Development of an online warfarin dosing platform using R programming language to facilitate healthcare professional duties and limit medication related errors.

Development of an online warfarin dosing platform using R programming language to facilitate healthcare professional duties and limit medication related errors. Monther Alsultan, Joshua M. Morriss, Daniel Contaifer Jr, Suad Alshammari; Silas Contaifer, Rachel W Flurie, Dayanjan S. Wijesinghe# Department of Pharmacotherapy and Outcome Sciences Objective: 1) Gain experience in developing platform agnostic, fully operational and clinically relevant web applications for effective pharmacist led patient care. 2) Create a decision- support tool using open source software to facilitate evidence-based management therapy of warfarin in clinical settings where it is available for everyone to use at anytime and anywhere. Introduction: Healthcare is continuously growing and modern technologies provide opportunities for the creation of effective tools to manage multiple diseases. Mobile devices such as smartphones enable easy access to a variety of websites remotely and make data and information readily available for use. Additionally, mobile devices can offer healthcare providers with fast and easy access to essential medical information to support patient care. The profession of pharmacy is fast changing from one primarily focused on dispensing medicinal goods to one intensely focused on the delivery of patient care. This has led pharmacists to be involved in a diverse clinical service such as patient\u27s education, Medication Therapy Management (MTM) and medications dose adjustment. Implementing such services often place additional stress on the daily routine of pharmacists. Therefore, there is a high need to find efficient ways to support healthcare related clinical services. One of the widely used anticoagulant medications is warfarin. Warfarin has been available on the market as effective therapy in management of thrombotic disorders. However, warfarin is frequently associated with medications errors which may lead to serious adverse events. The purpose of this paper is to demonstrate this fact fully via warfarin dosing web application to help support healthcare professionals in clinical settings. Methods: Open-source programming language R in conjunction with RStudio version 1.2.5033 were used to develop and implement our warfarin dosing platform. Shiny packages for R with other packages were used to create our platform as a web-based app. We based our calculations and function of our platform on the UW health warfarin management- adult- ambulatory clinical practice guidelines. Results: The platform contains three tools users can use:1) Calculating the warfarin maintenance dose,2) Selecting INR goals and duration of therapy,3) Assessment of Bleeding risk. Additionally, the app has a hyperlink to direct the users to the resource used in this app. On the first page of the app, the user can select their INR target and input a patients INR and weekly dose. Then, the app will immediately display the results. On the second page of the app, there is a feature for users helps to choose the INR target recommended based on patient conditions; There is a drop down menu contains different type of antithrombotic indications. Additionally, on the third page of the app, there is a feature for users helps to calculate the bleeding risk using HAS-BLED score. The users can answer “Yes” or “No” on multiple risk factors to stratify patients’ risk into low, moderate or high. Conclusion: Our warfarin dosing platform demonstrates the feasibility of creating a free-tool for healthcare professionals to facilitate their daily practice and potential for reducing medication related errors. Additionally, we demonstrate that pharmacists can take advantage of open-sources resources available to develop any health-related application suitable to their needs. Future Directions: The skills gained in the implementation of this full stack web application development will be further improved upon to develop additional clinical support tools for pharmacists. Further implementations will also incorporate fully or partially trained machine learning models. Our ultimate goal is to allow pharmacists to utilize data driven decision making strategies to implement fast and effective patient care.https://scholarscompass.vcu.edu/gradposters/1160/thumbnail.jp

A clustering based matrix for selecting optimal tools and techniques in quality management

The purpose of this research was to explore a systematic pattern for selecting quality tools and techniques in the manufacturing and service industries. This study asked, “What are the best DMAIC tools and techniques concerning circumstances of quality dimensions of products and services?” To answer this question, this research developed innovative, diagnostic matrices by mimicking the contradiction matrix of the Theory of Inventive Problem Solving (TRIZ). These innovative matrices are intended to help non-expert users to select the best sets of quality tools and techniques for solving different quality problems. By conducting a cluster analysis, the researcher uncovered homogeneous patterns of enough quality case studies, which ultimately provided the basis for selecting optimal groups of quality tools and techniques in different circumstances. Thus, the researcher examined the association and prevalence of different quality tools and techniques (independent variables) and the quality dimensions (dependent variables). The study developed the contradiction matrix for manufacturing, which includes the optimal 17 DMAIC lists of tools and techniques. Also, the study developed the contradiction matrix for service, which ultimately includes the optimal 15 DMAIC lists of tools and techniques. After developing and verifying the developed contradiction matrices, the researcher discussed their strengths and limitations as well as their roles for selecting the appropriate quality tools and techniques in the manufacturing and service industries. The results of this research can be used as a basis for many future investigations in the field of quality management and innovation

Tax Incentives in Three Common Markets

There are three approaches to dealing with tax incentives within common markets: permit them, limit them, or harmonize them. Broadly speaking, the United States (U.S.) follows the first approach, the European Union (EU) adopts the second, and the Gulf Cooperation Council (GCC) pursues the third by harmonizing some tax incentives, particularly those offered to the industrial sector. Unlike the U.S. and EU common markets, where incentives have gained significant scholarly attention, no academic literature exists on the legal framework of tax incentives in GCC common market. This work attempts to compensate for this insufficiency in scholarship and compares the three approaches. This work also explores the case against locational tax incentives and concludes that the conventional case against tax incentives is overall debatable, and further evidence considering the ongoing changes in international tax policy is needed to better evaluate the case. Furthermore, this work analyzes the advantages and disadvantages of the three approaches to dealing with tax incentives. In particular, this work explores how effective the approaches are in managing bidding wars, increasing tax law predictability, allowing flexibility to reform domestic tax policy as needed, and policing tax incentives. It concludes that each method has its limitations, advantages, and disadvantages. Thus, another contribution that this work offers is the inclusion of a holistic examination of the three approaches that merits focusing beyond the one consideration on which much of the existing literature focuses, that is, bidding wars between competitor states. Although this work primarily aims to assist GCC policymakers in deciding the best policy option for managing tax incentives, this scholarship is helpful even beyond the GCC. Federal countries and regional blocks that see and experience incentives competition can benefit from this work since it analyzes the merits of different approaches to managing incentives in general

Computational and Experimental Study on Innovative Horizontal-Axis Wind Turbine Blade Designs

This study was made to explore three novel blade geometries with intent to increase power production of a horizontal axes, three blade arrangement wind turbine. This was done by designing the blades using computer aided design (CAD) modeling software, followed by a rigorous testing phase, utilizing a computational fluid dynamics software (CFD). The blades then went into a cycle of iterative design to achieve the best parameters that will positively impact the overall power generation efficiency. These steps were followed by printing the blades utilizing 3D Printing technology, testing them for the power generation, and finally, tabulating these findings to validate the numerical results gathered using CFD software. The blade designs under investigation here are the slotted blade (blade with slot shaped cavity on leading edge extending to lower surface), A blade resembling the tubercles (local inflation or bulges on surface) found on a humpback whale and the winglet blade, which was compared to the baseline traditional straight blade. The slotted, tubercle and straight blade were experimentally investigated, while the winglet blade underwent a CFD study only and compared to the other designs. It was found experimentally that the slotted blade generates 26.1% more power on average than the straight blade, and was found very ideal for low wind vacancies, while the tubercle was found of less effectiveness than the straight, though it possesses superior characteristics in suppressing the resultant noise, which is a common wind turbine problem. The winglet showed very similar in results to the straight blade, where its addition would come very fruitful at higher wind velocities, due to the fact that the inertial forces needed to start the operation is a higher order of magnitude than the straight blade

Depositional setting of the Jaddala Formation at Kirkuk and Bai Hassan Fields, Kirkuk Area

يمثل تكوين الجدالة في حقول كركوك وباي حسن ترسيب على مصطبة جيريه على شكل رف مفتوح. أظهر تحليل السحنات المجهرية أن الترسيب كان ضمن ثلاثة مناطق وهي: الرف العميق وأسفل المنحدر والحوض العميق. يتكون الجدالة من أربع دورات ترسيبيه ذات الرتبة الثالثة، وتمثل هذه الدورات تعاقب فترات لارتفاع مستوي سطح البحر وثباته.  يمكن الاستنتاج من طبيعة التماثل وسمك هذه الدورات بأن التأثير التكتوني هو العامل الرئيسي المسؤول عن تطور هذه الدورات في حوض ذو معدل تجلس عالThe Jaddala Formation in Bai Hassan and Kirkuk oil fields was deposited on a carbonate platform with an open shelf setting. Microfacies analysis revealed that deposition took place within three zones; they include the Toe of slope, Deep shelf, and Deep basin. The succession consists of four third order cycles representing successive intervals of relative sea level rises and stillstand. The nature of cycle symmetry and thicknesses suggest that the tectonic component is the main controlling factor on cycle development in highly subsiding basin

Amplified, Synergistic (Photo) Catalytic Water-Splitting by Thin- Film Conducting Polymer Composites

There is currently great interest in harnessing sunlight to generate hydrogen from water. Hydrogen may serve as a future energy carrier that could one day supplant fossil fuels like gasoline or diesel. One of the major challenges with implementing this concept is that, present-day photoelectrochemical (PEC) water splitting systems are either inefficient in their capacity to catalytically split water and/or subject to photocorrosion. The problem typically lies at the interface at which the water-splitting catalytic reaction occurs. One potential solution is to develop a thin-film, catalytic, interfacial layer that may lie between the photo-activated species (e.g. the semiconductor) and the aqueous, liquid phase. Such an interfacial layer could be designed to catalyse water-splitting at a more accelerated rate than is possible in its absence, whilst simultaneously suppressing photocorrosion. Ideally, such a thin-film interface would provide the greatest possible catalytic effect, preferably by synergistic amplification of the catalysis beyond what may be achieved by the catalyst species themselves. This work aimed to study and develop thin-film composites, based on well-known conducting polymer supports, that may serve as such an interfacial layer and that display synergistically amplified water-splitting catalysis. Despite their potential for facilitating high activity, thin-film conducting polymer supports have, historically, expedited only relatively weak performances in, for example, catalytic water oxidation (with current densities in the μA/cm2 range)

Development of an R script for simple lipidomic and metabolomic data analysis

Background: Metabolomic and lipidomic studies generate vast quantities of data that are often analysed in a closed software environment with little to no access to the underlying algorithms. As a result, data processed via different software pipelines yield different results thus leading to a widespread problem of low reproducibility within these fields. To address this problem, we are developing LipidAnalyst; an R based lipidomics software pipeline. As a part of this project, we are creating a simple statistical analysis and graphing module in R to generate accurate, reproducible, high-resolution figures. Methods: R scripts were developed under version 3.5.3 with the capability to undertake statistical analyses (e.g. ANOVA) and post-hoc tests (e.g. Tukey). Additional code plotted resultant information as high resolution violin and box plots that depicted statistical significance. Thereafter, lipidomic and metabolomic data were analysed by this code and compared against commercial software and Metaboanalyst, a primary software used in metabolomic and lipidomic research. Results: Code generated in house demonstrated the same results as those generated using commercial software (e.g. JMP 14.0 Pro) but were different from results obtained by using the MetaboAnalyst pipeline. Conclusions: This study demonstrated the prevalent danger of using closed-source software pipelines for the analysis of lipidomic and metabolomic data without validating the analysis outcomes via open-source software. Open source software such as LipidAnalyst, that has also been independently validated using multiple data sets, can then be published with the results to enable transparency of data analysis and improve the replicability of results across different labs.https://scholarscompass.vcu.edu/gradposters/1092/thumbnail.jp

The Influence of Early Bilingual Education (English) on the First Language (Arabic) Literacy Skills in the Second Grade of Elementary School: Saudi Arabia

In bilingualism there are rigorous arguments among researches on the inclusion of second language in early phases of L1 education.  While some researchers support such inclusion, others advise that doing so might adversely affect the first language. In the context where this study was conducted (Saudi Arabia), despite the heated debate on introducing English to the Saudi primary schools, only few studies attempted to investigate the effect of teaching English from the first grade on the Arabic literacy skills. This research is a response to the lack of empirical evidence about the impact of learning a foreign language at a young age on L1 by investigating the effect of early bilingual education on the reading and writing (literacy) of Arabic (L1). The study was conducted on students from two Saudi elementary schools: a public school and a private school. The sample comprised 46 Arabic-speaking female students from grades two. The children were subdivided into 2 groups: 30 monolingual students and 16 bilingual students. The children took diagnostic tests to measure their linguistic development in their mother tongue. Over all, the results showed no negative impact on the reading and writing skills of Arabic if English is taught from the beginning of formal schooling. Keywords: Bilingualism, foreign languag

Free-text keystroke dynamics authentication with a reduced need for training and language independency

This research aims to overcome the drawback of the large amount of training data required for free-text keystroke dynamics authentication. A new key-pairing method, which is based on the keyboard’s key-layout, has been suggested to achieve that. The method extracts several timing features from specific key-pairs. The level of similarity between a user’s profile data and his or her test data is then used to decide whether the test data was provided by the genuine user. The key-pairing technique was developed to use the smallest amount of training data in the best way possible which reduces the requirement for typing long text in the training stage. In addition, non-conventional features were also defined and extracted from the input stream typed by the user in order to understand more of the users typing behaviours. This helps the system to assemble a better idea about the user’s identity from the smallest amount of training data. Non-conventional features compute the average of users performing certain actions when typing a whole piece of text. Results were obtained from the tests conducted on each of the key-pair timing features and the non-conventional features, separately. An FAR of 0.013, 0.0104 and an FRR of 0.384, 0.25 were produced by the timing features and non-conventional features, respectively. Moreover, the fusion of these two feature sets was utilized to enhance the error rates. The feature-level fusion thrived to reduce the error rates to an FAR of 0.00896 and an FRR of 0.215 whilst decision-level fusion succeeded in achieving zero FAR and FRR. In addition, keystroke dynamics research suffers from the fact that almost all text included in the studies is typed in English. Nevertheless, the key-pairing method has the advantage of being language-independent. This allows for it to be applied on text typed in other languages. In this research, the key-pairing method was applied to text in Arabic. The results produced from the test conducted on Arabic text were similar to those produced from English text. This proves the applicability of the key-pairing method on a language other than English even if that language has a completely different alphabet and characteristics. Moreover, experimenting with texts in English and Arabic produced results showing a direct relation between the users’ familiarity with the language and the performance of the authentication system