Search results for: virtual healthcare facilities

Authors: C. Castro-Egler, A. Durán-Escalante, A. García-González

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This paper presents a method to generate a finite element model of the human auditory inner ear system. The geometric model has been realized using 2D images from a virtual model of temporal bones. A point cloud has been gotten manually from those images to construct a whole mesh with hexahedral elements. The main difference with the predecessor models is the spiral shape of the cochlea with its three scales completely defined: scala tympani, scala media and scala vestibuli; which are separate by basilar membrane and Reissner membrane. To validate this model, numerical simulations have been realised with two models: an isolated inner ear and a whole model of human auditory system. Ideal conditions of displacement are applied over the oval window in the isolated Inner Ear model. The whole model is made up of the outer auditory channel, the tympani, the ossicular chain, and the inner ear. The boundary condition for the whole model is 1Pa over the auditory channel entrance. The numerical simulations by FEM have been done using a harmonic analysis with a frequency range between 100-10.000 Hz with an interval of 100Hz. The following results have been carried out: basilar membrane displacement; the scala media pressure according to the cochlea length and the transfer function of the middle ear normalized with the pressure in the tympanic membrane. The basilar membrane displacements and the pressure in the scala media make it possible to validate the response in frequency of the basilar membrane.

Keywords: finite elements method, human auditory system model, numerical analysis, 3D modelling cochlea

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Authors: Cihat Aşan

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Istanbul Strait is a crucial and narrow waterway, not only having a role in linking two continents but also has a crossover mission for the petroleum, which is the biggest energy resource, between its supply and demand sources. Besides its substantial features, sensitivities like around 18 million populations in surroundings, military facilities, ports, oil lay down areas etc. also brings the high risk to use of Istanbul Strait. Based on the statistics of Turkish Ministry of Transportation, Maritime and Communication, although the number of vessel passage in Istanbul Strait is declining, tonnage of hazardous and flammable cargo like oil and chemical transportation is increasing and subsequently the risk of oil pollution, loss of life and property is also rising. Based on the mentioned above; it is crucial to be prepared for the initial and subsequent response to eventual ship sourced oil spill which may cause to block the Strait for an unbearable duration. In this study; preconditioned Istanbul Strait sensitive areas studies has been taken into account and possible oil spill scenario is loaded to PISCES 2 (Potential Incident Simulation Control and Evaluation System) decision support system for the determined specific sea area. Consequences of the simulation like oil expanding process, required number and types of assets to response, had in hand and evaluated.

Keywords: Istanbul strait, oil spill, PISCES simulator, initial response

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Authors: Suhani Srivastava

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This research delves into the classification of orbital debris through machine learning (ML): it will categorize the intensity of the threat orbital debris poses through multiple ML models to gain an insight into effectively estimating the danger specific orbital debris can pose to future space missions. As the space industry expands, orbital debris becomes a growing concern in Low Earth Orbit (LEO) because it can potentially obfuscate space missions due to the increased orbital debris pollution. Moreover, detecting orbital debris and identifying its characteristics has become a major concern in Space Situational Awareness (SSA), and prior methods of solely utilizing physics can become inconvenient in the face of the growing issue. Thus, this research focuses on approaching orbital debris concerns through machine learning, an efficient and more convenient alternative, in detecting the potential threat certain orbital debris pose. Our findings found that the Logistic regression machine worked the best with a 98% accuracy and this research has provided insight into the accuracies of specific machine learning models when classifying orbital debris. Our work would help provide space shuttle manufacturers with guidelines about mitigating risks, and it would help in providing Aerospace Engineers facilities to identify the kinds of protection that should be incorporated into objects traveling in the LEO through the predictions our models provide.

Keywords: aerospace, orbital debris, machine learning, space, space situational awareness, nasa

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Authors: Merita Dauti, Edita Alili-Idrizi, Sihana Ahmeti –Lika, Ledjan Malaj

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The extermination and proper disposal of pharmaceutical wastes from expired and unused medications remains a disputable issue due to their specific nature and characteristics. Even though the hazards from these wastes are already well known in terms of environment and human health, people still treat them as usual wastes. At a national level, in many countries the management of pharmaceutical and medical wastes has been one of the main objectives in order to protect people’s health and the environment. Even though many legal regulations exist in this respect, there has not been a single law that would clearly explain the procedures of returning medicines, ways of selection, treatment and extermination of pharmaceutical wastes. This paper aims at analyzing the practices of pharmaceutical waste management and treatment in some European countries as well as a review of the legislation and official guidelines in managing these kinds of wastes and protecting the environment and human health. A suitable treatment and management of expired medications and other similar wastes would be in the interest of public health in the first place, as well as in the interest of healthcare institutions and other bodies engaged in environment protection.

Keywords: pharmaceutical waste, legal regulation, proper disposal, environment pollution

Procedia PDF Downloads 338

Authors: Cheng-Yang Lee, Petrus Tang, Tzu-Hao Chang

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Copy number variations (CNVs) have played an important role in many kinds of human diseases, such as Autism, Schizophrenia and a number of cancers. Many diseases are found in genome coding regions and whole exome sequencing (WES) is a cost-effective and powerful technology in detecting variants that are enriched in exons and have potential applications in clinical setting. Although several algorithms have been developed to detect CNVs using WES and compared with other algorithms for finding the most suitable methods using their own samples, there were not consistent datasets across most of algorithms to evaluate the ability of CNV detection. On the other hand, most of algorithms is using command line interface that may greatly limit the analysis capability of many laboratories. We create a series of simulated WES datasets from UCSC hg19 chromosome 22, and then evaluate the CNV detective ability of 19 algorithms from OMICtools database using our simulated WES datasets. We compute the sensitivity, specificity and accuracy in each algorithm for validation of the exome-derived CNVs. After comparison of 19 algorithms from OMICtools database, we construct a platform to install all of the algorithms in a virtual machine like VirtualBox which can be established conveniently in local computers, and then create a simple script that can be easily to use for detecting CNVs using algorithms selected by users. We also build a table to elaborate on many kinds of events, such as input requirement, CNV detective ability, for all of the algorithms that can provide users a specification to choose optimum algorithms.

Keywords: whole exome sequencing, copy number variations, omictools, pipeline

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Authors: Hassan Alsada

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Tank overfill accidents are major concerns for industries handling large volumes of hydrocarbons. Buncefield, Jaipur, Puerto Rico, and West Virginia are just a few accidents with catastrophic consequences. Thus, it is very important for any industry to take the right safety measures for overfill prevention. Moreover, one of the main causative factors in the overfill accidents was inadequate risk analysis and, subsequently, inadequate design. This study aims to provide a full assessment in accordance with the Functional safety standard: “IEC 615 11 – Safety instrumented systems for the process industry” to the tank overfill scenario according to the standard’s Safety Life Cycle (SLC), which includes: the analysis phase, the implementation phase, and the operation phase. The paper discusses in depth the tank overfills Independent Protection Layers (IPLs) with systematic analysis to avoid the safety risks of under-design and the financial risk of facility overdesign. The result shows a clear and systematic assessment in compliance with the standards that can help to assist existing tank overfilling setup or a guide to support designing new storage facilities overfill protection.

Keywords: IEC 61511, PHA, LOPA, process safety, safety, health, environment, safety instrumented systems, safety instrumented function, functional safety, safety life cycle

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Authors: Zhdanova A. O., Volkov R. S., Kuznetsov G. V., Strizhak P. A.

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Fires in different types of facilities are a serious problem worldwide.It is still an unaccomplished science and technology objective to establish the minimum number and type of sensors in automatic systems of compartment fire suppression which would turn the fire-extinguishing agent spraying on and off in real time depending on the state of the fire, minimize the amount of agent applied, delay time in fire suppression and system response, as well as the time of combustion suppression. Based on the results of experimental studies, the conclusion was made that it is reasonable to use a gas analysis system and heat sensors (in the event of their prior activation) to determine the effectiveness of fire suppression (fire-extinguishing composition interacts with the fire). Thus, the concentration of CO in the interaction of the firefighting liquid with the fire increases to 0.7–1.2%, which indicates a slowdown in the flame combustion, and heat sensors stop responding at a gas medium temperature below 80 ºC, which shows a gradual decrease in the heat release from the fire. The evidence from this study suggests that the information received from the video recording equipment (video camera) should be used in real time as an additional parameter confirming fire suppression. Research was supported by Russian Science Foundation (project No 21-19-00009, https://rscf.ru/en/project/21-19-00009/).

Keywords: compartment fires, fire suppression, continuous control of fire behavior, feedback systems

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Authors: Abduxukur Zayit, Guo Rui Chen

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Universities play important role for develop and distribute sustainable development ideas. This research based on the current situation of large and widely distributed university campuses in China. In view of the deterioration of campus performance, the aging of function and facilities, the large consumption of energy and resources, a logic of "problem-oriented-goal-oriented- At the level, taking the problem orientation as the focus,this paper analyzes the main influencing factors of the existing characteristics of the university campuses, establishes the digital assessment methods and clarifies the key points of the rennovation. Based on the goal orientation, this paper puts forward the existing university campus design principles, builds the green transformation-carding model and sets up the post-use evaluation model. In the end, with dual guidance as the constraint, we will formulate green design standards for campus greening, construct a greening enhancement measure for campus environment, and develop and promote a green campus after-use assessment platform. It provides useful research methods and research ideas for the reconstruction of the existing campus in China, especially the urban universities.

Keywords: design method, existing university campus, green renovation, sustainable development

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Authors: Jamilu Lawal Ajiya

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Background: Physical activity is essential for improving maternal health outcomes, particularly in low- and middle-income countries like Nigeria. Objective: The aim is to evaluate the effectiveness of physical activity interventions on maternal health outcomes among Nigerian pregnant women. Methods: Systematic review and meta-analysis of randomized controlled trials (RCTs) conducted in Nigeria, published in English, and focusing on physical activity and maternal health outcomes. Results: Ten RCTs (N=1,200) were included. Physical activity interventions significantly reduced the risk of gestational diabetes, hypertension and preterm birth. Also, the study found that brisk walking and aerobic exercise were more effective than yoga. Conclusion: Physical activity interventions improve maternal health outcomes among Nigerian pregnant women. Policy changes and public health programs should prioritize physical activity promotion during pregnancy. This study informs healthcare providers, policymakers, and researchers on the effectiveness of physical activity interventions in improving maternal health outcomes in Nigeria.

Keywords: physical activity, maternal health, Nigeria, randomized controlled trials

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Authors: Nalinee Sophatsathit

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The objectives of memorabilia of Suan Sunandha are to develop a general knowledge presentation about the historical royal garden through interactive graphic simulation technique and to employ high-functionality context in enhancing interactive user navigation. The approach infers non-intrusive display of relevant history in response to situational context. User’s navigation runs through the virtual reality campus, consisting of new and restored buildings. A flash back presentation of information pertaining to the history in the form of photos, paintings, and textual descriptions are displayed along each passing-by building. To keep the presentation lively, graphical simulation is created in a serendipity game play so that the user can both learn and enjoy the educational tour. The benefits of this human-computer interaction development are two folds. First, lively presentation technique and situational context modeling are developed that entail a usable paradigm of knowledge and information presentation combinations. Second, cost effective training and promotion for both internal personnel and public visitors to learn and keep informed of this historical royal garden can be furnished without the need for a dedicated public relations service. Future improvement on graphic simulation and ability based display can extend this work to be more realistic, user-friendly, and informative for all.

Keywords: interactive user navigation, high-functionality context, situational context, human-computer interaction

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Authors: Aishwarya Rai

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This study explores the transformative influence of generative AI on startups, businesses, and industries. We will explore how large businesses can benefit in the area of customer operations, where AI-powered chatbots can improve self-service and agent effectiveness, greatly increasing efficiency. In marketing and sales, generative AI could transform businesses by automating content development, data utilization, and personalization, resulting in a substantial increase in marketing and sales productivity. In software engineering-focused startups, generative AI can streamline activities, significantly impacting coding processes and work experiences. It can be extremely useful in product R&D for market analysis, virtual design, simulations, and test preparation, altering old workflows and increasing efficiency. Zooming into the retail and CPG industry, industry findings suggest a 1-2% increase in annual revenues, equating to $400 billion to $660 billion. By automating customer service, marketing, sales, and supply chain management, generative AI can streamline operations, optimizing personalized offerings and presenting itself as a disruptive force. While celebrating economic potential, we acknowledge challenges like external inference and adversarial attacks. Human involvement remains crucial for quality control and security in the era of generative AI-driven transformative innovation. This talk provides a comprehensive exploration of generative AI's pivotal role in reshaping businesses, recognizing its strategic impact on customer interactions, productivity, and operational efficiency.

Keywords: generative AI, digital transformation, LLM, artificial intelligence, startups, businesses

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Authors: Nitin Dewangan, Nitin Kattula, Megha Anawat

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Hydraulic reservoir is the key component in the mobile construction vehicles; most of the off-road earth moving construction machinery requires bigger side hydraulic reservoirs. Their reservoir construction is very much non-uniform and designers used such design to utilize the space available under the vehicle. There is no way to find out the space utilization of the reservoir by oil and validity of design except virtual simulation. Computational fluid dynamics (CFD) helps to predict the reservoir space utilization by vortex mapping, path line plots and dwell time prediction to make sure the design is valid and efficient for the vehicle. The dwell time acceptance criteria for effective reservoir design is 15 seconds. The paper will describe the hydraulic reservoir simulation which is carried out using CFD tool acuSolve using automated mesh strategy. The free surface flow and moving reference mesh is used to define the oil flow level inside the reservoir. The first baseline design is not able to meet the acceptance criteria, i.e., dwell time below 15 seconds because the oil entry and exit ports were very close. CFD is used to redefine the port locations for the reservoir so that oil dwell time increases in the reservoir. CFD also proposed baffle design the effective space utilization. The final design proposed through CFD analysis is used for physical validation on the machine.

Keywords: reservoir, turbulence model, transient model, level set, free-surface flow, moving frame of reference

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Authors: Junie B. Billones, Maria Constancia O. Carrillo, Voltaire G. Organo, Stephani Joy Y. Macalino, Inno A. Emnacen, Jamie Bernadette A. Sy

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One of the major interferences in the Philippines’ tuberculosis control program is the widespread prevalence of Mtb strains that are resistant to known drugs, such as the MDR-TB (Multi Drug Resistant Tuberculosis) and XDR-TB (Extensively Drug Resistant Tuberculosis). Therefore, there is a pressing need to search for novel Mtb drug targets in order to be able to combat these drug resistant strains. The enzyme 7,8-diaminopelargonic acid aminotransferase enzyme, or more commonly known as BioA, is one such ideal target, as it is known that humans do not possess this enzyme. BioA primarily plays a key role in Mtb’s lipid biosynthesis pathway; more specifically in the synthesis of the enzyme cofactor biotin. In this study, structure-based pharmacophore screening, docking, and ADMET evaluation of compounds obtained from the DrugBank chemical database were performed against the MtbBioA enzyme. Results of the screening, docking, ADMET, and TOPKAT calculations revealed that out of the 6,516 compounds in the library, only 7 compounds indicated more favorable binding energies as compared to the enzyme’s known inhibitor, amiclenomycin (ACM), as well as good solubility and toxicity properties. Moreover, out of these 7 compounds, Molecule 6 exhibited the best solubility and toxicity properties. In the future, these lead compounds may then be subjected to bioactivity assays in vitro or in vivo for further evaluation of its therapeutic efficacy.

Keywords: 7, 8-diaminopelargonic acid aminotransferase, BioA, pharmacophore, molecular docking, ADMET, TOPKAT

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Authors: Emmanouel Koumoulas, Aikaterini Rokkou, Marios Moschakis

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Theagenio" in Thessaloniki exists and works for three centuries now as a hospital. Since 1975, it has been operating as an Integrated Special Cancer Hospital and since 1985 it has been integrated into the National Health System. "Theagenio" Cancer Hospital is located at the central web of Thessaloniki residential complex and consists of two buildings, the "Symeonidio Research Center", which was completed in 1962 and the Nursing Ward, a project that was later completed in 1975. This paper examines the design of the Hospital Unit according to the requirements of the energy design of buildings. Initially, the energy characteristics of the Hospital are recorded, followed by a detailed presentation of the electromechanical installations. After the existing situation has been captured and with the help of the software TEE-KENAK, different scenarios for the energy upgrading of the buildings have been studied. Proposals for upgrading concern both the shell, e.g. installation of external thermal insulation, replacement of frames, addition of shading systems, etc. as well as electromechanical installations, e.g. use of ceiling fans, improvements in heating and cooling systems, interventions in lighting, etc. The simulation calculates the future energy status of the buildings and presents the economic benefits of the proposed interventions with reference to the environmental profits that arise.

Keywords: energy consumption in hospitals, energy saving interventions, energy upgrading, hospital facilities

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Authors: Aicha Akrout, Amira Echtioui, Mohamed Ghorbel

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Pneumonia remains a significant global health concern, posing a substantial threat to human lives due to its contagious nature and potentially fatal respiratory complications caused by bacteria, fungi, or viruses. The reliance on chest X-rays for diagnosis, although common, often necessitates expert interpretation, leading to delays and potential inaccuracies in treatment. This study addresses these challenges by employing transfer learning techniques to automate the detection of lung diseases, with a focus on pneumonia. Leveraging three pre-trained models, VGG-16, ResNet50V2, and MobileNetV2, we conducted comprehensive experiments to evaluate their performance. Our findings reveal that the proposed model based on VGG-16 demonstrates superior accuracy, precision, recall, and F1 score, achieving impressive results with an accuracy of 93.75%, precision of 94.50%, recall of 94.00%, and an F1 score of 93.50%. This research underscores the potential of transfer learning in enhancing pneumonia diagnosis and treatment outcomes, offering a promising avenue for improving healthcare delivery and reducing mortality rates associated with this debilitating respiratory condition.

Keywords: chest x-ray, lung diseases, transfer learning, pneumonia detection

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Authors: Eitan Elaad

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The present study's purpose was to examine lyingand pretend fairness by police interrogators in sharing situations. Forty police officers and 40 laypeople from the community, all males, self-assessed their lie-telling ability, rated the frequency of their lies, evaluated the acceptability of lying, and indicated using rational and intuitive thinking while lying. Next, according to the ultimatum game procedure, participants were asked to share 100 points with a virtual target, either a male police interrogator or a male layman. Participantsallocated points to the target person bearing in mind that the other person must accept their offer. Participants' goal was to retain as many points as possible, and to this end, they could tell the target person that fewer than 100 points were available for distribution. The difference between the available 100 points and the sum of points designated for sharing defines lying. The ratio of offered and designated points defines pretend fairness. Results indicate that those police officers lied more than laypeople. Similar results emergedeven when the target person was a police interrogator. However, police interrogators presented higher pretend fairness than laypeople. The higher pretend fairness may be in line with interrogation tactics of persuasion used in the criminal interrogation. Higher-lying frequency reported by police interrogators compared with laypeople support the present results. Finally, lie acceptability predicted lying in the ultimatum game. Specifically, participants who rated lying as more acceptable tended to lie more than low acceptability raters.

Keywords: lying, police interrogators, lie acceptability, ultimatum game, pretend fairness

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Authors: Turkan Sultan Yasar Ismail, Mehmet Cetin, M. Danial Ismail, Hakan Sevik

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Nowadays, there is a need for the real world to be translated to the virtual environment by three-dimensional visualisation for restoration and promotional modelling of historic sites in protected areas. Visualisation models have also become the very important basis for the creation of three-dimensional Geographic Information System. The protection of historical and cultural heritage and documenting in Turkey as well as all over the world is an important issue. This heritage is a bridge between the past and the future of humanity. Many historical and cultural heritages suffer neglect and for reasons arising from natural causes. This is to determine the current status of the work and documenting information from the selected buildings. This process is important for their conservation and renovation work that might be done in the future. Kastamonu city is one of the historical cities in Turkey with a number of heritage buildings. However, Tufekciler Village is not visited and famous even though it includes several historical buildings and peaceful landscape. Digital terrestrial photogrammetry is one of the most important methods used in the documentation of cultural and historical heritage. Firstly, measurements were made primarily around creating polygon mesh and 3D model drawings of the structures to be modelled on images with the move to digital media such as picture size and by subsequent visualisation process. Secondly, a restoration project is offered to the village with the concept of eco-tourism with all scales such as, interior space to landscape design.

Keywords: eco-tourism, restoration, sustainability, cultural village

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Authors: Danielle Page

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Foregoing studies, statistics, and medical evaluations have established a relationship between Posttraumatic stress disorder (PTSD) and criminal justice involvement in Vietnam veterans. War is highly trauma inducing and can leave combat veterans with mental disorders ranging from psychopathic thoughts to suicidal ideation. The majority of those suffering are unaware that they have PTSD, and as a coping mechanism, they often turn to self isolation. Beyond isolation, many veterans with symptomatic PTSD turn to aggression and substance abuse to cope with their internal agony. The most common crimes committed by veterans with PTSD fall into the assault and drug/alcohol abuse categories. Thus, a relationship is established between veteran populations and the criminal justice system. This dissertation aims to define the relationship between PTSD and criminal justice involvement in veterans, explore the mediating factors in this relationship, and analyze numerous court cases in this subject area. Further, it will examine the ways in which crime rates can be reduced for veterans with symptoms of PTSD. This ranges from the improvement of healthcare systems to the implementation of special courts to handle veteran cases.

Keywords: psychotraumatology, forensic psychology, PTSD, vietnam veterans

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Authors: Ian Walmsley

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The aim of this paper is to explore the influence of time and temporality on the experience of coming off heroin in prison. The presentation draws on qualitative data collected during a small-scale pilot study of the role of self-care in the process of coming off drugs in prison. Time and temporality emerged as a key theme in the interview transcripts. Drug dependent prisoners experience of time in prison has not been recognized in the research literature. Instead, the literature on prison time typically views prisoners as a homogenous group or tends to focus on the influence of aging and gender on prison time. Furthermore, there is a tendency in the literature on prison drug treatment and recovery to conceptualize drug dependent prisoners as passive recipients of prison healthcare, rather than active agents. In building on these gaps, this paper argues that drug dependent prisoners experience multiple temporalities which involve an interaction between the body-times of the drug dependent prisoner and the economy of time in prison. One consequence of this interaction is the feeling that they are doing, at this point in their prison sentence, double prison time. The second part of the argument is that time and temporality were a means through which they governed their withdrawing bodies. In addition, this paper will comment on the challenges of prison research in England.

Keywords: heroin withdrawal, time and temporality, prison, body

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Authors: Ademuyiwa Agbonyin, Stamatis Zoras, Mohammad Zandi

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This paper investigates the extent to which building energy modelling can be informed based on preliminary information provided by infrared thermography using a thermal imaging camera in a walkthrough audit. The case-study building is the Sheffield Cathedral, built in the early 1400s. Based on an informative qualitative report generated from the thermal images taken at the site, the regions showing significant heat loss are input into a computer model of the cathedral within the integrated environmental solution (IES) virtual environment software which performs an energy simulation to determine quantitative heat losses through the building envelope. Building data such as material thermal properties and building plans are provided by the architects, Thomas Ford and Partners Ltd. The results of the modelling revealed the portions of the building with the highest heat loss and these aligned with those suggested by the thermal camera. Retrofit options for the building are also considered, however, may not see implementation due to a desire to conserve the architectural heritage of the building. Results show that thermal imaging in a walk-through audit serves as a useful guide for the energy modelling process. Hand calculations were also performed to serve as a 'control' to estimate losses, providing a second set of data points of comparison.

Keywords: historic buildings, energy retrofit, thermal comfort, software modelling, energy modelling

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Authors: Shaoyi Lu

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Background: Traditional Chinese medicine has been used to treat stroke, which is a major cause of morbidity and mortality. There is, however, no clear agreement about the optimal timing, population, efficacy, and predictive prognosis factors of traditional Chinese medicine supplemental therapy. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend. Key words: traditional Chinese medicine, acupuncture, Stroke, NIH stroke scale, Barthel index, predictive factor. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend.

Keywords: traditional Chinese medicine, complementary and alternative medicine, stroke, acupuncture

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Authors: Nafe Moradkhani, Frederick Benaben, Benoit Montreuil, Ali Vatankhah Barenji, Dima Nazzal

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In the context of the global pandemic, the practical management of the 2020 presidential election in the USA was a strong concern. To anticipate and prepare for this election accurately, one of the main challenges was to confront (i) forecasts of voter turnout, (ii) capacities of the facilities and, (iii) potential configuration options of resources. The approach chosen to conduct this anticipative study consists of collecting data about forecasts and using simulation models to work simultaneously on resource allocation and facility configuration of polling places in Fulton County, Georgia’s largest county. A polling place is a dedicated facility where voters cast their ballots in elections using different devices. This article presents the results of the simulations of such places facing pre-identified potential risks. These results are oriented towards the efficiency of these places according to different criteria (health, trust, comfort). Then a dynamic framework is introduced to describe risks as physical forces perturbing the efficiency of the observed system. Finally, the main benefits and contributions resulting from this simulation campaign are presented.

Keywords: performance, decision support, simulation, artificial intelligence, risk management, election, pandemics, information system

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Authors: James Pietris

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Glaucoma is a collection of irreversible optic neuropathies which, if left untreated, lead to severe visual field loss. These diseases are a leading cause of blindness across the globe and are estimated to affect approximately 80 million people, particularly women and people of Asian descent.1This represents a major burden on healthcare systems worldwide. Recently, there has been increasing interest in the potential of nicotinamide (vitamin B3) as a novel option in the management of glaucoma. This review aims to analyse the currently available literature to determine whether there is evidence of an association between nicotinamide adenine dinucleotide (NAD+) and glaucomatous optic neuropathy and whether nicotinamide has the potential to prevent or reverse these effects. The literature showed a strong connection between reduced NAD+ levels and retinal ganglion cell dysfunction through multiple different studies. There is also evidence of the positive effect of nicotinamide supplementation on retinal ganglion cell function in models of mouse glaucoma and in a study involving humans. Based on the literature findings, a recommendation has been made that more research into the efficacy, appropriate dosing, and potential side effects of nicotinamide supplementation is needed before it can be definitively determined whether it is appropriate for widespread prophylactic and therapeutic use against glaucoma in humans.

Keywords: glaucoma, nicotinamide, vitamin B3, optic neuropathy

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Authors: Elzbieta Sikorska-Simmons

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

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

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Authors: Aticha Kwaengsopha

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The purpose of this research was to study the behaviour and related factors that tourists utilized for making decisions to choose their accommodations at a tourist destination, Bangkontee district, Samut Songkhran Province, Thailand. The independent variables included gender, age, income, occupation, and region, while the three important dependent variables included selection behaviour, factors related selection process, and satisfaction of the accommodation service. A total of 400 Thai and international tourists were interviewed at tourist destination of Bangkontee. A questionnaire was used as the tool for collecting data. Descriptive statistics in this research included percentage, mean, and standard deviation. The findings revealed that the majority of respondents were single, female, and with the age between 23-30 years old. Most of the international tourists were from Asia and planned to stay in Thailand about 1-6 days. In addition, the majority of tourists preferred to travel in small groups of 3 persons. The majority of respondents used internet and word of mouth as the main tool to search for information. The majority of respondents spent most of their budget on food & drink, accommodation, and travelling. Even though the majority of tourists were satisfied with the quality of accommodation, the price range of accommodation, and the image of accommodation and the facilities of the accommodation, they indicated that they were not likely to re-visit Thailand in the near future.

Keywords: behaviour, decision factors, tourists, media engineering

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Authors: Jessie Fazel, Kristen Smith

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Human trafficking is a multi-billion-dollar criminal industry that affects 24.9 million people around the world. There are several different types of trafficking, the most common being sex trafficking, labor trafficking, and domestic servitude. Survival sex is common in the pediatric population, as they engage in sex for food, a place to sleep, or other basic needs. Statistics show that health care workers are at a unique advantage to help identify victims and get them the help they need, as 88% of trafficked victims encounter a health care worker while being trafficked. Unfortunately, victims don’t usually self-identify that they are being trafficked and the situations they face can vary dramatically. It is imperative to remember that traditional red flags are not always present in the pediatric population. Risk factors and red flags with their history and physical exam are one of the best indicators that health care providers need to be vigilant in looking at. There are numerous barriers for disclosure in the healthcare setting. Periods of time before and after disclosure are often emotionally difficult and could be dangerous for the victim. It is extremely important to have a plan in place for intervention if the victim does disclose trafficking. A trauma informed approach to medical and mental health interventions, that focus on safety, are vital in this population. This is happening where you live and you can make a difference in their lives.

Keywords: human trafficking, public health, emergency medicine, sexual health

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Authors: Mehrnaz Mostafavi, Mahtab Shabani, Alireza Azani, Fatemeh Ghafari

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Artificial intelligence (AI) can transform breast cancer diagnosis and therapy by providing sophisticated solutions for screening, imaging interpretation, histopathological analysis, and treatment planning. This literature review digs into the many uses of AI in breast cancer treatment, highlighting the need for collaboration between AI scientists and healthcare practitioners. It emphasizes advances in AI-driven breast imaging interpretation, such as computer-aided detection and diagnosis (CADe/CADx) systems and deep learning algorithms. These have shown significant potential for improving diagnostic accuracy and lowering radiologists' workloads. Furthermore, AI approaches such as deep learning have been used in histopathological research to accurately predict hormone receptor status and categorize tumor-associated stroma from regular H&E stains. These AI-powered approaches simplify diagnostic procedures while providing insights into tumor biology and prognosis. As AI becomes more embedded in breast cancer care, it is crucial to ensure its ethical, efficient, and patient-focused implementation to improve outcomes for breast cancer patients ultimately.

Keywords: breast cancer, artificial intelligence, cancer diagnosis, clinical practice

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Authors: Danika Tynes

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Innovations in technology have implications for sustainable development in health and wellness. Remote monitoring is one innovation for which the evidence-base has grown to support its viability as a quality healthcare delivery adjunct. This research reviews global data on telehealth adoption, in particular, remote monitoring, and the conditions under which its success becomes more likely. System-level indicators were selected to represent four constructs of DoI theory (relative advantage, compatibility, complexity, and observability) and assessed against 5 types of Telehealth (Teleradiology, Teledermatology, Telepathology, Telepsychology, and Remote Monitoring) using ordinal logistic regression. Analyses include data from 84 countries, as extracted from the World Health Organization, World Bank, ICT (Information Communications Technology) Index, and HDI (Human Development Index) datasets. Analyses supported relative advantage and compatibility as the strongest influencers of remote monitoring adoption. Findings from this research may help focus on the allocation of resources, as a sustainability concern, through consideration of systems-level factors that may influence the success of remote monitoring adoption.

Keywords: remote monitoring, diffusion of innovation, telehealth, digital health

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Authors: Upeksha Jayasuriya

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The sudden transition from onsite to online teaching/learning due to the COVID-19 pandemic called for a need to incorporate feasible as well as effective methods of online teaching in most developing countries like Sri Lanka. The English as a Second Language (ESL) classroom faces specific challenges in this adaptation, and teaching writing can be identified as the most challenging task compared to teaching the other three skills. This study was therefore carried out to explore the challenges of teaching writing online and to provide effective means of overcoming them while taking into consideration the attitudes of students and teachers with regard to learning/teaching English writing via online platforms. A survey questionnaire was distributed (electronically) among 60 students from the University of Colombo, the University of Kelaniya, and The Open University in order to find out the challenges faced by students, while in-depth interviews were conducted with 12 lecturers from the mentioned universities. The findings reveal that the inability to observe students’ writing and to receive real-time feedback discourage students from engaging in writing activities when taught online. It was also discovered that both students and teachers increasingly prefer Google Slides over other platforms such as Padlet, Linoit, and Jam Board as it boosts learner autonomy and student-teacher interaction, which in turn allows real-time formative feedback, observation of student work, and assessment. Accordingly, it can be recommended that teaching writing online can be better facilitated by using interactive platforms such as Google Slides, for it promotes active learning and student engagement in the ESL class.

Keywords: ESL, teaching writing, online teaching, active learning, student engagement

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Authors: Saima Hirani, Emmanuela Ojukwu, Nilanga Aki Bandara

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Background: Mental health challenges that begin during the youth age period may continue across the entire life course. One way to support youth mental health is to encourage youth engagement in prosocial activities. This study aimed to explore youth’s perceptions about helping others and mental well-being, barriers, and enablers for youth to initiate and continue prosocial activities, and strategies for developing the attribute of helping others in youth. Methods: We conducted a qualitative study using semi-structured, virtual interviews with 18 young individuals (aged 16-24 years) living in Vancouver, British Columbia, Canada. Results: Youth perceived helping others as a source of feeling peace and calm, finding meaning in life, experiencing social connection and promoting self-care, and relieving stress. Participants reported opportunities to learn new skills, the role of religion, social connections, previous positive experiences, and role modeling as enablers for their prosocial behaviour. Heavy time commitment, negative behaviour from others, self-doubt, and late exposure to such activities were considered barriers by youth when participating in prosocial activities. Youth also brought forward key recommendations for engaging youth in helping others. Conclusions: The findings of this study support the notion that youth have positive experiences when engaging in helping others and that involving young people in prosocial activities could be used as a protective intervention for promoting youth mental health and overall well-being.

Keywords: helping others, prosocial behaviour, youth, mental well-being

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