Search results for: local complications

Authors: Ching-Yi Yiu, Hui-Chen Hsu

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Objectives: Head and neck cancer (HNC) is a big global health problem in the world. Despite the development of diagnosis and treatment, the overall survival of HNC is still low. The well recognition of the interaction of the host immune system and cancer cells has led to realizing the processes of tumor initiation, progression and metastasis. Many systemic inflammatory responses have been shown to play a crucial role in cancer progression. The pre and post-treatment nutritional and immunological status of HNC patients is a reliable prognostic indicator of tumor outcomes and survivors. Methods: Between July 2020 to June 2022, We have enrolled 60 HNC patients, including 59 males and 1 female, in Chi Mei Medical Center, Liouying, Taiwan. The age distribution was from 37 to 81 years old (y/o), with a mean age of 57.6 y/o. We evaluated the pre-and post-treatment nutritional and immunological status of these HNC patients with body weight, body weight loss, body mass index (BMI), whole blood count including hemoglobin (Hb), lymphocyte, neutrophil and platelet counts, biochemistry including prealbumin, albumin, c-reactive protein (CRP), with the time period of before treatment, post-treatment 3 and 6 months. We calculated the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to assess how these biomarkers influence the outcomes of HNC patients. Results: We have carcinoma of the hypopharynx in 21 cases with 35％, carcinoma of the larynx in 9 cases, carcinoma of the tonsil and tongue every 6 cases, carcinoma soft palate and tongue base every 5 cases, carcinoma of buccal mucosa, retromolar trigone and mouth floor every 2 cases, carcinoma of the hard palate and low lip each 1 case. There were stage I 15 cases, stage II 13 cases, stage III 6 cases, stage IVA 10 cases, and stage IVB 16 cases. All patients have received surgery, chemoradiation therapy or combined therapy. We have wound infection in 6 cases, 2 cases of pharyngocutaneous fistula, flap necrosis in 2 cases, and mortality in 6 cases. In the wound infection group, the average BMI is 20.4 kg/m2; the average Hb is 12.9 g/dL, the average albumin is 3.5 g/dL, the average NLR is 6.78, and the average PLR is 243.5. In the PC fistula and flap necrosis group, the average BMI is 21.65 kg/m2; the average Hb is 11.7 g/dL, the average albumin is 3.15 g/dL, average NLR is 13.28, average PLR is 418.84. In the mortality group, the average BMI is 22.3 kg/m2; the average Hb is 13.58 g/dL, the average albumin is 3.77 g/dL, the average NLR is 6.06, and the average PLR is 275.5. Conclusion: HNC is a big challenging public health problem worldwide, especially in the high prevalence of betel nut consumption area Taiwan. Besides the definite risk factors of smoking, drinking and betel nut related, the other biomarkers may play significant prognosticators in the HNC outcomes. We concluded that the average BMI is less than 22 kg/m2, the average Hb is low than 12.0 g/dL, the average albumin is low than 3.3 g/dL, the average NLR is low than 3, and the average PLR is more than 170, the surgical complications and mortality will be increased, and the prognosis is poor in HNC patients.

Keywords: nutritional, immunological, neutrophil-to-lymphocyte ratio, paltelet-to-lymphocyte ratio.

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Authors: Lotfi O. Gargab, Ruichong R. Zhang

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A wave-based framework is presented for modeling seismic motion in multistory buildings and using measured response for system identification which can be utilized to extract important information regarding structure integrity. With one pair of building response at two locations, a generalized model response is formulated based on wave propagation features and expressed as frequency and time response functions denoted, respectively, as GFRF and GIRF. In particular, GIRF is fundamental in tracking arrival times of impulsive wave motion initiated at response level which is dependent on local model properties. Matching model and measured-structure responses can help in identifying model parameters and infer building properties. To show the effectiveness of this approach, the Millikan Library in Pasadena, California is identified with recordings of the Yorba Linda earthquake of September 3, 2002.

Keywords: system identification, continuous-discrete mass modeling, damage detection, post-earthquake

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Authors: M. A. Ghebouli, H. Choutri, B. Ghebouli , M. Fatmi, L. Louail

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We employed the density-functional perturbation theory (DFPT) within the generalized gradient approximation (GGA), the local density approximation (LDA) and the virtual-crystal approximation (VCA) to study the effect of composition on the structure, stability, energy gaps, electron effective mass, the dynamic effective charge, optical and acoustical phonon frequencies and static and high dielectric constants of the rock-salt CaxMg1-xSe and CaxMg1-xTe alloys. The computed equilibrium lattice constant and bulk modulus show an important deviation from the linear concentration. From the Voigt-Reuss-Hill approximation, CaxMg1-xSe and CaxMg1-xTe present lower stiffness and lateral expansion. For Ca content ranging between 0.25-0.75, the elastic constants, energy gaps, electron effective mass and dynamic effective charge are predictions. The elastic constants and computed phonon dispersion curves indicate that these alloys are mechanically stable.

Keywords: CaxMg1-xSe, CaxMg1-xTe, band structure, phonon

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Authors: Abdulai Abubakari

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The rollercoaster relationship between farmers and herders in Sub-Saharan Africa has compelled most governments to undertake different mitigating strategies. Over the past two decades, the expulsion of migrant herdsmen, the killing of cattle and human beings, and fines have been used by the state and aggrieved individuals to resolve the conflicts. Unlike this paper, most of the research conducted on this subject matter has been largely theoretical and lacks practical solutions to the conflicts. This paper is unique because it focuses on concrete strategies and practical solutions to ending the century-old phenomenon of farmer-herder conflicts in Ghana. The paper employed power or compete (fight) theory as well as compromise and negotiation theories in the analyses. The paper employed, basically, socio-anthropological methods: interviews, focus group discussions, and observations to gather data. The paper found that compromises through negotiation with the stakeholders are the best ways of resolving these conflicts. Through this, we support the compromise and negotiation approach rather than expulsion to resolve farmer-herder conflicts.

Keywords: farmer-herder, conflict, prevention, strategies, stakeholders

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Authors: Hoda Manafian, Stephen Holland

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Problem statement: Rural areas in Iran are one of the most popular tourism destinations. Abyaneh Village is one of them with a long history behind it (more than 1500 years) which is a national heritage site and also is nominated as a world heritage site in UNESCO tentative list from 2007. There is a considerable foundation of religious-cultural heritage and also agricultural history and activities. However, this heritage site suffers from mass tourism which is beyond its social and physical carrying capacity, since the annual number of tourists exceed 500,000. While there are four adjacent villages around Abyaneh which can benefit from advantages of tourism. Local managers also can at the same time prorate the tourists’ flux of Abyaneh on those other villages especially in high-season. The other villages have some cultural and natural tourism attractions as well. Goal: The main goal of this study is to identify a feasible development strategy according to the current strengths, weaknesses, opportunities and threats of rural tourism in this area (Abyaneh Village and four adjacent villages). This development strategy can lead to sustainable management of these destinations. Method: To this end, we used SWOT analysis as a well-established tool for conducting a situational analysis to define a sustainable development strategy. The procedures included following steps: 1) Extracting variables of SWOT chart based on interviewing tourism experts (n=13), local elites (n=17) and personal observations of researcher. 2) Ranking the extracted variables from 1-5 by 13 tourism experts in Isfahan Cultural Heritage, Handcrafts and Tourism Organization (ICHTO). 3) Assigning weights to the ranked variables using Expert Choice Software and the method of Analytical Hierarchical Process (AHP). 4) Defining the Total Weighted Score (TWS) for each part of SWOT chart. 5) Identifying the strategic position according to the TWS 6) Selecting the best development strategy based on the defined position using the Strategic Position and Action Evaluation (SPACE) matrix. 7) Assessing the Probability of Strategic Success (PSS) for the preferred strategy using relevant formulas. 8) Defining two feasible alternatives for sustainable development. Results and recommendations: Cultural heritage attractions were first-ranked variable in strength chart and also lack of sufficient amenities for one-day tourists (catering, restrooms, parking, and accommodation) was firs-ranked weakness. The strategic position was in ST (Strength-Threat) quadrant which is a maxi-mini position. According this position we would suggest ‘Competitive Strategy’ as a development strategy which means relying on strengths in order to neutralization threats. The result of Probability of Strategic Success assessment which was 0.6 shows that this strategy could be successful. The preferred approach for competitive strategy could be rebranding the market of tourism in this area. Rebranding the market can be achieved by two main alternatives which are based on the current strengths and threats: 1) Defining a ‘Heritage Corridor’ from first adjacent village to Abyaneh as a final destination. 2) Focus on ‘educational tourism’ versus mass tourism and also green tourism by developing agritourism in that corridor.

Keywords: Abyaneh village, rural tourism, SWOT analysis, sustainable strategies

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Authors: Phakamas Rachamontree, Theerawut Phusantisampan, Natthakorn Woravutthikul, Peerapong Pornwongthong, Malinee Sriariyanun

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A total of 115 yeast strains isolated from local cassava processing wastes were measured for crude protein content. Among these strains, the strain MSY-2 possessed the highest protein concentration (>3.5 mg protein/mL). By using molecular identification tools, it was identified to be a strain of Pichia kudriavzevii based on similarity of D1/D2 domain of 26S rDNA region. In this study, to optimize the protein production by MSY-2 strain, Response Surface Methodology (RSM) was applied. The tested parameters were the carbon content, nitrogen content, and incubation time. Here, the value of regression coefficient (R2) = 0.7194 could be explained by the model, which is high to support the significance of the model. Under the optimal condition, the protein content was produced up to 3.77 g per L of the culture and MSY-2 strain contain 66.8 g protein per 100 g of cell dry weight. These results revealed the plausibility of applying the novel strain of yeast in single-cell protein production.

Keywords: single cell protein, response surface methodology, yeast, cassava processing waste

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Authors: Hoi Nga Ng, Kam Weng Boey, Chi Wai Kwan, Hing Kwan To

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The effectiveness of school-based sexuality education (SBSE) depends largely on adolescents’ attitudes towards sexuality and SBSE. This study examined factors (demographic characteristics, religiosity, and spirituality) associated with students’ sexual attitudes and their views on SBSE. Data were collected via a questionnaire through convenience sampling from three secondary schools. A total of 818 students participated in the study. Male students were generally more permissive in sexual attitudes. Female students were specifically more liberal in attitudes towards abortion, contraception, infection of sexually transmitted diseases, and homosexuality. Higher levels of religiosity and spirituality were negatively associated with permissive sexual attitudes. As in the West, students showed positive attitudes towards SBSE, which provided a fertile ground for SBSE. However, female gender, conservative sexual attitudes, religiosity, and spirituality were positively related to attitudes towards SBSE, which were incongruent with what was found in Western studies. Implementation of SBSE needs to consider factors specific to the local cultural setting.

Keywords: religiosity, school-based sexuality education, secondary school, spirituality

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Authors: Salihu Maiwada

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The large scale textile industry in Nigeria was at one time the second largest employer of labor after government. With recent developments and changing situations, there is a serious decline in this sector which consequently forced the local textile industries to close down and the workers retrenched. the category of people worst hit was the youths and the middle age. This paper examines the potentials of the textile cottage industry as a facilitator for capacity building and economic empowerment among the Nigerian youths. The paper focuses on economic viability, persistence, and above-all, its potentials for poverty reduction as well as self employment. The methodology used in the study is the survey method and the instrument used to collect the necessary information is field interview. The results obtained showed that the textile cottage industries are flourishing and the Nigerian youths are engaged in the practice. In addition, the paper suggests areas that require government's financial intervention which will facilitate the establishment and ensure the sustainability of the textile cottage industry. The paper concludes with some recommendations for the youths and for the government.

Keywords: capacity building, economic, empowerment, persistence, sustainability, youths

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Authors: Bachir Chemani, Halima Chemani

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The objective of this study is to investigate the effect of adding coal to obtain insulating ceramic product. The preparation of mixtures is achieved with 04 types of different masse compositions, consisting of gray and yellow clay, and coal. Analyses are performed on local raw materials by adding coal as additive. The coal content varies from 5 to 20 % in weight by varying the size of coal particles ranging from 0.25 mm to 1.60 mm. Initially, each natural moisture content of a raw material has been determined at the temperature of 105°C in a laboratory oven. The Influence of low-coal content on absorption, the apparent density, the contraction and the resistance during compression have been evaluated. The experimental results showed that the optimized composition could be obtained by adding 10% by weight of coal leading thus to insulating ceramic products with water absorption, a density and resistance to compression of 9.40 %, 1.88 g/cm3, 35.46 MPa, respectively. The results show that coal, when mixed with traditional raw materials, offers the conditions to be used as an additive in the production of lightweight ceramic products.

Keywords: clay, coal, resistance to compression, insulating bricks

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Authors: A.Zitouni, S.Bentata, B.Bouadjemi, T.Lantri, W. Benstaali, Z.Aziz, S.Cherid, A. Sefir

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Structural, electronic, and magnetic properties of Co and Mn-doped CdTe have been studied by employing the full potential linear augmented plane waves (FP-LAPW) method within the spin-polarized density functional theory (DFT). The electronic exchange-correlation energy is described by generalized gradient approximation (GGA) as exchange–correlation (XC) potential. We have calculated the lattice parameters, bulk modulii and the first pressure derivatives of the bulk modulii, spin-polarized band structures, and total and local densities of states. The value of calculated magnetic moment per Co and Mn impurity atoms is found to be 2.21 µB for CdCoTe and 3.20 µB for CdMnTe. The calculated densities of states presented in this study identify the half-metallic of Co and Mn-doped CdTe.

Keywords: electronic structure, density functional theory, band structures, half-metallic, magnetic moment

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Authors: Pedro Batista, André Vinha, Filipe Castelo, Bárbara Costa, Ricardo Sousa, Raquel Ricardo, André Pinto

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Background: Septic arthritis is a diagnosis that must be considered in any patient presenting with acute joint swelling and fever. Among the several risk factors for septic arthritis, such as age, rheumatoid arthritis, recent surgery, or skin infection, diabetes mellitus can sometimes be the main risk factor. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, it is uncommon in monomicrobial necrotizing fasciitis. Objectives: A case report of concomitant septic arthritis and necrotizing fasciitis in a patient with undiagnosed diabetes based on clinical history. Study Design & Methods: We report a case of a 58-year-old Portuguese previously healthy man who presented to the emergency department with fever and left knee swelling and pain for two days. The blood work revealed ketonemia of 6.7 mmol/L and glycemia of 496 mg/dL. The vital signs were significant for a temperature of 38.5 ºC and 123 bpm of heart rate. The left knee had edema and inflammatory signs. Computed tomography of the left knee showed diffuse edema of the subcutaneous cellular tissue and soft tissue air bubbles. A diagnosis of septic arthritis and necrotising fasciitis was made. He was taken to the operating room for surgical debridement. The samples collected intraoperatively were sent for microbiological analysis, revealing infection by multi-sensitive Staphylococcus aureus. Given this result, the empiric flucloxacillin (500 mg IV) and clindamycin (1000 mg IV) were maintained for 3 weeks. On the seventh day of hospitalization, there was a significant improvement in subcutaneous and musculoskeletal tissues. After two weeks of hospitalization, there was no purulent content and partial closure of the wounds was possible. After 3 weeks, he was switched to oral antibiotics (flucloxacillin 500 mg). A week later, a urinary infection by Pseudomonas aeruginosa was diagnosed and ciprofloxacin 500 mg was administered for 7 days without complications. After 30 days of hospital admission, the patient was discharged home and recovered. Results: The final diagnosis of concomitant septic arthritis and necrotizing fasciitis was made based on the imaging findings, surgical exploration and microbiological tests results. Conclusions: Early antibiotic administration and surgical debridement are key in the management of septic arthritis and necrotizing fasciitis. Furthermore, risk factors control (euglycemic blood glucose levels) must always be taken into account given the crucial role in the patient's recovery.

Keywords: septic arthritis, Necrotizing fasciitis, diabetes, Staphylococcus Aureus

Procedia PDF Downloads 289

Authors: Rajish Shil, Amal Alduhoori, Vipin Thomachan, Jamal Teir, Radhakrishnan Renganathan

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Background: Antiphospholipid antibody syndrome (APS) has a broad spectrum of thrombotic and non-thrombotic clinical manifestations. We present a case of APS presenting with seizure, stroke, and atrial mass. Case Description: A 38-year-old male presented with headache of 10 days duration and tonic-clonic seizure. The neurological examination was normal. Magnetic resonance imaging of brain showed small acute right cerebellar infarct. Magnetic resonance angiography of brain and neck showed a focal narrowing in the origin of the internal carotid artery bilaterally. Electroencephalogram was normal. He was started on aspirin, atorvastatin, and carbamazepine. Transthoracic and trans-esophageal echocardiography showed a pedunculated and lobular atrial mass, measuring 1 X 1.5 cm, which was freely mobile across mitral valve opening across the left ventricular inflow. Autoimmune screening showed positive Antiphospholipid antibodies in high titer (Cardiolipin IgG > 120 units/ml, B2 glycoprotein IgG 90 units/mL). Anti-nuclear antibody was negative. Erythrocyte sedimentation rate and C-reactive protein levels were normal. Platelet count was low (111 x 109/L). The patient underwent successful surgical removal of the mass, which looked like a thrombotic clot, and Histopathological analysis confirmed it as a fibrinous clot, with no evidence of tumor cells. The patient was started on full anticoagulation treatment and was followed up regularly in the clinic, where our patient did not have any further complications from the disease. Discussion: Our patient was diagnosed to have APS based on the features of high positive anticardiolipin antibody IgG and B2 glycoprotein IgG levels, Stroke, thrombocytopenia, and abnormal echo findings. Thrombotic vegetation can mimic an atrial myxoma on echo. Conclusion: APS can present with neurological and cardiac manifestations, and therefore a high index of suspicion is necessary for a diagnosis of the disease as it can affect both short and long term treatment plans and prognosis. Therefore, in patients presenting with neurological symptoms like seizures, weakness and radiological diagnosis of stroke in a young patient, where atrial masses could be thought to be the cause of stroke, they should be screened for any concomitant findings of thrombocytopenia and/or activated partial thromboplastin time prolongation, which should raise the suspicion of vasculitis, specifically APS to be the primary cause of the clinical presentation.

Keywords: antiphospholipid syndrome, seizures, atrial mass, stroke

Procedia PDF Downloads 100

Authors: Alagie Salieu Nankey

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Flood-resistant house is the key mechanism to withstand flood hazards in Ebo-Town. It emerged simple yet powerful way of mitigating flooding in the community of Ebo- Town. Even though there are different types of buildings, little is known yet how and why flood affects building severely. In this paper, we examine three different types of flood-resistant buildings that are suitable for Ebo Town. We gather content and contextual features from six (6) respondents and used this data set to identify factors that are significantly associated with the flood-resistant house. Moreover, we built a suitable design concept. We found that amongst all the theories studied in the literature study Slit or Elevated House is the most suitable building design in Ebo-Town and Pile foundation is the most appropriate foundation type in the study area. Amongst contextual features, local materials are the most economical materials for the proposed design. This research proposes a framework that explains the theoretical relationships between flood hazard zones and flood-resistant houses in Ebo Town. Moreover, this research informs the design of sense-making and analytics tools for the resistant house.

Keywords: flood-resistant, slit, flood hazard zone, pile foundation

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Authors: M. C. Akay, A. Aybakan, H. Temeltas

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Aerial and ground robots have various advantages of usage in different missions. Aerial robots can move quickly and get a different sight of view of the area, but those vehicles cannot carry heavy payloads. On the other hand, unmanned ground vehicles (UGVs) are slow moving vehicles, since those can carry heavier payloads than unmanned aerial vehicles (UAVs). In this context, we investigate the performances of various Similarity Metrics to provide a common map for Heterogeneous Robot Team (HRT) in complex environments. Within the usage of Lidar Odometry and Octree Mapping technique, the local 3D maps of the environment are gathered.  In order to obtain a common map for HRT, informative theoretic similarity metrics are exploited. All types of these similarity metrics gave adequate as allowable simulation time and accurate results that can be used in different types of applications. For the heterogeneous multi robot team, those methods can be used to match different types of maps.

Keywords: common maps, heterogeneous robot team, map matching, informative theoretic similarity metrics

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Authors: Haresh Sharma, Jaimini Luharia

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The ecology in the Western Himalayan region transforms with the change in altitude. This change is observed in terms of topography, species of flora and fauna and the quality of the soil. The current study focuses on women of indigenous communities of Pangi Valley, which is located in the state of Himachal Pradesh, India. The valley is bifurcated into three different areas –Saichu, Hudan Bhatori, and Sural Bhatori valleys. It is one of the most remote, rugged and difficult to access tribal regions of Chamba district. The altitude of the valley ranges from 2,000 m to 6,000 m above sea level. The Pangi valley is inhabited by ‘Pangwals’ and ‘Bhots’ tribes of the Himalayas who speak their local tribal language called’ Pangwali’. The valley is cut-off from the mainland due to heavy snow and lack of proper roads during peak winters. Due to difficult geographical location, the daily lives of the people are constantly challenged, and they are most of the times deprived of benefits targeted through government programs. However, the indigenous communities earn their livelihood through livestock and forest-based produce while some of them migrate to nearby places for better work. The current study involves snowball sampling methodology for data collection along with in-depth interviews of women members of Self-Help Groups and women farmers. The findings reveal that the lives of these indigenous communities largely depend on forest-based products. So, it creates all the more significance of enhancing, maintaining, and consuming natural resources sustainably. Under such circumstances, the women of the community play a significant role of guardians in conservation and protection of the forests. They are the custodians of traditional knowledge of environment conservation practices that have been followed for many years in the region. The present study also sought to establish a relationship between some of the development initiatives undertaken by the women in the valley that stimulate sustainable mountain economy and conservation practices. These initiatives include cultivation of products like hazelnut, ‘Gucchi’ rare quality mushroom, medicinal plants exclusively found in the region, thereby promoting long term sustainable conservation of agro-biodiversity of the Western Himalayan region. The measures taken by the community women are commendable as they ensure access and distribution of natural resources as well as manage them for future generations. Apart from this, the tribal women have actively formed Self-Help Groups promoting financial inclusion through various activities that augment ownership and accountability towards the overall development of the communities. But, the results also suggest that there’s not enough recognition given to women’s role in forests conservation practices due to several local socio-political reasons. There are not enough research studies done on communities of Pangi Valley due to inaccessibility created out of lack of proper roads and other resources. Also, there emerged a need to concretize indigenous and traditional knowledge of conservation practices followed by women in the community.

Keywords: forest conservation, indigenous community women, sustainable livelihoods, sustainable development, poverty alleviation, Western Himalayas

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Authors: Jamie Lee Harder

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In the context of rapidly changing social and economic circumstances in the developing world, this paper analyses access to public healthcare for poor people with disabilities in Cambodia. Like other countries of South East Asia, Cambodia is developing at rapid pace. The historical past of Cambodia, however, has set former social policy structures to zero. This past forces Cambodia and its citizens to implement new public health policies to align with the needs of social care, healthcare, and urban planning. In this context, the role of people with disabilities (PwDs) is crucial as new developments should and can take into consideration their specific needs from the beginning onwards. This paper is based on qualitative research with expert interviews and focus group discussions in Cambodia. During the field work it became clear that the identification tool for the poorest households (HHs) does not count disability as a financial risk to fall into poverty neither when becoming sick nor because of higher health expenditures and/or lower income because of the disability. The social risk group of poor PwDs faces several barriers in accessing public healthcare. The urbanization, the socio-economic health status, and opportunities for education; all influence social status and have an impact on the health situation of these individuals. Cambodia has various difficulties with providing access to people with disabilities, mostly due to barriers regarding finances, geography, quality of care, poor knowledge about their rights and negative social and cultural beliefs. Shortened budgets and the lack of prioritizations lead to the need for reorientation of local communities, international and national non-governmental organizations and social policy. The poorest HHs are identified with a questionnaire, the IDPoor program, for which the Ministry of Planning is responsible. The identified HHs receive an ‘Equity Card’ which provides access free of charge to public healthcare centers and hospitals among other benefits. The dataset usually does not include information about the disability status. Four focus group discussions (FGD) with 28 participants showed various barriers in accessing public healthcare. These barriers go far beyond a missing ramp to access the healthcare center. The contents of the FGDs were ratified and repeated during the expert interviews with the local Ministries, NGOs, international organizations and private persons working in the field. The participants of the FGDs faced and continue to face high discrimination, low capacity to work and earn an own income, dependency on others and less social competence in their lives. When discussing their health situation, we identified, a huge difference between those who are identified and hold an Equity Card and those who do not. Participants reported high costs without IDPoor identification, positive experiences when going to the health center in terms of attitude and treatment, low satisfaction with specific capacities for treatments, negative rumors, and discrimination with the consequence of fear to seek treatment in many cases. The problem of accessing public healthcare by risk groups can be adapted to situations in other countries.

Keywords: access, disability, health, inequality, Cambodia

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Authors: Navab Karimi, Tohid Alizadeh

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An intelligent vision-based system was designed to measure the quality and purity of raisins. A machine vision setup was utilized to capture the images of bulk raisins in ranges of 5-50% mixed pure-impure berries. The textural features of bulk raisins were extracted using Grey-level Histograms, Co-occurrence Matrix, and Local Binary Pattern (a total of 108 features). Genetic Algorithm and neural network regression were used for selecting and ranking the best features (21 features). As a result, the GLCM features set was found to have the highest accuracy (92.4%) among the other sets. Followingly, multiple feature combinations of the previous stage were fed into the second regression (linear regression) to increase accuracy, wherein a combination of 16 features was found to be the optimum. Finally, a Support Vector Machine (SVM) classifier was used to differentiate the mixtures, producing the best efficiency and accuracy of 96.2% and 97.35%, respectively.

Keywords: sun-dried organic raisin, genetic algorithm, feature extraction, ann regression, linear regression, support vector machine, south azerbaijan.

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Authors: Arijit Basuray

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It is well known that if an electrical insulation system is stressed under high voltage then discharge may occur in various form and if the system is made of composite dielectric having interfaces of materials having different dielectric constant discharge may occur due to gross mismatch of dielectric constant causing intense local field in the interfaces. Here author has studied, firstly, behavior of discharges in gaseous dielectric circuit under AC and DC voltages. A gaseous dielectric circuit is made such that a pair of electrode of typical geometry is used to make the discharges occur under application of AC and DC voltages. Later on, composite insulation system with air gap is also studied. Discharge response of the dielectric circuit is measured across a typically designed impedance. The time evolution of the discharge characteristics showed some interesting chaotic behavior. Author here proposed some analysis of such behavior of the discharge pattern and discussed about the possibility of presence of such discharge circuit in lumped electric circuit.

Keywords: electrical insulation system, EIS, composite dielectric, discharge, chaos

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Authors: Gassrm Alfaleh

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The new Law of Universities has many goals, one of them is how each university can be independent financially and educationally. Another goal is to open doors for foreign universities to open branches in the kingdom. This paper focuses on how these goals can create competition between local and foreign universities. And how this new law can bring significant changes in the Kingdom’s higher education sector. The methodology of this study is to compare the new Saudi law to another legal system, especially in Australia. And how this new law can affect the higher education environment and Saudi culture. It covers the view of other different legal jurisdictions and compares it to this new law. The major findings are that the new law of universities can give a chance to Saudi universities to achieve their goals based on empowerment, quality, and participate in developing the educational and research methods. It may allow universities to start their own resources, permit them to create endowments and companies, and may allow them to create their degrees and programs. It will help those universities to increase the efficiency of spending, developing financial resources, and human capabilities for universities in line with the Kingdom’s Vision 2030. As a result, this paper states whether this new law can improve higher education in the kingdom of Saudi Arabia.

Keywords: law, education, Saudi legal system, university

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Authors: Siyamthanda Makhwabe

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Tourism development and spatial planning within the broader spectrum of the Eastern Cape needs to be strategically integrated to give effectiveness to development planning within the province. Tourism was severely affected and limited by policies of the previous regime. Tourism development in the Eastern Cape has been identified as one of the underdeveloped sectors that have the potential to improve the province’s local economic development trajectory The proposed study reviews literature on tourism development in an urban/rural and regional context in the Eastern Cape province. The proposed study will therefore offer an in-depth literature review on issues pertaining to spatial planning, land use management policies and tourism development within the Eastern Cape using the scoping review method. The intention of the proposed study is to identify synergies between the intertwined municipalities within the Wild Coast region in order to create a tourism belt that would yield benefit from Coffee Bay to East London.

Keywords: development, Eastern Cape, policies, spatial planning, tourism

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Authors: M. Keršič, M. Lužnik, J. Lužnik

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Cervical dilatation and membrane herniation before 26th week of gestation poses very high risk for extremely and very premature childbirth. Cerclage with mesh cap (mesh cerclage, MC) can greatly diminish this risk and provide additional positive effects. Between 2005 and 2014, MC has been performed in 9 patients with singleton pregnancies who had prolapsed membranes beyond external cervical/uterine os before 25th week of pregnancy (one in 29th). With patients in general anaesthesia, lithotomy and Trendelenburg position (about 25°) prolapsed membranes were repositioned in the uterine cavity, using tampon soaked in antiseptic solution (Skinsept mucosa). A circular, a type of purse-string suture (main band) with double string Ethilon 1 was applied at about 1 to 1.5 cm from the border of the external uterine os - 6 to 8 stitches were placed, so the whole external uterine os was encircled (modified McDonald). In the next step additional Ethilon 0 sutures were placed around all exposed parts of the main double circular suture and loosely tightened. On those sutures, round tailored (diameter around 6 cm) mesh (Prolene® or Gynemesh* PS) was attached. In all 9 cases, gestation was prolonged on average for 9 weeks and 4 days (67 days). In four cases maturity was achieved. Mesh was removed in 37th–38th week of pregnancy or if spontaneous labour began. In two cases, a caesarean section was performed because of breech presentation. In the first week after birth in 22nd week one new born died because of immaturity (premature birth was threatening in 18th week and then MC was placed). Ten years after first MC, 8 of 9 women with singleton pregnancy and MC performed have 8 healthy children from these pregnancies. Mesh cerclage successfully closed the opened cervical canal or uterine orifice and prevented further membrane herniation and membrane rupture. MC also provides a similar effect as with occluding the external os with suturing but without interrupting the way for excretion of abundant cervical mucus. The mesh also pulls the main circular band outwards and thus lowers the chance of suture cutting through the remaining cervix. MC prolonged gestation very successfully (mean for 9 weeks and 4 days) and thus increased possibility for survival and diminished the risk for complications in very early preterm delivered survivors in cases with cervical dilatation and membrane herniation before 26th week of gestation. Without action possibility to achieve at least 28th or 32nd week of gestation would be poor.

Keywords: cervical insufficiency, mesh cerclage, membrane protrusion, premature birth prevention, physical exam-indicated cerclage, rescue cerclage

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Authors: Isaac Kofi Mensah

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Public sector organizations, ministries, departments and local government agencies are adopting e-government as a means to provide efficient and quality service delivery to citizens. The purpose of this research paper is to examine the extent to which perceived usefulness (PU) of e-government services moderates between perceived ease-of-use (PEOU) of e-government services and intention to use (IU) e-government services in Ghana. A structured research questionnaire instrument was developed and administered to 700 potential respondents in Ghana, of which 693 responded, representing 99% of the questionnaires distributed. The Technology Acceptance Model (TAM) was used as the theoretical framework for the study. The Statistical Package for Social Science (SPSS) was used to capture and analyze the data. The results indicate that even though predictors such as PU and PEOU are main determiners of citizens’ intention to adopt and use e-government services in Ghana, it failed to show that PEOU and IU e-government services in Ghana is significantly moderated by the PU of e-government services. The implication of this finding on theory and practice is further discussed.

Keywords: e-government services, intention to use, moderating role, perceived ease of use, perceived usefulness, Ghana, technology acceptance model

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Authors: Syed Hamid Farooq Bukhari

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This study intends to clarify the Friday sermon by evaluating the formation of its discourse, the composition, and selection of its subject matters, the structure, and functions of its rules as well as the outline of its communication proceeds, and the distinctiveness of its words along with definite provisions. In this research, a qualitative and descriptive method is used to draw out conclusions. This paper considers the sermon mechanism of the speech and advances it contextually. The information was composed in Pakistan and several of its mosques supposing the imams of the city and the location of the mosques. The presentation and analysis of the facts have directed to the subsequent conclusions: (1) the Friday sermon holds verbal discussion that has habitual and classic formation, (2) the approaches of the formation of the subjects consist of storytelling, quotation as well as the use of accepted terms, (3) the composition of the codes involves Arabic, English, Urdu, and many other local languages, (4) the expressions of the speech include all types of sermon acts, (5) different requisites emerge in the sermons demonstrating that the Friday sermon functions as an index or usage of verbal communication in an exacting field.

Keywords: Friday, sermons, Pakistan, social

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Authors: Nino Sulava, Brian Gilmour, Nana Rezesidze, Tamar Beridze, Rusudan Chagelishvili

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Studies of ancient metallurgy are a subject of worldwide current interest. Georgia with its famous early metalworking traditions is one of the central parts of in the Caucasus region. The aim of the present study is to introduce the results of archaeometallurgical investigations being undertaken in the mountain region of Colchis, Lechkhumi (the Tsageri Municipality of western Georgia) and establish their place in the existing archaeological context. Lechkhumi (one of the historic provinces of Georgia known from Georgian, Greek, Byzantine and Armenian written sources as Lechkhumi/Skvimnia/Takveri) is the part of the Colchian mountain area. It is one of the important but little known centres of prehistoric metallurgy in the Caucasian region and of Colchian Bronze Age culture. Reconnaissance archaeological expeditions (2011-2015) revealed significant prehistoric metallurgical sites in Lechkhumi. Sites located in the vicinity of Dogurashi Village (Tsageri Municipality) have become the target area for archaeological excavations. During archaeological excavations conducted in 2016-2018 two archaeometallurgical sites – Dogurashi I and Dogurashi II were investigated. As a result of an interdisciplinary (archaeological, geological and geophysical) survey, it has been established that at both prehistoric Dogurashi mountain sites, it was copper that was being smelted and the ore sources are likely to be of local origin. Radiocarbon dating results confirm they were operating between about the 13th and 9th century BC. More recently another similar site has been identified in this area (Dogurashi III), and this is about to undergo detailed investigation. Other prehistoric metallurgical sites are being located and investigated in the Lechkhumi region as well as chance archaeological finds (often in hoards) – copper ingots, metallurgical production debris, slag, fragments of crucibles, tuyeres (air delivery pipes), furnace wall fragments and other related waste debris. Other chance finds being investigated are the many copper, bronze and (some) iron artefacts that have been found over many years. These include copper ingots, copper, bronze and iron artefacts such as tools, jewelry, and decorative items. These show the important but little known or understood the role of Lechkhumi in the late Bronze Age culture of Colchis. It would seem that mining and metallurgical manufacture form part of the local agricultural yearly lifecycle. Colchian ceramics have been found and also evidence for artefact production, small stone mould fragments and encrusted material from the casting of a fylfot (swastika) form of Colchian bronze buckle found in the vicinities of the early settlements of Tskheta and Dekhviri. Excavation and investigation of previously unknown archaeometallurgical sites in Lechkhumi will contribute significantly to the knowledge and understanding of prehistoric Colchian metallurgy in western Georgia (Adjara, Guria, Samegrelo, and Svaneti) and will reveal the importance of this region in the study of ancient metallurgy in Georgia and the Caucasus. Acknowledgment: This work has been supported by the Shota Rustaveli National Science Foundation (grant FR # 217128).

Keywords: archaeometallurgy, Colchis, copper, Lechkhumi

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Authors: S. H. Borghei, E. Teymourian, M. Mobin, G. M. Komaki, S. Sheikh

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Imperialist competitive algorithm (ICA) is a recent meta-heuristic method that is inspired by the social evolutions for solving NP-Hard problems. The ICA is a population based algorithm which has achieved a great performance in comparison to other meta-heuristics. This study is about developing enhanced ICA approach to solve the cell formation problem (CFP) using sequence data. In addition to the conventional ICA, an enhanced version of ICA, namely EICA, applies local search techniques to add more intensification aptitude and embed the features of exploration and intensification more successfully. Suitable performance measures are used to compare the proposed algorithms with some other powerful solution approaches in the literature. In the same way, for checking the proficiency of algorithms, forty test problems are presented. Five benchmark problems have sequence data, and other ones are based on 0-1 matrices modified to sequence based problems. Computational results elucidate the efficiency of the EICA in solving CFP problems.

Keywords: cell formation problem, group technology, imperialist competitive algorithm, sequence data

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Authors: Camille Rich, Nadine Ferris France, Ann Nolan, Webster Mavhu, Vongai Munatsi

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Background and Aim: Zimbabwe has one of the highest HIV rates in the world, with a 12.7% adult prevalence rate. Young adults are a key group affected by HIV, and one-third of all new infections in Zimbabwe are amongst people ages 18-24 years. Stigma remains one of the main barriers to managing and reducing the HIV crisis, especially for young adults. There are several types of stigma, including enacted stigma, the outward discrimination towards someone and self-stigma, the negative self-judgments one has towards themselves. Self-stigma can have severe consequences, including feelings of worthlessness, shame, suicidal thoughts, and avoidance of medical help. This can have detrimental effects on those living with HIV. However, the unique beliefs and impacts of self-stigma amongst key groups living with HIV have not yet been explored. Therefore, the focus of this study is on the beliefs and experiences of HIV-related self-stigma, as experienced by young adults living in Harare, Zimbabwe. Research Methods: A qualitative approach was taken for this study, using sixteen semi-structured interviews with young adults (18-24 years) who are living with HIV in Harare. Participants were conveniently and purposefully sampled as members of Africa, an organization dedicated to young people living with HIV. Interviews were conducted over Zoom due to the COVID-19 pandemic, recorded and then coded using the software NVivo. The data was analyzed using both inductive and deductive Thematic Analysis to find common themes. Results: All of the participants experienced HIV-related self-stigma, and both beliefs and experiences were explored. These negative self-perceptions included beliefs of worthlessness, hopelessness, and negative body image. The young adults described believing they were not good enough to be around HIV negative people or that they could never be loved due to their HIV status. Developing self-stigmatizing thoughts came from internalizing negative cultural values, stereotypes about people living with HIV, and adverse experiences. Three main themes of self-stigmatizing experiences emerged: disclosure difficulties, relationship complications, and being isolated. Fear of telling someone their status, rejection in a relationship, and being excluded by others due to their HIV status contributed to their self-stigma. These experiences caused feelings of loneliness, sadness, shame, fear, and low self-worth. Conclusions: This study explored the beliefs and experiences of HIV-related self-stigma of these young adults. The emergence of negative self-perceptions demonstrated deep-rooted beliefs of HIV-related self-stigma that adversely impact the participants. The negative self-perceptions and self-stigmatizing experiences caused the participants to feel worthless, hopeless, shameful, and alone-negatively impacting their physical and mental health, personal relationships, and sense of self-identity. These results can now be used to pursue interventions to target the specific beliefs and experiences of young adults living with HIV and reduce the adverse consequences of self-stigma.

Keywords: beliefs, HIV, self-stigma, stigma, Zimbabwe

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Authors: Roya Yumul, Chse, Ofelia Loani Elvir Lazo, David Chernobylsky, Omar Durra

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Background: Preoperative anxiety has been shown to be caused by the fear associated with surgical and anesthetic complications; however, the current gold standard for assessing patient anxiety, the STAI, is problematic to use in the preoperative setting given the duration and concentration required to complete the 40-item extensive questionnaire. Our primary aim in the study is to investigate the correlation of the Visual Facial Anxiety Scale (VFAS) and Numerical Verbal Rating Scale (NVRS) to State-Trait Anxiety Inventory (STAI) to determine the optimal anxiety scale to use in the perioperative setting. Methods: A clinical study of patients undergoing various surgeries was conducted utilizing each of the preoperative anxiety scales. Inclusion criteria included patients undergoing elective surgeries, while exclusion criteria included patients with anesthesia contraindications, inability to comprehend instructions, impaired judgement, substance abuse history, and those pregnant or lactating. 293 patients were analyzed in terms of demographics, anxiety scale survey results, and anesthesia data via Spearman Coefficients, Chi-Squared Analysis, and Fischer’s exact test utilized for comparison analysis. Results: Statistical analysis showed that VFAS had a higher correlation to STAI than NVRS (rs=0.66, p<0.0001 vs. rs=0.64, p<0.0001). The combined VFAS-Categorization Scores showed the highest correlation with the gold standard (rs=0.72, p<0.0001). Subgroup analysis showed similar results. STAI evaluation time (247.7 ± 54.81 sec) far exceeds VFAS (7.29 ± 1.61 sec), NVRS (7.23 ± 1.60 sec), and Categorization scales (7.29 ± 1.99 sec). Patients preferred VFAS (54.4%), Categorization (11.6%), and NVRS (8.8%). Anesthesiologists preferred VFAS (63.9%), NVRS (22.1%), and Categorization Scales (14.0%). Of note, the top five causes of preoperative anxiety were determined to be waiting (56.5%), pain (42.5%), family concerns (40.5%), no information about surgery (40.1%), or anesthesia (31.6%). Conclusions: Combined VFAS-Categorization Score (VCS) demonstrates the highest correlation to the gold standard, STAI. Both VFAS and Categorization tests also take significantly less time than STAI, which is critical in the preoperative setting. Among both patients and anesthesiologists, VFAS was the most preferred scale. This forms the basis of the Yumul FACES Anxiety Scale, designed for quick quantization and assessment in the preoperative setting while maintaining a high correlation to the golden standard. Additional studies using the formulated Yumul FACES Anxiety Scale are merited.

Keywords: numerical verbal anxiety scale, preoperative anxiety, state-trait anxiety inventory, visual facial anxiety scale

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Authors: Yun-Shan Tsai, Si-Ping Lin, En-Chieh Lin, Xin-Hong Chen, Shin-Yun Ho, Shin-Hong Huang, Ching-ju Hsieh

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Background and significance: Uncorrected refractive errors and cataracts are the main visually debilitating ophthalmological abnormalities in adult participants with intellectual disability (ID). However, not all adult participants with ID may receive a regular and timely ophthalmological assessment. Consequently, some of the ocular diseases may not be diagnosed until late, thereby causing unnecessary ocular morbidity. In addition, recent clinical practice and researches have also suggested that eye-care services for this group are neglected. Purpose: To investigate the unmet need for eye care services, clinical characteristics of cataract, visual function, surgical outcome and prognostic predictors in adult participants with ID at Taipei City Hospital in Taiwan. Methods: This is a one-year prospective clinical study. We recruited about 120 eyes of 60 adult participants with ID who were received cataract surgery. Caregivers of all participants received a questionnaire on current eye care services. Clinical demographic data, such as age, gender, and associated systemic diseases or syndromes, were collected. All complete ophthalmologic examinations were performed 1 month preoperatively and 3 months postoperatively, including ocular biometry, visual function, refractive status, morphology of cataract, associated ocular features, anesthesia methods, surgical types, and complications. Morphology of cataract, visual and surgical outcome was analyzed. Results: A total of 60 participants with mean age 43.66 ± 13.94 years, including 59.02% male and 40.98% female, took part in comprehensive eye-care services. The prevalence of unmet need for eye care services was high (about 70%). About 50% of adult participants with ID have bilateral cataracts at the time of diagnosis. White cataracts were noted in about 30% of all adult participants with ID at the time of presentation. Associated ocular disorders were included myopic maculopathy (4.54%), corneal disorders (11.36%), nystagmus (20.45%), strabismus (38.64%) and glaucoma (2.27%). About 26.7% of adult participants with ID underwent extracapsular cataract extraction whereas a phacoemulsification was performed in 100% of eyes. Intraocular lens implantation was performed in all eyes. The most common postoperative complication was posterior capsular opacification (30%). The mean best-corrected visual acuity was significantly improved from preoperatively (mean log MAR 0.48 ± 0.22) to at 3 months postoperatively (mean log MAR 0.045 ± 0.22) (p < .05). Conclusions: Regular follow up will help address the need for eye-care services in participants with ID. A high incidence of bilateral cataracts, as well as white cataracts, was observed in adult participants with ID. Because of early diagnosis and early intervention of cataract, the visual and surgical outcomes of cataract are good, but the visual outcomes are suboptimal due to associated ocular comorbidities.

Keywords: adult participants with intellectual disability, cataract, cataract surgery

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Authors: Xu Mengyuan, Xu Lei

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Behind the rapid development of Chinese city, the contradiction of frequent urban waterlogging and the shortage of water resources is deepening. In order to solve this problem, introduce the low impact development "sponge city" construction mode in the process of the construction of new urbanization in China, make our city " resilience to adapt" environmental change and natural disaster. Firstly this paper analyses the basic reason of urban waterlogging, then introduces the basic connotation and realization approach of “sponge city”. Finally, study on the project in Lishui Guazhou, focuses on the analysis of the "urban ecological corridor" construction strategy and the positive impact on city in the construction of “sponge city”. Meanwhile, we put forward the ”local conditions” and ”sustainable” as the construction ideas, make use of ecological construction leading city development, explore the ecological balance through the city to enhance the regional value, and providing reference and reflection for the development and future of the “sponge city” in China.

Keywords: urban water logging, sponge city, urban ecological corridor, sustainable development, China

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Authors: Clemens Pizzinini, Philipp Rosner, David Ziegler, Markus Lienkamp

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Transportation is a constitutional part of most supply and value chains in modern economies. Smallholder farmers in rural Ethiopia face severe challenges along their supply and value chains. In particular, suitable, affordable, and available transport services are in high demand. To develop a context-specific technical solutions, a problem-to-solution methodology based on the interaction with technology is developed. With this approach, we fill the gap between proven transportation assessment frameworks and general user-centered techniques. Central to our approach is an electric test vehicle that is implemented in rural supply and value chains for research, development, and testing. Based on our objective and the derived methodological requirements, a set of existing methods is selected. Local partners are integrated into an organizational framework that executes major parts of this research endeavour in the Arsi Zone, Oromia Region, Ethiopia.

Keywords: agricultural value chain, participatory methods, agile methods, sub-Saharan Africa, Ethiopia, electric vehicle, transport service

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