Search results for: Hospital administration

Authors: Mohammed Almohammedali, Peter Duncan, David Edgar

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The aim of this exploratory research is to understand further how organisations can evaluate their activities, which generate knowledge creation, to meet changing stakeholder expectations. A Scale of Knowledge (SoK) Framework is proposed which links knowledge management and organisational activities to changing stakeholder expectations. The framework was informed by the knowledge management literature, as well as empirical work conducted via a single case study of a multi-site hospital organisation in Saudi Arabia. Eight in-depth semi-structured interviews were conducted with managers from across the organisation regarding current and future stakeholder expectations, organisational strategy/activities and knowledge management. Data were analysed using thematic analysis and a hierarchical value map technique to identify activities that can produce further knowledge and consequently impact on how stakeholder expectations are met. The SoK Framework developed may be useful to practitioners as an analytical aid to determine if current organisational activities produce organisational knowledge which helps them meet (increasingly higher levels of) stakeholder expectations. The limitations of the research and avenues for future development of the proposed framework are discussed.

Keywords: Knowledge creation, knowledge management, organisational knowledge, scale of knowledge, knowledge impact.

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Authors: A. Majeed, P. Ali

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Before designing an electrical system, the estimation of load is necessary for unit sizing and demand-generation balancing. The system could be a stand-alone system for a village or grid connected or integrated renewable energy to grid connection, especially as there are non–electrified villages in developing countries. In the classical model, the energy demand was found by estimating the household appliances multiplied with the amount of their rating and the duration of their operation, but in this paper, information exists for electrified villages could be used to predict the demand, as villages almost have the same life style. This paper describes a method used to predict the average energy consumed in each two months for every consumer living in a village by Artificial Neural Network (ANN). The input data are collected using a regional survey for samples of consumers representing typical types of different living, household appliances and energy consumption by a list of information, and the output data are collected from administration office of Piramagrun for each corresponding consumer. The result of this study shows that the average demand for different consumers from four villages in different months throughout the year is approximately 12 kWh/day, this model estimates the average demand/day for every consumer with a mean absolute percent error of 11.8%, and MathWorks software package MATLAB version 7.6.0 that contains and facilitate Neural Network Toolbox was used.

Keywords: Artificial neural network, load estimation, regional survey, rural electrification.

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Authors: A. Sharahi, R. Tehrani, A. Mollajan

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The final step to complete the “Analytical Systems Engineering Process” is the “Allocated Architecture” in which all Functional Requirements (FRs) of an engineering system must be allocated into their corresponding Physical Components (PCs). At this step, any design for developing the system’s allocated architecture in which no clear pattern of assigning the exclusive “responsibility” of each PC for fulfilling the allocated FR(s) can be found is considered a poor design that may cause difficulties in determining the specific PC(s) which has (have) failed to satisfy a given FR successfully. The present study utilizes the Axiomatic Design method principles to mathematically address this problem and establishes an “Axiomatic Model” as a solution for reaching good alternatives for developing the allocated architecture. This study proposes a “loss Function”, as a quantitative criterion to monetarily compare non-ideal designs for developing the allocated architecture and choose the one which imposes relatively lower cost to the system’s stakeholders. For the case-study, we use the existing design of U. S. electricity marketing subsystem, based on data provided by the U.S. Energy Information Administration (EIA). The result for 2012 shows the symptoms of a poor design and ineffectiveness due to coupling among the FRs of this subsystem.

Keywords: Allocated Architecture, Analytical Systems Engineering Process, Functional Requirements (FRs), Physical Components (PCs), Responsibility of a Physical Component, System’s Stakeholders.

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Authors: Rita U. Onolemhemhen, Saheed L. Bello, Akin P. Iwayemi

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The effectiveness of energy demand policy depends on identifying the key drivers of energy demand both in the short-run and the long-run. This paper examines the influence of regional differences on the link between energy demand and other explanatory variables for Nigeria, China and USA using the Vector Error Correction Model (VECM) approach. This study employed annual time series data on energy consumption (ED), real gross domestic product (GDP) per capita (RGDP), real energy prices (P) and urbanization (N) for a thirty-six-year sample period. The utilized time-series data are sourced from World Bank’s World Development Indicators (WDI, 2016) and US Energy Information Administration (EIA). Results from the study, shows that all the independent variables (income, urbanization, and price) substantially affect the long-run energy consumption in Nigeria, USA and China, whereas, income has no significant effect on short-run energy demand in USA and Nigeria. In addition, the long-run effect of urbanization is relatively stronger in China. Urbanization is a key factor in energy demand, it therefore recommended that more attention should be given to the development of rural communities to reduce the inflow of migrants into urban communities which causes the increase in energy demand and energy excesses should be penalized while energy management should be incentivized.

Keywords: Economic growth, energy demand, income, real GDP, urbanization, VECM.

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Authors: Jerry Szatko, Edan L. Jorgensen, Stacia Jorgensen

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A crucial component to the success of any financial advising relationship is for the financial professional to understand the perceptions, preferences and thought-processes carried by the financial clients they serve. Armed with this information, financial professionals are more quickly able to understand how they can tailor their approach to best match the individual preferences and needs of each personal investor. Our research explores the use of a quantitative assessment tool in the financial services industry to assist in the identification of the personal investor’s consumer behaviors, especially in terms of financial risk tolerance, as it relates to their financial decision making. Through this process, the Unitifi Consumer Insight Tool (UCIT) was created and refined to capture and categorize personal investor financial behavioral categories and the financial personality tendencies of individuals prior to the initiation of a financial advisement relationship. This paper discusses the use of this tool to place individuals in one of four behavior-based financial risk tolerance categories. Our discoveries and research were aided through administration of a web-based survey to a group of over 1,000 individuals. Our findings indicate that it is possible to use a quantitative assessment tool to assist in predicting the behavioral tendencies of personal consumers when faced with consumer financial risk and decisions.

Keywords: Behavior based advising, behavioral finance, financial advising, financial advisor tools, financial risk tolerance.

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Authors: Khelood A. Mkalaf, Peter Gibson, John Flanagan

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This study investigates the relationship between the reliability of critical medical equipment (CME) and the effectiveness of CME maintenance management strategies in relation to patient outcomes in 84 public hospitals of a top 20 OECD country. The work has examined the effectiveness of CME maintenance management strategies used by the public hospital system of a large state run health organization. The conceptual framework was designed to examine the significance of the relationship between six variables: (1) types of maintenance management strategies, (2) maintenance services, (3) maintenance practice, (4) medical equipment reliability, (5) maintenance costs and (6) patient outcomes. The results provide interesting insights into the effectiveness of the maintenance strategies used. For example, there appears to be about a 1 in 10 000 probability of failure of anesthesia equipment, but these seem to be confined to specific maintenance situations. There are also some findings in relation to outsourcing of maintenance. For each of the variables listed, results are reported in relation to the various types of maintenance strategies and services. Decision-makers may use these results to evaluate more effective maintenance strategies for their CME and generate more effective patient outcomes.

Keywords: Critical medical equipment, maintenance strategy, patient outcomes, reliability.

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Authors: Yung-Ting Chang, Chung-You Tsai, Yu-Chuan Li

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Nosocomial (i.e., hospital-acquired) infections (NI) is a major cause of morbidity and mortality in hospitals. NI rate is higher in intensive care units (ICU) than in the general ward due to patients with severe symptoms, poor immunity, and accepted many invasive therapies. Contact behaviors between health caregivers and patients is one of the infect factors. It is difficult to obtain complete contact records by traditional method of retrospective analysis of medical records. This paper establishes a contact history inferential model (CHIM) intended to extend the use of Proximity Sensing of rapid frequency identification (RFID) technology to transferring all proximity events between health caregivers and patients into clinical events (close-in events, contact events and invasive events).The results of the study indicated that the CHIM can infer proximity care activities into close-in events and contact events. The infection control team could redesign and build optimal workflow in the ICU according to the patient-specific contact history which provided by our automatic tracing system.

Keywords: Active Radio Frequency Identification, Intensive Care Unit, Nosocomial Infections

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Authors: G. Sokhansefat, M. Delavar, M. Banedj-Schafii

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Recently research on human wayfinding has focused mainly on mental representations rather than processes of wayfinding. The objective of this paper is to demonstrate the rationality behind applying multi-agent simulation paradigm to the modeling of rescuer team wayfinding in order to develop computational theory of perceptual wayfinding in crisis situations using image schemata and affordances, which explains how people find a specific destination in an unfamiliar building such as a hospital. The hypothesis of this paper is that successful navigation is possible if the agents are able to make the correct decision through well-defined cues in critical cases, so the design of the building signage is evaluated through the multi-agent-based simulation. In addition, a special case of wayfinding in a building, finding one-s way through three hospitals, is used to demonstrate the model. Thereby, total rescue time for rescue operation during building fire is computed. This paper discuses the computed rescue time for various signage localization and provides experimental result for optimization of building signage design. Therefore the most appropriate signage design resulted in the shortest total rescue time in various situations.

Keywords: Multi-Agent system (MAS), Spatial Cognition, Wayfinding, Indoor Environment, Geospatial Information System (GIS).

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Authors: Daniella Kucsma

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The examination of the Public Service Organization’s performance evaluation includes several steps that help public organizations to develop a more efficient system. Public sector organizations have different characteristics than the competitive sector, so it can be stated that other/new elements become more important in their performance processes. The literature in this area is diverse, so highlighting an indicator system can be useful for introducing a system, but it is also worthwhile to measure the specific elements of the organization. In the case of a public service organization, due to the service obligation, it is usually possible to talk about a high number of users, so compliance is more difficult. For the organization, it is an important target to place great emphasis on the increase of service standards and the development of related processes. In this research, the health sector is given a prominent role, as it is a sensitive area where both organizational and individual performance is important for all participants. As a primary step, the content of the strategy is decisive, as this is important for the efficient structure of the process. When designing any system, it is important to review the expectations of the stakeholders, as this is primary when considering the design. The goal of this paper is to build the foundations of a performance management and indexing framework that can help a hospital to provide effective feedback and a direction that is important in assessing and developing a service and can become a management philosophy.

Keywords: health sector, public sector, performance management, strategy

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Authors: M. Ricardo Lang, A. Costa, I. Iesbik, K. Haag, L. Trindade Buffara, O. Reimann Junior, C. Auswaldt Steclan

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Stroke affects not only the individual, but has significant impacts on the social and family context. Therefore, it is necessary to know the peculiarities of each region, in order to contribute to regional public health policies effectively. Thus, the present study discusses biomarkers in a post-stroke population, admitted to a stroke unit (U-stroke) of reference in the southern region of Brazil. Biomarkers were analyzed, such as age, length of stay, mortality rate, survival time, risk factors and family history of stroke in patients after ischemic stroke. In this studied population, comparing men and women, it was identified that men were more affected than women, and the average age of women affected was higher, as they also had the highest mortality rate and the shortest hospital stay. The risk factors identified here were according to the global scenario; with systemic arterial hypertension (SAH) being the most frequent and those associated with sedentary lifestyle in women the most frequent (dyslipidemia, heart disease and obesity). In view of this, the importance of studies that characterize populations regionally is evident, strengthening the strategic planning of policies in favor of health care.

Keywords: Biomarkers, population, stroke, sex, stroke unit.

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Authors: Won-Pil Park, Seung-Kwan Cho, Jai-Young Ko, Anders Kristensson, S.T.S. Al-Hassani, Han-Sung Kim, Dohyung Lim

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A number of previous studies were rarely considered the effects of transient non-uniform balloon expansion on evaluation of the properties and behaviors of stents during stent expansion, nor did they determine parameters to maximize the performances driven by mechanical characteristics. Therefore, in order to fully understand the mechanical characteristics and behaviors of stent, it is necessary to consider a realistic modeling of transient non-uniform balloon-stent expansion. The aim of the study is to propose design parameters capable of improving the ability of vascular stent through a comparative study of seven commercial stents using finite element analyses of a realistic transient non-uniform balloon-stent expansion process. In this study, seven representative commercialized stents were evaluated by finite element (FE) analysis in terms of the criteria based on the itemized list of Food and Drug Administration (FDA) and European Standards (prEN). The results indicate that using stents composed of opened unit cells connected by bend-shaped link structures and controlling the geometrical and morphological features of the unit cell strut or the link structure at the distal ends of stent may improve mechanical characteristics of stent. This study provides a better method at the realistic transient non-uniform balloon-stent expansion by investigating the characteristics, behaviors, and parameters capable of improving the ability of vascular stent.

Keywords: Finite Element Analysis, Mechanical Characteristic, Transient Non-uniform Balloon-Stent Expansion, Vascular Stent.

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Authors: Natasha Hussain, Maleeha Aslam, Robina Farooq

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Hepatitis B and hepatitis C are among the most significant hepatic infections all around the world that may lead to hepatocellular carcinoma. This study is first time performed at the blood transfussion centre of Omar hospital, Lahore. It aims to determine the sero-prevalence of these diseases by screening the apparently healthy blood donors who might be the carriers of HBV or HCV and pose a high risk in the transmission. It also aims the comparison between the sensitivity of two diagnostic tests; chromatographic immunoassay – one step test device and Enzyme Linked Immuno Sorbant Assay (ELISA). Blood serum of 855 apparently healthy blood donors was screened for Hepatitis B surface antigen (HBsAg) and for anti HCV antibodies. SPSS version 12.0 and X2 (Chi-square) test were used for statistical analysis. The seroprevalence of HCV was 8.07% by the device method and by ELISA 9.12% and that of HBV was 5.6% by the device and 6.43% by ELISA. The unavailability of vaccination against HCV makes it more prevalent. Comparing the two diagnostic methods, ELISA proved to be more sensitive.

Keywords: ELISA, Sensitivity comparison of diagnostic tests, seroprevalence of Hepatitis B and C

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Authors: Kasthurirangan Gopalakrishnan, Marshall R. Thompson, Anshu Manik

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This paper describes the use of artificial neural networks (ANN) for predicting non-linear layer moduli of flexible airfield pavements subjected to new generation aircraft (NGA) loading, based on the deflection profiles obtained from Heavy Weight Deflectometer (HWD) test data. The HWD test is one of the most widely used tests for routinely assessing the structural integrity of airport pavements in a non-destructive manner. The elastic moduli of the individual pavement layers backcalculated from the HWD deflection profiles are effective indicators of layer condition and are used for estimating the pavement remaining life. HWD tests were periodically conducted at the Federal Aviation Administration-s (FAA-s) National Airport Pavement Test Facility (NAPTF) to monitor the effect of Boeing 777 (B777) and Beoing 747 (B747) test gear trafficking on the structural condition of flexible pavement sections. In this study, a multi-layer, feed-forward network which uses an error-backpropagation algorithm was trained to approximate the HWD backcalculation function. The synthetic database generated using an advanced non-linear pavement finite-element program was used to train the ANN to overcome the limitations associated with conventional pavement moduli backcalculation. The changes in ANN-based backcalculated pavement moduli with trafficking were used to compare the relative severity effects of the aircraft landing gears on the NAPTF test pavements.

Keywords: Airfield pavements, ANN, backcalculation, newgeneration aircraft

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Authors: Laila Seada, Nouf Al Gharbi, Shaimaa Dawa

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Although skin cancers are prevalent worldwide, it is uncommon in Ha’il region in the Kingdom of Saudi Arabia, mostly non-melanoma sub-type. During a 4-year period from 2014 to 2017, out of a total of 120 cases of skin lesions, 29 non-melanoma cancers were retrieved from histopathology files obtained from King Khalid Hospital. As part of the study, all cases of skin cancer diagnosed during 2014 -2017 have been revised and the clinicopathological data recorded. The results show that Basal cell carcinoma (BCC) was the most common neoplasm (36%), followed by cutaneous lymphomas (mostly mycosis fungoides 25%), squamous cell carcinoma (SCC) (21%) and dermatofibrosarcoma protuberans (DFSP) (11%). Only one case of metastatic carcinoma was recorded. BCC nodular type was the most prevalent, with a mean age 57.6 years and mean size 2.73 cm. SCC was mostly grade 2, with mean size 1.9 cm and an older mean age of 72.3 cm. Increased size of lesion positively correlated with older age (p = 0.001). Non-melanoma skin cancer in Ha’il region is not frequently encountered. BCC is the most frequent followed by cutaneous T-cell lymphomas and SCC. The findings in this study were in accordance with other parts of, but much lower than other parts of the world.

Keywords: Non melanoma skin cancer, Hail Region, histopathology, BCC.

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Authors: Phusit Phukamchanoad

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The research studies the behaviors based on sufficiency economy philosophy at individual and community levelsas well as the satisfaction of the urban community leaders by collecting data with purposive sampling technique. For in-depth interviews with 26 urban community leaders, the result shows that the urban community leaders have good knowledge and understanding about sufficiency economy philosophy. Especially in terms of money spending, they must consider the need for living and be economical. The activities in the community or society should not take advantage of the others as well as colleagues. At present, most of the urban community leaders live in sufficient way. They often spend time with public service, but many families are dealing with debt. Many communities have some political conflict and high family allowances because of living in the urban communities with rapid social and economic changes. However, there are many communities that leaders have applied their wisdom in development for their people by gathering and grouping the professionals to form activities such as making chilli sauce, textile organization, making artificial flowers to worship the sanctity. The most prominent group is the foot massage business in Wat Pracha Rabue Tham. This professional group is supported continuously by the government. One of the factors in terms of satisfaction used for evaluating community leaders is the customary administration in brotherly, interdependent way rather than using the absolute power or controlling power, but using the roles of leader to perform the activities with their people intently, determinedly and having public mind for people.

Keywords: Performance and Activities, Sufficiency Economy, Urban Communities Leader.

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Authors: Funmilola O. Omoya, Abdul O. Momoh

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Malaria constitutes one of the major health problems in Nigeria. One of the reasons attributed for the upsurge was the development of resistance of Plasmodium falciparum and the emergence of multi-resistant strains of the parasite to anti-malaria drugs. A continued search for other effective, safe and cheap plantbased anti-malaria agents thus becomes imperative in the face of these difficulties. The objective of this study is therefore to evaluate the in vivo anti-malarial efficacy of ethanolic extracts of Chromolaena odorata and Androgaphis paniculata leaves. The two plants were evaluated for their anti-malaria efficacy in vivo in a 4-day curative test assay against Plasmodium berghei strain in mice. The group treated with 500mg/ml dose of ethanolic extract of A. paniculata plant showed parasite suppression with increase in Packed Cell Volume (PCV) value except day 3 which showed a slight decrease in PCV value. During the 4-day curative test, an increase in the PCV values, weight measurement and zero count of Plasmodium berghei parasite values was recorded after day 3 of drug administration. These results obtained in group treated with A. paniculata extract showed anti-malarial efficacy with higher mortality rate in parasitaemia count when compared with Chromolaena odorata group. These results justify the use of ethanolic extracts of A. paniculata plant as medicinal herb used in folklore medicine in the treatment of malaria.

Keywords: Anti-malaria, Curative, Plant-based anti-malaria agents.

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Authors: Kevin Fong-Rey Liu, Ken Yeh, Cheng-Wu Chen, Han-Hsi Liang

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The sanitary sewerage connection rate becomes an important indicator of advanced cities. Following the construction of sanitary sewerages, the maintenance and management systems are required for keeping pipelines and facilities functioning well. These maintenance tasks often require sewer workers to enter the manholes and the pipelines, which are confined spaces short of natural ventilation and full of hazardous substances. Working in sewers could be easily exposed to a risk of adverse health effects. This paper proposes the use of Bayesian belief networks (BBN) as a higher level of noncarcinogenic health risk assessment of sewer workers. On the basis of the epidemiological studies, the actual hospital attendance records and expert experiences, the BBN is capable of capturing the probabilistic relationships between the hazardous substances in sewers and their adverse health effects, and accordingly inferring the morbidity and mortality of the adverse health effects. The provision of the morbidity and mortality rates of the related diseases is more informative and can alleviate the drawbacks of conventional methods.

Keywords: Bayesian belief networks, sanitary sewerage, healthrisk assessment, hazard quotient, target organ-specific hazard index.

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Authors: Eva Tvrdá, Marek Halenár, Hana Greifová, Alica Mackovich, Faridullah Hashim, Norbert Lukáč

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Oxidative stress associated with semen cryopreservation may result in lipid peroxidation (LPO), DNA damage and apoptosis, leading to decreased sperm motility and fertilization ability. Curcumin (CUR), a natural phenol isolated from Curcuma longa Linn. has been presented as a possible supplement for a more effective semen cryopreservation because of its antioxidant properties. This study focused to evaluate the effects of CUR on selected oxidative stress parameters in cryopreserved bovine semen. 20 bovine ejaculates were split into two aliquots and diluted with a commercial semen extender containing CUR (50 μmol/L) or no supplement (control), cooled to 4 °C, frozen and kept in liquid nitrogen. Frozen straws were thawed in a water bath for subsequent experiments. Computer assisted semen analysis was used to evaluate spermatozoa motility, and reactive oxygen species (ROS) generation was quantified by using luminometry. Superoxide generation was evaluated with the NBT test, and LPO was assessed via the TBARS assay. CUR supplementation significantly (P<0.001) increased the spermatozoa motility and provided a significantly higher protection against ROS (P<0.001) or superoxide (P<0.01) overgeneration caused by semen freezing and thawing. Furthermore, CUR administration resulted in a significantly (P<0.01) lower LPO of the experimental semen samples. In conclusion, CUR exhibits significant ROS-scavenging activities which may prevent oxidative insults to cryopreserved spermatozoa and thus may enhance the post-thaw functional activity of male gametes.

Keywords: Bulls, cryopreservation, curcumin, lipid peroxidation, reactive oxygen species, spermatozoa.

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Authors: Atul Khurana, Rajul Rastogi, Hans-Joachim Gamperl

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The pharmaceutical companies are getting more inclined towards patient support programs (PSPs) which assist patients and/or healthcare professionals (HCPs) in more desirable disease management and cost-effective treatment. The utmost objective of these programs is patient care. The PSPs may include financial assistance to patients, medicine compliance programs, access to HCPs via phone or online chat centers, etc. The PSP has a crucial role in terms of customer acquisition and retention strategies. During the conduct of these programs, Marketing Authorisation Holder (MAH) may receive information related to concerned medicinal products, which is usually reported by patients or involved HCPs. This information may include suspected adverse reaction(s) during/after administration of medicinal products. Hence, the MAH should design PSP to comply with regulatory reporting requirements and avoid non-compliance during PV inspection. The emergence of wireless health devices is lowering the burden on patients to manually incorporate safety data, and building a significant option for patients to observe major swings in reference to drug safety. Therefore, to enhance the adoption of these programs, MAH not only needs to aware patients about advantages of the program, but also recognizes the importance of time of patients and commitments made in a constructive manner. It is indispensable that strengthening the public health is considered as the topmost priority in such programs, and the MAH is compliant to Pharmacovigilance (PV) requirements along with regulatory obligations.

Keywords: Drug safety, good pharmacovigilance practice, patient support program, pharmacovigilance.

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Authors: Ashraf Pirasteh, Alireza Hidarnia, Ali Asghari, Soghrate Faghihzadeh, Fazlollah Ghofranipour

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Background: Regular physical activity contributes positively to physical and psychological health. In the present study, the stages of change of physical activity and the total physical Aims: The aim of this study was to investigate the proportion of adolescent girls in each stages of change and the causative factors associated with physical activity such as the related social support and self efficacy in a sample of the high school students. Methods: In this study, Social Cognitive Theory (SCT) and the Transtheorical Model (TTM) guided instrument development. The data regarding the demographics, psychosocial determinants of physical activity, stage of change and physical activity was gathered by questionnaires. Several measures of psychosocial determinants of physical activity were translated from English into Persian using the back-translation technique. These translated measures were administered to 512 ninth and tenth-grade Iranian high school students for factor analysis. Results: The distribution of the stage of change for physical activity was as follow: 18/5% in precontemplation, 23.4% in contemplation, 38.2% in preparation, 4.6% in action and 15.3% in maintenance. They were in 80.1% pre-adoption stages (precontemplation stage, contemplation stage and preparation stage) and 19.9% post-adoption stages (action stage and maintenance stage) of physical activity. There was a significant relate between age and physical activity in adolescent girls (age-related decline of physical activity) p<0001. Conclusion: The findings of the present study can contribute to improve health behaviors and for administration of health promotion programs in the adolescent populations.

Keywords: Adolescent, Iranian girls, Physical activity, Stages of change

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Authors: Siham Jemal Kedir

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Information communication technology is dramatically transforming the health sector, especially in developing countries with few resources and burgeoning access to an internet connection. As a result, processes such as record keeping, administration, and human resources have been vastly simplified, allowing hospitals to focus on delivering urgent medical care. This paper will explore the impact of IT through a study of the electronic medical record system in the Mekelle City Health Center in Tigray Region, Ethiopia. This paper has four specific objectives: 1. developing artifacts in the Electronic Medical Record system, 2. preparing a diagram for step-by-step development of Electronic Medical Records, 3. creating a draft website with the proposed Electronic Medical Record system, and 4. Testing and evaluating the performance and user acceptance of the system. The research will be done in a qualitative manner employing interviews and in-person observation. The research has found the following major results: firstly, the medical record system has been difficult to implement. Second, the Mekelle Health Center is using a manual recording system which is time-consuming and inefficient. The old recording system in the Center leads to the dissatisfaction of patients as well as the service provider staff. As a result, to transform the manual recording system into a digital system, an electronic medical recording system has been developed. The developed system has been tested for implementation and has been successful. Consequently, the administrator of the health center is ready to implement and use the developed software to introduce a medical recording system in Mekelle Health Center.

Keywords: Electronic Health Record Implementation, EMR System Development, Medical Record.

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Authors: Simon B. N. Thompson

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Cortisol is essential to the regulation of the immune system and yawning is a pathological symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved and with yawning is highly correlated with cortisol levels in healthy people. Saliva samples from 59 participants were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, together with EMG data and questionnaire data: Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, health details. Exclusion criteria: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and post-stimuli, which was nonsignificant. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with yawning. Further research is exploring the use of cortisol as an early diagnostic tool for MS. Ethics approval granted and professional code of conduct, confidentiality, and safety issues are approved therein.

Keywords: Cortisol, Multiple Sclerosis, Yawning, Thompson’s Cortisol Hypothesis.

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Authors: Anthony Bawa, Konstantinos Banitsas

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Rheumatism is a muscular disorder that affects the muscles of the upper and lower limbs. This condition could potentially progress to impair the movement of patients. This study aims to investigate the hip muscular imbalance in patients with chronic rheumatism. A clinical trial involving a total of 15 participants, made up of 10 patients and five control subjects, took place in KATH Hospital between August and September. Participants recruited for the study were of age 54 ± 8 years, weight 65 ± 8 kg, and height 176 ± 8 cm. Muscle signals were recorded from the rectus femoris, and vastus lateralis on the right and left hip of participants. The parameters used in determining the hip muscular imbalances were the maximum voluntary contraction (MVC%), the mean difference, and hip muscle fatigue levels. The mean signals were compared using a t-test, and the metrics for muscle fatigue assessment were based on the root mean square (RMS), mean absolute value (MAV) and mean frequency (MEF), which were computed between the hip muscles of participants. The results indicated that there were significant imbalances in the muscle coactivity between the right and left hip muscles of patients. The patients’ MVC values were observed to be above 10% when compared with control subjects. Furthermore, the mean difference was seen to be higher with p > 0.002 among patients, which indicated clear differences in the hip muscle contraction activities. The findings indicate significant hip muscular imbalances for patients with rheumatism compared with control subjects. Information about the imbalances among patients will be useful for clinicians in designing therapeutic muscle-strengthening exercises.

Keywords: Muscular, imbalances, rheumatism, hip.

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Authors: Lebari B. Gboeloh

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Ficus exasperata is a plant used in the traditional management of malaria in south-south Nigeria. An investigation into the effects of the ethanolic extract of the leaf of the plant on some biochemical indices in albino mice infected with Plasmodium berghei (NK 65) was conducted. 48 mice with weight range of 13-23 g were grouped into six (A, B, C, D, E, and F). Each group contained 8 mice. Groups A, B, C, D and E were infected with blood containing the parasite. Group F was not infected and served as the normal control. On the 6^th day after infection, 4 mice from each group were sacrificed and blood samples are collected for investigation. The remaining mice in each group were treated. Mice in Groups A, B and C were administered orally with 200, 300 and 500 mg/kg body weight of Ficus exasperata respectively for six days. Group D was not treated while Group F was given distilled water. Group E was treated with 5 mg/kg body weight of chloroquine. On the 6^th day post treatment, these mice were sacrificed and blood samples were collected for biochemical analysis. The results indicated that on the 6^th day post inoculation, the levels of aspartate aminotransferase (AST), alkaline phosphatase (ALP) and alanine aminotransferase (ALT) in all the mice infected with the parasite were significantly (p < 0.05) elevated. However, on the 6^th day post administration of extract, the increased levels of AST, ALP and ALT were significantly (p < 0.05) reduced in groups administered with 300 and 500 mg/kg body weight of the extract compared with groups D and F. The reduction in the levels of these enzymes is an indication that F. exasperata have no hepatotoxic effect on the mice at the dose levels administered.

Keywords: Ficus exasperata, albino mice, Plasmodium berghei, biochemical parameters.

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Authors: Kjersti Engan, Thor Ole Gulsrud, Karl Fredrik Fretheim, Barbro Furebotten Iversen, Liv Eriksen

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Clusters of microcalcifications in mammograms are an important sign of breast cancer. This paper presents a complete Computer Aided Detection (CAD) scheme for automatic detection of clustered microcalcifications in digital mammograms. The proposed system, MammoScan μCaD, consists of three main steps. Firstly all potential microcalcifications are detected using a a method for feature extraction, VarMet, and adaptive thresholding. This will also give a number of false detections. The goal of the second step, Classifier level 1, is to remove everything but microcalcifications. The last step, Classifier level 2, uses learned dictionaries and sparse representations as a texture classification technique to distinguish single, benign microcalcifications from clustered microcalcifications, in addition to remove some remaining false detections. The system is trained and tested on true digital data from Stavanger University Hospital, and the results are evaluated by radiologists. The overall results are promising, with a sensitivity > 90 % and a low false detection rate (approx 1 unwanted pr. image, or 0.3 false pr. image).

Keywords: mammogram, microcalcifications, detection, CAD, MammoScan μCaD, VarMet, dictionary learning, texture, FTCM, classification, adaptive thresholding

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Authors: G. Sandhya Devi, G. Suvarna Kumar, S. Chandini

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This research work aims to develop a system that will analyze and identify students who indulge in malpractices/suspicious activities during the course of an academic offline examination. Automated Video Surveillance provides an optimal solution which helps in monitoring the students and identifying the malpractice event immediately. This work is organized into three modules. The first module deals with performing an impersonation check using a PCA-based face recognition method which is done by cross checking his profile with the database. The presence or absence of the student is even determined in this module by implementing an image registration technique wherein a grid is formed by considering all the images registered using the frontal camera at the determined positions. Second, detecting such facial malpractices in which a student gets involved in conversation with another, trying to obtain unauthorized information etc., based on the threshold range evaluated by considering his/her mouth state whether open or closed. The third module deals with identification of unauthorized material or gadgets used in the examination hall by training the positive samples of the object through various stages. Here, a top view camera feed is analyzed to detect the suspicious activities. The system automatically alerts the administration when any suspicious activities are identified, thereby reducing the error rate caused due to manual monitoring. This work is an improvement over our previous work published in identifying suspicious activities done by examinees in an offline examination.

Keywords: Impersonation, image registration, incrimination, object detection, threshold evaluation.

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Authors: Maryam Nazari, Majid Karandish, Alihossein Saberi

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Obesity as a global health challenge motivates pharmaceutical industries to produce anti-obesity drugs. However, effectiveness of these agents is remained unclear. Because of popularity of dietary supplements, the aim of this study was tp investigate the effects of Conjugated Linoleic Acid (CLA) and L-carnitine (LC) on serum glucose, triglyceride, cholesterol and weight changes in diet induced obese rats. 48 male Wistar rats were randomly divided into two groups: Normal fat diet (n=8), and High fat diet (HFD) (n=32). After eight weeks, the second group which was maintained on HFD until the end of study, was subdivided into four categories: a) 500 mg Corn Oil (as control group), b) 500 mg CLA, c) 200 mg LC, d) 500 mg CLA+ 200 mg LC.All doses are planned per kg body weights, which were administered by oral gavage for four weeks. Body weights were measured and recorded weekly by means of a digital scale. At the end of the study, blood samples were collected for biochemical markers measurement. SPSS Version 16 was used for statistical analysis. At the end of 8^th week, a significant difference in weight was observed between HFD and NFD group. After 12 weeks, LC significantly reduced weight gain by 4.2%. Trend of weight gain in CLA and CLA+LC groups was insignificantly decelerated. CLA+LC reduced triglyceride level significantly, but just CLA had significant influence on total cholesterol and insignificant decreasing effect on FBS. Our results showed that an obesogenic diet in a relative short time led to obesity and dyslipidemia which can be modified by LC and CLA to some extent.

Keywords: Conjugated linoleic acid, high fat diet, L-carnitine, obesity.

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Authors: Catherine A. Todd, Fazel Naghdy

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In this work a surgical simulator is produced which enables a training otologist to conduct a virtual, real-time prosthetic insertion. The simulator provides the Ear, Nose and Throat surgeon with real-time visual and haptic responses during virtual cochlear implantation into a 3D model of the human Scala Tympani (ST). The parametric model is derived from measured data as published in the literature and accounts for human morphological variance, such as differences in cochlear shape, enabling patient-specific pre- operative assessment. Haptic modeling techniques use real physical data and insertion force measurements, to develop a force model which mimics the physical behavior of an implant as it collides with the ST walls during an insertion. Output force profiles are acquired from the insertion studies conducted in the work, to validate the haptic model. The simulator provides the user with real-time, quantitative insertion force information and associated electrode position as user inserts the virtual implant into the ST model. The information provided by this study may also be of use to implant manufacturers for design enhancements as well as for training specialists in optimal force administration, using the simulator. The paper reports on the methods for anatomical modeling and haptic algorithm development, with focus on simulator design, development, optimization and validation. The techniques may be transferrable to other medical applications that involve prosthetic device insertions where user vision is obstructed.

Keywords: Haptic modeling, medical device insertion, real-time visualization of prosthetic implantation, surgical simulation.

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Authors: Jacqueline R. T. Alipo-on, Francesca I. F. Escobar, Myles J. T. Tan, Hezerul Abdul Karim, Nouar AlDahoul

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Electrocardiogram (ECG) signal analysis and processing are crucial in the diagnosis of cardiovascular diseases which are considered as one of the leading causes of mortality worldwide. However, the traditional rule-based analysis of large volumes of ECG data is time-consuming, labor-intensive, and prone to human errors. With the advancement of the programming paradigm, algorithms such as machine learning have been increasingly used to perform an analysis on the ECG signals. In this paper, various deep learning algorithms were adapted to classify five classes of heart beat types. The dataset used in this work is the synthetic MIT-Beth Israel Hospital (MIT-BIH) Arrhythmia dataset produced from generative adversarial networks (GANs). Various deep learning models such as ResNet-50 convolutional neural network (CNN), 1-D CNN, and long short-term memory (LSTM) were evaluated and compared. ResNet-50 was found to outperform other models in terms of recall and F1 score using a five-fold average score of 98.88% and 98.87%, respectively. 1-D CNN, on the other hand, was found to have the highest average precision of 98.93%.

Keywords: Heartbeat classification, convolutional neural network, electrocardiogram signals, ECG signals, generative adversarial networks, long short-term memory, LSTM, ResNet-50.

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Authors: Richa Grover, Rahul Grover, V. Balaji Rao, Kavish Kejriwal

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Selection of suppliers is a crucial problem in the supply chain management. On top of that, sustainable supplier selection is the biggest challenge for the organizations. Environment protection and social problems have been of concern to society in recent years, and the traditional supplier selection does not consider about this factor; therefore, this research work focuses on introducing sustainable criteria into the structure of supplier selection criteria. Sustainable Supply Chain Management (SSCM) is the management and administration of material, information, and money flows, as well as coordination among business along the supply chain. All three dimensions - economic, environmental, and social - of sustainable development needs to be taken care of. Purpose of this research is to maximize supply chain profitability, maximize social wellbeing of supply chain and minimize environmental impacts. Problem statement is selection of suppliers in a sustainable supply chain network by ranking the suppliers against sustainable criteria identified. The aim of this research is twofold: To find out what are the sustainable parameters that can be applied to the supply chain, and to determine how these parameters can effectively be used in supplier selection. Multicriteria decision making tools will be used to rank both criteria and suppliers. AHP Analysis will be used to find out ratings for the criteria identified. It is a technique used for efficient decision making. TOPSIS will be used to find out rating for suppliers and then ranking them. TOPSIS is a MCDM problem solving method which is based on the principle that the chosen option should have the maximum distance from the negative ideal solution (NIS) and the minimum distance from the ideal solution.

Keywords: Sustainable supply chain management, supplier selection, MCDM tools, AHP analysis, TOPSIS method.

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