Search results for: remote decentralized clinical trials
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5152

Search results for: remote decentralized clinical trials

4942 Accuracy of Fitbit Charge 4 for Measuring Heart Rate in Parkinson’s Patients During Intense Exercise

Authors: Giulia Colonna, Jocelyn Hoye, Bart de Laat, Gelsina Stanley, Jose Key, Alaaddin Ibrahimy, Sule Tinaz, Evan D. Morris

Abstract:

Parkinson’s disease (PD) is the second most common neurodegenerative disease and affects approximately 1% of the world’s population. Increasing evidence suggests that aerobic physical exercise can be beneficial in mitigating both motor and non-motor symptoms of the disease. In a recent pilot study of the role of exercise on PD, we sought to confirm exercise intensity by monitoring heart rate (HR). For this purpose, we asked participants to wear a chest strap heart rate monitor (Polar Electro Oy, Kempele). The device sometimes proved uncomfortable. Looking forward to larger clinical trials, it would be convenient to employ a more comfortable and user friendly device. The Fitbit Charge 4 (Fitbit Inc) is a potentially comfortable, user-friendly solution since it is a wrist-worn heart rate monitor. Polar H10 has been used in large trials, and for our purposes, we treated it as the gold standard for the beat-to-beat period (R-R interval) assessment. In previous literature, it has been shown that Fitbit Charge 4 has comparable accuracy to Polar H10 in healthy subjects. It has yet to be determined if the Fitbit is as accurate as the Polar H10 in subjects with PD or in clinical populations, generally. Goal: To compare the Fitbit Charge 4 to the Polar H10 for monitoring HR in PD subjects engaging in an intensive exercise program. Methods: A total of 596 exercise sessions from 11 subjects (6 males) were collected simultaneously by both devices. Subjects with early-stage PD (Hoehn & Yahr <=2) were enrolled in a 6 months exercise training program designed for PD patients. Subjects participated in 3 one-hour exercise sessions per week. They wore both Fitbit and Polar H10 during each session. Sessions included rest, warm-up, intensive exercise, and cool-down periods. We calculated the bias in the HR via Fitbit under rest (5min) and intensive exercise (20min) by comparing the mean HR during each of the periods to the respective means measured by the Polar (HRFitbit – HRPolar). We also measured the sensitivity and specificity of Fitbit for detecting HRs that exceed the threshold for intensive exercise, defined as 70% of an individual’s theoretical maximum HR. Different types of correlation between the two devices were investigated. Results: The mean bias was 1.68 bpm at rest and 6.29 bpm during high intensity exercise, with an overestimation by Fitbit in both conditions. The mean bias of Fitbit across both rest and intensive exercise periods was 3.98 bpm. The sensitivity of the device in identifying high intensity exercise sessions was 97.14 %. The correlation between the two devices was non-linear, suggesting a saturation tendency of Fitbit to saturate at high values of HR. Conclusion: The performance of Fitbit Charge 4 is comparable to Polar H10 for assessing exercise intensity in a cohort of PD subjects. The device should be considered a reasonable replacement for the more cumbersome chest strap technology in future similar studies of clinical populations.

Keywords: fitbit, heart rate measurements, parkinson’s disease, wrist-wearable devices

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4941 Design and Implementation of Remote Control Application for Elderly People Who Live Alone

Authors: Cristina Nieves Perdomo Delgado

Abstract:

The study consists of the design and use of an application for cell phones called “Me Cuido” that consists of remote control of elderly people who live alone with their families. The objective of the study is to analyze the usability of the application by 40-year-olds using the Questionnaire for User Interaction Satisfaction (QUIS) method. The results highlight that the application has a design adapted to the elderly and that it is easy to use and understand.

Keywords: design, assistive technology, elderly people, independence

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4940 Application of Federated Learning in the Health Care Sector for Malware Detection and Mitigation Using Software-Defined Networking Approach

Authors: A. Dinelka Panagoda, Bathiya Bandara, Chamod Wijetunga, Chathura Malinda, Lakmal Rupasinghe, Chethana Liyanapathirana

Abstract:

This research takes us forward with the concepts of Federated Learning and Software-Defined Networking (SDN) to introduce an efficient malware detection technique and provide a mitigation mechanism to give birth to a resilient and automated healthcare sector network system by also adding the feature of extended privacy preservation. Due to the daily transformation of new malware attacks on hospital Integrated Clinical Environment (ICEs), the healthcare industry is at an undefinable peak of never knowing its continuity direction. The state of blindness by the array of indispensable opportunities that new medical device inventions and their connected coordination offer daily, a factor that should be focused driven is not yet entirely understood by most healthcare operators and patients. This solution has the involvement of four clients in the form of hospital networks to build up the federated learning experimentation architectural structure with different geographical participation to reach the most reasonable accuracy rate with privacy preservation. While the logistic regression with cross-entropy conveys the detection, SDN comes in handy in the second half of the research to stack up the initial development phases of the system with malware mitigation based on policy implementation. The overall evaluation sums up with a system that proves the accuracy with the added privacy. It is no longer needed to continue with traditional centralized systems that offer almost everything but not privacy.

Keywords: software-defined network, federated learning, privacy, integrated clinical environment, decentralized learning, malware detection, malware mitigation

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4939 Creative Mathematics – Action Research of a Professional Development Program in an Icelandic Compulsory School

Authors: Osk Dagsdottir

Abstract:

Background—Gait classifying allows clinicians to differentiate gait patterns into clinically important categories that help in clinical decision making. Reliable comparison of gait data between normal and patients requires knowledge of the gait parameters of normal children's specific age group. However, there is still a lack of the gait database for normal children of different ages. Objectives—This study aims to investigate the kinematics of the lower limb joints during gait for normal children in different age groups. Methods—Fifty-three normal children (34 boys, 19 girls) were recruited in this study. All the children were aged between 5 to 16 years old. Age groups were defined as three types: young child aged (5-7), child (8-11), and adolescent (12-16). When a participant agreed to take part in the project, their parents signed a consent form. Vicon® motion capture system was used to collect gait data. Participants were asked to walk at their comfortable speed along a 10-meter walkway. Each participant walked up to 20 trials. Three good trials were analyzed using the Vicon Plug-in-Gait model to obtain parameters of the gait, e.g., walking speed, cadence, stride length, and joint parameters, e.g., joint angle, force, moments, etc. Moreover, each gait cycle was divided into 8 phases. The range of motion (ROM) angle of pelvis, hip, knee, and ankle joints in three planes of both limbs were calculated using an in-house program. Results—The temporal-spatial variables of three age groups of normal children were compared between each other; it was found that there was a significant difference (p < 0.05) between the groups. The step length and walking speed were gradually increasing from young child to adolescent, while cadence was gradually decreasing from young child to adolescent group. The mean and standard deviation (SD) of the step length of young child, child and adolescent groups were 0.502 ± 0.067 m, 0.566 ± 0.061 m and 0.672 ± 0.053 m, respectively. The mean and SD of the cadence of the young child, child and adolescent groups were 140.11±15.79 step/min, 129±11.84 step/min, and a 115.96±6.47 step/min, respectively. Moreover, it was observed that there were significant differences in kinematic parameters, either whole gait cycle or each phase. For example, RoM of knee angle in the sagittal plane in the whole cycle of young child group is (65.03±0.52 deg) larger than child group (63.47±0.47 deg). Conclusion—Our result showed that there are significant differences between each age group in the gait phases and thus children walking performance changes with ages. Therefore, it is important for the clinician to consider the age group when analyzing the patients with lower limb disorders before any clinical treatment.

Keywords: action research, creative learning, mathematics education, professional development

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4938 Wearable Interface for Telepresence in Robotics

Authors: Uriel Martinez-Hernandez, Luke W. Boorman, Hamideh Kerdegari, Tony J. Prescott

Abstract:

In this paper, we present architecture for the study of telepresence, immersion and human-robot interaction. The architecture is built around a wearable interface, developed here, that provides the human with visual, audio and tactile feedback from a remote location. We have chosen to interface the system with the iCub humanoid robot, as it mimics many human sensory modalities, such as vision, with gaze control and tactile feedback. This allows for a straightforward integration of multiple sensory modalities, but also offers a more complete immersion experience for the human. These systems are integrated, controlled and synchronised by an architecture developed for telepresence and human-robot interaction. Our wearable interface allows human participants to observe and explore a remote location, while also being able to communicate verbally with humans located in the remote environment. Our approach has been tested from local, domestic and business venues, using wired, wireless and Internet based connections. This has involved the implementation of data compression to maintain data quality to improve the immersion experience. Initial testing has shown the wearable interface to be robust. The system will endow humans with the ability to explore and interact with other humans at remote locations using multiple sensing modalities.

Keywords: telepresence, telerobotics, human-robot interaction, virtual reality

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4937 Monitoring Deforestation Using Remote Sensing And GIS

Authors: Tejaswi Agarwal, Amritansh Agarwal

Abstract:

Forest ecosystem plays very important role in the global carbon cycle. It stores about 80% of all above ground and 40% of all below ground terrestrial organic carbon. There is much interest in the extent of tropical forests and their rates of deforestation for two reasons: greenhouse gas contributions and the impact of profoundly negative biodiversity. Deforestation has many ecological, social and economic consequences, one of which is the loss of biological diversity. The rapid deployment of remote sensing (RS) satellites and development of RS analysis techniques in the past three decades have provided a reliable, effective, and practical way to characterize terrestrial ecosystem properties. Global estimates of tropical deforestation vary widely and range from 50,000 to 170,000km2 /yr Recent FAO tropical deforestation estimates for 1990–1995 cite 116,756km2 / yr globally. Remote Sensing can prove to be a very useful tool in monitoring of forests and associated deforestation to a sufficient level of accuracy without the need of physically surveying the forest areas as many of them are physically inaccessible. The methodology for the assessment of forest cover using digital image processing (ERDAS) has been followed. The satellite data for the study was procured from Indian institute of remote Sensing (IIRS), Dehradoon in the digital format. While procuring the satellite data, care was taken to ensure that the data was cloud free and did not belong to dry and leafless season. The Normalized Difference Vegetation Index (NDVI) has been used as a numerical indicator of the reduction in ground biomass. NDVI = (near I.R - Red)/ (near I.R + Red). After calculating the NDVI variations and associated mean, we have analysed the change in ground biomass. Through this paper, we have tried to indicate the rate of deforestation over a given period of time by comparing the forest cover at different time intervals. With the help of remote sensing and GIS techniques, it is clearly shown that the total forest cover is continuously degrading and transforming into various land use/land cover category.

Keywords: remote sensing, deforestation, supervised classification, NDVI, change detection

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4936 Community Participation in Decentralized Management of Natural Resources in the Sudano-Sahelian Zone of West Africa

Authors: Clarisse Umutoni, Augustine Ayantunde, Matthew Turner, Germain J. Sawadogo

Abstract:

Decentralized governance of natural resources is considered one of the key strategies for promoting sustainable management of natural resources at local level. The rationale behind decentralization of natural resources is that local populations are both better situated and more highly motivated than outside agencies to manage the resources in an ecologically and economically sustainable manner. Effective decentralized natural resource management requires strong local natural resource institutions. Therefore, strengthening local institutions governing natural resource management is essential to promoting strong participation of local communities in managing their resources. This paper investigated the existing local institutions (rules, norms and or local conventions) governing the management of natural resources and forms of community participation in the development of these natural resource institutions. Group discussions and individual interviews were conducted to collect data. Our findings showed significant variation within the study sites regarding the level of knowledge of existing local rules and norms governing the management of natural resources by the respondents. The results also show that participation was dominated by a small group of individuals, often community leaders and elites. The results suggest that women are marginalized. In general, factors which influence the level of participation include; age, year of residence in the community, gender and education level. This study also highlights the strengths of local natural resource institutions especially if enforced. Presently, the big challenge that faces the institutions governing natural resource use in the study area is the system of representativeness in the community in the development of local rules and norms as community leaders and household heads often dominate, which does not encourage active participation of community members. Therefore, for effective implementation of local natural resource institutions, the interest of key natural resource users should be taken into account. It is also important to promote rules and norms that attempt to protect or strengthen women’s access to natural resources in the community.

Keywords: decentralization, land use plan, local institutions, Mali

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4935 Small Wind Turbine Hybrid System for Remote Application: Egyptian Case Study

Authors: M. A. Badr, A. N. Mohib, M. M. Ibrahim

Abstract:

The objective of this research is to study the technical and economic performance of wind/diesel/battery (W/D/B) system supplying a remote small gathering of six families using HOMER software package. The electrical energy is to cater for the basic needs for which the daily load pattern is estimated. Net Present Cost (NPC) and Cost of Energy (COE) are used as economic criteria, while the measure of performance is % of power shortage. Technical and economic parameters are defined to estimate the feasibility of the system under study. Optimum system configurations are estimated for two sites. Using HOMER software, the simulation results showed that W/D/B systems are economical for the assumed community sites as the price of generated electricity is about 0.308 $/kWh, without taking external benefits into considerations. W/D/B systems are more economical than W/B or diesel alone systems, as the COE is 0.86 $/kWh for W/B and 0.357 $/kWh for diesel alone.

Keywords: optimum energy systems, remote electrification, renewable energy, wind turbine systems

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4934 Rotor Concepts for the Counter Flow Heat Recovery Fan

Authors: Christoph Speer

Abstract:

Decentralized ventilation systems should combine a small and economical design with high aerodynamic and thermal efficiency. The Counter Flow Heat Recovery Fan (CHRF) provides the ability to meet these requirements by using only one cross flow fan with a large number of blades to generate both airflows and which simultaneously acts as a regenerative counter flow heat exchanger. The successful development of the first laboratory prototype has shown the potential of this ventilation system. Occurring condensate on the surfaces of the fan blades during the cold and dry season can be recovered through the characteristic mode of operation. Hence the CHRF provides the possibility to avoid the need for frost protection and condensate drain. Through the implementation of system-specific solutions for flow balancing and summer bypass the required functionality is assured. The scalability of the CHRF concept allows the use in renovation as well as in new buildings from single-room devices through to systems for office buildings. High aerodynamic and thermal efficiency and the lower number of required mechatronic components should enable a reduction in investment as well as operating costs. The rotor is the key component of the system, the requirements and possible implementation variants are presented.

Keywords: CHRF, counter flow heat recovery fan, decentralized ventilation system, renovation

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4933 Unfolding Simulations with the Use of Socratic Questioning Increases Critical Thinking in Nursing Students

Authors: Martha Hough RN

Abstract:

Background: New nursing graduates lack the critical thinking skills required to provide safe nursing care. Critical thinking is essential in providing safe, competent, and skillful nursing interventions. Educational institutions must provide a curriculum that improves nursing students' critical thinking abilities. In addition, the recent pandemic resulted in nursing students who previously received in-person clinical but now most clinical has been converted to remote learning, increasing the use of simulations. Unfolding medium and high-fidelity simulations and Socratic questioning are used in many simulations debriefing sessions. Methodology: Google Scholar was researched with the keywords: critical thinking of nursing students with unfolding simulation, which resulted in 22,000 articles; three were used. A second search was implemented with critical thinking of nursing students Socratic questioning, which resulted in two articles being used. Conclusion: Unfolding simulations increase nursing students' critical thinking, especially during the briefing (pre-briefing and debriefing) phases, where most learning occurs. In addition, the use of Socratic questions during the briefing phases motivates other questions, helps the student analyze and critique their thinking, and assists educators in probing students' thinking, which further increases critical thinking.

Keywords: briefing, critical thinking, Socratic thinking, unfolding simulations

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4932 Experiences of Military Nurse-Manager: Implication to Clinical Leadership

Authors: Maria Monica D. Espinosa

Abstract:

This study aimed to identify and examine the characteristics of an effective leader in a Hospital institution from the perspectives of military nurse-managers. The researcher extracted the different facets of leadership from the stories of six nurse- managers from a military hospital. The stories which are in pre-reflective stage convey an unbiased perspective from which clinical leadership may be defined. Using Phenomenology as a method of Research, the lived experiences of the military nurse-managers served as empirical data which were reflected upon until the formulation of insights. The information from the co-researchers became gallows from which the characteristics of effective leadership in the clinical area were drawn. These insights were synthesized through layers of reflection that resulted to the knowledge about clinical leadership. The reflections are the following, (a) Clinical leaders develop their skills through experiences and hardwork; (b) Clinical leaders are devoted; (c) Clinical leaders are focused; (d) Clinical leaders are good in interpersonal relationship; (e) Clinical leaders are mentors; (f) Clinical leaders seek affirmation and recognition; and (g) Clinical leaders are responsible and dependable. The common themes that emerged from the nurse manager’s stories showed that clinical leadership maybe attained if leaders possessed the following traits, (a) The gift to establish a steadfast and firm management; (b) The proficiency to guide and encourage others towards the achievement of their goals and objectives; (c) The ability to instigate participative and collaborative work among his/her subordinates and (d) The aptitude and skill to address the institutional concerns in their unit. In the future, Clinical leaders should continually adapt an evaluation program on how they can relate socially with their subordinates, the result of which can be used as a basis in developing strategies on relationship enhancement. Moreover, they should empower the nurses by allowing them to voice out their opinions and concerns regarding assignments, role expectations, and workload issues to improve and strengthen the relationships among nurses. Lastly, they can incorporate a collaborative strategy to promote professional socialization attitudes of nurse managers who work with staff nurses to improve the quality of their proficiencies and enhance a positive clinical environment.

Keywords: clinical leadership, experiences, implications, military nurse - managers, phenomenology

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4931 A Decision Tree Approach to Estimate Permanent Residents Using Remote Sensing Data in Lebanese Municipalities

Authors: K. Allaw, J. Adjizian Gerard, M. Chehayeb, A. Raad, W. Fahs, A. Badran, A. Fakherdin, H. Madi, N. Badaro Saliba

Abstract:

Population estimation using Geographic Information System (GIS) and remote sensing faces many obstacles such as the determination of permanent residents. A permanent resident is an individual who stays and works during all four seasons in his village. So, all those who move towards other cities or villages are excluded from this category. The aim of this study is to identify the factors affecting the percentage of permanent residents in a village and to determine the attributed weight to each factor. To do so, six factors have been chosen (slope, precipitation, temperature, number of services, time to Central Business District (CBD) and the proximity to conflict zones) and each one of those factors has been evaluated using one of the following data: the contour lines map of 50 m, the precipitation map, four temperature maps and data collected through surveys. The weighting procedure has been done using decision tree method. As a result of this procedure, temperature (50.8%) and percentage of precipitation (46.5%) are the most influencing factors.

Keywords: remote sensing, GIS, permanent residence, decision tree, Lebanon

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4930 Remote Sensing and Gis Use in Trends of Urbanization and Regional Planning

Authors: Sawan Kumar Jangid

Abstract:

The paper attempts to study various facets of urbanization and regional planning in the framework of the present conditions and future needs. Urbanization is a dynamic system in which development and changes are prominent features; which implies population growth and changes in the primary, secondary and tertiary sector in the economy. Urban population is increasing day by day due to a natural increase in population and migration from rural areas, and the impact is bound to have in urban areas in terms of infrastructure, environment, water supply and other vital resources. For the organized way of planning and monitoring the implementation of Physical urban and regional plans high-resolution satellite imagery is the potential solution. Now the Remote Sensing data is widely used in urban as well as regional planning, infrastructure planning mainly telecommunication and transport network planning, highway development, accessibility to market area development in terms of catchment and population built-up area density. With Remote Sensing it is possible to identify urban growth, which falls outside the formal planning control. Remote Sensing and GIS technique combined together facilitate the planners, in making a decision, for general public and investors to have relevant data for their use in minimum time. This paper sketches out the Urbanization modal for the future development of Urban and Regional Planning. The paper suggests, a dynamic approach towards regional development strategy.

Keywords: development, dynamic, migration, resolution

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4929 Assesing Spatio-Temporal Growth of Kochi City Using Remote Sensing Data

Authors: Navya Saira George, Patroba Achola Odera

Abstract:

This study aims to determine spatio-temporal expansion of Kochi City, situated on the west coast of Kerala State in India. Remote sensing and GIS techniques have been used to determine land use/cover and urban expansion of the City. Classification of Landsat images of the years 1973, 1988, 2002 and 2018 have been used to reproduce a visual story of the growth of the City over a period of 45 years. Accuracy range of 0.79 ~ 0.86 is achieved with kappa coefficient range of 0.69 ~ 0.80. Results show that the areas covered by vegetation and water bodies decreased progressively from 53.0 ~ 30.1% and 34.1 ~ 26.2% respectively, while built-up areas increased steadily from 12.5 to 42.2% over the entire study period (1973 ~ 2018). The shift in land use from agriculture to non-agriculture may be attributed to the land reforms since 1980s.

Keywords: Geographical Information Systems, Kochi City, Land use/cover, Remote Sensing, Urban Sprawl

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4928 Sub-Pixel Level Classification Using Remote Sensing For Arecanut Crop

Authors: S. Athiralakshmi, B.E. Bhojaraja, U. Pruthviraj

Abstract:

In agriculture, remote sensing is applied for monitoring of plant development, evaluating of physiological processes and growth conditions. Especially valuable are the spatio-temporal aspects of the remotely sensed data in detecting crop state differences and stress situations. In this study, hyperion imagery is used for classifying arecanut crops based on their age so that these maps can be used in yield estimation of crops, irrigation purposes, applying fertilizers etc. Traditional hard classifiers assigns the mixed pixels to the dominant classes. The proposed method uses a sub pixel level classifier called linear spectral unmixing available in ENVI software. It provides the relative abundance of surface materials and the context within a pixel that may be a potential solution to effectively identifying the land-cover distribution. Validation is done referring to field spectra collected using spectroradiometer and the ground control points obtained from GPS.

Keywords: FLAASH, Hyperspectral remote sensing, Linear Spectral Unmixing, Spectral Angle Mapper Classifier.

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4927 Covariate-Adjusted Response-Adaptive Designs for Semi-Parametric Survival Responses

Authors: Ayon Mukherjee

Abstract:

Covariate-adjusted response-adaptive (CARA) designs use the available responses to skew the treatment allocation in a clinical trial in towards treatment found at an interim stage to be best for a given patient's covariate profile. Extensive research has been done on various aspects of CARA designs with the patient responses assumed to follow a parametric model. However, ranges of application for such designs are limited in real-life clinical trials where the responses infrequently fit a certain parametric form. On the other hand, robust estimates for the covariate-adjusted treatment effects are obtained from the parametric assumption. To balance these two requirements, designs are developed which are free from distributional assumptions about the survival responses, relying only on the assumption of proportional hazards for the two treatment arms. The proposed designs are developed by deriving two types of optimum allocation designs, and also by using a distribution function to link the past allocation, covariate and response histories to the present allocation. The optimal designs are based on biased coin procedures, with a bias towards the better treatment arm. These are the doubly-adaptive biased coin design (DBCD) and the efficient randomized adaptive design (ERADE). The treatment allocation proportions for these designs converge to the expected target values, which are functions of the Cox regression coefficients that are estimated sequentially. These expected target values are derived based on constrained optimization problems and are updated as information accrues with sequential arrival of patients. The design based on the link function is derived using the distribution function of a probit model whose parameters are adjusted based on the covariate profile of the incoming patient. To apply such designs, the treatment allocation probabilities are sequentially modified based on the treatment allocation history, response history, previous patients’ covariates and also the covariates of the incoming patient. Given these information, an expression is obtained for the conditional probability of a patient allocation to a treatment arm. Based on simulation studies, it is found that the ERADE is preferable to the DBCD when the main aim is to minimize the variance of the observed allocation proportion and to maximize the power of the Wald test for a treatment difference. However, the former procedure being discrete tends to be slower in converging towards the expected target allocation proportion. The link function based design achieves the highest skewness of patient allocation to the best treatment arm and thus ethically is the best design. Other comparative merits of the proposed designs have been highlighted and their preferred areas of application are discussed. It is concluded that the proposed CARA designs can be considered as suitable alternatives to the traditional balanced randomization designs in survival trials in terms of the power of the Wald test, provided that response data are available during the recruitment phase of the trial to enable adaptations to the designs. Moreover, the proposed designs enable more patients to get treated with the better treatment during the trial thus making the designs more ethically attractive to the patients. An existing clinical trial has been redesigned using these methods.

Keywords: censored response, Cox regression, efficiency, ethics, optimal allocation, power, variability

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4926 Examining Audiology Students: Clinical Reasoning Skills When Using Virtual Audiology Cases Aided With no Collaboration, Live Collaboration, and Virtual Collaboration

Authors: Ramy Shaaban

Abstract:

The purpose of this study was to examine the difference in clinical reasoning skills of students when using virtual audiology cases with and without collaborative assistance from major learning approaches important to clinical reasoning skills and computer-based learning models: Situated Learning Theory, Social Development Theory, Scaffolding, and Collaborative Learning. A quasi-experimental design was conducted at two United States universities to examine whether there is a significant difference in clinical reasoning skills between three treatment groups using IUP Audiosim software. Two computer-based audiology case simulations were developed, and participants were randomly placed into the three groups: no collaboration, virtual collaboration, and live collaboration. The clinical reasoning data were analyzed using One-Way ANOVA and Tukey posthoc analyses. The results show that there was a significant difference in clinical reasoning skills between the three treatment groups. The score obtained by the no collaboration group was significantly less than the scores obtained by the virtual and live collaboration groups. Collaboration, whether virtual or in person, has a positive effect on students’ clinical reasoning. These results with audiology students indicate that combining collaboration models with scaffolding and embedding situated learning and social development theories into the design of future virtual patients has the potential to improve students’ clinical reasoning skills.

Keywords: clinical reasoning, virtual patients, collaborative learning, scaffolding

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4925 Effect of Clinical Depression on Automatic Speaker Verification

Authors: Sheeraz Memon, Namunu C. Maddage, Margaret Lech, Nicholas Allen

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The effect of a clinical environment on the accuracy of the speaker verification was tested. The speaker verification tests were performed within homogeneous environments containing clinically depressed speakers only, and non-depresses speakers only, as well as within mixed environments containing different mixtures of both climatically depressed and non-depressed speakers. The speaker verification framework included the MFCCs features and the GMM modeling and classification method. The speaker verification experiments within homogeneous environments showed 5.1% increase of the EER within the clinically depressed environment when compared to the non-depressed environment. It indicated that the clinical depression increases the intra-speaker variability and makes the speaker verification task more challenging. Experiments with mixed environments indicated that the increase of the percentage of the depressed individuals within a mixed environment increases the speaker verification equal error rates.

Keywords: speaker verification, GMM, EM, clinical environment, clinical depression

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4924 Continual Learning Using Data Generation for Hyperspectral Remote Sensing Scene Classification

Authors: Samiah Alammari, Nassim Ammour

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When providing a massive number of tasks successively to a deep learning process, a good performance of the model requires preserving the previous tasks data to retrain the model for each upcoming classification. Otherwise, the model performs poorly due to the catastrophic forgetting phenomenon. To overcome this shortcoming, we developed a successful continual learning deep model for remote sensing hyperspectral image regions classification. The proposed neural network architecture encapsulates two trainable subnetworks. The first module adapts its weights by minimizing the discrimination error between the land-cover classes during the new task learning, and the second module tries to learn how to replicate the data of the previous tasks by discovering the latent data structure of the new task dataset. We conduct experiments on HSI dataset Indian Pines. The results confirm the capability of the proposed method.

Keywords: continual learning, data reconstruction, remote sensing, hyperspectral image segmentation

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4923 Remote Electroacupuncture Analgesia at Contralateral LI4 Acupoint in Complete Freund's Adjuvant-Induced Inflammatory Hindpaw Pain

Authors: Tong-Chien Wu, Ching-Liang Hsieh, Yi-Wen Lin

Abstract:

There are accumulating evidences surrounding the therapeutic effect of electroacupuncture (EA). Local EA can reliably attenuate inflammatory pain in mouse with unclear mechanisms. However, the effect of EA on distal and contralateral acupoint for pain control has been rarely studied and the result was controversial. Here in our study, we found that inflammatory hindpaw pain in mouth, which was induced by injecting the complete Freund’s adjuvant (CFA) 2 days ago can be alleviated immediately after 2Hz 15mins EA treatment at contralateral forefoot acupoint LI4 through both mechanic and thermal behavior test, while sham acupoint group is not. The efficacy was observed to be more obvious after the second round of EA treatment on the following day. This analgesic effect is produced by applying EA to a site remote from the painful area. The present study provides a powerful experimental animal model that can be used for investigating the unique physiological mechanisms involved in acupuncture analgesia.

Keywords: remote electroacupuncture, distal EA, pain control, anti-inflammation

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4922 Utilizing Literature Review and Shared Decision-Making to Support a Patient Make the Decision: A Case Study of Virtual Reality for Postoperative Pain

Authors: Pei-Ru Yang, Yu-Chen Lin, Jia-Min Wu

Abstract:

Background: A 58-year-old man with a history of osteoporosis and diabetes presented with chronic pain in his left knee due to severe knee joint degeneration. The knee replacement surgery was recommended by the doctor. But the patient suffered from low pain tolerance and wondered if virtual reality could relieve acute postoperative wound pain. Methods: We used the PICO (patient, intervention, comparison, and outcome) approach to generate indexed keywords and searched systematic review articles from 2017 to 2021 on the Cochran Library, PubMed, and Clinical Key databases. Results: The initial literature results included 38 articles, including 12 Cochrane library articles and 26 PubMed articles. One article was selected for further analysis after removing duplicates and off-topic articles. The eight trials included in this article were published between 2013 and 2019 and recruited a total of 723 participants. The studies, conducted in India, Lebanon, Iran, South Korea, Spain, and China, included adults who underwent hemorrhoidectomy, dental surgery, craniotomy or spine surgery, episiotomy repair, and knee surgery, with a mean age (24.1 ± 4.1 to 73.3 ± 6.5). Virtual reality is an emerging non-drug postoperative analgesia method. The findings showed that pain control was reduced by a mean of 1.48 points (95% CI: -2.02 to -0.95, p-value < 0.0001) in minor surgery and 0.32 points in major surgery (95% CI: -0.53 to -0.11, p-value < 0.03), and the overall postoperative satisfaction has improved. Discussion: Postoperative pain is a common clinical problem in surgical patients. Research has confirmed that virtual reality can create an immersive interactive environment, communicate with patients, and effectively relieve postoperative pain. However, virtual reality requires the purchase of hardware and software and other related computer equipment, and its high cost is a disadvantage. We selected the best literature based on clinical questions to answer the patient's question and used share decision making (SDM) to help the patient make decisions based on the clinical situation after knee replacement surgery to improve the quality of patient-centered care.

Keywords: knee replacement surgery, postoperative pain, share decision making, virtual reality

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4921 Geographic Information Systems and Remotely Sensed Data for the Hydrological Modelling of Mazowe Dam

Authors: Ellen Nhedzi Gozo

Abstract:

Unavailability of adequate hydro-meteorological data has always limited the analysis and understanding of hydrological behaviour of several dam catchments including Mazowe Dam in Zimbabwe. The problem of insufficient data for Mazowe Dam catchment analysis was solved by extracting catchment characteristics and aerial hydro-meteorological data from ASTER, LANDSAT, Shuttle Radar Topographic Mission SRTM remote sensing (RS) images using ILWIS, ArcGIS and ERDAS Imagine geographic information systems (GIS) software. Available observed hydrological as well as meteorological data complemented the use of the remotely sensed information. Ground truth land cover was mapped using a Garmin Etrex global positioning system (GPS) system. This information was then used to validate land cover classification detail that was obtained from remote sensing images. A bathymetry survey was conducted using a SONAR system connected to GPS. Hydrological modelling using the HBV model was then performed to simulate the hydrological process of the catchment in an effort to verify the reliability of the derived parameters. The model output shows a high Nash-Sutcliffe Coefficient that is close to 1 indicating that the parameters derived from remote sensing and GIS can be applied with confidence in the analysis of Mazowe Dam catchment.

Keywords: geographic information systems, hydrological modelling, remote sensing, water resources management

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4920 Introducing Design Principles for Clinical Decision Support Systems

Authors: Luca Martignoni

Abstract:

The increasing usage of clinical decision support systems in healthcare and the demand for software that enables doctors to take informed decisions is changing everyday clinical practice. However, as technology advances not only are the benefits of technology growing, but so are the potential risks. A growing danger is the doctors’ over-reliance on the proposed decision of the clinical decision support system, leading towards deskilling and rash decisions by doctors. In that regard, identifying doctors' requirements for software and developing approaches to prevent technological over-reliance is of utmost importance. In this paper, we report the results of a design science research study, focusing on the requirements and design principles of ultrasound software. We conducted a total of 15 interviews with experts about poten-tial ultrasound software functions. Subsequently, we developed meta-requirements and design principles to design future clinical decision support systems efficiently and as free from the occur-rence of technological over-reliance as possible.

Keywords: clinical decision support systems, technological over-reliance, design principles, design science research

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4919 Effectiveness of Cranberry Ingesting for Prevention of Urinary Tract Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Authors: Yu-Chieh Huang, Pei-Shih Chen, Tao-Hsin Tung

Abstract:

Background: Urinary tract infection is the most common bacterial infection to our best knowledge. Objective: This study is to investigate whether cranberry ingesting could improve the urinary tract infection. Methods: We searched the PubMed and Cochrane Library for relevant randomized controlled trials without language limitations between 9 March 1994 and June 30, 2017, with a priori defined inclusion and exclusion criteria. The search terms included (cranberry OR Vaccinium macrocarpon OR Vaccinium oxy-coccus OR Vaccinium microcarpum OR Vaccinium erythrocarpum OR Vaccinium) AND (urinary tract infection OR bacteriuria OR pyuria) AND (effect OR effective-ness OR efficacy) AND (random OR randomized). Results: There were 26 studies met the selection criteria included among 4709 eligible participants. We analyzed all trials in meta-analysis. The random-effects pooled risk ratio (RR) for the group using cranberry versus using placebo was 0.75; 95%CI[0.63, 0.880]; p-value=0.0002) and heterogeneity was 56%. Furthermore, we divided the subjects into different subgroup to analysis. Ingesting cranberry seemed to be more effective in some subgroups, including the patients with recurrent UTI (RR, 0.71; 95%CI[0.54,0.93]; p-value=0.002) (I²= 65%) and female population (RR, 0.73, 95%CI[0.58,0.92]; p-value=0.002) (I²= 59%). The prevention effect was not different between cranberry and trimethoprim (RR, 1.25, 95%CI[0.67, 2.33]; p-value=0.49) (I²= 68%). No matter the forms of cranberry were capsules or juice, the efficacy was useful. Conclusions: It is showed that cranberry ingesting is usefully associated with prevention UTI. There are more effective in prevention of UTI in some groups.

Keywords: cranberry, effectiveness, prevention, urinary tract infect

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4918 Scope, Relevance and Sustainability of Decentralized Renewable Energy Systems in Developing Economies: Imperatives from Indian Case Studies

Authors: Harshit Vallecha, Prabha Bhola

Abstract:

‘Energy for all’, is a global issue of concern for the past many years. Despite the number of technological advancements and innovations, significant numbers of people are living without access to electricity around the world. India, an emerging economy, tops the list of nations having the maximum number of residents living off the grid, thus raising global attention in past few years to provide clean and sustainable energy access solutions to all of its residents. It is evident from developed economies that centralized planning and electrification alone is not sufficient for meeting energy security. Implementation of off-grid and consumer-driven energy models like Decentralized Renewable Energy (DRE) systems have played a significant role in meeting the national energy demand in developed nations. Cases of DRE systems have been reported in developing countries like India for the past few years. This paper attempts to profile the status of DRE projects in the Indian context with their scope and relevance to ensure universal electrification. Diversified cases of DRE projects, particularly solar, biomass and micro hydro are identified in different Indian states. Critical factors affecting the sustainability of DRE projects are extracted with their interlinkages in the context of developers, beneficiaries and promoters involved in such projects. Socio-techno-economic indicators are identified through similar cases in the context of DRE projects. Exploratory factor analysis is performed to evaluate the critical sustainability factors followed by regression analysis to establish the relationship between the dependent and independent factors. The generated EFA-Regression model provides a basis to develop the sustainability and replicability framework for broader coverage of DRE projects in developing nations in order to attain the goal of universal electrification with least carbon emissions.

Keywords: climate change, decentralized generation, electricity access, renewable energy

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4917 A Stepped Care mHealth-Based Approach for Obesity with Type 2 Diabetes in Clinical Health Psychology

Authors: Gianluca Castelnuovo, Giada Pietrabissa, Gian Mauro Manzoni, Margherita Novelli, Emanuele Maria Giusti, Roberto Cattivelli, Enrico Molinari

Abstract:

Diabesity could be defined as a new global epidemic of obesity and being overweight with many complications and chronic conditions. Such conditions include not only type 2 diabetes, but also cardiovascular diseases, hypertension, dyslipidemia, hypercholesterolemia, cancer, and various psychosocial and psychopathological disorders. The financial direct and indirect burden (considering also the clinical resources involved and the loss of productivity) is a real challenge in many Western health-care systems. Recently the Lancet journal defined diabetes as a 21st-century challenge. In order to promote patient compliance in diabesity treatment reducing costs, evidence-based interventions to improve weight-loss, maintain a healthy weight, and reduce related comorbidities combine different treatment approaches: dietetic, nutritional, physical, behavioral, psychological, and, in some situations, pharmacological and surgical. Moreover, new technologies can provide useful solutions in this multidisciplinary approach, above all in maintaining long-term compliance and adherence in order to ensure clinical efficacy. Psychological therapies with diet and exercise plans could better help patients in achieving weight loss outcomes, both inside hospitals and clinical centers and during out-patient follow-up sessions. In the management of chronic diseases clinical psychology play a key role due to the need of working on psychological conditions of patients, their families and their caregivers. mHealth approach could overcome limitations linked with the traditional, restricted and highly expensive in-patient treatment of many chronic pathologies: one of the best up-to-date application is the management of obesity with type 2 diabetes, where mHealth solutions can provide remote opportunities for enhancing weight reduction and reducing complications from clinical, organizational and economic perspectives. A stepped care mHealth-based approach is an interesting perspective in chronic care management of obesity with type 2 diabetes. One promising future direction could be treating obesity, considered as a chronic multifactorial disease, using a stepped-care approach: -mhealth or traditional based lifestyle psychoeducational and nutritional approach. -health professionals-driven multidisciplinary protocols tailored for each patient. -inpatient approach with the inclusion of drug therapies and other multidisciplinary treatments. -bariatric surgery with psychological and medical follow-up In the chronic care management of globesity mhealth solutions cannot substitute traditional approaches, but they can supplement some steps in clinical psychology and medicine both for obesity prevention and for weight loss management.

Keywords: clinical health psychology, mhealth, obesity, type 2 diabetes, stepped care, chronic care management

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4916 Application of Advanced Remote Sensing Data in Mineral Exploration in the Vicinity of Heavy Dense Forest Cover Area of Jharkhand and Odisha State Mining Area

Authors: Hemant Kumar, R. N. K. Sharma, A. P. Krishna

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The study has been carried out on the Saranda in Jharkhand and a part of Odisha state. Geospatial data of Hyperion, a remote sensing satellite, have been used. This study has used a wide variety of patterns related to image processing to enhance and extract the mining class of Fe and Mn ores.Landsat-8, OLI sensor data have also been used to correctly explore related minerals. In this way, various processes have been applied to increase the mineralogy class and comparative evaluation with related frequency done. The Hyperion dataset for hyperspectral remote sensing has been specifically verified as an effective tool for mineral or rock information extraction within the band range of shortwave infrared used. The abundant spatial and spectral information contained in hyperspectral images enables the differentiation of different objects of any object into targeted applications for exploration such as exploration detection, mining.

Keywords: Hyperion, hyperspectral, sensor, Landsat-8

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4915 Applying Cognitive Psychology to Education: Translational Educational Science

Authors: Hammache Nadir

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The scientific study of human learning and memory is now more than 125 years old. Psychologists have conducted thousands of experiments, correlational analyses, and field studies during this time, in addition to other research conducted by those from neighboring fields. A huge knowledge base has been carefully built up over the decades. Given this backdrop, we may ask ourselves: What great changes in education have resulted from this huge research base? How has the scientific study of learning and memory changed practices in education from those of, say, a century ago? Have we succeeded in building a translational educational science to rival medical science (in which biological knowledge is translated into medical practice) or types of engineering (in which, e.g., basic knowledge in chemistry is translated into products through chemical engineering)? The answer, I am afraid, is rather mixed. Psychologists and psychological research have influenced educational practice, but in fits and starts. After all, some of the great founders of American psychology—William James, Edward L. Thorndike, John Dewey, and others—are also revered as important figures in the history of education. And some psychological research and ideas have made their way into education—for instance, computer-based cognitive tutors for some specific topics have been developed in recent years—and in years past, such practices as teaching machines, programmed learning, and, in higher education, the Keller Plan were all important. These older practices have not been sustained. Was that because they failed or because of a lack of systematic research showing they were effective? At any rate, in 2012, we cannot point to a well-developed translational educational science in which research about learning and memory, thinking and reasoning, and related topics is moved from the lab into controlled field trials (like clinical trials in medicine) and the tested techniques, if they succeed, are introduced into broad educational practice. We are just not there yet, and one question that arises is how we could achieve a translational educational science.

Keywords: affective, education, cognition, pshychology

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4914 The Disposable Identities; Enabling Trust-by-Design to Build Sustainable Data-Driven Value

Authors: Lorna Goulden, Kai M. Hermsen, Jari Isohanni, Mirko Ross, Jef Vanbockryck

Abstract:

This article introduces disposable identities, with reference use cases and explores possible technical approaches. The proposed approach, when fully developed as an open-source toolkit, enables developers of mobile or web apps to employ a self-sovereign identity and data privacy framework, in order to rebuild trust in digital services by providing greater transparency, decentralized control, and GDPR compliance. With a user interface for the management of self-sovereign identity, digital authorizations, and associated data-driven transactions, the advantage of Disposable Identities is that they may also contain verifiable data such as the owner’s photograph, official or even biometric identifiers for more proactive prevention of identity abuse. These Disposable Identities designed for decentralized privacy management can also be time, purpose and context-bound through a secure digital contract; with verification functionalities based on tamper-proof technology.

Keywords: dentity, trust, self-sovereign, disposable identity, privacy toolkit, decentralised identity, verifiable credential, cybersecurity, data driven business, PETs, GDPRdentity, trust, self-sovereign, disposable identity, privacy toolkit, decentralised identity, verifiable credential, cybersecurity, data driven business, PETs, GDPRI

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4913 Treatment with RRx-001, a Minimally Toxic NLRP3 Inhibitor in Phase 3 Clinical Trials, Improves Exercise and Skeletal Muscle Oxidative Capacity in Untrained Mice

Authors: Pedro Cabrales, Scott Caroen, Tony R. Reid, Bryan Oronsky

Abstract:

Introduction and Purpose RRx-001 is an NLRP3 inhibitor and Nrf2 agonist in Phase 3 trials for the treatment of cancer. The purpose of this study was to examine whether treatment with RRx-001, given itsanti-inflammatory and antioxidant properties, improvedexercise and skeletal muscle oxidative capacity in mice on the generalpremiss that better health outcomes correlatewith more activity. Material and Methods Male and female adult mice (n=6 per group) were subjected to an endurance exercise capacity (EEC)test until exhaustion on a motorized treadmill after 3 once weekly doses of either RRx-001 5 mg/kg, RRx-001 2 mg/kg, or vehicle. The EEC protocol consisted of a treadmill velocity of 30meters per min at an uphill inclination (slope of 10%) until the mice reached fatigue, which was defined as the inability of the mice to maintain the appropriate pace despitecontinuous hand stimulation for 1 min. The concentration of malondialdehyde (MDA), an indicator of lipid peroxidation, and creatine kinase (CK), an indicator of muscle damage, in the blood samples collected immediately after the acute exercise was determined with a commercial ELISA assay kit. ResultsThe exhaustive exercise times of the RRx-001 groups were significantly longer than that of the vehicle group (p<0.05) by weeks 2 and 3. In addition, MDA levels in the gastrocnemius, soleus, and extensor digitorum longus muscles were significantly lower than those of the vehicle group were (p<0.05), as were the serum CK levels(p<0.05). ConclusionsIn conclusion, this study found that RRx-001 has anti-fatigue properties, as evidenced by an increase in exercise capacity with RRx-001 treatment, and protects against strenuous exercise-induced muscle damage and lipid peroxidation. This data potentially supports the use of RRx-001 in the clinic to improve exercise performance and reduce physical fatigue.

Keywords: RRx-001, anti-fatigue, muscle protection, increased exercise tolerance, lipid peroxidation

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