Search results for: clinical deterioration prediction

Authors: Gangmin Li, Fan Yang

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Personalized recommendation is crucial for any recommendation system. One of the techniques for personalized recommendation is to identify the intention. Traditional user intention identification uses the user’s selection when facing multiple items. This modeling relies primarily on historical behaviour data resulting in challenges such as the cold start, unintended choice, and failure to capture intention when items are new. Motivated by recent advancements in Large Language Models (LLMs) like ChatGPT, we present an approach for user intention identification by embracing LLMs with Chain-of-Thought (CoT) prompting. We use the initial user profile as input to LLMs and design a collection of prompts to align the LLM's response through various recommendation tasks encompassing rating prediction, search and browse history, user clarification, etc. Our tests on real-world datasets demonstrate the improvements in recommendation by explicit user intention identification and, with that intention, merged into a user model.

Keywords: personalized recommendation, generative user modelling, user intention identification, large language models, chain-of-thought prompting

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Authors: L. V. S. S. Phaneendra Bolem, S. Shankar

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Low Volume Rural Roads (LVRRs) constitute an integral component of the road system in all countries. These encompass all aspects of the social and economic development of rural communities. It is known that on a worldwide basis the number of low traffic roads far exceeds the length of high volume roads. Across India, 90% of the roads are LVRRs, and they often form the most important link in terms of providing access to educational, medical, recreational and commercial activities in local and regional areas. In the recent past, Government of India (GoI), with the initiation of the ambitious programme namely 'Pradhan Mantri Gram Sadak Yojana' (PMGSY) gave greater importance to LVRRs realizing their role in economic development of rural communities. The vast expansion of the road network has brought connectivity to the rural areas of the country. Further, it is noticed that due to increasing axle loads and lack of timely maintenance, is accelerated the process of deterioration of LVRRs. In addition to this due to limited budget for maintenance of these roads systematic and scientific approach in utilizing the available resources has been necessitated. This would enable better prioritization and ranking for the maintenance and make ‘all-weather roads’. Taking this into account the present study has adopted a multi-criteria approach. The multi-criteria approach includes parameters such as social, economic, environmental and pavement condition as the main criterion and some sub-criteria to find the best suitable parameters and their weight. For this purpose the expert’s opinion survey was carried out using Delphi Technique (DT) considering Likert scale, pairwise comparison and ranking methods and entire data was analyzed. Finally, this study developed the maintenance criterion considering the socio-economic, environmental and pavement condition parameters for effective maintenance of low volume roads based on the engineering judgment.

Keywords: Delphi technique, experts opinion survey, low volume rural road maintenance, multi criteria analysis

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Authors: Sheetla Prasad

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The objective of this study is ‘discovering the real psyche of human beings for prediction of mode, direction and strength of the potential of actions of the individual. The human face was taken as a source of central point to search for the route of real psyche. Analysis of the face architecture (shape and salient features of face) was done by three directional photographs ( 600 left and right and camera facing) of human beings. The shapes and features of the human face were scaled in 177 units on the basis of face–features locations (FFL). The mathematical analysis was done of FFLs by self developed and standardized formula. At this phase, 800 samples were taken from the population of students, teachers, advocates, administrative officers, and common persons. The finding shows that real psyche has two external rings (ER). These ER are itself generator of two independent psyches (manifested and manipulated). Prima-facie, it was proved that micro differences in FFLs have potential to predict the state of art of the human psyche. The potential of psyches was determined by the saving and distribution of mental energy. It was also mathematically proved.

Keywords: face architecture, psyche, potential, face functional ratio, external rings

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Authors: Sagir M. Yusuf, Chris Baber

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We describe issues bedeviling the coordination of heterogeneous (different sensors carrying agents) multi-agent missions such as belief conflict, situation reasoning, etc. We applied Bayesian and agents' presumptions inferential reasoning to solve the outlined issues with the heterogeneous multi-agent belief variation and situational-base reasoning. Bayesian Belief Network (BBN) was used in modeling the agents' belief conflict due to sensor variations. Simulation experiments were designed, and cases from agents’ missions were used in training the BBN using gradient descent and expectation-maximization algorithms. The output network is a well-trained BBN for making inferences for both agents and human experts. We claim that the Bayesian learning algorithm prediction capacity improves by the number of training data and argue that it enhances multi-agents robustness and solve agents’ sensor conflicts.

Keywords: distributed constraint optimization problem, multi-agent system, multi-robot coordination, autonomous system, swarm intelligence

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Authors: L. S. Chathurika

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Early prediction of student performance is an important factor to be gained academic excellence. Whatever the study stream in secondary education, students lay the foundation for higher studies during the first year of their degree or diploma program in Sri Lanka. The information technology (IT) field has certain improvements in the education domain by selecting specialization areas to show the talents and skills of students. These specializations can be software engineering, network administration, database administration, multimedia design, etc. After completing the first-year, students attempt to select the best path by considering numerous factors. The purpose of this experiment is to predict the best study path using machine learning algorithms. Five classification algorithms: decision tree, support vector machine, artificial neural network, Naïve Bayes, and logistic regression are selected and tested. The support vector machine obtained the highest accuracy, 82.4%. Then affecting features are recognized to select the best study path.

Keywords: algorithm, classification, evaluation, features, testing, training

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Authors: Vaibhav Baliyan, Shweta Mehrotra, S. S. Parihar

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The agricultural productivity is challenged by climate change and depletion in natural resources, including water and land, which significantly affects the crop yield. Wheat is a thermo-sensitive crop and is prone to heat stress. High temperature decreases crop duration, yield attributes, and, subsequently, grain yield and biomass production. Terminal heat stress affects grain filling duration, grain yield, and yield attributes, thus causing a reduction in wheat yield. A field experiment was conducted at Indian Agricultural Research Institute, New Delhi, for two consecutive rabi seasons (2017-18 and 2018-19) on six varieties of wheat (early sown - HD 2967, HD 3086, HD 2894 and late sown - WR 544, HD 3059, HD 3117 ) with three moisture regimes (100%, 80%, and 60% ETc, and no irrigation) and six sowing dates in three replications to investigate the effect of different moisture regimes and sowing dates on growth, yield and water use efficiency of wheat for development of best management practices for mitigation of terminal heat stress. HD3086 and HD3059 gave higher grain yield than others under early sown and late sown conditions, respectively. Maximum soil moisture extraction was recorded from 0-30 cm soil depth across the sowing dates, irrigation regimes, and varieties. Delayed sowing resulted in reducing crop growth period and forced maturity, in turn, led to significant deterioration in all the yield attributing characters and, there by, reduction in yield, suggesting that terminal heat stress had greater impact on yield. Early sowing and irrigation at 80% ETc resulted in improved growth and yield attributes and water use efficiency in both the seasons and helped to some extent in reducing the risk of terminal heat stress of wheat grown on sandy loam soils of semi-arid regions of India.

Keywords: sowing, irrigation, yield, heat stress

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Authors: Ajoy Kumar Das, Prasenjit Dey

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Heat transfer due to forced convection of copper water based nanofluid has been predicted by Artificial Neural network (ANN). The present nanofluid is formed by mixing copper nano particles in water and the volume fractions are considered here are 0% to 15% and the Reynolds number are kept constant at 100. The back propagation algorithm is used to train the network. The present ANN is trained by the input and output data which has been obtained from the numerical simulation, performed in finite volume based Computational Fluid Dynamics (CFD) commercial software Ansys Fluent. The numerical simulation based results are compared with the back propagation based ANN results. It is found that the forced convection heat transfer of water based nanofluid can be predicted correctly by ANN. It is also observed that the back propagation ANN can predict the heat transfer characteristics of nanofluid very quickly compared to standard CFD method.

Keywords: forced convection, square cylinder, nanofluid, neural network

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Authors: Arjun Prakash, Vinutha H., Karthik N.

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BACKGROUND: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy with an estimated prevalence of 0.6 - 5.8% in the general adult population. It is caused by compression of the Median Nerve (MN) at the wrist as it passes through a narrow osteofibrous canal. Presently, the diagnosis is established by the clinical symptoms and physical examination and Nerve conduction study (NCS) is used to assess its severity. However, it is considered to be painful, time consuming and expensive, with a false-negative rate between 16 - 34%. Ultrasonography (USG) is now increasingly used as a diagnostic tool in CTS due to its non-invasive nature, increased accessibility and relatively low cost. Elastography is a newer modality in USG which helps to assess stiffness of tissues. However, there is limited available literature about its applications in peripheral nerves. OBJECTIVES: Our objectives were to measure the Cross-Sectional Area (CSA) and elasticity of MN at the carpal tunnel using Grey scale Ultrasonography (USG), Strain Elastography (SE) and Shear Wave Elastography (SWE). We also made an attempt to independently evaluate the role of Gray scale USG, SE and SWE in grading the severity of CTS, keeping NCS as the gold standard. MATERIALS AND METHODS: After approval from the Institutional Ethics Review Board, we conducted a comparative cross sectional study for a period of 18 months. The participants were divided into two groups. Group A consisted of 54 patients with clinically diagnosed CTS who underwent NCS, and Group B consisted of 50 controls without any clinical symptoms of CTS. All Ultrasound examinations were performed on SAMSUNG RS 80 EVO Ultrasound machine with 2 - 9 Mega Hertz linear probe. In both groups, CSA of the MN was measured on Grey scale USG, and its elasticity was measured at the carpal tunnel (in terms of Strain ratio and Shear Modulus). The variables were compared between both groups by using ‘Independent t test’, and subgroup analyses were performed using one-way analysis of variance. Receiver operating characteristic curves were used to evaluate the diagnostic performance of each variable. RESULTS: The mean CSA of the MN was 13.60 + 3.201 mm2 and 9.17 + 1.665 mm2 in Group A and Group B, respectively (p < 0.001). The mean SWE was 30.65 + 12.996 kPa and 17.33 + 2.919 kPa in Group A and Group B, respectively (p < 0.001), and the mean Strain ratio was 7.545 + 2.017 and 5.802 + 1.153 in Group A and Group B respectively (p < 0.001). CONCLUSION: The combined use of Gray scale USG, SE and SWE is extremely useful in grading the severity of CTS and can be used as a painless and cost-effective alternative to NCS. Early diagnosis and grading of CTS and effective treatment is essential to avoid permanent nerve damage and functional disability.

Keywords: carpal tunnel, ultrasound, elastography, nerve conduction study

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Authors: Ghada Mahmoud El Kassas, Maged Atta El Wakeel

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Background: Environmental enteric dysfunction (EED) is impending trouble that flared up in the last decades to be pervasive in infants and children. EED is asymptomatic villous atrophy of the small bowel that is prevalent in the developing world and is associated with altered intestinal function and integrity. Evidence has suggested that supplementary zinc might ameliorate this damage by reducing gastrointestinal inflammation and may also benefit cognitive development. Objective: We tested whether zinc supplementation improves intestinal integrity, growth, and cognitive function in stunted children predicted to have EED. Methodology: This case–control prospective interventional study was conducted on 120 Egyptian Stunted children aged 1-10 years who recruited from the Nutrition clinic, the National research center, and 100 age and gender-matched healthy children as controls. At the primary phase of the study, Full history taking, clinical examination, and anthropometric measurements were done. Standard deviation score (SDS) for all measurements were calculated. Serum markers as Zonulin, Endotoxin core antibody (EndoCab), highly sensitive C-reactive protein (hsCRP), alpha1-acid glycoprotein (AGP), Tumor necrosis factor (TNF), and fecal markers such as myeloperoxidase (MPO), neopterin (NEO), and alpha-1-anti-trypsin (AAT) (as predictors of EED) were measured. Cognitive development was assessed (Bayley or Wechsler scores). Oral zinc at a dosage of 20 mg/d was supplemented to all cases and followed up for 6 months, after which the 2ry phase of the study included the previous clinical, laboratory, and cognitive assessment. Results: Serum and fecal inflammatory markers were significantly higher in cases compared to controls. Zonulin (P < 0.01), (EndoCab) (P < 0.001) and (AGP) (P < 0.03) markedly decreased in cases at the end of 2ry phase. Also (MPO), (NEO), and (AAT) showed a significant decline in cases at the end of the study (P < 0.001 for all). A significant increase in mid-upper arm circumference (MUAC) (P < 0.01), weight for age z-score, and skinfold thicknesses (P< 0.05 for both) was detected at end of the study, while height was not significantly affected. Cases also showed significant improvement of cognitive function at phase 2 of the study. Conclusion: Intestinal inflammatory state related to EED showed marked recovery after zinc supplementation. As a result, anthropometric and cognitive parameters showed obvious improvement with zinc supplementation.

Keywords: stunting, cognitive function, environmental enteric dysfunction, zinc

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Authors: Maryam Kiani, Abdul Basit Kiani

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At larger scales, the performance of cementitious materials is impacted by processes occurring at the nanometer scale. These materials boast intricate hierarchical structures with random features that span from the nanometer to millimeter scale. It is fascinating to observe how the nanoscale processes influence the overall behavior and characteristics of these materials. By delving into and manipulating these processes, scientists and engineers can unlock the potential to create more durable and sustainable infrastructure and construction materials. It's like unraveling a hidden tapestry of secrets that hold the key to building stronger and more resilient structures. The present work employs simulations as the computational modeling methodology to predict mechanical properties for carbon/silica based cementitious materials at the molecular/nano scale level. Studies focused on understanding the effect of higher mechanical properties of cementitious materials with carbon silica nanoparticles via Material Studio materials modeling.

Keywords: nanomaterials, SiO₂, carbon black, mechanical properties

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Authors: Hassam Hassan Elborombaly

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The pollution generated from transportation modes, congestion and traffic heritage has led to the deterioration of historic buildings and the urban heritage in historic cities. Accordingly, this paper attempts to diagnose the transport and traffic problems in historic cities. In general and in Heritage Cities, and to investigate methods for conserving the urban heritage from negative effects of traffic congestion and of the traditional red modes of transportation. It also attempts to explore possible areas for intervention to mitigate transportation and traffic problems in the light of the principles of the sustainable transportation framework. It aims to draw conclusion and propose recommendation that would increase the efficiency and effectiveness of transportation plans in historic Cairo and consequently achieve sustainable transportation. Problems In historic cities public paths compose an irregular network enclosing large residential plots (defined as super blocks quarters or hettas). The blocks represent the basic morphology units in historic Cities. Each super block incorporates several uses (i.e. residential, non-residential, service uses and others). Local paths reach the interior of the super blocks in an organized inter core, which deals mainly with residential functions mixed with handicraft activities and is composed of several local path units; (b) the other core, which is bound by the public paths and contains a combination of residential, commercial and social activities. Objectives: 1- To provide amenity convenience and comfort for visitors and people who live and work in the area. Pedestrianizing, accessibility and safety are to be reinforced while respecting the organic urban pattern. 2- To enhance street life, vitality and activity, in order to attract people and increase economic prosperity. Research Contents • Relation between residential areas and transportation in the inner core • Analytical studies for historic areas in heritage cities • Sustainable transportation planning in heritage cities • Dynamic and flexible methodology for achieving sustainable transportation network for the Heritage Cities • Result and Recommendation

Keywords: irregular network, public paths, sustainable transportation, urban heritage

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Authors: Armineh Nourbakhsh, Sameena Shah, Carolyn Rose

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Layout-aware language models have been used to create multimodal representations for documents that are in image form, achieving relatively high accuracy in document understanding tasks. However, the large number of parameters in the resulting models makes building and using them prohibitive without access to high-performing processing units with large memory capacity. We propose an alternative approach that can create efficient representations without the need for a neural visual backbone. This leads to an 80% reduction in the number of parameters compared to the smallest SOTA model, widely expanding applicability. In addition, our layout embeddings are pre-trained on spatial and visual cues alone and only fused with text embeddings in downstream tasks, which can facilitate applicability to low-resource of multi-lingual domains. Despite using 2.5% of training data, we show competitive performance on two form understanding tasks: semantic labeling and link prediction.

Keywords: layout understanding, form understanding, multimodal document understanding, bias-augmented attention

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Authors: Komol Phaisarn, Anuphan Suttimarn, Vitchanan Keawtong, Kittisak Thongyoun, Chaiyos Jamsawang

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This article is intended to analyze insurance information which contains information on the customer decision when purchasing life insurance pay package. The data were analyzed in order to present new customers with Life Insurance Perfect Pay package to meet new customers’ needs as much as possible. The basic data of insurance pay package were collect to get data mining; thus, reducing the scattering of information. The data were then classified in order to get decision model or decision tree using Algorithm C4.5 (J-48). In the classification, WEKA tools are used to form the model and testing datasets are used to test the decision tree for the accurate decision. The validation of this model in classifying showed that the accurate prediction was 68.43% while 31.25% were errors. The same set of data were then tested with other models, i.e. Naive Bayes and Zero R. The results showed that J-48 method could predict more accurately. So, the researcher applied the decision tree in writing the program used to introduce the product to new customers to persuade customers’ decision making in purchasing the insurance package that meets the new customers’ needs as much as possible.

Keywords: decision tree, data mining, customers, life insurance pay package

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Authors: Moustafa Osman

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The paper describes and analyses different good practice examples of protective levels, and initiatives actions (“framework conditions”) and encourages the uptake of environmental management systems (EMSs) to small and medium-sized enterprises (SMEs). Most of industries tend to take EMS as tools leading towards sustainability planning. The application of these tools has numerous environmental obligations that neither suggests decision nor recommends what a company should achieve ultimately. These set up clearly defined criteria to evaluate environmental protective action (EEPA) into sustainability indicators. The physical integration will evaluate how to incorporate traditional knowledge into baseline information, preparing impact prediction, and planning mitigation measures in monitoring conditions. Thereby efforts between the government, industry and community led protective action to concern with present needs for future generations, meeting the goal of sustainable development. The paper discusses how to set out distinct aspects of sustainable indicators and reflects inputs, outputs, and modes of impact on the environment.

Keywords: environmental management, sustainability, indicators, protective action

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Authors: Milica Karadzic, Lidija Jevric, Sanja Podunavac-Kuzmanovic, Strahinja Kovacevic, Aleksandra Tepic-Horecki, Zdravko Sumic

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In this paper, the influence of six different phytochemical content (phenols, carotenoids, chlorophyll a, chlorophyll b, chlorophyll a + b and vitamin C) on antioxidant potential of Murai and Levistro lettuce varieties was evaluated. Variable selection was made by generalized pair correlation method (GPCM) as a novel ranking method. This method is used for the discrimination between two variables that almost equal correlate to a dependent variable. Fisher’s conditional exact and McNemar’s test were carried out. Established multiple linear (MLR) models were statistically evaluated. As the best phytochemicals for the antioxidant potential prediction, chlorophyll a, chlorophyll a + b and total carotenoids content stand out. This was confirmed through both GPCM and MLR, predictive ability of obtained MLR can be used for antioxidant potential estimation for similar lettuce samples. This article is based upon work from the project of the Provincial Secretariat for Science and Technological Development of Vojvodina (No. 114-451-347/2015-02).

Keywords: antioxidant activity, generalized pair correlation method, lettuce, regression analysis

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Authors: Ahmed Saeed, Sadok Sassi, Mohammad Roshun

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Gears are important components with a vital role in many rotating machines. One of the common gear failure causes is tooth fatigue crack; however, its early detection is still a challenging task. The objective of this study is to develop a numerical model that simulates the effect of teeth cracks on the resulting gears vibrations and permits consequently to perform an early fault detection. In contrast to other published papers, this work incorporates the possibility of multiple simultaneous cracks with different depths. As cracks alter significantly the stiffness of the tooth, finite element software is used to determine the stiffness variation with respect to the angular position, for different combinations of crack orientation and depth. A simplified six degrees of freedom nonlinear lumped parameter model of a one-stage spur gear system is proposed to study the vibration with and without cracks. The model developed for calculating the stiffness with the crack permitted to update the physical parameters of the second-degree-of-freedom equations of motions describing the vibration of the gearbox. The vibration simulation results of the gearbox were by obtained using Simulink/Matlab. The effect of one crack with different levels was studied thoroughly. The change in the mesh stiffness and the vibration response were found to be consistent with previously published works. In addition, various statistical time domain parameters were considered. They showed different degrees of sensitivity toward the crack depth. Multiple cracks were also introduced at different locations and the vibration response along with the statistical parameters were obtained again for a general case of degradation (increase in crack depth, crack number and crack locations). It was found that although some parameters increase in value as the deterioration level increases, they show almost no change or even decrease when the number of cracks increases. Therefore, the use of any statistical parameters could be misleading if not considered in an appropriate way.

Keywords: Spur gear, cracked tooth, numerical simulation, time-domain parameters

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Authors: Chi-Yueh Hsu, Hsuan-Liang Hsu, Hsiu-Hui Chiang

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This study is to explore the relationship between the conspicuous consumption, leisure involvement and physical and mental health, and to understand the prediction of conspicuous consumption and leisure involvement to physical and mental health. The data was collected and analysed by purposive sampling, and the research objects were the dog walkers in Taiwan area. A total of 300 questionnaires were issued and after shaving the invalid questionnaire, a total of 246 valid samples were collected, and the effective rate was 82%.. The data were analyzed by correlation analysis and multiple stepwise regression analysis. The results showed that there was a significant correlation between conspicuous consumption and leisure involvement, and the conspicuous consumption and leisure involvement of dog walkers have a significant impact on physical and mental health, especially in self-expression, attractiveness and centrality of leisure involvement have a significant impact on physical and mental health.

Keywords: walking dog, attractiveness, self-expression, multiple stepwise regression analysis

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Authors: Khenenou Tarek, Benzaoui Hassina, Melizi Mohamed

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The diagnosis requires a background of current knowledge in the field and also complementary means in which the laboratory occupies the central place for a better investigation. A correct diagnosis allows to establish the most appropriate treatment as soon as possible and avoids both the economic losses associated with mortality and growth retardation often observed in poultry furthermore it may reduce the high cost of treatment. Epedemiologic survey, hematologic and histopathologic study’s are three aspects of diagnosis heavily used in both human and veterinary pathology and the advanced researches in human medicine would be exploited to be applied in veterinary medicine with given modification .Whereas, the diagnostic methods in the east of Algeria are limited to the clinical signs and necropsy finding. Therefore, the diagnosis is based simply on the success or the failure of the therapeutic methods (therapeutic diagnosis).

Keywords: chicken, diagnosis, hematology, histopathology

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Authors: F. Allag, S. Bouharati, M. Belmahdi, R. Zegadi

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The rapid expansion of deserts in recent decades as a result of human actions combined with climatic changes has highlighted the necessity to understand biological processes in arid environments. Whereas physical processes and the biology of flora and fauna have been relatively well studied in marginally used arid areas, knowledge of desert soil micro-organisms remains fragmentary. The objective of this study is to conduct a diversity analysis of bacterial communities in unvegetated arid soils. Several biological phenomena in hot deserts related to microbial populations and the potential use of micro-organisms for restoring hot desert environments. Dry land ecosystems have a highly heterogeneous distribution of resources, with greater nutrient concentrations and microbial densities occurring in vegetated than in bare soils. In this work, we found it useful to use techniques of artificial intelligence in their treatment especially artificial neural networks (ANN). The use of the ANN model, demonstrate his capability for addressing the complex problems of uncertainty data.

Keywords: desert soil, climatic changes, bacteria, vegetation, artificial neural networks

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Authors: Yu-Ching Lin, Meei-Ling Gau, Ghi-Hwei Kao, Hung-Chang Lee

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Objective: To compare the pushing experiences and birth outcomes of three different pushing positions during the second stage of labor. The three positions were: semi-recumbent, squatting, and squatting with the aid of ergonomically designed ankle supports. Methods: A randomized controlled trial was conducted at a regional teaching hospital in northern Taiwan. Data were collected from 168 primiparous women in their 38th to 42nd gestational week. None of the participants received epidural analgesia during labor and all were free of pregnancy and labor-related complications. Intervention: During labor, after full cervical dilation and when the fetal head had descended to at least the +1 station and had turned to the occiput anterior position, the experimental group was asked to push in the squatting position while wearing the ergonomically designed ankle supports; comparison group A was asked to push in the squatting position without the use of these supports; and comparison group B was asked to push in a standard semi-recumbent position. Measures: The participants completed a demographic and obstetrics datasheet, the Short Form McGill Pain Questionnaire (MPQ-SF), and the Labor Pushing Experience scale within 4-hours postpartum. Conclusion: In terms of delivery time, the duration between the start of pushing to crowning for the experimental group (squatting with ankle supports) averaged 25.52 minutes less (F =6.02, p< .05) than the time for comparison group B (semi-recumbent). Furthermore, the duration between the start of pushing to infant birth averaged 25.21 minutes less for the experimental group than for comparison group B (F =6.14, p< .05). Moreover, the experimental group had a lower average VAS pain score (5.05±3.22) than comparison group B and the average McGill pain score for the experimental group was lower than both comparison groups (F=18.12, p< .001). In summary, the participants in the group that delivered from a squatting position with ankle supports had better labor pushing experiences than their peers in the comparison groups. Results: In comparison to both unsupported squatting and semi-recumbent pushing, squatting with the aid of ergonomically designed ankle supports reduced pushing times, ameliorated labor pain, and improved the pushing experience. Clinical application and suggestion: The squatting with ankle-support intervention introduced in the present study may significantly reduce tiredness and difficulties in maintaining balance as well as increase pushing efficiency. Thus, this intervention may reduce the caring needs of women during the second stage of labor. This intervention may be introduced in midwifery education programs and in clinical practice as a method to improve the care of women during the second stage of labor.

Keywords: second stage of labor, pushing, squatting with ankle supports, squatting

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Authors: Jerome T. Tolentino, Ma. Victoria Rejuso, Jara Kaye Villanueva, Loureal Camille Inocencio, Ma. Rosario Concepcion O. Ang

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Wind energy is rapidly emerging as the primary source of electricity in the Philippines, although developing an accurate wind resource model is difficult. In this study, Weather Research and Forecasting (WRF) Model, an open source mesoscale Numerical Weather Prediction (NWP) model, was used to produce a 1-year atmospheric simulation with 4 km resolution on the Ilocos Region of the Philippines. The WRF output (netCDF) extracts the annual mean wind speed data using a Python-based Graphical User Interface. Lastly, wind resource assessment was produced using a GIS software. Results of the study showed that it is more flexible to use Python scripts than using other post-processing tools in dealing with netCDF files. Using WRF Model, Python, and Geographic Information Systems, a reliable wind resource map is produced.

Keywords: wind resource assessment, weather research and forecasting (WRF) model, python, GIS software

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Authors: Maria Sciammarella, Uttam M. Shrestha, Youngho Seo, Grant T. Gullberg, Elias H. Botvinick

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Background: Myocardial perfusion imaging (MPI) is typically performed with static imaging protocols and visually assessed for perfusion defects based on the relative intensity distribution. Dynamic cardiac SPECT, on the other hand, is a new imaging technique that is based on time varying information of radiotracer distribution, which permits quantification of myocardial blood flow (MBF). In this abstract, we report a progress and current status of dynamic cardiac SPECT using conventional gamma camera (Infinia Hawkeye 4, GE Healthcare) for estimation of myocardial blood flow and coronary flow reserve. Methods: A group of patients who had high risk of coronary artery disease was enrolled to evaluate our methodology. A low-dose/high-dose rest/pharmacologic-induced-stress protocol was implemented. A standard rest and a standard stress radionuclide dose of ⁹⁹ᵐTc-tetrofosmin (140 keV) was administered. The dynamic SPECT data for each patient were reconstructed using the standard 4-dimensional maximum likelihood expectation maximization (ML-EM) algorithm. Acquired data were used to estimate the myocardial blood flow (MBF). The correspondence between flow values in the main coronary vasculature with myocardial segments defined by the standardized myocardial segmentation and nomenclature were derived. The coronary flow reserve, CFR, was defined as the ratio of stress to rest MBF values. CFR values estimated with SPECT were also validated with dynamic PET. Results: The range of territorial MBF in LAD, RCA, and LCX was 0.44 ml/min/g to 3.81 ml/min/g. The MBF between estimated with PET and SPECT in the group of independent cohort of 7 patients showed statistically significant correlation, r = 0.71 (p < 0.001). But the corresponding CFR correlation was moderate r = 0.39 yet statistically significant (p = 0.037). The mean stress MBF value was significantly lower for angiographically abnormal than that for the normal (Normal Mean MBF = 2.49 ± 0.61, Abnormal Mean MBF = 1.43 ± 0. 0.62, P < .001). Conclusions: The visually assessed image findings in clinical SPECT are subjective, and may not reflect direct physiologic measures of coronary lesion. The MBF and CFR measured with dynamic SPECT are fully objective and available only with the data generated from the dynamic SPECT method. A quantitative approach such as measuring CFR using dynamic SPECT imaging is a better mode of diagnosing CAD than visual assessment of stress and rest images from static SPECT images Coronary Flow Reserve.

Keywords: dynamic SPECT, clinical SPECT/CT, selective coronary angiograph, ⁹⁹ᵐTc-Tetrofosmin

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Authors: Saud Hassan

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This paper shows simulation for the prediction of the flow around the backlight angle of the passenger vehicle. The CFD simulations are carried out on different car models. The Ahmed model “bluff body” used as the stander model to study aerodynamics of the backlight angle. This paper described the airflow over the different car models with different backlight angles and also on the Ahmed model to determine the trailing vortices with the varying backlight angle of a passenger vehicle body. The CFD simulation is carried out with the Ahmed body which has simplified car model mainly used in automotive industry to investigate the flow over the car body surface. The main goal of the simulation is to study the behavior of trailing vortices of these models. In this paper the air flow over the slant angle of 0,5o, 12.5o, 20o, 30o, 40o are considered. As investigating on the rear backlight angle two dimensional flows occurred at the rear slant, on the other hand when the slant angle is 30o the flow become three dimensional. Above this angle sudden drop occurred in drag.

Keywords: aerodynamics, Ahemd vehicle , backlight angle, finite element method

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Authors: Buddhi Arachchige, Hessam Ghasemnejad

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In this study, the post impact behavior of curved composite plates subjected to low velocity impact was studied analytically and numerically. Approaches to damage modelling are proposed through the degradation of stiffness in the damaged region by reduction of thickness in the damage region. Spring-mass models were used to model the impact response of the plate and impactor. The study involved designing two damage models to compare and contrast the model best fitted with the numerical results. The theoretical force-time responses were compared with the numerical results obtained through a detailed study carried out in LS-DYNA. The modified damage model established a good prediction with the analytical force-time response for different layups and geometry. This study provides a gateway in selecting the most effective layups for variable stiffness curved composite panels able to withstand a higher impact damage.

Keywords: analytical modelling, composite damage, impact, variable stiffness

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Authors: Muhammad Tariq, Jafar Khan Kasi, Samiullah, Ajab Khan Kasi

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Biosensors are playing vital role in industrial, clinical, and chemical analysis applications. Among other techniques, ZnO based biosensor is an easy approach due to its exceptional chemical and electrical properties. ZnO nanorods have positively charged isoelectric point which helps immobilize the negative charge glucose oxides (GOx). Here, we report ZnO nanorods based biosensors for the immobilization of GOx. The ZnO nanorods were grown by hydrothermal method on indium tin oxide substrate (ITO). The fabrication of biosensors was carried through batch processing using conventional photolithography. The buffer solutions of GOx were prepared in phosphate with a pH value of around 7.3. The biosensors effectively immobilized the GOx and result was analyzed by calculation of voltage and current on nanostructures.

Keywords: hydrothermal growth, sol-gel, zinc dioxide, biosensors

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Authors: Nabeel M. Alikunhi, Zenon B. Batang, Aymen Charef, Abdulaziz M. Al-Suwailem

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Saudi Arabia has a long history of using traps as a traditional fishing gear for catching commercially important demersal, mainly coral reef-associated fish species. Fish traps constitute the dominant small-scale fisheries in Saudi waters of Arabian Gulf (eastern seaboard of Saudi Arabia). Recently, however, traps have been increasingly used along the Saudi Red Sea coast (western seaboard), with a coastline of 1800 km (71%) compared to only 720 km (29%) in the Saudi Gulf region. The production trend for traps indicates a recent increase in catches and percent contribution to traditional fishery landings, thus ascertaining the rapid proliferation of trap fishing along the Saudi Red Sea coast. Reef-associated fish species, mainly groupers (Serranidae), emperors (Lethrinidae), parrotfishes (Scaridae), scads and trevallies (Carangidae), and snappers (Lutjanidae), dominate the trap catches, reflecting the reef-dominated shelf zone in the Red Sea. This ongoing investigation covers following major objectives (i) Baseline studies to characterize trap fishery through landing site visit and interview surveys (ii) Stock assessment by fisheries and biological data obtained through monthly landing site monitoring using fishery operational model by FLBEIA, (iii) Operational impacts, derelict traps assessment and by-catch analysis through bottom-mounted video camera and onboard monitoring (iv) Elucidation of fishing grounds and derelict traps impacts by onboard monitoring, Remotely Operated underwater Vehicle and Autonomous Underwater Vehicle surveys; and (v) Analysis of gear design and operations which covers colonization and deterioration experiments. The progress of this investigation on the impacts of the trap fishery on fish stocks and the marine environment in the Saudi Red Sea region is presented.

Keywords: red sea, Saudi Arabia, fish trap, stock assessment, environmental impacts

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Authors: Maria Ahmad, Michael Page, Danë Goodsman

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‘Educational’ debriefing – a construct distinct from clinical debriefing – is used following simulated scenarios and is central to learning and development in fields ranging from aviation to emergency medicine. However, little research into educational debriefing in prehospital medicine exists. This qualitative study explored the facilitation and effects of prehospital educational debriefing and identified obstacles to debriefing, using the London’s Air Ambulance Pre-Hospital Care Course (PHCC) as a model. Method: Ethnographic observations of moulages and debriefs were conducted over two consecutive days of the PHCC in October 2019. Detailed contemporaneous field notes were made and analysed thematically. Subsequently, seven one-to-one, semi-structured interviews were conducted with four PHCC debrief facilitators and three course participants to explore their experiences of prehospital educational debriefing. Interview data were manually transcribed and analysed thematically. Results: Four overarching themes were identified: the approach to the facilitation of debriefs, effects of debriefing, facilitator development, and obstacles to debriefing. The unpredictable debriefing environment was seen as both hindering and paradoxically benefitting educational debriefing. Despite using varied debriefing structures, facilitators emphasised similar key debriefing components, including exploring participants’ reasoning and sharing experiences to improve learning and prevent future errors. Debriefing was associated with three principal effects: releasing emotion; learning and improving, particularly participant compound learning as they progressed through scenarios; and the application of learning to clinical practice. Facilitator training and feedback were central to facilitator learning and development. Several obstacles to debriefing were identified, including mismatch of participant and facilitator agendas, performance pressure, and time. Interestingly, when used appropriately in the educational environment, these obstacles may paradoxically enhance learning. Conclusions: Educational debriefing in prehospital medicine is complex. It requires the establishment of a safe learning environment, an understanding of participant agendas, and facilitator experience to maximise participant learning. Aspects unique to prehospital educational debriefing were identified, notably the unpredictable debriefing environment, interdisciplinary working, and the paradoxical benefit of educational obstacles for learning. This research also highlights aspects of educational debriefing not extensively detailed in the literature, such as compound participant learning, display of ‘professional honesty’ by facilitators, and facilitator learning, which require further exploration. Future research should also explore educational debriefing in other prehospital services.

Keywords: debriefing, prehospital medicine, prehospital medical education, pre-hospital care course

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Authors: Rachel Gough

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In 2014, Skellig Michael, an island off Ireland’s western seaboard and UNESCO world heritage site became a major setting in Disney’s Star Wars franchise. The subsequent influx of tourists to the site has proven to be a point of contention nationally. The increased visitor numbers have uplifted certain areas of the local economy, the mainland, but have caused irreparable damage to historic monuments and to endangered bird populations who breed on the island. Recent research carried out by a state body suggests far-reaching and longterm negative impacts on the island’s culture and environment, should the association with the Star Wars franchise persist. In spite of this, the film has been widely endorsed by the Irish government as providing a vital economic boost to historically marginalised rural areas through film tourism. This paper argues quite plainly that what is taking place on Skellig is neocolonialism. Skellig Michael’s unique resources, its aesthetic qualities, its ecosystem, and its cultural currency have been sold by the state to a multinational corporation, who profit from their use. Meanwhile, locals are left to do their best to turn a market trend into sustainable business at the expense of culture ecology and community. This paper intends to be the first dedicated study into the psychogeographic and cultural impact of Skellig Michael’s deterioration as a result of film tourism. It will discuss the projected impact of this incident on Irish culture more broadly and finally will attempt to lay out a roadmap for more collaborative filmmaking and touristic approach, which allows local cultures and ecosystem’s to thrive without drastically inhibiting cultural production. This paper will ultimately find that the consequences of this representation call for a requirement to read tourism as a split concept — namely into what we might loosely call “eco-tourism” and more capital-based “profit-bottom-line tourism.”

Keywords: ecology, film tourism, neocolonialism, sustainability

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Authors: Rajish Shil, Mohammad Ali Houri, Mohammad Milad Ismail, Fatimah Al Kaabi

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The clinical presentation of Primary hyperparathyroidism can vary from simple asymptomatic hypercalcemia to severe life-threatening hypercalcemic crisis with multi-organ dysfunction, which can be due to parathyroid adenoma or sometimes with malignant cancer. This cascade of clinical presentation can lead to a diagnostic and therapeutic challenge for treating the disease. We are presenting a case of severe hypercalcemic crisis due to parathyroid adenoma with an emphasis on early management, diagnosis, and interventions to prevent any lifelong complications and any permanent organ dysfunction. A 30 years old female with a history of primary Infertility, admitted to Al Ain Hospital critical care unit with Acute Severe Necrotizing Pancreatitis. She initially had a 1-month history of abdominal pain on and off, for which she was treated conservatively with no much improvement, and later on, she developed life-threatening severe pancreatitis, which required her to be admitted to the critical care unit. She was transferred from a private healthcare facility, where she was found to have a very high level of calcium up to 15mmol/L. She received systemic Zoledronic Acid, which lowered her calcium level transiently and later was increased again. She went on to develop multiple end-organ damages along with multiple electrolytes disturbances. She was found to have high levels of Parathyroid hormone, which was correlated with a parathyroid mass on the neck via radiological imaging. After a long course of medical treatment to lower the calcium to a near-normal level, parathyroidectomy was done, which showed parathyroid adenoma on histology. She developed hungry bone syndrome after the surgery and pancreatic pseudocyst after resolving of pancreatitis. She required aggressive treatment with Intravenous calcium for her hypocalcemia as she received zoledronic acid at the beginning of the disease. Later on, she was discharged on long term calcium and other electrolytes supplements. In patients presenting with hypercalcemia, it is prudent to investigate and start treatment early to prevent complications and end-organ damage from hypercalcemia and also to treat the primary cause of the hypercalcemia, with conscious follow up to prevent hypocalcemic complications after treatment. It is important to follow up patients with parathyroid adenomas for a long period in order to detect any recurrence of the tumor or to make sure if the primary tumor is either benign or malignant.

Keywords: hypercalcemia, pancreatitis, hypocalcemia, hyperparathyroidism

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Authors: Zenah Gheblawi, Susan Armijo-Olivo, Elisa B. Pelai, Vaishali Sharma, Musa Tashfeen, Angela Fung, Francisca Claveria

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Due to physiological differences between men and women, pain is experienced differently between the two sexes. Chronic pain disorders, notably temporomandibular disorders (TMDs), disproportionately affect women in diagnosis, and pain severity in opposition of their male counterparts. TMDs are a type of musculoskeletal disorder that target the masticatory muscles, temporalis muscle, and temporomandibular joints, causing considerable orofacial pain which can usually be referred to the neck and back. Therapeutic methods are scarce, and are not TMD-centered, with the latest research suggesting that subjects with chronic musculoskeletal pain disorders have abnormal alterations in the grey matter of their brains which can be remedied with exercise, and thus, decreasing the pain experienced. The aim of the study is to investigate the effects of exercise therapy in TMD female patients experiencing chronic jaw pain and to assess the consequential effects on brain activity. In a randomized controlled trial, the effectiveness of an exercise program to improve brain alterations and clinical outcomes in women with TMD pain will be tested. Women with chronic TMD pain will be randomized to either an intervention arm or a placebo control group. Women in the intervention arm will receive 8 weeks of progressive exercise of motor control training using visual feedback (MCTF) of the cervical muscles, twice per week. Women in the placebo arm will receive innocuous transcutaneous electrical nerve stimulation during 8 weeks as well. The primary outcomes will be changes in 1) pain, measured with the Visual Analogue Scale, 2) brain structure and networks, measured by fractional anisotropy (brain structure) and the blood-oxygen level dependent signal (brain networks). Outcomes will be measured at baseline, after 8 weeks of treatment, and 4 months after treatment ends and will determine effectiveness of MCTF in managing TMD, through improved clinical outcomes. Results will directly inform and guide clinicians in prescribing more effective interventions for women with TMD. This study is underway, and no results are available at this point. The results of this study will have substantial implications on the advancement in understanding the scope of plasticity the brain has in regards with pain, and how it can be used to improve the treatment and pain of women with TMD, and more generally, other musculoskeletal disorders.

Keywords: exercise therapy, musculoskeletal disorders, physical therapy, rehabilitation, tempomandibular disorders

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