Search results for: architecture department in Islamic

Authors: Apoorva Vinod, Archana Mathur, Snehanshu Saha

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Though there exists a plethora of Activation Functions (AFs) used in single and multiple hidden layer Neural Networks (NN), their behavior always raised curiosity, whether used in combination or singly. The popular AFs –Sigmoid, ReLU, and Tanh–have performed prominently well for shallow and deep architectures. Most of the time, AFs are used singly in multi-layered NN, and, to the best of our knowledge, their performance is never studied and analyzed deeply when used in combination. In this manuscript, we experiment with multi-layered NN architecture (both on shallow and deep architectures; Convolutional NN and VGG16) and investigate how well the network responds to using two different AFs (Sigmoid-Tanh, Tanh-ReLU, ReLU-Sigmoid) used alternately against a traditional, single (Sigmoid-Sigmoid, Tanh-Tanh, ReLUReLU) combination. Our results show that using two different AFs, the network achieves better accuracy, substantially lower loss, and faster convergence on 4 computer vision (CV) and 15 Non-CV (NCV) datasets. When using different AFs, not only was the accuracy greater by 6-7%, but we also accomplished convergence twice as fast. We present a case study to investigate the probability of networks suffering vanishing and exploding gradients when using two different AFs. Additionally, we theoretically showed that a composition of two or more AFs satisfies Universal Approximation Theorem (UAT).

Keywords: activation function, universal approximation function, neural networks, convergence

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Authors: Wang Haining, Zhang Hong

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In China, rapid urbanization needs more and more buildings constructed for the growing population in cities. With the help of the methodology which contains investigation, contrastive analysis, design based on component with BIM and experiment before real construction, this research based on mobile light structure system, trying to the sustainable problems partly in present China by systematic study. The system cannot replace the permanent heavy structure completely. So the goal is the improvement of the whole building system by the addition of light structure. This house system uses modularized envelopes and standardized connections, which are pre-fabricated and assembled in factories and transported like containers. Aluminum is used as the structural material in this system, and inorganic thermal insulation material used in the envelope, which have high fireproof properties. The relationship between manufactory and construction of the system is progressive hierarchy. They exist as First Industrial, Second Industrial, Third Industrial and Site Assembly Stage. It could maximize the land usage capacity by fully exploit the area where normal permanent architecture can't take advantage of. Not only the building system itself especially the thermal isolated materials used and active solar photovoltaic system equipped can save energy, but also the way of product development is sustainable.

Keywords: aluminum house, light Structure, rapid assembly, repeat construction

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Authors: Naila Awan, Shahrukh Inam

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This study was conducted to highlight the role of basic health units in district Swabi, which provides primary health services to the people of district Swabi having four tehsils. Tehsil Swabi was selected purposively for the study. Three villages were purposively selected from district Swabi. A sum of 110 respondents was randomly selected for interview i.e., 27 from Botakaa, 39 from Gulatee, and 44 from Darra Cham, using proportion allocation sampling technique. A pretested and well-designed interview schedule was used to collect as per the objective and Chi square test was applied to find an association between the quality of medicines and health improvement. The output of the test shows that the government was doing its best and providing enough facilities to the individuals at the healthcare units, and they were utilizing them. These resources were easily accessible to the people of the community. Medicines provided by the government were of good quality and quantity. There were also school health sessions and community health sessions (SHS/CHS) to deliver useful information and awareness regarding health problems and diseases were conducted. The staff of the BHU was present at work time and was performing their duties. The respondents seemed satisfied with their behavior and the duty of the staff. However, there were no emergency resources existing at the BHU after the working hours of the medical staff. It is recommended that government should provide appropriate quantity and quality of medicines to the basic health units so that these healthcare units don’t have to face any shortages regarding medicines at the end of the month. In addition, laboratory and blood testing facilities need to be provided in the basic health units, and also the infrastructure should be made suitable, satisfactory, and more functional.

Keywords: community health session, basic health units, outpatient department, tuberculosis

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Authors: Daud Muhammad

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Introduction: Ankle radiographs are frequently requested in Emergency Departments (ED) for patients presenting with traumatic ankle pain. The Ottawa Ankle Rules (OAR) serve as a clinical guideline to determine the necessity of these radiographs, aiming to reduce unnecessary imaging. This audit was conducted to evaluate the adequacy of clinical information provided in radiograph requests in relation to the OAR. Methods: A retrospective analysis was performed on 50 consecutive ankle radiograph requests under ED clinicians' names for patients aged above 5 years, specifically excluding follow-up radiographs for known fractures. The study assessed whether the provided clinical information met the criteria outlined by the OAR. Results: The audit revealed that none of the 50 radiograph requests contained sufficient information to satisfy the Ottawa Ankle Rules. Furthermore, 10 out of the 50 radiographs (20%) identified fractures. Discussion: The findings indicate a significant lack of adherence to the OAR, suggesting potential overuse of radiography and unnecessary patient exposure to radiation. This non-compliance may also contribute to increased healthcare costs and resource utilization, as well as possible delays in diagnosis and treatment. Recommendations: To address these issues, the following recommendations are proposed: (1) Education and Training: Enhance awareness and training among ED clinicians regarding the OAR. (2) Standardised Request Forms: Implement changes to imaging request forms to mandate relevant information according to the OAR. (3) Scan Vetting: Promote awareness among radiographers to discuss the appropriateness of scan requests with clinicians. (4) Regular re-audits should be conducted to monitor improvements in compliance.

Keywords: Ottawa ankle rules, ankle radiographs, emergency department, traumatic pain

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Authors: Ma'ruf

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Pilgrimage has a universal value, founded in every religion. No exception to Islam, has a ritual value, and became part of the religion, as well as the procession of a social culture in nature. The tradition of pilgrimage, especially in Indonesia, rooted in the society, because the Islam that entered into the archipelago through Sufism (tasawuf). In the Sufi tradition, the interconnecty of the human spirit (ruh) to the spirit (ruh) of God, must go through a guardian (wasilah) appointed by God himself ,the prophet Muhammad and wali. In the process of pilgrimage rituals usually by reading the prayer to praise God, the prophet and wali, then convey intent (hajat). In the pilgrimage procession, usually not only done in the house, but aslo completed the process by direct pilgrimage visiting the tombs of saints. The tradition of pilgrimage, especially in Indonesia continues to be maintained, and still attached to the traditions in Nahdiyin (NU followers). The relationship with God manifested in wasilah prayer to God, the prophet Muhammad, the best companions of the Prophet and Nine wali (Songo), who had been influential in spreading Islam in Java. The tradition of pilgrimage in Indonesia is also linked to the Shia community in Indonesia, along with a growing number of followers of the Shia in Indonesia, especially after the Islamic revolution of Iran after the 1979. Pilgrimage in the Shia community, Likewise NU members also pray with supplication of tawasul to the Prophet and Shia Imams. If NU members to make improvements pilgrimage to visit the tomb wali Songo in Java, residents Shia pilgrimage rituals abroad, usually one package with umrah trip, with a pilgrimage to the tomb of the prophet, proceed to the tomb of the Imam Shia, in Iran and Iraq. Trends of pilgrimage as a ritual in the Indonesian Shia tradition, together with the growing number of Shia residents increased, followed by increasing the awareness (syi’isme) - bond with the Imam, Shia. In every certain months (arbaeen, asyuro) Shia pilgrims routinely perform pilgrimage, along with increasing number spiritual travel.

Keywords: traditional approach, religious experience, culture, religion, pilgrimage, Syria

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Authors: Erin Brands-Saliba

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In this evaluation study, we explore the efficacy and implementation of the five guiding principles of Bekaadendang “Being Peaceful,” a suite of services facilitated by our Anti-Human Trafficking Team, and a pivotal component of the Holistic Prevention Services department at NCFST. The guiding principles—trauma-informed care, cultural safety, 4-quadrant medicine wheel approach, harm reduction, and after-care peer support—are the foundation of Bekaadendang's mission to support at-risk individuals and survivors of human trafficking. This evaluation is of paramount importance given the profound impact of human trafficking on these communities and aims to ensure that Bekaadendang's principles are not only understood by staff but experienced by community members in a purposeful and meaningful manner. The issues at the heart of this evaluation are deeply entrenched in the historical and contemporary challenges faced by Indigenous communities, with a particular emphasis on Indigenous women and 2SLGBTQQIA+ individuals. Well-documented reports like the National Inquiry into Missing and Murdered Indigenous Women and Girls (MMIWG) have cast a glaring light on the disproportionately high rates of violence, exploitation, and trafficking experienced by these communities. The MMIWG report underlines the pressing need for holistic, culturally informed interventions like Bekaadendang. Furthermore, the research efforts of scholars, both Indigenous and non-Indigenous, shed light on the persistent systemic issues that make Indigenous individuals more vulnerable to trafficking and exploitation. Recognizing this broader context is crucial to truly grasp the importance of evaluating the guiding principles that underpin Bekaadendang's service model.

Keywords: human trafficking, indigenous healing, MMIWG, program evaluation

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Authors: F. Amirarfaei, K. Khorasani

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In this paper, reconfigurable consensus achievement of a team of agents with marginally stable linear dynamics and single input channel has been considered. The control algorithm is based on a first order linear protocol. After occurrence of a LOE fault in one of the actuators, using the imperfect information of the effectiveness of the actuators from fault detection and identification module, the control gain is redesigned in a way to still reach consensus. The idea is based on the modeling of change in effectiveness as change of Laplacian matrix. Then as special cases of this class of systems, a team of single integrators as well as double integrators are considered and their behavior subject to a LOE fault is considered. The well-known relative measurements consensus protocol is applied to a leaderless team of single integrator as well as double integrator systems, and Gersgorin disk theorem is employed to determine whether fault occurrence has an effect on system stability and team consensus achievement or not. The analyses show that loss of effectiveness fault in actuator(s) of integrator systems affects neither system stability nor consensus achievement.

Keywords: multi-agent system, actuator fault, stability analysis, consensus achievement

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Authors: Zia Ullah, Ruh Ullah

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A research study was conceded in four locations (Swat, Dir, Kakul and Balakot) of Khyber Pakhtunkhwa, to find agro-climatic classes by using aridity index, Growing Degree Days of wheat and maize, crop growth index and Spatio-temporal analysis of rainfall by using long term climatic data (1970-2010). The climatic data used for research was acquired from Pakistan Meteorological Department (PMD) Islamabad, Agriculture Research Institute, Weather Station Peshawar and Tarnab Peshawar. Agro-climatic classes of each location were determined using three criteria mean temperature of the coldest month, mean temperature of the warmest month and aridity index. The agro-climatic classes of Dir, Swat, Kakul and Balakot were classified as Humid, Cold and very Warm (H-K-VW). Average aridity index of wheat for Dir, Swat, Kakul, and Balakot was 2.23, 2.67, 1.94 and 2.34 and for Maize was 1.31, 1.26, 1.97, and 2.83 respectively. The overall and decade-wise trend of GDD of Wheat and Maize was declined in Swat and Kakul while increased in Dir and Balakot.The average maximum CGI (1.26) and (0.73) of Wheat and Maize was observed for Balakot and Dir, while the minimum (1.09) and (0.62) was observed for Swat and Kakul. Spatio-temporal analysis of rainfall shows that the trend has increased in Swat while decreased in Dir, Kakul and Balakot. From the relation between rainfalls with altitude showed that there was an increasing trend between rainfalls with altitude. The maximum average rainfall was in Swat (2703mm) on altitude 2000m while the minimum average rainfall was observed in Kakul (1410mm) on altitude of 1255m.

Keywords: agro-climatic zones, aridity index, GDD, rainfall

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Authors: Scarlet Alejandra Romano, Joni Kareco

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The three pillars of sustainability (social, economic and environmental) are relevant concepts to the Architecture, Engineering, and Construction (AEC) industry because of the increase of international agreements and guidelines related to this topic during the last years. Considering these three pillars, the AEC industry faces important challenges, for instance, to decrease the carbon emissions (environmental challenge), design sustainable spaces for people (social challenge), and improve the technology of this field to reduce costs and environmental problems (economic and environmental challenge). One alternative to overcome these challenges is Building Information Modelling program (BIM) because according to several authors, this technology improves the performance of the sustainable buildings in all their lifecycle phases. The main objective of this paper is to explore and analyse the current advantages and disadvantages of the BIM implementation in the life-cycle of sustainable buildings considering the three pillars of sustainability as analysis parameters. The methodology established to achieve this objective is exploratory-descriptive with the literature review technique. The partial results illustrate that despite the BIM disadvantages and the lack of information about its social sustainability advantages, this software represents a significant opportunity to improve the three sustainable pillars of the sustainable buildings.

Keywords: building information modelling, building lifecycle analysis, sustainability, sustainable buildings

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Authors: Telesphore Tiendrebeogo, Oumarou Sié

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Cloud computing technologies have attracted considerable interest in recent years. Thus, these latters have become more important for many existing database applications. It provides a new mode of use and of offer of IT resources in general. Such resources can be used “on demand” by anybody who has access to the internet. Particularly, the Cloud platform provides an ease to use interface between providers and users, allow providers to develop and provide software and databases for users over locations. Currently, there are many Cloud platform providers support large scale database services. However, most of these only support simple keyword-based queries and can’t response complex query efficiently due to lack of efficient in multi-attribute index techniques. Existing Cloud platform providers seek to improve performance of indexing techniques for complex queries. In this paper, we define a new cloud computing architecture based on a Distributed Hash Table (DHT) and design a prototype system. Next, we perform and evaluate our cloud computing indexing structure based on a hyperbolic tree using virtual coordinates taken in the hyperbolic plane. We show through our experimental results that we compare with others clouds systems to show our solution ensures consistence and scalability for Cloud platform.

Keywords: virtual coordinates, cloud, hyperbolic plane, storage, scalability, consistency

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Authors: Remon Karam Zakry Kelada

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This survey research ambitions to examine the usual of carrier quality of meals and beverage provider staffs in lodge business by way of studying the carrier fashionable of 3 pattern inns, Siam Kempinski lodge Bangkok, four Seasons lodge Chiang Mai, and Banyan Tree Phuket. as a way to locate the international provider general of food and beverage provider, triangular research, i.e. quantitative, qualitative, and survey were hired. on this research, questionnaires and in-depth interview have been used for getting the statistics on the sequences and method of services. There had been three components of modified questionnaires to degree carrier pleasant and visitor’s satisfaction inclusive of carrier facilities, attentiveness, obligation, reliability, and circumspection. This observe used pattern random sampling to derive topics with the go back fee of the questionnaires changed into 70% or 280. information have been analyzed via SPSS to find mathematics mean, SD, percent, and comparison by using t-take a look at and One-manner ANOVA. The outcomes revealed that the service first-rate of the three lodges have been in the worldwide stage that could create excessive pride to the international clients. hints for studies implementations have been to hold the area of precise carrier satisfactory, and to enhance some dimensions of service fine together with reliability. training in service fashionable, product expertise, and new generation for employees must be provided. furthermore, for you to develop the provider pleasant of the enterprise, training collaboration among inn corporation and academic institutions in food and beverage carrier should be considered.

Keywords: food and beverage staff, food poisoning, food production, hygiene knowledge BPA, health, regulations, toxicity service standard, food and beverage department, sequence of service, service method

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Authors: Raweyah Al-Sedairawi

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While high-rise housing detained massive negative connotations on several societies and well-being, this typology did deliver housing demand efficiently. Despite its adverse reference due to declining precedents, high-rise housing is still in global demand. Yet the suitability of this typology is still questioned. In this research, the suitability of high-rise housing as a socio-culturally sustainable solution to meet housing demands will be examined. By questioning what is the potential of high-rise housing as a socio-culturally sustainable solution for housing demands, the research will examine some high-rise housing practices. Through reviewing the literature on the origins of high-rise housing, how and why they were developed, some unsuccessful cases, and some successful cases, with the identification of factors for successful high-rise living. Thus, the research groundings will materialize from existing patterns of housing demands. Whilst most of the literature covers the housing market from an economic, real estate, and political perspective, there is less amount that discloses occupants’ reactions towards this typology and its appropriateness for the reason that income controls individuals’ choices. To bridge the gap, the prospect of implementing the study would be effective. This will be applied through a mixture of a qualitative and a quantitative methodology by conducting questionnaires and focus groups on existing cases of high-net-worth residential towers.

Keywords: architecture, behaviors, high-rise, socio-cultural, sustainability

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Authors: Omkar More, Isha Saini, Gracy Mathai

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To study whether there is any clinical correlation between pterygium and dry eye and to evaluate the status of the tear film in patients with pterygium. Methods: 100 eyes with pterygium were compared with 100 control eyes without pterygium. Patients between 20 – 70 years were included in the study. A detailed history was taken and Schirmer’s test and TBUT were performed on all to evaluate the status of dry eye. Schirmer’s test ˂ 10 mm and TBUT ˂10 seconds was considered abnormal. Results: Maximum number (52) of patients affected by dry eye in both the groups were in the age group 31-40 years which statistically showed age as a significant factor of association for both pterygium and dry eye (P < 0.01).Schirmer’s test was slightly reduced in patients with pterygium(18.73±5.69 mm). TBUT was significantly reduced in the case group (12.26±2.24sec).TBUT decreased maximally in 51-60 yrs age group (13.00±2.77sec) with pterygium showing a tear film instability. On comparison of pterygia and controls with normal and abnormal tear film, Odd’s Ratio was 1.14 showing a risk of dry eye in pterygia patients to be 1.14 times higher than controls. Conclusion: Whether tear dysfunction is a precursor to pterygium growth or pterygium causes tear dysfunction is still not clear. Research and clinical evidence, however, suggest that there is a relationship between the two. This study is, therefore, undertaken to investigate the correlation between pterygium and dry eye. The patients with pterygia were compared with normals to evaluate their status regarding dryness. A close relationship exists between ocular irritation symptoms and functional evidence of tear instability. Schirmer’s test and TBUT should routinely be used in the outpatient department to diagnose dry eye in patients with pterygium and these patients should be promptly treated to prevent any sight-threatening complications.

Keywords: footfall, nursing assessment, quality improvement, six sigma

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Authors: Mahmoud Hassanin, Roshan Thawale, Kiran Yelamati

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Background: During current practice, intraoperative regular endotracheal cuff pressure monitoring is not routine, despite the significant number of clinicians interested in checking it after intubation to ensure a good seal and adequate ventilation. Aims and objectives: to highlight that the current practice has no guidance related to regular intra-operative monitoring of the endotracheal tube cuff pressure, which can improve patient safety and post-operative experience. Methods: local department survey was done targeting anaesthetists' current practice, measuring their knowledge and problem awareness to improve patient satisfaction and change the current approach. Results: The participants were not using the manometer, despite their interest in ensuring that the cuff pressure was high enough and there was a proper seal. More than 50% of the participant don't know the ideal range of the endotracheal tube cuff pressure range, and 32% don't know whether it is available or not in the theatre. Despite the previous finding, 100% of the participants used different methods to ensure adequate cuff pressure. The collected data revealed that at least 26% of the participant confirmed that they had seen patients having post-intubation complications. Conclusion: There is an increasing importance placed on quality assurance. Clinical practice varies widely among practitioners, with the only consistency being the omission of cuff manometers during routine intra-operative management, despite their proven benefit and efficacy. Encourage the anaesthetists and ODPs to use cuff pressure manometers. The availability of portable pressure manometers can help to maintain safe cuff pressures in patients requiring endotracheal intubation.

Keywords: endotracheal cuff pressure, intra-operative monitoring, current practice, patient satisfaction

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Authors: Binish Ahmed

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Corporate Social Responsibility (CSR) is regarded as voluntary behaviors that contribute to the social welfare based on the concept of sustainable development. The corporations should not only stress on their economic and business outcomes but also pay attention to their effect on the society and environment. It could attract investors and customers, as well as maintain a positive interaction with the government. In spite of the broad diffusion, and its potential significance to employees' perspective, CSR is now examined and has built-in Organizational Behavior (OB), and Human Resource Management (HRM) look into the broad structure of relationship between employees' perspective, work attitudes and behavior to improve the research on CSR. The purpose of this research is to investigate the impact of employees’ perception of CSR on work attitudes and behaviors of employees. A conceptual framework is proposed, based on the literature and practices. The research would conduct the primary data survey of convenient sampling from the employees and managers-using detailed questionnaire- to address the following questions. The survey of 180 respondents of age greater than 20 having at least six-month experience from companies based in Karachi are source of data. The application of professional empirical models for data analysis and interpretation are source to draw the conclusion. 1. What are the dynamics of CSR in an organization? Why is it important to have a CSR department? What sort of business approach are CSR activities practiced? Do CSR activities improve the quality of life of workplace? And, how it linked with welfare of society? 2. How the positive job attitude and behavior does encourage the employees about the perception of CSR? How is it linked with the job satisfaction? What is the relationship between employees’ perception of CSR and job satisfaction?

Keywords: corporate social responsibility, job satisfaction, organizational commitment, work behaviors

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Authors: S. Vadivukkarasi, K. Karthi, M. Karthick, C. Dinesh, S. Santhosh, A. Yogaraj

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The appointment system was designed to minimize patient’s idle time overlooking patients waiting time in hospitals. This is no longer valid in today’s consumer oriented society. Long waiting times for treatment in the outpatient department followed by short consultations has long been a complaint. Nowadays, customers use waiting time as a decisive factor in choosing a service provider. Queuing theory constitutes a very powerful tool because queuing models require relatively little data and are simple and fast to use. Because of this simplicity and speed, modelers can be used to quickly evaluate and compare various alternatives for providing service. The application of queuing models in the analysis of health care systems is increasingly accepted by health care decision makers. Timely access to care is a key component of high-quality health care. However, patient delays are prevalent throughout health care systems, resulting in dissatisfaction and adverse clinical consequences for patients as well as potentially higher costs and wasted capacity for providers. Arguably, the most critical delays for health care are the ones associated with health care emergencies. The allocation of resources can be divided into three general areas: bed management, staff management, and room facility management. Effective and efficient patient flow is indicated by high patient throughput, low patient waiting times, a short length of stay at the hospital and overtime, while simultaneously maintaining adequate staff utilization rates and low patient’s idle times.

Keywords: appointment system, patient scheduling, bed management, queueing calculation, system analysis

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Authors: Muzamil Mahmood, Afshan Naseem, Muhammad Zeeshan Mirza, Yasir Ahmad, Masood Raza

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The purpose of this research is to analyze how aviation maintenance workers’ characteristics and work demand affect their development of work-related musculoskeletal disorders (WMSDs). Guided by literature on task characteristics, work demand, and WMSDs, data is collected from 128 aviation maintenance workers of private and public airlines. Data is then analyzed through descriptive and inferential statistics. It is found that task characteristics have a significant positive effect on WMSDs and an increase in tasks performed by aviation maintenance workers leads to increase in WMSDs. Work demand did not have a significant effect on WMSDs. The task characteristics of aviation maintenance workers moderates the relationship between their work demand and WMSDs. This reveals that task characteristics of aviation maintenance workers enhance the effect of work demand on WMSDs. The task characteristics of aviation maintenance workers are challenging and unpredictable. Subsequently, WMSDs are prevalent among aviation maintenance workers. The work demand of aviation maintenance workers does not influence their development of WMSDs. Pakistan Civil Aviation Authority should minimize the intensity of tasks assigned to aviation maintenance workers by introducing work dynamisms such as task sharing, job rotation, and probably teleworking to enhance flexibility. Human Resource and Recruitment Department need to consider the ability and fitness levels of potential aviation maintenance workers during recruitment. In addition, regular physical activities and ergonomic policies should be put in place by the management of the Pakistan Civil Aviation Authority to reduce the incidences of WMSDs.

Keywords: work related musculoskeletal disorders, ergonomics, occupational health and safety, human factors

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Authors: Meng-Huan Wu, Wei-Er Wang, Tsu-Nai Wang, Wei-Jian Hsu, Vincent Chin-Hung Chen

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Objective: Studies have reported a strong link between asthma and bipolar disorder. We conducted a 17-year community-based large cohort study to examine the relationship between asthma, early smoking initiation, and bipolar disorder during adolescence and early adulthood. Methods: A total of 162,766 participants aged 11–16 years were categorized into asthma and non-asthma groups at baseline and compared within the observation period. Covariates during late childhood or adolescence included parental education, cigarette smoking by family members of participants, and participant’s gender, age, alcohol consumption, smoking, and exercise habits. Data for urbanicity, prednisone use, allergic comorbidity, and Charlson comorbidity index were acquired from the National Health Insurance Research Database. The Cox proportional-hazards model was used to evaluate the association between asthma and bipolar disorder. Results: Our findings revealed that asthma increased the risk of bipolar disorder after adjustment for key confounders in the Cox proportional hazard regression model (adjusted HR: 1.31, 95% CI: 1.12-1.53). Hospitalizations or visits to the emergency department for asthma exhibited a dose–response effect on bipolar disorder (adjusted HR: 1.59, 95% CI: 1.22-2.06). Patients with asthma with onset before 20 years of age who smoked during late childhood or adolescence had the greatest risk for bipolar disorder (adjusted HR: 3.10, 95% CI: 1.29-7.44). Conclusions: Patients newly diagnosed with asthma had a 1.3 times higher risk of developing bipolar disorder. Smoking during late childhood or adolescence increases the risk of developing bipolar disorder in patients with asthma.

Keywords: adolescence, asthma, smoking, bipolar disorder, early adulthood

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Authors: Muhammad Ejaz1

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Rework has been defined as: "The unnecessary effort of re-doing a process or activity that was incorrectly implemented the first time." A great threat to the construction industry is rework. By and large due attention has not been given to avoid the causes of reworks, resulting time and cost over runs, in civil engineering projects. Besides these direct consequences, there might also be indirect consequences, such as stress, de-motivation or loss of future clients. When delivered products do not meet the requirements or expectations, work often has to be redone. Rework occurs in various phases of the construction process or in various divisions of a company. Rework can occur on the construction site or in a management department due to for example bad materials management. Rework can also have internal or external origins. Changes in clients’ expectations are an example of an external factor that might lead to rework. Rework can cause many costs to be higher than calculated at the start of the project. Rework events can have many different origins and for this research they have been categorized into four categories; changes, errors, omissions, and damages. The research showed that the major source of reworks were non professional attitude from technical hands and ignorance of total quality management principals by stakeholders. It also revealed that sources of reworks have not major differences among project categories. The causes were further analyzed by interviewing employees. Based on existing literature an extensive list of rework causes was made and during the interviews the interviewees were asked to confirm or deny statements regarding rework causes. The causes that were most frequently confirmed can be grouped into the understanding categories. 56% (max) of the causes are change-related, 30% (max) is error-related and 18% (max) falls into another category. Therefore, by recognizing above mentioned factors, reworks can be reduced to a great extent.

Keywords: total quality management, construction industry, cost overruns, rework, material management, client’s expectations

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Authors: Chinmay V. Deshpande

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Purpose: To assess the efficiency of visual functions and visual skills in strabismic & anisometropic amblyopes and to assess visual acuity and contrast sensitivity in anisometropic amblyopes with spectacles & contact lenses. Method: In a prospective clinical study, 32 children ageing from 5 to 15 years presenting with amblyopia in a pediatric department of Shri Ganapati Netralaya Jalna, India, were assessed for a period of three & half months. Visual acuity was measured with Snellen’s and Bailey-Lovie log MAR charts whereas contrast sensitivity was measured with Pelli-Robson chart with spectacles and contact lenses. Saccadic movements were assessed with SCCO scoring criteria and accommodative facility was checked with ±1.50 DS flippers. Stereopsis was assessed with TNO test. Results: By using Wilcoxon sign rank test p-value < 0.05 (< 0.001), the mean linear visual acuity was 0.29 (≈ 6/21) and mean single optotype visual acuity found to be 0.36 (≈ 6/18). Mean visual acuity of 0.27(≈ 6/21) with spectacles improved to 0.33 (≈ 6/18) with contact lenses in amblyopic eyes. The mean Log MAR visual acuity with spectacles and contact lens were found to be 0.602( ≈6/24) and 0.531(≈ 6/21) respectively. The contrast threshold out of 20 amblyopic eyes shows that mean contrast threshold changed in 9 patients from spectacles 0.27 to contact lens 0.19 respectively. The mean accommodative facility assessed was 5.31(± 2.37). 24 subjects (75%) revealed marked saccadic defects on the test applied. 78% subjects didn’t show even gross stereoscopic ability on TNO test. Conclusion: This study supports the facts about amblyopia and associated deficits in visual skills which are claimed in previous studies. In addition, anisometropic amblyopia can be managed better with contact lenses.

Keywords: strabismus, anisometropia, amblyopia, contrast sensitivity, saccades, stereopsis

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Authors: Jamshaid Ul Rahman, Faiza Makhdoom, Dianchen Lu

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Activation functions play a decisive role in determining the capacity of Deep Neural Networks (DNNs) as they enable neural networks to capture inherent nonlinearities present in data fed to them. The prior research on activation functions primarily focused on the utility of monotonic or non-oscillatory functions, until Growing Cosine Unit (GCU) broke the taboo for a number of applications. In this paper, a Convolutional Neural Network (CNN) model named as ASU-CNN is proposed which utilizes recently designed activation function ASU across its layers. The effect of this non-monotonic and oscillatory function is inspected through feature map visualizations from different convolutional layers. The optimization of proposed network is offered by Adam with a fine-tuned adjustment of learning rate. The network achieved promising results on both training and testing data for the classification of CIFAR-10. The experimental results affirm the computational feasibility and efficacy of the proposed model for performing tasks related to the field of computer vision.

Keywords: amplifying sine unit, activation function, convolutional neural networks, oscillatory activation, image classification, CIFAR-10

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Authors: Yu-Hong Lin

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Background: An adverse drug reaction (ADR) reported is an injury which caused by taking medicines. Sometimes the severity of ADR reported may be minor, but sometimes it could be a life-threatening situation. In order to provide healthcare professionals as a better reference in clinical practice, we do data collection and analysis from our hospital. Methods: This was a retrospective study of ADRs reported performed from 2014 to 2015 in our hospital in Taiwan. We collected assessment items of ADRs reported, which contain gender and age, occurring sources, Anatomical Therapeutic Chemical (ATC) classification of suspected drugs, types of adverse reactions, Naranjo score calculating by Naranjo Adverse Drug Reaction Probability Scale and so on. Results: The investigation included two hundred and seven ADRs reported. Most of ADRs reported were occurring in outpatient department (92%). The average age of ADRs reported was 65.3 years. Less than 65 years of age were in the majority in this study (54%). Majority of all ADRs reported were males (51%). According to ATC classification system, the major classification of suspected drugs was cardiovascular system (19%) and antiinfectives for systemic use (18%) respectively. Among the adverse reactions, Dermatologic Effects (35%) were the major type of ADRs. Also, the major Naranjo scores of all ADRs reported ranged from 1 to 4 points (91%), which represents a possible correlation between ADRs reported and suspected drugs. Conclusions: Definitely, ADRs reported is still an extremely important information for healthcare professionals. For that reason, we put all information of ADRs reported into our hospital's computer system, and it will improve the safety of medication use. By hospital's computer system, it can remind prescribers to think of information about patient's ADRs reported. No drugs are administered without risk. Therefore, all healthcare professionals should have a responsibility to their patients, who themselves are becoming more aware of problems associated with drug therapy.

Keywords: adverse drug reaction, Taiwan, healthcare professionals, safe use of medicines

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Authors: Sonia Perez-Gamboa, Qingquan Sun, Yan Zhang

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Non-intrusive sensor-based human activity recognition (HAR) is utilized in a spectrum of applications, including fitness tracking devices, gaming, health care monitoring, and smartphone applications. Deep learning models such as convolutional neural networks (CNNs) and long short term memory (LSTM) recurrent neural networks (RNNs) provide a way to achieve HAR accurately and effectively. In this paper, we design a multi-layer hybrid architecture with CNN and LSTM and explore a variety of multi-layer combinations. Based on the exploration, we present a lightweight, hybrid, and multi-layer model, which can improve the recognition performance by integrating local features and scale-invariant with dependencies of activities. The experimental results demonstrate the efficacy of the proposed model, which can achieve a 94.7% activity recognition rate on a benchmark human activity dataset. This model outperforms traditional machine learning and other deep learning methods. Additionally, our implementation achieves a balance between recognition rate and training time consumption.

Keywords: deep learning, LSTM, CNN, human activity recognition, inertial sensor

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Authors: Chia-Chen Wei, Pack Hsieh, Jeffrey Chen

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Surface Mount Technology (SMT) is widely used in the area of the electronic assembly in which the electronic components are mounted to the surface of the printed circuit board (PCB). Most of the defects in the SMT process are mainly related to the quality of solder paste printing. These defects lead to considerable manufacturing costs in the electronics assembly industry. Therefore, the solder paste inspection (SPI) machine for controlling and monitoring the amount of solder paste printing has become an important part of the production process. So far, the setting of the SPI threshold is based on statistical analysis and experts’ experiences to determine the appropriate threshold settings. Because the production data are not normal distribution and there are various variations in the production processes, defects related to solder paste printing still occur. In order to solve this problem, this paper proposes an online machine learning algorithm, called the automatic threshold adjustment (ATA) algorithm, and closed-loop architecture in the SMT process to determine the best threshold settings. Simulation experiments prove that our proposed threshold settings improve the accuracy from 99.85% to 100%.

Keywords: big data analytics, Industry 4.0, SPI threshold setting, surface mount technology

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Authors: Mokhtar Azizi

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Due to heavy traffic and congested roads, it is crucial that the most popular main public transport services in Kuala Lumpur i.e. Putra LRT, Star LRT, KTM Commuter, KL Monorail and Rapid Bus must be continuously monitored and improved to fulfill the rider’s requirement and kept updated by the transit agencies. Evaluation on the current status of the services has been determined out by calculating the transit supportive area (TSA) and level of service (LOS) for each transit station. This research study has carried out the TSA and LOS mapping based on GIS techniques. The detailed census data of the region along the line of services has been collected from the Department of Statistics Malaysia for this purpose. The service coverage has been decided by 400 meters buffer zone for bus stations and 800 meters for rails station and railways in measurement the Quality of Service along the line of services. All the required information has been calculated by using the customized GIS software called Kuala Lumpur Transit Information System (KLTIS). The transit supportive area was calculated with the employment density at least 10 job/hectare or household density at 7.5 unit/hectare and total area covered by transit supportive area is 22516 hectare and the total area that is not supported by transit is 1718 hectare in Kuala Lumpur. The level of service is calculated with the percentage of transit supportive area served by transit for each station. In overall the percentage transit supportive areas served by transit for all the stations were less than 50% which falls in a very low level of service category. This research has proven its benefit by providing the current transit services operators with vital information for improvement of existing public transport services.

Keywords: service coverage, transit supportive area, level of service, transit system

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Authors: Sofia Cramerotti, Angela Cattoni, Laura Biancato, Dario Ianes

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The recognition of specific standards for new professionals, within the teaching profile, is a necessary process in order to foster an innovative school vision in accordance with the change that school is experiencing. In line with the reform of the national education and training system and with the National Training Plan for teachers, our Research and Development department developed a training project based on a framework (Syllabus) of skills that each 'Expert Teacher' should master in order to fulfill what the different specific profiles request. The syllabus is a fundamental tool for a training process consistent with the teaching profiles, both to guide the to-become teachers entering in service and to provide the in-service teachers with a system of evaluation and improvement of their skills. According to the national and international literature about professional standards for teachers, we aggregated the skills of the syllabus in three macro areas: (1) Area of professional skills related to the teacher profile and their continuous training; (2) area of teaching skills related to the school innovation; (3) area of organizing skills related to school participation for its improvement. The syllabus is a framework that identifies and describes the skills of the expert teacher in all of their roles. However, the various skills take on different importance in the different profiles involved in the school; some of those skills are determining a role, others could be secondary. Therefore, the characterization of the different profiles is represented by suitably weighted skills sets. In this way, the same skill could differently characterize each profile. In the future, we hope that the skills development and training for the teacher could evolve in a skills development and training for the whole school staff ('Expert Team'). In this perspective, the school will, therefore, benefit from a solid team, in which the skills of the various profiles are all properly developed and well represented.

Keywords: framework, skills, teachers, training

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Authors: Ahmad Jawad Fardin

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Over 60% of patients with breast cancer in Afghanistan present late with advanced stage III and IV, a major cause for the poor survival rate. The objectives of this study were to identify the contributing factors for the diagnosis and treatment delay and its outcome. This cross-sectional study was conducted on 318 patients with histologically confirmed breast cancer in the oncology department of Jamhoriat hospital, which is the first and only national cancer center in Afghanistan; data were collected from medical records and interviews conducted with women diagnosed with breast cancer, linear regression and logistic regression were used for analysis. Patient delay was defined as the time from first recognition of symptoms until first medical consultation and doctor form first consultation with a health care provider until histological confirmation of breast cancer. The mean age of patients was 49.2+_ 11.5years. The average time for the final diagnosis of breast cancer was 8.5 months; most patients had ductal carcinoma 260.7 (82%). Factors associated with delay were low education level 76% poor socioeconomic and cultural conditions 81% lack of cancer center 73% lack of screening 19%. The stage distribution was as follows stage IV 4 22% stage III 44.4% stage II 29.3% stage I 4.3%. Complex associated factors were identified to delayed the diagnosis of breast cancer and increased adverse outcomes consequently. Raising awareness and education in women, the establishment of cancer centers and providing accessible diagnosis service and screening, training of general practitioners; required to promote early detection, diagnosis and treatment.

Keywords: delayed diagnosis and poor outcome, breast cancer in Afghanistan, poor outcome of delayed breast cancer treatment, breast cancer delayed diagnosis and treatment in Afghanistan

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Authors: K. Pankaj, R. K. Chaudhary, B. P. Mishra, S. Kochar

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Introduction: Consultation-Liaison psychiatry is a branch of psychiatry that includes clinical service, teaching and research. A consultation-liaison psychiatrist plays a role in having an expert opinion and linking the patients to other medical professionals and the patient’s bio-psycho-social aspects that may be leading to his/her symptoms. Consultation-Liaison psychiatry has been recognised as 'The guardian of the holistic approach to the patient', underlining its pre-eminent role in the management of patients who are admitted in a tertiary care hospital. Aims/ Objectives: The aim of the study was to analyse the utilization of psychiatric services and reasons for referrals in a tertiary care hospital. Materials and Methods: The study was done in a tertiary care hospital. The study included all the cases referred from different Inpatient wards to the psychiatry department for consultation. The study was conducted on 300 patients over a 3 month period. International classification of diseases 10 was used to diagnose the referred cases. Results: The majority of the referral was from the Medical Intensive care unit (22%) followed by general medical wards (18.66%). Majority of the referral was taken for altered sensorium (24.66%), followed by low mood or unexplained medical symptoms (21%). Majority of the referrals had a diagnosis of alcohol withdrawal syndrome (21%) as per International classification of diseases criteria, followed by unipolar Depression and Anxiety disorder (~ 14%), followed by Schizophrenia (5%) and Polysubstance abuse (2.6%). Conclusions: Our study concludes the importance of utilization of consultation-liaison psychiatric services. Also, the study signifies the need for sensitization of our colleagues regarding psychiatric sign and symptoms from time to time and seek psychiatric consult timely to decrease morbidity.

Keywords: consultation-liaison, psychiatry, referral, tertiary care hospital

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Authors: Yu-Chuan Huang

Abstract:

Introduction: There is a higher mortality rate for unplanned transfer to intensive care units. It also needs a longer length of stay and makes the intensive care unit beds cannot be effectively used. It affects the immediate medical treatment of critically ill patients, resulting in a drop in the quality of medical care. Purpose: The purpose of this study was using SOFA and APACHEII score to analyze the mortality rate of the cases transferred from ED to ICU. According to the score that should be provide an appropriate care as early as possible. Methods: This study was a descriptive experimental design. The sample size was estimated at 220 to reach a power of 0.8 for detecting a medium effect size of 0.30, with a 0.05 significance level, using G-power. Considering an estimated follow-up loss, the required sample size was estimated as 242 participants. Data were calculated by medical system of SOFA and APACHEII score that cases transferred from ED to ICU in 2016. Results: There were 233 participants meet the study. The medical records showed 33 participants’ mortality. Age and sex with QSOFA , SOFA and sex with APACHEII showed p>0.05. Age with APCHHII in ED and ICU showed r=0.150, 0,268 (p < 0.001**). The score with mortality risk showed: ED QSOFA is r=0.235 (p < 0.001**), exp(B)=1.685(p = 0.007); ICU SOFA 0.78 (p < 0.001**), exp(B)=1.205(p < 0.001). APACHII in ED and ICU showed r= 0.253, 0.286 (p < 0.001**), exp(B) = 1.041,1.073(p = 0.017,0.001). For SOFA, a cutoff score of above 15 points was identified as a predictor of the 95% mortality risk. Conclusions: The SOFA and APACHE II were calculated based on initial laboratory data in the Emergency Department, and during the first 24 hours of ICU admission. In conclusion, the SOFA and APACHII score is significantly associated with mortality and strongly predicting mortality. Early predictors of morbidity and mortality, which we can according the predicting score, and provide patients with a detail assessment and proper care, thereby reducing mortality and length of stay.

Keywords: SOFA, APACHEII, mortality, ICU

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Authors: Eny Syatriana, Ardiansyah

Abstract:

The purpose of recent study was to develop a learning model on writing, based on the reading texts which will be read by the students using reflection strategy. The strategy would allow the students to read the text and then they would write back the main idea and to develop the text by using their own sentences. So, the writing practice was begun by reading an interesting text, then the students would develop the text which has been read into their writing. The problem questions are (1) what kind of learning model that can develop the students writing ability? (2) what is the achievement of the students of STKIP YPUP through reflection strategy? (3) is the using of the strategy effective to develop students competence In writing? (4) in what level are the students interest toward the using of a strategy In writing subject? This development research consisted of some steps, they are (1) need analysis (2) model design (3) implementation (4) model evaluation. The need analysis was applied through discussion among the writing lecturers to create a learning model for writing subject. To see the effectiveness of the model, an experiment would be delivered for one class. The instrument and learning material would be validated by the experts. In every steps of material development, there was a learning process, where would be validated by an expert. The research used development design. These Principles and procedures or research design and development .This study, researcher would do need analysis, creating prototype, content validation, and limited empiric experiment to the sample. In each steps, there should be an assessment and revision to the drafts before continue to the next steps. The second year, the prototype would be tested empirically to four classes in STKIP YPUP for English department. Implementing the test greatly was done through the action research and followed by evaluation and validation from the experts.

Keywords: learning model, reflection, strategy, reading, writing, development

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