of these coupled systems for enhanced response control of structural systems.

Keywords: frictional damping, parallel coupling, response control, series coupling, supplemental damping, viscous damping

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Authors: S. V. Ncube, A. I. O. Jideani, E. T. Gwata

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The plight of food insecurity in developing countries has led to renewed interest in underutilized legumes. Their nutritional versatility, desirable functionality, pharmaceutical value and inherent bioactive compounds have drawn the attention of researchers. This has provoked the development of value added products with the aim of commercially exploiting their full potential. However processing of these legumes leads to changes in nutritional composition as affected by processing variables like pH, temperature and pressure. There is therefore a need for process control and quality assurance during production of the value added products. However, conventional methods for microbiological and biochemical identification are labour intensive and time-consuming. Biosensors offer rapid and affordable methods to assure the quality of the products. They may be used to quantify nutrients and anti-nutrients in the products while manipulating and monitoring variables such as pH, temperature, pressure and oxygen that affect the quality of the final product. This review gives an overview of the types of biosensors used in the food industry, their advantages and disadvantages and their possible application in processing of legumes.

Keywords: legume processing, biosensors, quality control, nutritional versatility

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Authors: Daniela Tapusi, Adrian Andronic, Naomi Tufan, Ruxandra Erbașu, Ioana Teodorescu

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The proposed theme of this article falls within the policy of reducing carbon emissions imposed by the ‘Green New Deal’ by replacing structural elements made of energy-intensive materials with ecological materials. In this sense, wood has many qualities (high strength/mass and stiffness/mass ratio, low specific gravity, recovery/recycling) that make it competitive with classic building materials. The topological optimization of the linear glulam elements, resulting from different types of analysis (Finite Element Method, simple regression on metamodels), tests on models or by Monte-Carlo simulation, leads to a material reduction of more than 10%. This article proposes a method of obtaining topologically optimized shapes for different types of glued laminated timber beams. The results obtained will constitute the database for AI training.

Keywords: timber, glued laminated timber, artificial-intelligence, environment, carbon emissions

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Authors: Palak V. Patel, Jessica Pixley, Steven R. Feldman

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Introduction: Basal cell carcinoma (BCC) is the most common skin cancer worldwide and requires substantial resources to treat. When choosing between indicated therapies, providers consider their associated adverse effects, efficacy, cosmesis, and function preservation. The patient’s tumor burden, infiltrative risk, and risk of tumor recurrence are also considered. Treatment cost is often left out of these discussions. This can lead to financial toxicity, which describes the harm and quality of life reductions inflicted by high care costs. Methods: We studied the guidelines set forth by the American Academy of Dermatology for the treatment of BCC. A PubMed literature search was conducted to identify the costs of each recommended therapy. We discuss costs alongside treatment efficacy and side-effect profile. Results: Surgical treatment for BCC can be cost-effective if the appropriate treatment is selected for the presenting tumor. Curettage and electrodesiccation can be used in low-grade, low-recurrence tumors in aesthetically unimportant areas. The benefits of cost-conscious care are not likely to be outweighed by the risks of poor cosmesis or tumor return ($471 BCC of the cheek). When tumor burden is limited, MMS offers better cure rates and lower recurrence rates than surgical excision, and with comparable costs (MMS $1263; SE $949). Surgical excision with permanent sections may be indicated when tumor burden is more extensive or if molecular testing is necessary. The utility of surgical excision with frozen sections, which costs substantially more than MMS without comparable outcomes, is less clear (SE with frozen sections $2334-$3085). Less data exists on non-surgical treatments for BCC. These techniques cost less, but recurrence-risk is high. Side-effects of nonsurgical treatment are limited to local skin reactions, and cosmesis is good. Cryotherapy, 5-FU, and MAL-PDT are all more affordable than surgery, but high recurrence rates increase risk of secondary financial and psychosocial burden (recurrence rates 21-39%; cost $100-270). Radiation therapy offers better clearance rates than other nonsurgical treatments but is associated with similar recurrence rates and a significantly larger financial burden ($2591-$3460 BCC of the cheek). Treatments for advanced or metastatic BCC are extremely costly, but few patients require their use, and the societal cost burden remains low. Vismodegib and sonidegib have good response rates but substantial side effects, and therapy should be combined with multidisciplinary care and palliative measures. Expert-review has found sonidegib to be the less expensive and more efficacious option (vismodegib $128,358; sonidegib $122,579). Platinum therapy, while not FDA-approved, is also effective but expensive (~91,435). Immunotherapy offers a new line of treatment in patients intolerant of hedgehog inhibitors ($683,061). Conclusion: Dermatologists working within resource-compressed practices and with resource-limited patients must prudently manage the healthcare dollar. Surgical therapies for BCC offer the lowest risk of recurrence at the most reasonable cost. Non-surgical therapies are more affordable, but high recurrence rates increase the risk of secondary financial and psychosocial burdens. Treatments for advanced BCC are incredibly costly, but the low incidence means the overall cost to the system is low.

Keywords: nonmelanoma skin cancer, basal cell skin cancer, squamous cell skin cancer, cost of care

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Authors: Barbora Haltofová

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In recent years, citizens have become an important source of geographic information and, therefore, geo-crowdsourcing, often known as volunteered geographic information, has provided an interesting alternative to traditional mapping practices which are becoming expensive, resource-intensive and unable to capture the dynamic nature of urban environments. In order to address a gap in research literature, this paper deals with a survey conducted to assess the current state of geo-crowdsourcing, a recent phenomenon popular with people who collect geographic information using their smartphones. This article points out that there is an increasing body of knowledge of geo-crowdsourcing mobile applications in the Visegrad countries marked by the ubiquitous Internet connection and the current massive proliferation of smartphones. This article shows how geo-crowdsourcing can be used as a complement, or in some cases a replacement, to traditionally generated sources of spatial data and information in public management. It discusses the new spaces of citizen participation constructed by these geo-crowdsourcing practices.

Keywords: citizen participation, e-Government, geo-crowdsourcing, participatory mapping, mobile applications

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Authors: Xavier Ruiz Del Portal

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This paper incorporates mobility between the legal and black economies into a model of tax evasion with endogenous labor supply in which underreporting is possible in one sector but impossible in the other. We have found that the results of the effects along the extensive margin (number of evaders) become more robust and conclusive than those along the intensive margin (hours of illegal work) usually considered by the literature. In particular, it is shown that the following policies reduce the number of evaders: (a) larger and more progressive evasion penalties; (b) higher detection probabilities; (c) an increase in the legal sector wage rate; (d) a decrease in the moonlighting wage rate; (e) higher costs for creating opportunities to evade; (f) lower opportunities to evade, and (g) greater psychological costs of tax evasion. When tax concealment and illegal work also are taken into account, the effects do not vary significantly under the assumptions in Cowell (1985), except for the fact that policies (a) and (b) only hold as regards low- and middle-income groups and policies (e) and (f) as regards high-income groups.

Keywords: income taxation, tax evasion, extensive margin responses, the penalty system

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Authors: Supria Sarkar, Vasit Sagan, Sourav Bhadra, Meghnath Pokharel, Felix B.Fritschi

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Soybean and their derivatives are very important agricultural commodities around the world because of their wide applicability in human food, animal feed, biofuel, and industries. However, the significance of soybean production depends on the quality of the soybean seeds rather than the yield alone. Seed composition is widely dependent on plant physiological properties, aerobic and anaerobic environmental conditions, nutrient content, and plant phenological characteristics, which can be captured by high temporal resolution remote sensing datasets. Planet scope (PS) satellite images have high potential in sequential information of crop growth due to their frequent revisit throughout the world. In this study, we estimate soybean seed composition while the plants are in the field by utilizing PlanetScope (PS) satellite images and different machine learning algorithms. Several experimental fields were established with varying genotypes and different seed compositions were measured from the samples as ground truth data. The PS images were processed to extract 462 hand-crafted vegetative and textural features. Four machine learning algorithms, i.e., partial least squares (PLSR), random forest (RFR), gradient boosting machine (GBM), support vector machine (SVM), and two recurrent neural network architectures, i.e., long short-term memory (LSTM) and gated recurrent unit (GRU) were used in this study to predict oil, protein, sucrose, ash, starch, and fiber of soybean seed samples. The GRU and LSTM architectures had two separate branches, one for vegetative features and the other for textures features, which were later concatenated together to predict seed composition. The results show that sucrose, ash, protein, and oil yielded comparable prediction results. Machine learning algorithms that best predicted the six seed composition traits differed. GRU worked well for oil (R-Squared: of 0.53) and protein (R-Squared: 0.36), whereas SVR and PLSR showed the best result for sucrose (R-Squared: 0.74) and ash (R-Squared: 0.60), respectively. Although, the RFR and GBM provided comparable performance, the models tended to extremely overfit. Among the features, vegetative features were found as the most important variables compared to texture features. It is suggested to utilize many vegetation indices for machine learning training and select the best ones by using feature selection methods. Overall, the study reveals the feasibility and efficiency of PS images and machine learning for plot-level seed composition estimation. However, special care should be given while designing the plot size in the experiments to avoid mixed pixel issues.

Keywords: agriculture, computer vision, data science, geospatial technology

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Authors: Peter G. Youssef, Saad M. Mahmoud, Raya K. AL-Dadah

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Many water desalination technologies have been developed but in general they are energy intensive and have high cost and adverse environmental impact. Recently, adsorption technology for water desalination has been investigated showing the potential of using low temperature waste heat (50-85oC) thus reducing energy consumption and CO2 emissions. This work mathematically compares the performance of an adsorption cycle that produces two useful effects namely, fresh water and cooling using two different adsorbents, silica-gel and an advanced zeolite material AQSOA-ZO2, produced by Mitsubishi plastics. It was found that at low chilled water temperatures, typically below 20oC, the AQSOA-Z02 is more efficient than silica-gel as the cycle can produce 5.8 m3 of fresh water per day and 50.1 Rton of cooling per tonne of AQSOA-ZO2. Above 20oC silica-gel is still better as the cycle production reaches 8.4 m3 per day and 62.4 Rton per tonne of silica-gel. These results show the potential of using the AQSOA-Z02 at low chilled water temperature for water desalination and cooling applications.

Keywords: adsorption, desalination, refrigeration, seawater

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Authors: Priyanka Yadav, Umesh Bnasal, Yashvinder Kumar

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The placenta is an important structure that provides oxygen and nutrients to the growing fetus in utero. It is usually thrown away after birth, but it has a therapeutic role in the regeneration of tissue. It is covered by the amniotic membrane, which can be easily separated into the amnion layer and the chorion layer—the amnion layer act as a biofilm for the healing of burn wound and non-healing ulcers. The freshly collected membrane has stem cells, cytokines, growth factors, and anti-inflammatory properties, which act as a biofilm for the healing of wounds. It functions as a barrier and prevents heat and water loss and also protects from bacterial contamination, thus supporting the healing process. The application of Amnion membranes has been successfully used for wound and reconstructive purposes for decades. It is a very cheap and easy process and has shown superior results to allograft and xenograft. However, there are very few case reports of amnion membrane grafting in newborns; we intend to highlight its therapeutic importance in burn injuries in newborns. We present a case of 9 days old male neonate who presented to the neonatal unit of Maulana Azad Medical College with a complaint of fluid-filled blisters and burns wound on the body for six days. He was born outside the hospital at 38 weeks of gestation to a 24-year-old primigravida mother by vaginal delivery. The presentation was cephalic and the amniotic fluid was clear. His birth weight was 2800 gm and APGAR scores were 7 and 8 at 1 and 5 minutes, respectively. His anthropometry was appropriate for gestational age. He developed respiratory distress after birth requiring oxygen support by nasal prongs for three days. On the day of life three, he developed blisters on his body, starting from than face then over the back and perineal region. At a presentation on the day of life nine, he had blisters and necrotic wound on the right side of the face, back, right shoulder and genitalia, affecting 60% of body surface area with full-thickness loss of skin. He was started on intravenous antibiotics and fluid therapy. Pus culture grew Pseudomonas aeuroginosa, for which culture-specific antibiotics were started. Plastic surgery reference was taken and regular wound dressing was done with antiseptics. He had a storming course during the hospital stay. On the day of life 35 when the baby was hemodynamically stable, amnion membrane grafting was done on the wound site; for the grafting, fresh amnion membrane was removed under sterile conditions from the placenta obtained by caesarean section. It was then transported to the plastic surgery unit in half an hour in a sterile fluid where the graft was applied over the infant’s wound. The amnion membrane grafting was done twice in two weeks for covering the whole wound area. After successful uptake of amnion membrane, skin from the thigh region was autografted over the whole wound area by Meek technique in a single setting. The uptake of autograft was excellent and most of the areas were healed. In some areas, there was patchy regeneration of skin so dressing was continued. The infant was discharged after three months of hospital stay and was later followed up in the plastic surgery unit of the hospital.

Keywords: amnion membrane grafting, autograft, meek technique, newborn, regeneration of skin

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Authors: Wesam Jasim, Dongbing Gu

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This paper presents an iterative linear quadratic regulator optimal control technique to solve the problem of quadrotors path tracking. The dynamic motion equations are represented based on unit quaternion representation and include some modelled aerodynamical effects as a nonlinear part. Simulation results prove the ability and effectiveness of iLQR to stabilize the quadrotor and successfully track different paths. It also shows that iLQR controller outperforms LQR controller in terms of fast convergence and tracking errors.

Keywords: iLQR controller, optimal control, path tracking, quadrotor UAVs

Procedia PDF Downloads 455

Authors: Siddiq Ahmed

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The current study aimed to investigate the effectiveness of a Peer-Mediated Intervention (PMI) on writing skills for a student with autism spectrum disorders in inclusive classrooms. The participants in this study were two students, one as a tutor and another as a tutee who was diagnosed with autism spectrum disorder (ASD). The target participant struggled with writing skills and was paired with a student with high academic outcomes. The Tutor had a readiness to act as a tutor for his peer and was trained on how to assist his peer and how to identify and guide his peer’s writing mistakes. Multiple baseline design across behaviors was implemented to monitor the student’s progress in writing skills. The results of the present study showed that PMI yielded significant improvements in academic achievements for the target student. This study suggests that further studies should replicate the current study with an intensive focus on other academic skills such as reading comprehension, writing social stories, and math.

Keywords: peer tutoring, writing skills, autism, inclusion

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Authors: David Tennison

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In the wake of the Covid-19 pandemic, a new chronic illness emerged onto the global stage: Long Covid. Long Covid presents with several symptoms commonly seen in other poorly-understood illnesses, such as fibromyalgia (FM) and myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS). However, while Long Covid has swiftly become a recognised illness, FM and ME/CFS are still seen as contested, which impacts patient care and healthcare experiences. This study aims to examine what the differences are between Long Covid and FM; and if the Long Covid case can provide guidance for how to address the healthcare challenge of contested illnesses. To address this question, this study performed comprehensive research into the history of FM; our current biomedical understanding of it; and available healthcare interventions (within the context of the UK NHS). Analysis was undertaken of the stigma and stereotypes around FM, and a comparison made between FM and the emerging Long Covid literature, along with the healthcare response to Long Covid. This study finds that healthcare for chronic contested illnesses in the UK is vastly insufficient - in terms of pharmaceutical and holistic interventions, and the provision of secondary care options. Interestingly, for Long Covid, many of the treatment suggestions are pulled directly from those used for contested illnesses. The key difference is in terms of funding and momentum – Long Covid has generated exponentially more interest and research in a short time than there has been in the last few decades of contested illness research. This stands to help people with FM and ME/CFS – for example, research has recently been funded into “brain fog”, a previously elusive and misunderstood symptom. FM is culturally regarded as a “women’s disease” and FM stigma stems from notions of “hysteria”. A key finding is that the idea of FM affecting women disproportionally is not reflected in modern population studies. Emerging data on Long Covid also suggests a slight leaning towards more female patients, however it is less feminised, potentially due to it emerging in the global historical moment of the pandemic. Another key difference is that FM is rated as an extremely low-prestige illness by healthcare professionals, while it was in large part due to the advocacy of affected healthcare professionals that Long Covid was so quickly recognised by science and medicine. In conclusion, Long Covid (and the risk of future pandemics and post-viral illnesses) highlight a crucial need for implementing new, and reinforcing existing, care networks for chronic illnesses. The difference in how contested illnesses like FM, and new ones like Long Covid are treated have a lot to do with the historical moment in which they emerge – but cultural stereotypes, from within and without medicine, need updating. Particularly as they contribute to disease stigma that causes genuine harm to patients. However, widespread understanding and acceptance of Long Covid could help fight contested illness stigma, and the attention, funding and research into Long Covid may actually help raise the profile of contested illnesses and uncover answers about their symptomatology.

Keywords: long COVID, fibromyalgia, myalgic encephalomyelitis, chronic fatigue syndrome, NHS, healthcare, contested illnesses, chronic illnesses, COVID-19 pandemic

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Authors: Lucie Mrackova, Helena Kisvetrova

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Spirituality is an integral part of human life. In a secular environment, spiritual needs are often overlooked, especially in acute nursing care. Spiritual needs assessment for patients (SNAP), which also exists in the Czech version (SNAP-CZ), can be used for objective evaluation. The aim of this study was to measure the psychometric properties of SNAP-CZ and to find correlations between SNAP-CZ and sociodemographic and clinical variables. A cross-sectional study with tools assessing spiritual needs (SNAP-CZ), anxiety (Beck Anxiety Inventory; BAI), depression (Beck Depression Inventory; BDI), pain (Visual Analogue Scale; VAS), self-sufficiency (Barthel Index; BI); cognitive function (Montreal Cognitive Test; MoCa) and selected socio-demographic data was performed. The psychometric properties of SNAP-CZ were tested using factor analysis, reliability and validity tests, and correlations between the questionnaire and sociodemographic data and clinical variables. Internal consistency was established with Cronbach’s alfa for the overall score, respective domains, and individual items. Reliability was assessed by test-retest by Interclass correlation coefficient (ICC). Data for correlation analysis were processed according to Pearson's correlation coefficient. The study included 172 trauma patients (the mean age = 40.6 ± 12.1 years) who experienced polytrauma or severe monotrauma. There were a total of 106 (61.6%) male subjects, 140 (81.4%) respondents identified themselves as non-believers. The full-scale Cronbach's alpha was 0.907. The test-retest showed the reliability of the individual domains in the range of 0.924 to 0.960 ICC. Factor analysis resulted in a three-factor solution (psychosocial needs (alfa = 0.788), spiritual needs (alfa = 0.886) and religious needs (alfa = 0.841)). Correlation analysis using Pearson's correlation coefficient showed that the domain of psychosocial needs significantly correlated only with gender (r = 0.178, p = 0.020). Males had a statistically significant lower average value in this domain (mean = 12.5) compared to females (mean = 13.8). The domain of spiritual needs significantly correlated with gender (r = 0.199, p = 0.009), social status (r = 0.156, p = 0.043), faith (r = -0.250, p = 0.001), anxiety (r = 0.194, p = 0.011) and depression (r = 0.155, p = 0.044). The domain of religious needs significantly correlated with age (r = 0,208, p = 0,007), education (r = -0,161, p = 0,035), faith (r = -0,575, p < 0,0001) and depression (r = 0,179, p = 0,019). Overall, the whole SNAP scale significantly correlated with gender (r = 0.219, p = 0.004), social status (r = 0.175, p = 0.023), faith (r = -0.334, p <0.0001), anxiety (r = 0.177, p = 0.022) and depression (r = 0.173, p = 0.025). The results of this study corroborate the reliability of the SNAP-CZ and support its future use in the nursing care of trauma patients in a secular society. Acknowledgment: The study was supported by grant nr. IGA_FZV_2020_003.

Keywords: acute nursing care, assessment of spiritual needs, patient, psychometric validation, spirituality

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Authors: Vijaya K. Srivastava, Davide Spinello

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This paper presents established 3ⁿ enumeration procedure for mixed integer optimization problems for solving multi-objective reliability and redundancy allocation problem subject to design constraints. The formulated problem is to find the optimum level of unit reliability and the number of units for each subsystem. A number of illustrative examples are provided and compared to indicate the application of the superiority of the proposed method.

Keywords: integer programming, mixed integer programming, multi-objective optimization, Reliability Redundancy Allocation

Procedia PDF Downloads 175

Authors: Diaa Othman, Muhammad Adil Khan, Muhammad Riaz

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Without an early intervention to correct the unilateral complete cleft lip and palate deformity, nasal architecture can progress to an exaggerated cleft nose deformity. We present the results of a modified unilateral cleft rhinoplasty procedure ‘the Gujrat technique’ to correct this deformity. Ninety pediatric and adult patients with non-syndromic unilateral cleft lip underwent primary and secondary composite cleft rhinoplasty using the Gujrat technique as a single stage operation over a 10-year period. The technique involved an open rhinoplasty with Tennison lip repair, and employed a combination of three autologous cartilage grafts, seven cartilage-molding sutures and a prolene mesh graft for alar base support. Post-operative evaluation of nasal symmetry was undertaken using the validated computer program ‘SymNose’. Functional outcome and patient satisfaction were assessed using the NOSE scale and ROE (rhinoplasty outcome evaluation) questionnaires. The single group study design used the non-parametric matching pairs Wilcoxon Sign test (p < 0.001), and showed overall good to excellent functional and aesthetic outcomes, including nasal projection and tip definition, and higher scores of the digital SymNose grading system. Objective assessment of the Gujrat cleft rhinoplasty technique demonstrates its aesthetic appeal and functional versatility. Overall it is a simple and reproducible technique, with no significant complications.

Keywords: cleft lip and palate, congenital rhinoplasty, nasal deformity, secondary rhinoplasty

Procedia PDF Downloads 203