Abstract: When public transportation projects were delivered through design-bid-build and later design-build, governments found a serious issue: inadequate funding. With population growth, governments began to develop new arrangements in which the private sectors were involved to cut the financial burden. This arrangement, Public-Private Partnership (PPP), has its own risks; however, performance outputs can motivate or discourage its use. On top of such output are time and budget, which can be affected by the type of project delivery methods. Project completion within or ahead of schedule as well as within or under budget is among any owner’s objectives. With a higher application of PPP in the highway industry in the US and insufficient research, the current study addresses the schedule and cost performance of PPP highway projects and determines which one outperforms the other. To meet this objective, after collecting performance data of all PPP projects, schedule growth and cost growth are calculated, and finally, statistical analysis is conducted to evaluate the PPP performance. The results show that PPP highway projects on average have saved time and cost; however, the main benefit is a faster delivery rather than an under-budget completion. This study can provide better insights to understand PPP highways’ performance and assist practitioners in applying PPP for transportation projects with the opportunity to save time and cost.
Abstract: Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. This work evaluates the association between the average risk score and measures of socioeconomic status (index of multiple deprivation) and health (index of health and disability). The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, suggesting that females are more at risk from this kind of multiple medication. The risk may be monitored and controlled in a healthcare management system that is well-equipped with tools implementing appropriate techniques of artificial intelligence.
Abstract: Developing new medicine and health solutions and improving patient health currently rely on the successful execution of clinical trials, which generate relevant safety and efficacy data. For their success, recruitment and retention of participants are some of the most challenging aspects of protocol adherence. Main barriers include: i) lack of awareness of clinical trials; ii) long distance from the clinical site; iii) the burden on participants, including the duration and number of clinical visits, and iv) high dropout rate. Most of these aspects could be addressed with a new paradigm, namely the Remote Decentralized Clinical Trials (RDCTs). Furthermore, the COVID-19 pandemic has highlighted additional advantages and challenges for RDCTs in practice, allowing participants to join trials from home and not depending on site visits, etc. Nevertheless, RDCTs should follow the process and the quality assurance of conventional clinical trials, which involve several processes. For each part of the trial, the Building Blocks, existing software and technologies were assessed through a systematic search. The technology needed to perform RDCTs is widely available and validated but is yet segmented and developed in silos, as different software solutions address different parts of the trial and at various levels. The current paper is analyzing the availability of technology to perform RDCTs, identifying gaps and providing an overview of Basic Building Blocks and functionalities that need to be covered to support the described processes.
Abstract: Assessment of geotechnical properties of the subsoil is necessary for generating relevant input for the design and construction of a foundation. It is significant for the future development in the area. The focus of this research is to investigate the preliminary geotechnical properties of the uncemented sandstone from Kati formation at Puncak Iskandar, Seri Iskandar. A series of basic soil tests, oedometer and direct shear box tests were carried out to obtain the soil parameters. The uncemented sandstone of Kati Formation was found to have well-graded and poorly graded sand distribution, depending on the location where the samples were obtained. The sand grains distribution was in a range of 82%-100% while, the specific gravity of the uncemented sandstone is in the range 2.65-2.86. The preconsolidation pressure for USB3 was 990 kPa indicating that the sandstone at USB3 sample had undergone 990 kPa of overburden pressure. The angle of friction for uncemented sandstone was ranging between 23.34°-32.92°.
Abstract: Traffic control has been one of the most common and irritating problems since the time automobiles have hit the roads. Problems like traffic congestion have led to a significant time burden around the world and one significant solution to these problems can be the proper implementation of the Intelligent Transport System (ITS). It involves the integration of various tools like smart sensors, artificial intelligence, position technologies and mobile data services to manage traffic flow, reduce congestion and enhance driver's ability to avoid accidents during adverse weather. Road and traffic signs’ recognition is an emerging field of research in ITS. Classification problem of traffic signs needs to be solved as it is a major step in our journey towards building semi-autonomous/autonomous driving systems. The purpose of this work focuses on implementing an approach to solve the problem of traffic sign classification by developing a Convolutional Neural Network (CNN) classifier using the GTSRB (German Traffic Sign Recognition Benchmark) dataset. Rather than using hand-crafted features, our model addresses the concern of exploding huge parameters and data method augmentations. Our model achieved an accuracy of around 97.6% which is comparable to various state-of-the-art architectures.
Abstract: Robotic assistance in nursing care is an increasingly
important area of research and development. Facing a shortage of
labor and an increasing number of people in need of care, the
German Nursing Care Innovation Center (Pflegeinnovationszentrum,
PIZ) aims to address these challenges from the side of technology.
Little is known about nurses experiences with existing robotic
assistance systems. Especially nurses perspectives on starting points
for the development of robotic solutions, that target recurring
burdensome tasks in everyday nursing care, are of interest. This
paper presents findings focusing on robotics resulting from an
explanatory mixed-methods study on nurses experiences with and
their expectations for innovative technologies in nursing care in
stationary and ambulant care facilities and hospitals in Germany.
Based on the findings, eight scenarios for robotic assistance are
identified based on the real needs of practitioners. An initial system
addressing a single use-case is described to show perspectives for the
use of robots in nursing care.
Abstract: Geophysical investigation was carried out at wacot rice factory Argungu north-western Nigeria, using the 2D electrical resistivity method. The area falls between latitude 12˚44′23ʺN to 12˚44′50ʺN and longitude 4032′18′′E to 4032′39′′E covering a total area of about 1.85 km. Two profiles were carried out with Wenner configuration using resistivity meter (Ohmega). The data obtained from the study area were modeled using RES2DIVN software which gave an automatic interpretation of the apparent resistivity data. The inverse resistivity models of the profiles show the high resistivity values ranging from 208 Ωm to 651 Ωm. These high resistivity values in the overburden were due to dryness and compactness of the strata that lead to consolidation, which is an indication that the area is free from leachate contaminations. However, from the inverse model, there are regions of low resistivity values (1 Ωm to 18 Ωm), these zones were observed and identified as clayey and the most contaminated zones. The regions of low resistivity thereby indicated the leachate plume or the highly leachate concentrated zones due to similar resistivity values in both clayey and leachate. The regions of leachate are mainly from the factory into the surrounding area and its groundwater. The maximum leachate infiltration was found at depths 1 m to 15.9 m (P1) and 6 m to 15.9 m (P2) vertically, as well as distance along the profiles from 67 m to 75 m (P1), 155 m to 180 m (P1), and 115 m to 192 m (P2) laterally.
Abstract: This study evaluates the management of osteoporosis in a tertiary care government hospital in Malaysia. As the number of admitted patients having osteoporotic fractures is on the rise, osteoporotic medications are an increasing financial burden to government hospitals because they account for half of the orthopedic budget and expenditure. Comprehensive knowledge among practitioners is important to detect early and avoid this preventable disease and its serious complications. The purpose of this study is to evaluate the awareness, knowledge, and practices in managing osteoporosis among practitioners in Hospital Tengku Ampuan Rahimah (HTAR), Klang. A questionnaire from an overseas study in managing osteoporosis among primary care physicians is adapted to Malaysia’s Clinical Practice Guideline of Osteoporosis 2012 (revised 2015) and international guidelines were distributed to all orthopedic practitioners in HTAR Klang (including surgeons, orthopedic medical officers), endocrinologists, rheumatologists and geriatricians. The participants were evaluated on their expertise in the diagnosis, prevention, treatment decision and medications for osteoporosis. Collected data were analyzed for all descriptive and statistical analyses as appropriate. All 45 participants responded to the questionnaire. Participants scored highest on expertise in prevention, followed by diagnosis, treatment decision and lastly, medication. Most practitioners stated that own-initiated continuing professional education from articles and books was the most effective way to update their knowledge, followed by attendance in conferences on osteoporosis. This study confirms the importance of comprehensive training and education regarding osteoporosis among tertiary care physicians and surgeons, predominantly in pharmacotherapy, to deliver wholesome care for osteoporotic patients.
Abstract: In this research, Self-Potential (SP) method was employed to locate anomalous electrical conductivity located in Goronyo area and also to determine the condition of the embankment of the dam. SP data were plotted against distance along with the profile and spacing of electrode using surfer software (version 12). High and low zones of SP values were identified along the right and left abutments of the dam reservoir. The regions with high SP values were described to be high tendency of fluid flow associate with wet sandy soil. These zones have the SP values ranging from 200 mV and above. High SP values were due to the high moisture content that may lead to the seepage of water leaking through this zone. The zones with high SP values occupied Profiles S1, S2, S3, S4 and S5 indicating the presence of potential seepage paths within the subsurface of the embankment. These regions of seepage were identified as weak zones and potential pathways through which water could be lost from the dam reservoir. The SP values for the regions range from 250 m to 400 m (S1), 306 m to 400 m (S2), 192 m to 400 m (S3), 48 m to 200 m (S4) and 7 m to 170 m (S5) with their corresponding maximum depths of 30 m, 28 m, 28 m, 30 m and 26 m respectively. However, zones of low SP values in the overburden were observed which shows the presence of intact regions, which may be due to the compactness and dryness around the dam. The weak zones were considered as geological features (such as fractures, joints, and faults) that have undermined the integrity of the dam structure, which has led to the abnormal seepage.
Abstract: Work-related illnesses and disorders have been a constant aspect of work. Although their nature has changed over time, from musculoskeletal disorders to illnesses related to psychosocial aspects of work, its impact on the life of workers remains significant. Despite significant efforts worldwide to protect workers, the disparity between changes in work legislation and actual benefit for workers’ health has been creating a significant economic burden for social security and health systems around the world. In this context, this study aims to propose, test and validate a modular prototype that allows for work environmental aspects to be assessed, monitored and better controlled. The main focus is also to provide a historical record of working conditions and the means for workers to obtain comprehensible and useful information regarding their work environment and legal limits of occupational exposure to different types of environmental variables, as means to improve prevention of work-related accidents and disorders. We show the developed prototype provides useful and accurate information regarding the work environmental conditions, validating them with standard occupational hygiene equipment. We believe the proposed prototype is a cost-effective and adequate approach to work environment monitoring that could help elucidate the links between work and occupational illnesses, and that different industry sectors, as well as developing countries, could benefit from its capabilities.
Abstract: Intelligibility is an essential characteristic of a speech
signal, which is used to help in the understanding of information in
speech signal. Background noise in the environment can deteriorate
the intelligibility of a recorded speech. In this paper, we presented a
simple variance subtracted - variable level discrete wavelet transform,
which improve the intelligibility of speech. The proposed algorithm
does not require an explicit estimation of noise, i.e., prior knowledge
of the noise; hence, it is easy to implement, and it reduces the
computational burden. The proposed algorithm decides a separate
decomposition level for each frame based on signal dominant and
dominant noise criteria. The performance of the proposed algorithm
is evaluated with speech intelligibility measure (STOI), and results
obtained are compared with Universal Discrete Wavelet Transform
(DWT) thresholding and Minimum Mean Square Error (MMSE)
methods. The experimental results revealed that the proposed scheme
outperformed competing methods
Abstract: The diversity and complexity of modern IT systems make it almost impossible for internal teams to find vulnerabilities in all software before the software is officially released. The emergence of threat intelligence and vulnerability reporting policy has greatly reduced the burden on software vendors and organizations to find vulnerabilities. However, to prove the existence of the reported vulnerability, it is necessary but difficult for security incident response team to build a deliberated vulnerable environment from the vulnerability report with limited and incomplete information. This paper presents a structured, standardized, machine-oriented vulnerability intelligence format, that can be used to automate the orchestration of Deliberated Vulnerable Environment (DVE). This paper highlights the important role of software configuration and proof of vulnerable specifications in vulnerability intelligence, and proposes a triad model, which is called DIR (Dependency Configuration, Installation Configuration, Runtime Configuration), to define software configuration. Finally, this paper has also implemented a prototype system to demonstrate that the orchestration of DVE can be automated with the intelligence.
Abstract: Plastic as an environmental burden is a well-rehearsed topic in the research area. This is due to its global demand and destructive impacts on the environment, which has been a significant concern to the governments. Typically, the use of plastic in the construction industry is seen across low-density, non-structural applications due to its diverse range of benefits including high strength-to-weight ratios, manipulability and durability. It can be said that with the level of plastic consumption experienced in the construction industry, an ongoing responsibility is shown for this sector to continually innovate alternatives for application of recycled plastic waste such as using plastic made replacement from polyethylene, polystyrene, polyvinyl and polypropylene in the concrete mix design. In this study, the impact of partially replaced fine aggregate with polypropylene in the concrete mix design was investigated to evaluate the concrete’s compressive strength by conducting an experimental work which comprises of six concrete mix batches with polypropylene replacements ranging from 0.5 to 3.0%. The results demonstrated a typical decline in the compressive strength with the addition of plastic aggregate, despite this reduction generally mitigated as the level of plastic in the concrete mix increased. Furthermore, two of the six plastic-containing concrete mixes tested in the current study exceeded the ST5 standardised prescribed concrete mix compressive strength requirement at 28-days containing 1.50% and 2.50% plastic aggregates, which demonstrated the potential for use of recycled polypropylene in structural applications, as a partial by mass, fine aggregate replacement in the concrete mix.
Abstract: The aim of this study is to analyse the works of playwrights within the framework of existential philosophy. It is to observe the ontological existence in the plays of No Exit and Endgame. Literary works will be discussed separately in each section of this study. The despair of post-war generation of Europe problematized the ‘human condition’ in every field of literature which is the very product of social upheaval. With this concern in his mind, Sartre’s creative works portrayed man as a lonely being, burdened with terrifying freedom to choose and create his own meaning in an apparently meaningless world. The traces of the existential thought are to be found throughout the history of philosophy and literature. On the other hand, the theatre of the absurd is a form of drama showing the absurdity of the human condition and it is heavily influenced by the existential philosophy. Beckett is the most influential playwright of the theatre of the absurd. The themes and thoughts in his plays share many tenets of the existential philosophy. The existential philosophy posits the meaninglessness of existence and it regards man as being thrown into the universe and into desolate isolation. To overcome loneliness and isolation, the human ego needs recognition from the other people. Sartre calls this need of recognition as the need for ‘the Look’ (Le regard) from the Other. In this paper, existentialist philosophy and existentialist angst will be elaborated and then the works of existentialist theatre and theatre of absurd will be discussed within the framework of existential philosophy.
Abstract: South Africa, a water scarce country, experiences the phenomenon that its life supporting natural water resources is seriously threatened by the users that are totally dependent on it. South Africa is globally applauded to have of the best and most progressive water laws and policies. There are however growing concerns regarding natural water resource quality deterioration and a critical void in the management of natural resources and compliance to policies due to increasing institutional uncertainties and failures. These are in accordance with concerns of many South African researchers and practitioners that call for a change in paradigm from talk to practice and a more constructive, practical approach to governance challenges in the management of water resources. A qualitative theory-building case study through longitudinal action research was conducted from 2014 to 2017. The research assessed whether a strategic positioned institutional agent can be parlayed to facilitate and execute WRM on catchment level by engaging multiple stakeholders in a polycentric setting. Through a critical realist approach a distinction was made between ex ante self-deterministic human behaviour in the realist realm, and ex post governance-management in the constructivist realm. A congruence analysis, including Toulmin’s method of argumentation analysis, was utilised. The study evaluated the unique case of a self-steering local water management institution, the Impala Water Users Association (WUA) in the Pongola River catchment in the northern part of the KwaZulu-Natal Province of South Africa. Exploiting prevailing water resource threats, it expanded its ancillary functions from 20,000 to 300,000 ha. Embarking on WRM activities, it addressed natural water system quality assessments, social awareness, knowledge support, and threats, such as: soil erosion, waste and effluent into water systems, coal mining, and water security dimensions; through structured engagement with 21 different catchment stakeholders. By implementing a proposed polycentric governance-management model on a catchment scale, the WUA achieved to fill the void. It developed a foundation and capacity to protect the resilience of the natural environment that is critical for freshwater resources to ensure long-term water security of the Pongola River basin. Further work is recommended on appropriate statutory delegations, mechanisms of sustainable funding, sufficient penetration of knowledge to local levels to catalyse behaviour change, incentivised support from professionals, back-to-back expansion of WUAs to alleviate scale and cost burdens, and the creation of catchment data monitoring and compilation centres.
Abstract: The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.
Abstract: The Grand Canal of China has been in use for more than two thousand years. It runs through the central and eastern regions of China and communicates with the five major river systems of Haihe River, Yellow River, Huaihe River, Yangtze River and Qiantang River from north to south. It is a complex, systematic and comprehensive water conservancy project in the period of agricultural civilization and includes the three parts of the Beijing-Hangzhou Canal, the Sui and Tang Dynasties Canal and the Eastern Zhejiang Canal. It covers eight provinces and cities including Beijing, Tianjin, Hebei, Shandong, Jiangsu, Zhejiang, Henan and Anhui. The Grand Canal is an important channel connecting the Central Plains and the Beijing-Hangzhou Canal, and it is also an important waterway trade channel. Nowadays, although the Grand Canal no longer bears the burden of communicating water transportation between the north and the south, the site of the Grand Canal is still a “historical museum” of the lifestyle of people who lived on the canal from the Ming and Qing Dynasties to the Republic of China. By means of literature reading and field investigation, this paper compares the different protection strategies of the Grand Canal in the region between the ancient villages of Huaxian and Xunxian, which witness the vicissitudes of canal water transport, to explore whether the protective renovation of historical and cultural routes is “protection” or “destruction”, and puts forward some protection suggestions.
Abstract: An important and influential factor in design and determining the safety factor in Soil Nailing is the ultimate pullout capacity, or, in other words, bond strength. This important parameter depends on several factors such as material and soil texture, method of implementation, excavation diameter, friction angle between the nail and the soil, grouting pressure, the nail depth (overburden pressure), the angle of drilling and the degree of saturation in soil. Federal Highway Administration (FHWA), a customary regulation in the design of nailing, is considered only the effect of the soil type (or rock) and the method of implementation in determining the bond strength, which results in non-economic design. The other regulations are each of a kind, some of the parameters affecting bond resistance are not taken into account. Therefore, in the present paper, at first the relationships and tables presented by several valid regulations are presented for estimating the ultimate pullout capacity, and then the effect of several important factors affecting on ultimate Pullout capacity are studied. Finally, it was determined, the effect of overburden pressure (in method of injection with pressure), soil dilatation and roughness of the drilling surface on pullout strength is incremental, and effect of degree of soil saturation on pullout strength to a certain degree of saturation is increasing and then decreasing. therefore it is better to get help from nail pullout-strength test results and numerical modeling to evaluate the effect of parameters such as overburden pressure, dilatation, and degree of soil saturation, and so on to reach an optimal and economical design.
Abstract: 790 lungs from brown hares (Lepus europeus L.) from different regions of Bulgaria were investigated during the period 2009-2017. The parasitological status and pathomorphological features in the lungs were recorded. The following parasite species were established: one nematode - Protostrongylus tauricus (7.59% prevalence), one tapeworm – larva of Taenia pisiformis – Cysticercus pisiformis (3.04% prevalence) and one arthropod – larva of Linguatula serrata – Pentastomum dentatum (0.89% prevalence). Macroscopic lesions in the lungs were different depending on the causative agents. The infections with C. pisiformis and P. dentatum were attended with small, mainly superficial changes in the lungs. Protostrongylid infections were connected with different in appearance and burden macroscopic changes. In 77.7%, they were nodular, and in the rest of cases, they diffuse. The consistency of the lesions was compact. In most of the cases, alterations were grey in colour, rarely were dark-red or marble-like. In 91.7% of these cases, they were spread on the apical parts of large lung lobes. In 36.7% middle parts of the large lung lobes, and, in 26.7% small lung lobes, were also affected. The small lung lobes were never independently infected.
Abstract: Port institutions serve as a link connecting the land areas that receive the goods and the areas from where ships sail. These areas hold great significance for the conversion of goods into commodities of economic value, capable of meeting the needs of the society. Development of ports constitutes a fundamental component of the comprehensive economic development process. Recognizing this fact, developing countries have always resorted to this infrastructural element to resolve the numerous problems they face, taking into account its contribution to the reformation of their economic conditions. Iraqi ports have played a major role in boosting the commercial movement in Iraq, as they are the starting point of its oil exports and a key constituent in fulfilling the consumer and production needs of the various economic sectors of Iraq. With the Gulf wars and the economic blockade, Iraqi ports have continued to deteriorate and become unable to perform their functions as first-generation ports, prompting Iraq to use the ports of neighboring countries such as Jordan's Aqaba commercial port. Meanwhile, Iraqi ports face strong competition from the ports of neighboring countries, which have achieved progress and advancement as opposed to the declining performance and efficiency of Iraqi ports. The great developments in the economic conditions of Iraq lay a too great burden on the Iraqi maritime transport and ports, which require development in order to be able to meet the challenges arising from the fierce international and regional competition in the markets. Therefore, it is necessary to find appropriate solutions in support of the role that can be played by Iraqi ports in serving Iraq's foreign trade transported by sea and in keeping up with the development of foreign trade. Thus, this research aims at tackling the current situation of the Iraqi ports and their commercial activity and studying the problems and obstacles they face. The research also studies the future prospects of these ports, the potentials of maritime openness to Iraq under the fierce competition of neighboring ports, and the possibility of enhancing Iraqi ports’ competitiveness. Among the results produced by this research is the future scenario it proposes for Iraqi ports, mainly represented in the establishment of Al-Faw Port, which will contribute to a greater openness of maritime transport in Iraq, and the rehabilitation and expansion of existing ports. This research seeks to develop solutions to Iraq ports so that they can be repositioned as a vital means of promoting economic development.