Search results for: clinical decision support sytem

Authors: Marwa Hussien Mohamed, Mohamed Helmy Khafagy

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Map-Reduce is a programming model which is widely used to extract valuable information from enormous volumes of data. Map-reduce designed to support heterogeneous datasets. Apache Hadoop map-reduce used extensively to uncover hidden pattern like data mining, SQL, etc. The most important operation for data analysis is joining operation. But, map-reduce framework does not directly support join algorithm. This paper explains and compares two-way and multi-way map-reduce join algorithms for map reduce also we implement MR join Algorithms and show the performance of each phase in MR join algorithms. Our experimental results show that map side join and map merge join in two-way join algorithms has the longest time according to preprocessing step sorting data and reduce side cascade join has the longest time at Multi-Way join algorithms.

Keywords: Hadoop, MapReduce, multi-way join, two-way join, Ubuntu

Procedia PDF Downloads 487

Authors: Sandip Tambare, Revati Ghadge

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Alcohol withdrawal syndrome continue to be concerning health issue worldwide in alcoholics. Many current option for treating alcohol withdrawal signs are habit forming causing dependency of sedatives. The divine science of Ayurveda recommends Nasya for improvement of alcohol withdrawal signs. As per the latest reports 1/3 of the Indian population is using alcohol in an unhealthy manner, the complication being wide and varied among which, the Alcohol Withdrawal Syndrome is the dominant one. The presentation varies from mild sleep loss or anxiety to delirium. Ayurveda has given utmost in the context of Madatyaya(Alcoholism). Various protocols based on the identification of the status of tridoshas are explained which includes sodhana, samana and satwavachaya chikitsa. Various medications are being used, with appreciated effects in the clinical practice. As per reports, the panchakarma procedure nasya seems highly effective, in managing of the alcohol withdrawal syndrome. Nasya with Ksheerabala Taila is given for 7 days in the condition of Alcohol Withdrawal syndrome and it was the non Randomized trial with 30 subjects satisfying the DSM V criteria for alcohol withdrawl and the assessment was done using the Clinical Institute Withdrawal Assessment for Alcohol Scale revised (CIWA-Ar). Conclusion: Among the symptoms which were studied after the interventions, it was found that there was high significant response in almost all the symptoms in the given subjects. The eternal science of Ayurveda is able to answer the existing problem of alcohol and its abuse in the society.

Keywords: nasya, alcohol withdrawal, madatyaya, ksheerabala taila

Procedia PDF Downloads 139

Authors: Sophonie Sarielle Jean Jacques Bertrand

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Background: Acute flaccid paralysis (PFA) is the sudden weakness or paralysis of muscles seen in children under 15 years of age. According to the WHO, PFA remains a real public health problem. For Haiti, the PFA represents a national priority. This study aims to describe the epidemiological profile of cases of Acute Flaccid Paralysis (PFA) in Haiti from 2018-2020. Methods: A descriptive cross-sectional study covering the period of 2018-2021 was carried out. epidemiological surveillance data PFA exported to Integrated Monitoring Evaluation Surveillance (MESI) were used. Sociodemographic variables were studied. Prevalence and clinical mortality rate were calculated. Epi Info 7.2 and Excel 2016 were used for data analysis. Results: 76 AFP cases were recorded for the period, or 13 (17%) in 2018, 23 (30%) in 2019, 8 (11%) in 2020 32 (42%) in 2021. Children aged 5-14 years accounted for 36% of cases (n= 26). The M/F sex ratio was 0.52, with a predominance of the female sex. The clinical mortality rate was 2.6%. The prevalence was 1.77/100,000 people. Conclusion: From 2018-2021, 76 cases of PFA cases were recorded in the 10 departments of the country, of which the West department was the most affected. Maintaining high vaccination coverage and a standard acute flaccid paralysis surveillance system are essential for the eradication of this condition. Strengthen epidemiological surveillance of PFA.

Keywords: epidemiology, PFA, Haïti, MESI

Procedia PDF Downloads 85

Authors: Ravija Gunawardana, Banuka Athuraliya

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Machine learning has emerged as a powerful tool for disease diagnosis and prediction. The use of machine learning algorithms has the potential to improve the accuracy of disease prediction, thereby enabling medical professionals to provide more effective and personalized treatments. This study focuses on developing a machine-learning model for disease prediction using symptoms and X-ray images. The importance of this study lies in its potential to assist medical professionals in accurately diagnosing diseases, thereby improving patient outcomes. Respiratory diseases are a significant cause of morbidity and mortality worldwide, and chest X-rays are commonly used in the diagnosis of these diseases. However, accurately interpreting X-ray images requires significant expertise and can be time-consuming, making it difficult to diagnose respiratory diseases in a timely manner. By incorporating machine learning algorithms, we can significantly enhance disease prediction accuracy, ultimately leading to better patient care. The study utilized the Mask R-CNN algorithm, which is a state-of-the-art method for object detection and segmentation in images, to process chest X-ray images. The model was trained and tested on a large dataset of patient information, which included both symptom data and X-ray images. The performance of the model was evaluated using a range of metrics, including accuracy, precision, recall, and F1-score. The results showed that the model achieved an accuracy rate of over 90%, indicating that it was able to accurately detect and segment regions of interest in the X-ray images. In addition to X-ray images, the study also incorporated symptoms as input data for disease prediction. The study used three different classifiers, namely Random Forest, K-Nearest Neighbor and Support Vector Machine, to predict diseases based on symptoms. These classifiers were trained and tested using the same dataset of patient information as the X-ray model. The results showed promising accuracy rates for predicting diseases using symptoms, with the ensemble learning techniques significantly improving the accuracy of disease prediction. The study's findings indicate that the use of machine learning algorithms can significantly enhance disease prediction accuracy, ultimately leading to better patient care. The model developed in this study has the potential to assist medical professionals in diagnosing respiratory diseases more accurately and efficiently. However, it is important to note that the accuracy of the model can be affected by several factors, including the quality of the X-ray images, the size of the dataset used for training, and the complexity of the disease being diagnosed. In conclusion, the study demonstrated the potential of machine learning algorithms for disease prediction using symptoms and X-ray images. The use of these algorithms can improve the accuracy of disease diagnosis, ultimately leading to better patient care. Further research is needed to validate the model's accuracy and effectiveness in a clinical setting and to expand its application to other diseases.

Keywords: K-nearest neighbor, mask R-CNN, random forest, support vector machine

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Authors: Awais Ali, Hesham Ali

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The absence of teeth through either premature loss or developmental absence is a common condition with potentially severe impact on affected individuals. Management of these cases presents a clinical challenge which may be difficult to resolve given the effects of tooth loss or hypodontia over the course of a patient’s lifetime. Treatment of such cases is often best provided by a multi-disciplinary team, where the patient’s expectations and care delivery can be optimally managed. Orthodontic treatment is often used to prepare the dentition in advance of restorative replacement of missing teeth. Conversely, the placement of implants may precede the delivery of orthodontic treatment and indeed may function as an adjunctive orthodontic procedure. We discuss the use of both approaches here and illustrate their clinical implementation with two case reports. The first case demonstrates the use of fixed appliances to prepare the mouth for an opposing implant-retained complete denture. A second case demonstrates the use of implant-retained crowns to provide orthodontic anchorage in a partially dentate patient. We propose that complex cases such as these should always be planned and treated by a multi-disciplinary team in order to optimise the delivery of care, patient experience, and treatment outcome. The presented cases add to the body of evidence in this area.

Keywords: orthodontics, dental implantology, hypodontia, multi-disciplinary

Procedia PDF Downloads 128

Authors: Zo Hasina Rabemananjara

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The North-East of Madagascar is the pillar of Madagascar's foreign trade, providing 41% and 80% of world exports of cloves and vanilla, respectively, in 2016. For Madagascar, the north-eastern escarpment is home to the last massifs of humid forest in large scale of the island, surrounded by a small scale agricultural mosaic. In the sites where this study is taking place, located in the peripheral zones of protected areas, the production of rent aims to supply international markets. In fact, importers of the cash crops produced in these areas are located mainly in India, Singapore, France, Germany and the United States. Recently, the price of these products has increased significantly, especially from the year 2015. For vanilla, the price has skyrocketed, from an approximate price of 73 USD per kilo in 2015 to more than 250 USD per kilo in 2016. The value of clove exports increased sharply by 49.4% in 2017, largely to Singapore and India due to the sharp increase in exported volume (+47, 6%) in 2017. If the relationship between the rise in prices of rented products and the change in physical environments is known, the evolution of the behavior of land users linked to this aspect was not yet addressed by research. In fact, the consequence of this price increase in the organization of the use of space at the local level still raises questions. Hence, the research question is: to what extent does this improvement in the price of imported products affect user behavior linked to the local organization of access to the factor of soil production? To fully appreciate this change in behavior, surveys of 144 land user households were carried out, and group interviews were also carried out. The results of this research showed that the rise in the prices of annuity products from the year 2015 caused significant changes in the behavior of land users in the study sites. Young people, who have not been attracted to farming for a long time, have started to show interest in it since the period of rising vanilla and clove prices. They have set up their own fields of vanilla and clove cultivation. This revival of interest conferred an important value on the land and caused conflicts especially between family members because the acquisition of the cultivated land was done by inheritance or donation. This change in user behavior has also affected the farmers' life strategy since the latter have decided to abandon rain-fed rice farming, which has long been considered a guaranteed subsistence activity for cash crops. This research will contribute to nourishing scientific reflection on the management of land use and also to support political decision-makers in decision-making on spatial planning.

Keywords: behavior of land users, North-eastern Madagascar, price of export products, spatial planning

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Authors: Awotidebe Taofeek, Oyinsuyi Oluwafunmbi

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Psychosocial factors play a significant role in physical activity participation in diseased conditions and the general population. However, little is known about the role of exercise self-efficacy (ESE), exercise perceived barriers (EPB), and social support (SOS) in patients with asthma. This study investigated the influence of psychosocial factors on physical activity participation in patients with asthma in ile-ife. This cross-sectional study involved 130 patients with asthma. They were recruited from the Chest Clinic of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-ife using purposive sampling technique. Ethical approval was obtained from the Ethics and Research Committee of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-ife, Nigeria. Socio-demographic characteristics of respondents were recorded. Information on ESE, EPB, and SOS were obtained using Exercise Self-Efficacy, Exercise Benefit, and Barrier and Medical Outcome Social Support Scales respectively. Physical activity level was assessed in the last 7 days using international physical activity questionnaire. Descriptive and inferential statistics were used to analyze the data. Alpha level was set at p<0.5. The mean age of the respondents was 25.15 ± 9.38, and a majority, 110 (84.60%), engaged in low physical activity, 69(53%) had low exercise self-efficacy. However, less than two-third 80 (62.20%) reported high social support, with the majority of 95 (73.10%) reported high exercise perceived barriers. The means of ESE for male and femalerespondents were 29.01 ± 20.62 and 24.35 ± 17.36, respectively. The means of SOS formale and female respondents were 49.52 ± 22.22 and 61.87 ± 22.66, respectively. Themeans of EPB for male and female respondents were 53.37 ± 10.23 and 57.43 ± 9.65, respectively. The respondents were comparable in exercise self-efficacy and physicalactivity level (p>0.05). However, there were significant differences in social support (t=-2.791; p=0.006) and exercise perceived barriers (t=-2.108, p=0.037).Theresultsshowthattherewasasignificantrelationshipbetweenexerciseperceivedbarriersandlowphysicalactivitylevel(r=-0.216;p=0.023).TherewasasignificantassociationbetweenExerciseself-efficacyandmarried individuals(OR=0.967;95%CI=0.936-0.998;p= 0.037). Similarly, However,thereweresignificantassociationsbetweensocialsupport Andagegroup35-54years(OR=1.036;95%CI=1.007-1.067;p=0.014),females(OR= 1.024;95%CI=1.006;p=0.009)andmarriedindividuals(OR=1.049;95%CI=1.020-1.079. p=0.001).Therewasasignificantassociationbetweenexerciseperceivedbarriersand females(OR=1.043;95%CI=1.002-1.085;p=0.040).However, thereweresignificant associationsbetweenexerciseperceivedbarriersandoccupationgroup;civilservants (OR=1.092;95%CI=1.009-1.182;p=0.028),retiree(OR=1.092;95%CI=1.040-1.469;p= 0.016)andstudents(OR=1.110;95%CI=1.040;p=0.002). Inconclusion,agreaterpercentageofpatientswithasthmahadlowphysicalactivityleveland it was associatedwithhighexerciseperceivedbarriers,whileexerciseself-efficacyandsocialsupportwerenot.

Keywords: asthma, psychosocial factors, physical activity, physical fitness

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Authors: Evangelia-Chrysanthi Kouklari, Stella Tsermentseli, Claire P. Monks

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Executive function (EF) refers to a set of future-oriented and goal-directed cognitive skills that are crucial for problem solving and social behaviour, as well as the ability to organise oneself. It has been suggested that EF could be conceptualised as two distinct but interrelated constructs, one emotional (hot) and one cognitive (cool), as it facilitates both affective and cognitive regulation. Cool EF has been found to be strongly related to Theory of Mind (ToM) that is the ability to infer mental states, but research has not taken into account the association between hot EF and ToM in Autism Spectrum Disorder (ASD) to date. The present study investigates the associations between both hot and cool EF and ToM in school-aged children with ASD. This cross-sectional study assesses 79 school-aged children with ASD (7-15 years) and 91 controls matched for age and IQ, on tasks tapping cool EF (working memory, inhibition, planning), hot EF (effective decision making, delay discounting), and ToM (emotional understanding and false/no false belief). Significant group differences in each EF measure support a global executive dysfunction in ASD. Strong associations between hot EF and ToM in ASD are reported for the first time (i.e. ToM emotional understanding and delay discounting). These findings highlight that hot EF also makes a unique contribution to the developmental profile of ASD. Considering the role of both hot and cool EF in association with ToM in individuals with ASD may aid in gaining a greater understanding not just of how these complex multifaceted cognitive abilities relate to one another, but their joint role in the distinct developmental pathway followed in ASD.

Keywords: ASD, executive function, school age, theory of mind

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Authors: Daniel Herrera Gonzalez, Maria Luisa Montas

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There are some factors affecting consumer decision-making regarding the use of the front of package labels in order to find benefits to the well-being of the human being. Currently, there are several labels that help influence or change the purchase decision for food products. These labels communicate the impact that food has on human health; therefore, consumers are more critical and intelligent when buying and consuming food products. The research explores the association between front-of-pack labeling and food choice; the association between label content and purchasing decisions is complex and influenced by different factors, including the packaging itself. The main objective of this study was to examine the perception of health labels and nutritional declarations and their influence on buying decisions in the non-alcoholic beverages sector. This comparative study of two developing countries will show how consumers take nutritional labels into account when deciding to buy certain foods. This research applied a quantitative methodology with correlational scope. This study has a correlational approach in order to analyze the degree of association between variables. Likewise, the confirmatory factor analysis (CFA) method and structural equation modeling (SEM) as a powerful multivariate technique was used as statistical technique to find the relationships between observable and unobservable variables. The main findings of this research were the obtaining of three large groups and their perception and effects on nutritional and wellness labels. The first group is characterized by taking an attitude of high interest on the issue of the imposition of the nutritional information label on products and would agree that all products should be packaged given its importance to preventing illnesses in the consumer. Likewise, they almost always care about the brand, the size, the list of ingredients, and nutritional information of the food, and also the effect of these on health. The second group stands out for presenting some interest in the importance of the label on products as a purchase decision, in addition to almost always taking into account the characteristics of size, money, components, etc. of the products to decide on their consumption and almost always They are never interested in the effect of these products on their health or nutrition, and in group 3, it differs from the others by being more neutral regarding the issue of nutritional information labels, and being less interested in the purchase decision and characteristics of the product and also on the influence of these on health and nutrition. This new knowledge is essential for different companies that manufacture and market food products because they will have information to adapt or anticipate the new laws of developing countries as well as the new needs of health-conscious consumers when they buy food products.

Keywords: healthy labels, consumer behavior, nutritional information, healthy products

Procedia PDF Downloads 107

Authors: Shamas Ul Hassan, Nasir Mukhtar, Sajjad Ur Rehman, Asghar Ali Mian, Iftikhar Hussain, Muhammad Safdar Anjum

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The Mycoplasma gallisepticum (MG) is the major cause of economic looses in birds which is transmitted by free flying birds in the environment. These demands for improving the biosecurity measures at farm level including proper disposal of farm mortality and other wastes along with the inclusion of zoos and wild life parks in the MG surveillance programme. For the purpose of doing surveillance of MG in different pet, game and free flying birds a total of 12 samples each of peacocks, pheasants, ducks, pigeons, parrots, and house crows were included in the first ever study of its nature in Pakistan. During the study, the relevant samples along with recording clinical and postmortem findings were subjected to sero-prevalence, culture isolation and PCR system. Further PCR being more sensitive proves to be a better epidemiological tool. Seropositive findings revealed in peacocks, pheasants, ducks, pigeons, parrots, and crows were 66.7%, 58.3%, 41.7%, 41.7%, 16.7% and 16.7% respectively with some free flying birds giving ambiguous reactions. Whereas in the same order the culture/isolation positive results were recorded as 25%, 16.7%, 8.3%, 16.7%, 16.7%, and 25%. The samples were further confirmed on the basis of 732 bp product in PCR system. High rate of prevalence of MG in the pet, game and free flying birds regardless to their clinical findings demands to improve the biosecurity measures at the farm level with the minimum interaction of these birds with commercial poultry. Further the proper and timely disposal of all sorts of carcasses contaminated litter and wasted feed in such ways that the free flying birds are denied of picking up at those wastages. Moreover, MG surveillance system including the advances diagnostic techniques in wildlife parks and zoos be devised with proper timely preventive and therapeutic measures. The study proves that a variety of birds other then chicken either with or without clinical exhibitions carry MG organism which could be the potential source of infection for commercial poultry. The routine surveillance will be done to reduce the economic losses in poultry production.

Keywords: epidemiology, Mycoplasma gallisepticum (MG), free flying birds, surveillance, PCR

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Authors: Ndidi Ofole

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Ongoing Boko Haram crisis and instability in North-Eastern Nigeria has placed additional stress on academic resilience of female undergraduates who are already challenged by gender discrimination in educational opportunities. Students without resilience lack stress hardiness to cope with academic challenges. There is a limited study on academic resilience targeting this disadvantaged population in Nigeria. Consequently, survey research design was employed to investigate the contextual and personal factors that could predict academic resilience among female undergraduates in Boko Haram Neighbourhood in North-Eastern, Nigeria. Five hundred and thirty female students with age range of 18 to 24 years ( = 19.2; SD=6.9) were randomly drawn from 3 Universities in North-Eastern Nigeria. They responded to five instruments, namely; Academic Resilience scale (r=0.72); Social Support questionnaire (r=0. 64); Social Connectedness questionnaire (r=0.75); Self-Efficacy scale (r=0. 68) and Emotional Regulation questionnaire (r=78). Results showed that there was significant positive relationship between the four independent variables and academic resilience. The variables jointly contributed 5.9% variance in the prediction of academic resilience. In terms of magnitude, social support was most potent while self-efficacy was the least. It concluded that the factors considered in this study are academic resilience facilitators. The outcomes of the study have both theoretical and practical implications.

Keywords: academic resilience, emotional regulation, school connectedness, self-efficacy , social support

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Authors: A. Porshnev, A. Zaporozhtchuk

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Motivation regarded as a key factor of labor turnover, is especially important for volunteers working on an altruistic basis in NGO. Despite the motivational letter, candidate selection depends on the impression of the selection committee, which can be subject to human bias. We expect that structured and unstructured information provided in motivation letters could be used to improve candidate selection procedures. In our paper, we perform qualitative and quantitative analysis of 2280 motivation letters, create logistic regression, and build a decision tree to improve selection procedures. Our analysis showed that motivation factors are significant and enable human resources department to forecast labor turnover and provide extra information to demographic, professional and timing questions. In spite of the average level of accuracy the model demonstrates the selection procedures of company of under consideration can be improved. We also discuss interrelation between answers to open and closed motivation questions, recommend changes in motivational letter templates to ensure more relevant information about applicants and further steps to create more accurate model.

Keywords: decision trees, logistic regression, model, motivational letter, non-governmental organization, retention, turnover

Procedia PDF Downloads 177

Authors: Gulhan Sen

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Disasters could result in many deaths and injuries. In these difficult times, accessible resources are limited, demand and supply balance is distorted, and there is a need to make urgent interventions. Disproportionateness between accessible resources and intervention capacity makes triage a necessity in every stage of disaster response. Healthcare professionals, who are in charge of triage, have to evaluate swiftly and make ethical decisions about which patients need priority and urgent intervention given the limited available resources. For such critical times in disaster triage, 'doing the greatest good for the greatest number of casualties' is adopted as a code of practice. But there is no guide for healthcare professionals about ethical decision-making during disasters, and this study is expected to use as a source in the preparation of the guide. This study aimed to examine whether the qualities healthcare professionals in Izmir related to disaster triage were adequate and whether these qualities influence their capacity to make ethical decisions. The researcher used a survey developed for data collection. The survey included two parts. In part one, 14 questions solicited information about socio-demographic characteristics and knowledge levels of the respondents on ethical principles of disaster triage and allocation of scarce resources. Part two included four disaster scenarios adopted from existing literature and respondents were asked to make ethical decisions in triage based on the provided scenarios. The survey was completed by 215 healthcare professional working in Emergency-Medical Stations, National Medical Rescue Teams and Search-Rescue-Health Teams in Izmir. The data was analyzed with SPSS software. Chi-Square Test, Mann-Whitney U Test, Kruskal-Wallis Test and Linear Regression Analysis were utilized. According to results, it was determined that 51.2% of the participants had inadequate knowledge level of ethical principles of disaster triage and allocation of scarce resources. It was also found that participants did not tend to make ethical decisions on four disaster scenarios which included ethical dilemmas. They stayed in ethical dilemmas that perform cardio-pulmonary resuscitation, manage limited resources and make decisions to die. Results also showed that participants who had more experience in disaster triage teams, were more likely to make ethical decisions on disaster triage than those with little or no experience in disaster triage teams(p < 0.01). Moreover, as their knowledge level of ethical principles of disaster triage and allocation of scarce resources increased, their tendency to make ethical decisions also increased(p < 0.001). In conclusion, having inadequate knowledge level of ethical principles and being inexperienced affect their ethical decision-making during disasters. So results of this study suggest that more training on disaster triage should be provided on the areas of the pre-impact phase of disaster. In addition, ethical dimension of disaster triage should be included in the syllabi of the ethics classes in the vocational training for healthcare professionals. Drill, simulations, and board exercises can be used to improve ethical decision making abilities of healthcare professionals. Disaster scenarios where ethical dilemmas are faced should be prepared for such applied training programs.

Keywords: disaster triage, medical ethics, ethical principles of disaster triage, ethical decision-making

Procedia PDF Downloads 245

Authors: Mostafa Najim, Alaa Rahhal, Fadi Khir, Safae Abu Yousef, Amer Aljundi, Feryal Ibrahim, Aliaa Amer, Ahmed Soliman Mohamed, Samira Saleh, Dekra Alfaridi, Ahmed Mahfouz, Sumaya Al-Yafei, Faraj Howady, Mohamad Yahya Khatib, Samar Alemadi

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Background: Coronavirus disease 2019 (COVID-19) increases the risk of coagulopathy among critically ill patients. Although the presence of antiphospholipid antibodies (aPLs) has been proposed as a possible mechanism of COVID-19 induced coagulopathy, their clinical significance among critically ill patients with COVID-19 remains uncertain. Methods: This prospective observational study included patients with COVID-19 admitted to intensive care units (ICU) to evaluate the prevalence and clinical significance of aPLs, including anticardiolipin IgG/IgM, anti-β2-glycoprotein IgG/IgM, and lupus anticoagulant. The study outcomes included the prevalence of aPLs, a primary composite outcome of all-cause mortality, and arterial or venous thrombosis among aPLs positive patients versus aPLs negative patients during their ICU stay. Multiple logistic regression was used to assess the influence of aPLs on the primary composite outcome of mortality and thrombosis. Results: A total of 60 critically ill patients were enrolled. Of whom, 57 (95%) were male, with a mean age of 52.8 ± 12.2 years, and the majority were from Asia (68%). Twenty-two patients (37%) were found to have positive aPLs; of whom 21 patients were positive for lupus anticoagulant, whereas one patient was positive for anti-β2-glycoprotein IgG/IgM. The composite outcome of mortality and thrombosis during ICU did not differ among patients with positive aPLs compared to those with negative aPLs (4 (18%) vs. 6 (16%), aOR= 0.98, 95% CI 0.1-6.7; p-value= 0.986). Likewise, the secondary outcomes, including all-cause mortality, venous thrombosis, arterial thrombosis, discharge from ICU, time to mortality, and time to discharge from ICU, did not differ between those with positive aPLs upon ICU admission in comparison to patients with negative aPLs. Conclusion: The presence of aPLs does not seem to affect the outcomes of critically ill patients with COVID-19 in terms of all-cause mortality and thrombosis. Therefore, clinicians may not screen critically ill patients with COVID-19 for aPLs unless deemed clinically appropriate.

Keywords: antiphospholipid antibodies, critically ill patients, coagulopathy, coronavirus

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Authors: N. Boutaghane, F. Z. Tounsi

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Many physical and technological factors degrade the SPECT images, both qualitatively and quantitatively. For this, it is not always put into leading technological advances to improve the performance of tomographic gamma camera in terms of detection, collimation, reconstruction and correction of tomographic images methods. We have to master firstly the choice of various acquisition and reconstruction parameters, accessible to clinical cases and using the attenuation and scatter correction methods to always optimize quality image and minimized to the maximum dose received by the patient. In this work, an evaluation of qualitative and quantitative tomographic images is performed based on the acquisition parameters (counts per projection) and reconstruction parameters (filter type, associated cutoff frequency). In addition, methods for correcting physical effects such as attenuation and scatter degrading the image quality and preventing precise quantitative of the reconstructed slices are also presented. Two approaches of attenuation and scatter correction are implemented: the attenuation correction by CHANG method with a filtered back projection reconstruction algorithm and scatter correction by the subtraction JASZCZAK method. Our results are considered as such recommandation, which permits to determine the origin of the different artifacts observed both in quality control tests and in clinical images.

Keywords: attenuation, scatter, reconstruction filter, image quality, acquisition and reconstruction parameters, SPECT

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Authors: Sulafah Basahel

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Nowadays, Higher Education Institutions (HEIs) around the world are attempting to utilize Information and Communication Technologies (ICTs) to enhance learning process and strategies of knowledge delivery for students through Distance Education (DE) system. Stakeholders in DE system face a complex situation of different ill-defined and related issues that influence decision making process. In this study system thinking as a body of knowledge is used to explore the emergent properties that produced from these connections between issues and could have either positive or negative outcomes for the DE development. Checkland Soft System Methodology (SSM) - Mode 2 is employed in a cultural context of Saudi Arabia for more knowledge acquisition purposes among multiple stakeholders in DE rather than solving problems to achieve an overall development of DE system. This paper will discuss some political, cultural issues and connections between them that impact on effectiveness of stakeholders’ activities and relations. This study will significantly contribute to both system thinking and education fields by leading decision makers in DE to reconsider future plans, strategies and right actions for more successful educational practices.

Keywords: distance education, higher education institutions, ill-defined issues, soft system methodology-Mode 2

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Authors: K. Hariohm, V. Prakash, J. Saravana Kumar

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Introduction and Rationale: Increased scope of Physiotherapy (PT) practice also has contributed to research in the field of PT. It is essential to determine the production and quality of the clinical trials from India since, it may reflect the scientific growth of the profession. These trends can be taken as a baseline to measure our performance and also can be used as a guideline for the future trials. Objective: To quantify and analyze qualitatively the RCT’s from India from the period 2000-2013’ May, and classify data for the information process. Methods: Studies were searched in the Medline database using the key terms “India”, “Indian”, “Physiotherapy”. Clinical trials only with PT authors were included. Trials out of scope of PT practice and on animals were excluded. Retrieved valid articles were analyzed for published year, type of participants, area of study, PEDro score, outcome measure domains of impairment, activity, participation; ‘a priori’ sample size calculation, region, and explanation of the intervention. Result: 45 valid articles were retrieved from the year 2000-2013’ May. The majority of articles were done on symptomatic participants (81%). The frequencies of conditions repeated more were low back pain (n-7) and diabetes (n-4). PEDro score with mode 5 and upper limit of 8 and lower limit 4 was found. 97.2% of studies measure the outcome at the impairment level, 34% in activity level, and 27.8% in participation level. 29.7% of studies did ‘a priori’ sample size calculation. Correlation of year trend and PEDro score found to be not significant (p>.05). Individual PEDro item analysis showed, randomization (100%), concealment (33%) baseline (76%), blinding-subject, therapist, assessor (9.1%, 0%, 10%), follow-up (89%) ITT (15%), statistics between groups (100%), measures of variance (88 %). Conclusion: The trend shows an upward slope in terms of RCTs published from India which is a good indicator. The qualitative analysis showed some gaps in the clinical trial design, which can be expected to be, fulfilled by the future researchers.

Keywords: RCT, PEDro, physical therapy, rehabilitation

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Authors: Tayyab Hassan, Talha Rehman, Qasim Abdul Aziz, Ahmad Salman

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The constant monitoring of blood glucose level is necessary for maintaining health of patients and to alert medical specialists to take preemptive measures before the onset of any complication as a result of diabetes. The current clinical monitoring of blood glucose uses invasive methods repeatedly which are uncomfortable and may result in infections in diabetic patients. Several attempts have been made to develop non-invasive techniques for blood glucose measurement. In this regard, the existing methods are not reliable and are less accurate. Other approaches claiming high accuracy have not been tested on extended dataset, and thus, results are not statistically significant. It is a well-known fact that acetone concentration in breath has a direct relation with blood glucose level. In this paper, we have developed the first of its kind, reliable and high accuracy breath analyzer for non-invasive blood glucose measurement. The acetone concentration in breath was measured using MQ 138 sensor in the samples collected from local hospitals in Pakistan involving one hundred patients. The blood glucose levels of these patients are determined using conventional invasive clinical method. We propose a linear regression classifier that is trained to map breath acetone level to the collected blood glucose level achieving high accuracy.

Keywords: blood glucose level, breath acetone concentration, diabetes, linear regression

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Authors: K. C. Sony

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This paper investigates the coping strategies of households confronting disease in large cardamom (Amomum Subulatum Roxb.) in eastern Nepal. Cardamom farmers draw on various coping strategies to reduce the impact of crop disease in their livelihoods. Yet farmers face tremendous decline in production with a constant effort for revival. Past evidences provides dearth of information about coping strategies employed by farmers and institutional intervention to combat disease. Using factual data from Ilam district, and conducting a political economic analysis, this research addresses the gap by 1) understanding the impact of crop disease in farmers’ livelihoods, 2) identifying the coping strategies adopted by farmers and, 3) examining the existing institutional arrangements to address the disease. Coping strategies vary by household’s status defined by size of land, alternative income, and access to supporting institutions. Measures adopted are burning the cardamom field, changing land use pattern, diversifying crops, and visiting institutions for support. The local government’s support is limited to providing trainings and producing new varieties of cardamom. During crisis, farmers expect institutions to help revive the cardamom production, despite customary practice to combat disease. To retain and improve the livelihoods of farmers, there needs to be institutional innovation at the community level and policies that endorse immediate and sustainable support during hazards.

Keywords: cardamom, coping strategy, disease, institutions, Nepal

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Authors: K. S. Vedasingha, K. K. M. T. Perera, K. I. Hathurusinghe, H. W. I. Akalanka, Nelum Chathuranga Amarasena, Nalaka R. Dissanayake

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Railways provide the most convenient and economically beneficial mode of transportation, and it has been the most popular transportation method among all. According to the past analyzed data, it reveals a considerable number of accidents which occurred at railways and caused damages to not only precious lives but also to the economy of the countries. There are some major issues which need to be addressed in railways of South Asian countries since they fall under the developing category. The goal of this research is to minimize the influencing aspect of railway level crossing accidents by developing the “railway process automation system”, as there are high-risk areas that are prone to accidents, and safety at these places is of utmost significance. This paper describes the implementation methodology and the success of the study. The main purpose of the system is to ensure human safety by using the Internet of Things (IoT) and image processing techniques. The system can detect the current location of the train and close the railway gate automatically. And it is possible to do the above-mentioned process through a decision-making system by using past data. The specialty is both processes working parallel. As usual, if the system fails to close the railway gate due to technical or a network failure, the proposed system can identify the current location and close the railway gate through a decision-making system, which is a revolutionary feature. The proposed system introduces further two features to reduce the causes of railway accidents. Railway track crack detection and motion detection are those features which play a significant role in reducing the risk of railway accidents. Moreover, the system is capable of detecting rule violations at a level crossing by using sensors. The proposed system is implemented through a prototype, and it is tested with real-world scenarios to gain the above 90% of accuracy.

Keywords: crack detection, decision-making, image processing, Internet of Things, motion detection, prototype, sensors

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Authors: Rose-Michelle Smith, Musandji Fuamba, Salomon Salumu

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Water is vital for life. Access to drinking water and sanitation for humans is one of the Sustainable Development Goals (specifically the sixth) approved by United Nations Member States in September 2015. There are various problems identified relating to water: insufficient fresh water, inequitable distribution of water resources, poor water management in certain places on the planet, detection of water-borne diseases due to poor water quality, and the negative impacts of climate change on water. One of the major challenges in the world is finding ways to ensure that people and the environment have enough water resources to sustain and support their existence. Thus, this research project aims to develop a tool to assess the availability, quality and needs of water in current and future situations with regard to climate change. This tool was tested using threshold values for three regions in three countries: the Metropolitan Community of Montreal (Canada), Normandie Region (France) and North Department (Haiti). The WEAP software was used to evaluate the available quantity of water resources. For water quality, two models were performed: the Canadian Council of Ministers of the Environment (CCME) and the Malaysian Water Quality Index (WQI). Preliminary results showed that the ratio of the needs could be estimated at 155, 308 and 644 m3/capita in 2023 for Normandie, Cap-Haitian and CMM, respectively. Then, the Water Quality Index (WQI) varied from one country to another. Other simulations regarding the water availability and quality are still in progress. This tool will be very useful in decision-making on projects relating to water use in the future; it will make it possible to estimate whether the available resources will be able to satisfy the needs.

Keywords: climate change, water needs, balance sheet, water quality

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Authors: Shara Toibayeva, Irbulat Utepbergenov, Lyazzat Issabekova, Aidana Bodesova

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The article discusses the importance of quality assessment as a strategic tool in business and emphasizes the significance of the effectiveness of quality management systems (QMS) for enterprises. The evaluation of these systems takes into account the specificity of quality indicators, the multilevel nature of the system, and the need for optimal selection of the number of indicators and evaluation of the system state, which is critical for making rational management decisions. Methods and models of automated enterprise quality management are proposed, including an intelligent automated quality management system integrated with the Management Information and Control System. These systems make it possible to automate the implementation and support of QMS, increasing the validity, efficiency, and effectiveness of management decisions by automating the functions performed by decision makers and personnel. The paper also emphasizes the use of recurrent neural networks to improve automated quality management. Recurrent neural networks (RNNs) are used to analyze and process sequences of data, which is particularly useful in the context of document quality assessment and non-conformance detection in quality management systems. These networks are able to account for temporal dependencies and complex relationships between different data elements, which improves the accuracy and efficiency of automated decisions. The project was supported by a grant from the Ministry of Education and Science of the Republic of Kazakhstan under the Zhas Galym project No. AR 13268939, dedicated to research and development of digital technologies to ensure consistency of QMS regulatory documents.

Keywords: automated control system, quality management, document structure, formal language

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Authors: Musyimi Mbathi

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Information regarding social, political, demographic, economic and other attributes of human settlement is important for decision makers at all levels of planning, as they have to grapple with dynamic environments often associated with settlements. At the local level, it is particularly important for both communities and urban managers to have accurate and reliable information regarding all planning attributes. Settlement mapping, in particular, informal settlements mapping in Kenya, has over the past few years been carried out using modern tools like Geographic information systems (GIS) and remote sensing for spatial data analysis and planning. GIS tools offer a platform for integration of spatial and non-spatial data as well as visualisation of the settlements. The capabilities offered by these tools have enabled communities to participate especially in the planning and management of new infrastructure as well as settlement upgrading. Land tenure based projects within informal settlements have also relied on GIS and related tools with considerable success. Additionally, the adoption of participatory approaches and use of geo-information tools helped to provide a basis for all inclusive planning thus promoting accountability, transparency, legitimacy, and other dimensions of governance within human settlement planning. The paper examines the context and application of geo-information tools for planning within low-income settlements of Kenya. A case study of Kiambiu settlement will be used to demonstrate how the tools have been applied for planning and decision-making purposes.

Keywords: informal settlements, GIS, governance, modern tools

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Authors: Melissa Langevin, Natalie Ward, Colleen Fitzgibbons, Christa Ramsey, Melanie Hogue, Anna Theresa Lobos

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Description: Root Cause Analysis (RCA) is used by health care teams to examine adverse events (AEs) to identify causes which then leads to recommendations for prevention Despite widespread use, RCA has limitations. Best practices have not been established for implementing recommendations or tracking the impact of interventions after AEs. During phase 1 of this study, we used simulation to analyze two fictionalized AEs that occurred in hospitalized paediatric patients to identify and understand how the errors occurred and generated recommendations to mitigate and prevent recurrences. Scenario A involved an error of commission (inpatient drug error), and Scenario B involved detecting an error that already occurred (critical care drug infusion error). Recommendations generated were: improved drug labeling, specialized drug kids, alert signs and clinical checklists. Aim: Use simulation to optimize interventions recommended post critical event analysis prior to implementation in the clinical environment. Methods: Suggested interventions from Phase 1 were designed and tested through scenario simulation in the clinical environment (medicine ward or pediatric intensive care unit). Each scenario was simulated 8 times. Recommendations were tested using different, voluntary teams and each scenario was debriefed to understand why the error was repeated despite interventions and how interventions could be improved. Interventions were modified with subsequent simulations until recommendations were felt to have an optimal effect and data saturation was achieved. Along with concrete suggestions for design and process change, qualitative data pertaining to employee communication and hospital standard work was collected and analyzed. Results: Each scenario had a total of three interventions to test. In, scenario 1, the error was reproduced in the initial two iterations and mitigated following key intervention changes. In scenario 2, the error was identified immediately in all cases where the intervention checklist was utilized properly. Independently of intervention changes and improvements, the simulation was beneficial to identify which of these should be prioritized for implementation and highlighted that even the potential solutions most frequently suggested by participants did not always translate into error prevention in the clinical environment. Conclusion: We conclude that interventions that help to change process (epinephrine kit or mandatory checklist) were more successful at preventing errors than passive interventions (signage, change in memory aids). Given that even the most successful interventions needed modifications and subsequent re-testing, simulation is key to optimizing suggested changes. Simulation is a safe, practice changing modality for institutions to use prior to implementing recommendations from RCA following AE reviews.

Keywords: adverse events, patient safety, pediatrics, root cause analysis, simulation

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Authors: Caren Hilger, Silke Burkert, Friederike Kendel

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Men with localized prostate cancer (PCa) have to choose among different treatment options, such as active surveillance (AS) and radical prostatectomy (RP). All available treatment options may be accompanied by specific psychological or physiological side effects. Depending on the nature and extent of these side effects, patients are more or less likely to be satisfied or to struggle with their treatment decision in the long term. Therefore, the aim of this study was to assess and explain decisional regret in men with localized PCa. The role of erectile functioning as one of the main physiological side effects of invasive PCa treatment, depressive symptoms as a common psychological side effect, and the association of erectile functioning and depressive symptoms with decisional regret were investigated. Men with localized PCa initially managed with AS or RP (N=292) were matched according to length of therapy (mean 47.9±15.4 months). Subjects completed mailed questionnaires assessing decisional regret, changes in erectile functioning, depressive symptoms, and sociodemographic variables. Clinical data were obtained from case report forms. Differences among the two treatment groups (AS and RP) were calculated using t-tests and χ²-tests, relationships of decisional regret with erectile functioning and depressive symptoms were computed using multiple regression. Men were on average 70±7.2 years old. The two treatment groups differed markedly regarding decisional regret (p<.001, d=.50), changes in erectile functioning (p<.001, d=1.2), and depressive symptoms (p=.01, d=.30), with men after RP reporting higher values, respectively. Regression analyses showed that after adjustment for age, tumor risk category, and changes in erectile functioning, depressive symptoms were still significantly associated with decisional regret (B=0.52, p<.001). Additionally, when predicting decisional regret, the interaction of changes in erectile functioning and depressive symptoms reached significance for men after RP (B=0.52, p<.001), but not for men under AS (B=-0.16, p=.14). With increased changes in erectile functioning, the association of depressive symptoms with decisional regret became stronger in men after RP. Decisional regret is a phenomenon more prominent in men after RP than in men under AS. Erectile functioning and depressive symptoms interact in their prediction of decisional regret. Screening and treating depressive symptoms might constitute a starting point for interventions aiming to reduce decisional regret in this target group.

Keywords: active surveillance, decisional regret, depressive symptoms, erectile functioning, prostate cancer, radical prostatectomy

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Authors: Siqi Qiu, Yijian Zheng, Xin Guo Ming

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In many reliability and risk analysis, failures of components are supposed to be independent. However, in reality, the ignorance of failure dependencies among components may render the results of reliability and risk analysis incorrect. There are two principal ways to incorporate failure dependencies in system reliability and risk analysis: implicit and explicit methods. In the implicit method, failure dependencies can be modeled by joint probabilities, correlation values or conditional probabilities. In the explicit method, certain types of dependencies can be modeled in a fault tree as mutually independent basic events for specific component failures. In this paper, explicit and implicit methods based on BDD will be proposed to evaluate the reliability of systems considering failure dependencies. The obtained results prove the equivalence of the proposed implicit and explicit methods. It is found that the consideration of failure dependencies decreases the reliability of systems. This observation is intuitive, because more components fail due to failure dependencies. The consideration of failure dependencies helps designers to reduce the dependencies between components during the design phase to make the system more reliable.

Keywords: reliability assessment, risk assessment, failure dependencies, binary decision diagram

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Authors: Amy Claridge, Tishra Beeson

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Background: Maternal depression is a serious health concern impacting between 10-16% of birthing persons. It is associated with difficulty in emotional interaction and the formation of attachment bonds between parent and infant. Longitudinally, maternal depression can have severe, lasting impacts on both parent and child, increasing the risk for mental, social, and physical health issues. Rates of prenatal depression have been higher among individuals who were pregnant during the first year of the COVID-19 pandemic. Pregnant persons are considered a high-risk group for poor clinical outcomes from COVID-19 infection and may also have faced or continue to face additional stressors such as financial burdens, loss of income or employment, and the benefits accompanying employment, especially among those in the United States (U.S.). It is less clear whether individuals who gave birth during the pandemic continue to experience high levels of depressive symptoms or whether symptoms have been reduced as a pandemic response has shifted. The current study examined longitudinal reports of depressive symptoms among individuals in the U.S. who gave birth between March 2020 and September 2021. Methods: This mixed-method study involved surveys and interviews with birthing persons (18-45 years old) in their third trimester of pregnancy and at 8 weeks postpartum. Participants also completed a follow-up survey at 12-18 months postpartum. Participants were recruited using convenience methods via an online survey. Survey participants included 242 U.S. women who self-reported depressive symptoms (10-item Edinburgh Postnatal Depression Scale) at each data collection wave. A subset of 23 women participated in semi-structured prenatal and 8-week postpartum qualitative interviews. Follow-up interviews are currently underway and will be integrated into the presentation. Preliminary Results: Prenatal depressive symptoms were significantly positively correlated to 8-week and 12-18-month postpartum depressive symptoms. Participants who reported clinical levels of depression prenatally were 3.29 times (SE = .32, p < .001) more likely to report clinical levels of depression at 18 months postpartum. Those who reported clinical depression at 8-weeks postpartum were 6.52 times (SE = .41, p < .001) more likely to report clinical levels of depression at 18 months postpartum. Participants who gave birth earlier in the pandemic reported significantly higher prenatal (t(103) = 2.84, p < .01) and 8-week postpartum depressive symptoms (t(126) = 3.31, p < .001). Data from qualitative interviews contextualize the findings. Participants reported negative emotions during pregnancy, including sadness, grief, and anxiety. They attributed this in part to their experiences of pregnancy during the pandemic and uncertainty related to the birth experience and postpartum period. Postpartum interviews revealed some stressors specific to childbirth during the COVID-19 pandemic; however, most women reflected on positive experiences of birth and postpartum. Conclusions: Taken together, findings reveal a pattern of persistent depressive symptoms among U.S. parents who gave birth during the pandemic. Depressive symptoms are of significant concern for the health of parents and children, and the findings of this study suggest a need for continued mental health intervention for parents who gave birth during the pandemic. Policy and practice implications will be discussed.

Keywords: maternal mental health, perinatal depression, postpartum depression, covid-19 pandemic

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Authors: A. Ascenso, C. Silveira, B. Augusto, S. Rafael, S. Coelho, J. Ferreira, A. Monteiro, P. Roebeling, A. I. Miranda

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Innovative nature-based solutions (NBSs) can provide answers to the challenges that urban areas are currently facing due to urban densification and extreme weather conditions. The effects of NBSs are recognized and include improved quality of life, mental and physical health and improvement of air quality, among others. Part of the work developed in the scope of the UNaLab project, which aims to guide cities in developing and implementing their own co-creative NBSs, intends to assess the impacts of NBSs on air quality, using Eindhoven city as a case study. The state-of-the-art online air quality modelling system WRF-CHEM was applied to simulate meteorological and concentration fields over the study area with a spatial resolution of 1 km2 for the year 2015. The baseline simulation (without NBSs) was validated by comparing the model results with monitored data retrieved from the Eindhoven air quality database, showing an adequate model performance. In addition, land use changes were applied in a set of simulations to assess the effects of different types of NBSs. Finally, these simulations were compared with the baseline scenario and the impacts of the NBSs were assessed. Reductions on pollutant concentrations, namely for NOx and PM, were found after the application of the NBSs in the Eindhoven study area. The present work is particularly important to support public planners and decision makers in understanding the effects of their actions and planning more sustainable cities for the future.

Keywords: air quality, modelling approach, nature based solutions, urban area

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Authors: Veronica Sorgato, Jeremy Belhassen, Philippe Chartier, Roddy Sihanath, Nicolas Docquiere, Jean-Yves Giraud

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We analyzed the image-guided radiotherapy method used by the TomoTherapy® System (Accuray Corp.) for patient repositioning in clinical routine. The TomoTherapy® System computes X, Y, Z and roll displacements to match the reference CT, on which the dosimetry has been performed, with the pre-treatment MV CT. The accuracy of the repositioning method has been studied according to the treatment localization. For this, a database of 18774 treatment sessions, performed during 2 consecutive years (2016-2017 period) has been used. The database includes the X, Y, Z and roll displacements proposed by TomoTherapy® System as well as the manual correction of these proposals applied by the radiation therapist. This manual correction aims to further improve the repositioning based on the clinical situation and depends on the structures surrounding the target tumor tissue. The statistical analysis performed on the database aims to define repositioning limits to be used as security and guiding tool for the manual adjustment implemented by the radiation therapist. This tool will participate not only to notify potential repositioning errors but also to further improve patient positioning for optimal treatment.

Keywords: accuracy, IGRT MVCT, image-guided radiotherapy megavoltage computed tomography, statistical analysis, tomotherapy, localization

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Authors: Yin-Yann Chen, Jia-Ying Li

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Assembly line balancing problems can be categorized into one-sided, two-sided, and multi-manned ones by using the number of operators deployed at workstations. This study explores the balancing problem of a resource-constrained assembly line with multi-manned workstations. Resources include machines or tools in assembly lines such as jigs, fixtures, and hand tools. A mathematical programming model was developed to carry out decision-making and planning in order to minimize the numbers of workstations, resources, and operators for achieving optimal production efficiency. To improve the solution-finding efficiency, a genetic algorithm (GA) and a simulated annealing algorithm (SA) were designed and developed in this study to be combined with a practical case in car making. Results of the GA/SA and mathematics programming were compared to verify their validity. Finally, analysis and comparison were conducted in terms of the target values, production efficiency, and deployment combinations provided by the algorithms in order for the results of this study to provide references for decision-making on production deployment.

Keywords: heuristic algorithms, line balancing, multi-manned workstation, resource-constrained

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