Patient Perspectives on Telehealth during the Pandemic in the United States

Telehealth is an advanced technology using digital information and telecommunication facilities that provide access to health services from a distance. It slows the transmission factor of COVID-19, especially for elderly patients and patients with chronic diseases during the pandemic. Therefore, understanding patient perspectives on telehealth services and the factors impacting their option of telehealth service will shed light on the measures that healthcare providers can take to improve the quality of telehealth services. This study aimed to evaluate perceptions of telehealth services among different patient groups and explore various aspects of telehealth utilization in the United States during the COVID-19 pandemic. An online survey distributed via social media platforms was used to collect research data. In addition to the descriptive statistics, both correlation and regression analyses were conducted to test research hypotheses. The empirical results highlighted that the factors such as accessibility to telehealth services and the type of specialty clinics that the patients required play important roles in the effectiveness of telehealth services they received. However, the results found that patients’ waiting time to receive telehealth services and their annual income did not significantly influence their desire to select receiving healthcare services via telehealth. The limitations of the study and future research directions are discussed.

Security Strengths and Weaknesses of Blockchain Smart Contract System: A Survey

Smart contracts are computer protocols that facilitate, verify, and execute the negotiation or execution of a contract, or that render a contractual term unnecessary. Blockchain and smart contracts can be used to facilitate almost any financial transaction. Thanks to these smart contracts, the settlement of dividends and coupons could be automated. Smart contracts have become lucrative and profitable targets for attackers because they can hold a great amount of money. Smart contracts, although widely used in blockchain technology, are far from perfect due to security concerns. Although a series of attacks are listed, there is a lack of discussions and proposals on improving security. This survey takes stock of smart contract security from a more comprehensive perspective by correlating the level of vulnerability and systematic review of security levels in smart contracts.

Tailormade Geometric Properties of Chitosan by Gamma Irradiation

Chitosans, CSs, in solution are increasingly used in a range of geometric properties in various academic and industrial sectors, especially in the domain of pharmaceutical and biomedical engineering. In order to provide a tailoring guide of CSs to the applicants, gamma (γ)-irradiation technology and simple viscosity measurements have been used in this study. Accordingly, CS solid discs (0.5 cm thickness and 2.5 cm diameter) were exposed in air to Cobalt-60 (γ)-radiation, at room temperature and constant 50 kGy dose for different periods of exposer time (tγ). Diluted solutions of native and different irradiated CS were then prepared by dissolving 1.25 mg cm-3 of each polymer in 0.1 M NaCl/0.2 M CH3COOH. The single-concentration relative viscosity (ƞr) measurements were employed to obtain their intrinsic viscosity ([ƞ]) values and interrelated parameters, like: the molar mass (Mƞ), hydrodynamic radiuses (RH,ƞ), radius of gyration (RG,ƞ), and second virial coefficient (A2,ƞ) of CSs in the solution. The results show an exponential decrease of ƞr, [ƞ], Mƞ, RH,ƞ and RG,ƞ with increasing tγ. This suggests the influence of random chain-scission of CSs glycosidic bonds, with rate constant kr and kr-1 (lifetime τr ~ 0.017 min-1 and 57.14 min, respectively). The results also show an exponential decrease of A2ƞ with increasing tγ, which can be attributed to the growth of excluded volume effect in CS segments by tγ and, hence, better solution quality. The results are represented in following scaling laws as a tailoring guide to the applicants: RH,ƞ = 6.98 x 10-3 Mr0.65; RG,ƞ = 7.09 x 10-4 Mr0.83; A2,ƞ = 121.03 Mƞ,r-0.19.

Recommended Practice for Experimental Evaluation of the Seepage Sensitivity Damage of Coalbed Methane Reservoirs

The coalbed methane (CBM) extraction industry (an unconventional energy source) has not established guidelines for experimental evaluation of sensitivity damage for coal samples. The existing experimental process of previous researches mainly followed the industry standard for conventional oil and gas reservoirs (CIS). However, the existing evaluation method ignores certain critical differences between CBM reservoirs and conventional reservoirs, which could inevitably result in an inaccurate evaluation of sensitivity damage and, eventually, poor decisions regarding the formulation of formation damage prevention measures. In this study, we propose improved experimental guidelines for evaluating seepage sensitivity damage of CBM reservoirs by leveraging on the shortcomings of the existing methods. The proposed method was established via a theoretical analysis of the main drawbacks of the existing methods and validated through comparative experiments. The results show that the proposed evaluation technique provided reliable experimental results that can better reflect actual reservoir conditions and correctly guide the future development of CBM reservoirs. This study is pioneering the research on the optimization of experimental parameters for efficient exploration and development of CBM reservoirs.

The Morphology and Meaning of the Pārs Based on the Linguistic Evolutions and Historical-Mythological Traditions

The morphology of most Persian words goes back to the Indo-European and Indo-Iranian periods. These words show the beliefs and views of the earliest people about their structure. It is also necessary to search for the vocabulary in the Indo-European and Indo-Iranian periods. During recent centuries, comparative linguistics and mythology have facilitated the common Indo-European lexicon to reconstruct. The Persians have been appeared in the Assyrian inscriptions and affected by the Mesopotamians. It is also worth paying attention to the cultural and linguistic exchanges with the Mesopotamian civilizations. This paper aims to show the morphology of Pārsa based on linguistic evolutions and historical-mythological traditions. The method of this study is also to reconstruct both morphology and the earliest form of Persia. Then, it is tried to find the most plausive meaning according to the historical-mythological traditions. In the end, the sickle or scythe is considered the most probable meaning for Pārsa.

Spatial Correlation of Channel State Information in Real LoRa Measurement

The Internet of Things (IoT) is developed to ensure monitoring and connectivity within different applications. Thus, it is critical to study the channel propagation characteristics in Low Power Wide Area Network (LPWAN), especially LoRaWAN. In this paper, an in-depth investigation of the reciprocity between the uplink and downlink Channel State Information (CSI) is done by performing an outdoor measurement campaign in the area of Campus Beaulieu in Rennes. At each different location, the CSI reciprocity is quantified using the Pearson Correlation Coefficient (PCC) which shows a very high linear correlation between the uplink and downlink CSI. This reciprocity feature could be utilized for the physical layer security between the node and the gateway. On the other hand, most of the CSI shapes from different locations are highly uncorrelated with each other. Hence, it can be anticipated that this could achieve significant localization gain by utilizing the frequency hopping in the LoRa systems to get access to a wider band.

Networked Implementation of Milling Stability Optimization with Bayesian Learning

Machining instability, or chatter, can impose an important limitation to discrete part machining. In this work, a networked implementation of milling stability optimization with Bayesian learning is presented. The milling process was monitored with a wireless sensory tool holder instrumented with an accelerometer at the TU Wien, Vienna, Austria. The recorded data from a milling test cut were used to classify the cut as stable or unstable based on a frequency analysis. The test cut result was used in a Bayesian stability learning algorithm at the University of Tennessee, Knoxville, Tennessee, USA. The algorithm calculated the probability of stability as a function of axial depth of cut and spindle speed based on the test result and recommended parameters for the next test cut. The iterative process between two transatlantic locations was repeated until convergence to a stable optimal process parameter set was achieved.

How International College Students Understand Entrepreneurial Readiness and Business-Related Skills: A Qualitative Study

The free-market economy provides many opportunities for entrepreneurship or starting one’s own business, attracting many students to study business at for-profit colleges in the United States. This is also true for international students, many of whom are filled with the hope of making a better life for themselves and their families through entrepreneurial endeavors. This qualitative research showed that not all graduates business students start their own business. In investigating this phenomenon, the effectiveness of entrepreneurship curricula at international colleges needs to be examined in order to adjust, improve and reform entrepreneurship curricula. This qualitative study will explore how business skills learned in college for-profit play a role in the entrepreneurial readiness of undergraduate business students in the south Florida. Business curricula helps international students achieve goals and transform their actions to understand challenges in a corporate society. Students will be interviewed to gain information about the students’ experience with entrepreneurship curricula in a for-profit college in south Florida.

Development of the Maturity Sensor Prototype and Method of Its Placement in the Structure

Maturity sensors are used to determine concrete strength by the non-destructive method. The method of placement of the maturity sensors determines their number required for a certain frame of a monolithic building. This paper proposes a cheap prototype of an embedded wireless sensor for monitoring concrete structures, as well as an alternative strategy for placing sensors based on the transitional boundaries of the temperature distribution of concrete curing, which were determined by building a heat map of the temperature distribution, where unknown values are calculated by the method of inverse distance weighing. The developed prototype can simultaneously measure temperature and relative humidity over a smartphone-controlled time interval. It implements a maturity method to assess the in-situ strength of concrete, which is considered an alternative to the traditional shock impulse and compression testing method used in Kazakhstan. The prototype was tested in laboratory and field conditions. The tests were aimed at studying the effect of internal and external temperature and relative humidity on concrete's strength gain. Based on an experimentally poured concrete slab with randomly integrated maturity sensors, it the transition boundaries form elliptical forms were determined. Temperature distribution over the largest diameter of the ellipses was plotted, resulting in correct and inverted parabolas. As a result, the distance between the closest opposite crossing points of the parabolas is accepted as the maximum permissible step for setting the maturity sensors. The proposed placement strategy can be applied to sensors that measure various continuous phenomena such as relative humidity. Prototype testing has also revealed Bluetooth inconvenience due to weak signal and inability to access multiple prototypes simultaneously. For this reason, further prototype upgrades are planned in the future work.

Virtual Reality for PostCOVID-19 Stroke: A Case Report

COVID-19 has been associated with stroke and neurological complications. The patient was a 59-year-old male presented with sudden left hemiparesis and diplopia due to cavernous sinus thrombosis (CST) on 28/03/2020. The COVID-19 test was positive. Multislice computerized tomography (MSCT) showed ischemic infarction. He underwent surgical sinectomy 9 days after admission. Physiotherapy began for him on August 2020. Our game-based virtual reality (VR) technology developed for stroke patients was based on upper extremity exercises and function for stroke. After 6 weeks of VR therapy plus conventional physiotherapy exercises (18 sessions, three times per week, 60 minutes each session), there were significant improvements in Brunnstrom Motor Recovery Stage (from “4” to “5”), Fugl-Meyer Scale score of upper extremity section (from 49 to 54), and Modified Barthel Index (from 15 to 18). There were no adverse effects. This case with stroke post COVID-19 due to the CST showed the usefulness of VR therapy used as an adjunct to conventional physiotherapy in improving affected upper extremity.

Rehabilitation of Contaminated Surface and Groundwater for Selected Sites in the Illawarra and Sydney Regions Utilising Nanotechnology

A comprehensive study was conducted to examine the removal of inorganic contaminants that exist in surface and groundwater in the Illawarra and Sydney regions. The ability of multi-walled carbon nanotubes (MWCNT), as a generation of membrane technology, was examined using a dead-end filtration cell setup. A set of ten compounds were examined in this study that represent the significant inorganic cations and anions commonly found in contaminated surface and groundwater. The performance of MWCNT buckypaper membranes in excluding anions was found to be better than that of its cation exclusion. This phenomenon can be attributed to the Donnan exclusion mechanism (charge repulsion mechanism). Furthermore, the results revealed that phosphate recorded the highest exclusion value reaching 69.2%, whereas the lowest rejection value was for potassium where no removal occurred (0%). The reason for this is that the molecular weight of phosphate (95.0 g/mol) is greater than the molecular weight of potassium (39.10 g/mol).

Using Statistical Significance and Prediction to Test Long/Short Term Public Services and Patients Cohorts: A Case Study in Scotland

Health and Social care (HSc) services planning and scheduling are facing unprecedented challenges, due to the pandemic pressure and also suffer from unplanned spending that is negatively impacted by the global financial crisis. Data-driven approaches can help to improve policies, plan and design services provision schedules using algorithms that assist healthcare managers to face unexpected demands using fewer resources. The paper discusses services packing using statistical significance tests and machine learning (ML) to evaluate demands similarity and coupling. This is achieved by predicting the range of the demand (class) using ML methods such as Classification and Regression Trees (CART), Random Forests (RF), and Logistic Regression (LGR). The significance tests Chi-Squared and Student’s test are used on data over a 39 years span for which data exist for services delivered in Scotland. The demands are associated using probabilities and are parts of statistical hypotheses. These hypotheses, as their NULL part, assume that the target demand is statistically dependent on other services’ demands. This linking is checked using the data. In addition, ML methods are used to linearly predict the above target demands from the statistically found associations and extend the linear dependence of the target’s demand to independent demands forming, thus, groups of services. Statistical tests confirmed ML coupling and made the prediction statistically meaningful and proved that a target service can be matched reliably to other services while ML showed that such marked relationships can also be linear ones. Zero padding was used for missing years records and illustrated better such relationships both for limited years and for the entire span offering long-term data visualizations while limited years periods explained how well patients numbers can be related in short periods of time or that they can change over time as opposed to behaviours across more years. The prediction performance of the associations were measured using metrics such as Receiver Operating Characteristic (ROC), Area Under Curve (AUC) and Accuracy (ACC) as well as the statistical tests Chi-Squared and Student. Co-plots and comparison tables for the RF, CART, and LGR methods as well as the p-value from tests and Information Exchange (IE/MIE) measures are provided showing the relative performance of ML methods and of the statistical tests as well as the behaviour using different learning ratios. The impact of k-neighbours classification (k-NN), Cross-Correlation (CC) and C-Means (CM) first groupings was also studied over limited years and for the entire span. It was found that CART was generally behind RF and LGR but in some interesting cases, LGR reached an AUC = 0 falling below CART, while the ACC was as high as 0.912 showing that ML methods can be confused by zero-padding or by data’s irregularities or by the outliers. On average, 3 linear predictors were sufficient, LGR was found competing well RF and CART followed with the same performance at higher learning ratios. Services were packed only when a significance level (p-value) of their association coefficient was more than 0.05. Social factors relationships were observed between home care services and treatment of old people, low birth weights, alcoholism, drug abuse, and emergency admissions. The work found  that different HSc services can be well packed as plans of limited duration, across various services sectors, learning configurations, as confirmed by using statistical hypotheses.

eLearning for Electric Distribution Planning Engineers

This paper presents the experience in an eLearning training project that is being implemented for electrical planning engineers from the national Mexican utility Comision Federal de Electricidad (CFE) Distribution. This modality is implemented and will be used in the utility for training purposes to help personnel in their daily technical activities. One important advantage of this training project is that once it is implemented and applied, financial resources will be saved by CFE Distribution Company because online training will be used in all the country; the infrastructure for the eLearning training will be uploaded in computational servers installed in the National CFE Distribution Training Department, in Ciudad de Mexico, and can be used in workplaces of 16 Distribution Divisions and 150 Zones of CFE Distribution. In this way, workers will not need to travel to the National Training Department, saving enormous efforts, financial, and human resources.

Fuzzy Uncertainty Theory for Stealth Fighter Aircraft Selection in Entropic Fuzzy TOPSIS Decision Analysis Process

The purpose of this paper is to present fuzzy TOPSIS in an entropic fuzzy environment. Due to the ambiguous concepts often represented in decision data, exact values are insufficient to model real-life situations. In this paper, the rating of each alternative is defined in fuzzy linguistic terms, which can be expressed with triangular fuzzy numbers. The weight of each criterion is then derived from the decision matrix using the entropy weighting method. Next, a vertex method is proposed to calculate the distance between two triangular fuzzy numbers. According to the TOPSIS concept, a closeness coefficient is defined to determine the ranking order of all alternatives by simultaneously calculating the distances to both the fuzzy positive-ideal solution (FPIS) and the fuzzy negative-ideal solution (FNIS). Finally, an illustrative example of selecting stealth fighter aircraft is shown at the end of this article to highlight the procedure of the proposed method. Correlation analysis and validation analysis using TOPSIS, WSM, and WPM methods were performed to compare the ranking order of the alternatives.

Clustering for Detection of Population Groups at Risk from Anticholinergic Medication

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.

Governance, Risk Management, and Compliance Factors Influencing the Adoption of Cloud Computing in Australia

A business decision to move to the cloud brings fundamental changes in how an organization develops and delivers its Information Technology solutions. The accelerated pace of digital transformation across businesses and government agencies increases the reliance on cloud-based services. Collecting, managing, and retaining large amounts of data in cloud environments make information security and data privacy protection essential. It becomes even more important to understand what key factors drive successful cloud adoption following the commencement of the Privacy Amendment Notifiable Data Breaches (NDB) Act 2017 in Australia as the regulatory changes impact many organizations and industries. This quantitative correlational research investigated the governance, risk management, and compliance factors contributing to cloud security success. The factors influence the adoption of cloud computing within an organizational context after the commencement of the NDB scheme. The results and findings demonstrated that corporate information security policies, data storage location, management understanding of data governance responsibilities, and regular compliance assessments are the factors influencing cloud computing adoption. The research has implications for organizations, future researchers, practitioners, policymakers, and cloud computing providers to meet the rapidly changing regulatory and compliance requirements.

Performance Evaluation and Plugging Characteristics of Controllable Self-Aggregating Colloidal Particle Profile Control Agent

In low permeability reservoirs, the reservoir pore throat is small and the micro heterogeneity is prominent. Conventional microsphere profile control agents generally have good injectability but poor plugging effect; however, profile control agents with good plugging effect generally have poor injectability, which makes it difficult for agent to realize deep profile control of reservoir. To solve this problem, styrene and acrylamide were used as monomers in the laboratory. Emulsion polymerization was used to prepare the Controllable Self-Aggregating Colloidal Particle (CSA), which was rich in amide group. The CSA microsphere dispersion solution with a particle diameter smaller than the pore throat diameter was injected into the reservoir to ensure that the profile control agent had good inject ability. After dispersing the CSA microsphere to the deep part of the reservoir, the CSA microspheres dispersed in static for a certain period of time will self-aggregate into large-sized particle clusters to achieve plugging of hypertonic channels. The CSA microsphere has the characteristics of low expansion and avoids shear fracture in the process of migration. It can be observed by transmission electron microscope that CSA microspheres still maintain regular and uniform spherical and core-shell heterogeneous structure after aging at 100 ºC for 35 days, and CSA microspheres have good thermal stability. The results of bottle test showed that with the increase of cation concentration, the aggregation time of CSA microspheres gradually shortened, and the influence of divalent cations was greater than that of monovalent ions. Physical simulation experiments show that CSA microspheres have good injectability, and the aggregated CSA particle clusters can produce effective plugging and migrate to the deep part of the reservoir for profile control.

Effects of Virtual Reality on the Upper Extremity Spasticity and Motor Function in Patients with Stroke: A Single Blinded Randomized Controlled Trial

Background: Stroke is a disabling neurological disease. Rehabilitative therapies are important treatment methods. This clinical trial was done to compare the effects of virtual reality (VR) beside conventional rehabilitation versus conventional rehabilitation alone on the spasticity and motor function in stroke patients. Materials and methods: In this open-label randomized controlled clinical trial, 40 consecutive patients with stable first-ever ischemic stroke in the past three to 12 months that were referred to a rehabilitation clinic in Tehran, Iran in 2020 were enrolled. After signing the informed written consent form, subjects were randomly assigned by block randomization of five in each block as cases with 1:1 into two groups of 20 cases; conventional plus VR therapy group: 45-minute conventional therapy session plus 15-minute VR therapy, and conventional group: 60-minute conventional therapy session. VR rehabilitation is designed and developed with different stages. Outcomes were Modified Ashworth scale, Recovery Stage score for motor function, range of motion (ROM) of shoulder abduction/wrist extension, and patients’ satisfaction rate. Data were compared after study termination. Results: The satisfaction rate among the patients was significantly better in combination group (P = 0.003). Only wrist extension was varied between groups and was better in combination group. The variables generally had statistically significant difference (P < 0.05). Conclusion: VR plus conventional rehabilitation therapy is superior versus conventional rehabilitation alone on the wrist and elbow spasticity and motor function in patients with stroke.

Biomarkers in a Post-Stroke Population: Allied to Health Care in Brazil

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

Gas Generator Pyrotechnics Using Gun Propellant Technology Methods

This research article describes the gas generator pyro-cartridge using gun propellant technology methods for fighter aircraft application. The emphasis of this work is to design and develop a gas generating device with pyro-cartridge using double base (DB) propellant to generate a high temperature and pressure gas. This device is utilised for dropping empty fuel tank in an emergency from military aircraft. A data acquisition system (DAS) is used to record time to maximum pressure, maximum pressure and time to half maximum pressure generated in a vented vessel (VV) for gas generator. Pyro-cartridge as a part of the gas generator creates a maximum pressure and time in the closed vessel (CV). This article also covers the qualification testing of gas generator. The performance parameters of pyro-cartridge devices such as ignition delay and maximum pressure are experimentally presented through the CV tests.