Coronavirus, also known as COVID-19, has been declared a pandemic by the World Health Organization (WHO). At the time of conducting this study, it had recorded over 1.6 million cases while more than 105,000 have died due to it, with these figures rising on a daily basis across the globe. The burden of this highly contagious respiratory disease is that it presents itself in both symptomatic and asymptomatic patterns in those already infected, thereby leading to an exponential rise in the number of contractions of the disease and fatalities. It is therefore crucial to expedite the process of early detection and diagnosis of the disease across the world. The case-based reasoning (CBR) model is an effective paradigm that allows for the utilization of cases’ specific knowledge previously experienced, concrete problem situations or specific patient cases for solving new cases. This study therefore aims to leverage the very rich database of cases of COVID-19 to solve new cases. The approach adopted in this study employs the use of an improved CBR model for state-of-the-art reasoning task in classification of suspected cases of Covid19. The CBR model leverages on a novel feature selection and semantic-based mathematical model proposed in this study for case similarity computation. An initial population of the archive was achieved with 68 cases obtained from the Italian Society of Medical and Interventional Radiology (SIRM) repository. Results obtained revealed that the proposed approach in this study successfully classified suspected cases into their categories at an accuracy of 97.10%. The study found that the proposed model can support physicians to easily diagnose suspected cases of Covid19 base on their medical records without subjecting the specimen to laboratory test. As a result, there will be a global minimization of contagion rate occasioned by slow testing and as well reduce false positive rates of diagnosed cases as observed in some parts of the globe.

This article investigates the prospect of implementing multidisciplinary and multicultural student teamwork (MMT) involving Case-based Learning (CBL) and Problem-based Learning (PBL) as a sustainable teaching practice. Based on a mixed methods approach, which includes direct observation (both physical and virtual), questionnaire distribution and focus-group interviews the study reveals that MMT through CBL and PBL can both facilitate and hinder sustainable learning. Our findings show that while MMT enhances knowledge sharing, it also poses a wide range of challenges, raising questions about its social significance as a sustainable teaching practice. The study suggests the implementation of certain mechanisms, such as ‘Teamwork Training’ and ‘Pedagogical Mentors’, aiming to strengthen the sustainable orientation of MMT through CBL and PBL.

Information regarding the cost of a construction project is available to the investor and project participants in order to determine the subsequent success of a project, given that the information they collect has an impact on the decisions they make. Cost calculations, especially in the initial phase of a project, often generate large errors. This paper presents the new approach based on a combination of the Case Based Reasoning method (CBR) with the originally selected criteria for the description of a construction project (as a result of Pearson correlation coefficient and Spearman's rank correlation coefficient) and Building Information Modeling (BIM) technology. The CBR method fulfils expectations for a simple and fast system supporting the cost estimation process. It does not require any specialist knowledge, so it will be comprehensible to cost estimation practitioners. The BIM-based model gives the opportunity for the calculation of quantity take-offs and enables the use of the information contained in the BIM model in the cost estimation process. In order to prepare the model an appropriate relational database had to be developed. With extensive research, a database of 173 construction projects, including the construction of a sports field, was obtained. There were 14 variables defined originally by authors; however, only 10 (as a result of the correlation analysis) were used for the calculation. Data related to the project were collected in the BIM model. Results estimating the project’s unit price, using the CBR method, were presented and discussed. The Mean Absolute Estimate Error was used to evaluate the model.

Initial choice of Learning Rate is a key part of gradient based methods and has a great effect on the performance of the Deep Learning Model.This paper studies the behavior of multiple gradient based optimization algorithm which are commonly used in Deep Learning and compare their performance on various learning rate. As observed popular choice of optimization algorithms are highly sensitive to various choice of learning rates. Our goal is to find which optimizer has an edge over others for a specific setting. We look at two datasets namely MNIST and CIFAR10 for benchmarking. The results are quite surprising, and it will help us to choose a learning rate more efficiently.

In recent years, team-based learning (TBL) is gaining popularity as a student-centered active collaborative learning strategy in healthcare education. This paper reports the design, implementation, and impact of a "hybrid team-based learning" (H-TBL) for one respiratory lecture in year two undergraduate physiotherapy program in 2019. A retrospective study was conducted, including 136 second-year undergraduate physiotherapy students using H-TBL design for one respiratory lecture topic. Student engagement was evaluated based on the percentage of completion for pre-class work, attendance to classroom session, and submission of formative creative assignment. Student' performance on formative creative tasks was evaluated based on thinking and learning rubric. Student perceptions were assessed based on the student's feedback using "Mentimeter." 109/ 136 (80%) students attended the COPD 2 session. 90/109 (82%) students engaged in COPD 1 (web-based) and tRAT in COPD 2 session. 54/109 (50%) students provided feedback and 67/90 (74%) students submitted formal formative creative assignment on completion of COPD 2 session. This study confirms that H-TBL enhances student's active engagement, creativity, and equilibration of their subject knowledge. Future randomized studies are mandated to explore the validity and specificity of H-TBL in diverse physiotherapy curriculum to evaluate the long-term student engagement and academic performance.

Prediction of stock groups values has always been attractive and challenging for shareholders. This paper concentrates on the future prediction of stock market groups. Four groups named diversified financials, petroleum, non-metallic minerals and basic metals from Tehran stock exchange are chosen for experimental evaluations. Data are collected for the groups based on ten years of historical records. The values predictions are created for 1, 2, 5, 10, 15, 20 and 30 days in advance. The machine learning algorithms utilized for prediction of future values of stock market groups. We employed Decision Tree, Bagging, Random Forest, Adaptive Boosting (Adaboost), Gradient Boosting and eXtreme Gradient Boosting (XGBoost), and Artificial neural network (ANN), Recurrent Neural Network (RNN) and Long short-term memory (LSTM). Ten technical indicators are selected as the inputs into each of the prediction models. Finally, the result of predictions is presented for each technique based on three metrics. Among all algorithms used in this paper, LSTM shows more accurate results with the highest model fitting ability. Also, for tree_based models, there is often an intense competition between Adaboost, Gradient Boosting and XGBoost.

Background: In an age where information is generally accessible, most of the interest these days has focused on how accessible and convenient technology can be. So small and personal, mobile devices can transform our perception of learning by combining both mobility and convenience. Mobile learning is part of the digital learning landscape alongside e-learning and serious games. However, knowledge about effective design of mobile learning experiences remains of interest with a focus on appropriate design models and the embodiments that can be implemented to achieve the intended educational outcomes. Exploring the instructor's perspective on mobile learning is essential. Therefore, the aim of this study was to investigate the Moroccan instructors' perception and practice of mobile learning to inform the development of an ecologically valid mobile learning integration model. Methods: Higher education Instructors (n=41) were recruited to the study. The Moroccan instructors' perception and their experiences regarding their adoption of mobile learning were collected using an online survey. The analysis focused on their mobile use, perceived IT competency, and opinions on mobile learning. Results: We described most of the instructors' considerations regarding integrating mobile technologies into their teaching activities. We found that most of the mobile learning activities defined by the respondents corresponded to relatively advanced use of mobile devices. More promising, instructors have found innovative ways to use the educational potential of mobile devices. However, the prospect of mobile devices was still to challenge. No or poor Wi-Fi connection, number of devices or limited access, sometimes fees or applications incompatibility were identified as reasons and obstacles to mobile learning usage. Conclusion: Mobile learning is mostly perceived positively among Moroccan instructors allowing many applications and usage to enhance teaching and learning. In this study, a better understanding of aspects and factors influencing the integration of mobile learning in the Moroccan educational context is exposed, helping further the development of an ecologically valid mobile learning integration model. Future work on mobile learning should consider the highly paced evolution of mobile technologies, emphasizing the flexibility of integration frameworks to support instructors and learners.

This paper proposes a cognitive radio engine platform for making exploitation of available frequency channels usable for a tactical wireless sensor network in presence of incumbent communication devices known as the primary user (PU) required to be protected from undesired harmful interference. In the field of tactical communication networks, it is desperate to find available frequencies for opportunistic and dynamic access to channels in which PU is in active. This paper introduces a cognitive engine plaform for determining available channels on the basis of case-based reasoning technique deployable as core functionality on cognitive radio engine to enable dynamic spectrum access (DSA) with high fidelity. Towards this, this paper introduces a plausible learning engine to characterize channel usage pattern to extract best channel candiates for the tactical cognitive radio node (TCRN). Performance of the proposed cognitive engine is verified by conducting simulation tests which confirm the reliability in functional aspect of the proposed cognitive engine covering the learning engine as well as the case-based reasoning engine with showing how well TCRN can avoid the collision against the PU operation considered as the etiquette secondary user (SU) should have.

This case study was conducted to disentangle the stories of unsuccessful LET examinees, their responses to failure, and their perspectives of the factors that contributed to their failure. The results demonstrate five themes related to the failure experience. Factors related to the physical environment, psychological well-being, and preparedness influenced the performance of the examinees. Contributory factors to failure provided several implications to teacher education practice. Educators have a responsibility to identify, inform, and intervene with students who are at high risk of failing the LET, and this responsibility could be executed capably. However, the role should be extended beyond graduation. The responsibility to help graduates transition from failure to licensure is the final step of successful undergraduate teacher education.

With the rapid surge in technological advancements, an equal amount of investment in technology-embedded teaching has become vital to pace up with the ongoing educational needs. Distance education has evolved from the era of postal services to the use of ICT tools in current times. With the aid of globally updated content across the board, technology usage ensures all students receive equal attention without any discrimination. Importantly, web-based teaching allows all kind of students to learn at their own pace, without the fear of being judged, including professionals who can learn remotely without disturbing their job schedules. Having web-based content allows low-cost and robust implementation of the content upgradation. An improved, yet effective, version of the education using such tools is Hybrid Learning (HL). This learning mode aims to provide luxurious reinforcement to its legitimate candidates while maintaining the quality standards of various elements. Incorporated with both traditional and distance learning methods, along with exploiting social media tools for increased comfort level and peer-to-peer collaboration, HL ultimately facilitates the end user and educational setup. The structure of such a hybrid model is realized by delivering the study material via a learning management system (LMS) designed in compliance with quality standards, which is one of the fundamental tackling techniques for controlling quality constraints. In this paper, we present the recently piloted project by COMSATS University Islamabad (previously known as COMSATS Institute of Information Technology) which is driven by technology-embedded teaching model. This model is an amalgam of the traditional class room model with the aid of state-of-the-art online learning technologies. The students are enrolled as full-time students, with all the courses in traditional classroom mode, except one course offered as hybrid course. This globally adapted model helps the students to benefit from both face-to-face learning as well as gaining hands-on experience on technology-enriched education model providing flexibility of timings, learning pace, and boundaries. Our HL model is equipped with two major synchronous and asynchronous blocks. The synchronous block delivers real-time live interaction scenarios using discussion boards, thereby providing a face-to-face environment. Interactions via social network has witnessed equally surging improvement in the output performance. The asynchronous block refers to the lecture videos, slides and handouts, prepared by imminent professors, available 24/7 for students. To ensure quality output, our HL model follows the course learning outcomes (CLOs), and program learning outcomes (PLOs) as per international standards. As a proof of concept, we have deployed a mechanism at the end of each semester to verify the effectiveness of our model. This mechanism fundamentally surveys the satisfaction levels of all the students enrolled in the HL courses. With the surveys already conducted, a significant level of satisfaction has been noted. Extensive results from these surveys are presented in the paper to further validate the efficiency and robustness of our proposed HL model.

Regardless of country and age, the importance of history education is always being emphasized. Although the importance of history education is being emphasized in Korea, there are many difficulties in getting students to understand history properly through school classes alone, and it is also difficult to attract students to participate in classes. The effectiveness of education using games has been proven 20 years ago, and the demand for game-based education is gradually increasing in the current education world, which is becoming more open. In this paper, based on the effects proven through research on the existing game-based education, the improvement of historical thinking ability, experiential history learning, and the problems of game-based education introduced in the ESN report and the discomfort of teachers who participated in the education were improved. A plan was suggested to select and use games suitable for basic education. In this thesis, we selected a history game with a clear historical and periodic background and without distortion of history, and experimented with teaching using games focusing on historical thinking and empirical history learning. The learning achievement of textbook-based education was compared.

Regardless of country and age, the importance of history education is always being emphasized. Although the importance of history education is being emphasized in Korea, there are many difficulties in getting students to understand history properly through school classes alone, and it is also difficult to attract students to participate in classes. The effectiveness of education using games has been proven 20 years ago, and the demand for game-based education is gradually increasing in the current education world, which is becoming more open. In this paper, based on the effects proven through research on the existing game-based education, the improvement of historical thinking ability, experiential history learning, and the problems of game-based education introduced in the ESN report and the discomfort of teachers who participated in the education were improved. A plan was suggested to select and use games suitable for basic education. In this thesis, we selected a history game with a clear historical and periodic background and without distortion of history, and experimented with teaching using games focusing on historical thinking and empirical history learning. The learning achievement of textbook-based education was compared.

Premature ventricular contraction (PVC) is one of the common ventricular arrhythmias, which may cause stroke or sudden cardiac death. Automatic long-term electrocardiogram (ECG) analysis algorithms could provide diagnosis suggestion even early warning for physicians, however, they are mutually-exclusive in terms of robustness, generalization and low complexity. In this study, a novel PVC recognition algorithm that combines deep learning-based heartbeat template clusterer and expert system-based heartbeat classifier is proposed. Long short-term memory-based auto-encoder (LSTM-AE) network was used to extract features from ECG heartbeats for K-means clustering. Thus, the templates were constructed and determined based on clustering results. Finally, the PVC heartbeats were recognized based on a combination of multiple rules, including template matching and rhythm characteristics. Three quantitative parameters, sensitivity (Se), positive predictive value (P+) and accuracy (ACC), were used to evaluate the performances of the proposed method on the MIT-BIH Arrhythmia database and the St. Petersburg Institute of Cardiological Technics database. Se on the two test databases was 87.51% and 87.92%, respectively; P+ was 92.47% and 93.18%, respectively; and ACC was 98.63% and 97.89%, respectively. The PVC scores on the 3rd China Physiological Signal Challenge 2020 training set and hidden test set were 36,256 and 46,706, respectively, which could rank first in the open-source codes. The results showed that the combination strategy of expert system and deep learning can provide new insights for robust and generalized PVC identification from long-term single-lead ECG recordings.

The comprehensibility of good predictive models learned from high-dimensional gene expression data is attractive because it can lead to biomarker discovery. Several good classifiers provide comparable predictive performance but differ in their abilities to summarize the observed data. We extend a Bayesian Rule Learning (BRL-GSS) algorithm, previously shown to be a significantly better predictor than other classical approaches in this domain. It searches a space of Bayesian networks using a decision tree representation of its parameters with global constraints, and infers a set of IF-THEN rules. The number of parameters and therefore the number of rules are combinatorial to the number of predictor variables in the model. We relax these global constraints to a more generalizable local structure (BRL-LSS). BRL-LSS entails more parsimonious set of rules because it does not have to generate all combinatorial rules. The search space of local structures is much richer than the space of global structures. We design the BRL-LSS with the same worst-case time-complexity as BRL-GSS while exploring a richer and more complex model space. We measure predictive performance using Area Under the ROC curve (AUC) and Accuracy. We measure model parsimony performance by noting the average number of rules and variables needed to describe the observed data. We evaluate the predictive and parsimony performance of BRL-GSS, BRL-LSS and the state-of-the-art C4.5 decision tree algorithm, across 10-fold cross-validation using ten microarray gene-expression diagnostic datasets. In these experiments, we observe that BRL-LSS is similar to BRL-GSS in terms of predictive performance, while generating a much more parsimonious set of rules to explain the same observed data. BRL-LSS also needs fewer variables than C4.5 to explain the data with similar predictive performance. We also conduct a feasibility study to demonstrate the general applicability of our BRL methods on the newer RNA sequencing gene-expression data.

Increasing the metacognitive abilities of chemistry students is an indisputable output of the teaching and learning process today. Collaborative problem based learning is a learning method that has been tested and proven to be applied, especially in Western countries in increasing the metacognitive abilities of students, but it is still very minimal applied in Asian countries, including Indonesia. Thus, this study was conducted to explore previous studies that examined collaborative problem-based learning in improving students' metacognitive abilities. The research design used in this study is a Systematic Literature Review with the requirements of the inclusion of articles on collaborative problem-based learning in improving the metacognitive abilities of chemistry students, accredited national and international publications between 2010 and 2020, full text, journal articles, and open access. The results of the exploration that were carried out found 102 articles, then the title and abstract were read into 20 articles, and 4 articles were read in full, which fulfilled all the stipulated inclusion requirements. The results of the systematic literature review conducted in this study provide empirical evidence of literacy that problem based learning improves the metacognitive abilities of chemistry students. However, most of research conducted still uses various instruments, which are not standardized and validated.

Time and cost-efficient techniques are essential to avoid extra conventional experimental studies with large date-set to characterize the mechanical properties of composite materials. Correlation between the structural performance and mechanical properties could be captured through the efficient predictive models. Several ensembled Machine Learning (ML) methods were implemented in this study, to materially characterize carbon nanotube (CNT)-reinforced cement-based composites. Proposed models were compared with each other to represent the accuracy of each method. The Flexural and Compressive Strength (target values) of CNT reinforced composites were predicted based on the data-rich framework provided in previous experimental investigations. These data were utilized for training of the proposed models by employing SciKit-Learn library in Python, followed by hyper-parameter tuning and k-fold cross-validation method for obtaining an efficient model to predict the target values. Random Forest (RF) and Gradient Boosting Machine (GBM) were developed for this purpose. The findings of this study would be useful for prospective composite designers in case of sufficient experimental data availability for ML model training.

In this work, the decennial experience of Policumbent student team at Politecnico di Torino is summarized by focusing on the acquired knowledge in design of Human Powered Vehicles (HPVs) and on soft skills developed by both students and staff. Policumbent was funded by the authors at the end of 2008 in order to gather engineering students interested in design and construction of HPVs. In the last decade, the team has grown from 10 up to 50 students enrolled per year, exploring a range of HPV design for sports and mobility. Even when focusing on sport vehicles and extreme HPVs for speed record, such kind of projects allows students to familiarize with important concepts related to sustainable mobility: the amount of resistive forces and dissipated power, the role of vehicle weight and the impact of acceleration on the overall energetic balance as far as fundamental concepts about energy consumption, efficiency and emissions of the ``human engine'' in comparison with other kind of engines. By touching with hands such topics in the framework of a ``human-centred'' design project, the students have opportunity to develop awareness about the impact of design choices on sustainability of any kind of vehicle for transportation. Also, the paper retraces the team evolution path by focusing on a thorough analysis of what factors contributed to the success of this project.

This paper proposes a Case-Based Reasoning (CBR) system to contribute to reinforce the sustainable performance of an environmental management system. The CBR system aims to support the decision-making process to select environmental management actions aimed at reducing risky trends of the environmental state of a region. The CBR system takes advantage of a set of situation-solution pairs called cases, which are stored in a memory and then retrieved as candidates to solve new problems. Situations in this work are represented by a set of risky trends of the following key environmental variables: CO2 emissions, Air-Quality, Loss of Vegetation Cover, Water Availability, and Solid Waste, whose combination damage the environmental state quality of a region. Meanwhile, solutions are represented by a set of environmental management actions. Similar situations to a given current situation are retrieved from the memory of cases and then their solutions are combined, through an adaptation mechanism, until the solution of the current problem is obtained. We used risky trends derived from real data related to the environmental states of a Mexican region to test the proposed CBR system. The results obtained provided insights into the potential of CBR systems to support the decision-making process to select environmental management actions aimed at reducing risky trends of current environmental states.

The collision avoidance mechanism adopted by the IEEE 802.11 standard is not optimal. The mechanism employs a binary exponential backoff (BEB) algorithm in the medium access control (MAC) layer. Such an algorithm increases the backoff interval whenever a collision is detected to minimize the probability of subsequent collisions. However, the expansion of the backoff interval causes degradation of the radio spectrum utilization (i.e., bandwidth wastage). That problem worsens when the network has to manage the channel access to a dense number of stations, leading to a dramatic decrease in network performance. Furthermore, a wrong backoff setting increases the probability of collisions such that the stations experience numerous collisions before achieving the optimal backoff value. Therefore, to mitigate bandwidth wastage and, consequently, maximize the network performance, this work proposes using reinforcement learning (RL) algorithms, namely Deep Q Learning (DQN) and Deep Deterministic Policy Gradient (DDPG), to tackle such an optimization problem. As for the simulations, the NS-3 network simulator is used along with a toolkit known as NS3-gym, which integrates a reinforcement-learning (RL) framework into NS-3. The results demonstrate that DQN and DDPG have much better performance than BEB for static and dynamic scenarios, regardless of the number of stations. Moreover, the performance difference is amplified as the number of stations increases, with DQN and DDPG showing a 27% increase in throughput with 50 stations compared to BEB. Furthermore, DQN and DDPG presented similar performances.

Deep reinforcement learning (DRL) has achieved significant results in many Machine Learning (ML) benchmarks. In this short survey we provide an overview of DRL applied to trading on financial markets, including a short meta-analysis using Google Scholar, with an emphasis on using hierarchy for dividing the problem space as well as using model-based RL to learn a world model of the trading environment which can be used for prediction. In addition, multiple risk measures are defined and discussed, which not only provide a way of quantifying the performance of various algorithms, but they can also act as (dense) reward-shaping mechanisms for the agent. We discuss in detail the various state representations used for financial markets, which we consider critical for the success and efficiency of such DRL agents. The market in focus for this survey is the cryptocurrency market.

Purpose: Now traditional lecture-based teaching and learning have been affected by the COVID-19. The objectives of this article are to design the novel educational technique called ‘dynamic-based learning’ (DBL) that provides the combination of online teaching-learning methods and student’s creativity, to evaluate primary dynamic-based learning function, and to propose dynamic-based learning for higher education. Methods: DBL composes of four steps, including, preparation, homework, classroom, and evaluation, which was designed, and taught in medical and dental schools. Online support materials included mobile phone, email, Facebook Messenger, Line Messenger, Cisco Webex, and Zoom Meetings applications were recruited for this novel method. Results: A total of 32 third-year medical students and 26 sixth-year dental students was treated by DBL similarly. three subjects, including, Innovation in Dentistry, Basic Medical Research, and Principles of Pathology and Forensic Medicine were selected in this article. The results showed students could create their knowledge, ideas, and creativity during the online classes.Conclusion: DBL can be used as an alternative learning mode during the COVID-19 crisis. The benefits of DBL also include high flexibility, dynamic process, active learning, and high creativity. DBL should be tested with other disciplines such as engineering school, laws school, health sciences school, and should be compared with other traditional teaching and learning modes in the future. This method may support the global higher education systems to move forward the COVID-19 pandemic to set a novel standard of a future normal.

The aim of this paper is to contribute to the body of knowledge about Project-Based Learning (PBL) methodology in higher education by describing and analysing interrelations between competencies, and their contribution to knowledge transfer (KT) and students’ rating of the project. The sample consisted of 464 students from the Universities of Huelva (N=347; 74.8%) and Murcia (N= 117; 25.2%), enrolled in the second year of a degree in either Infant or Primary Education. Data was collected through a self-administered questionnaire comprising a total of 53 items measuring General, Specific and Transversal competencies, as well as students’ rating of the project. Competencies were selected from the course programmes for the degrees in Infant and Primary Education. Preliminary results showed that competencies were moderately to highly acquired after PBL, and that students reported notable KT as well as a positive assessment of the project. KT showed a high degree of association with students’ ratings and was established as a key factor in learning and learner satisfaction in higher education.

A systematic review of the potential of implementing augmented reality (AR) in inquiry-based learning was conducted. We considered the purposes, potential advantages, application characteristics and the effects of using AR in inquiry-based learning. The findings reveal that AR, in the context of inquiry-based learning, is mostly implemented successfully to achieve cognitive and, less often, motivational and emotional learning goals. The AR solutions have mainly been applied in the Conceptualization and less in the Investigation phase. The affordances of AR in the Orientation, Conclusion and Discussion phase need to be applied in further studies.

Efficient use of the operating room (OR) is crucial for any hospital. One of the major inefficiencies in the OR is surgical cases not starting or finishing on time as scheduled. When a case is delayed, it affects all subsequent cases in that OR. This study uses discrete choice analysis to determine the significant factors, including team familiarity, that influence OR case on-time start and finish. A case is considered on-time if the documented procedure start and finish times are no more than 10 minutes after the scheduled start and finish times. The analysis uses surgical case data from a large tertiary referral hospital and academic center in Greenville, South Carolina. The case data includes all surgical cases (15,091) performed during regular workdays in 2013. Two binary logit models are developed: one for case on-time start and one for case on-time finish. Results indicate that higher team familiarity between surgeon and anesthesiologist, surgeon and circulating nurse, surgeon and scrub nurse, and surgeon and CRNA improve the likelihood of an OR case on-time start and on-time finish. This finding indicates that the OR scheduling staff in the study hospital make a concerted effort to schedule the surgical teams with members who have worked well together in the past.

This work considers the task of representation learning on the attributed relational graph (ARG). Both the nodes and edges in an ARG are associated with attributes/features allowing ARGs to encode rich structural information widely observed in real applications. Existing graph neural networks offer limited ability to capture complex interactions within local structural contexts, which hinders them from taking advantage of the expression power of ARGs. We propose Motif Convolution Module (MCM), a new motif-based graph representation learning technique to better utilize local structural information. The ability to handle continuous edge and node features is one of MCM’s advantages over existing motif-based models. MCM builds a motif vocabulary in an unsupervised way and deploys a novel motif convolution operation to extract the local structural context of individual nodes, which is then used to learn higher-level node representations via multilayer perceptron and/or message passing in graph neural networks. When compared with other graph learning approaches to classifying synthetic graphs, our approach is substantially better in capturing structural context. We also demonstrate the performance and explainability advantages of our approach by applying it to several molecular benchmarks.

Active participation of students is paramount not only for their learning experiences but also for their academic performance. Therefore, various methods have been developed and proven to help students achieve active learning. However, several shortcomings in these methods have been indicated as increasing students’ sense of burden and discomfort, eventually preventing them from benefiting sufficiently. This study aimed to determine the efficiency of a low-load web-based review quiz built by the researchers on Google Forms to enhance students’ reviewing habits and active class participation. Participants in this study were 53 first-year dental hygiene students in a 10-class microbiology course. After each class, all students were given the web-based quiz to prepare for a paper-based review test, which assessed the learning of the content covered in the previous classes. We analyzed the correlations between frequency of participation in the web-based quiz and the average scores of the weekly review tests or the final examination scores. Consequently, voluntary participation in the web-based quiz positively correlated with both short-term and long-term students’ learning outcomes. Through this web-based quiz during the first year of the dental hygiene program, students can develop the “self-learning attitude” needed to pass the national examination.

Reliable quantification of pulmonary arterial pressure is essential in the diagnostic and prognostic assessment of a range of cardiovascular pathologies including rheumatic heart disease, yet an accurate and routinely available method for its quantification remains elusive. This work proposes an approach to infer pulmonary arterial pressure based on scientific machine learning techniques and non-invasive, clinically available measurements. A 0-D multicompartment model of the cardiovascular system was optimized using several optimization algorithms, subject to forward-mode automatic differentiation. Measurement data were synthesized from known parameters to represent the healthy, mitral regurgitant, aortic stenosed and combined valvular disease situations with and without pulmonary hypertension. Eleven model parameters were selected for optimization based on 95 % explained variation in mean pulmonary arterial pressure. A hybrid Adam and limited-memory Broyden-Fletcher-Goldfarb-Shanno optimizer yielded the best results with input data including valvular flow rates, heart chamber volume changes and systematic arterial pressure. Mean absolute percentage errors ranged from 1.8 % to 3.78 % over the simulated test cases. The model was able to capture pressure dynamics under hypertensive conditions with pulmonary arterial systole, diastole, and mean pressure average percentage errors of 1.12 %, 2.49 % and 2.14 %, respectively. The relatively low errors highlight the potential of the proposed model to recover pulmonary pressures for diseased heart valve and pulmonary hypertensive conditions.

The use of Information Communication Technologies (ICT) in education brings up new possibilities of promoting the learning and health experiences. In this sense, education contexts of 21st century must consider these two areas of knowledge, especially their integration. This article presents learning practices developed with mobile devices and games, in order to improve learning and well-being in children and adolescents undergoing cancer treatment in non-formal educational setting. The methodology is based on qualitative case studies with content-based data analysis, involving informal interviews and observation methods. The study considers data from 5 patients who participated in the research between 2015 and 2019. The results demonstrate a positive influence of the practices with mobile technologies and games in terms of learning and in the well-being feeling of patients during the treatment.

Indoor positioning based on the received signal strength (RSS) of the WiFi signal has become the most popular solution for indoor localization. In order to realize the rapid deployment of indoor localization systems, solutions based on crowdsourcing have been proposed. However, compared to conventional methods, crowdsourced RSS values are more erroneous and can result in large localization errors. To mitigate the negative effect of the erroneous measurements, a graph-based semi-supervised learning (G-SSL) method is used to exploit the correlation between the RSS values at nearby locations to estimate an optimal RSS value at each location. Before using the G-SSL method, the Linear Regression (LR) algorithm is proposed to solve the device diversity problem in crowdsourcing system. Since the spatial distribution of the APs is sparse, the Compressed Sensing (CS) method is applied to precisely estimate the location of the APs. Based on the location of the APs and a simple signal propagation model, the RSS difference between different locations is calculated and used as an additional constraint to improve the performance of G-SSL. Furthermore, to exploit the sparsity of the weights used in the G-SSL, we use the CS method to reconstruct these weights more accurately and make a further improvement on the performance of the G-SSL. Experimental results show improved results in terms of the smoothness of the radio map and the localization accuracy.

Several studies suggest that COVID-19 may be accompanied by symptoms such as a dry cough, muscle aches, sore throat, and mild to moderate respiratory illness. The symptoms of this disease indicate the fact that COVID-19 causes noticeable negative effects on the lungs. Therefore, considering the health status of the lungs using X-rays and CT scans of the chest can significantly help diagnose COVID-19 infection. Due to the fact that most of the methods that have been proposed to COVID-19 diagnose deal with the lengthy testing time and also might give more false positive and false negative results, this paper aims to review and implement artificial intelligence (AI) image-based diagnosis methods in order to detect coronavirus infection with zero or near to zero false positives and false negatives rates. Besides the already existing AI image-based medical diagnosis method for the other well-known disease, this study aims on finding the most accurate COVID-19 detection method among AI methods such as machine learning (ML) and artificial neural network (ANN), ensemble learning (EL) methods.

Worldwide, diarrhoea in children under-five years of age is the second leading cause of death. Despite having high morbidity and mortality, diarrhoeal diseases can be averted by simple and cost-effective interventions. The Integrated Management of Childhood Illness (IMCI) has proposed the use of Oral Rehydration Salt (ORS) and zinc together with adequate food and fluid intake for the management of acute non-dysenteric watery diarrhoea in children. In the past, few studies examined the determinants of adherence to diarrhoea case management. Therefore, this study measured the determinants of therapeutic and dietary adherence to diarrhoea case management using the third and fourth wave of Pakistan Demographics & Health Surveys (PDHS) datasets. Data from 4,068 children between 0 to 59.9 months with positive history of diarrhoea were included, while data on children with dysentery, severe dehydration, and co-morbid condition was excluded. This study reported therapeutic adherence in less than 10% of children in Pakistan, while dietary adherence was reported in 39.2% of children (37.7% in 2012-2013 ~ 40.7% in 2017-2018). A significant improvement in therapeutic (0.8% in 2012-2013 ~ 8.1% in 2017-2018) and dietary adherence (37.7% in 2012-2013 ~ 40.7% in 2017-2018) was reported in the 2017-2018 survey, compared to the 2012-2013 survey. In general, children over the age of one year (compared to children <1 year) and of the richer/richest socioeconomic class (compared to poorest/poorer socioeconomic class) have showed higher therapeutic and dietary adherence. Therapeutic and dietary adherence among diarrhoeal children can be improved by increasing the awareness and accessibility of ORS, zinc, and essential foods.

Background: This study aimed to present the development process and characteristics of the Korean Registry of Acute Myocardial Infarction for Regional Cardiocerebrovascular Centers (KRAMI-RCC). Methods: We developed KRAMI-RCC, a web-based registry for patients with AMI. Patients from 14 RCCs were registered for more than 3 years from July 2016. It includes an automatic error-checking system, and user training and on-site monitoring are performed to manage data quality. Results: A total of 11,700 AMI patients were registered in KRAMI-RCC over 3 years (73.9% men). The proportions of patients with ST-elevation and non-ST-elevation myocardial infarction at discharge were 43.4% and 56.6%, respectively. Of the total 3-year patients, 5.6% died in the hospital and 4.4% died 12 months after discharge. The case fatality within 12 months was 9.7%. Prehospital care data showed delayed arrival time after onset of symptoms (median 153 min) and low transportation rate by public ambulance (25.2%). Post-hospital care data showed lower participation rate in the second rehabilitation program (16.8%). Conclusions: The recently developed KRAMI-RCC registry has been more focused on pre-hospital and post-hospital data, which will be helpful in understanding the current state of AMI disease management and in making policy decisions to reduce case fatality in Korea.

Covid-19 has now become a public health concern worldwide. The infection primarily involves the respiratory tract. Hitherto, some Covid-19 pneumonia patients carry the viral nucleic acids, and the active virus was detected in stool specimens. The virus discharged with feces is a potential contagious source. In the present study, three Covid-19 respiratory tract infection patients showed no gastrointestinal symptoms, and two were positive for viral nucleic acids in anal swab specimens remained positive 6 and at least 14 days after virus turned negative in the respiratory tract, respectively (details of the patients were listed in Fig 1). Thus, for Covid-19-infected patients with or without gastrointestinal symptoms, viral nucleic acids in stool specimens or anal swab specimens should be focused on for testing in order to decide the isolation duration of the patient.

Through history, particular attention has been paid of the study of the relationship between the energy use and the city structure. Improving energy efficiency in modern agglomerations is the most promising means to mitigate climate change and its impacts. In this current context of globalisation, European Union proposes initiatives and policy targets to rethink the urban development strategies towards the ‘zero energy objectives’. Providing a methodological approach with a simulation district analysis, the present article summarizes how the ‘zero energy’ challenge is analyzed in an existing district (Epinlieu) to articulate the users’ requirements in energy. This study contributes to the scientific discussion of the districts’ urban structure and energy planning by establishing a linkage among the beneficial influence of the KPIs of the districts’ form to increase their energy efficiency and its application in a real case study in Belgium.

Achieving global goals on sustainable nutrition, health, and wellbeing will depend on delivering enhanced diets to humankind. This will require, among others, instantaneous access to information on food quality at key points within agri-food systems. Although stationary methods are usually used to quantify grain quality (wet-lab chemistry, benchtop NIR spectrometer); these do not suit many required user-cases, such as stakeholders in decentralized agri-food-chains that are typical for emerging economies. Therefore, we explored new technologies and models that might aid these particular user-cases. For this purpose, we generated the NIR spectra of 328 grain samples from multiple cereals (finger millet, foxtail millet, maize, pearl millet, sorghum) with a standard benchtop NIR Spectrometer (DS2500, FOSS) and a novel mobile NIR-based sensor (HL-EVT5, Hone). We explored a range of classical deterministic and novel machine learning (ML)-driven models to build calibrations out of the NIR spectra. We were able to build relevant calibrations out of both types of spectra. At the same time, ML-based methods enhanced the prediction capacity of calibration models compared to classical deterministic methods. We also documented that the prediction of grain protein content based on NIR spectra generated by a mobile sensor (HL-EVT5, Hone) was highly relevant for quantitative protein predictions (R2 = 0.91, RMSE = 0.97, RPD = 3.48). Thus, the findings of this study lay the foundations on which to expand the utilization of NIR spectroscopy applications for agricultural research and development.

During the COVID-19 outbreak, most university courses have been offered on online platforms. A sudden shift from face-to-face classroom learning to online formats could influence the learning effectiveness of classes. This study aims to investigate differences in the learning effectiveness of online and face-to-face lecture courses. It also explores factors that impact the effectiveness of online instruction. These factors include interactions among learners, interactions between learners and the instructor, the quality of online platforms, learners’ ability to use devices and follow instructions, and learners’ situational challenges. The study participants were 261 university students at King Mongkut’s University of Technology Thonburi in Bangkok, Thailand. All participants were enrolled in at least one lecture course, such as history, humans and the environment, the environment and development, or general philosophy, during the 2019 academic year. A questionnaire was distributed to participants after they completed these courses in May 2020. Paired simple t-test analyses were used to compare the effectiveness of online and face-to-face classes, and a multiple regression analysis was used to identify factors that impact the learning effectiveness of online classes. The results show that online classes are less effective than face-to-face courses. The multiple regression analysis also revealed that the effectiveness of online learning was significantly impacted by learners’ ability to interact with classmates during class, their ability to interact with instructors after the class, the quality of online platforms, and disturbances or distractions in learners’ environments.

Urinary cytology is a useful, essential diagnostic method in routine urological clinical practice. Liquid-based cytology (LBC) for urothelial carcinoma screening is commonly used in the routine clinical cytodiagnosis because of its high cell collection rate. Since conventional screening processes by cytoscreeners and cytopathologists using microscopes is limited in terms of human resources, it is important to integrate new deep learning methods that can automatically and rapidly diagnose a large amount of specimens without delay. The goal of this study was to investigate the use of deep learning models for the classification of urine LBC whole-slide images (WSIs) into neoplastic and non-neoplastic (negative). We trained deep learning models using 786 WSIs by transfer learning, fully supervised, and weakly supervised learning approaches. We evaluated the trained models on two test sets (equal and clinical balance) with a combined total of 750 WSIs, achieving ROC-AUCs for WSI diagnosis in the range of 0.984-0.990 by the best model, demonstrating the promising potential use of our model for aiding urine cytodiagnostic processes.

A 'little brother' of pain, itch is an unpleasant sensation that creates a specific urge to scratch. To date, various machine-learning based image classifiers (MBICs) have been proposed for quantitative analysis of itch-induced scratch behaviour of laboratory animals in an automated, non-invasive, inexpensive and real-time manner. In spite of MBICs' advantages, the overall performances (accuracy, sensitivity and specificity) of current MBIC approaches remains inconsistent, with their values varying from ~50% to ~99%, for which the reasons underlying have yet to be investigated further, both computationally and experimentally. To look into the variation of the performance of MBICs in automated detection of itch-induced scratch, this article focuses on the experimental data recording step, and reports here for the first time that MBICs' overall performance is inextricably linked to the sharpness of experimentally recorded video of laboratory animal scratch behaviour. This article furthermore demonstrates for the first time that a linearly correlated relationship exists between video sharpness and overall performance (accuracy and specificity, but not sensitivity) of MBICs, and highlight the primary role of experimental data recording in rapid, accurate and consistent quantitative assessment of laboratory animal itch.

As a representative of Exponential Organizations, MI went from obscurity to the Fortune 500 in just ten years. Mi's success is inextricably linked to its outstanding business model. This paper summarizes the elements of MI's business model from four perspectives: value proposition, value creation, value delivery, and value capture, as well as its measures for developing into an exponential organization. Expecting to provide theoretical references for the transformation and upgrading of manufacturing organizations.

This study proposes a novel hybrid machine learning approach for modeling of rainfall-induced shallow landslides. The proposed approach is a combination of an instance-based learning algorithm (k-NN) and Rotation Forest (RF), state of the art machine techniques that have seldom explored for landslide modeling. The Lang Son city area (Vietnam) is selected as a case study. For this purpose, a spatial database for the study area was constructed, and then, was used to build and evaluate the hybrid model. Performance of the model was assessed using Receiver Operating Characteristic (ROC), area under the ROC curve (AUC), success rate and prediction rate, and several statistical evaluation metrics. The results showed that the model has high performance with both the training data (AUC = 0.948) and the validation data (AUC = 0.848). The results were compared with those obtained from soft computing techniques i.e. Random Forest, J48 Decision Trees, and Multilayer Perceptron Neural Networks. Overall, the performance of the proposed model is better than those obtained from the above methods. Therefore, the proposed model is a promising tool for landslide modeling. The research result can be highly useful for land use planning and management in landslide prone areas.

Over the last few decades there has been an exponential growth in IT, motivating IT professionals and scientists to explore new dimensions resulting in the advancement of artificial intelligence and its subcategories like computer vision, deep learning and augmented reality. AR is comparatively a new area which was initially explored for gaming but recently a lot of work has been done in education using AR. Most of this focuses on improving students understanding and motivation. Like any other project, the performance of an AR based project is determined by the customer satisfaction which is usually affected by the theory of triple constraints; cost, time and scope. many studies have shown that most of the projects are under development because they are unable to overcome these constraints and meet project objectives. We were unable to find any notable work done regarding project management for augmented reality systems and application. Therefore, in this paper, we propose a system for management of AR applications which mainly focuses on catering triple constraints to meet desired objectives. Each variable is further divided into subprocesses and by following these processes successful completion of the project can be achieved.

Community-based case managers in health have been compared to glue which holds the dynamic needs of clients to a disjointed range of health and social services. However, case manager roles are difficult to understand due to poorly defined roles, confusing terminology, and low visibility in New Zealand. This review aims to map the landscape of case management work to advance workforce planning by clarifying the jobs, roles, and relationships of case managers in Aotearoa New Zealand (NZ). Our scoping and mapping review includes peer-reviewed articles, grey literature sources, and interview data from 15 case managers. Data was charted iteratively until convergent patterns emerged and distinctive roles identified. A rich and diverse body of literature describing and evaluating case management work in NZ (n=148) is uncovered with at least 38 different job titles recorded. 18 distinctive roles are further analysed with sufficient data to explore the research question. Social ecology maps highlight diverse interprofessional and intersectoral relationships. Significant innovation and adaptations are evident in this field, particularly in the last five years. Case managers also known as health navigators, play a pivotal but often undervalued role in NZ health care, through their interprofessional and intersectoral relationships. Their work is often unrecognised which impedes workforce development and the promotion of person-centred and integrated health care.

Underpinned by the new world Kirkpatrick model and in the context of a community-based, sport psychology program (My Strengths Training for Life™) for young people experiencing homelessness, this process evaluation investigated: (1) young peoples’ reactions (program and facilitator evaluation, enjoyment, attendance, and engagement) to and learning (mental skills and transfer intention), (2) the relationship between reaction and learning variables, and (3) the mediators underpinning this relationship. 301 young people living in a West Midlands housing service completed questionnaires on demographics, reaction and learning variables. Higher levels of program engagement were positively associated with more favorable reactions to the program. Enjoyment positively predicted learning outcomes, which was mediated by transfer intention. Recommendations are made for: (1) a balance between rigor and flexibility for evaluation methods with disadvantaged youth, (2) including engagement as well as attendance for indicators of meaningful program participation, (3) measuring program experiences (e.g., enjoyment) to understand program effectiveness, and (4) providing opportunities for skill transfer during and after program participation. Findings have implications for researchers, program commissioners, and policy makers working designing and evaluating programs in community-based settings.

Protein phosphorylation and ADP-ribosylation (ADPr), as two types of post-translational modifications (PTM), are the process of adding phosphate group and ADP-ribose moieties to proteins, respectively. Although both PTM types can occur on many amino acid types, serine is the most common. Serine phosphorylation (pS), serine ADPr (SADPr), and their in situ crosstalks (pSADPr) play essential roles in biological processes. Although in silico classifiers have been developed for predicting pS and SADPr sites, the classifier for predicting pSADPr sites is unavailable. In this study, we developed classifiers to predict pSADPr sites. Specifically, we collected 3250 human pSADPr, 7520 SADPr, 151,227 pS and 80,096 unmodified serine sites. Based on them, we investigated the characteristics of pSADPr sites and constructed three classifiers to predict pSADPr sites from the pS dataset, the SADPr dataset and the protein sequences separately. We built and evaluated five deep-learning classifiers in ten-fold cross-validation and independent test datasets. Three of them (e.g. Convolutional Neural Network with the One-Hot encoding, dubbed CNNOH) performed better than the rest two. For instance, CNNOH had the AUC values of 0.700, 0.914 and 0.954 for recognizing pSADPr sites from the SADPr, pS and unmodified serine sites.Therefore, it is challenging to distinguish pSADPr sites from SADPr sites compared to the other two. It is consistent with our observation that pSADPr's characteristics are more similar to those of SADPr than the rest. Furthermore, we used the classifiers as base classifiers to develop a few stacking-based ensemble classifiers to improve performance. However, none of the ensemble classifiers showed better performances, suggesting that the base classifiers have good enough performances. Finally, we developed an online tool for extensively predicting human pSADPr sites based on the CNNOH classifier, dubbed EdeepSADPr. It is freely available through http://edeepsadpr.bioinfogo.org/.

Despite the increasing interest in ‘smart city’ initiatives worldwide, current literature still lacks the approaches and models that address challenges in organization and collaboration, which boost sustainability and ‘smartness’ in modern cities. This paper provides an overview of ‘smart city’ ecosystems as a mechanism to promote the expected outcomes of their sustainable development, and highlights the importance of conceptualizing cities from organizational and managerial perspectives. Representative exploratory models of ‘city organization’, which emphasize on the role of ‘governance’ and synergies, are presented to ‘decode’ complex city mechanisms and to determine key components that lead to ‘smart’ initiatives. Interesting case studies and applications are then analysed to examine the practical dimension of these approaches. As a review paper, this article lays out a general framework on the importance of ‘collaboration’, ‘governance’, ‘management’, and ‘ecosystem’. However, 'planning smartly’ and achieving ‘sustainability’ at the level of city ‘organization’ remain as challenges in this pioneering study of smart cities.

The initial outbreak of COVID-19 was first reported in Wuhan (China) during the latter part of December 2019. Indonesia has the fourth-largest population globally and reported the country’s first case of the virus on 2nd March 2020. The World Health Organisation (WHO) in addition to several neighbouring provinces and educational institutions within the region began questioning the Indonesian government upon the initial case reported. The objective of this study was to describe the epidemiological characteristics of the COVID-19 outbreak in Indonesia during March 2020. The data were collected from Indonesian government databases and non-government organisations (NGOs). The data were analysed using Microsoft Office 2019 (Excel) and Adobe Illustrator 2017 software, was used in drawing the map depicting the distribution of COVID-19 in Indonesia. As at 31st March 2020, a total of 1,528 people in Indonesia have been infected by COVID-19, in addition to 136 mortalities (CFR of 8.9%). Jakarta, as the principal capital of Indonesia, quickly has become the epicentre of the virus since this period. Most patient cases were attributed to those aged between 31 and 70 years (72.64%), with male patients (64.93%) representing the highest incidence of cases compared to female patients (35.07%). The number of ventilating machines was 3,326, with hospital numbers at 859. The distribution of cases depicting COVID-19 was mainly seen in urban areas compared to rural areas. Males compared to females, are at a higher risk of contracting COVID-19, including those aged below 30, between 30 and 60 or above. Indonesia also has the highest case fatality rate (CFR) with respect to mortalities in Southeast Asia and has the second-highest CFR globally. Similarly, while the number of ventilator machines as at 31st March 2020 were sufficient in meeting the growing number of COVID-19 cases in the country, it is possible that the government may need to increase the number of ventilators if the cases continue to escalate.

Estimation of the reality can easily be flawed, hence, in order to result in accurate and useful estimates the process has to be protected from bias and confounding and should follow other methodological milestones inherent to different types of empirical observations. Candidate-gene association studies are a specific form of observations that have been rather extensively applied in psychiatry yielding valuable information on various aspects – when methodologically adequate and used in appropriate settings. However, certain flaws that may occur in such studies might not be bluntly obvious, at least not at first glance, and may pass unnoticed by researchers and reviewers. This case study uses two recent published candidate-gene association reports suggesting involvement of cannabinoid receptor type 1 and of heat shock protein single nucleotide polymorphisms in development of neurocognitive performance and psychopathology in a cohort of adult first episode psychosis patients to point-out the types of flaws inevitably resulting in inaccurate and useless estimates.

Background: World Health Organization (WHO) declared that COVID-19 as a pandemic on March 11, 2020. There is sudden need of statistical modeling due to onset of COVID-19 pandemic across the world. But health planning and policy requirements the estimates of disease problem form clinical data. Objective: To predict recovery rate, cases load rate on the basis of cumulative confirmed Novel Corona virus (NCV) cases, recovered cases and deaths form COVID-19 in India. Methods: The reported COVID-19 cases in the country were obtained from website (https://datahub.io/core/covid-19#resource-covid-19_zip/). The cumulative NCV confirmed cases; recovery cases and deaths were used for estimating recovery rate, cases load rate and death rate till date 24 April 2020. Results: A total of 24530 NCV confirmed cases were reported nationwide in India on 24 April 2020. It is found that the recovery rate increased 22% and case load rate decreased 74%. Death rate is found to be very low 3%. The difference of cases load rate and recovery rate (delta) coincide at 50 % then NCV cases expected would be declined. Conclusion: The epidemic in the country was mainly caused by the importation of India. Lockdown as restricting the migration of population and decided to quarantine of population may greatly reduce the risk of continued spread of the epidemic in India. This study predicts that by 20 May 2020, the cases load rate lesser than recovery rate there after COVID-19 patients would be started to reducing.

This paper contributes to the understating of tornadoes in South Africa using case study analysis. In South Africa tornadoes are the recurring phenomenon (the climatology) but so far they have received less attention. Damages from storms itself (tornadoes inclusive) are significant in South Africa relative to other weather-related disasters for example floods, heat waves, and droughts. For their understanding, a case study approach was adopted in the current study. Data were in courtesy of the following, National Oceanic and Atmospheric Administration (NOAA), National Centers for Environmental Predictions (NCEP), Eumetsat Germany, and South African Weather Service (SAWS). The aim of the study was to provide an overview of the occurrence of tornadoes in South Africa using a Klerksdorp tornado, which occurred on March 4, 2007, Northwest Province in South Africa. From the case study analysis, the tornado was associated with the cold front and cut-off low (both are extratropical circulation) which were the dominant weather systems of the day. Therefore we conclude that, a case study approach may be the best way to study events of these nature for a more informed decision, for example, issuing an early warning system. In future, case studies, for example, involving interaction between extratropical and tropical circulation will also be an interesting study.

The current performance indicator for universal salt iodization (USI) is the percent of households using adequately iodized salt. However, the proportion of dietary salt from household salt is decreasing with the increase in consumption of processed foods and condiments globally. This paper reports on case studies supported by the GAIN-UNICEF USI Partnership Project to investigate processed food industry use of adequately iodized salt in contrasting national contexts. Studies were conducted in Egypt, Indonesia, the Philippines, the Russian Federation, and Ukraine. In all cases, the potential iodine intake from iodized salt in selected food products was modelled according to the formula: Quantity of salt per unit of food product x minimum regulated iodine level of salt at production x average daily per capita consumption of the product. The percent of adult recommended nutrient intake for iodine potentially provided by the average daily intake of bread and frequently consumed foods and condiments was from 10% to 80% at the individual product level. The potential contribution to iodine intake from the use of iodized salt in the processed food industry is of growing significance. National USI strategies should encourage co-operative industry engagement and include regulatory monitoring of iodized salt use in the food industry in order to achieve optimal population iodine status.

probiotics. However, these bacteria caused rare infections mostly in diabetic and immunocompromised subjects in presence of risk factors such as prosthetic hearth valves and dental procedures or caries. The scope of this survey was re-assessing the pathogenic potential of lactobacilli based on the infection case reports published in the last three years. In 2019, 2020 and 2021 17, 15 and 16 cases, respective-ly,.including endocarditis, bacteremia and other infections, were reported. These annual numbers are higher than observed previously. Lacticaseibacillus rhamnosus (13 cases), comprising strain GG (ATCC 53103) with established applications in healthcare, L. paracasei (7 cases), Lactobacillus acidophilus (5 cas-es), L. jensenii (5 cases), Lactiplantibacillus plantarum (3 cases), L. paraplantarum, L. delbrueckii subsp. del-brueckii, L. gasseri, L. paragasseri, Limosilactobacillus fermentum and L. reuteri (1 case each) were involved. Virulence characterization of two strains that caused infections, a derivative of L. rhamnosus GG and L.paracasei LP10266, indicated that increased biofilm forming capacity favors pathogenicity and it is determined by variable genetic traits. This survey highlighted that strains of lactobacilli able to cause infections were little characterized genet-ically. Instead, to avoid that these bacteria become a hazard, genetic stability should be periodically re-evaluated by whole genome sequencing (WGS) to ensure that only non-pathogenic variants are ad-ministered to vulnerable individuals.

Background: Although persistent systemic inflammation is considered to be predictive for future cardiovascular events, it remains unclear whether or not C-reactive protein (CrP) plays an active role in coronary-plaque instability. Here, we report a case of a patient with failed and super-infected renal allograft as a source for systemic inflammation presenting with repeat acute coronary syndromes. Case presentation: A 52-years-old male type-2 diabetic with a failed kidney transplant who was hospitalized for acute urinary-tract infection. In the presence of other, classic cardiovascular risk factors, peak values of CrP coincided with episodes of unstable angina treated by percutaneous coronary interventions. Besides pyelonephritis, the histological examination of the kidney transplant revealed signs of chronic rejection and the presence of a renal cell carcinoma in situ. Once the renal allograft has been removed, systemic inflammation was attenuated, the patient was not re-hospitalized for acute-coronary syndrome within the next 12 months. Conclusion: In this case, systemic inflammation was paralleled by instability of coronary plaques as documented by repeat percutaneous coronary interventions.

This paper aims to provide the reader with an organic view of the eyewear sector considering both market and quality aspects and evaluating the role of Industry 4.0 in process and product innovation for managing consumer health, analyzing a case study of a leading multinational company in the eyewear and ophthalmic lenses sector. The research has been developed with a qualitative approach. The study is a conceptual development and it uses an exploratory interview to create a single case study. The case study was developed with the realization by the researcher of a semi-structured interview. The selected interlocutor was the Innovation Manager of Alpha Optics. it has been decided to focus the attention on this figure, as it was responsible for the realization and introduction into the company of Industry 4.0 enabling technologies for developing health innovations. From this case study it was possible to observe how the connection with the trends that influence the demand for eyeglasses is a driving factor for product innovation. Products increasingly adapted to the needs of young people and the use of digital devices seem to be the ones on which the greatest number of innovations are concentrated.

In this retrospective report we present five cases of critically ill pregnant or newly delivered women positive for Covid-19 admitted to our obstetrical departments at Karolinska University Hospital. They compose 6% of eighty-three pregnant women that tested positive for SARS-CoV-2 during the period March 25 to May 4, 2020. Three patients were at the time of admission in gestational week between 21+4 to 22+5 and treated during their antenatal period, meanwhile the other two were admitted within 1 week postpartum. All of them were in a need of intensive care, one was treated with high flow oxygen therapy, the other four with invasive mechanical ventilation (three with endotracheal intubation and one with extra corporeal membrane oxygenation). Age above thirty, overweight and gestational diabetes are notable factors in the cases presented. At the time of admission, they all presented with symptoms as fever, cough and dyspnea. Chest imaging with computer tomography scan was performed in each case and demonstrated multifocal pneumonic infiltrates in all of them but no pulmonary embolism was confirmed in any. Neither did the echocardiogram indicates any cardiomyopathy. Four of the patients have been discharged from the hospital, with an average of 20 hospital days. One antenatal pregnant woman needed prolonged ECMO therapy, in gestational week 27+3 she went into cardiac arrest, resulting in an urgent c-section on maternal indication. At the time of writing she is still hospitalized. In coherence with other published reports our cases indicate that critically ill pregnant women infected by SARS-Cov-2 may develop severe respiratory distress syndrome requiring prolonged intensive care. The material is limited for conclusions to be taken, more detailed information on symptoms, treatment, and outcomes for pregnant and postpartum women managed in intensive care is therefore needed.

Objectives: The aim of the present study was to evaluate the association between psoriasis and osteoporosis using two different studies. Methods: Data from the Korean National Health Insurance Service-Health Screening Cohort of participants who were ≥ 40 years old were collected from 2002 to 2013. Psoriasis and osteoporosis were included using ICD-10 codes. In study I (a follow-up study), a total of 25,306 psoriasis participants were matched to 101,224 controls with respect to age group, sex, income group, and region of residence, and the occurrence of osteoporosis was analyzed. Crude (simple) and adjusted hazard ratios (HRs) were analyzed using a stratified Cox proportional hazard model. In study II (a nested case–control study), a total of 79,212 osteoporosis patients were matched to 79,212 controls, and a previous history of psoriasis was analyzed. Crude and adjusted odds ratios (ORs) were analyzed using a conditional logistic regression analysis. Subgroup analyses were conducted according to age group and sex. Results: The adjusted HR of osteoporosis was 1.11 (95% confidence interval [CI] = 1.07-1.15, P < 0.001) in study I. In the subgroup analysis according to age and sex, the results were consistent except for the ≥ 60-year-old women. The adjusted OR of psoriasis was 1.22 (95% CI = 1.16-1.28, P < 0.001) in study II. All subgroups demonstrated high adjusted ORs of osteoporosis for psoriasis. Conclusions: Psoriasis increased the risk of osteoporosis in the population of participants aged ≥ 40 years in Korea.

The prevalence and case fatality rates of Pediatric Lassa fever disease (LFD) are not well documented. This study was aimed at determining the prevalence, pattern and outcome of Pediatric LFD. It was a prospective observational study. A total of 183 subjects that met the criteria for LFD suspects were recruited consecutively and subjected to Lassa virus PCR test. Structured questionnaire was used to collect information. Of the 183 children recruited, 24 tested positive to Lassa virus PCR, giving a positivity rate of 13.1%. Mean duration of illness at presentation was 8.54 ± 3.83 days. Fever, abdominal pain and vomiting were the three highest presenting complaints. Seven out of 24 children died giving a case fatality rate (CFR) of 29.2%. Subjects with bleeding, poor urine output, convulsions and unconsciousness were more likely to die of LFD. Positivity and CFR of LFD are high. Improved case finding and prompt treatment is advocated.

The purpose of this study is to assess the concentration-response relations between conjunctivitis and exposure to ambient ozone. This retrospective study includes emergency department (ED) visits for conjunctivitis in Edmonton, Canada, for the period April 1992–March 2002. Daily average levels of ozone (range: 1.2–50.9, ppb), of temperature, and of relative humidity were estimated and used for the period of the study. For each of the considered exposure lags, (from 0 to 9 days), six different models were fitted to estimate the concentration-response function. The goodness of fit was assessed using the Akaike information criterion. During the period of the study, 17,211 ED visits for conjunctivitis were recorded and used. For all subjects together, a positive statistically significant association was obtained for the exposure lagged by 5 days. For female subjects, lags 1, 3, and 9 had positive statistically significant associations (lag 2 had negative associations). For male subjects, only lag 5 had a positive statistically significant association. The estimated non-linear concentration-response functions for the considered groups (all, males, females) and lags, revealed the associations along the exposure levels. The fitted shapes are described by algebraic functions and may have various forms. The estimated functions are useful to determine the risk associated with exposure to ground-level ozone.

Introduction: Neonatal mortality has declined in Cambodia but remains a key contributor to under-five deaths. The aim of this study was to further understanding of potential factors contributing to high neonatal mortality rates in Cambodia through assessment of verbal autopsies collected following newborn deaths. The study team analyzed verbal autopsies of perinatal deaths in order to describe timing and causes of neonatal deaths, demographic data, and factors potentially related to mortality. Methods: The case series data derive from 13 verbal autopsy reports collected in rural southern Cambodia. The mortality review was nested within a trial of a behavioral intervention to improve newborn survival, and was conducted after the close of the trial. The study examined all neonatal deaths occurring to infants born at 16 health centers between in the study site of Takeo province. The World Health Organization standardized definition of neonatal mortality was employed, and two pediatricians independently reviewed data collected from each event to assign a cause of death. Results: Thirteen newborn deaths of infants born at a health facility were reported during the time period February 2015–November 2016. Ten out of the 13 deaths (76.92%) were early neonatal deaths, two (15.38%) were late neonatal deaths, and one was a stillbirth. Five out of 13 deaths (38.46%) occurred within the first day of life, indicating death was likely due to an intrapartum event. The largest single contributor to mortality was neonatal sepsis; six of 13 deaths (46.15%) were attributed to some form of sepsis. Twenty-three percent of the deaths were attributed to asphyxia. Other causes of death included stillbirth and prematurity. Eight deaths (61.54%) occurred within the control group of the larger intervention study. Conclusion: The study highlights the continuing need to improve both intrapartum and postnatal quality of care and infection prevention and control, and to fully address causes of sepsis, in order to effectively reduce mortality in the newborn period.

Sustainability addresses environmental and social issues affecting this and future generations. When family businesses perceive that the community is disrupted, recognize an environmental problem and respond by implementing new environmental policies or regulations, the family business’s socio-emotional values press to transition to a more sustainable production system, such as the ‘Circular Economy.’ Drawing on the Dubin (1978) methodology—a paradigm for building models through deduction—we design a sustainable model, which shows family businesses’ responses to changes in the environment. It explains the reasons why family firms transition to the Circular Economy, based on the theory of Socio-Emotional Wealth (SEW). We check the model through the case study of the food retail leader in the Spanish market—Mercadona—which applies policies about energy, resources and waste to become a Circular Economy business model. Because of the strong family character of Mercadona, this case can be useful for the decision-making of other family businesses.

Pancreatic cancer is one of the most fatal common cancers affecting both men and women, representing about 3 percent of all new cancer cases in the United States. In this study, we aimed to investigate the association of pancreatic cancer risk with alcohol consumption as well as folate intake. We performed a case-control study of 384 patients diagnosed with pancreatic cancer from May 2004 to December 2009 and 983 primary care healthy controls. Our findings showed no significant association between risk of pancreatic cancer and either overall alcohol consumption or type of alcohol consumed (drinks/day). Our study showed dietary folate intake was modestly but significantly inversely associated with pancreatic cancer (OR=0.99, P <.0001). The current study supports the hypothesis that pancreatic cancer risk is reduced with higher food-based folate intake.

This paper presents an Application Based Active Learning (ABAL) methodology on Power Electronics (PE) and Electric Machines (EM) as a hybrid laboratory course for the undergraduate students to design and implement the real-world engineering problems. The ABAL is a type of active learning which is a branch of Learner-centered teaching (LCT). The DC/DC converter along with the speed control of DC separately excites the motor. In addition, a DC/AC converter is designed to control the speed of an induction motor. The results are then investigated on a hardware platform under the ABAL experimental methodology. This paper also discusses the problem identification selection of the equipment, circuit design, hardware mounting and critical analysis of the results acquired from the hybrid laboratory. The ABAL methodology was evaluated based on student satisfaction, feedback, grades and interest to solve the real-world problem rather than cramming the engineering concepts and fulfill so-called lab routine and tasks

The identification of informal settlements in urban areas is an important step in developing and implementing pro-poor urban policies. Understanding when, where and who lives inside informal settlements is critical to efforts to improve their resilience. This study aims to analyse the capability of machine-learning (ML) methods to map informal areas in Jeddah, Saudi Arabia, using very-high-resolution (VHR) imagery and terrain data. Fourteen indicators of settlement characteristics were derived and mapped using an object-based ML approach and VHR imagery. These indicators were categorised according to three different spatial levels: environ, settlement and object. The most useful indicators for prediction were found to be density and texture measures, (with random forest (RF) relative importance measures of over 25% and 23% respectively). The success of this approach was evaluated using a small, fully independent validation dataset. Informal areas were mapped with an overall accuracy of 91%. Object-based ML as a hybrid approach performed better (8%) than object-based image analysis alone due to its ability to encompass all available geospatial levels.

The importance of antibodies in health care and the biotechnology research and development demands not only knowledge of their experimental structures at high resolution, but also practical implementation of this knowledge for both effective and efficient design and production of antibody for its use in both medical and research applications. While the experimental wet-lab approach is usually costly, laborious and time-consuming, computational (dry-lab) approaches, in spite of their intrinsic limitations in comparison with its experimental (wet-lab) counterpart, provide a cheaper and faster alternative option. For the first time, this article reports a comprehensive set of structural electrostatic features extracted from experimentally determined antigen-antibody-related structures, including especially those structural electrostatic features at the interfaces of all experimentally determined antigen-antibody complex structures as of February 29, 2020, to facilitate effective and efficient machine learning-based computational antibody design using currently available experimental structures inside Protein Data Bank.

Cloud Computing is a promising and emerging technology that is rapidly being adopted by many IT companies due to a number of benefits that it provides, such as large storage space, low investment cost, virtualization, resource sharing, etc. Users are able to store a vast amount of data and information in the cloud and access it from anywhere, anytime on a pay-per-use basis. Since many users are able to share the data and the resources stored in the cloud, there arises a need to provide access to the data to only those users who are authorized to access it. This can be done through access control schemes which allow the authenticated and authorized users to access the data and deny access to unauthorized users. In this paper, a comprehensive review of all the existing access control schemes has been discussed along with analysis. Keywords: role-based access control, attribute-based access control, attribute-based encryption

There are two contrary opinions regarding the risk if mainland China (MC) moves away from its zero-COVID policy. Some experts think the risk shall be much lower than influenza as per MC’s own COVID-19 case fatality rate (CFR), while some other experts think the risk shall be much higher than influenza as per the COVID-19 CFRs of other regions. We elucidate here that this and multiple other striking differences in the CFR between various scenarios all support and substantially resulted from the view that good IDM is highly powerful to mitigate COVID-19, where IDM (isolation-disinfection-maintenance) means isolation of COVID-19 cases from other people, disinfection of their living environments, and health maintenance (e.g., rest, nutrition, breathing). The high effect of good IDM is also supported by the theoretic functions of IDM in minimizing co-infections and maintaining body functions, and the fact that all the 505 COVID-19 deaths reported in MC in 2022 before May 5 died directly of severe underlying diseases with COVID-19. Although it is tough for people in poverty to obtain good IDM, good IDM can be feasible at home for the most mild cases and in hospitals for the most severe cases. Therefore, good IDM can be crucial to mitigating COVID-19 worldwide. It also suggests that the risk for China to end its zero-COVID policy depends on China’s control policies or measures. Based on the effect of IDM, the cautious co-existence policy was proposed for COVID-19 control. This policy could reduce the whole death toll in MC because good IDM is non-specific and can reduce deaths of various other diseases. The cautious co-existence policy (non-specific) and the vaccination policy (specific) aid each other to mitigate COVID-19, and they cannot replace each other. Those who are qualified in health for vaccination should be vaccinated against COVID-19 timely.

This study examines the relation between ambient air pollution and emergency department (ED) visits due to certain infectious diseases in Toronto, Canada. The National Ambulatory Care Reporting System database was used to draw the corresponding health cases. Daily data on ED visits, ambient air pollution concentration levels, and weather conditions during the period from April 2004 to December 2015 (4,292 days in total) were linked together and used in statistical models. Six air pollutants (fine particulate matter PM2.5, CO, NO2, SO2, ozone O3 as a daily average, and ozone O3-8 hour ozone, as a maximum eight hour average) were investigated. In addition, the Air Quality Health Index (combining NO2, O3, and PM2.5) was also considered. The time-stratified case-crossover technique was applied in the study design. Conditional Poisson models were created using the daily counts of ED visit data. The considered factors, air pollutants and weather, were lagged by the same number of days, from 0 to 14. In the period of the study 339,644 ED visits were identified; 177,619 for females and 162,025 for males. For each air pollutant 270 models were realized (15 lags x 18 strata). Ambient air pollution concentrations lagged by 2, 3, and 5 days have the highest impact on ED visits, with 34, 32, and 35 positive associations, respectively. For all patients and an increase in a one interquartile range (IQR=1.2 ppb) of sulphur dioxide, the following values of the relative risks (RR) were estimated: RR=1.005 (95% confidence interval: 0.998, 1.013), 1.008 (1.001, 1.016), 1.009 (1.001, 1.016), 1.011 (1.004, 1.019), 1.007 (0.987, 1.028), and 1.009 (1.002, 1.016) for lags from 0 to 5, respectively. The results suggest that exposures for certain air pollutants (mainly CO, O3, and SO2) in urban environment affect the number of ED visits related to infectious diseases.

Psychotherapy is one of the evidence-based clinical interventions for the treatment of depression in older adults with dementia. Randomized Controlled Trials are often the first methodological choice to gain evidence, yet they are not applicable to a wide range of humanistic psychotherapies. Amongst all, the efficacy of the Gestalt therapy (GT) is under-investigated. The purpose of this paper is to present a research protocol aiming to assess the effects of a GT-based intervention on people with dementia (PWD) and the indirect influence on their family carers. The study implements the Single-Case Experimental Design with Time-Series Analysis that will be carried out in Italy and Mexico. Ten people in each country, who received a diagnosis of dementia and present depressive symptoms, will be recruited. Eight or more GT sessions will be provided whose fidelity will be assessed by the GT Fidelity Scale. Quantitative outcome measures are foreseen for monitoring participants’ depression, anxiety, quality of life, carers’ burden, and the caregiving dyad mutuality, at baseline and follow-up. The advantages and limitations of the research design are considered. If GT will result effective in the treatment of depression in PWD, it could enrich the range of evidence-based interventions provided by healthcare services.

The chemical graph theory is a subfield of mathematical chemistry which applies classic graph theory to chemical entities and phenomena. Chemical graphs are main data structures to represent chemical structures in cheminformatics. Computable properties of graphs lay the foundation for (quantitative) structure activity and structure property predictions - a core discipline of cheminformatics. It has a historic relevance for natural sciences, such as chemistry, biochemistry and biology, and is in the heart of modern disciplines, such as cheminformatics and bioinformatics. This review first covers the history of chemical graph theory, then provides an overview of its various techniques and applications for CASE, and finally summarises modern tools using chemical graph theory for CASE.

Clearly policy makers should consider the impacts of any decisions they might make before making them. Science can provide estimates of various economic, ecologic, environmental, and even social impacts of alternative policies, impacts that determine how effective any particular policy will be. These impact estimates can be used to compare and evaluate alternative policies in the search for identifying the best one to implement. Among all scientists providing inputs to policy making processes are analysts who develop and apply models that provide these estimated impacts and, possibly, their probabilities of occurrence. But just producing them is not a guarantee that they will be considered by policy makers. This paper discusses ways scientists, including systems analysts, can effectively contribute to and inform those involved in making water management decisions. Brief descriptions of a variety of past and on-going water management policy making processes illustrate both some successes and failures of science informing policy.

This research article reports the results of a qualitative case study that correlates academic literature with five Industry 4.0 cyber trends, seven cyber risk frameworks and two cyber risk models. While there is a strong interest in industry and academia to standardise existing cyber risk frameworks, models and methodologies, an attempt to combine these approaches has not been done until present. We apply the grounded theory approach to derive with integration criteria for the reviewed frameworks, models and methodologies. Then, we propose a new architecture for the integration of the reviewed frameworks, models and methodologies. We therefore advance the efforts of integrating standards and governance into Industry 4.0 and offer a better understanding of a holistic economic impact assessment model for IoT cyber risk.

A case-crossover study examined how PM_2.5 from Asian Dust Storms (ADS) affects the number of emergency room (ER) admissions for cardiovascular diseases (CVDs) and respiratory diseases (RDs). Our data indicated that PM_2.5 concentration from ADS was highly correlated with ER visits for CVDs and RDs. The odds ratios (OR) increased by 2.92 (95% CI: 1.22-5.08) and 1.86 (95% CI: 1.30-2.91) per increase 10 µg/m³ in PM_2.5 levels, for CVDs and RDs, respectively. A 10 µg/m³ increase in PM_2.5 from ADSs was significantly associated with increase in ER visits for CVDs among those 65 years of age and older (an increase of 2.77 in OR) and for females (an increase of 3.09 in OR). In contrast, PM_2.5 levels had a significant impact on RD ER visits among those under 65 years of age (OR=1.77). The risk of ER visits for CVDs increased on the day when the ADS occurred in Taiwan and the day after (lag 0 and lag 1); the corresponding risk increase for RDs only increased on the fifth day after the ADS (lag 5). In Taiwan’s late winter and spring, the severity of ER visits for CVDs and RDs increases. Environmental protection agencies should employ an early warning system for ADS to reduce high-risk groups’ exposure to PM_2.5.

Urbanization is considered as a main indicator of regional economic development due to its positive effect on promoting industrial development; however, many regions, especially developing countries, are troubled by its negative effect — the aggravating environmental pollution. Many researchers have indicated that rapid urbanization stimulated the expansion of industrial production scale and increased industrial pollutant emissions. However, this judgement contains a grave deficiency in that urbanization not only expands industrial production scales but can also increase industrial labour productivity and change the industrial structure. To modify this deficiency, we first decompose the influence which urbanization impacts on industrial pollutant emissions into the scale effect, the intensive effect and the structure effect by using the Kaya Identity and the LMDI Method; second, we perform an empirical study of the three effects’ impacts by applying the spatial panel model with data from 282 Chinese cities between 2003 and 2013. Our results indicate that (1) there are significant reverse U-shapes between Chinese urbanization rate and its industrial pollutant emissions; (2) the scale effect and the structure effect have aggravated Chinese industrial waste water discharge, sulphur dioxide emissions and soot (dust) emissions, while the intensive effect has generated a decreasing and ameliorative impact on that aggravated trend. The definite relationship between urbanization and industrial pollutant emissions depends on the combined influence of the scale effect, the intensive effect and the structure effect; (3) there are significant spatial autocorrelations of industrial pollutant emissions between Chinese cities, but the spatial spillover effect from other cities does not aggravate local urban industrial pollutant emissions, we offer an explanation to this contradiction that the vast rural areas surrounding Chinese cities have served as sponge belts and have absorbed the spatial spillover of cities’ industrial pollutant emissions. According to the results, we argue that this type of decomposition of the influence into three effects is necessary and meaningful, it establishes a solid foundation for understanding the relationship between urbanization and industrial pollutant emissions, and effectively helps to meet relative policy making.

Incorporating substantial sustainable development issues into teaching and learning is the ultimate task of Education for Sustainable Development (ESD). The purpose of our study is to identify the confused students who have failed to master the skill(s) given by the tutors as a homework using Intelligent Tutoring System (ITS). We have focused ASSISTments, an ITS in this study and scrutinized the skill-builder data using machine learning techniques and methods. We used seven candidate models that include: Naïve Bayes (NB), Generalized Linear Model (GLM), Logistic Regression (LR), Deep Learning (DL), Decision Tree (DT), Random Forest (RF), and Gradient Boosted Trees (XGBoost). We trained, validated and tested learning algorithms, performed stratified cross-validation and measured the performance of the models through various performance metrics i.e., ROC (Receiver Operating Characteristic), Accuracy, Precision, Recall, F-Measure, Sensitivity & Specificity. We found GLM, DT & RF are high accuracies achieving classifiers. However, other perceptions such as detection of unexplored features that might be related to the forecasting of outputs can also boost the accuracy of the prediction model. Through machine learning methods, we identified the group of students which were confused attempting the homework exercise and can help students foster their knowledge, and talent to play a vital role in environmental development.

Breast cancer is the most common cause of death for women worldwide. Thus, the ability of artificial intelligence systems to predict and classify breast cancer is very important. In this paper, a hybrid ensemble method classification mechanism is proposed based on a majority voting mechanism. First, the performance of different state-of-the-art machine learning classification algorithms for the Wisconsin Breast Cancer Dataset (WBCD) were evaluated. The three best classifiers were then selected based on their F3 score. F3 score is used to emphasize the importance of false negatives (recall) in breast cancer classification. Then, these three classifiers, simple logistic Regression learning, stochastic gradient descent learning and multilayer perceptron network, are used for ensemble classification using a voting mechanism. We also evaluated the performance of hard and soft voting mechanism. For hard voting, majority-based voting mechanism was used and for soft voting we used average of probabilities, product of probabilities, maximum of probabilities and minimum of probabilities-based voting methods. The hard voting (majority-based voting) mechanism shows better performance with 99.42% as compared to the state-of-the-art algorithm for WBCD.

Consumer rhythm-monitoring devices, such as the Apple Watch, are becoming more readily available. Irregular pulses can be detected using an optical sensor built into the wearable device. The Apple Watch (Apple Inc., Cupertino, CA, USA) is a class II medical device with pulse rate and electrocardiography (ECG) monitoring capabilities. Here we report a case in which an arrhythmia that was conventionally perceived but undiagnosed was identified as atrial fibrillation by self-acquisition of ECG data using an Apple Watch.

The problem of filling the bone cavity-forming after tooth extraction remains relevant in maxillo-facial surgery. There is a large selection of osteotropic materials of various natures for filling bone defects. In this article, our experience in the treatment of patients with combined mandible angle fracture and radicular cyst and fractures is introduced. A feature of the treatment is to fill the bone defect with the osteotropic material. Using collagen osteotropic material, possessing osteoconductive property can improve the treatment of patients with mandibular fractures within the dentition. This is due to both the stabilization of the fracture line, a decrease in the likelihood of displacement of fragments along with fixation with devices, and a reduction in the time of bone tissue regeneration, which reduces the rehabilitation period and allows further orthopedic treatment of patients after 4-5 months without additional bone grafting operations.

Background: After allogeneic hematopoietic stem cell transplantation (allo-HSCT), acute leukemia relapse is common, and asymmetric bone marrow recurrence hasn’t been reported. Because the anatomical distribution of acute leukemia clones in the bone marrow after allo-HSCT is presumed to be diffuse, bone marrow aspirations are performed in single site. Case presentation: We identified two acute leukemia patients, whose leukemic burden in bilateral bone marrow specimens differed significantly. The first case was a 20-year-old man who was diagnosed with acute myelomonocytic leukemia and received haploidentical allo-HSCT. He had been in complete remission for two years and off immunosuppressive medications for a year, with normal peripheral blood count. Routine bone marrow biopsy of his left posterior iliac bone marrow showed 52% leukemia blasts, while the right side had 0% blasts ten days later. Due to the discordant results, the patient refused further intervention and died of high leukocyte syndrome four months later. The second case was a 23-year-old woman who was diagnosed with acute B lymphoblastic leukemia and received HLA-identical sibling allo-HSCT. Although 62% of blasts were found in her left iliac marrow on day +122, 0 % of blasts were found on a sample obtained from the right iliac crest on day +128. Whole-body 18F-FDG PET/CT scans confirmed that the leukemic infiltration in her bone marrow was asymmetric. Considering the higher leukemic burden on the left, we chose the left posterior iliac crest aspiration for further response evaluation. After chemotherapy combined with donor lymphocyte infusion, she achieved transient hematologic complete remission. She died of septic shock with heart failure at +258 days after allo-HSCT before infusion of anti-CD19 donor chimeric antigen receptor T cells. Conclusions: To our knowledge, these are the first case reports of asymmetric bone marrow infiltration of blasts in acute leukemia patients after allo-HSCT. Bilateral posterior iliac crest aspirations or 18F-FDG-PET/CT scans may help distinguish such distribution. If discordant bone marrow specimens are observed, physicians should restrict future bone marrow studies to the more involved side.

Unmanned aerial vehicles (UAVs) are one of the most promising innovative technologies invented in recent years to promote precision agriculture and smart farming. UAVs can not only reduce labor requirements but also increase production output, reduce the use of pesticides, and protect the environment. However, previous studies on agricultural UAVs have mostly focused on technical problems such as software and hardware design. Few studies have examined users’ behaviors in the implementation process. On the basis of Orlikowski and Gash’s technological frames, this study explored the participants’ cognition and expectation of farmers, pesticide, sprayers, and agriculture officials, who are three key groups of stakeholders involved in the application of UAVs to pesticide spraying, regarding agricultural UAVs and examined how the conflicts between their cognition and expectation influenced the choice of using pesticide spraying UAVs. The conclusions of this study contributed to supplement the content and broaden the scope of application of technological frame theory and provided a crucial reference for the promotion of agricultural UAVs in practice.

In recent years, demand has been increasing for target detection and tracking from aerial imagery via drones using onboard powered sensors and devices. We propose a very effective method for this application based on a deep learning framework. A state-of-art embedded hardware system empowers small flying robots to carry out the real-time onboard computation necessary for object tracking. Two types of embedded modules were developed: one is designed using a Jetson TX or AGX Xavier, and the other is based on an Intel Neural Compute Stick. These are suitable for real-time onboard computing power on small flying drones with limited space. A comparative analysis of current state-of-art deep-learning-based multi-object detection algorithms was carried out utilizing the designated GPU-based embedded computing modules to obtain detailed metric data about frame rates as well as the computation power. We also introduce an effective target tracking approach for moving objects. The algorithm for tracking moving objects is based on the extension of simple online and real-time tracking. It was developed by integrating a deep-learning-based association metric approach (Deep SORT), which uses a hypothesis tracking methodology with Kalman filtering and a deep-learning-based association metric. In addition, a guidance system that tracks the target position using a GPU-based algorithm is introduced. Finally, we demonstrate the effectiveness of the proposed algorithms by real-time experiments with a small multi-rotor drone.

Background: Since the previous study dealing with the case fatality ratio and infection fatality ratio caused by COVID-19, the author has received many comments that prompted the question: "Why did an optimistic prognosis fail?" To answer this question, a more detailed and expanded analysis was carried out in a new study. Objective: To evaluate the dynamics of monthly numbers of cases, deaths, tests and CFR worldwide during three phases of the COVID-19 pandemic. Material and Methods: Twenty three sets of databases, dated the 22nd of each month from January 2020 to November 2021, for 213 countries were collected from the Worldometer website. The number of cases, deaths, tests, CFR, IFR, etc. were counted for various periods of time for each of the 213 countries, then results related to different periods of time were compared. Results: The analysis of the main epidemiological parameters led to the division of three phases of the global pandemic evolution. The first phase (23.01.20-22.07.20), the second phase (23.07.20-22.01.21) and the third phase (23.01.21-22.07.21) were different in terms of the number of tests performed, new cases, and mortality due to COVID-19. By the end of the second phase, the worldwide statistics indicated the imminent end of the pandemic, but the third phase was characterized by a sudden rise in the number of new cases and deaths that could not be explained rationally. The most dramatic evolution of the epidemic curve occurred in the countries where doctors had successfully battled COVID-19 during the first two phases of the pandemic. Conclusions: Despite the decrease in overall death numbers during the latest months analyzed, additional study is necessary to identify the cause for the increase in the number of new cases and deaths during the third phase of the pandemic. Only complete information regarding the positive and negative impact of medical and non-medical methods of diagnostics and prophylaxis of COVID-19 can help to organize effective measures to end the current pandemic and prevent a similar one from occurring in the future. Presumably, there are several causes of the negative evolution of the current pandemic, including the overreliance on PCR tests, application of non-specialized premises for quarantine and treatment, decrease in herd and individual immunity, inadequate change of therapeutic protocols, and ignoring prophylactic treatment. It can be suggested that the use of immunemodulatory drugs, for example, thymus extract or thymic peptides, in groups of people with compromised immunity is necessary, and prophylactic and therapeutic protocols should be changed from the 'standard' types to 'personalized' ones.

Introduction: Valproic acid (VPA) is an antiepileptic drug extensively used for treating partial and generalised seizures, acute mania and as prophylaxis for bipolar disorder. Drug-induced liver injury (DILI) persists as a significant issue related to fatal outcomes by VPA. The aim of this study was to increase our knowledge about this condition and to better identify patients affected. Methods: We conducted an observational retrospective case-control study that identified cases of DILI by VPA from the Pharmacovigilance Programme from our Laboratory Signals at La Paz University Hospital from January 2007 to December 2019. From the Therapeutic VPA Monitoring Programme, two control groups were assigned, VPA-tolerant patients and the other with patients who developed mild VPA-related hepatitis but who did not meet the DILI criteria, matched for date, age and sex. Results: A total of 60 patients were included in the study: 15 cases of DILI, 30 VPA-tolerant controls and 15 controls with mild hepatitis. Mean age for the cases was 45.7 years, 4(26.7%) were women and 5(33.34%) were children under 18 years, of them 3(20%) were fatal. Polytherapy with other antiepileptic drugs (p=0.047) and alcohol consumption (p<0.001) were associated with a greater risk of developing DILI by VPA. A diagnosis of epileptic seizure was more frequently related to DILI when compared with the VPA-tolerant controls (p<0.001). The cases developed hepatocellular hepatitis (p<0.001), while the mild hepatitis controls had a higher rate of cholestatic hepatitis (p<0.001). The laboratory lactate dehydrogenase values were statistically higher (even at baseline) in patients with DILI than in both control groups (p= 0.033 and p=0.039). Conclusions: VPA hepatotoxicity remains a considerable problem. This study offers interesting findings for characterising VPA-induced liver injury and at-risk patients.

Background. Neoplastic diseases and infections have become the leading causes of death in SLE in recent decades. Cancers and infections were also precipitating factors in the development of catastrophic APS. Case summary. We describe two patients: one of them had definite antiphospholipid syndrome (APS) and melanoma and the other had definite systemic lupus erythematosus (SLE) with APS, melanoma, infiltrative tuberculosis and severe Herpes Zoster (HZ). Management of patients with SLE concurrent with APS is a rather difficult task in rheumatology practice. In addition to kidney damage and cardiovascular disease, infections and malignancies are a significant cause of death in this cohort. The risk of malignancy in SLE is of considerable interest, since the immune and genetic pathways underlying the pathogenesis of this disease, as well as the immunosuppressive therapy, can significantly alter the risk. Both patients still had reliable APS, confirmed by triple-positive aPL. Both were at high risk of thrombosis. Patients ' adherence to treatment with direct oral anticoagulants and relapse of thrombosis on the background of rivaroxaban were noted. Conclusion. The cases where cancer or tuberculosis develops in the presence of rheumatic diseases are not so common and complicate the possibilities of therapeutic approaches, limiting the use of drugs that are not regulated by clinical recommendations.

(1) Background: It is unclear whether the reported presenting clinical features of coronavirus disease 2019 (COVID-19) are useful in identifying high-risk patients for early testing and isolation in the emergency department (ED). We aimed to compare the exposure history, clinical, laboratory, and radiographic features of ED patients who tested positive and negative for COVID-19; (2) Methods: We conducted a case-control study in seven EDs during the first five weeks of the COVID-19 outbreak in Hong Kong. Thirty-seven laboratory-confirmed COVID-19 patients were compared with 111 age- and gender-matched controls; (3) Results: There were no significant differences in patient characteristics and reported symptoms between the groups, except patient-reported fever. A positive travel history or contact history was the most significant predictor for COVID-19 infection. After adjustment for age and presumed location of acquiring the infection in Wuhan/Hubei, patient-reported fever (OR 2.6, 95% CI 1.1 to 6.3), delayed presentation (OR 5.0, 95% CI 2.0 to 12.5), having medical consultation before ED presentation (OR 7.4, 95% 2.9 to19.1), thrombocytopenia (OR 4.0, 95% CI 1.6 to 9.7), raised lactate dehydrogenase (OR 5.9, 95% CI 1.9 to 18.5), haziness, consolidation or ground-glass opacity on chest radiography (OR 5.6, 95% CI 2.0 to 16.0), and bilateral changes on chest radiography (OR 13.2, 95% CI 4.7 to 37.4) were associated with a higher odds of COVID-19 separately while neutrophilia was associated with a lower odds (OR 0.3, 95% CI 0.1-0.8); and (4) Conclusions: This study highlights several features that may be useful in identifying high-risk patients for early testing and isolation while waiting for test result. Further studies are warranted to verify the findings.

Objectives: COVID-19, a respiratory disease caused by SARS-COV2 and transmitted from person-to-person through viral droplets remains a global pandemic. There is a need to understand the transmission modes, populations at risk, and how to mitigate the spread and case fatality in the United States (US) and globally. The current study aimed to assess the global COVID-19 transmission and case fatality, examine similar parameters by countries and determine evidence-based practice in extreme epidemiology response in epidemic curve flattening and case fatality reduction. Methods: A cross-sectional ecologic design was used to assess the preexisting data on confirmed COVID-19 cases and mortality in March 2020 from the CDC, WHO, Worldodomter, and STATISTA. A rapid assessment between March 23^rd and 31^st, 2020, was utilized for the extreme epidemiology response. The case fatality, termed fatality proportion, was examined using mortality in relation to confirmed cases involving the world, United States of America (USA), United Kingdom (UK), Italy, France, Spain, China, Germany, India and South Korea. Results: The COVID-19 is a global pandemic, with the US as the epicenter for transmission, representing 20.9% of all confirmed cases worldwide, while Italy is the epicenter for case fatality, 30.6% of mortality as at 03/31/ 2020. The fatality proportion (FP) in Italy was 11.4%, Spain (8.8%), France (6.8%) and UK (6.4%). Despite the increased number of confirmed cases, the lowest FP was observed in Germany (0.96%) and South Korea (1.66%). There is increasing linear tends in transmission in the US, R²=0.97 as well as positive daily percentage change, ranging from 1.27% to 20.5%. Conclusions: The USA remains the epicenter for COVID-19 transmission, while Italy is the epicenter for case fatality. The observed relatively low case fatality in Germany and South Korea is due to an “extreme epidemiology” response through the application of Wuhan, China’s early data on COVID-19 transmission control measures and optimized patient care. These data are suggestive of relaxing the clinical guidelines in the United States in COVID-19 testing, application of contact tracing and testing, case isolation and most importantly enhancing resources for case management and social and physical distancing globally, hence epidemic curve flattening and case fatality reduction.

Social media has become part and parcel of the world of today. These days, it’s still the most talked about thing. It cannot be overlooked because it plays a key role in our business functions such as marketing and advertising. Social Media is all about collaboration on files, ideas and projects that help users and stakeholders to successfully complete the project. It influences how people communicate, develop relationship, build trust, increase transparency and provide cultural context. The fundamental aim of this research is to investigate the capacity for project management in social media. This paper explains how social media is used for project management knowledge areas and process groups. Also this research aims to identify SM tools that can be suitable for project management processes. Two studies Delphi Study of three rounds and structured case study interview are used to investigate the impact on the performance of the project team and process robustness. These studies support social media use by accessing the contribution to relationship building, trusts, coordination and cohesion.

Lake Rawapening, Semarang Regency, Indonesia, has incorporated a holistic plan in its management practices. However, despite successful target achievements, some limitations remain that a review of its management plan is needed. This paper identifies and analyzes existing lake management strategies as a standard specifically in Lake Rawapening by exploring various literature, both legal frameworks and scholarly articles indexed in Google Scholar and published in Water by MDPI about lake management in many countries. There are two major types of lake management, namely pillar-based and object-based. While the former is the foundation of a conceptual paradigm that does not comprehensively consider the roles of finance and technology in the lake management, the latter indicates the objects to manage so as to create standards or benchmarks for the implementation of various programs. Overall, Lake Rawapening management should include more programs on erosion-sedimentation control and monitoring of operational performance using information systems.

Nature-based solutions (NbS) are increasingly recognised for their potential to address both the climate and biodiversity crises. These outcomes are interdependent, and both rely on the capacity of NbS to support and enhance the health of an ecosystem: its biodiversity, the condition of its abiotic and biotic elements, and its capacity to function normally despite environmental change. However, while understanding of ecosystem health outcomes of nature-based interventions for climate change mitigation is growing, the outcomes of those implemented for adaptation remain poorly understood with evidence scattered across multiple disciplines. To address this, we conducted a systematic review of the outcomes of 109 nature-based interventions for climate change adaptation using 33 indicators of ecosystem health across eight broad categories (e.g. diversity, biomass, ecosystem functioning and population dynamics). We showed that 88% of interventions with positive outcomes for climate change adaptation also reported measurable benefits for ecosystem health. We also showed that interventions were associated with a 67% average increase in local species richness. All eight studies that reported benefits in terms of both climate change mitigation and adaptation also supported ecosystem health, leading to a triple win. However, there were also trade-offs, mainly for forest management and creation of novel ecosystems such as monoculture plantations of non-native species. Our review highlights two major limitations of research to date. First, only a limited selection of metrics are used to assess ecosystem health and these rarely include key aspects such as functional diversity and habitat connectivity. Second, taxonomic coverage is poor: 67% of outcomes assessed only plants and 57% did not distinguish between native and non-native species. Future research addressing these issues will allow the design and adaptive management of NbS to support healthy and resilient ecosystems, and thereby enhance their effectiveness for meeting both climate and biodiversity targets.

Background: This study presents a graph-based and purely structural analysis to detect echo chambers on Twitter. Echo chambers are a concern as they can spread misinformation and reinforce harmful stereotypes and biases in social networks. Methods: The study recorded the German-language Twitter stream over two months, recording about 180.000 accounts and their interactions. The study focuses on retweet interaction patterns in the German-speaking Twitter stream and found that the greedy modularity maximization and HITS metric are the most effective methods for identifying echo chambers. Results: The purely structural detection approach was able to identify an echo chamber (red community) that was focused on a few topics with a triad of Anti-Covid, right-wing populism, and pro-Russian positions (very likely reinforced by Kremlin-orchestrated troll accounts). In contrast, a blue community was much more heterogeneous and showed "normal" communication interaction patterns. Conclusions: The study highlights the effects of echo chambers as they can make political discourse dysfunctional and foster polarization in open societies. The presented results contribute to identifying problematic interaction patterns in social networks often involved in the spread of disinformation by problematic actors. It is important to note that not the content but only the interaction patterns would be used as a decision criterion, thus avoiding problematic content censorship.

Care coordination (CC) for children with special healthcare needs and medical complexity (CSHCN-CMC) is challenging, and medication management is especially difficult for providers, parents/caregivers, and patients alike. While numerous strategies for CC have been suggested and implemented, barriers to medication optimization remain. The report describes the creation of a pediatric clinical pharmacotherapy practice, related standard operating procedures to assure consistent application of screening tools and care provision through comprehensive medication management (CMM), and establishment of a collaborative practice agreement (CPA) to guide drug therapy delegation, monitoring, and modification. The methodology of a prospective case series is also presented to highlight drug therapy problems and their resolution in CSHCN-CMC. Future opportunities to expand the practice for engagement in population health management as well as prior authorization activities on behalf of physicians will be discussed.

A single coronary artery is a very rare condition, commonly associated with other congenital anomalies. It could be generally classified as neither benign nor malignant form of congenital coronary artery anomalies since its pathophysiological and clinical implications grossly depend on different anatomical patterns defined by the site of origin and distribution of the branches. By presenting the patient with an isolated single coronary artery, who underwent successful combined aortic valve replacement and coronary artery bypass grafting surgery, we intend to distinguish casual from causal in this extremely rare clinical and surgical scenario. This is the first-ever case published, combining such underlying pathology, clinical presentation, and surgical treatment.

In the ongoing Covid-19 pandemic, in the global data on the case fatality ratio and other indices reflecting death rate, there is a consistent downward trend from mid-April to mid-August. The downward trend can be an illusion caused by biases and limitations of data or it could faithfully reflect a declining death rate. A variety of explanations for this trend are possible, but a systematic analysis of the testable predictions of the alternative hypotheses has not yet been attempted. We state six testable alternative hypotheses, analyse their testable predictions using public domain data and evaluate their relative contributions to the downward trend. We show that a decline in the death rate is real; changing age structure of the infected population and evolution of the virus towards reduced virulence are the most supported hypotheses and together contribute to major part of the trend. The testable predictions from other explanations including altered testing efficiency, time lag, improved treatment protocols and herd immunity are not consistently supported, or do not appear to make a major contribution to this trend although they may influence some other patterns of the epidemic.

Background: Administrative healthcare databases are widespread and are often standardized with regard to their content and data coding, thus they can be used also as data sources for surveillance and epidemiological research. Chronic dialysis requires patients to frequently access hospital and clinic services, causing a heavy burden to healthcare providers. This also means that these patients are routinely tracked on administrative databases, yet very few case definitions for their identification are currently available. The aim of this study was to develop two algorithms derived from administrative data for identifying incident chronic dialysis patients and test their validity compared to the reference standard of the regional dialysis registry. Methods: The algorithms are based on data retrieved from hospital discharge records (HDR) and ambulatory specialty visits (ASV) to identify incident chronic dialysis patients in an Italian region. Subjects are included if they have at least one event in the HDR or ASV databases based on the ICD9-CM dialysis-related diagnosis or procedure codes in the study period. Exclusion criteria comprise non-residents, prevalent cases, or patients undergoing temporary dialysis, and are evaluated only on ASV data by the first algorithm, on both ASV and HDR data by the second algorithm. We validated the algorithms against the Emilia-Romagna regional dialysis registry by searching for incident patients in 2014. Results: Algorithm 1 identified 680 patients and algorithm 2 identified 676 initiating dialysis in 2014, compared to 625 patients included in the regional dialysis registry. Sensitivity for the two algorithms was respectively 90.8% and 88.4%, positive predictive value 84.0% and 82.0%, and percentage agreement was 77.4% and 74.1%. Conclusions: These results suggest that administrative data have high sensitivity and positive predictive value for the identification of incident chronic dialysis patients. Algorithm 1, which showed the higher accuracy and has a simpler case definition, can be used in place of regional dialysis registries when they are not present or sufficiently developed in a region, or to improve the accuracy and timeliness of existing registries.

China is one of the world’s most important countries for waterfowl because of the large amount of potential habitat and its position along major migratory routes. Waterfowl poaching in China is a serious threat, and for over twenty years colleagues and I have tracked waterfowl poaching in China including hunting methods, trade routes and prices involved. According to the latest survey of a NGO, 11.8% of Chinese people have participated in wildlife consumption, and about 32.0% of people have seen wildlife consumption (Not necessarily involved in killing and eating the wildlife). The survey results come from 100 000 internet questionnaires. The current report provides an update focusing on waterfowl poaching in Xinjiang Province of the northwest China, where is highly pathogenic area on the avian influenza, SARS and the Wuhan coronavirus pneumonia (such as COVID-19). The cases in 2011, 2012, and 2014 involved about 1816 to 2760 birds of more than 20 species, with an estimated total of 200 000 wild birds being hunted by a group per year in Xinjiang. Strangely, the poacher was not punished by any law. We know a few waterfowl species are protected as a list of Key Protected Species in China, and hopefully this report will draw attention to the scope of waterfowl poaching in China. China has made great progress with protecting other wildlife, and hopefully more can be done to protect migrating waterfowl.

Background and Objectives: Many epidemiological studies have shown a positive association between black carbon (BC) and the exacerbation of allergic rhinitis and allergic asthma. However, none of the studies in Serbia examined this relationship so far. The aim of this study was to examine the associations between BC and emergency department (ED) visits for allergic rhinitis and allergic asthma in the Užice region of Serbia. Materials and Methods: A time-stratified case-crossover design was applied to 523 ED visits for allergic rhinitis and asthma exacerbation that occurred in the Užice region of Serbia between 2012−2014. Data regarding ED visits were routinely collected in the Health Center of Užice. The daily average concentrations of BC were measured by automatic ambient air quality monitoring stations. Odds ratios and their corresponding 95% confidence intervals were estimated using conditional logistic regression adjusted for the potential confounding influence of weather variables (temperature, humidity, and air pressure). Results: Statistically significant associations were observed between ED visits for allergic rhinitis and 2-day lagged exposure to BC (OR = 3.20; CI = 1.00−10.18; p < 0.05) and allergic asthma and 3-day lagged exposure to BC (OR = 3.23; CI = 1.05−9.95; p < 0.05). Conclusion: Exposure to BC in the Užice region increases the risk of ED visits for allergic rhinitis and asthma, particularly during the heating season.

For disciplines like biological science, security, and the medical field, link prediction is a popular research area. To demonstrate the link prediction many methods have been proposed. Some of them that have been demonstrated through this review paper are TransE, Complex, DistMult, and DensE models. Each model defines link prediction with different perceptions. We argue that the practical performance potential of these methods, having similar parameter values, using the fine-tuning technique to evaluate their reliability and reproducibility of results. We describe those methods and experiments; provide theoretical proofs and experimental examples, demonstrating how current link prediction methods work in such settings. We use the standard evaluation metrics for testing the model's ability.

Zoos are increasingly putting in place formalized animal welfare assessment programs to allow monitoring of welfare over time, as well as to aid in resource prioritization. These programs tend to rely on assessment tools that incorporate resource-based and observational animal- focused measures since it is rarely feasible to obtain measures of physiology in zoo-housed animals. A range of assessment tools are available which commonly have a basis in the Five Domains framework. A comprehensive review of the literature was conducted to bring together recent studies examining welfare assessment methods in zoo animals. A summary of these methods is provided with advantages and limitations of the approach es presented. We then highlight practical considerations with respect to implementation of these tools into practice, for example scoring schemes, weighting of criteria, and innate animal factors for consideration. It is concluded that would be value in standardizing guidelines for development of welfare assessment tools since zoo accreditation bodies rarely prescribe these. There is also a need to develop taxon or species- specific assessment tools to inform welfare management.

This article addresses the question how the religious narrative identity and subjective religiosity change over the course of 15 years. The cases portrayed are deconverts who have changed their religious affiliations multiple times. It will be carved out what led to their deconversion and what remains as a core of their faith after they have turned away from organized religion for good. Interviews have been conducted at three time points and are analyzed using content analysis. It will become clear that the needs and expectations of the two individuals differ highly, as well as the reasons for turning away from a religious community; yet what is a common core in this joint faithful journey is their need to live their religiosity, now in a private setting.

Bovine tuberculosis (bTB) remains a challenging endemic pathogen of cattle in many parts of the globe. Spatial clustering of Mycoacterium bovis molecular types in cattle suggests that local factors are the primary drivers of spread. Northern Ireland’s agricultural landscape is comprised of highly fragmented farms, distributed across spatially discontinuous land parcels, and these highly fragmented farming structures are thought to facilitate localised spread. We conducted a matched case control study to quantify the risks of bTB breakdown with farm area, farm fragmentation, fragment dispersal, and contact with neighbouring herds. Whilst our results show small but significant increases in breakdown risk associated with each of farm fragmentation, farm area, fragment dispersal, and contact with neighbouring herds, these relationships were strongly confounded with the number of contiguous neighbours with bTB. Our key finding was that every infected neighbour led to an increase in the odds of breakdown by 40% to 50%, and that highly fragmented farms were almost twice as likely to have a bTB positive neighbour compared to non-fragmented farms. Our results suggest that after controlling for herd size, herd type, spatial and temporal factors, farm fragmentation increasingly exposes herds to infection originating from first order spatial neighbours. Given NI’s particularly fragmented landscape, and reliance on short-term leases, our data supports the hypothesis that between-herd contiguous spread is a particularly important component of NI’s bTB disease system.

Since identified as the pathogen responsible for an outbreak of severe respiratory distress in Wuhan, China, the 2019-nCoV coronavirus has caused over 30M cases and 1M deaths globally. Sporadic cases were identified in several states in the US from early January, and large-scale community transmission is believed to have started in late February, leading to a first spike in COVID-19 deaths and overall mortality in late April, and a second spike later in the summer. I show here that the dynamics of the pandemic were different in different regions of the US, showing a north-south pattern, with a first pandemic wave mainly in northern regions, followed by a second wave mainly in southern regions. Analysis of overall mortality data shows that the increase in mortality correlates well with COVID-19 incidence in most regions, and that from April through August COVID-19 deaths accounted for a substantial proportion of all deaths in all parts of the US.

BACKGROUND Krukenberg tumor is a rare metastatic tumor of the ovary with characteristic histopathological features known as signet-ring cells. It usually presents in women around 45 years of age, however, we present an uncommon case in a 38-year-old pregnant woman. We report this case because of the unusual findings, the uncommon presentation in this younger age bracket, its diagnostic challenge, and poor prognosis. CASE PRESENTATION We describe an unusual case of a young woman with a history of painful vaginal bleeding at 13 weeks of pregnancy and treated for abruptio placentae. In her routine prenatal visit at week 20 of pregnancy, she was found to have a uterine fundus greater than her gestational age and referred to the hospital to discard polyhydramnios. At her admission a pelvic ultrasound was performed with normal findings of a 25 weeks pregnancy, also showing bilateral enlarged ovaries with heterogeneous echogenicity. The MRI showed a left tumoral lesion with dimensions of 22.1 x 13.6 x 16.3 cm, with lobulated regular contours with displacement of peripheral structures and mild compression of the bladder, the left ureter, and the inferior vena cava. The lesion was heterogeneous with irregular borders. The patient was programmed for a cesarean section; during the operation, the abdominal cavity showed bilateral tumors compatible with MRI findings, the ovarian tumors were sent to pathology and the results showed poorly differentiated mucinous adenocarcinoma (WHO III) with extensive signet-ring cells, an indicative of Krukenberg tumor. CONCLUSION: The case presented is rare due to its presentation in a pregnant woman without identifiable risk factors for gastric cancer. The incidental finding suggests the pregnancy masked the clinical presentation of gastric cancer, and the rapid deterioration of the patient is consistent with the aggressiveness described in the literature. The limited descriptions of this neoplasm in our country and the torpid evolution of this case highlight the importance of further studies of this cancer in Mexico.