Search results for: career outcomes

Authors: Moustafa Osman Mohammed

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This paper is mapping air quality model to engineering the industrial system that ultimately utilized in extensive range of energy systems, distribution resources, and end-user technologies. The model is determining long-range transport patterns contribution as area source can either traced from 48 hrs backward trajectory model or remotely described from background measurements data in those days. The trajectory model will be run within stable conditions and quite constant parameters of the atmospheric pressure at the most time of the year. Air parcel trajectory is necessary for estimating the long-range transport of pollutants and other chemical species. It provides a better understanding of airflow patterns. Since a large amount of meteorological data and a great number of calculations are required to drive trajectory, it will be very useful to apply HYPSLIT model to locate areas and boundaries influence air quality at regional location of Windsor. 2–days backward trajectories model at high and low concentration measurements below and upward the benchmark which was areas influence air quality measurement levels. The benchmark level will be considered as 30 (μg/m3) as the moderate level for Ontario region. Thereby, air quality model is incorporating a midpoint concept between biotic and abiotic components to broaden the scope of quantification impact. The later outcomes’ theories of environmental obligation suggest either a recommendation or a decision of what is a legislative should be achieved in mitigation measures of air emission impact ultimately.

Keywords: air quality, management systems, environmental impact assessment, industrial ecology, climate change

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Authors: Lady Salvador Purganan, Jojo M. Villamin, Noel L. Lansang

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Tourism is a multifaceted but interdependent industry. This industry is composed of four major players, the public sector, the private sector, the local community, and the tourists. Each player has a vital role in the success of delivering high-quality tourism products and activities. There are various manifestations of positive economic outcomes that benefit the local community. Pro-poor tourism development approach has a great potential to serve as an avenue for capacity building leading to economic independence since natural attractions and cultural resources are assets that can be capitalized on, especially by the poor, because it is more accessible to them compared to financial resources. In the National Tourism Development Plan 2016-2022, specific mechanisms are not reflected to combat and lower poverty incidence through tourism. The researcher used the multidimensional poverty theory and sustainable tourism theory to formulate indicators in the research instrument and social exchange theory. The expected output of the study is to unlock opportunities, specifically in Brgy. Sta. Lucia, Guimba, Nueva Ecija, by crafting policies taking into utmost consideration local community involvement and participation in the process of tourism development which is essential in attaining inclusive growth and sustainability. This study will apply the sequential explanatory design mixed-method approach.

Keywords: pro-poor tourism, poverty alleviation, livelihood opportunities, tourism development plan

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Authors: Mohamed Majrashi, Patricia Connolly, Terry Gourlay

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Cardiopulmonary bypass is known to cause inflammatory response during open heart surgery. It includes the initiation of different cascades such as coagulation, complement system and cytokines. Although the immune system is body’s key defense mechanism against external assault, when overexpressed, it can be injurious to the patient, particularly in a cohort of patients in which there is a heightened and uncontrolled response. The inflammatory response develops in these patients to an exaggerated level resulting in an autoimmune injury and may lead to poor postoperative outcomes (systemic inflammatory response syndrome and multi-organs failure). Previous studies by this group have suggested a correlation between the level of IL6 measured in patient’s blood before surgery and after polymeric activation and the observed inflammatory response during surgery. Based upon these findings, the present work is aimed at using this response to develop a test which can be used prior to the open heart surgery to identify the high-risk patients before their operation. The work will be accomplished via three main clinical phases including some pilot in-vitro studies, device development and clinical investigation. Current findings from studies using animal blood, employing DEHP and DEHP plasticized PVC materials as the activator, support the earlier results in patient samples. Having established this relationship, ongoing work will focus on developing an activated lateral flow strip technology as a screening device for heightened inflammatory propensity.

Keywords: cardiopulmonary bypass, cytokines, inflammatory response, overexpression

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Authors: Marcelo Sifuentes López

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Strategic performance definition and follow-up processes have to be clear in order to provide value in today’s competitive world. Customer expectations must be linked to internal organization strategic objectives leading to profitability and supported by visibility and flexibility among others.By taking a whole picture of the supply chain, the executive, and its team will define the current supply chain situation and an insight into potential opportunities to improve processes and provide value to main stakeholders. A systematic performance evaluation process based on operational and financial indicators defined by customer requirements needs to be implemented and periodically reviewed in order to mitigate costs and risks on time.Supplier long term relationship and collaboration plays a key role using resources available, real-time communication, innovation and new ways to capitalize global opportunities like emerging markets; efforts have to focus on the reduction of uncertainties in supply and demand. Leadership has to promote consistency of communication and execution involving suppliers, customers, and the entire organization through the support of a strategic sourcing methodology that assure the targeted competitive strategy and sustainable growth. As customer requirements and expectations are met, results could be captured in a casual picture like a “selfie”; where outcomes could be perceived from any desired angle by them; or like most “selfies”, can be taken with a camera held at arm's length by a third party company rather than using a self-timer.

Keywords: supply chain management, competitive advantage, value creation, collaboration and innovation, global marketplace

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Authors: Alin Veronika, Yusuf Latief

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This critical review meticulously delineates and elucidates the considerable deficiencies and voids that exist within the extant body of literature concerning the development strategies associated with risk-based Project Management Offices (PMOs). Although the advantages and positive outcomes linked to the establishment and functioning of PMOs are regularly articulated and acknowledged in various academic discourses, the empirical evidence that supports these claims frequently demonstrates a significant shortfall in methodological rigor and often encounters challenges when attempting to distinctly isolate and delineate the unique contributions and impacts of PMOs in contrast to other multifaceted organizational factors that may also play a role. This comprehensive review systematically scrutinizes and evaluates the current research landscape pertaining to the critical success factors that include, but are not limited to, strategic alignment, organizational structure, human capital, operational efficiency, technology, and the overarching influence of organizational culture, thereby identifying notable limitations within this research domain and proposing targeted areas for further scholarly investigation. Furthermore, the analysis accentuates the imperative need for the development and implementation of more sophisticated, nuanced risk assessment and mitigation frameworks that are specifically designed to cater to the unique operational characteristics of PMOs while simultaneously advocating for an elevated focus on the profound influence exerted by organizational culture and its various subcultures on the overall effectiveness and success of PMOs.

Keywords: organizational culture, project management office, risk management, risk-based PMO development

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Authors: Alimohamad Asghari, Ahmad Daneshi, Mohammad Farhadi, Arash Bayat, Mohammad Ajalloueyan, Marjan Mirsalehi, Mohsen Rajati, Seyed Basir Hashemi, Nader Saki, Ali Omidvari

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Evidence suggests that Cochlear Implantation (CI) is a beneficial approach for auditory and speech skills improvement in children with severe to profound hearing loss. However, it remains controversial if implantation in children <12 months is safe and effective compared to older children. The present study aimed to determine whether children's ages affect surgical complications and auditory and speech development. The current multicenter study enrolled 86 children who underwent CI surgery at <12 months of age (group A) and 362 children who underwent implantation between 12 and 24 months of age (group B). The Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores were determined pre-impanation, and "one-year" and "two-year" post-implantation. Four complications (overall rate: 4.65%; three minor) occurred in group A and 12 complications (overall rate: 4.41%; nine minor) occurred in group B. We found no statistically significant difference in the complication rates between the groups (p>0.05). The mean SIR and CAP scores improved over time following CI activation in both groups. However, we did not find significant differences in CAP and SIR scores between the groups across different time points. Cochlear implantation is a safe and efficient procedure in children younger than 12 months, providing substantial auditory and speech benefits comparable to children undergoing implantation at 12 to 24 months of age. Furthermore, surgical complications in younger children are similar to those of children undergoing the CI at an older age.

Keywords: cochlear implant, Infant, complications, outcome

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Authors: Miron A., Tadmor R., Pinkert S.

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Soil contamination is a pressing environmental concern, drawing considerable focus due to its adverse ecological and health outcomes, and the frequent occurrence of contamination incidents in recent years. The interaction between the oil pollutant and the host soil can alter the mechanical properties of the soil in a manner that can crucially affect engineering challenges associated with the stability of soil systems. The geotechnical investigation of contaminated soils has gained momentum since the Gulf War in the 1990s, when a massive amount of oil was spilled into the ocean. Over recent years, various types of soil contaminations have been studied to understand the impact of pollution type, uncovering the mechanical complexity that arises not just from the pollutant type but also from the properties of the host soil and the interplay between them. This complexity is associated with diametrically opposite effects in different soil types. For instance, while certain oils may enhance the frictional properties of cohesive soils, they can reduce the friction in granular soils. This striking difference can be attributed to the different mechanisms at play: physico-chemical interactions predominate in the former case, whereas lubrication effects are more significant in the latter. this study introduces an empirical law designed to quantify the mechanical effect of oil contamination in granular soils, factoring the properties of both the contaminating oil and the host soil. This law is achieved by comprehensive experimental research that spans a wide array of oil types and soils with unique configurations and morphologies. By integrating these diverse data points, our law facilitates accurate predictions of how oil contamination modifies the frictional characteristics of general granular soils.

Keywords: contaminated soils, lubrication, friction, granular media

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Authors: Shivaram P. Arunachalam, Mustafa Y. Sir, Andy Boggust, David M. Nestler, Thomas R. Hellmich, Kalyan S. Pasupathy

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Emergency departments (EDs) provide urgent care to patients throughout the day in a complex and chaotic environment. Real-time location systems (RTLS) are increasingly being utilized in healthcare settings, and have shown to improve safety, reduce cost, and increase patient satisfaction. Radio Frequency Identification Device (RFID) data in an ED has been shown to compute variables such as patient-provider contact time, which is associated with patient outcomes such as 30-day hospitalization. These variables can provide avenues for improving ED operational efficiency. A major challenge with ED financial operations is under-coding of critical care services due to physicians’ difficulty reporting accurate times for critical care provided under Current Procedural Terminology (CPT) codes 99291 and 99292. In this work, the authors propose a framework to optimize ED critical care billing using RFID data. RFID estimated physician-patient contact times could accurately quantify direct critical care services which will help model a data-driven approach for ED critical care billing. This paper will describe the framework and provide insights into opportunities to prevent under coding as well as over coding to avoid insurance audits. Future work will focus on data analytics to demonstrate the feasibility of the framework described.

Keywords: critical care billing, CPT codes, emergency department, RFID

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Authors: Azita Ramezani, Ghazal Mashhadiagha, Bahareh Sanabakhsh

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This study researches the combination of Random. Forest classifiers with large language models (LLMs) and natural language processing (NLP) to improve diagnostic accuracy in chest X-ray analysis using the Indiana University dataset. Utilizing advanced NLP techniques, the research preprocesses textual data from radiological reports to extract key features, which are then merged with image-derived data. This improved dataset is analyzed with Random Forest classifiers to predict specific clinical results, focusing on the identification of health issues and the estimation of case urgency. The findings reveal that the combination of NLP, LLMs, and machine learning not only increases diagnostic precision but also reliability, especially in quickly identifying critical conditions. Achieving an accuracy of 99.35%, the model shows significant advancements over conventional diagnostic techniques. The results emphasize the large potential of machine learning in medical imaging, suggesting that these technologies could greatly enhance clinician judgment and patient outcomes by offering quicker and more precise diagnostic approximations.

Keywords: natural language processing (NLP), large language models (LLMs), random forest classifier, chest x-ray analysis, medical imaging, diagnostic accuracy, indiana university dataset, machine learning in healthcare, predictive modeling, clinical decision support systems

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Authors: Essam Amerian

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The aim of this study was to investigate the effects of improving waist-to-hip ratio (WHR) and visceral fat components on the health of shift workers in an offshore petrochemical company. A total of 100 male shift workers participated in the study, with an average age of 40.5 years and an average BMI of 28.2 kg/m². The study employed a randomized controlled trial design, with participants assigned to either an intervention group or a control group. The intervention group received a 12-week program that included dietary counseling, physical activity recommendations, and stress management techniques. The control group received no intervention. The outcomes measured were changes in WHR, visceral fat components, blood pressure, and lipid profile. The results showed that the intervention group had a statistically significant improvement in WHR (p<0.001) and visceral fat components (p<0.001) compared to the control group. Furthermore, there were statistically significant improvements in systolic blood pressure (p=0.015) and total cholesterol (p=0.034) in the intervention group compared to the control group. These findings suggest that implementing a 12-week program that includes dietary counseling, physical activity recommendations, and stress management techniques can effectively improve WHR, visceral fat components, and cardiovascular health among shift workers in an offshore petrochemical company.

Keywords: body composition, waist-hip-ratio, visceral fat, shift worker, work efficiency

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Authors: Büşra Güven, Ebru Kerimoğlu

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Relevant departments of universities in creative fields are increasingly facing the challenge of developing curriculum for more employable creative workforce. In Turkey, as a developing country, the creative industries have not yet argued in the political axis and higher education also has not been addressed in this context. Istanbul has the highest creative and cultural industries share also provides both rooted and developing higher education institutes for these sectors in Turkey. With this in mind, the main purpose of the paper attempts to clarify that how does higher education in creative fields deal with the demands of creative industries in Istanbul? First, the paper elaborated creative class theory, second creative industries, employability and curriculum triangle is examined. The research methodology consisted of a qualitative model based on interview analysis. Data are collected by interviews with the head of the relevant departments and professional associations authorities in selected sectors. Four higher education institutes in Istanbul are selected according to the some clarified factors related to the literature. This also offered a comparing between public and private universities in terms of the adaptability of this changing concept of work. Industry expectations and content of educations were compared and found the blind spots in the education-industry relationships. As a consequence, produced inclusive policies for universities and industries to overcome these spots with collaboration, flexibility, adaptability, openness and feedback management and also for future policies in particular outcomes of university-industry collaborations.

Keywords: creative industries, curriculum, employability, high education, Istanbul

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Authors: Isra Elfatih Salih Edrees, Mehmet Serdar Ufuk Türeli

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In this paper, an energy-aware method is presented, integrating energy-efficient relay-augmented techniques for correlated data routing with the goal of optimizing bottleneck throughput in wireless sensor networks. The system tackles the dual challenge of throughput optimization while considering sensor network energy consumption. A unique routing metric has been developed to enable throughput maximization while minimizing energy consumption by utilizing data correlation patterns. The paper introduces a game theoretic framework to address the NP-complete optimization problem inherent in throughput-maximizing correlation-aware routing with energy limitations. By creating an algorithm that blends energy-aware route selection strategies with the best reaction dynamics, this framework provides a local solution. The suggested technique considerably raises the bottleneck throughput for each source in the network while reducing energy consumption by choosing the best routes that strike a compromise between throughput enhancement and energy efficiency. Extensive numerical analyses verify the efficiency of the method. The outcomes demonstrate the significant decrease in energy consumption attained by the energy-efficient relay-augmented bottleneck throughput maximization technique, in addition to confirming the anticipated throughput benefits.

Keywords: correlated data aggregation, energy efficiency, game theory, relay-augmented routing, throughput maximization, wireless sensor networks

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Authors: Jamie R. Chua, Christina Irene D. Mejia, Regina P. Berba

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Disseminated tuberculosis is an infectious disease caused by Mycobacterium tuberculosis involving two or more non-contiguous sites identified through bacteriologic confirmation or clinical diagnosis. Over the five year period included in the study, the UP-PGH TB DOTS clinic had total of 3,967 referrals, and the prevalence of disseminated tuberculosis is 1% (68/3967). The mean age was 33.9 years (range 19-64 years) with a male: female ratio of 1:1. 67% (52 patients) had no predisposing comorbid illness or immune disorder. The most common presenting symptoms were abdominal pain (19%), back pain (13%), abdominal enlargement (11%) and mass (10.2%). Anemia, leukocytosis, hypoalbuminemia, and high-normal serum calcium were common biochemical and hematologic findings. Around 36% (25) of patients were diagnosed clinically with disseminated tuberculosis despite lacking bacteriologic evidence of multi-organ involvement. The lungs (86%) is still the most commonly involved site, followed by intestinal (22%), vertebral/Pott’s (27%), and pelvic/genital (19%). The mean time from presentation to initiation of therapy was 22 days (SD 32.7). Only 18 patients (29.3%) were properly recorded to have been referred to local TB DOTs facilities. Of the 68 patients, only 16% (11 patients) continued follow-up at PGH, and all had documented treatment completion. Treatment outcomes of the remaining were unknown. Due to the variety of involved sites, a high index of suspicion is required. Knowledge on clinical features, common radiographic findings, and histopathologic characteristics of disseminated TB is important as bacteriologic evidence of infection is not always apparent.

Keywords: disseminated tuberculosis, Mycobacterium tuberculosis, miliary tuberculosis, tuberculosis

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Authors: Sadeq Al Yaari, Fayza Al Hammadi, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari, Salah Al Yami

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Background: When we further take Arabic grammatical issues into account in accordance with applied linguistic investigations on Arabic as Second Language (ASL) learners, a fundamental issue arises at this point as to the production of speech in Arabic: Oral grammatical errors committed by ASL learners. Aims: Using manual rating as well as computational analytic methodology to test a corpus of recorded speech by Second Language (ASL) learners of Arabic, this study aims to find the areas of difficulties in learning Arabic grammar. More specifically, it examines how and why ASL learners make grammatical errors in their oral speech. Methods: Tape recordings of four (4) Arabic as Second Language (ASL) learners who ranged in age from 23 to 30 were naturally collected. All participants have completed an intensive Arabic program (two years) and 20 minute-speech was recorded for each participant. Having the collected corpus, the next procedure was to rate them against Arabic standard grammar. The rating includes four processes: Description, analysis and assessment. Conclusions: Outcomes made from the issues addressed in this paper can be summarized in the fact that ASL learners face many grammatical difficulties when studying Arabic word order, tenses and aspects, function words, subject-verb agreement, verb form, active-passive voice, global and local errors, processes-based errors including addition, omission, substitution or a combination of any of them.

Keywords: grammar, error, oral, Arabic, second language, learner, applied linguistics.

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Authors: Mi-Hyang Lee, Seung-Hoon Han

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Korean traditional residences have been built with deep design issues for various values such as social, cultural, and environmental influences to be started from a few thousand years ago, but its meaning is being vanished due to the different lifestyles these days. It is necessary, therefore, to grasp the meaning of the Korea traditional building called Hanok and to get Korean people understand its real advantages. The purpose of this study is to propose a standardization methodology for evaluating comfort features towards Korean traditional houses. This paper is also trying to build an official standard evaluation system and to integrate aesthetic and psychological values induced from Hanok. Its comfort performance values could be divided into two large categories that are physical and psychological, and fourteen methods have been defined as the Korean Standards (KS). For this research, field survey data from representative Hanok types were collected for each method. This study also contains a qualitative in-depth analysis of the Hanok comfort index by the professions using AHP (Analytical Hierarchy Process) and has examined the effect of the methods. As a result, this paper could define what methods can provide trustful outcomes and how to evaluate the own strengths in aspects of spatial comfort of Hanok using suggested procedures towards the spatial configuration of the traditional dwellings. This study has finally proposed an integrated development of a standardization methodology assessing the comfort performance for Korean traditional residences, and it is expected that they could evaluate inhabitants of the residents and interior environmental conditions especially structured by wood materials like Hanok.

Keywords: Hanok, comfort performance, human condition, analytical hierarchy process

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Authors: Komal Saeed

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Introduction: Rhinoplasty is considered one of the challenging aesthetic procedures. Psychosocial concerns motivate the urge for aesthetic procedures especially rhinoplasty. Males who fall in this category are designated as single, immature, male, over expectant and narcissistic (SIMON) in literature. As of yet, there is no term that depicts females showing similar characteristics. The purpose of this study is to evaluate the incidence of body dysmorphic disorder (BDD) in females seeking rhinoplasty and to introduce a term for such individuals. Materials and Methods: A prospective, questionnaire based, qualitative study was conducted in the Department Of Plastic Surgery between March 2018 and March 2020. 110 female candidates seeking aesthetic rhinoplasty were included in the study. BDD was evaluated using the Dysmorphic Concerns Questionnaire, DCQ. Data were analyzed using SPSS version 25 software and correlation between the groups was evaluated. Results: Out of 110 female subjects, 77.3% (n=85) were single, 16.4% (n=18) were married and 6.4% (n=7) were divorced. BDD was found in 41.8% (n=46) of the candidates, majority being single (n=41, 89.1%) and having educational status above diploma (n=39, 84.8%). There was a statistically higher percentage of young adults between 24 and 28 years (n=33, 71.7%) having BDD (p= 0.0001). Conclusion: Considering the high frequency of BDD among females seeking rhinoplasty, a standardized term ‘SIFON’ is introduced to describe such individuals who are S; single, I; immature, F; female, O; over expectant, N; narcissistic as apposed to SIMON in males. These individuals perceive aesthetic procedures as a solution to their body dissatisfaction. Therefore, preoperative counseling seems necessary to avoid unsatisfactory outcomes secondary to mental health.

Keywords: aesthetic rhinoplasty, body dismorphic disorder, single, immature, obsessive

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Authors: Mario Isaza-Ruget, Claudia C. Colmenares-Mejia, Nancy Yomayusa, Camilo A. González, Andres Cely, Jossie Murcia

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Quantification of risks associated with complications development from chronic kidney disease (CKD) through accurate survival models can help with patient management. A retrospective cohort that included patients diagnosed with CKD from a primary care program and followed up between 2013 and 2018 was carried out. Time-dependent and static covariates associated with demographic, clinical, and laboratory factors were included. Deep Learning (DL) survival analyzes were developed for three CKD outcomes: CKD stage progression, >25% decrease in Estimated Glomerular Filtration Rate (eGFR), and Renal Replacement Therapy (RRT). Models were evaluated and compared with Random Survival Forest (RSF) based on concordance index (C-index) metric. 2.143 patients were included. Two models were developed for each outcome, Deep Neural Network (DNN) model reported C-index=0.9867 for CKD stage progression; C-index=0.9905 for reduction in eGFR; C-index=0.9867 for RRT. Regarding the RSF model, C-index=0.6650 was reached for CKD stage progression; decreased eGFR C-index=0.6759; RRT C-index=0.8926. DNN models applied in survival analysis context with considerations of longitudinal covariates at the start of follow-up can predict renal stage progression, a significant decrease in eGFR and RRT. The success of these survival models lies in the appropriate definition of survival times and the analysis of covariates, especially those that vary over time.

Keywords: artificial intelligence, chronic kidney disease, deep neural networks, survival analysis

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Authors: Mohammad A. Bani-Khaled

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In this work we use the Discrete Proper Orthogonal Decomposition transform to characterize the properties of coupled dynamics in thin-walled beams by exploiting numerical simulations obtained from finite element simulations. The outcomes of the will improve our understanding of the linear and nonlinear coupled behavior of thin-walled beams structures. Thin-walled beams have widespread usage in modern engineering application in both large scale structures (aeronautical structures), as well as in nano-structures (nano-tubes). Therefore, detailed knowledge in regard to the properties of coupled vibrations and buckling in these structures are of great interest in the research community. Due to the geometric complexity in the overall structure and in particular in the cross-sections it is necessary to involve computational mechanics to numerically simulate the dynamics. In using numerical computational techniques, it is not necessary to over simplify a model in order to solve the equations of motions. Computational dynamics methods produce databases of controlled resolution in time and space. These numerical databases contain information on the properties of the coupled dynamics. In order to extract the system dynamic properties and strength of coupling among the various fields of the motion, processing techniques are required. Time- Proper Orthogonal Decomposition transform is a powerful tool for processing databases for the dynamics. It will be used to study the coupled dynamics of thin-walled basic structures. These structures are ideal to form a basis for a systematic study of coupled dynamics in structures of complex geometry.

Keywords: coupled dynamics, geometric complexity, proper orthogonal decomposition (POD), thin walled beams

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Authors: Anisa Suraya Ab Razak, Izza Hayat

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Introduction: The diagnosis and management of severe hyponatremia in neuropsychiatric patients present a significant challenge to physicians. Several factors contribute, including diagnostic shadowing and attributing abnormal behavior to intellectual disability or psychiatric conditions. Hyponatraemia is the commonest electrolyte abnormality in the inpatient population, ranging from mild/asymptomatic, moderate to severe levels with life-threatening symptoms such as seizures, coma and death. There are several documented fatal case reports in the literature of severe hyponatremia secondary to psychogenic polydipsia, often diagnosed only in autopsy. This paper presents a case study of acute severe hyponatremia in a neuropsychiatric patient with early diagnosis and admission to intensive care. Case study: A 21-year old Caucasian male with known epilepsy and learning disability was admitted from residential living with generalized tonic-clonic self-terminating seizures after refusing medications for several weeks. Evidence of superficial head injury was detected on physical examination. His laboratory data demonstrated mild hyponatremia (125 mmol/L). Computed tomography imaging of his brain demonstrated no acute bleed or space-occupying lesion. He exhibited abnormal behavior - restlessness, drinking water from bathroom taps, inability to engage, paranoia, and hypersexuality. No collateral history was available to establish his baseline behavior. He was loaded with intravenous sodium valproate and leveritircaetam. Three hours later, he developed vomiting and a generalized tonic-clonic seizure lasting forty seconds. He remained drowsy for several hours and regained minimal recovery of consciousness. A repeat set of blood tests demonstrated profound hyponatremia (117 mmol/L). Outcomes: He was referred to intensive care for peripheral intravenous infusion of 2.7% sodium chloride solution with two-hourly laboratory monitoring of sodium concentration. Laboratory monitoring identified dangerously rapid correction of serum sodium concentration, and hypertonic saline was switched to a 5% dextrose solution to reduce the risk of acute large-volume fluid shifts from the cerebral intracellular compartment to the extracellular compartment. He underwent urethral catheterization and produced 8 liters of urine over 24 hours. Serum sodium concentration remained stable after 24 hours of correction fluids. His GCS recovered to baseline after 48 hours with improvement in behavior -he engaged with healthcare professionals, understood the importance of taking medications, admitted to illicit drug use and drinking massive amounts of water. He was transferred from high-dependency care to ward level and was initiated on multiple trials of anti-epileptics before achieving seizure-free days two weeks after resolution of acute hyponatremia. Conclusion: Psychogenic polydipsia is often found in young patients with intellectual disability or psychiatric disorders. Patients drink large volumes of water daily ranging from ten to forty liters, resulting in acute severe hyponatremia with mortality rates as high as 20%. Poor outcomes are due to challenges faced by physicians in making an early diagnosis and treating acute hyponatremia safely. A low index of suspicion of water intoxication is required in this population, including patients with known epilepsy. Monitoring urine output proved to be clinically effective in aiding diagnosis. Early referral and admission to intensive care should be considered for safe correction of sodium concentration while minimizing risk of fatal complications e.g. central pontine myelinolysis.

Keywords: epilepsy, psychogenic polydipsia, seizure, severe hyponatremia

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Authors: Eugenija Strazdiene, Violeta Bytautaite, Daivute Krisciuniene

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The object of the investigation is the suit for chemical protection, which totally covers human body together with breathing apparatus, breathing mask and helmet (JSC Ansell Protective Solutions Lithuania). The end users of such clothing are the members of rescue team – firefighters. During the presentation, the results of 3D scanning with stationary Human Solutions scanner and portable Artec Eva scanner will be compared on the basis of the efficiency of scanning procedure and scanning accuracy. Also, the possibilities to exporting scanned bodies into specialized CAD systems for suit design development and material consumption calculation will be analyzed. The necessity to understand and to implement corresponding clothing material properties during 3D visualization of garment on CAD systems will be presented. During the presentation, the outcomes of the project ‘Smart and Safe Work Wear Clothing SWW’ will be discussed. The project is carried out under the Interreg Baltic Sea Region Program as 2014-2020 European territorial cooperation objective. Thematic priority is Capacity for Innovation. The main goal of the project is to improve competitiveness and to increase business possibilities for work wear enterprises in the Baltic Sea Region. The project focuses on mass customization of products for various end users. It engages textile and clothing manufacturing technology researchers, work wear producers, end users, as well as national textile and clothing branch organizations in Finland, Lithuania, Latvia, Estonia and Poland.

Keywords: CAD systems, mass customization, 3D scanning, safe work wear

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Authors: Danielle Preziuso, Kamila Kazimierczuk, Annalise Stein, Bethel Tarekegne

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Coastal communities experience a variety of distinct socioeconomic, technical, and environmental vulnerabilities, all of which accrue heightened risk with increasingly frequent and severe climate change impacts. Marine renewable energy (MRE) offers a potential solution for mitigating coastal community vulnerabilities, especially water-energy dependencies while delivering promising co-benefits such as increased resilience and more sustainable energy outcomes. This paper explores coastal community vulnerabilities and service dependencies based on the local drivers that create them, with attention to climate change impacts and how they catalyze water-energy unmet needs in these communities. We examine the vulnerabilities through the lens of coastal Tribal communities (i.e., the Makah Tribe, the Kenaitze Tribe, Quinault Nation), as indigenous communities often face compounded impacts of technical, economic, and environmental vulnerabilities due to their underlying socio-demographic inequalities. We offer an environmental and energy justice indicators framework to understand how these vulnerabilities disproportionately manifest and impact the most vulnerable community members, and we subsequently utilize the framework to inform a weighted decision matrix tool that compares the viability of MRE-based alternative energy futures in addressing these vulnerabilities. The framework and complementary tool highlight opportunities for future MRE research and pilot demonstrations that directly respond to the vulnerabilities of coastal communities.

Keywords: coastal communities, decision matrix, energy equity, energy vulnerability, marine energy, service dependency

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Authors: Abobaker Mohammed Qasem Farhan, Shangming Yang, Mohammed Al-Nehari

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Pneumonia is a kind of lung disease that creates congestion in the chest. Such pneumonic conditions lead to loss of life of the severity of high congestion. Pneumonic lung disease is caused by viral pneumonia, bacterial pneumonia, or Covidi-19 induced pneumonia. The early prediction and classification of such lung diseases help to reduce the mortality rate. We propose the automatic Computer-Aided Diagnosis (CAD) system in this paper using the deep learning approach. The proposed CAD system takes input from raw computerized tomography (CT) scans of the patient's chest and automatically predicts disease classification. We designed the Hybrid Deep Learning Algorithm (HDLA) to improve accuracy and reduce processing requirements. The raw CT scans have pre-processed first to enhance their quality for further analysis. We then applied a hybrid model that consists of automatic feature extraction and classification. We propose the robust 2D Convolutional Neural Network (CNN) model to extract the automatic features from the pre-processed CT image. This CNN model assures feature learning with extremely effective 1D feature extraction for each input CT image. The outcome of the 2D CNN model is then normalized using the Min-Max technique. The second step of the proposed hybrid model is related to training and classification using different classifiers. The simulation outcomes using the publically available dataset prove the robustness and efficiency of the proposed model compared to state-of-art algorithms.

Keywords: CT scan, Covid-19, deep learning, image processing, lung disease classification

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Authors: M. Moiz

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Family planning has been known and accepted as a key tool to decrease fertility, provides birth spacing and plays a vital role to attain better outcomes for maternal and child health. Pakistan initiated various family planning programs to preserve maternal and child health for six decades. However, less contraceptive use leading to high fertility and low birth spacing is ultimately a risk for increasing morbidity and mortality. As an outcome of 2012 London Summit on Family Planning where 20 countries including Pakistan made its commitment to increase contraceptive prevalence rate by 55% and provide a universal access to reproductive health to protect human rights of women and ensure safe, choice informed and affordable contraceptives throughout the country. This paper will assess some of the factors of service delivery, coverage and the role of Ministry of Health and Population Welfare Department in providing Family Planning services and how it can be improved in Pakistan. In view of Pakistan Demographic Health Survey 2017-18, there are total nine million potential users of contraceptives and one third among them never used with unmet need while every fifth pregnancy ends into abortion indicates need for Family Planning services. In order to explain this concern, a comprehensive analysis has been done on role of governance in implementing family planning policy and its limitations are discussed. Moreover, this paper highlights policy options and recommendations for improving service provision through public and private sector in creating demand for Family Planning services in Pakistan.

Keywords: contraceptive prevalence rate, family planning, maternal and child health, policy options

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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

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Authors: Sana Fatima, Paul Sadler, Jon Cooper, David Mendel, Ayesha Jameel

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Background: Neurodiversity refers to intrinsic differences between human minds and encompasses dyspraxia, dyslexia, attention deficit hyperactivity disorder, dyscalculia, autism spectrum disorder, and Tourette syndrome. There is increasing recognition of neurodiversity in relation to disability/diversity in medical education and the associated impact on training, career progression, and personal and professional wellbeing. In addition, documented and anecdotal evidence suggests that medical educators and training providers in all four nations (UK) are increasingly concerned about understanding neurodiversity and identifying and providing support for neurodivergent trainees. Summary of Work: A national Neurodiversity Task and Finish group were established to survey Health Education England local office Professional Support teams about insights into infrastructure, training for educators, triggers for assessment, resources, and intervention protocols. This group drew from educational leadership, professional and personal neurodiverse expertise, occupational medicine, employer human resource, and trainees. An online, exploratory survey was conducted to gather insights from supervisors and trainers across England using the Professional Support Units' platform. Summary of Results: This survey highlighted marked heterogeneity in the identification, assessment, and approaches to support and management of neurodivergent trainees and highlighted a 'deficit' approach to neurodiversity. It also demonstrated a paucity of educational and protocol resources for educators and supervisors in supporting neurodivergent trainees. Discussions and Conclusions: In phase one, we focused on faculty development. An educational repository for all supervising trainees using a thematic approach was formalised. This was guided by our survey findings specific for neurodiversity and took a triple 'A' approach: awareness, assessment, and action. This is further supported by video material incorporating stories in training as well as mobile workshops for trainers for more immersive learning. The subtle theme from both the survey and Task and finish group suggested a move away from deficit-focused methods toward a positive holistic, interdisciplinary approach within a biopsychosocial framework. Contributions: 1. Faculty Knowledge and basic understanding of neurodiversity are key to supporting trainees with known or underlying Neurodiverse conditions. This is further complicated by challenges around non-disclosure, varied presentations, stigma, and intersectionality. 2. There is national (and international) inconsistency in the approach to how trainees are managed once a neurodiverse condition is suspected or diagnosed. 3. A carefully constituted and focussed Task and Finish group can rapidly identify national inconsistencies in neurodiversity and implement rapid educational interventions. 4. Nuanced findings from surveys and discussion can reframe the approach to neurodiversity; from a medical model to a more comprehensive, asset-based, biopsychosocial model of support, fostering a cultural shift, accepting 'diversity' in all its manifestations, visible and hidden.

Keywords: neurodiversity, professional support, human considerations, workplace wellbeing

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Authors: Freya Zinovieff

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In the age of the Anthropocene, all ecosystems, no matter how remote, is influenced by the relations between humans and technology. These influences are evidenced by current extinction rates, changes in species diversity, and species adaptation to pollution. Field recording is a tool through which we are able to document the extent to which life forms associated with the place are entangled with human-technology relationships. This paper documents the convergence of interaction between technologies, species, and landscape via an auto-ethnographic account of a field recording taken from a cell phone tower in Bali, Indonesia. In the recording, we hear a confluence of relations where critter and technology meet. The electrical hum of the tower merges with frogs and the amaranthine throb of crickets, in such a way that it is hard to tell where technology begins and the voice of creatures ends. The outcomes of this venture resulted in a framework for evaluating the sensorial relations within field recording. The framework calls for the soundscape to be understood as a multilayered ontology through which there is a convergence of multispecies relationships, or entanglements, across time and geographic location. These entanglements are not necessarily obvious. Sometimes quiet, sometimes elusive, sometimes only audible through the mediated conduit of digital technology. The paper argues that to be aware of these entanglements is to open ourselves to a type of beauty that is firmly rooted in the present paradigm of extinction and loss. By virtue of this understanding, we are bestowed with an opportunity to embrace the grave reality of the current sixth mass extinction and move forwards with what activist Joanna Macy calls the compassionate action.

Keywords: anthropocene, human-technology relationships, multispecies ethnography, field recording

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Authors: Nahashon Mwirigi

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The management of HIV/AIDS is a global challenge, demanding precise tools to predict disease progression and guide tailored treatment. CD4 cell count dynamics, a crucial immune function indicator, play an essential role in understanding HIV/AIDS progression and enhancing patient care through effective modeling. While several models assess disease progression, existing methods often fall short in capturing the complex, non-linear nature of HIV/AIDS, especially across diverse demographics. A need exists for models that balance predictive accuracy with clinical applicability, enabling individualized care strategies based on patient-specific progression rates. This study utilizes patient data from Kenyatta National Hospital (2003–2014) to model HIV/AIDS progression across six CD4-defined states. The Exponential, 2-Parameter Weibull, and 3-Parameter Weibull models are employed to analyze failure rates and explore progression patterns by age and gender. Model selection is based on Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) to identify models best representing disease progression variability across demographic groups. The 3-Parameter Weibull model emerges as the most effective, accurately capturing HIV/AIDS progression dynamics, particularly by incorporating delayed progression effects. This model reflects age and gender-specific variations, offering refined insights into patient trajectories and facilitating targeted interventions. One key finding is that older patients progress more slowly through CD4-defined stages, with a delayed onset of advanced stages. This suggests that older patients may benefit from extended monitoring intervals, allowing providers to optimize resources while maintaining consistent care. Recognizing slower progression in this demographic helps clinicians reduce unnecessary interventions, prioritizing care for faster-progressing groups. Gender-based analysis reveals that female patients exhibit more consistent progression, while male patients show greater variability. This highlights the need for gender-specific treatment approaches, as men may require more frequent assessments and adaptive treatment plans to address their variable progression. Tailoring treatment by gender can improve outcomes by addressing distinct risk patterns in each group. The model’s ability to account for both accelerated and delayed progression equips clinicians with a robust tool for estimating the duration of each disease stage. This supports individualized treatment planning, allowing clinicians to optimize antiretroviral therapy (ART) regimens based on demographic factors and expected disease trajectories. Aligning ART timing with specific progression patterns can enhance treatment efficacy and adherence. The model also has significant implications for healthcare systems, as its predictive accuracy enables proactive patient management, reducing the frequency of advanced-stage complications. For resource limited providers, this capability facilitates strategic intervention timing, ensuring that high-risk patients receive timely care while resources are allocated efficiently. Anticipating progression stages enhances both patient care and resource management, reinforcing the model’s value in supporting sustainable HIV/AIDS healthcare strategies. This study underscores the importance of models that capture the complexities of HIV/AIDS progression, offering insights to guide personalized, data-informed care. The 3-Parameter Weibull model’s ability to accurately reflect delayed progression and demographic risk variations presents a valuable tool for clinicians, supporting the development of targeted interventions and resource optimization in HIV/AIDS management.

Keywords: HIV/AIDS progression, 3-parameter Weibull model, CD4 cell count stages, antiretroviral therapy, demographic-specific modeling

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Authors: Neha Parekh, Divya Ladha, Poonam Wadhwani, Nisha Shah

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Nano scaled materials have attracted tremendous interest as corrosion inhibitor due to their high surface area on the metal surfaces. It is well known that the zinc oxide nanoparticles have higher reactivity towards aqueous acidic solution. This work presents a new method to incorporate zinc oxide nanoparticles with white sesame seeds extract (nano-green inhibitor) for corrosion protection of zinc in acidic medium. The morphology of the zinc oxide nanoparticles was investigated by TEM and DLS. The corrosion inhibition efficiency of the green inhibitor and nano-green inhibitor was determined by Gravimetric and electrochemical impedance spectroscopy (EIS) methods. Gravimetric measurements suggested that nano-green inhibitor is more effective than green inhibitor. Furthermore, with the increasing temperature, inhibition efficiency increases for both the inhibitors. In addition, it was established the Temkin adsorption isotherm fits well with the experimental data for both the inhibitors. The effect of temperature and Temkin adsorption isotherm revealed Chemisorption mechanism occurring in the system. The activation energy (Ea) and other thermodynamic parameters for inhibition process were calculated. The data of EIS showed that the charge transfer controls the corrosion process. The surface morphology of zinc metal (specimen) in absence and presence of green inhibitor and nano-green inhibitor were performed using Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM) techniques. The outcomes indicated a formation of a protective layer over zinc metal (specimen).

Keywords: corrosion, green inhibitor, nanoparticles, zinc

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Authors: Donna-Marie Phyllis Lanton

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Sarcopenia is a well-known geriatric syndrome characterized by the progressive and generalized loss of muscle quantity or quality. The incidence of sarcopenia increases with age and is associated with adverse outcomes such as the increased risk of falls, cognitive impairment, loss of independence, diminished quality of life, increased health costs, need for care in a skilled nursing facility, and increased mortality. Physical activity, including resistance training, is the most prevalent recommendation for treating and preventing sarcopenia. Residents (N = 23) of a skilled nursing facility in East Orlando, Florida, participated in a 90-day strength training program designed using the PARIHS framework to improve measures of muscle mass, muscle strength, physical performance, and quality of life. Residents engaged in both resistance and balance exercises for 1 hour two times a week. Baseline data were collected and compared to data at Days 30, 60, and 90. T tests indicated significant gains on all measures from baseline to 90 days: muscle mass increased by 1.2 (t[22] = 2.85, p = .009), grip strength increased by 4.02 (t[22] = 8.15, p < .001), balance increased by 2.13 (t[22] = 18.64, p < .001), gait speed increased by 1.83 (t[22] = 17.84, p < .001), chair speed increased 1.87 (t[22] = 16.36, p < .001), and quality of life score increased by 17.5 (t[22] = 19.26, p < .001). For residents with sarcopenia in skilled nursing facilities, a 90-day strength training program with resistance and balance exercises may provide an option for decreasing the incidence of sarcopenia among that population

Keywords: muscle mass, muscle strength, older adults, PARIHS framework

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Authors: Abu S. M. G. Kibria, Alison M. Behie, Robert Costanza, Colin Groves, Tracy Farrell

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This study is aimed to understand the level of access and the influence of livelihood capitals in maintaining access and control of ecosystem services (ESS) in the Sundarbans, Bangladesh. Besides the villagers, we consider other stakeholders including the forest department, coast guard, police, merchants, pirates and villagers who ‘controlled’ or ‘maintained’ access to ESS (crab catching, shrimp fry, honey, shrimp, mixed fish, fuel wood) in this region. Villagers used human, physical, natural and social capitals to gain access to ESS. The highest level of access was observed in crab catching and the lowest was found in honey collection, both of which were done when balancing the costs and benefits of accessing one ESS against another. The outcomes of these ongoing access negotiations were determined by livelihood capitals of the households. In addition, it was often found that the certain variables could have a positive effect on one ESS and a negative effect on another. For instance, human, social and natural capitals (eldest daughter’s education and No. of livelihood group membership and) had significant positive effects on honey collection while two components of human and social capitals including ‘eldest son’s education’ and ‘severity of pirate problem’ had exactly the opposite impact. These complex interactions were also observed in access to other ESS. It thus seems that access to ESS is not anything which is provided, but rather it is achieved by using livelihood capitals. Protecting any ecosystem from over exploitation and improve wellbeing can be achieved by properly balancing the livelihood capital-access nexus.

Keywords: provisioning services, access level, livelihood capital, interaction, access gain

Procedia PDF Downloads 282