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.

Development of a Quantitative Material Wastage Management Plan for Effective Waste Reduction in the Building Construction Industry

Combating climate change is becoming a hot topic in various sectors. Building construction and infrastructure sectors contributed a significant proportion of waste and greenhouse gas (GHG) emissions in the environment of different countries and cities. However, there is little research on the micro-level of waste management, “building construction material wastage management,” and fewer reviews about regulatory control in the building construction sector. This paper focuses on the potentialities and importance of material wastage management and reviews the deficiencies of the current standard to take into account the reduction of material wastage in a systematic and quantitative approach.

Logistics Support as a Key Success Factor in Gastronomy

Gastronomy is one of the oldest forms of commercial activity. It is currently one of the most popular and still dynamically developing branches of business. Socio-economic changes, its widespread occurrence, new techniques or culinary styles affect the almost unlimited possibilities of its development. Importantly, regardless of the form of business adopted, foodservice is strongly related to logistics processes, and areas of foodservice that are closely linked to logistics are of strategic importance. Any inefficiency in logistics processes results in reduced chances for success and achieving competitive advantage by companies belonging to the catering industry. The aim of the paper is to identify the areas of logistic support, occurring in the catering business, and affecting the scope of the logistic processes implemented. The aim of the paper is implemented through a plural homogeneous approach, based on direct observation, text analysis of current documents, and in-depth free targeted interviews.

The COVID-19 Pandemic: Lessons Learned in Promoting Student Internationalisation

In higher education, a great degree of importance is placed on the internationalisation of the student experience. This is seen as a valuable contributor to elements such as building confidence, broadening knowledge, creating networks, and connections and enhancing employability for current students who will become the next generation of managers in technology and business. The COVID-19 pandemic has affected all areas of people’s lives. The limitations of travel coupled with the fears and concerns generated by the health risks have dramatically reduced the opportunity for students to engage with this agenda. Institutions of higher education have been required to rethink fundamental aspects of their business model from recruitment and enrolment, through learning approaches, assessment methods and the pathway to employment. This paper presents a case study which focuses on student mobility and how the physical experience of being in another country either to study, to work, to volunteer or to gain cultural and social enhancement has of necessity been replaced by alternative approaches. It considers trans-national education as an alternative to physical study overseas, virtual mobility and internships as an alternative to international work experience and adopting collaborative on-line projects as an alternative to in-person encounters. The paper concludes that although these elements have been adopted to address the current situation, the lessons learnt and the feedback gained suggests that they have contributed successfully in new and sometimes unexpected ways, and that they will persist beyond the present to become part of the "new normal" for the future. That being the case, senior leaders of institutions of higher education will be required to revisit their international plans and to rewrite their international strategies to take account of and build upon these changes.

Knowledge, Attitude and Practice of Pregnant Women toward Antenatal Care at Public Hospitals in Sana'a City-Yemen

Background: Antenatal care can be defined as the care provided by skilled healthcare professionals to pregnant women and adolescent girls to ensure the best health conditions for both mother and baby during pregnancy. The components of Antenatal Care (ANC) include risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion. The aim of this study: to assess the knowledge, attitude, and practice of pregnant women regarding ANC. Methodology: A descriptive knowledge, attitude, and practice (KAP) study was conducted in public hospitals in Sana'a City, Yemen. The study population included all pregnant women that intended to the prenatal department and clinical outpatient department; the final sample size was 371 pregnant women. A self-administered questionnaire was used to collect the data, statistical package for social sciences SPSS was used to data analysis. The results: Most (79%) of pregnant women had correct answers in total knowledge regarding ANC, and about two-thirds (67%) of pregnant women had performance practice regarding ANC and two-third (68%) of pregnant women had a positive attitude. Conclusions: More than three quarter of pregnant women had good knowledge level, most of pregnant women had moderate practice level, and more than two-thirds of pregnant women had a positive attitude regarding antenatal care. There was a statistically significant association between overall knowledge and practice level toward ANC and demographic characteristics of pregnant women, at P-value ≤ 0.05. Recommendations: we recommended more education and training courses, lecturers, and education sessions in clinical facilitators focused on ANC, which relies on evidence-based interventions provided to women during pregnancy by skilled healthcare providers such as midwives, doctors, and nurses.

A Business-to-Business Collaboration System That Promotes Data Utilization While Encrypting Information on the Blockchain

To promote Industry 4.0 and Society 5.0 and so on, it is important to connect and share data so that every member can trust it. Blockchain (BC) technology is currently attracting attention as the most advanced tool and has been used in the financial field and so on. However, the data collaboration using BC has not progressed sufficiently among companies on the supply chain of the manufacturing industry that handle sensitive data such as product quality, manufacturing conditions, etc. There are two main reasons why data utilization is not sufficiently advanced in the industrial supply chain. The first reason is that manufacturing information is top secret and a source for companies to generate profits. It is difficult to disclose data even between companies with transactions in the supply chain. Blockchain mechanism such as Bitcoin using Public Key Infrastructure (PKI) requires plaintext to be shared between companies in order to verify the identity of the company that sent the data. Another reason is that the merits (scenarios) of collaboration data between companies are not specifically specified in the industrial supply chain. For these problems, this paper proposes a Business to Business (B2B) collaboration system using homomorphic encryption and BC technique. Using the proposed system, each company on the supply chain can exchange confidential information on encrypted data and utilize the data for their own business. In addition, this paper considers a scenario focusing on quality data, which was difficult to collaborate because it is top-secret. In this scenario, we show an implementation scheme and a benefit of concrete data collaboration by proposing a comparison protocol that can grasp the change in quality while hiding the numerical value of quality data.

Elegant: An Intuitive Software Tool for Interactive Learning of Power System Analysis

A common complaint from power system analysis students lies in the overly complex tools they need to learn and use just to simulate very basic systems or just to check the answers to power system calculations. The most basic power system studies are power-flow solutions and short-circuit calculations. This paper presents a simple tool with an intuitive interface to perform both these studies and assess its performance in comparison with existent commercial solutions. With this in mind, Elegant is a pure Python software tool for learning power system analysis developed for undergraduate and graduate students. It solves the power-flow problem by iterative numerical methods and calculates bolted short-circuit fault currents by modeling the network in the domain of symmetrical components. Elegant can be used with a user-friendly Graphical User Interface (GUI) and automatically generates human-readable reports of the simulation results. The tool is exemplified using a typical Brazilian regional system with 18 buses. This study performs a comparative experiment with 1 undergraduate and 4 graduate students who attempted the same problem using both Elegant and a commercial tool. It was found that Elegant significantly reduces the time and labor involved in basic power system simulations while still providing some insights into real power system designs.

From the Fields to the Concrete: Urban Development of Campo Mourão

The automobile incentive policy in Brazil since the 1950s creates several problems in its cities, more visible in large centers such as São Paulo or Rio de Janeiro, but also strongly present in smaller cities, resulting in an increase in social and spatial inequality, together with a drop in the quality of life. The analyzed city, Campo Mourão, reflects these policies, a city that is initially planned to be compact and walkable, took other directions and currently suffers from urban mobility and social inequality in this urban environment, despite being a medium-sized city in Brazil. The research aims to understand and diagnose how these policies shaped the city and what are the results in Brazilian`s inland cities. Based on historical, bibliographical and field research in the city, the result is a diagnosis of the problem faced and how it can be reversed, in search of social equality and better quality of life.

Improving the Software Homologation Process through Peer Review: An Experience Report on Android Development Environment

In the current technological market environment, ensuring the quality of new products has become a complex challenge. In this scenario, companies have been investing in solutions that aim to reduce the execution time of software testing and lead to cost efficiency. However, companies that have a complex and specialized testing environment usually face barriers related to costly testing processes, especially in distributed settings. Sidia Institute of Technology works on research and development for the Android platform for mobile devices in Latin America. As we work in a global software development (GSD) scope, we have faced barriers caused by failures detected lately that have caused delays in the homologation release process on Android projects. Thus, we adopt an Internal Review process, using as an alternative to reduce these failures. In this paper it was presented the experience of a homologation team adopting an Internal Review process in order to increase the performance through of improving test efficiency. Using this approach, it was possible to realize a substantial improvement in quality, reliability and timeliness of our deliveries. Through the quantitative analyses, it was possible identify a positive growth in homologation efficiency of 6% after adoption of the process. In addition, we performed a qualitative analysis from the collected data through an online questionnaire. In particular, results show that association between failure reduction and review process adoption provides the most quality that has a positive effect on project milestones. We hope this report can be helpful to other companies and the scientific community to improve their process thereby increasing competitive advantages.

Holistic Approach to Assess the Potential of Using Traditional and Advance Insulation Materials for Energy Retrofit of Office Buildings

Improving the energy performance of existing buildings can be challenging, particularly when facades cannot be modified, and the only available option is internal insulation. In such cases, the choice of the most suitable material becomes increasingly complex, as in addition to thermal transmittance and capital cost, the designer needs to account for the impact of the intervention on the internal spaces, and in particular the loss of usable space due to the additional layers of materials installed. This paper explores this issue by analyzing a case study of an average office building needing to go through a refurbishment in order to reach the limits imposed by current regulations to achieve energy efficiency in buildings. The building is simulated through dynamic performance simulation under three different climate conditions in order to evaluate its energy needs. The use of Vacuum Insulated Panels as an option for energy refurbishment is compared to traditional insulation materials (XPS, Mineral Wool). For each scenario, energy consumptions are calculated and, in combination with their expected capital costs, used to perform a financial feasibility analysis. A holistic approach is proposed, taking into account the impact of the intervention on internal space by quantifying the value of the lost usable space and used in the financial feasibility analysis. The proposed approach highlights how taking into account different drivers will lead to the choice of different insulation materials, showing how accounting for the economic value of space can make VIPs an attractive solution for energy retrofitting under various climate conditions.

Injury Prediction for Soccer Players Using Machine Learning

Injuries in professional sports occur on a regular basis. Some may be minor while others can cause huge impact on a player’s career and earning potential. In soccer, there is a high risk of players picking up injuries during game time. This research work seeks to help soccer players reduce the risk of getting injured by predicting the likelihood of injury while playing in the near future and then providing recommendations for intervention. The injury prediction tool will use a soccer player’s number of minutes played on the field, number of appearances, distance covered and performance data for the current and previous seasons as variables to conduct statistical analysis and provide injury predictive results using a machine learning linear regression model.

Early Age Behavior of Wind Turbine Gravity Foundations

Wind turbine gravity foundations are designed to resist overturning failure through gravitational forces resulting from their masses. Owing to the relatively high volume of the cementitious material present, the foundations tend to suffer thermal strains and internal cracking due to high temperatures and temperature gradients depending on factors such as geometry, mix design and level of restraint. This is a result of a fully coupled mechanism commonly known as THMC (Thermo- Hygro - Mechanical - Chemical) coupling whose kinetics peak during the early age of concrete. The focus of this paper is therefore to present and offer a discussion on the temperature and humidity evolutions occurring in mass pours such as wind turbine gravity foundations based on sensor results obtained from the monitoring of an actual wind turbine foundation. To offer prediction of the evolutions, the formulation of a 3D Thermal-Hydro-Chemical (THC) model that is mainly derived from classical fundamental physical laws is also presented and discussed. The THC model can be mathematically fully coupled in Finite Element analyses. In the current study, COMSOL Multi-physics software was used to simulate the 3D THC coupling that occurred in the monitored wind turbine foundation to predict the temperature evolution at five different points within the foundation from time of casting.

Investigating the Effect of Velocity Inlet and Carrying Fluid on the Flow inside Coronary Artery

In this study OpenFOAM 4.4.2 was used to investigate flow inside the coronary artery of the heart. This step is the first step of our future project, which is to include conjugate heat transfer of the heart with three main coronary arteries. Three different velocities were used as inlet boundary conditions to see the effect of velocity increase on velocity, pressure, and wall shear of the coronary artery. Also, three different fluids, namely the University of Wisconsin solution, gelatin, and blood was used to investigate the effect of different fluids on flow inside the coronary artery. A code based on Reynolds Stress Navier Stokes (RANS) equations was written and implemented with the real boundary condition that was calculated based on MRI images. In order to improve the accuracy of the current numerical scheme, hex dominant mesh is utilized. When the inlet velocity increases to 0.5 m/s, velocity, wall shear stress, and pressure increase at the narrower parts.

Utilization of Schnerr-Sauer Cavitation Model for Simulation of Cavitation Inception and Super Cavitation

In this study, the Reynolds-Stress-Navier-Stokes framework is utilized to investigate the flow inside the diesel injector nozzle. The flow is assumed to be multiphase as the formation of vapor by pressure drop is visualized. For pressure and velocity linkage, the coupled algorithm is used. Since the cavitation phenomenon inherently is unsteady, the quasi-steady approach is utilized for saving time and resources in the current study. Schnerr-Sauer cavitation model is used, which was capable of predicting flow behavior both at the initial and final steps of the cavitation process. Two different turbulent models were used in this study to clarify which one is more capable in predicting cavitation inception and super-cavitation. It was found that K-ε was more compatible with the Shnerr-Sauer cavitation model; therefore, the mentioned model is used for the rest of this study.

Analysis of Incidences of Collapsed Buildings in the City of Douala, Cameroon from 2011-2020

This study focuses on the problem of collapsed buildings within the city of Douala over the past ten years, and more precisely within the period from 2011 to 2020. It was carried out in a bid to ascertain the real causes of this phenomenon, which has become recurrent in the leading economic city of Cameroon. To achieve this, it was first necessary to review some works dealing with construction materials and technology as well as some case histories of structural collapse within the city. Thereafter, a statistical study was carried out on the results obtained. It was found that the causes of building collapses in the city of Douala are: Neglect of administrative procedures, use of poor quality materials, poor composition and confectioning of concrete, lack of Geotechnical study, lack of structural analysis and design, corrosion of the reinforcement bars, poor maintenance in buildings, and other causes. Out of the 46 cases of failure and collapse of buildings within the city of Douala, 7 of these were identified to have had no geotechnical study carried out, giving a percentage of 15.22%. It was also observed that out of the 46 cases of structural failure, 6 were as a result of lack of proper structural analysis and design giving a percentage of 13.04%. Subsequently, recommendations and suggestions are made in a bid to placing particular emphasis on the choice of materials, the manufacture and casting of concrete as well as the placement of the required reinforcements. All this guarantees the stability of a building.

Florida’s Groundwater and Surface Water System Reliability in Terms of Climate Change and Sea-Level Rise

Florida is one of the most vulnerable states to natural disasters among the 50 states of the USA. The state exposed by tropical storms, hurricanes, storm surge, landslide, etc. Besides the mentioned natural phenomena, global warming, sea-level rise, and other anthropogenic environmental changes make a very complicated and unpredictable system for decision-makers. In this study, we tried to highlight the effects of climate change and sea-level rise on surface water and groundwater systems for three different geographical locations in Florida; Main Canal of Jacksonville Beach in the northeast of Florida adjacent to the Atlantic Ocean, Grace Lake in central Florida, far away from surrounded coastal line, and Mc Dill in Florida and adjacent to Tampa Bay and Mexican Gulf. An integrated hydrologic and hydraulic model was developed and simulated for all three cases, including surface water, groundwater, or a combination of both. For the case study of Main Canal-Jacksonville Beach, the investigation showed that a 76 cm sea-level rise in time horizon 2060 could increase the flow velocity of the tide cycle for the main canal's outlet and headwater. This case also revealed how the sea level rise could change the tide duration, potentially affecting the coastal ecosystem. As expected, sea-level rise can raise the groundwater level. Therefore, for the Mc Dill case, the effect of groundwater rise on soil storage and the performance of stormwater retention ponds is investigated. The study showed that sea-level rise increased the pond’s seasonal high water up to 40 cm by time horizon 2060. The reliability of the retention pond is dropped from 99% for the current condition to 54% for the future. The results also proved that the retention pond could not retain and infiltrate the designed treatment volume within 72 hours, which is a significant indication of increasing pollutants in the future. Grace Lake case study investigates the effects of climate change on groundwater recharge. This study showed that using the dynamically downscaled data of the groundwater recharge can decline up to 24 % by the mid-21st century. 

Digital Learning and Entrepreneurship Education: Changing Paradigms

Entrepreneurship is an essential source of economic growth and a prominent factor influencing socio-economic development. Entrepreneurship education educates and enhances entrepreneurial activity. This study aims to understand current trends in entrepreneurship education and evaluate the effectiveness of diverse entrepreneurship education programs. An increasing number of universities offer entrepreneurship education courses to create and successfully continue entrepreneurial ventures. Despite the prevalence of entrepreneurship education, research studies lack inconsistency about the effectiveness of entrepreneurship education to promote and develop entrepreneurship. Strategies to develop entrepreneurial attitudes and intentions among individuals are hindered by a lack of understanding of entrepreneurs' educational purposes, components, methodology, and resources required. Lack of adequate entrepreneurship education has been linked with low self-efficacy and lack of entrepreneurial intent. Moreover, in the age of digitisation and during the COVID-19 pandemic, digital learning platforms (e.g. online entrepreneurship education courses and programs) and other digital tools (e.g. digital game-based entrepreneurship education) have become more relevant to entrepreneurship education. This paper contributes to the continuation of academic literature in entrepreneurship education by evaluating and assessing current trends in entrepreneurship education programs, leading to better understanding to reduce gaps between entrepreneurial development requirements and higher education institutions.

A Modern Review of the Non-Invasive Continuous Blood Glucose Measuring Devices and Techniques for Remote Patient Monitoring System

Diabetes disease that arises from the higher glucose level due to insulin shortage or insulin opposition in the human body has become a common disease in the world. No medicine can cure it completely. However, by taking medicine, maintaining diets, and having exercises regularly, a diabetes patient can keep his glucose level within the specified limits and in this way, he/she can lead a normal life like a healthy person. But to control glucose levels, a patient needs to monitor them regularly. Various techniques are being used over the last four decades. This modern review article aims to provide a comparative study report on various blood glucose monitoring techniques in a very concise and organized manner. The review mainly emphasizes working principles, cost, technology, sensors, measurement types, measurement accuracy, advantages, and disadvantages, etc. of various techniques and then compares among each other. Besides, the use of algorithms and simulators for the growth of this technology is also presented. Finally, current research trends of this measurement technology have also been discussed.

Spatial Indeterminacy: Destabilization of Dichotomies in Modern and Contemporary Architecture

Since the advent of modern architecture, notions of free plan and transparency have proliferated well into current trends. The movement’s notion of a spatially homogeneous, open and limitless ‘free plan’ contrasts with the spatially heterogeneous ‘series of rooms’ defined by load bearing walls, which in turn triggered new notions of transparency created by vast expanses of glazed walls. Similarly, transparency was also dichotomized as something that was physical or optical, as well as something conceptual, akin to spatial organization. As opposed to merely accepting the duality and possible incompatibility of these dichotomies, this paper seeks to ask how can space be both literally and phenomenally transparent, as well as exhibit both homogeneous and heterogeneous qualities? This paper explores this potential destabilization or blurring of spatial phenomena by dissecting the transparent layers and volumes of a series of selected case studies to investigate how different architects have devised strategies of spatial ambiguity and interpenetration. Projects by Peter Eisenman, Sou Fujimoto, and SANAA will be discussed and analyzed to show how the superimposition of geometries and spaces achieve different conditions of layering, transparency, and interstitiality. Their particular buildings will be explored to reveal various innovative kinds of spatial interpenetration produced through the articulate relations of the elements of architecture, which challenge conventional perceptions of interior and exterior whereby visual homogeneity blurs with spatial heterogeneity. The results show how spatial conceptions such as interpenetration and transparency have the ability to subvert not only inside-outside dialectics, but could also produce multiple degrees of interiority within complex and indeterminate spatial dimensions in constant flux as well as present alternative forms of social interaction.

A Practical Construction Technique to Enhance the Performance of Rock Bolts in Tunnels

In Swedish tunnel construction, a critical issue that has been repeatedly acknowledged is corrosion and, consequently, failure of the rock bolts in rock support systems. The defective installation of rock bolts results in the formation of cavities in the cement mortar that is regularly used to fill the area under the dome plates. These voids allow for water-ingress to the rock bolt assembly, which results in corrosion of rock bolt components and eventually failure. In addition, the current installation technique consists of several manual steps with intense labor works that are usually done in uncomfortable and exhausting conditions, e.g., under the roof of the tunnels. Such intense tasks also lead to a considerable waste of materials and execution errors. Moreover, adequate quality control of the execution is hardly possible with the current technique. To overcome these issues, a non-shrinking/expansive cement-based mortar filled in the paper packaging has been developed in this study which properly fills the area under the dome plates without or with the least remaining cavities, ultimately that diminishes the potential of corrosion. This article summarizes the development process and the experimental evaluation of this technique for the installation of rock bolts. In the development process, the cementitious mortar was first developed using specific cement and shrinkage reducing/expansive additives. The mechanical and flow properties of the mortar were then evaluated using compressive strength, density, and slump flow measurement methods. In addition, isothermal calorimetry and shrinkage/expansion measurements were used to elucidate the hydration and durability attributes of the mortar. After obtaining the desired properties in both fresh and hardened conditions, the developed dry mortar was filled in specific permeable paper packaging and then submerged in water bath for specific intervals before the installation. The tests were enhanced progressively by optimizing different parameters such as shape and size of the packaging, characteristics of the paper used, immersion time in water and even some minor characteristics of the mortar. Finally, the developed prototype was tested in a lab-scale rock bolt assembly with various angles to analyze the efficiency of the method in real life scenario. The results showed that the new technique improves the performance of the rock bolts by reducing the material wastage, improving environmental performance, facilitating and accelerating the labor works, and finally enhancing the durability of the whole system. Accordingly, this approach provides an efficient alternative for the traditional way of tunnel bolt installation with considerable advantages for the Swedish tunneling industry.