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Blockchain technology has a great potential for improving efficiency, security and privacy of Electronic Health Records (EHR) sharing systems. However, existing solutions relying on a centralized database are susceptible to traditional security problems such as Denial of Service (DoS) attacks and a single point of failure similar to traditional database systems. In addition, past solutions exposed users to privacy linking attacks and did not tackle performance and scalability challenges. In this paper, we propose a permissioned Blockchain based healthcare data sharing system that integrates Blockchain technology, decentralized file system and threshold signature to address the aforementioned problems. The proposed system is based on Istanbul Byzantine Fault Tolerant (IBFT) consensus algorithm and Interplanetary File System (IPFS). We implemented the proposed system on an enterprise Ethereum Blockchain known as Hyperledger Besu. We evaluated and compared the performance of the proposed system based on various performance metrics such as transaction latency, throughput and failure rate. Experiments were conducted on a variable network size and number of transactions. The experimental results indicate that the proposed system performs better than existing Blockchain based systems. Moreover, the decentralized file system provides better security than existing traditional centralized database systems while providing the same level of performance.

98% of people with surgical conditions living in low- and middle-income countries (LMICs) do not receive safe, timely and affordable surgical and anesthesia care. Research exploring barriers to receiving care has tended to be narrow in focus, often facility-based and ignoring the community beliefs, experiences and behaviours that will be an essential component of closing the gap in surgical care. Using qualitative methods, we captured diverse community perspectives in rural Ethiopia: exploring beliefs, perceptions, knowledge and experiences related to surgical conditions, with the overall aim of (re)constructing explanatory models. Our study was nested within a community-based survey of surgical conditions conducted in the Butajira Health and Demographic Surveillance Site, southern Ethiopia, and a follow-up study of people accessing surgical care in two local hospitals. We carried out 24 in-depth interviews. Participants were community members who needed but did/did not access surgical care, community-based healthcare workers and traditional bone-setters. Interviews were conducted in Amharic, audio-recorded, transcribed, and translated into English. We carried out thematic analysis. We found that community members primarily understood surgical conditions according to severity. We identified two categories: conditions you could live with and those which required urgent care, with the latter indicating a clear and direct path to surgical care whilst the former was associated with a longer, more complex and experimental pattern of help-seeking. Fear of surgery and poverty disrupted help-seeking, whilst community narratives based on individual experiences fed into the body of knowledge people used to inform decisions about care. We found explanatory models to be flexible, responsive to new evidence about what might work best in the context of limited community resources. Our findings have important implications for future research and policy, suggesting that community-level barriers have the potential to be responsive to carefully designed interventions which take account of local knowledge and beliefs.

Several recent studies have suggested Blockchain for Peer-to-Peer energy trading (P2P-ET) to achieve better security, privacy and fast payment settlement. Most of them however rely on either public Blockchains (which have low performance) or permissioned blockchains (which have low decentralization level and do not provide byzantine fault tolerance). Moreover, these solutions have limitations when capturing the business model of existing energy trading systems. This article proposes a Unified permissioned blockchain-based P2P-ET Architecture (UBETA) that integrates three different types of energy markets and provides a unified energy trading and payment settlement model. The UBETA system is based on an enterprise Ethereum Blockchain, known as Hyperledger Besu, and Istanbul Byzantine Fault Tolerance (IBFT) consensus algorithm. We compared the performance of the proposed IBFT-based system with three existing systems (i.e., Ethereum Clique, Ethereum Proof of Work and Hyperledger Fabric’s Raft) using specific performance metrics (i.e., read/write transaction latency, read/write transaction throughput and fail rate). The experiments were carried out on a network size of up to 60 nodes and a real energy trading data set from the Western Australian energy market was used. The experiment results indicate that the IBFT-based system has 15x lower latency and nearly 2x throughput compared to existing Proof of Work based P2P-ET solutions. Moreover, the system provides better scalability and success rate than existing Raft based P2P-ET systems: the fail rate of the IBFT-based system only increased by 11% while that of Raft increased by 20% when increasing the number of nodes from 20 to 60. In addition, the proposed unified energy trading model provides lower latency and reduces the number of blockchain transactions compared to the non-unified counterpart.

Ahmed Abdella,1 Endayen Deginet,1 Fitsum Weldegebreal,2 Indeshaw Ketema,3 Bajrond Eshetu,4 Assefa Desalew5 1Department of Pediatrics and Child Health, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 3Department of Emergency and Critical Care Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 5Department of Pediatrics and Child Health Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Assefa Desalew, Email assefad100@gmail.comBackground: Tuberculous meningitis is a serious public health problem, particularly in low-income countries. It is associated with high rates of mortality and morbidity. The outcome of tuberculous meningitis in children is not well documented in Ethiopia, particularly in eastern Ethiopia. This study aimed to determine the treatment outcomes of tuberculous meningitis at discharge and its associated factors in eastern Ethiopia.Methods: An institutional-based retrospective cross-sectional study was conducted on 121 children who were admitted and treated for tuberculous meningitis between January 2017 and December 2021. Data were collected using a pretested checklist, coded and entered into EpiData version 3.1, and analyzed using Statistical Package for the Social Sciences (SPSS) version 25. Factors associated with treatment outcomes were identified using multivariable logistic regression analyses. The association was described using the adjusted odds ratio (AOR) at a 95% confidence interval (CI). Finally, statistical significance was set at a p-value < 0.05.Results: Of the 121 medical records of children, 33.9% (95% CI:25– 42%) died. Among the survivors, 28.1% were discharged with neurological sequelae and the remains (38.0%) were discharged with normal outcomes. In multivariable analyses, nutritional status (AOR=2.87; 95% CI:1.04– 7.94), duration of illness (AOR = 0.33; 95% CI: 0.15– 0.86), hydrocephalus (AOR=3.78; 95% CI:1.08– 13.34), and stage-III Tuberculous Meningitis (AOR = 5.29; 95% CI:1.88– 14.84) were identified as significantly associated factors with poor clinical outcomes.Conclusion: The treatment outcomes for tuberculous meningitis in children are unfavorable. Two-thirds of children had poor treatment outcomes. Malnutrition, disease stage, hydrocephalus, and illness duration were associated with poor treatment outcomes at discharge. Health workers in primary health care should be aware of the importance of early screening, diagnosis, and treatment to improve clinical outcomes and reduce associated mortality and disability. In practice, more attention should be paid to children with malnutrition and hydrocephalus.Keywords: tuberculous meningitis, pediatric, children, clinical outcome, Ethiopia

ObjectiveTo explore hospital-level care for pre-eclampsia in Ethiopia, considering the perspectives of those affected and healthcare providers, in order to understand barriers and facilitators to early detection, care escalation and appropriate management.SettingA primary and a general hospital in southern Ethiopia.ParticipantsWomen with lived experience of pre-eclampsia care in the hospital, families of women deceased due to pre-eclampsia, midwives, doctors, integrated emergency surgical officers and healthcare managers.ResultsThis study identified numerous systemic barriers to provision of quality, person-centred care for pre-eclampsia in hospitals. Individual staff efforts to respond to maternal emergencies were undermined by a lack of consistency in availability of resources and support. The ways in which policies were applied exacerbated inequities in care. Staff improvised as a means of managing with limited material or human resources and knowledge. Social hierarchies and punitive cultures challenged adequacy of communication with women, documentation of care given and supportive environments for quality improvement.ConclusionsQuality care for pre-eclampsia requires organisational change to create a safe space for learning and improvement, alongside efforts to offer patient-centred care and ensure providers are equipped with knowledge, resources and support to adhere to evidence-based practice.

Background Optimum glycemic control is necessary to reduce and even prevent the risk of micro- and macrovascular complications of type 1 diabetes mellitus (T1DM). The main aim of this study was to assess the prevalence of T1DM patients with adequate glycemic control in 4 Arabian Gulf countries. Methods This study was a multicenter, observational, cross-sectional disease registry. Data were collected from adult T1DM patients who were treated with insulin within 6 months prior to the study visit. Results Out of 241 patients whose data were eligible for primary endpoint analysis, 27.4% had adequate glycemic control (HbA1c P P = 0.002). Conclusions We found that the glycemic control of T1DM adult patients in Kuwait, UAE, Oman and Bahrain is suboptimal. More efforts are necessary to pinpoint the causes of inadequate control in this population.

Background: World Health Organization (WHO) estimates that there were 558000 new cases with resistance to Rifampicin, of which 82% had multidrug-resistant tuberculosis (MDR-TB). Objectives: We aimed to identify the prevalence of MDR-TB in River Nile state, Sudan, and the risk factors contributing to its occurrence. Methods: This was a descriptive cross-sectional hospital-based study involved 200 specimens taken from patients suspected of having MDR-TB tested using an automated GeneXpert assay. Results: Results of GeneXpert assay showed that the presence of Mycobacterium tuberculosis in 81 (40.5%), and out of 81 positive test results there were 13 (16%) had MDR-TB. Additionally, 7 cases of MDR-TB were previously treated which represented about (53%) of MDR patients, the remaining 6 MDR-TB patients were new cases and represented (47%) of MDR-TB patients. Moreover, there were 4 MDR-TB patients who had a history of contact with MDR-TB patients. Conclusion: Prevalence of MDR-TB in River Nile State, Sudan was 16%, which is greater than WHO estimation for Sudan (10.1%). The results revealed that the main risk factor to develop MDR-TB was a history of contact with MDR-TB, so adherence to treatment and social awareness about the spread of MDR-TB are crucial preventive measures.

The effectiveness of selection in any cropdepends on the magnitude of the available genetic variability in the gene pool of the species. In this study, 12 cowpea genotypes (ten accessions and two check cultivars) were assessed for agronomic performance, extent of genetic variability and the association between different traits. The genotypes were sown in twoconsecutive seasons (October 2015/2016 and 2016/2017) at Shambat using a randomized complete block design with three replicates. Agronomic performance, variance components, genetic coefficient of variation, heritability, genetic advance and genotypic and phenotypic correlation coefficients were estimated. The genotypes exhibited wide variation in all ofthe studied traits. Seed yield ranged from 477.71 (genotypeHSD-5674) to 2204 kg/ha (genotypeHSD-5131).Highest estimates of genetic coefficient of variation (48.98) and genetic advance as percentage of the mean (81.21) were obtained for number of pods/plant and seed yield/plant, whereas days to maturity showed the lowest estimates. However, days to maturity had thehighest heritability estimate (86%) and seed yield/plant had the lowest (40%) value. Seed yield (Kg/ha)had significant positive genotypic and phenotypic association with each of seed yield/plant, number of pods/peduncle and number of pods/plant indicating that selection for these traits may be effective in yield improvement of the present cowpea genotypes. Genotypes HSD-5131, HSD-5130 and HSD-5672 appeared promising for future seed yield improvement breeding programs under the semi-tropics of Sudan

Background Preeclampsia is a well-known cause of maternal mortality and morbidity in Ethiopia. The exact pathophysiology has not been fully understood. Calcium and magnesium deficiencies have been given emphasis to play roles in the pathophysiology. Although evidence is abundant, they are equivocal. The study aimed to see the association of dietary calcium intake, serum total calcium level and ionized calcium level with preeclampsia. It also evaluated the association between dietary calcium intake and serum calcium levels. Materials and methods An unmatched case–control study was conducted in Gandhi Memorial, Tikur Anbessa, and Zewditu Memorial Hospitals, all in Addis Ababa, between October to December, 2019. Cases were 42 women with preeclampsia and controls were 42 normotensive women. The medical and obstetric history was gathered using a structured questionnaire and the dietary calcium intake information using a 24-h dietary recall. The serum levels of total serum calcium and ionized (free) calcium were measured using an inductively coupled mass spectrophotometer. Bivariate and multivariate logistic regression and Pearson correlation test were utilized during data analysis. Results In comparison with controls, women with preeclampsia had lower mean (± 1SD) levels of ionized calcium level (1.1 mmol/l ± 0.11), total serum calcium level (1.99 mmol/l ± 0.35) and lower median (IQR) dietary calcium intake (704 mg/24 h,458–1183). The odds of having preeclampsia was almost eight times greater in those participants with low serum ionized calcium level (OR 7.5, 95% CI 2.388–23.608) and three times higher in those with low total serum calcium level (OR 3.0, 95% CI 1.024–9.370). Low dietary calcium intake also showed statistically significant association with preeclampsia (OR 3.4, 95% CI 1.092 -10.723). Serum ionized calcium level and total serum calcium level showed positive correlation of moderate strength (p = 0.004, r = 0.307), but no correlation was found between dietary calcium intake with both forms of serum calcium levels. Conclusion This study showed significant association between low dietary calcium intake and low serum calcium levels with preeclampsia, hence this can be used as a supportive local evidence for the current context-specific recommendation of calcium supplementation in societies with low-dietary calcium consumption in an attempt to prevent preeclampsia, therefore implementation study should be considered in Ethiopia to look for the feasibility of routine supplementation.

Nowadays, airline ticket prices can vary dynamically and significantly for the same flight, even for nearby seats within the same cabin. Customers are seeking to get the lowest price while airlines are trying to keep their overall revenue as high as possible and maximize their profit. Airlines use various kinds of computational techniques to increase their revenue such as demand prediction and price discrimination. From the customer side, two kinds of models are proposed by different researchers to save money for customers: models that predict the optimal time to buy a ticket and models that predict the minimum ticket price. In this paper, we present a review of customer side and airlines side prediction models. Our review analysis shows that models on both sides rely on limited set of features such as historical ticket price data, ticket purchase date and departure date. Features extracted from external factors such as social media data and search engine query are not considered. Therefore, we introduce and discuss the concept of using social media data for ticket/demand prediction. (c) 2019 The Authors. Production and hosting by Elsevier B.V. on behalf of King Saud University. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Research to date has addressed that there is incompatibility (gap) between the skills of university graduates and the labour market requirements in Egypt. The factors that affect this gap, as well as HOW to bridge the gap, have not been surveyed in previous studies in Egypt. The purpose of this research is to identify the key factors in the Egyptian higher education (HE) system which affect the quality of the public universities, and to explore the changes that must be made by the Egyptian HE Management (Ministry of HE) within the boundaries factors to achieve significant and real improvements in the quality of the Egyptian HE system; thus the skills gap will then be bridged and the mismatch between skills of the university graduates and the skills needed by market will be decreased. This study develops a new model (system dynamics model) of the factors that leads to the gap between the skills of the Egyptian university graduates and the requirements of the labour market. Particular focus is on identification of the key structural changes that need to be made to reduce this gap and their effects, using public Egyptian universities as a case study. The initial influence diagram is built based on relationships identified by semi-structured interviews with the administrative and academic staff members from various public universities in Egypt; all these staff members have experience in the quality of the HE system. This initial structure has been validated by using two groups of standard system dynamics tests, namely the structural validation and behavioural validation tests and empirical tests using a group of administrative and academic staff members with experience that exceeds 15 years in the HE system. The model contains more than90 variables that are associated with the quality of Egyptian HE system. PowerSim Studio 10 Academic® is used as system dynamics software to build a stocks-and-flows diagram from the influence diagram. Many scenarios have been made to test the effects of different variables in order to find the dominant variables. The model is simulated over a five-year period from the academic year 2012-2013 till the academic year 2016-2017.As shown in this study, there are seven key variables that influence the quality of the Egyptian HE system and thus affect the skills gap. Some of these factors have instant and rapid effects, while others take time for their effects to appear on the quality of services provided by Egyptian universities. The increase of these variables leads to increase the quality of services provided by the Egyptian universities. Therefore, this increase will lead to an uptake of the skills of graduates and then a decrease of the skills gap. This achieves the compatibility between the skills of university graduates and the requirements of the labour market in Egypt.

The use of positron-emitting radioactive isotopes for heavy ion therapy has been proposed as a means to increase the number of annihilation photons available for Positron Emission Tomography (PET)-based quality assurance (QA) imaging. The particle stopping point itself, which highly correlates to point of maximum dose, can be directly obtained from PET images with the use of these isotopes. An important step for clinical realisation of this idea is to evaluate the relative biological effectiveness (RBE) of the positron-emitting radioactive heavy ions and compare them to those of the corresponding stable nuclides. In this study, the RBE at 10% survival of two positron-emitting radioactive beams, 11C and 15O, and their corresponding non-radioactive isotopes 12C and 16O, were experimentally evaluated by measuring microdosimetric lineal energy deposition using a silicon-on-insulator mushroom microdosimeter. It was found that the RBE10 of the radioactive beams were statistically indistinguishable from their respective stable counterparts in each of the the entrance, Bragg peak and tail regions. The microdosimetric dose-mean lineal energy, yD was also evaluated for each ion species, with multiple measurements made along the path of the beam, and post-irradiation PET images were acquired and compared between the radioactive and stable beams, demonstrating the greatly improved signal to noise ratio (SNR) which can be achieved with positron-emitting radioactive ion beams., 2019 IEEE Nuclear Science Symposium and Medical Imaging Conference

Electric Vehicles are becoming popular among car owners now a day with several car manufacturing companies expanding their productivity with different models and sizes. However, there is a lack of proper charging infrastructure to support their wide spread. Blockchain as a technology first was used for money transactions while not relying on any trusted third parties such as central banks to securely approve and validate such exchanges. This paper is focusing on procedures of Blockchains in controlling and sharing charging stations and billing records to permit customers, organizations/authorities, and other power stakeholders to share information among themselves, and increment the ability of systems to exchange and make use of information. Despite the fact that the use of Blockchains may diminish repetition and provide power organizations with constant records about their customers, regardless it accompanies few difficulties which could invade customer’s privacy. In this paper, we study different blockchain constructions, discuss the challenges and provide a possible framework to facilitate Electric Vehicles charging across the UAE.