Search results for: Children care

Authors: Noor Azlina Mohd Salleh, Salmiah Kasolang, Ahmed Jaffar

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Green Lean Total Quality Management (TQM) System is a system comprises of Environmental Management System (EMS) practices which is integrated to TQM with Lean Manufacturing (LM) principles. The ultimate goal of this system is to focus on achieving total customer satisfaction and environmental care by removing eight wastes available in any process in an organization. A survey questionnaire was developed and distributed to 30 highly active automotive vendors in Malaysia and analyzed by SPSS v.17. It was found out that some vendors have been practicing TQM and LM while some have started to implement EMS. This study is only focusing on highly active companies that have been involved in MAJAICO Program and Proton Vendor Development Program. This is the first study conducted to know the current status of TQM, LM and EMS practices in highly active automotive companies in Malaysia. It was found out that EMS has been practiced by 16 companies out of 30. Within these 16 companies the approach is more holistic and green. This is a preliminary study that combined 4 awards practices, ISO/TS16949, Toyota Production System SAEJ4000, MAJAICO Lean Production System and EMS.

Keywords: Automotive Industry, Lean Manufacturing, Operational Engineering Management, Total Quality Management. Environmental Management System.

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Authors: F. P. Chew, Z. Ishak

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Malay Folk Literature in early childhood education served as an important agent in child development that involved emotional, thinking and language aspects. Up to this moment not much research has been carried out in Malaysia particularly in the teaching and learning aspects nor has there been an effort to publish “big books." Hence this article will discuss the stance taken by university undergraduate students, teachers and parents in evaluating Malay Folk Literature in early childhood education to be used as big books. The data collated and analyzed were taken from 646 respondents comprising 347 undergraduates and 299 teachers. Results of the study indicated that Malay Folk Literature can be absorbed into teaching and learning for early childhood with a mean of 4.25 while it can be in big books with a mean of 4.14. Meanwhile the highest mean value required for placing Malay Folk Literature genre as big books in early childhood education rests on exemplary stories for undergraduates with mean of 4.47; animal fables for teachers with a mean of 4.38. The lowest mean value of 3.57 is given to lipurlara stories. The most popular Malay Folk Literature found suitable for early children is Sang Kancil and the Crocodile, followed by Bawang Putih Bawang Merah. Pak Padir, Legends of Mahsuri, Origin of Malacca, and Origin of Rainbow are among the popular stories as well. Overall the undergraduates show a positive attitude toward all the items compared to teachers. The t-test analysis has revealed a non significant relationship between the undergraduate students and teachers with all the items for the teaching and learning of Malay Folk Literature.

Keywords: Big Book, Early Childhood Education, Malay FolkLiterature

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Authors: Sarayu Agarwal

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This paper aims to teach English (secondary language) by bridging the understanding between the Regional language (primary language) and the English Language (secondary language). Here primary language is the one a person has learned from birth or within the critical period, while secondary language would be any other language one learns or speaks. The paper also focuses on evolving old teaching methods to a contemporary participatory model of learning and teaching. Pilot studies were conducted to gauge an understanding of student’s knowledge of the English language. Teachers and students were interviewed and their academic curriculum was assessed as a part of the initial study. Extensive literature study and design thinking principles were used to devise a solution to the problem. The objective is met using a holistic learning kit/card game to teach children word recognition, word pronunciation, word spelling and writing words. Implication of the paper is a noticeable improvement in the understanding and grasping of English language. With increasing usage and applicability of English as a second language (ESL) world over, the paper becomes relevant due to its easy replicability to any other primary or secondary language. Future scope of this paper would be transforming the idea of participatory learning into self-regulated learning methods. With the upcoming govt. learning centres in rural areas and provision of smart devices such as tablets, the development of the card games into digital applications seems very feasible.

Keywords: English as a second language, vocabulary-building, learning through gamification.

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Authors: Hamed Alizadeh Dashagholi, Hossein Yousefi-Banaem, Mina Naeimi

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Current study established for EEG signal analysis in patients with language disorder. Language disorder can be defined as meaningful delay in the use or understanding of spoken or written language. The disorder can include the content or meaning of language, its form, or its use. Here we applied Z-score, power spectrum, and coherence methods to discriminate the language disorder data from healthy ones. Power spectrum of each channel in alpha, beta, gamma, delta, and theta frequency bands was measured. In addition, intra hemispheric Z-score obtained by scoring algorithm. Obtained results showed high Z-score and power spectrum in posterior regions. Therefore, we can conclude that peoples with language disorder have high brain activity in frontal region of brain in comparison with healthy peoples. Results showed that high coherence correlates with irregularities in the ERP and is often found during complex task, whereas low coherence is often found in pathological conditions. The results of the Z-score analysis of the brain dynamics showed higher Z-score peak frequency in delta, theta and beta sub bands of Language Disorder patients. In this analysis there were activity signs in both hemispheres and the left-dominant hemisphere was more active than the right.

Keywords: EEG, electroencephalography, coherence methods, language disorder, power spectrum, z-score.

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Authors: R. F. Ajayi, U. Sidwaba, U. Feleni, S. F. Douman, E. Nxusani, L. Wilson, C. Rassie, O. Tovide, P. G. L. Baker, S. L. Vilakazi, R. Tshikhudo, E. I. Iwuoha

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Pyrazinamide (PZA) is among the first-line pro-drugs  in the tuberculosis (TB) combination chemotherapy used to treat  Mycobacterium tuberculosis. Numerous reports have suggested that  hepatotoxicity due to pyrazinamide in patients is due to inappropriate  dosing. It is, therefore necessary to develop sensitive and reliable  techniques for determining the PZA metabolic profile of diagnosed  patients promptly and at point-of-care. This study reports the  determination of PZA based on nanobiosensor systems developed  from disuccinimidyl octanedioate modified Cytochrome P450-2E1  (CYP2E1) electrodeposited on gold substrates derivatised with  (poly(8-anilino-1-napthalene sulphonic acid) PANSA/PVP-AgNPs  nanocomposites. The rapid and sensitive amperometric PZA  detection gave a dynamic linear range of 2µM to 16µM revealing a  limit of detection of 0.044µM and a sensitivity of 1.38µA/µM. The  Michaelis-Menten parameters; KM, KM app and IMAX were calculated to  be 6.0µM, 1.41µM and 1.51x10-6 A, respectively, indicating a  nanobiosensor suitable for use in serum.

Keywords: Cytochrome P450-2E1, Disuccinimidyl octanedioate, Pyrazinamide, Tuberculosis.

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Authors: K. Shiba, T. Kaburagi, Y. Kurihara

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With global aging, people who require care, such as people with dementia (PwD), are increasing within many developed countries. And PwDs may wander and unconsciously set foot outdoors, it may lead serious accidents, such as, traffic accidents. Here, round-the-clock monitoring by caregivers is necessary, which can be a burden for the caregivers. Therefore, an automatic wandering detection system is required when an elderly person wanders outdoors, in which case the detection system transmits a ‘moving’ followed by an ‘absence’ state. In this paper, we focus on the transition from the ‘resting’ to the ‘absence’ state, via the ‘moving’ state as one of the wandering transitions. To capture the transition of the three states, our method based on the hidden Markov model (HMM) is built. Using our method, the restraint where the ‘resting’ state and ‘absence’ state cannot be transmitted to each other is applied. To validate our method, we conducted the experiment with 10 subjects. Our results show that the method can classify three states with 0.92 accuracy.

Keywords: Wander, microwave Doppler sensor, respiratory frequency band, the state transition, hidden Markov model.

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Authors: Reza Ariaeinejad, Norm Archer

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Self-management is becoming a new emphasis for healthcare systems around the world. But there are many different problems with adoption of new health-related intervention systems. The situation is even more complicated for chronically ill patients with disabilities, illiteracy, and impairment in judgment in addition to their conditions, or having multiple co-morbidities. Providing online decision support to manage patient health and to provide better support for chronically ill patients is a new way of dealing with chronic disease management. In this study, the importance of mobile technology through an m-Health system that supports self-management interventions including the care provider, family and social support, education and training, decision support, recreation, and ongoing patient motivation to promote adherence and sustainability of the intervention are discussed. A proposed theoretical model for adoption and sustainability of system use is developed, based on UTAUT2 and IS Continuance of Use models, both of which have been pre-validated through longitudinal studies. The objective of this paper is to show the importance of using mobile technology in adoption and sustainability of use of an m-Health system which will result in commercially sustainable self-management support for chronically ill patients.

Keywords: M-health, e-health, self-management, disease.

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Authors: Chang, Chun-Lang, Liu, Chun-Kai

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This study, for its research subjects, uses patients who had undergone total knee replacement surgery from the database of the National Health Insurance Administration. Through the review of literatures and the interviews with physicians, important factors are selected after careful screening. Then using Cross Entropy Method, Genetic Algorithm Logistic Regression, and Particle Swarm Optimization, the weight of each factor is calculated and obtained. In the meantime, Excel VBA and Case Based Reasoning are combined and adopted to evaluate the system. Results show no significant difference found through Genetic Algorithm Logistic Regression and Particle Swarm Optimization with over 97% accuracy in both methods. Both ROC areas are above 0.87. This study can provide critical reference to medical personnel as clinical assessment to effectively enhance medical care quality and efficiency, prevent unnecessary waste, and provide practical advantages to resource allocation to medical institutes.

Keywords: Total knee replacement, Case Based Reasoning, Cross Entropy Method, Genetic Algorithm Logistic Regression, Particle Swarm Optimization.

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Authors: J. Kolář, V. Dvořák

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In this work, we try to find the best setting of Computational Fluid Dynamic solver available for the problems in the field of supersonic internal flows. We used the supersonic air-toair ejector to represent the typical problem in focus. There are multiple oblique shock waves, shear layers, boundary layers and normal shock interacting in the supersonic ejector making this device typical in field of supersonic inner flows. Modeling of shocks in general is demanding on the physical model of fluid, because ordinary conservation equation does not conform to real conditions in the near-shock region as found in many works. From these reasons, we decided to take special care about solver setting in this article by means of experimental approach of color Schlieren pictures and pneumatic measurement. Fast pressure transducers were used to measure unsteady static pressure in regimes with normal shock in mixing chamber. Physical behavior of ejector in several regimes is discussed. Best choice of eddy-viscosity setting is discussed on the theoretical base. The final verification of the k-ω SST is done on the base of comparison between experiment and numerical results.

Keywords: CFD simulations, color Schlieren, k-ω SST, supersonic flows, shock waves.

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Authors: Okolie Uchenna, Ehiemere Ijeoma, Ezenduka Pauline, Ogbu Sylvester

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A cross sectional survey design was used to collect data from 370 diabetic patients. Two instruments were used in obtaining data; in-depth interview guide and researchers- developed questionnaire. Fisher's exact test was used to investigate association between the identified factors and nonadherence. Factors identified were: socio-demographic factors such as: gender, age, marital status, educational level and occupation; psychosocial obstacles such as: non-affordability of prescribed diet, frustration due to the restriction, limited spousal support, feelings of deprivation, feeling that temptation is inevitable, difficulty in adhering in social gatherings and difficulty in revealing to host that one is diabetic; health care providers obstacles were: poor attitude of health workers, irregular diabetes education in clinics , limited number of nutrition education sessions/ inability of the patients to estimate the desired quantity of food, no reminder post cards or phone calls about upcoming patient appointments and delayed start of appointment / time wasting in clinics.

Keywords: Behavior change, diabetes mellitus, dietarymanagement, diet adherence.

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Authors: Abdul Baqi, Zaid Mohammad

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Reinforced concrete stair slabs with mid landings i.e. Dog-legged shaped are conventionally designed as per specifications of standard codes of practices which guide about the effective span according to the varying support conditions. Presently, the behavior of such slabs has been investigated using Finite Element method. A single flight stair slab with landings on both sides and supported at ends on wall, and a multi flight stair slab with landings and six different support arrangements have been analyzed. The results obtained for stresses, strains and deflections are used to describe the behavior of such stair slabs, including locations of critical moments and deflections. Values of critical moments obtained by F.E. analysis have also have been compared with that obtained from conventional analysis. Analytical results show that the moments are also critical near the kinks i.e. junction of mid-landing and inclined waist slab. This change in the behavior of dog-legged stair slab may be due to continuity of the material in transverse direction in two landings adjoining the waist slab, hence additional stiffness achieved. This change in the behavior is generally not taken care of in conventional method of design.

Keywords: Dog-legged, Stair slab, F.E. Analysis, Landing, Reinforced concrete.

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Authors: Z. Karakus, Z. Ozer

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Nurses are responsible for the care and treatment of individuals, as well as health maintenance and education. Medication administration is an important part of health promotion. The administration of a medicine is a common but important clinical procedure for nurses because of its complex structure. Therefore, medication errors are inevitable for nurses or nursing students. Medication errors can cause ineffective treatment, patient’s prolonged hospital stay, disablement or death. Additionally, medication errors affect the global economy adversely by increasing health costs. Hence, preventing or decreasing of medication errors is a critical and essential issue in nursing. Nurse educators are in pursuit of new teaching methods to teach students significance of medication application. In the light of technological developments of this age, e-learning has started to be accepted as an important teaching method. E-learning is the use of electronic media and information and communication technologies in education. It has advantages such as flexibility of time and place, lower costs, faster delivery and lower environmental impact. Students can make their own schedule and decide the learning method. This study is conducted to determine the impact of e-learning on medication administration of nursing students.

Keywords: E-Learning, Medication Administration, Nursing, Nursing Students.

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Authors: T. Thulare, M. Herselman, A. Botha

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Poor system use, including inappropriate design of health information systems, causes difficulties in communication with patients and increased time spent by healthcare professionals in recording the necessary health information for medical records. System features like pop-up reminders, complex menus, and poor user interfaces can make medical records far more time consuming than paper cards as well as affect decision-making processes. Although errors associated with health information and their real and likely effect on the quality of care and patient safety have been documented for many years, more research is needed to measure the occurrence of these errors and determine the causes to implement solutions. Therefore, the purpose of this paper is to identify data integrity challenges in hospital information systems through a scoping review and based on the results provide recommendations on how to manage these. Only 34 papers were found to be most suitable out of 297 publications initially identified in the field. The results indicated that human and computerized systems are the most common challenges associated with data integrity and factors such as policy, environment, health workforce, and lack of awareness attribute to these challenges but if measures are taken the data integrity challenges can be managed.

Keywords: Data integrity, data integrity challenges, hospital information systems, South Africa.

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Authors: Y. Lacroix, J.-F. Malbranque

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We present a chronological evolution for naval telecommunication networks. We distinguish periods: with or without multiplexers, with switch systems, with federative systems, with medium switching, and with medium switching with wireless networks. This highlights the introduction of new layers and technology in the architecture. These architectures are presented using layer models of transmission, in a unified way, which enables us to integrate pre-existing models. A ship of a naval fleet has internal communications (i.e. applications' networks of the edge) and external communications (i.e. the use of the means of transmission between edges). We propose architectures, deduced from the layer model, which are the point of convergence between the networks on board and the HF, UHF radio, and satellite resources. This modelling allows to consider end-to-end naval communications, and in a more global way, that is from the user on board towards the user on shore, including transmission and networks on the shore side. The new architectures need take care of quality of services for end-to-end communications, the more remote control develops a lot and will do so in the future. Naval telecommunications will be more and more complex and will use more and more advanced technologies, it will thus be necessary to establish clear global communication schemes to grant consistency of the architectures. Our latest model has been implemented in a military naval situation, and serves as the basic architecture for the RIFAN2 network.

Keywords: Equilibrium beach profile, eastern tombolo of Giens, potential function, erosion.

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Authors: Osamah M. Al-Qershi, Khoo Bee Ee

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In recent years image watermarking has become an important research area in data security, confidentiality and image integrity. Many watermarking techniques were proposed for medical images. However, medical images, unlike most of images, require extreme care when embedding additional data within them because the additional information must not affect the image quality and readability. Also the medical records, electronic or not, are linked to the medical secrecy, for that reason, the records must be confidential. To fulfill those requirements, this paper presents a lossless watermarking scheme for DICOM images. The proposed a fragile scheme combines two reversible techniques based on difference expansion for patient's data hiding and protecting the region of interest (ROI) with tamper detection and recovery capability. Patient's data are embedded into ROI, while recovery data are embedded into region of non-interest (RONI). The experimental results show that the original image can be exactly extracted from the watermarked one in case of no tampering. In case of tampered ROI, tampered area can be localized and recovered with a high quality version of the original area.

Keywords: DICOM, reversible, ROI-based, watermarking.

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Authors: Reihaneh Ahmadzadeh Ghavidel, Mehdi Ghiafeh Davoodi

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The usefulness of weaning foods to meet the nutrient needs of children is well recognized, and most of them are precooked roller dried mixtures of cereal and/or legume flours which posses a high viscosity and bulk when reconstituted. The objective of this study was to formulate composite weaning foods using cereals, malted legumes and vegetable powders and analyze them for nutrients, functional properties and sensory attributes. Selected legumes (green gram and lentil) were germinated, dried and dehulled. Roasted wheat, rice, carrot powder and skim milk powder also were used. All the ingredients were mixed in different proportions to get four formulations, made into 30% slurry and dried in roller drier. The products were analyzed for proximate principles, mineral content, functional and sensory qualities. The results of analysis showed following range of constituents per 100g of formulations on dry weight basis, protein, 18.1-18.9 g ; fat, 0.78-1.36 g ; iron, 5.09-6.53 mg; calcium, 265-310 mg. The lowest water absorption capacity was in case of wheat green gram based and the highest was in rice lentil based sample. Overall sensory qualities of all foods were graded as “good" and “very good" with no significant differences. The results confirm that formulated weaning foods were nutritionally superior, functionally appropriate and organoleptically acceptable.

Keywords: malted legumes, weaning foods, nutrition, functional properties

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Authors: K. Shiba, T. Kobayashi, T. Kaburagi, Y. Kurihara

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Elderly population in the world is increasing, and consequently, their nursing burden is also increasing. In such situations, monitoring and evaluating their daily action facilitates efficient nursing care. Especially, we focus on an unconscious activity during sleep, i.e. turnover. Monitoring turnover during sleep is essential to evaluate various conditions related to sleep. Bedsores are considered as one of the monitoring conditions. Changing patient’s posture every two hours is required for caregivers to prevent bedsore. Herein, we attempt to develop an unconstrained nocturnal monitoring system using a sensing device based on piezoelectric ceramics that can detect the vibrations owing to human body movement on the bed. In the proposed method, in order to construct a multi-points sensing, we placed two sensing devices under the right and left legs at the head-side of an ordinary bed. Using this equipment, when a subject lies on the bed, feature is calculated from the output voltages of the sensing devices. In order to evaluate our proposed method, we conducted an experiment with six healthy male subjects. Consequently, the period during which turnover occurs can be correctly classified as the turnover period with 100% accuracy.

Keywords: Turnover, piezoelectric ceramics, multi-points sensing, unconstrained monitoring system.

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Authors: Alexander V. Libin, Manon Schladen, Assya Pascalev, Nawar Shara, Miriam Philmon, Yuri Millo, Joseph Verbalis

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Chronic conditions carry with them strong emotions and often lead to charged relationships between patients and their health providers and, by extension, patients and health researchers. Persons are both autonomous and relational and a purely cognitive model of autonomy neglects the social and relational basis of chronic illness. Ensuring genuine informed consent in research requires a thorough understanding of how participants perceive a study and their reasons for participation. Surveys may not capture the complexities of reasoning that underlies study participation. Contradictory reasons for participation, for instance an initial claim of altruism as rationale and a subsequent claim of personal benefit (therapeutic misconception), affect the quality of informed consent. Individuals apply principles through the filter of personal values and lived experience. Authentic autonomy, and hence authentic consent to research, occurs within the context of patients- unique life narratives and illness experiences.

Keywords: ethical dilemmas, open source technology, patient education, psychology of decision making

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Authors: Cheng-Chia Yang , Yi-Shun Wang , Sue-Ting Chang, Suh-Er Guo, Mei-Fen Huang

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Object: Review recent publications of patient safety culture to investigate the relationship between leadership behavior, safety culture, and safety performance in the healthcare industry. Method: This study is a cross-sectional study, 350 questionnaires were mailed to hospital workers with 195 valid responses obtained, and a 55.7% valid response rate. Confirmatory factor analysis (CFA) was carried out to test the factor structure and determine if the composite reliability was significant with a factor loading of >0.5, resulting in an acceptable model fit. Results: Through the analysis of One-way ANOVA, the results showed that physicians significantly have more negative patient safety culture perceptions and safety performance perceptions than non- physicians. Conclusions: The path analysis results show that leadership behavior affects safety culture and safety performance in the health care industry. Safety performance was affected and improved with contingency leadership and a positive patient safety organization culture. The study suggests improving safety performance by providing a well-managed system that includes: consideration of leadership, hospital worker training courses, and a solid safety reporting system.

Keywords: Leadership Behavior, Patient Safety, Safety Culture, Safety Performance

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Authors: M. Dahiru, O. I. Enabulele

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The research aims to investigate the occurrence of multidrug-resistant Acinetobacter, in carrot and estimate the role of carrot in its transmission in a rapidly growing urban population. Thus, 50 carrot samples were collected from Jakara wastewater irrigation farms and are analyzed on MacConkey agar and screened by Microbact 24E (Oxoid) and susceptibility of isolates is tested against 10 commonly used antibiotics. Acinetobacter baumannii and A. lwoffii were isolated in 22.00% and 16% of samples respectively. Resistance to ceporex and penicillin of 36.36% and 27.27% in A. baumannii, and sensitivity to ofloxacin, pefloxacin, gentimycin and co-trimoxazole were observed. However, for A. lwoffii apart from 37.50% resistance to ceporex, it was also resistant to all other drugs tested. There were similarities in the resistances shown by A. baumannii and A. lwoffii to fluoroquinolones and β- lactame drug families in addition to between sulfonamide and animoglycoside demonstrated by A. lwoffii. Significant correlation in similarities were observed at P < 0.05 to CPX to NA (46.2%), and SXT to AU (52.6%) A. baumannii and A. lwoffii respectively and high multi drug resistance (MDR) of 27.27% and 62.50% by A. baumannii and A. lwoffii respectively. The occurrence of multidrug-resistance pathogen in carrot is a serious challenge to public health care, especially in a rapidly growing urban population where subsistence agriculture contributes greatly to urban livelihood and source of vegetables.

Keywords: Urban agriculture, Public health, Fluoroquinolone, Sulfonamide, Multidrug-resistance.

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Authors: Jaruphan Supprung

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Aims of this research were to study Thai Buddhist temple festivals and Balinese Hindu temple festivals, to compare Thai Buddhist temple festival dress with Balinese Hindu temple festival dress, and to create the knowledge which can be useful for Thai attitudes and cultural perceptions, especially for Thai children and youth. The findings of the research disclosed that there are four temple festivals of Thai Buddhists in Thailand, namely Songkran Festival, Buddhist Lent Festival, Sart Thai Festival and End of Buddhist Lent Festival. In island of Bali, Indonesia, there are three Balinese Hindu temple festivals, namely Odalan Festival, Galungan Festival and Nyepi Festival. Thai Songkran Festival is similar to New Year Celebration in Balinese Nyepi Festival. Thai Songkran Festival and Sart Thai Festival have the same purpose as that of Balinese Galungan Festival in practice of dedicating merit to the spirits of deceased relatives. In these temple festivals, Thai Buddhist men will wear round collar outerwear and wide leg trousers or loincloths but will never wear headdresses, while Balinese Hindu men wear turbans or fabric headbands, shirts and Sarong, which are similar to Sarong of Thai Buddhist men in central and northern part of Thailand. Most of Thai Buddhist women wear Sarong like Balinese Hindu women but wear only round collar outerwear, while Balinese Hindu women wear diamond neck camisole as inner wear and shawl collar as outerwear.

Keywords: Temple festival dresses, Thai Buddhists, Balinese Hindus.

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Authors: Sharifah Mousli, Sona Taheri, Jiayuan He

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Autism spectrum disorder (ASD) is a complex developmental condition involving persistent difficulties with social communication, restricted interests, and repetitive behavior. The challenges associated with ASD can interfere with an affected individual’s ability to function in social, academic, and employment settings. Although there is no effective medication known to treat ASD, to our best knowledge, early intervention can significantly improve an affected individual’s overall development. Hence, an accurate diagnosis of ASD at an early phase is essential. The use of machine learning approaches improves and speeds up the diagnosis of ASD. In this paper, we focus on the application of unsupervised clustering methods in ASD, as a large volume of ASD data generated through hospitals, therapy centers, and mobile applications has no pre-existing labels. We conduct a comparative analysis using seven clustering approaches, such as K-means, agglomerative hierarchical, model-based, fuzzy-C-means, affinity propagation, self organizing maps, linear vector quantisation – as well as the recently developed optimization-based clustering (COMSEP-Clust) approach. We evaluate the performances of the clustering methods extensively on real-world ASD datasets encompassing different age groups: toddlers, children, adolescents, and adults. Our experimental results suggest that the COMSEP-Clust approach outperforms the other seven methods in recognizing ASD with well-separated clusters.

Keywords: Autism spectrum disorder, clustering, optimization, unsupervised machine learning.

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Authors: Xiaodong Li, Peng Gao, Chao-Jung Huang, Shiying Hao, Xuefeng B. Ling, Yongxia Han, Yaqi Zhang, Le Zheng, Chengyin Ye, Modi Liu, Minjie Xia, Changlin Fu, Bo Jin, Karl G. Sylvester, Eric Widen

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Predicting the risk of Pancreatic Adenocarcinoma (PA) in advance can benefit the quality of care and potentially reduce population mortality and morbidity. The aim of this study was to develop and prospectively validate a risk prediction model to identify patients at risk of new incident PA as early as 3 months before the onset of PA in a statewide, general population in Maine. The PA prediction model was developed using Deep Neural Networks, a deep learning algorithm, with a 2-year electronic-health-record (EHR) cohort. Prospective results showed that our model identified 54.35% of all inpatient episodes of PA, and 91.20% of all PA that required subsequent chemoradiotherapy, with a lead-time of up to 3 months and a true alert of 67.62%. The risk assessment tool has attained an improved discriminative ability. It can be immediately deployed to the health system to provide automatic early warnings to adults at risk of PA. It has potential to identify personalized risk factors to facilitate customized PA interventions.

Keywords: Cancer prediction, deep learning, electronic health records, pancreatic adenocarcinoma.

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Authors: B. Karakas, S. Lakestani, C. Guler, B. Guciz Dogan, S. Acar Vaizoglu, A. Taner, B. Sekerel, R. Tıpırdamaz, G. Gullu

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Particulate matter (PM) in ambient air is responsible for adverse health effects in adults and children. Relatively little is known about the concentrations, sources and health effects of PM in indoor air. A monitoring study was conducted in Ankara by three campaigns in order to measure PM levels in indoor and outdoor environments to identify and quantify associations between sources and concentrations. Approximately 82 homes (1st campaign for 42, 2nd campaign for 12, and 3rd campaign for 28), three rooms (living room, baby-s room and living room used as a baby-s room) and outdoor ambient at each home were sampled with Grimm Environmental Dust Monitoring (EDM) 107, during different seasonal periods of 2011 and 2012. In this study, the relationship between indoor and outdoor PM levels for particulate matter less than 10 micrometer (.m) (PM10), particulate matter less than 2.5.m (PM2.5) and particulate matter less than 1.0.m (PM1) were investigated. The mean concentration of PM10, PM2.5, and PM1.0 at living room used as baby-s room is higher than living and baby-s room (or bedroom) for three sampling campaigns. It is concluded that the household activities and environmental conditions are very important for PM concentrations in the indoor environments during the sampling periods. The amount of smokers, being near a main street and/or construction activities increased the PM concentration. This study is based on the assessment the relationship between indoor and outdoor PM levels and the household activities and environmental conditions

Keywords: Indoor air quality, particulate matter (PM), PM10, PM2.5, PM1.0.

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Authors: A. A. Alshabanat, R. B. Albacker, A. A. Basalama, A. A. Bin Salamah, A. S. Alfrayh

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The study was conducted to investigate the profile of hepatitis in Kingdom of Saudi Arabia, and to determine which age group hepatitis viruses most commonly infect. The epidemiology of viral hepatitis in Saudi Arabia has undergone major changes, concurrent with major socioeconomic developments over the last two to three decades. This disease represents a major public health problem in Saudi Arabia resulting in the need for considerable healthcare resources. A retrospective cross sectional analysis of the reported cases of viral hepatitis was conducted based on the reports of The Ministry of Health in Saudi Arabia about Hepatitis A, B and C infections in all regions from the period of January 2006 to December 2010. The study demonstrated that incidence of viral Hepatitis is decreasing, except for Hepatitis B that showed minimal increase. Of hepatitis A, B, and C, Hepatitis B virus (HBV) was the most predominant type, accounting for (53%) of the cases, followed by Hepatitis C virus (HCV) (30%) and HAV (17%). HAV infection predominates in children (5–14 years) with 60% of viral hepatitis cases, HBV in young adults (15–44 years) with 69% of viral hepatitis cases, and HCV in older adults (>45 years) with 59% of viral hepatitis cases. Despite significant changes in the prevalence of viral hepatitis A, B and C, it remains a major public health problem in Saudi Arabia; however, it showed a significant decline in the last two decades that could be attributed to the vaccination programs and the improved health facilities. Further researches are needed to identify the risk factors making a specific age group or a specific region in Saudi Arabia targeted for a specific type of hepatitis viruses.

Keywords: Epidemiology, Hepatitis, Saudi Arabia.

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Authors: Virgil Miranda, Gissele Mosqueda, Pablo Delgado, Yimesker Yihun

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Muscular fatigue affects the muscle activation that is needed for producing the desired clinical outcome. Integrating optimal muscle relaxation periods into a variety of health care rehabilitation protocols is important to maximize the efficiency of the therapy. In this study, four muscle relaxation periods (30, 60, 90 and 120 seconds) and their effectiveness in producing consistent muscle activation of the muscle biceps brachii between sets of an elbow flexion and extension task were investigated among a sample of 10 subjects with no disabilities. The same resting periods were then utilized in a controlled exoskeleton-based exercise for a sample size of 5 subjects and have shown similar results. On average, the muscle activity of the biceps brachii decreased by 0.3% when rested for 30 seconds, and it increased by 1.25%, 0.76% and 0.82% when using muscle relaxation periods of 60, 90 and 120 seconds, respectively. The preliminary results suggest that a muscle relaxation period of about 60 seconds is needed for optimal continuous muscle activation within rehabilitation regimens. Robot-based rehabilitation is good to produce repetitive tasks with the right intensity and knowing the optimal resting period will make the automation more effective.

Keywords: Rest intervals, muscle biceps brachii, robot rehabilitation, muscle fatigue.

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Authors: B. Stroetmann, A. Aisenbrey

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The Siemens Healthcare Sector is one of the world's largest suppliers to the healthcare industry and a trendsetter in medical imaging and therapy, laboratory diagnostics, medical information technology, and hearing aids. Siemens offers its customers products and solutions for the entire range of patient care from a single source – from prevention and early detection to diagnosis, and on to treatment and aftercare. By optimizing clinical workflows for the most common diseases, Siemens also makes healthcare faster, better, and more cost effective. The optimization of clinical workflows requires a multidisciplinary focus and a collaborative approach of e.g. medical advisors, researchers and scientists as well as healthcare economists. This new form of collaboration brings together experts with deep technical experience, physicians with specialized medical knowledge as well as people with comprehensive knowledge about health economics. As Charles Darwin is often quoted as saying, “It is neither the strongest of the species that survive, nor the most intelligent, but the one most responsive to change," We believe that those who can successfully manage this change will emerge as winners, with valuable competitive advantage. Current medical information and knowledge are some of the core assets in the healthcare industry. The main issue is to connect knowledge holders and knowledge recipients from various disciplines efficiently in order to spread and distribute knowledge.

Keywords: Business Excellence, Clinical Knowledge, Knowledge Management, Knowledge Services, Learning Organizations, Trust.

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Authors: Kerstin Grunden, Ann Svensson, Berit Forsman, Christina Karlsson, Ayman Obeid

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The research question of the article is to explore whether the dialogue meetings method could be relevant for reflective learning among researchers and practitioners when welfare technology should be implemented in municipalities, or not. A testbed was planned to be implemented in a retirement home in a Swedish municipality, and the practitioners worked with a pre-study of that testbed. In the article, the dialogue between the researchers and the practitioners in the dialogue meetings is described and analyzed. The potential of dialogue meetings as an arena for learning and reflection among researchers and practitioners is discussed. The research methodology approach is participatory action research with mixed methods (dialogue meetings, focus groups, participant observations). The main findings from the dialogue meetings were that the researchers learned more about the use of traditional research methods, and the practitioners learned more about how they could improve their use of the methods to facilitate change processes in their organization. These findings have the potential both for the researchers and the practitioners to result in more relevant use of research methods in change processes in organizations. It is concluded that dialogue meetings could be relevant for reflective learning among researchers and practitioners when welfare technology should be implemented in a health care organization.

Keywords: Dialogue meetings, implementation, reflection, test bed, welfare technology, participatory action research.

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Authors: Yveta Pohnětalová, Veronika Nováková, Lucie Hrašová

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The paper presents the results of research in which we were looking for common characteristics of the family environment of students alternative and innovative education systems. Topicality comes from the fact that nowadays in the Czech Republic there are several civic and parental initiatives held with the aim to establish schools for their children. The goal of our research was to reveal key aspects of these families and to identify their common indicators. Among other things, we were interested what reasons lead parents to decide to enroll their child into different education than standard (common). The survey was qualitative and there were eighteen respondents of parents of alternative schools´ pupils. The reason to implement qualitative design was the opportunity to gain deeper insight into the essence of phenomena and to obtain detailed information, which would become the basis for subsequent quantitative research. There have been semi structured interviews done with the respondents which had been recorded and transcribed. By an analysis of gained data (categorization and by coding), we found out that common indicator of our respondents is higher education and higher economic level. This issue should be at the forefront of the researches because there is lack of analysis which would provide a comparison of common and alternative schools in the Czech Republic especially with regard to quality of education. Based on results, we consider questions whether approaches of these parents towards standard education come from their own experience or from the lack of knowledge of current goals and objectives of education policy of the Czech Republic.

Keywords: Alternative schools, family environment, quality of education, parents´ approach.

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Authors: Ghias ul Hassan, Bilal Nasir, Israr ul Haque, ShafiqAwan, Ghias Un NabiTayyab, S. Hassan Akhtar Bokhari, Khawar Saeed, Qazi Masroor

Abstract:

Introduction: Pegylated Interferon and Ribavirin combination is standard of care in the management of chronic HCV infected patients. Efficacy of the therapy is judged by the ability to achieve biochemical and virological response as judged by RVR, EVR, ETR and SVR.Objective: To evaluate the efficacy of newly marketed biosimilar Pegylated Interferon Alpha 40KD (Peg INF) in chronic HCV patients. Materials and methods: This was observational, prospective multicentre study to evaluate the ability of biosimilar pegylated interferon alfa 2a (40KD) along with Ribavirin (weight based) to achieve SVR. The enrolled patients were separated into Naïve (A), Relapsers (B) and Non Responders(C) based on the previous history of interferon exposure and its response. The RGT was followed on ALT and RVR, EVR, ETR and SVR.Results:As per protocol analysis estimated SVR for three groups is 86.6% for naïve, 89.4% for relapsers and 52.4% for non-responders to standard interferon. Conclusion: It is concluded that Bio-similar pegylated interferon alfa-2a (40kD) along with Ribavirin has good anti-viral efficacy in Naïve, Relapsers and Non-responders to standard IFN of chronic HCV infected patients requiring treatment.

Keywords: SVR (Sustained virological response), NR (Nonresponders), Pegylated Interferon.

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