Search results for: Anam Saiyeda

Authors: Misbah Fatma, Anam Saiyeda

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This analysis charts the introduction and expansion of research into the filter bubble phenomena over the last 10 years using a large dataset of academic publications. This bibliometric study demonstrates how interdisciplinary filter bubble research is. The identification of key authors and organizations leading the filter bubble study sheds information on collaborative networks and knowledge transfer. Relevant papers are organized based on themes including algorithmic bias, polarisation, social media, and ethical implications through a systematic examination of the literature. In order to shed light on how these patterns have changed over time, the study plots their historical history. The study also looks at how research is distributed globally, showing geographic patterns and discrepancies in scholarly output. The results of this bibliometric analysis let us fully comprehend the development and reach of filter bubble research. This study offers insights into the ongoing discussion surrounding information personalization and its implications for societal discourse, democratic participation, and the potential risks to an informed citizenry by exposing dominant themes, interdisciplinary collaborations, and geographic patterns. In order to solve the problems caused by filter bubbles and to advance a more diverse and inclusive information environment, this analysis is essential for scholars and researchers.

Keywords: bibliometric analysis, social media, social networking, algorithmic personalization, self-selection, content moderation policies and limited access to information, recommender system and polarization

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Authors: Misbah Shaheen, Anam Qureshi

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In this work we will discuss the challenges faced by tourism industry in Pakistan. Tourism plays vital role in the socio-economic growth of a country. The countries of world, with less tourism opportunities are lagging behind from other nations of the world. Pakistan is one of those countries which rich in historical places, natural beauty, and uniqueness in handmade items and also of green forests. Present study will discuss the challenges being faced by tourism industry with special focus on hotel industry and law and order situation.

Keywords: Pakistan, tourism, handmade items, hotel industry

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Authors: Roman Kalvin, Anam Nadeem, Saba Arif

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Turbocharger is a device that is driven by the turbine and increases efficiency and power output of the engine by forcing external air into the combustion chamber. This study focused on the distribution of stress on the turbine blades and total deformation that may occur during its working along with turbocharger to carry out its static structural analysis of turbine blades. Structural steel was selected as the material for turbocharger. Assembly of turbocharger and turbine blades was designed on PRO ENGINEER. Furthermore, the structural analysis is performed by using ANSYS. This research concluded that by using structural steel, the efficiency of engine is improved and by increasing number of turbine blades, more waste heat from combustion chamber is emitted.

Keywords: turbocharger, turbine blades, structural steel, ANSYS

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Authors: Anam Gopi

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The undesired torque and flux ripple may occur in conventional direct torque control (DTC) induction motor drive. DTC can improve the system performance at low speeds by continuously tuning the regulator by adjusting the Kp, Ki values. In this Teaching Learning Based Optimization (TLBO) is proposed to adjust the parameters (Kp, Ki) of the speed controller in order to minimize torque ripple, flux ripple, and stator current distortion. The TLBO based PI controller has resulted is maintaining a constant speed of the motor irrespective of the load torque fluctuations.

Keywords: teaching learning based optimization, direct torque control, PI controller

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Authors: Sahar Mobeen, Anam Rafique, Irum Baig

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Acoustic echo cancellation in multichannel is a system identification application. In real time environment, signal changes very rapidly which required adaptive algorithms such as Least Mean Square (LMS), Leaky Least Mean Square (LLMS), Normalized Least Mean square (NLMS) and average (AFA) having high convergence rate and stable. LMS and NLMS are widely used adaptive algorithm due to less computational complexity and AFA used of its high convergence rate. This research is based on comparison of acoustic echo (generated in a room) cancellation thorough LMS, LLMS, NLMS, AFA and newly proposed average normalized leaky least mean square (ANLLMS) adaptive filters.

Keywords: LMS, LLMS, NLMS, AFA, ANLLMS

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Authors: Anam Noshaba, Mahr Muhammad Saeed Akhtar

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The aim of this study was to find out the relationship between quality education and organizational culture. The population of this study was all the teachers of Public Degree Colleges located in Punjab. A sample of 400 teachers was selected by using a simple random sampling technique. Quality Education Assessment Questionnaire (QEAQ) and Organizational Culture Assessment Instrument (OCAI) were used for data collection. Out of all, 90% of teachers responded. Findings showed that quality education and organizational culture are positively correlated. Results indicated that there is no difference in quality education and organizational culture by demographic variables of teachers. Future research is needed to study the viewpoint of other stakeholders of education regarding quality education and organizational culture.

Keywords: quality education, minimum quality standards, organizational culture, college level

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Authors: Anam Ashraf, Arif Raza

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In this era of globalization, adoption of technology is quite difficult for people with physical disabilities compared to people with normal abilities. The advancement in mobile based accessible applications has opened up several different avenues for the visually challenged across the globe. Smartphones applications are not very common for blind people, but they access and use these applications in their daily lives to some extent. Several smartphone applications have a number of usability issues for the visually impaired. In this paper, we evaluate the usability of various android and iPhone applications for blind people through analysis and surveys. This paper aspires to provide guidance in order to increase smartphone application accessibility for the visually impaired. An abstract application design is also proposed to overcome usability issues in smartphone applications for visually challenged people.

Keywords: eyes-free shell, human computer interaction, usability engineering, visually challenged

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Authors: Anam Alam, Rahim Jamaluddin Kanji

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With the rapid growth of event in everywhere, event extraction has now become an important matter to retrieve the information from the unstructured data. One of the challenging problems is to extract the event from it. An event is an observable occurrence of interaction among entities. The paper investigates the effectiveness of event extraction capabilities of three software tools that are Wandora, Nitro and SPSS. We performed standard text mining techniques of these tools on the data sets of (i) Afghan War Diaries (AWD collection), (ii) MUC4 and (iii) WebKB. Information retrieval measures such as precision and recall which are computed under extensive set of experiments for Event Extraction. The experimental study analyzes the difference between events extracted by the software and human. This approach helps to construct an algorithm that will be applied for different machine learning methods.

Keywords: event extraction, Wandora, nitro, SPSS, event analysis, extraction method, AFG, Afghan War Diaries, MUC4, 4 universities, dataset, algorithm, precision, recall, evaluation

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Authors: Iqbal Abd. Muhbir Hadi Anam

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The purpose of the study is to discuss the relationship between organizational culture, teacher psychological empowerment, and organizational citizenship behavior at the University of Bangkalan District. The data was obtained using a survey of 100 respondents tested for validity and reliability. The analytical technique used is a hierarchical regression test. The results showed that the organizational culture of the university had a strong influence on the psychological empowerment of teachers and the psychological empowerment of teachers and that the organizational culture and psychological empowerment of teachers provided effective predictions of the psychological empowerment of the university. In addition, organizational culture directly or indirectly influences teachers' organizational citizenship behavior through psychological empowerment. Given these results, universities need to build an organizational culture that reflects the nature of the university.

Keywords: organizational behavior, teacher psychological empowerment, organizational citizenship behavior, universities

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Authors: Saba Arif, Anam Nadeem, Roman Kalvin, Tanzeel Rashid, Burhan Ali, Juntakan Taweekun

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Currently, the energy crisis is taking serious attention. Globally, industries and building are major share takers of energy. 72% of total global energy is consumed by residential houses, markets, and commercial building. Additionally, in appliances air conditioners are major consumer of electricity; about 60% energy is used for cooling purpose in houses due to HVAC units. Energy demand will aid in determining what changes will be needed whether it is the estimation of the required energy for households or instituting conservation measures. Bottom-up model is one of the most famous methods for forecasting. In current research bottom-up model of air conditioners' energy consumption in all income classes in comparison with seasonal variation and hourly consumption is calculated. By comparison of energy consumption of all income classes by usage of air conditioners, total consumption of actual demand and current availability can be seen.

Keywords: air conditioning, bottom up model, income classes, energy demand

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Authors: Anam Bhatti, Sumbal Arif, Mariam Mehar, Sohail Younas

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CSR has become one of the imperative implements in satisfying customers. The impartial of this research is to calculate CSR, relationship marketing, and customer satisfaction. In Pakistan, there is not enough research work on the effect of CSR and relationship marketing on relationship maintainer and customer loyalty. To find out deductive approach and survey method is used as research approach and research strategy respectively. This research design is descriptive and quantitative study. For data, collection questionnaire method with semantic differential scale and seven point scales are adopted. Data has been collected by adopting the non-probability convenience technique as sampling technique and the sample size is 400. For factor confirmatory factor analysis, structure equation modeling and medication analysis, regression analysis Amos software were used. Strong empirical evidence supports that the customer’s perception of CSR performance is highly influenced by the values.

Keywords: CSR, Relationship marketing, Relationship maintainer, Customer loyalty, Customer satisfaction

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Authors: Roman Kalvin, Anam Nadeem, Saba Arif, Juntakan Taweekun

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In the current scenario demand of power is increasing day by day with increasing population. It is needed to sort out this problem with a technique which will not only overcome this energy crisis but also should be environment friendly. This project emphasizes on idea which shows that power could be generated by specially designed speed breaker. This project shows clearly how power can be generated by using Cam Mechanism where basically linear motion is converted into rotatory motion that can be used to generate electricity. When vehicle passes over the speed breaker, presses the cam with the help of connecting rod which rotate main shaft attached with large pulley. A flywheel is coupled with the shaft whose purpose is to normalize the oscillation in the energy and to make the energy unvarying. So, the shafts will spin with firm rpm. These shafts are coupled from end to end with a belt drive. The results show that power generated from this mechanism is 12 watts. The generated electricity does not required any fuel consumption it only generates power which can be used for the street light as well as for the traffic signals.

Keywords: revolution per minute, RPM, cam, speed breaker, rotatory motion

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Authors: Roman Kalvin, Anam Nadeem, Shahab Khushnood

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Differential is an integral part of four wheeled vehicle, and its main function is to transmit power from drive shaft to wheels. Differential assembly allows both rear wheels to turn at different speed along curved paths. It consists of four gears which are assembled together namely pinion, ring, spider and bevel gears. This research focused on the spider gear and its static structural analysis using ANSYS. The main aim was to evaluate the distribution of stresses on the teeth of the spider gear. This study also analyzed total deformation that may occur during its working along with bevel gear that is meshed with spider gear. Structural steel was chosen for spider gear in this research. Modeling and assembling were done on SolidWorks for both spider and bevel gear. They were assembled exactly same as in a differential assembly. This assembly was then imported to ANSYS. After observing results that maximum amount of stress and deformation was produced in the spider gear, it was concluded that structural steel material for spider gear possesses greater amount of strength to bear maximum stress.

Keywords: ANSYS, differential, spider gear, structural steel

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Authors: Roman Kalvin, Saba Arif, Anam Nadeem, Burhan Ali Ghumman, Juntakan Taweekun

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Bicycles are important parts of the transportation industry. In the current world, use of sprocket is very high on bicycles these days. Sprocket and chains are important parts of the transmission of power in the bicycle. However, transmission of power is highly dependent on sprocket design. In conventional bicycles, sprockets are made up of mild steel which undergoes wear and tears with the passage of time due to high pressures applied on it. In the current research, a new sprocket is designed by changing its structure and material to carbon fiber from mild steel. The existing sprocket of a bicycle is compared with the new and modified sprocket design. However, new design has structural and material changes as well. According to the results, in carbon fiber, sprocket deformation is 0.091 mm while sprocket stress value is 371.13N/mm². Also, comparison based analysis is done by physical testing and software analysis. There is 8.1% variation in software and experimental results of steel. Additionally, the difference between both methods comes 8 to 9%. This improved design can be used in future for more durability and long run timings for bicycles.

Keywords: sprocket, mild steel, drafting, stress, deformation

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Authors: Anam Naveed, Asma Andleeb, Mehreen Sirshar

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In the article, Image processing techniques have been applied on cardiac images for enhancing the image quality. Two types of methodologies considers for survey, invasive techniques and non-invasive techniques. Different image processes for improvement of cardiac image quality and reduce the amount of radiation exposure for invasive techniques are explored. Different image processing algorithms for enhancing the noninvasive cardiac image qualities are described. Beside these two methodologies, third methodology has applied on live streaming of heart rate on ECG window for extracting necessary information, removing noise and enhancing quality. Sensitivity analyses have been carried out to investigate the impacts of cardiac images for diagnosis of cardiac arteries disease and how the enhancement on images will help the cardiologist to diagnoses disease. The paper evaluates strengths and weaknesses of different techniques applied for improved the image quality and draw a conclusion. Some specific limitations must be considered for whole survey, like the patient heart beat must be 70-75 beats/minute while doing the angiography, similarly patient weight and exposure radiation amount has some limitation.

Keywords: cardiac images, CT angiography, critical analysis, exposure radiation, invasive techniques, invasive techniques, non-invasive techniques

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Authors: Saba Arif, Anam Nadeem, Roman Kalvin, Muzaffar Ali, Burhan Ali, Juntakan Taweekun

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Globally transportation sector accounts for around 25% of energy demand and nearly 62% of oil consumed. Therefore, new energy sources are required to introduce for this huge demand replenishment of depleting conventional energy sources. Currently, biofuels such as Jatropha trees as an energy carrier for transportation sector are being utilized effectively round the globe. However, climate conditions at low altitudes with an average annual temperature above 20 degrees Celsius and rainfall of 300-1000mm are considered the most suitable environment for the efficient growth of Jatropha trees. The current study is providing a theoretical survey-based analysis to investigate the effect of rate of cultivation of jatropha trees on the reduction of fuel prices and its environmental benefits. The resulted study shows that jatropha tree’s 100 kg seeds give 80kg oil and the conversion process cost is very small as 890 PKR. Moreover, the extraction of oil from Jatropha tree is tax-free compared to other fuels. The analysis proved very essential for potential assessment of Jatropha regarding future energy fuel for transportation sector at global level. Additionally, it can be very beneficial for increment in the total amount of transportation fuel in Pakistan.

Keywords: jatropha tree, environmental impact, energy contents, theoretical survey

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Authors: M. Sivakumar, D. Chamundeeswari

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Glycosmis pentaphylla is one of the medicinally important plants belonging to the family Rutaceae, commonly known as “Anam or Panal” in Tamil. Traditionally, leaves are useful in fever, hepatopathy, eczema, skin disease, helminthiasis, wounds, and erysipelas. The fruits are sweet and are useful in vitiated conditions of vata, kapha, cough, and bronchitis. The roots are good for facial inflammations, rheumatism, jaundice, and anemia. The preliminary phytochemical investigations indicated the presence of alkaloids, terpenoids, flavonoids, tannins, sugar, glycoside, and phenolic compounds. In the present study, the root part of Glycosmis pentaphylla was used, and the root was collected from Western Ghats of South India. The root was sun/shade dried and pulverized to powder in a mechanical grinder. The powder was successively extracted with various solvents, and the ethyl acetate extract of Glycosmis pentaphylla has been subjected to the GC-MS analysis. Amongst the 46 chemical constituents identified from this plant, three major phytoconstituents were reported for the first time. Marmesin, a furanocumarin compound with the chemical structure 7H-Furo (3,2-G) (1)Benzopyran-7-one,2,3–dihydro–2 - (1-Hydroxy-1methylethyl)-(s) is one of the three compounds identified for the first time at the concentration of 11-60% in ethyl acetate extract of Glycosmis pentaphylla. Others include, Beta.-Fagarine (4.71%) and Paverine (13.08%).

Keywords: ethyl acetate extract, Glycosmis pentaphylla, GC-MS analysis, Phytochemicals

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Authors: Anam Nawaz

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The present study is an attempt to compare the translations of Faiz’s poetry made by native and non-native translators, to determine the role of the translator in terms of preserving the cultural ethos of the original text. Peter Newmark and Katharine Reiss’s approaches to translation criticism have been used to provide a theoretical framework for the study. This study also emphasizes those cultural and semantic aspects of the original which are translated more convincingly by a native translator, and contrasting those features which the non-natives can tackle more ably. The research also highlights the linguistic sockets, ignored by the interpreters in the translation process. The analysis showed that both native and non-native translators have made an admirable effort to stay as close to the original as possible. The natives with their advantage of belonging to the same culture have excelled in preserving the original subject matter, whereas the non-native renderings have been presented in a much rhythmic and poetic manner with an excellent choice of words. Though none of the four translators has been successfully able to recreate Faiz’s magic, however V. G. Kiernan and Sarvat Rahman’s translations can be regarded as the closest to the original. Whereas V. G. Kiernan with his outstanding command over English mesmerizes the readers, Sarvat Rahman’s profound understanding of cultural ties helps establish her translations as a brilliant example of faithful re-renderings.

Keywords: comparative translations, linguistic and cultural constraints, native translators, non-native translators, poetry and translation, Faiz Ahmad Faiz

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Authors: Muhammad Imran Hussain, Ramisha Ibtisam, Tayyaba Fatima, Huba Khalid, Ayesha Aziz, Khansa, Adan Sitara, Anam Shahzad, Aymen Jabeen

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Vitamin D supports the immune system fight TB by inhibiting Interferon-gamma (IFN-γ) and lowering host inflammation. The purpose of the research was to see if giving the vitamin D supplements to TB patients affected their prognosis. A randomized placebo control study of 200 TB patients was performed among which 106 received 400,000 IU of injectable vitamin D3 and 94 received placebo for 2 doses. Assessment was carried out at the end of every month for 3 months. IFN-γ responses to whole blood stimulation generated by the Mycobacterium tuberculosis sonicate (MTBs) antigen and early secreted and T cell activated 6 kDa (ESAT6) were assessed at 0 and 12 weeks. The statistical analysis used descriptive statistics (mean and standard deviation), Friedman's test and Fisher's test. The vitamin D group gained significantly more weight (+3.90 pounds) and had less persistent lung disease on imaging (1.33 zones vs. 1.84 zones). They also had a 50% decrease in cavity size. Additionally, patients with low baseline serum concentrations of 25-(OH)D had a significant increase in MTB-induced IFN-γ production after taking vitamin D supplements. Vitamin D administration in large amounts can hasten the recovery of TB patients. The findings point is a therapeutically useful activity of Vitamin D's in the management for tuberculosis.

Keywords: tuberculosis, vitamin D, interferon gamma, protein, infection

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Authors: Nasir Mehmood, Muhammad Yar Khan, Anam Javeed

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This study aims to scrutinize the dynamics which tend to impact customer’s purchasing intention of Islamic credit card and nexus of product’s knowledge and religiosity with the attitude of potential Islamic credit card’s customer. The theory of reasoned action strengthened the idea that intentions due to its proven predictive power are most likely to instigate intended consumer behavior. Particularly, the study examines the relationships of perceived financial cost (PFC), subjective norms (SN), and attitude (ATT) with the intention to purchase Islamic credit cards. Using a convenience sampling approach, data have been collected from 450 customers of banks located in Rawalpindi and Islamabad. A five-point Likert scale self-administered questionnaire was used to collect the data. The data were analyzed using the Statistical Package of Social Sciences (SPSS) through the procedures of principal component and multiple regression analysis. The results suggested that customer’s religiosity and product knowledge are strong indicators of attitude towards buying Islamic credit cards. Likewise, subjective norms, attitude, and perceived financial cost have a significant positive impact on customers’ purchase intent of Islamic bank’s credit cards. This study models a useful path for future researchers to further investigate the underlined phenomenon along with a variety of psychodynamic factors which are still in its infancy, at least in the Pakistani banking sector. The study also provides an insight to the practitioners and Islamic bank managers for directing their efforts toward educating customers regarding the use of Islamic credit cards and other financial products.

Keywords: attitude, Islamic credit card, religiosity, subjective norms

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Authors: Anam Layla, Qamar Abbas Syed, Tahir Zahoor, Muhammad Shahid

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Brassicaceae sprouts are promising candidates for functional food because of their unique phytochemistry and high nutrient density compared to their seeds and matured vegetables. Despite being admired for their health-promoting properties, white cabbage sprouts have been least explored for their nutritional significance and behavior to lactic acid fermentation. This study aimed to investigate the role of lactic acid fermentation i.e., inoculum vs. spontaneous, in reducing intrinsic toxicants load and improving nutrients delivering potential of the white cabbage sprouts. White cabbage sprouts with a 5 – 7 cm average size were processed as raw, blanched, Lactiplantibacillus plantarum inoculated fermentation and spontaneous fermentation. Plant material was dehydrated at 40˚C and evaluated for microbiological quality, macronutrients, minerals, and anti-nutrient contents. The results indicate L. plantarum inoculum fermentation of blanched cabbage sprouts (IF-BCS) to increase lactic acid bacteria count of the sprouts from 0.97 to 8.47 log CFU/g. Compared with the raw cabbage sprouts (RCS), inoculum fermented-raw cabbage sprouts (IF-RCS), and spontaneous fermented-raw cabbage sprouts (SF-RCS), the highest content of Ca (447 mg/ 100g d.w.), Mg (204 mg/100g d.w.), Fe (9.3 mg/100g d.w.), Zn (5 mg/100g d.w.) and Cu (0.5 mg/100g d.w.) were recorded in IF-BCS. L. plantarum led fermentation of BCS demonstrated a reduction in phytates, tannins, and oxalates contents at a rate of 42%, 66%, and 53%, respectively, while standalone lactic acid fermentation of the raw sprouts reduced the burden of anti-nutrients in a range between 32 to 56%. The results suggest L. plantarum led lactic acid fermentation coupled with sprouts blanching is the most promising way to improve the nutritional quality and safety of the white cabbage sprouts.

Keywords: lactic acid fermentation, anti-nutrients, mineral content, nutritional quality

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Authors: Muhammad Naveed Aslam, Rida Fatima, Anam Moosa, Muhammad Taimoor Shakeel

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Bacillus strains produce antifungal secondary metabolites making them potential candidates for suppressing Fusarium wilt of chickpea disease. In this study, eighteen Bacillus strains were evaluated for their antagonistic effect against Fusarium oxysporum f. sp. ciceris causing Fusarium wilt of chickpea disease. In a direct antifungal assay, thirteen strains showed significant inhibition zones while the remaining five strains did not produce inhibition zones of FOC. Bacillus thuringiensis CHGP12 was the most promising strain exhibiting the highest inhibition of FOC. Antifungal lipopeptides were extracted from CHGP12 strain which showed significant inhibition of the pathogen. Liquid chromatography mass spectrometry (LCMS) analysis revealed that CHGP12 was positive for the presence of iturin, fengycin, surfactin, bacillaene, bacillibactin, plantazolicin, and bacilysin. CHGP12 was tested for biochemical determinants in an in vitro qualitative test where it showed the ability to produce lipase, amylase, cellulase, protease, siderophores, and indole 3-acetic acid (IAA). Furthermore, in a greenhouse experiment CHGP12 also showed a significant decrease in the disease severity in treated plants compared to control. Moreover, CHGP12 also exhibited a significant increase in plant growth parameters viz, root and shoot growth parameters, stomatal conductance, and photosynthesis rate. Conclusively, our findings present the promising potential of Bacillus strain CHGP12 to suppress Fusarium wilt of chickpea and to promote plant growth.

Keywords: liquid chromatography mass spectrometry, growth promotion, antagonism, hydrolytic enzymes, inhibition, lipopeptides.

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Authors: Hassan Wajid, Syed T. Ahmed, Syed G. Haider Jr., Razia Latif, Ahsan Ali, Maira Anam

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The phenomenon of Metamorphosis can be associated with any object, organism, or structure gradually and progressively going through the change of systemic or morphological form. This phenomenon can be integrated while teaching drawing to architecture students. In architectural drawings, metamorphosis’s main focus and purpose are not to completely imitate any object. In the process of drawing, the changes in systemic or morphological form happen until the complete process, and the visuals of the complete process change the drawing, opening up possibilities for the imagination of the perceivers. Metamorphosis in architectural drawings begins with an initial form and, through various noticeable stages, ends up final form or manifestation. How much of the initial form is manifested in the final form and progressively among various intermediate stages becomes an indication of the nature of metamorphosis as a phenomenon. It is important at this stage to clarify that the term metamorphosis is presently being coopted from its original domain, usually in life sciences. In this current exercise, the architectural drawings are to act as an operative analog process transforming one image of art and/or architecture in its broadest sense. That composition is claimed to have come from one source (individual work, a cultural artifact, civilizational remain). It dialectically meets, opposes, or confronts some carefully chosen alien opposites from a different domain. As an example, the layers of a detailed drawing of a Turkish prayer rug of 5 x 7 ratio over a detailed architectural plan of a religious, historical complex can be observed such that the two drawings, though at markedly different scales could dialectically converse with one another and through their mutual congruencies. In the final stage, the idea concludes contradictions across the scales to initiate the analogous roles of metamorphosed third reality, which suggests the previous un-acknowledged architectural or artistic identity. The proposed paper explores the trajectory of reproduction by analyzing drawings through detailed drawing stages and analyzes challenges as well as opportunities in the discovered realm of imagination. This description further aims at identifying factors influencing creativity and innovation in producing architectural drawings through the process of observing drawings from inception to the concluding stage.

Keywords: architectural drawings, metamorphosis, perceptions, discovery

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Authors: Jason Ceavers, Travis Thompson, Juan Torres, Ramanakumar Anam, Alan Wong, Andrei Carvalho, Shane Quo, Shawn Alonso, Moises Cintron, Ricardo C. Carrero, German Lopez, Vamsi Garimella, German Giese

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Introduction: Advance directives (AD) are essential for patients to communicate their wishes when they are not able to. Ideally, these discussions should not occur for the first time when a patient is hospitalized with an acute life-threatening illness. There is a large number of patients who do not have clearly documented ADs, resulting in the misutilization of resources and additional patient harm. This is a nationwide issue, and the Joint Commission has it as one of its national quality metrics. Presented here is a proposed protocol to increase the number of documented AD discussions in a community-based, internal medicine residency primary care clinic in South Florida. Methods: The SMART Aim for this quality improvement project is to increase documentation of AD discussions in the outpatient setting by 25% within three months in medicare patients. A survey was sent to stakeholders (clinic attendings, residents, medical assistants, front desk staff, and clinic managers), asking them for three factors they believed contributed most to the low documentation rate of AD discussions. The two most important factors were time constraints and systems issues (such as lack of a standard method to document ADs and ADs not being uploaded to the chart) which were brought up by 25% and 21.2% of the 32 survey responders, respectively. Pre-intervention data from clinic patients in 2020-2021 revealed 17.05% of patients had clear, actionable ADs documented. To address these issues, an AD pocket card was created to give to patients. One side of the card has a brief explanation of what ADs are. The other side has a column of interventions (cardiopulmonary resuscitation, mechanical ventilation, dialysis, tracheostomy, feeding tube) with boxes patients check off if they want the intervention done, do not want the intervention, do not want to discuss the topic, or need more information. These cards are to be filled out and scanned into their electronic chart to be reviewed by the resident before their appointment. The interventions that patients want more information on will be discussed by the provider. If any changes are made, the card will be re-scanned into their chart. After three months, we will chart review the patients seen in the clinic to determine how many medicare patients have a pocket card uploaded and how many have advance directives discussions documented in a progress note or annual wellness note. If there is not enough time for an AD discussion, a follow-up appointment can be scheduled for that discussion. Discussion: ADs are a crucial part of patient care, and failure to understand a patient’s wishes leads to improper utilization of resources, avoidable litigation, and patient harm. Time constraints and systems issues were identified as two major factors contributing to the lack of advance directive discussion in our community-based resident primary care clinic. Our project aims at increasing the documentation rate for ADs through a simple pocket card intervention. These are self-explanatory, easy to read and allow the patients to clearly express what interventions they desire or what they want to discuss further with their physician.

Keywords: advance directives, community-based, pocket card, primary care clinic

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Authors: Kaleem Kashif, Tayyaba Anam, Yizhi Wu

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This paper introduces a methodology for advancing Italian speech vowels landmark detection within the distinctive feature-based speech recognition domain. Leveraging the legacy tool 'xkl' by integrating combined convolutional neural networks (CNNs) and recurrent neural networks (RNNs), the study presents a comprehensive enhancement to the 'xkl' legacy software. This integration incorporates re-assigned spectrogram methodologies, enabling meticulous acoustic analysis. Simultaneously, our proposed model, integrating combined CNNs and RNNs, demonstrates unprecedented precision and robustness in landmark detection. The augmentation of re-assigned spectrogram fusion within the 'xkl' software signifies a meticulous advancement, particularly enhancing precision related to vowel formant estimation. This augmentation catalyzes unparalleled accuracy in landmark detection, resulting in a substantial performance leap compared to conventional methods. The proposed model emerges as a state-of-the-art solution in the distinctive feature-based speech recognition systems domain. In the realm of deep learning, a synergistic integration of combined CNNs and RNNs is introduced, endowed with specialized temporal embeddings, harnessing self-attention mechanisms, and positional embeddings. The proposed model allows it to excel in capturing intricate dependencies within Italian speech vowels, rendering it highly adaptable and sophisticated in the distinctive feature domain. Furthermore, our advanced temporal modeling approach employs Bayesian temporal encoding, refining the measurement of inter-landmark intervals. Comparative analysis against state-of-the-art models reveals a substantial improvement in accuracy, highlighting the robustness and efficacy of the proposed methodology. Upon rigorous testing on a database (LaMIT) speech recorded in a silent room by four Italian native speakers, the landmark detector demonstrates exceptional performance, achieving a 95% true detection rate and a 10% false detection rate. A majority of missed landmarks were observed in proximity to reduced vowels. These promising results underscore the robust identifiability of landmarks within the speech waveform, establishing the feasibility of employing a landmark detector as a front end in a speech recognition system. The synergistic integration of re-assigned spectrogram fusion, CNNs, RNNs, and Bayesian temporal encoding not only signifies a significant advancement in Italian speech vowels landmark detection but also positions the proposed model as a leader in the field. The model offers distinct advantages, including unparalleled accuracy, adaptability, and sophistication, marking a milestone in the intersection of deep learning and distinctive feature-based speech recognition. This work contributes to the broader scientific community by presenting a methodologically rigorous framework for enhancing landmark detection accuracy in Italian speech vowels. The integration of cutting-edge techniques establishes a foundation for future advancements in speech signal processing, emphasizing the potential of the proposed model in practical applications across various domains requiring robust speech recognition systems.

Keywords: landmark detection, acoustic analysis, convolutional neural network, recurrent neural network

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