Search results for: Primary care

Authors: Edith Esparza-Young, Ángel M. Matos, Yaritza Gonzalez, Kirthana Sugunathevan

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Introduction: This research describes the existing medical school program which supports a multicultural setting and bilingualism. The rise of Spanish speakers in the United States has led to the recruitment of bilingual medical students who can serve the evolving demographics. This paper includes anecdotal evidence, narratives and the latest research on the outcomes of supporting a multilingual academic experience in medical school and beyond. People in the United States will continue to need health care from physicians who have experience with multicultural competence. Physicians who are bilingual and possess effective communication skills will be in high demand. Methodologies: This research is descriptive. Through this descriptive research, the researcher will describe the qualities and characteristics of the existing medical school programs, curriculum, and student services. Additionally, the researcher will shed light on the existing curriculum in the medical school and also describe specific programs which help to serve as safety nets to support diverse populations. The method included observations of the existing program and the implementation of the medical school program, specifically the Accelerated Review Program, the Language Education and Professional Communication Program, student organizations and the Global Health Institute. Concluding Statement: This research identified and described characteristics of the medical school’s program. The research explained and described the current and present phenomenon of this medical program, which has focused on increasing the graduation of bilingual and minority physicians. The findings are based on observations of the curriculum, programs and student organizations which evolves and remains innovative to stay current with student enrollment.

Keywords: Bilingual, English, medicine, doctor.

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Authors: Mohammed Sani Abdulai

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Government budgets are the primary instruments for formulating and implementing a country’s fiscal policy objectives, development priorities, and the overall socio-economic aspirations of its people. Thus, in this paper, the author examined the Government of Ghana’s budgets with respect to their functions, coverage, classifications, and integration with the country’s chart of accounts. The author did so by amalgamating the research findings of extant literature with (a) the operational and procedural guidelines underpinning the formulation and execution of the government’s budgets; (b) the recommendations made by various development partners and thinktanks on reforming the country’s budgeting processes and procedures; and (c) the lessons Ghana could learn from the budget reform efforts of other countries. By way of research findings, the paper showed that the Government of Ghana’s budgets in terms of function are both eclectic and multidimensional. On coverage, the paper showed that the country’s budgets duly cover the revenues and expenditures of the general government (i.e., both the central and sub-national governments). Finally, on classifications, the paper noted with delight the Government of Ghana’s effort in providing classificatory codes to both its national development agenda and such international development goals as the AU’s Agenda 2063 and the UN’s Sustainable Development Goals. However, the paper found some significant lapses that require a complete overhaul and structuring on the integrations of its budget classifications with its chart of accounts. Thus, the paper concluded with a detailed examination of the challenges confronting the country’s current chart of accounts and recommendations for addressing them.

Keywords: Budget, budgetary transactions, budgetary governance, Chart of Accounts, classification, composition, coverage, Public Financial Management.

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Authors: S. Rao Rayapudi

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Economic Load Dispatch (ELD) is a method of determining the most efficient, low-cost and reliable operation of a power system by dispatching available electricity generation resources to supply load on the system. The primary objective of economic dispatch is to minimize total cost of generation while honoring operational constraints of available generation resources. In this paper an intelligent water drop (IWD) algorithm has been proposed to solve ELD problem with an objective of minimizing the total cost of generation. Intelligent water drop algorithm is a swarm-based natureinspired optimization algorithm, which has been inspired from natural rivers. A natural river often finds good paths among lots of possible paths in its ways from source to destination and finally find almost optimal path to their destination. These ideas are embedded into the proposed algorithm for solving economic load dispatch problem. The main advantage of the proposed technique is easy is implement and capable of finding feasible near global optimal solution with less computational effort. In order to illustrate the effectiveness of the proposed method, it has been tested on 6-unit and 20-unit test systems with incremental fuel cost functions taking into account the valve point-point loading effects. Numerical results shows that the proposed method has good convergence property and better in quality of solution than other algorithms reported in recent literature.

Keywords: Economic load dispatch, Transmission loss, Optimization, Valve point loading, Intelligent Water Drop Algorithm.

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Authors: Hock Chuan, Lim

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This paper presents an approach for identifying interactive effects using Network Science (NS) supported by Social Network Analysis (SNA) techniques. Based on general observations that learning processes and behaviors are shaped by the social relationships and influenced by learning environment, the central idea was to understand both the human and non-human interactive effects for a blended learning mode of delivery of computer science modules. Important findings include (a) the importance of non-human nodes to influence the centrality and transfer; (b) the degree of non-human and human connectivity impacts learning. This project reveals that the NS pattern and connectivity as measured by node relationships offer alternative approach for hypothesis generation and design of qualitative data collection. An iterative process further reinforces the analysis, whereas the experimental simulation option itself is an interesting alternative option, a hybrid combination of both experimental simulation and qualitative data collection presents itself as a promising and viable means to study complex scenario such as blended learning delivery mode. The primary value of this paper lies in the design of the approach for studying interactive effects of human (social nodes) and non-human (learning/study environment, Information and Communication Technologies (ICT) infrastructures nodes) components. In conclusion, this project adds to the understanding and the use of SNA to model and study interactive effects in blended social learning.

Keywords: Blended learning, network science, social learning, social network analysis, study environment.

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Authors: Andressa S. T. Gomes, Luiza A. Souza, Luciana H. Yamane, Renato R. Siman

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The segregation of waste of electrical and electronic equipment (WEEE) in the generating source, its characterization (quali-quantitative) and identification of origin, besides being integral parts of classification reports, are crucial steps to the success of its integrated management. The aim of this paper was to count WEEE generation at the Federal University of Espírito Santo (UFES), Brazil, as well as to define sources, temporary storage sites, main transportations routes and destinations, the most generated WEEE and its recycling potential. Quantification of WEEE generated at the University in the years between 2010 and 2015 was performed using data analysis provided by UFES’s sector of assets management. EEE and WEEE flow in the campuses information were obtained through questionnaires applied to the University workers. It was recorded 6028 WEEEs units of data processing equipment disposed by the university between 2010 and 2015. Among these waste, the most generated were CRT screens, desktops, keyboards and printers. Furthermore, it was observed that these WEEEs are temporarily stored in inappropriate places at the University campuses. In general, these WEEE units are donated to NGOs of the city, or sold through auctions (2010 and 2013). As for recycling potential, from the primary processing and further sale of printed circuit boards (PCB) from the computers, the amount collected could reach U$ 27,839.23. The results highlight the importance of a WEEE management policy at the University.

Keywords: Solid waste, waste of electric and electronic equipment, waste management, institutional generation of solid waste.

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Authors: Ajay Mandal, Achinta Bera

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Nanoemulsions are a class of emulsions with a droplet size in the range of 50–500 nm and have attracted a great deal of attention in recent years because it is unique characteristics. The physicochemical properties of nanoemulsion suggests that it can be successfully used to recover the residual oil which is trapped in the fine pore of reservoir rock by capillary forces after primary and secondary recovery. Oil-in-water nanoemulsion which can be formed by high-energy emulsification techniques using specific surfactants can reduce oil-water interfacial tension (IFT) by 3-4 orders of magnitude. The present work is aimed on characterization of oil-inwater nanoemulsion in terms of its phase behavior, morphological studies; interfacial energy; ability to reduce the interfacial tension and understanding the mechanisms of mobilization and displacement of entrapped oil blobs by lowering interfacial tension both at the macroscopic and microscopic level. In order to investigate the efficiency of oil-water nanoemulsion in enhanced oil recovery (EOR), experiments were performed to characterize the emulsion in terms of their physicochemical properties and size distribution of the dispersed oil droplet in water phase. Synthetic mineral oil and a series of surfactants were used to prepare oil-in-water emulsions. Characterization of emulsion shows that it follows pseudo-plastic behaviour and drop size of dispersed oil phase follows lognormal distribution. Flooding experiments were also carried out in a sandpack system to evaluate the effectiveness of the nanoemulsion as displacing fluid for enhanced oil recovery. Substantial additional recoveries (more than 25% of original oil in place) over conventional water flooding were obtained in the present investigation.

Keywords: Nanoemulsion, Characterization, Enhanced Oil Recovery, Particle Size Distribution

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Authors: Wanda Luen-Wun Siu, Xiaowen Zhang

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This paper offered the primary methodical proof on how Corporate Social Responsibility (CSR) reporting related to enterprise earnings in listed firms in China in light of most evidence focusing on cross-sectional data or data in a short span of time. Using full economic and business panel data on China’s publicly listed enterprises from 2006 to 2020 over two decades in the China Stock Market & Accounting Research database, we found initial evidence of significant direct relations between CSR reporting and firm corporate performance in both state-owned and privately-owned firms over this period, supporting the stakeholder theory. Results also revealed that state-owned enterprises performed as well as private enterprises in the current period. But private enterprises performed better than state-owned enterprises in the subsequent years. Moreover, the release of social responsibility reports had the more significant impact on the financial performance of state-owned and private enterprises in the current period than in the subsequent periods. Specifically, CSR release was not significantly associated to the financial performance of state-owned enterprises on the lag of the first, second, and third periods. But it had an impact on the lag of the first, second, and third periods among private enterprises. Such findings suggested that CSR reporting helped improve the corporate financial performance of state-owned and private enterprises in the current period, but this kind of effect was more significant among private enterprises in the lag periods.

Keywords: China’s Listed Firm, CSR reporting, financial performance, panel analysis.

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Authors: Teka Haile, Behailu Hawulte, Solomon Alemayehu

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Background: HIV virological failure still remains a problem in HV/AIDS treatment and care. This study aimed to describe the prevalence and identify the factors associated with viral non-suppression among HIV-positive adult patients on antiretroviral therapy in Woliso Town, Oromia, Ethiopia. Methods: A retrospective cross-sectional study was conducted among 424 HIV-positive patient’s attending antiretroviral therapy (ART) in Woliso Town during the period from August 25, 2020 to August 30, 2020. Data collected from patient medical records were entered into Epi Info version 2.3.2.1 and exported to SPSS version 21.0 for analysis. Logistic regression analysis was done to identify factors associated with viral load non-suppression, and statistical significance of odds ratios were declared using 95% confidence interval and p-value < 0.05. Results: A total of 424 patients were included in this study. The mean age (± SD) of the study participants was 39.88 (± 9.995) years. The prevalence of HIV viral load non-suppression was 55 (13.0%) with 95% CI (9.9-16.5). Second-line ART treatment regimen (Adjusted Odds Ratio (AOR) = 8.98, 95% Confidence Interval (CI): 2.64, 30.58) and routine viral load testing (AOR = 0.01, 95% CI: 0.001, 0.02) were significantly associated with virological non-suppression. Conclusion: Virological non-suppression was high, which hinders the achievement of the third global 95 target. The second-line regimen and routine viral load testing were significantly associated with virological non-suppression. It suggests the need to assess the effectiveness of antiretroviral drugs for epidemic control. It also clearly shows the need to decentralize third-line ART treatment for those patients in need.

Keywords: Virological non-suppression, HIV-positive, ART, Woliso Town, Ethiopia.

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Authors: Ammar Ayad Issa Al-Rifaie, Zuhreya Muazu, Maysam Ali Abdulwahid, Dermot Gleeson

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The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.

Keywords: Alcohol screening, AUDIT-C, CAGE, Hazardous drinking.

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Authors: S. Ziaran, M. Musil, M. Cekan, O. Chlebo

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The paper analyzes the response of buildings and industrially structures on seismic waves (low frequency mechanical vibration) generated by blasting operations. The principles of seismic analysis can be applied for different kinds of excitation such as: earthquakes, wind, explosions, random excitation from local transportation, periodic excitation from large rotating and/or machines with reciprocating motion, metal forming processes such as forging, shearing and stamping, chemical reactions, construction and earth moving work, and other strong deterministic and random energy sources caused by human activities. The article deals with the response of seismic, low frequency, mechanical vibrations generated by nearby blasting operations on a residential home. The goal was to determine the fundamental natural frequencies of the measured structure; therefore it is important to determine the resonant frequencies to design a suitable modal damping. The article also analyzes the package of seismic waves generated by blasting (Primary waves – P-waves and Secondary waves S-waves) and investigated the transfer regions. For the detection of seismic waves resulting from an explosion, the Fast Fourier Transform (FFT) and modal analysis, in the frequency domain, is used and the signal was acquired and analyzed also in the time domain. In the conclusions the measured results of seismic waves caused by blasting in a nearby quarry and its effect on a nearby structure (house) is analyzed. The response on the house, including the fundamental natural frequency and possible fatigue damage is also assessed.

Keywords: Building structure, seismic waves, spectral analysis, structural response.

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Authors: A. Rajesh Kanna, G. Suresh Kumar, Sathyanaryana N. Gummadi

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There are various sources of energies available worldwide and among them, crude oil plays a vital role. Oil recovery is achieved using conventional primary and secondary recovery methods. In-order to recover the remaining residual oil, technologies like Enhanced Oil Recovery (EOR) are utilized which is also known as tertiary recovery. Among EOR, Microbial enhanced oil recovery (MEOR) is a technique which enables the improvement of oil recovery by injection of bio-surfactant produced by microorganisms. Bio-surfactant can retrieve unrecoverable oil from the cap rock which is held by high capillary force. Bio-surfactant is a surface active agent which can reduce the interfacial tension and reduce viscosity of oil and thereby oil can be recovered to the surface as the mobility of the oil is increased. Research in this area has shown promising results besides the method is echo-friendly and cost effective compared with other EOR techniques. In our research, on laboratory scale we produced bio-surfactant using the strain Pseudomonas putida (MTCC 2467) and injected into designed simple sand packed column which resembles actual petroleum reservoir. The experiment was conducted in order to determine the efficiency of produced bio-surfactant in oil recovery. The column was made of plastic material with 10 cm in length. The diameter was 2.5 cm. The column was packed with fine sand material. Sand was saturated with brine initially followed by oil saturation. Water flooding followed by bio-surfactant injection was done to determine the amount of oil recovered. Further, the injection of bio-surfactant volume was varied and checked how effectively oil recovery can be achieved. A comparative study was also done by injecting Triton X 100 which is one of the chemical surfactant. Since, bio-surfactant reduced surface and interfacial tension oil can be easily recovered from the porous sand packed column.

Keywords: Bio-surfactant, Bacteria, Interfacial tension, Sand column.

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Authors: Khaled Elbehiery, Hussam Elbehiery

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The success of education is dependent on evolution and adaptation, while the traditional system has worked before, one type of education evolved with the digital age is virtual education that has influenced efficiency in today’s learning environments. Virtual learning has indeed proved its efficiency to overcome the drawbacks of the physical environment such as time, facilities, location, etc., but despite what it had accomplished, the educational system over all is not adequate for being a productive system yet. Earning a degree is not anymore enough to obtain a career job; it is simply missing the skills and creativity. There are always two sides of a coin; a college degree or a specialized certificate, each has its own merits, but having both can put you on a successful IT career path. For many of job-seeking individuals across world to have a clear meaningful goal for work and education and positively contribute the community, a productive correlation and cooperation among employers, universities alongside with the individual technical skills is a must for generations to come. Fortunately, the proposed research “Entrepreneur Universal Education System” is an evolution to meet the needs of both employers and students, in addition to gaining vital and real-world experience in the chosen fields is easier than ever. The new vision is to empower the education to improve organizations’ needs which means improving the world as its primary goal, adopting universal skills of effective thinking, effective action, effective relationships, preparing the students through real-world accomplishment and encouraging them to better serve their organization and their communities faster and more efficiently.

Keywords: Virtual education, academic degree, certificates, internship, amazon web services, Microsoft Azure, Google cloud platform, hybrid models.

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Authors: Chi-Fang Huang, Yun-Shiow Chen, Yun-Kung Chung

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In the past decade, artificial neural networks (ANNs) have been regarded as an instrument for problem-solving and decision-making; indeed, they have already done with a substantial efficiency and effectiveness improvement in industries and businesses. In this paper, the Back-Propagation neural Networks (BPNs) will be modulated to demonstrate the performance of the collaborative forecasting (CF) function of a Collaborative Planning, Forecasting and Replenishment (CPFR®) system. CPFR functions the balance between the sufficient product supply and the necessary customer demand in a Supply and Demand Chain (SDC). Several classical standard BPN will be grouped, collaborated and exploited for the easy implementation of the proposed modular ANN framework based on the topology of a SDC. Each individual BPN is applied as a modular tool to perform the task of forecasting SKUs (Stock-Keeping Units) levels that are managed and supervised at a POS (point of sale), a wholesaler, and a manufacturer in an SDC. The proposed modular BPN-based CF system will be exemplified and experimentally verified using lots of datasets of the simulated SDC. The experimental results showed that a complex CF problem can be divided into a group of simpler sub-problems based on the single independent trading partners distributed over SDC, and its SKU forecasting accuracy was satisfied when the system forecasted values compared to the original simulated SDC data. The primary task of implementing an autonomous CF involves the study of supervised ANN learning methodology which aims at making “knowledgeable" decision for the best SKU sales plan and stocks management.

Keywords: CPFR, artificial neural networks, global logistics, supply and demand chain.

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Authors: Manoj Sarda, Abhishek Agarwal, Juhi Kaushik, Vatsal Sanjay, Arup Kumar Das

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Railways in India remain primary mode of transport having one of the largest networks in the world and catering to billions of transits yearly. Catastrophic economic damage and loss to life is encountered over the past few decades due to fire to locomotives. Study of fire dynamics and fire propagation plays an important role in evacuation planning and reducing losses. Simulation based study of propagation of fire and soot inside an air conditioned coach of Indian locomotive is done in this paper. Finite difference based solver, Fire Dynamic Simulator (FDS) version 6 has been used for analysis. A single air conditioned 3 tier coupe closed to ambient surroundings by glass windows having occupancy for 8 people is the basic unit of the domain. A system of three such coupes combined is taken to be fundamental unit for the entire study to resemble effect to an entire coach. Analysis of flame and soot contours and concentrations is done corresponding to variations in heat release rate per unit volume (HRRPUA) of fire source, variations in conditioned air velocity being circulated inside coupes by vents and an alternate fire initiation and propagation mechanism via ducts. Quantitative results of fractional area in top and front view of the three coupes under fire and smoke are obtained using MATLAB (IMT). Present simulations and its findings will be useful for organizations like Commission of Railway Safety and others in designing and implementing safety and evacuation measures.

Keywords: Air-conditioned coaches, fire propagation, flame contour, soot flow, train fire.

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Authors: Alireza Ansariyar, Safieh Laaly

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Over the last decades, the vehicle industry has shown increased interest in integrating autonomous, connected, and electrical technologies in vehicle design with the primary hope of improving mobility and road safety while reducing transportation’s environmental impact. Using the State of Maryland (M.D.) in the United States as a pilot study, this research investigates Connected and Autonomous Vehicles (CAVs) fuel consumption and air pollutants including Carbon Monoxide (CO), Particulate Matter (PM), and Nitrogen Oxides (NOx) and utilizes meaningful linear regression models to predict CAV’s environmental effects. Maryland transportation network was simulated in VISUM software, and data on a set of variables were collected through a comprehensive survey. The number of pollutants and fuel consumption were obtained for the time interval 2010 to 2021 from the macro simulation. Eventually, four linear regression models were proposed to predict the amount of C.O., NOx, PM pollutants, and fuel consumption in the future. The results highlighted that CAVs’ pollutants and fuel consumption have a significant correlation with the income, age, and race of the CAV customers. Furthermore, the reliability of four statistical models was compared with the reliability of macro simulation model outputs in the year 2030. The error of three pollutants and fuel consumption was obtained at less than 9% by statistical models in SPSS. This study is expected to assist researchers and policymakers with planning decisions to reduce CAV environmental impacts in M.D.

Keywords: Connected and autonomous vehicles, statistical model, environmental effects, pollutants and fuel consumption, VISUM, linear regression models.

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Authors: Vahid Mazloum, Mansour Sahebozamani, Amirhossein Barati, Nouzar Nakhaee, Pouya Rabiei

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Non-specific chronic low back pain (NSCLBP) is a common condition with no exact diagnosis and mechanism for its occurrence. Recently, different therapeutic exercises have taken into account to manage NSCLBP. So, the aim of this study has mainly been placed on comparing the effects of Pilates and Mackenzie exercises on quality of life (QOL) lumbar spine position sense (LSPS) in patients with NSCLBP. In this randomized clinical trial, 47 patients with NSCLBP were voluntarily divided into three groups of Pilates (n=16) (with mean age 37.1 ± 9.5 years, height 168.9 ± 7.4 cm, body mass 76.1 ± 5.9 k), McKenzie (n=15) (with mean age 42.7 ± 8.1 years, height 165.7 ± 6.8, body mass 74.1 ± 4.8 kg) and control (n=16) (with mean age 39.3 ± 9.8 years, height 168.1 ± 8.1 cm, body mass 74.2 ± 5.8 kg). Primary outcome included QOL and secondary was LSPS. Both variables were assessed by the WHOQOL-BREF questionnaires and electrogoniameter, respectively. The measurements were performed at baseline, following a 6-week intervention, and after a 4-week follow-up. The ANCOVA test at P < 0.05 was administrated to analyze the collected data using SPSS software. There was a statistically significant difference between experimental groups and the control group to improve QOL. But, no difference was seen regarding the effects of two exercises on LSPS (p < 0.05). Both Pilates and Mackenzie exercises demonstrated improvement in QOL after 6-week intervention and a 4-week follow-up while none of them considerably affected LSPS. Further studies are required to establish a supporting evidence for the effectiveness of two exercises on NSCLBP.

Keywords: Pilates, Mackenzie, proprioception, low back pain, physical health.

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Authors: T. Hopkin, S. Lu, P. Rogers, M. Sexton

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Housing Associations (HAs) contribute circa 20% of the UK’s housing supply. HAs are however under increasing pressure as a result of funding cuts and rent reductions. Due to the increased pressure, a number of processes are currently being reviewed by HAs, especially how they manage and learn from defects. Learning from defects is considered a useful approach to achieving defect reduction within the UK housebuilding industry. This paper contributes to our understanding of how HAs learn from defects by undertaking an initial round table discussion with key HA stakeholders as part of an ongoing collaborative research project with the National House Building Council (NHBC) to better understand how house builders and HAs learn from defects to reduce their prevalence. The initial discussion shows that defect information runs through a number of groups, both internal and external of a HA during both the defects management process and organizational learning (OL) process. Furthermore, HAs are reliant on capturing and recording defect data as the foundation for the OL process. During the OL process defect data analysis is the primary enabler to recognizing a need for a change to organizational routines. When a need for change has been recognized, new options are typically pursued to design out defects via updates to a HAs Employer’s Requirements. Proposed solutions are selected by a review board and committed to organizational routine. After implementing a change, both structured and unstructured feedback is sought to establish the change’s success. The findings from the HA discussion demonstrates that OL can achieve defect reduction within the house building sector in the UK. The paper concludes by outlining a potential ‘learning from defects model’ for the housebuilding industry as well as describing future work.

Keywords: Defects, new homes, housing associations, organizational learning.

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Authors: Bryce Benson, Sooin Lee, Ashwin Belle

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Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: Clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring.

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Authors: Akhtar N, Khan BA, Khan MS, Mahmood T, Khan HMS, Iqbal M, Bashir S

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This study was designed to formulate, pharmaceutically evaluate a topical skin-care cream (w/o emulsion) of Aloe Vera versus its vehicle (Base) as control and determine their effects on Stratum Corneum (SC) water content and Transepidermal water loss (TEWL). Base containing no extract and a Formulation containing 3% concentrated extract of Aloe Vera was developed by entrapping in the inner aqueous phase of w/o emulsion (cream). Lemon oil was incorporated to improve the odor. Both the Base and Formulation were stored at 8°C ±0.1°C (in refrigerator), 25°C±0.1°C, 40°C±0.1°C and 40°C± 0.1°C with 75% RH (in incubator) for a period of 4 weeks to predict their stability. The evaluation parameters consisted of color, smell, type of emulsion, phase separation, electrical conductivity, centrifugation, liquefaction and pH. Both the Base and Formulation were applied to the cheeks of 21 healthy human volunteers for a period of 8 weeks Stratum corneum (SC) water content and Transepidermal water loss (TEWL) were monitored every week to measure any effect produced by these topical creams. The expected organoleptic stability of creams was achieved from 4 weeks in-vitro study period. Odor was disappeared with the passage of time due to volatilization of lemon oil. Both the Base and Formulation produced significant (p≤0.05) changes in TEWL with respect to time. SC water content was significantly (p≤0.05) increased by the Formulation while the Base has insignificant (p 0.05) effects on SC water content. The newly formulated cream of Aloe Vera, applied is suitable for improvement and quantitative monitoring of skin hydration level (SC water content/ moisturizing effects) and reducing TEWL in people with dry skin.

Keywords: Aloe Vera; Skin; Stratum corneum (SC) water content and Transepidermal water loss (TEWL).

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Authors: C. Xavier Mendieta, J. J McArthur

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Governments are playing an increasingly active role in reducing carbon emissions, and a key strategy has been the introduction of mandatory energy disclosure policies. These policies have resulted in a significant amount of publicly available data, providing researchers with a unique opportunity to develop location-specific energy and carbon emission benchmarks from this data set, which can then be used to develop building archetypes and used to inform urban energy models. This study presents the development of such a benchmark using the public reporting data. The data from Ontario’s Ministry of Energy for Post-Secondary Educational Institutions are being used to develop a series of building archetype dynamic building loads and energy benchmarks to fill a gap in the currently available building database. This paper presents the development of a benchmark for college and university residences within ASHRAE climate zone 6 areas in Ontario using the mandatory disclosure energy and greenhouse gas emissions data. The methodology presented includes data cleaning, statistical analysis, and benchmark development, and lessons learned from this investigation are presented and discussed to inform the development of future energy benchmarks from this larger data set. The key findings from this initial benchmarking study are: (1) the importance of careful data screening and outlier identification to develop a valid dataset; (2) the key features used to develop a model of the data are building age, size, and occupancy schedules and these can be used to estimate energy consumption; and (3) policy changes affecting the primary energy generation significantly affected greenhouse gas emissions, and consideration of these factors was critical to evaluate the validity of the reported data.

Keywords: Building archetypes, data analysis, energy benchmarks, GHG emissions.

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Authors: Morteza Alizadeh Foroutan, Hassan Moayeri, Keivan Sabooni, Motahareh Rouhi Ardeshiri

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Breast cancer incidence is annually increasing in various parts of the world, and sentinel lymph node biopsy (SLNB) has turned into a new standard for care as a staging process in this regard. In the present study, the gamma probe technique was used for SLNB as a safe method with more accuracy and less complications. The study sought to compare the results of two surgical techniques, namely, axillary lymph node dissection (ALND) and SLNB, including epidemiological results and clinicopathological features of BC patients from the western provinces of Iran. In general, 420 BC women were identified who referred to the breast clinic in Sanandaj, Kurdistan province during 2017-2021. Of whom, 318 patients underwent breast surgery, and from these patients, 277 cases participated in the current study. Patients were divided into those undergoing ALND and SLNB. The criteria for complete dissection or axillary biopsy using the gamma probe were based on the results of clinical examinations and the presence of palpable lymph nodes. Overall complications after surgery belonged to 58 (18.9%) cases, including 15 (25.9%) and 43 (74.1%) patients in the SLNB and ALND groups, respectively (P = 0.74). Based on the findings, Seroma (60.3%) was the most reported complication in each group. Most patients had tumors in the upper-outer quadrant of their left breast. The mean of the tumor dimension in the SLNB and ALND groups was 2.1 ± 1.3 cm and 3.2 ± 1.8 cm, respectively, (P = 0.003). The benefits of breast-conserving surgery (BCS) with the SLNB technique are clearly undeniable and can be considered a method with less complications and a better prognosis. Accordingly, SLNB and BCS are favorable methods that can be performed, along with gamma probe technique, which is safe and accurate.

Keywords: Breast cancer, Sentinel lymph node biopsy, Axillary lymph node dissection, Gamma probe.

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Authors: Franklin Nantui Mabe, Samuel A. Donkoh, Seidu Al-Hassan

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Rice yields among agro-ecological zones are heterogeneous. Farmers, researchers and policy makers are making frantic efforts to bridge rice yield gaps between agro-ecological zones through the promotion of improved agricultural technologies (IATs). Farmers are also modifying these IATs and blending them with indigenous farming practices (IFPs) to form farmer innovation systems (FISs). Also, different metafrontier models have been used in estimating productivity performances and their drivers. This study used the two-step stochastic metafrontier model to estimate the productivity performances of rice farmers and their determining factors in GSZ, FSTZ and CSZ. The study used both primary and secondary data. Farmers in CSZ are the most technically efficient. Technical inefficiencies of farmers are negatively influenced by age, sex, household size, education years, extension visits, contract farming, access to improved seeds, access to irrigation, high rainfall amount, less lodging of rice, and well-coordinated and synergized adoption of technologies. Albeit farmers in CSZ are doing well in terms of rice yield, they still have the highest potential of increasing rice yield since they had the lowest TGR. It is recommended that government through the ministry of food and agriculture, development partners and individual private companies promote the adoption of IATs as well as educate farmers on how to coordinate and synergize the adoption of the whole package. Contract farming concept and agricultural extension intensification should be vigorously pursued to the latter.

Keywords: Efficiency, farmer innovation systems, improved agricultural technologies, two-step stochastic metafrontier approach.

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Authors: Prakash Singh

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Many schools throughout the world are facing constant pressure to cope with the violence and drug abuse of learners who show little or no respect for acceptable and desirable social norms. These delinquent learners tend to harbour feelings of being beyond reproach because they strongly believe that it is well within their rights to engage in violent and destructive behaviour. Knives, guns, and other weapons appear to be more readily used by them on the school premises than before. It is known that learners smoke, drink alcohol, and use drugs during school hours, hence, their ability to concentrate, work, and learn, is affected. They become violent and display disruptive behaviour in their classrooms as well as on the school premises, and this atrocious behaviour makes it possible for drug dealers and gangsters to gain access onto the school premises. The primary purpose of this exploratory quantitative study was therefore to establish how tobephobia (TBP), caused by school violence and drug abuse, affects teaching and learning in schools. The findings of this study affirmed that poor discipline resulted in producing poor quality education. Most of the teachers in this study agreed that educating learners who consumed alcohol and other drugs on the school premises resulted in them suffering from TBP. These learners are frequently abusive and disrespectful, and resort to violence to seek attention. As a result, teachers feel extremely demotivated and suffer from high levels of anxiety and stress. The word TBP will surely be regarded as a blessing by many teachers throughout the world because finally, there is a word that will make people sit up and listen to their problems that cause real fear and anxiety in schools.

Keywords: Aims and objectives of quality education, Debilitating effects of tobephobia, Fear of failure associated with education, learners’ violent behaviour and drug abuse.

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Authors: Frodouard Minani

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Since last decade, wireless sensor networks (WSNs) have been used in many areas like health care, agriculture, defense, military, disaster hit areas and so on. Wireless Sensor Networks consist of a Base Station (BS) and more number of wireless sensors in order to monitor temperature, pressure, motion in different environment conditions. The key parameter that plays a major role in designing a protocol for Wireless Sensor Networks is energy efficiency which is a scarcest resource of sensor nodes and it determines the lifetime of sensor nodes. Maximizing sensor node’s lifetime is an important issue in the design of applications and protocols for Wireless Sensor Networks. Clustering sensor nodes mechanism is an effective topology control approach for helping to achieve the goal of this research. In this paper, the researcher presents an energy efficiency protocol to prolong the network lifetime based on Energy efficient clustering algorithm. The Low Energy Adaptive Clustering Hierarchy (LEACH) is a routing protocol for clusters which is used to lower the energy consumption and also to improve the lifetime of the Wireless Sensor Networks. Maximizing energy dissipation and network lifetime are important matters in the design of applications and protocols for wireless sensor networks. Proposed system is to maximize the lifetime of the Wireless Sensor Networks by choosing the farthest cluster head (CH) instead of the closest CH and forming the cluster by considering the following parameter metrics such as Node’s density, residual-energy and distance between clusters (inter-cluster distance). In this paper, comparisons between the proposed protocol and comparative protocols in different scenarios have been done and the simulation results showed that the proposed protocol performs well over other comparative protocols in various scenarios.

Keywords: Base station, clustering algorithm, energy efficient, wireless sensor networks.

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Authors: Wenbo Wang, Yi-fang Brook Wu

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The spread of misinformation and disinformation has become a major concern, particularly with the rise of social media as a primary source of information for many people. As a means to address this phenomenon, automated fact-checking has emerged as a safeguard against the spread of misinformation and disinformation. Existing fact-checking approaches aim to determine whether a news claim is true or false, and they have achieved decent veracity prediction accuracy. However, the state of the art methods rely on manually verified external information to assist the checking model in making judgments, which requires significant human resources. This study presents a framework, SAC, which focuses on 1) augmenting the representation of a claim by incorporating additional context using general-purpose, comprehensive and authoritative data; 2) developing a search function to automatically select relevant, new and credible references; 3) focusing on the important parts of the representations of a claim and its reference that are most relevant to the fact-checking task. The experimental results demonstrate that: 1) Augmenting the representations of claims and references through the use of a knowledge base, combined with the multi-head attention technique, contributes to improved performance of fact-checking. 2) SAC with auto-selected references outperforms existing fact-checking approaches with manual selected references. Future directions of this study include I) exploring knowledge graph in Wikidata to dynamically augment the representations of claims and references without introducing too much noises; II) exploring semantic relations in claims and references to further enhance fact-checking.

Keywords: Fact checking, claim verification, Deep Learning, Natural Language Processing.

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Authors: M. C. Pardo-Ferreira, J. C. Rubio-Romero, M. Martínez-Rojas

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Resilience Engineering is a new paradigm of safety management that proposes to change the way of managing the safety to focus on the things that go well instead of the things that go wrong. Many complex and high-risk sectors such as air traffic control, health care, nuclear power plants, railways or emergencies, have applied this new vision of safety and have obtained very positive results. In the construction sector, safety management continues to be a problem as indicated by the statistics of occupational injuries worldwide. Therefore, it is important to improve safety management in this sector. For this reason, it is proposed to apply Resilience Engineering to the construction sector. The Construction Phase Health and Safety Plan emerges as a key element for the planning of safety management. One of the key tools of Resilience Engineering is the Resilience Assessment Grid that allows measuring the four essential abilities (respond, monitor, learn and anticipate) for resilient performance. The purpose of this paper is to develop a questionnaire based on the Resilience Assessment Grid, specifically on the ability to learn, to assess whether a Construction Phase Health and Safety Plans helps companies in a construction site to implement this ability. The research process was divided into four stages: (i) initial design of a questionnaire, (ii) validation of the content of the questionnaire, (iii) redesign of the questionnaire and (iii) application of the Delphi method. The questionnaire obtained could be used as a tool to help construction companies to evolve from Safety-I to Safety-II. In this way, companies could begin to develop the ability to learn, which will serve as a basis for the development of the other abilities necessary for resilient performance. The following steps in this research are intended to develop other questions that allow evaluating the rest of abilities for resilient performance such as monitoring, learning and anticipating.

Keywords: Resilience engineering, construction sector, resilience assessment grid, construction phase health and safety plan.

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Authors: K. Jyothi, T. S. Mohamed Saleem, L. Vineela, C. Gopinath, K. B. Yadavender Reddy

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Objective: Acute coronary syndrome is a clinical condition encompassing ST segments elevation myocardial infraction, Non ST segment is elevation myocardial infraction and un stable angina is characterized by ruptured coronary plaque, stress and myocardial injury. Angina pectoris is a pressure like pain in the chest that is induced by exertion or stress and relived with in the minute after cessation of effort or using sublingual nitroglycerin. The present research was undertaken to study the drug utilization pattern of antiplatelet drugs for the ischemic heart disease in a tertiary care hospital. Method: The present study is retrospective drug utilization study and study period is 6months. The data is collected from the discharge case sheet of general medicine department from medical department Rajiv Gandhi institute of medical sciences, Kadapa. The tentative sample size fixed was 250 patients. Out of 250 cases 19 cases was excluded because of unrelated data. Results: A total of 250 prescriptions were collected for the study according to the inclusion criteria 233 prescriptions were diagnosed with ischemic heart disease 17 prescriptions were excluded due to unrelated information. out of 233 prescriptions 128 are male (54.9%) and 105 patients are were female (45%). According to the gender distribution, the prevalence of ischemic heart disease in males are 90 (70.31%) and females are 39 (37.1%). In the same way the prevalence of ischemic heart disease along with cerebrovascular disease in males are 39 (29.6%) and females are 66 (62.6%). Conclusion: We found that 94.8% of drug utilization of antiplatelet drugs was achieved in the Rajiv Gandhi institute of medical sciences, Kadapa from 2011-2012.

Keywords: Angina pectoris, aspirin, clopidogrel, myocardial infarction.

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Authors: Gaurav Bhanjana, Ganga Ram Chaudhary, Sandeep Kumar, Neeraj Dilbaghi

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Main sources of endocrine disrupting compounds in the ecosystem are hormones, pesticides, phthalates, flame retardants, dioxins, personal-care products, coplanar polychlorinated biphenyls (PCBs), bisphenol A, and parabens. These endocrine disrupting compounds are responsible for learning disabilities, brain development problems, deformations of the body, cancer, reproductive abnormalities in females and decreased sperm count in human males. Although discharge of these chemical compounds into the environment cannot be stopped, yet their amount can be retarded through proper evaluation and detection techniques. The available techniques for determination of these endocrine disrupting compounds mainly include high performance liquid chromatography (HPLC), mass spectroscopy (MS) and gas chromatography-mass spectrometry (GC–MS). These techniques are accurate and reliable but have certain limitations like need of skilled personnel, time consuming, interference and requirement of pretreatment steps. Moreover, these techniques are laboratory bound and sample is required in large amount for analysis. In view of above facts, new methods for detection of endocrine disrupting compounds should be devised that promise high specificity, ultra sensitivity, cost effective, efficient and easy-to-operate procedure. Nowadays, electrochemical sensors/biosensors modified with nanomaterials are gaining high attention among researchers. Bioelement present in this system makes the developed sensors selective towards analyte of interest. Nanomaterials provide large surface area, high electron communication feature, enhanced catalytic activity and possibilities of chemical modifications. In most of the cases, nanomaterials also serve as an electron mediator or electrocatalyst for some analytes.

Keywords: Sensors, endocrine disruptors, nanoparticles, electrochemical, microscopy.

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Authors: C. A. Oloo, C. Ojwang

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The performances of small and medium enterprises have stagnated in the last two decades. This has mainly been due to the emergence of HIV / Aids. The disease has had a detrimental effect on the general economy of the country leading to morbidity and mortality of the Kenyan workforce in their primary age. The present study sought to establish the economic impact of HIV / Aids on the micro-enterprise development in Obunga slum – Kisumu, in terms of production loss, increasing labor related cost and to establish possible strategies to address the impact of HIV / Aids on microenterprises. The study was necessitated by the observation that most micro-enterprises in the slum are facing severe economic and social crisis due to the impact of HIV / Aids, they get depleted and close down within a short time due to death of skilled and experience workforce. The study was carried out between June 2008 and June 2009 in Obunga slum. Data was subjected to computer aided statistical analysis that included descriptive statistic, chi-squared and ANOVA techniques. Chi-squared analysis on the micro-enterprise owners opinion on the impact of HIV / Aids on depletion of microenterprise compared to other diseases indicated high levels of the negative effects of the disease at significance levels of P<0.01. Analysis of variance on the impact of HIV / Aids on the performance and productivity of micro-enterprises also indicated a negative effect on the general performance of micro-enterprise at significance levels of P<0.01. Therefore reducing the negative impacts of HIV/Aids on micro-enterprise development, there is need to improve the socioeconomic environment, mobilize donors and stake holders in training and funding, and review the current strategies for addressing the disease. Further conclusive research should also be conducted on a bigger scale.

Keywords: Entrepreneurship, HIV-AIDS, Micro-enterprise, Poverty.

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Authors: Yoshitaka Fujiwara, Jun-ichirou Fukushima, Yasunari Maeda

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Keys to high-quality face-to-face education are ensuring flexibility in the way lectures are given, and providing care and responsiveness to learners. This paper describes a face-to-face education support system that is designed to raise the satisfaction of learners and reduce the workload on instructors. This system consists of a lecture adaptation assistance part, which assists instructors in adapting teaching content and strategy, and a Q&A assistance part, which provides learners with answers to their questions. The core component of the former part is a “learning achievement map", which is composed of a Bayesian network (BN). From learners- performance in exercises on relevant past lectures, the lecture adaptation assistance part obtains information required to adapt appropriately the presentation of the next lecture. The core component of the Q&A assistance part is a case base, which accumulates cases consisting of questions expected from learners and answers to them. The Q&A assistance part is a case-based search system equipped with a search index which performs probabilistic inference. A prototype face-to-face education support system has been built, which is intended for the teaching of Java programming, and this approach was evaluated using this system. The expected degree of understanding of each learner for a future lecture was derived from his or her performance in exercises on past lectures, and this expected degree of understanding was used to select one of three adaptation levels. A model for determining the adaptation level most suitable for the individual learner has been identified. An experimental case base was built to examine the search performance of the Q&A assistance part, and it was found that the rate of successfully finding an appropriate case was 56%.

Keywords: Bayesian network, face-to-face education, lecture adaptation, Q&A assistance.

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