Search results for: medical imaging analysis

Authors: Ling-Lang Huang

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Research Background: Historically, the evolution of medicine has not only aimed to extend life but has also inadvertently introduced suffering in the process of maintaining life, presenting a contemporary challenge. We must carefully assess the conflict between the length of life and the quality of living. Evidence-Based Medicine (EBM) exists primarily to ensure the quality of cures. However, EBM alone does not fulfill our ultimate medical goals; we must also evaluate Value-Based Medicine (VBM) to find the best treatment for patients. Research Methodology: We can attempt to integrate EBM with VBM. Within the five steps of EBM, the first three steps (Ask—Acquire—Appraise) focus on the physical aspect of humans. However, in the fourth and fifth steps (Apply—Assess), the focus shifts from the physical to applying evidence-based treatment to the patient and assessing its effectiveness, considering a holistic approach to the individual. To consider VBM for patients, we can divide the process into three steps: The first step is "awareness," recognizing that each patient inhabits a different life-world and possesses unique differences. The second step is "integration," akin to the hermeneutic concept of the Fusion of Horizons. This means being aware of differences and also understanding the origins of these patient differences. The third step is "respect," which involves setting aside our adherence to medical objectivity and scientific rigor to respect the ultimate healthcare decisions made by individuals regarding their lives. Discussion and Conclusion: After completing these three steps of VBM, we can return to the fifth step of EBM: Assess. Our assessment can now transcend the physical treatment focus of the initial steps to align with a holistic care philosophy.

Keywords: shared decision-making, evidence-based medicine, values-based medicine, holistic healthcare

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Authors: Manish Kumar Pillai, Madhavi Pathak Pillai, Rajender Lal, Dinesh P. Sharma

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India has not yet been able to produce many weightlifters in the past years. Karnam Malleshwari is the only woman to win a medal for India in Olympics. When we try to introspect, there seem to be different reasons. One of the probable cause could be the lack of biomechanical analysis for technique improvements. The analysis of motion in sports has gained prime importance for technical improvement. It helps an athlete to develop a better understanding of his own skills and increasing the rate of technical learning process. Kinematics is concerned with describing and quantifying both the linear and angular position of bodies and their time derivatives. The techniques analysis of barbell movement is very important in weightlifting. But women weightlifting has a shorter history than men’s. Research on women weightlifting based on video analysis is less; there is a lack of scientific evidence based on kinematic analysis of especially on Indian weightlifters at national level are limited. Hence, the present investigation was aimed to analyze the barbell kinematics of women weightlifters in India. The study was delimited to the medal winners of 69-kilogram weight category in the All India Inter-University Competition, age ranging between 18 and 28 years. The variables selected for the mechanical analysis of Barbell kinematics included barbell trajectory, velocity, acceleration, potential energy, kinetic energy, mechanical energy, and average power output. The performance was captured during the competition by two DV PC-60 Digital cameras (Panasonic Company, Ltd). Two cameras were placed 6-meters perpendicular to the plane of the motion, 130 cm. above the ground to record/capture the frontal and lateral view of the lifters simultaneously. Video recordings were analyzed by using Dartfish software, and barbell kinematics were analyzed with the information derived with the help of software. The result documented on the basis of the finding of the study clearly states that there are differences in the selected kinematic variables in all three lifters in respect to their technique in five phases during snatch technique using by them.

Keywords: dartfish, digital camera, kinematic, snatch, weightlifting

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Authors: Breanna Wright, Peter Bragge

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Diagnostic error rates in healthcare are approximately 10% of cases. Diagnostic errors can cause patient harm due to inappropriate, inadequate or delayed treatment, and such errors contribute heavily to medical liability claims globally. Therefore, addressing diagnostic error is a high priority. In most cases, diagnostic errors are the result of faulty information synthesis rather than lack of knowledge. Specifically, the majority of diagnostic errors involve cognitive factors, and in particular, cognitive biases. Emergency Departments are an environment with heightened risk of diagnostic error due to time and resource pressures, a frequently chaotic environment, and patients arriving undifferentiated and with minimal context. This project aimed to develop a behavioural, evidence-informed intervention to reduce diagnostic error in Emergency Departments through co-design with emergency physicians, insurers, researchers, hospital managers, citizens and consumer representatives. The Forum Process was utilised to address this aim. This involves convening a small (4 – 6 member) expert panel to guide a focused literature and practice review; convening of a 10 – 12 person citizens panel to gather perspectives of laypeople, including those affected by misdiagnoses; and a 18 – 22 person structured stakeholder dialogue bringing together representatives of the aforementioned stakeholder groups. The process not only provides in-depth analysis of the problem and associated behaviours, but brings together expertise and insight to facilitate identification of a behaviour change intervention. Informed by the literature and practice review, the Citizens Panel focused on eliciting the values and concerns of those affected or potentially affected by diagnostic error. Citizens were comfortable with diagnostic uncertainty if doctors were honest with them. They also emphasised the importance of open communication between doctors and patients and their families. Citizens expect more consistent standards across the state and better access for both patients and their doctors to patient health information to avoid time-consuming re-taking of long patient histories and medication regimes when re-presenting at Emergency Departments and to reduce the risk of unintentional omissions. The structured Stakeholder Dialogue focused on identifying a feasible behavioural intervention to review diagnoses in Emergency Departments. This needed to consider the role of cognitive bias in medical decision-making; contextual factors (in Victoria, there is a legislated 4-hour maximum time between ED triage and discharge / hospital admission); resource availability; and the need to ensure the intervention could work in large metropolitan as well as small rural and regional ED settings across Victoria. The identified behavioural intervention will be piloted in approximately ten hospital EDs across Victoria, Australia. This presentation will detail the findings of all review and consultation activities, describe the behavioural intervention developed and present results of the pilot trial.

Keywords: behavioural intervention, cognitive bias, decision-making, diagnostic error

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Authors: Yi Zhang, Yuan Tian, Jiehua Chen, Sihong Gu

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Chip-scale spin-exchange relaxation free (SERF) atomic magnetometer makes use of millimeter-scale vapor cells micro-fabricated by Micro-electromechanical Systems (MEMS) technique and SERF mechanism, resulting in the characteristics of high spatial resolution and high sensitivity. It is useful for biomagnetic imaging including magnetoencephalography and magnetocardiography. In a prevailing scheme, circularly polarized on-resonance laser beam is adapted for both pumping and probing the atomic polarization. And the magnetic-field-sensitive signal is extracted by transmission laser intensity enhancement as a result of atomic polarization increase on zero field level crossing resonance. The scheme is very suitable for integration, however, the laser amplitude modulation (AM) noise and laser frequency modulation to amplitude modulation (FM-AM) noise is superimposed on the photon shot noise reducing the signal to noise ratio (SNR). To suppress AM and FM-AM noise the paper puts forward a novel scheme which adopts circularly polarized on-resonance light pumping and linearly polarized frequency-detuning laser probing. The transmission beam is divided into transmission and reflection beams by a polarization analyzer, the angle between the analyzer's transmission polarization axis and frequency-detuning laser polarization direction is set to 45°. The magnetic-field-sensitive signal is extracted by polarization rotation enhancement of frequency-detuning laser which induces two beams intensity difference increase as the atomic polarization increases. Therefore, AM and FM-AM noise in two beams are common-mode and can be almost entirely canceled by differential detection. We have carried out an experiment to study our scheme. The experiment reveals that the noise in the differential signal is obviously smaller than that in each beam. The scheme is promising to be applied for developing more sensitive chip-scale magnetometer.

Keywords: atomic magnetometer, chip scale, differential detection, spin-exchange relaxation free

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Authors: Seden Demirtaş, Feyza Tantekin Erden

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The importance of research in early childhood education is growing all around the world. This study aims to investigate research trends in graduate theses written in Turkey in the area of early childhood education. Descriptive, contextual and methodological aspects of graduate theses were analyzed to investigate the trends. A sample of the study consisted of 1000 graduate theses (n= 1000) including both MS theses and Ph.D. dissertations. Theses and dissertations were obtained from the thesis database of Council of Higher Education (CoHE). An investigation form was developed by the researcher to analyze graduate theses. The investigation forms validated by expert opinion from early childhood education department. To enhance the reliability of the investigation form, inter-coder agreement was measured by Cohen’s Kappa value (.86). Data were gathered via using the investigation form, and content analysis method was used to analyze the data. Results of the analysis were presented by descriptive statistics and frequency tables. Analysis of the study is on-going and preliminary results of the study show that master theses related to early childhood education have started to be written in 1986, and the number of the theses has increased gradually. In most of the studies, sample group consisted of children especially in between 5-6 age group. Child development, activities (applied in daily curriculum of preschools) and teaching methods are the mostly examined concepts in graduate theses. Qualitative and quantitative research methods were referred equally by researchers in these theses.

Keywords: content analysis, early childhood education, graduate thesis, research trends

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Authors: Peter W. Woodruff, Georgios Ponirakis, Reem Ibrahim, Amani Ahmed, Hoda Gad, Ioannis N. Petropoulos, Adnan Khan, Ahmed Elsotouhy, Surjith Vattoth, Mahmoud K. M. Alshawwaf, Mohamed Adil Shah Khoodoruth, Marwan Ramadan, Anjushri Bhagat, James Currie, Ziyad Mahfoud, Hanadi Al Hamad, Ahmed Own, Peter Haddad, Majid Alabdulla, Rayaz A. Malik

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Introduction:- We aimed to test the hypothesis that, using corneal confocal microscopy (a non-invasive method for assessing corneal nerve fibre integrity), patients with schizophrenia would show neuronal abnormalities compared with healthy participants. Schizophrenia is a neurodevelopmental and progressive neurodegenerative disease, for which there are no validated biomarkers. Corneal confocal microscopy (CCM) is a non-invasive ophthalmic imaging biomarker that can be used to detect neuronal abnormalities in neuropsychiatric syndromes. Methods:- Patients with schizophrenia (DSM-V criteria) without other causes of peripheral neuropathy and healthy controls underwent CCM, vibration perception threshold (VPT) and sudomotor function testing. The diagnostic accuracy of CCM in distinguishing patients from controls was assessed using the area under the curve (AUC) of the Receiver Operating Characterstics (ROC) curve. Findings:- Participants with schizophrenia (n=17) and controls (n=38) with comparable age (35.7±8.5 vs 35.6±12.2, P=0.96) were recruited. Patients with schizophrenia had significantly higher body weight (93.9±25.5 vs 77.1±10.1, P=0.02), lower Low Density Lipoproteins (2.6±1.0 vs 3.4±0.7, P=0.02), but comparable systolic and diastolic blood pressure, HbA1c, total cholesterol, triglycerides and High Density Lipoproteins were comparable with control participants. Patients with schizophrenia had significantly lower corneal nerve fiber density (CNFD, fibers/mm2) (23.5±7.8 vs 35.6±6.5, p<0.0001), branch density (CNBD, branches/mm2) (34.4±26.9 vs 98.1±30.6, p<0.0001), and fiber length (CNFL, mm/mm2) (14.3±4.7 vs 24.2±3.9, p<0.0001) but no difference in VPT (6.1±3.1 vs 4.5±2.8, p=0.12) and electrochemical skin conductance (61.0±24.0 vs 68.9±12.3, p=0.23) compared with controls. The diagnostic accuracy of CNFD, CNBD and CNFL to distinguish patients with schizophrenia from healthy controls were, according to the AUC, (95% CI): 87.0% (76.8-98.2), 93.2% (84.2-102.3), 93.2% (84.4-102.1), respectively. Conclusion:- In conclusion, CCM can be used to help identify neuronal changes and has a high diagnostic accuracy to distinguish subjects with schizophrenia from healthy controls.

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Authors: Armando Cartenì, Ilaria Henke

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Recently, the Italian government has approved a new law for public contracts and has been laying the groundwork for restarting a planning phase. The government has adopted the indications given by the European Commission regarding the estimation of the external costs within the Cost-Benefit Analysis, and has been approved the ‘Guidelines for assessment of Investment Projects’. In compliance with the new Italian law, the aim of this research was to perform a feasibility study applying quantitative methods regarding the revamping of an Italian tourist railway line. A Cost-Benefit Analysis was performed starting from the quantification of the passengers’ demand potentially interested in using the revamped rail services. The benefits due to the external costs reduction were also estimated (quantified) in terms of variations (with respect to the not project scenario): climate change, air pollution, noises, congestion, and accidents. Estimations results have been proposed in terms of the Measure of Effectiveness underlying a positive Net Present Value equal to about 27 million of Euros, an Internal Rate of Return much greater the discount rate, a benefit/cost ratio equal to 2 and a PayBack Period of 15 years.

Keywords: cost-benefit analysis, evaluation analysis, demand management, external cost, transport planning, quality

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Authors: Anusha Vaddiraj Pallapu

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Measuring urban sustainable development is at the forefront in contributing to overall sustainability, and it refers to attaining social equity, environmental protection and minimizing the impacts of urbanization. Assessing performance of urban issues ranging from larger consumption of natural resources by humans in terms of lifestyle to creating a polluted nearby environment, social and even economic dimensions of sustainability major issues observed such as water quality, transportation, management of solid waste and traffic pollution. However, relying on the framework of the project to do the goals of sustainable development or minimization of urban impacts through management practices is not enough to deal with the present urban issues. The aim of the sustainability is to know how severely the resources are depleted because of human consumption and how issues are characterized. The paper aims to assign benchmarks for the selected sustainability indicators for research, and analysis is done through multivariate analysis in Indian context a case of Nagpur city to identify the play role of each urban issues in the overall sustainability. The main objectives of this paper are to examine the indicators over by time basis on various scenarios and how benchmarking is used, what and which categories of values should be considered as the performance of indicators function.

Keywords: environmental sustainability indicators, principal component analysis, urban sustainability, urban clusters, benchmarking

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Authors: Mudassir Ghafoor, Irsalan Arif, Shuaib Salamat

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This paper presents modeling and analysis of different intake bump (compression surface) configurations and comparison with an existing supersonic aircraft having bump intake configuration. Many successful aircraft models have shown that Diverter less Supersonic Inlet (DSI) as compared to conventional intake can reduce weight, complexity and also maintenance cost. The research is divided into two parts. In the first part, four different intake bumps are modeled for comparative analysis keeping in view the consistency of outer perimeter dimensions of fighter aircraft and various characteristics such as flow behavior, boundary layer diversion and pressure recovery are analyzed. In the second part, modeled bumps are integrated with intake duct for performance analysis and comparison with existing supersonic aircraft data is carried out. The bumps are named as uniform large (Config 1), uniform small (Config 2), uniform sharp (Config 3), non-uniform (Config 4) based on their geometric features. Analysis is carried out at different Mach Numbers to analyze flow behavior in subsonic and supersonic regime. Flow behavior, boundary layer diversion and Pressure recovery are examined for each bump characteristics, and comparative study is carried out. The analysis reveals that at subsonic speed, Config 1 and Config 2 give similar pressure recoveries as diverterless supersonic intake, but difference in pressure recoveries becomes significant at supersonic speed. It was concluded from research that Config 1 gives better results as compared to Config 3. Also, higher amplitude (Config 1) is preferred over lower (Config 2 and 4). It was observed that maximum height of bump is preferred to be placed near cowl lip of intake duct.

Keywords: bump intake, boundary layer, computational fluid dynamics, diverter-less supersonic inlet

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Authors: K. Rana, H.A.Saeed, S. Zahir

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Inter Laminar Shear Stress (ILSS) is a main key parameter which quantify the properties of composite materials. These properties can ascertain the use of material for a specific purpose like aerospace, automotive etc. A modelling approach for determination of ILSS is presented in this paper. Geometric modelling of composite material is performed in TEXGEN software where reinforcement, cured matrix and their interfaces are modelled separately as per actual geometry. Mechanical properties of matrix and reinforcements are modelled separately which incorporated anisotropy in the real world composite material. ASTM D2344 is modelled in ANSYS for ILSS. In macroscopic analysis model approximates the anisotropy of the material and uses orthotropic properties by applying homogenization techniques. Shear Stress analysis in that case does not show the actual real world scenario and rather approximates it. In this paper actual geometry and properties of reinforcement and matrix are modelled to capture the actual stress state during the testing of samples as per ASTM standards. Testing of samples is also performed in order to validate the results. Fibre volume fraction of yarn is determined by image analysis of manufactured samples. Fibre volume fraction data is incorporated into the numerical model for correction of transversely isotropic properties of yarn. A comparison between experimental and simulated results is presented.

Keywords: ILSS, FEA, micromechanical, fibre volume fraction, image analysis

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Authors: Layal Mansour

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This paper breaks down Egypt’s financial crisis by constructing a customized financial stress index by including the vulnerable economic indicator “dollarization” as a vulnerable indicator in the credit and exchange sector. The Financial Stress Index for Egypt (FSIE) includes informative vulnerable indicators of the main financial sectors: the banking sector, the equities market, and the foreign exchange market. It is calculated on a monthly basis from 2010 to December 2022, so to report the two recent world’s most devastating financial crises: Covid 19 crisis and Ukraine-Russia War, in addition to the local 2016 and 2022 financial crises. We proceed first by a graphical analysis then by empirical analysis in running under Vector Autoregression (VAR) Model, dynamic causality tests between foreign reserves, dollarization rate, and FSIE. The graphical analysis shows that unexpectedly, Egypt’s economy seems to be immune to internal economic/political instabilities, however it is highly exposed to the foreign and exchange market. Empirical analysis confirms the graphical observations and proves that dollarization, or more precisely debt in foreign currency seems to be the main trigger of Egypt’s current financial crisis.

Keywords: egypt, financial crisis, financial stress index, dollarization, VAR model, causality tests

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Authors: Leo Carlo B. Rondina

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Self-image is an important factor to improve the self-esteem of the personnel. The purpose of the study is to determine the self-image of the police. The respondents were the 503 policemen assigned in different Police Station in Davao City, and they were chosen with the used of random sampling. With the used of Exploratory Factor Analysis (EFA), latent construct variables of police image were identified as follows; professionalism, obedience, morality and justice and fairness. Further, ordinal regression indicates statistical characteristics on ages 21-40 which means the age of the respondent statistically improves self-image.

Keywords: police image, exploratory factor analysis, ordinal regression, Galatea effect

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Authors: T. Almutairi, K. Naudi, N. Nairn, X. Ju, B. Eng, J. Whitters, A. Ayoub

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Purpose: At present Cone Beam Computed Tomography (CBCT) imaging does not record dental morphology accurately due to the scattering produced by metallic restorations and the reported magnification. The aim of this pilot study is the development and validation of a new method for the replacement of the distorted dentition of CBCT scans with the dental image captured by the digital intraoral camera. Materials and Method: Six dried skulls with orthodontics brackets on the teeth were used in this study. Three intra-oral markers made of dental stone were constructed which were attached to orthodontics brackets. The skulls were CBCT scanned, and occlusal surface was captured using TRIOS® 3D intraoral scanner. Marker based and surface based registrations were performed to fuse the digital intra-oral scan(IOS) into the CBCT models. This produced a new composite digital model of the skull and dentition. The skulls were scanned again using the commercially accurate Laser Faro® arm to produce the 'gold standard' model for the assessment of the accuracy of the developed method. The accuracy of the method was assessed by measuring the distance between the occlusal surfaces of the new composite model and the 'gold standard' 3D model of the skull and teeth. The procedure was repeated a week apart to measure the reproducibility of the method. Results: The results showed no statistically significant difference between the measurements on the first and second occasions. The absolute mean distance between the new composite model and the laser model ranged between 0.11 mm to 0.20 mm. Conclusion: The dentition of the CBCT can be accurately replaced with the dental image captured by the intra-oral scanner to create a composite model. This method will improve the accuracy of orthognathic surgical prediction planning, with the final goal of the fabrication of a physical occlusal wafer without to guide orthognathic surgery and eliminate the need for dental impression.

Keywords: orthognathic surgery, superimposition, models, cone beam computed tomography

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Authors: Mijoh A. Gbededo, Kapila Liyanage, Ilias Oraifige

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Decision making for sustainable manufacturing design and management requires critical considerations due to the complexity and partly conflicting issues of economic, social and environmental factors. Although there are tools capable of assessing the combination of one or two of the sustainability factors, the frameworks have not adequately integrated all the three factors. Case study and review of existing simulation applications also shows the approach lacks integration of the sustainability factors. In this paper we discussed the development of a simulation based framework for support of a holistic assessment of sustainable manufacturing design and management. To achieve this, a strategic approach is introduced to investigate the strengths and weaknesses of the existing decision supporting tools. Investigation reveals that Discrete Event Simulation (DES) can serve as a rock base for other Life Cycle Analysis frameworks. Simio-DES application optimizes systems for both economic and competitive advantage, Granta CES EduPack and SimaPro collate data for Material Flow Analysis and environmental Life Cycle Assessment, while social and stakeholders’ analysis is supported by Analytical Hierarchy Process, a Multi-Criteria Decision Analysis method. Such a common and integrated framework creates a platform for companies to build a computer simulation model of a real system and assess the impact of alternative solutions before implementing a chosen solution.

Keywords: discrete event simulation, life cycle sustainability analysis, manufacturing, sustainability

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Authors: Danish Farooq, Janos Juhasz

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Car-motorcycle accidents have been observed higher in recent years, which caused mainly riders’ fatalities and serious injuries. In-depth crash investigation methods aim to investigate the main factors which are likely involved in fatal road accidents and injury outcomes. The main objective of this study is to investigate the involved factors in car-motorcycle accidents in Budapest city. The procedure included statistical analysis and data sampling to identify car-motorcycle accidents by dominant accident types based on collision configurations. The police report was used as a data source for specified accidents, and simulation models were plotted according to scale (M 1:200). Car-motorcycle accidents were simulated in Virtual Crash software for 5 seconds before the collision. The simulation results showed that the main involved factors to car-motorcycle accidents were human behavior and view obstructions. The comprehensive, in-depth analysis also found that most of the car drivers and riders were unable to perform collision avoidance manoeuvres before the collision. This study can help the traffic safety authorities to focus on simulated involved factors to solve road safety issues in car-motorcycle accidents. The study also proposes safety measures to improve safe movements among road users.

Keywords: car motorcycle accidents, in-depth analysis, microscopic simulation, safety measures

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Authors: Changfeng Fu

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Sustainable urban development has been widely accepted a common sense in the modern urban planning and design. However, the measurement and assessment of urban sustainability, especially the quantitative assessment have been always an issue obsessing planning and design professionals. This paper will present an on-going research on the principles and technologies to develop a quantitative urban sustainability assessment principles and techniques which aim to integrate indicators, geospatial and geo-reference data, and assessment techniques together into a mechanism. It is based on the principles and techniques of geospatial analysis with GIS and statistical analysis methods. The decision-making technologies and methods such as AHP and SMART are also adopted to address overall assessment conclusions. The possible interfaces and presentation of data and quantitative assessment results are also described. This research is based on the knowledge, situations and data sources of UK, but it is potentially adaptable to other countries or regions. The implementation potentials of the mechanism are also discussed.

Keywords: urban sustainability assessment, quantitative analysis, sustainability indicator, geospatial data, big data

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Authors: Masoud Charkhabi

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We examine trade theory with this motivation. The full set of World Trade Organization data are organized into country-year pairs, each treated as a different entity. Topological Data Analysis reveals that among the 16 region and 240 region-year pairs there exists in fact a distinguishable group of region-period pairs. The generally accepted periods of shifts from dissimilar-dissimilar to similar-similar trade in goods among regions are examined from this new perspective. The period breaks are treated as cumulative and are flexible. This type of all-subsets analysis is motivated from computer science and is made possible with Lossy Compression and Graph Theory. The results question many patterns in similar-similar to dissimilar-dissimilar trade. They also show indications of economic shifts that only later become evident in other economic metrics.

Keywords: econometrics, globalization, network science, topological data, analysis, trade theory, visualization, world trade

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Authors: Aybike Ayfer Karadağ

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Today, the amount of water available is decreasing day by day due to global warming, environmental problems and population increase. To protect water resources, it is necessary to take a lot of measures from the global scale to the local scale. Some of these measures are related to spatial planning studies. In this study, the impact of water process analysis was assessed in the development of spatial planning for water conservation. The study was conducted in the Kovada sub-watershed (Isparta, Turkey). By means of water process analysis, the way to reach underground water of surface water in the study area is mapped. In this context, plant cover, soil and rock permeability were evaluated holistically with geographic information systems technologies. Then, on the map, water permeability is classified and this is spatially expressed. The findings show that the permeability of the water is different in the study case. As a result, the water permeability map needs to be included in the planning for water conservation planning.

Keywords: water, conservation, spatial planning, water process analysis

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Authors: Lv Shizeng, Han Xiao, Zhang Yi, Ding Wenjing

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The lunar sample storage device is mainly used for the preparation of the lunar samples, observation, physical analysis and other work. The lunar samples and operating equipment are placed directly inside the storage device. The inside of the storage device is a high purity nitrogen environment to ensure that the sample is not contaminated by the Earth's environment. In order to ensure that the water and oxygen indicators in the storage device meet the sample requirements, a dynamic gas cycle is required between the storage device and the external purification equipment. However, the internal gas disturbance in the storage device can affect the operation of the sample. In this paper, the storage device model is established, and the tetrahedral mesh is established by Tetra/Mixed method. The influence of different inlet position and gas flow on the internal flow field disturbance is calculated, and the disturbed flow area should be avoided during the sampling operation.

Keywords: lunar samples, gas disturbance, storage device, characteristic analysis

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Authors: Ecem Deniz Kırkpantur, Ozge Ecmel Onur, Tuba Cimilli Ozturk, Ebru Unal Akoglu

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Moyamoya disease is a unique chronic progressive cerebrovascular disease characterized by bilateral stenosis or occlusion of the arteries around the circle of Willis with prominent arterial collateral circulation. The occurrence of Moyamoya disease is related to immune, genetic and other factors. There is no curative treatment for Moyamoya disease. Secondary prevention for patients with symptomatic Moyamoya disease is largely centered on surgical revascularization techniques. We present here a 62-year old male presented with headache and vision loss for 2 days. He was previously diagnosed with hypertension and glaucoma. On physical examination, left eye movements were restricted medially, both eyes were hyperemic and their movements were painful. Other neurological and physical examination were normal. His vital signs and laboratory results were within normal limits. Computed tomography (CT) showed dilated vascular structures around both lateral ventricles and atherosclerotic changes inside the walls of internal carotid artery (ICA). Magnetic resonance imaging (MRI) and angiography (MRA) revealed dilated venous vascular structures around lateral ventricles and hyper-intense gliosis in periventricular white matter. Ischemic gliosis around the lateral ventricles were present in the Digital Subtracted Angiography (DSA). After the neurology, ophthalmology and neurosurgery consultation, the patient was diagnosed with Moyamoya disease, pulse steroid therapy was started for vision loss, and super-selective DSA was planned for further investigation. Moyamoya disease is a rare condition, but it can be an important cause of stroke in both children and adults. It generally affects anterior circulation, but posterior cerebral circulation may also be affected, as well. In the differential diagnosis of acute vision loss, occipital stroke related to Moyamoya disease should be considered. Direct and indirect surgical revascularization surgeries may be used to effectively revascularize affected brain areas, and have been shown to reduce risk of stroke.

Keywords: headache, Moyamoya disease, stroke, visual loss

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Authors: Collen Kawiya

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In an effort of reducing post-harvest losses and improving the supply of quality fish products in Malawi, the fish solar tent dryers have been designed in the southern part of Lake Malawi for processing small fish species under the project of Cultivate Africa’s Future (CultiAF). This study was done to promote the adoption of the fish solar tent dryers by the many small scale fish processors in Malawi through the assessment of the economic viability of these dryers. With the use of the project’s baseline survey data, a business model for a constructed ‘ready for use’ solar tent dryer was developed where investment appraisal techniques were calculated in addition with the sensitivity analysis. The study also conducted a risk analysis through the use of the Monte Carlo simulation technique and a probabilistic net present value was found. The investment appraisal results showed that the net present value was US$8,756.85, the internal rate of return was 62% higher than the 16.32% cost of capital and the payback period was 1.64 years. The sensitivity analysis results showed that only two input variables influenced the fish solar dryer investment’s net present value. These are the dried fish selling prices that were correlating positively with the net present value and the fresh fish buying prices that were negatively correlating with the net present value. Risk analysis results showed that the chances that fish processors will make a loss from this type of investment are 17.56%. It was also observed that there exist only a 0.20 probability of experiencing a negative net present value from this type of investment. Lastly, the study found that the net present value of the fish solar tent dryer’s investment is still robust in spite of any changes in the levels of investors risk preferences. With these results, it is concluded that the fish solar tent dryers in Malawi are an economically viable investment because they are able to improve the returns in the fish processing activity. As such, fish processors need to adopt them by investing their money to construct and use them.

Keywords: investment appraisal, risk analysis, sensitivity analysis, solar tent drying

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Authors: Jolanta Jonak, Sylvia Tolczyk

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Students demonstrate various learning preferences and learning styles that range from visual, auditory to kinesthetic preferences. These learning preferences are further impacted by individual cognitive make up that characterizes itself in linguistic strengths, logical- special, inter-or intra- personal, just to name a few. Students from culturally and linguistically diverse backgrounds (CLD) have an increased risk of being misunderstood by many school systems and even medical personnel. CLD students are influenced by many factors (like acculturation and experience) that may impact their achievements and functioning levels. CLD students who develop initial or basic interpersonal communication proficiency skills in the target language are even at a higher risk for being suspected of learning disability when they are underachieving academically. Research indicates that large numbers of students arenot provided the type of education and types of supports they need in order to be successful in an academicenvironment. Multiple research findings indicate that significant numbers of school staff self-reports that they do not feel adequately prepared to work with CLD students. It is extremely important for the school staff, especially school psychologists, who often are the first experts that are consulted, to be educated about overlapping symptoms and settle differences between learning difference and disability. It is equally important for medical personnel, mainly pediatricians, psychologists, and psychiatrists, to understand the subtle differences to avoid inaccurate opinions. Having the knowledge, school staff can avoid unnecessary referrals for special education evaluations and avoid inaccurate decisions about the presence of a disability. This presentation will illustrate distinctions based on research between learning differences and disabilities, how to recognize them, and how to assess for them.

Keywords: special education, learning disability, differentiation, differences

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Authors: Alaa Abdellatif, Gabrièle Breda

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Background. Advanced therapy medicinal products (ATMPs) are innovative therapies that mainly target orphan diseases and high unmet medical needs. ATMP includes gene therapy medicinal products (GTMP), somatic cell therapy medicinal products (CTMP), and tissue-engineered therapies (TEP). Since legislation opened the way in 2007, 25 ATMPs have been approved in the EU, which is about the same amount as the U.S. Food and Drug Administration. However, not all of the ATMPs that have been approved have successfully reached the market and retained their approval. Objectives. We aim to understand all the factors limiting the market access to very promising therapies in a systemic approach, to be able to overcome these problems, in the future, with scientific, regulatory and commercial innovations. Further to recent reviews that focus either on specific countries, products, or dimensions, we will address all the challenges faced by ATMP development today. Methodology. We used mixed methods and a multi-level approach for data collection. First, we performed an updated academic literature review on ATMP development and their scientific and market access challenges (papers published between 2018 and April 2023). Second, we analyzed industry feedback from cell and gene therapy webinars and white papers published by providers and pharmaceutical industries. Finally, we established a comparative analysis of the regulatory guidelines published by EMA and the FDA for ATMP approval. Results: The main challenges in bringing these therapies to market are the high development costs. Developing ATMPs is expensive due to the need for specialized manufacturing processes. Furthermore, the regulatory pathways for ATMPs are often complex and can vary between countries, making it challenging to obtain approval and ensure compliance with different regulations. As a result of the high costs associated with ATMPs, challenges in obtaining reimbursement from healthcare payers lead to limited patient access to these treatments. ATMPs are often developed for orphan diseases, which means that the patient population is limited for clinical trials which can make it challenging to demonstrate their safety and efficacy. In addition, the complex manufacturing processes required for ATMPs can make it challenging to scale up production to meet demand, which can limit their availability and increase costs. Finally, ATMPs face safety and efficacy challenges: dangerous adverse events of these therapies like toxicity related to the use of viral vectors or cell therapy, starting material and donor-related aspects. Conclusion. As a result of our mixed method analysis, we found that ATMPs face a number of challenges in their development, regulatory approval, and commercialization and that addressing these challenges requires collaboration between industry, regulators, healthcare providers, and patient groups. This first analysis will help us to address, for each challenge, proper and innovative solution(s) in order to increase the number of ATMPs approved and reach the patients

Keywords: advanced therapy medicinal products (ATMPs), product development, market access, innovation

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Authors: Ehsan Sadie

Abstract:

The use of steel braces in concrete structures has been considered by researchers in recent decades due to its easy implementation, economics and the ability to create skylights in braced openings compared to shear wall openings as well as strengthening weak concrete structures to earthquakes. The purpose of this article is to improve and strengthen concrete structures with steel bracing. In addition, cases such as different numbers of steel braces in different openings of concrete structures and interaction between concrete frames and metal braces have been studied. In this paper, by performing static nonlinear analysis and examining ductility, the relative displacement of floors, examining the performance of samples, and determining the coefficient of behavior of composite frames (concrete frames with metal bracing), the behavior of reinforced concrete frames is compared with frame without bracing. The results of analyzes and studies show that the addition of metal bracing increases the strength and stiffness of the frame and reduces the ductility and lateral displacement of the structure. In general, the behavior of the structure against earthquakes will be improved.

Keywords: behavior coefficient, bracing, concrete structure, convergent bracing, earthquake, linear static analysis, nonlinear analysis, pushover curve

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Authors: Rao Fu, Jie Chen, Shutian Zeng, Yiping Zhuang, Agus Sudjianto

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Generative Adversarial Net (GAN) has proved to be a powerful machine learning tool in image data analysis and generation. In this paper, we propose to use Conditional Generative Adversarial Net (CGAN) to learn and simulate time series data. The conditions include both categorical and continuous variables with different auxiliary information. Our simulation studies show that CGAN has the capability to learn different types of normal and heavy-tailed distributions, as well as dependent structures of different time series. It also has the capability to generate conditional predictive distributions consistent with training data distributions. We also provide an in-depth discussion on the rationale behind GAN and the neural networks as hierarchical splines to establish a clear connection with existing statistical methods of distribution generation. In practice, CGAN has a wide range of applications in market risk and counterparty risk analysis: it can be applied to learn historical data and generate scenarios for the calculation of Value-at-Risk (VaR) and Expected Shortfall (ES), and it can also predict the movement of the market risk factors. We present a real data analysis including a backtesting to demonstrate that CGAN can outperform Historical Simulation (HS), a popular method in market risk analysis to calculate VaR. CGAN can also be applied in economic time series modeling and forecasting. In this regard, we have included an example of hypothetical shock analysis for economic models and the generation of potential CCAR scenarios by CGAN at the end of the paper.

Keywords: conditional generative adversarial net, market and credit risk management, neural network, time series

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Authors: Hsiao-Lin Fang

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The Patient Self-Determination Act is based on the belief that each life is unique. The act regards each patient as an autonomous entity and explicitly protects the patient’s rights to know and make decisions and choices while ensuring that the patient’s wish for a peaceful end is granted. Even when the patient is unconscious and unable to express himself/herself, the patient’s self-determination and its exercise are still protected under the law. The act also ensures that healthcare professionals (HCPs) have a specific set of rules to follow and complete legal protection when their patients are unable to express themselves clearly. This report is about a 55-year-old female patient who weighed 110 kg and was diagnosed with acute type A aortic dissection. The case was that the patient suddenly felt backache and nausea during sleep before daybreak and was therefore transferred to this hospital from the original one. After the doctor explained the patient’s conditions, it was concluded that surgery was necessary. However, the patient’s family was immediately against the surgery after having heard its possible complications. Nevertheless, the patient was still willing to receive the surgery. Being at odds with her family, the patient decided to sign the surgery agreement herself and agreed to receive the two surgical procedures: (1) ascending aorta replacement and (2) innominate artery debranching. After the surgery, the patient did not regain consciousness and therefore received computed tomography scanning of the brain, which revealed false lumen involving proximal left common carotid artery, left subclavian artery and innominate artery, and severe compression of the true lumen with total/subtotal occlusion in the left common carotid artery. On the following day, the doctor discussed two further surgical procedures: (1) endografting for descending aorta and (2) endografting for left common carotid artery and subclavian artery with the family. However, as the patient’s postoperative recovery of consciousness only reached the level of stupor and her family had no intention of subsequent healthcare for the patient, the family made the joint decision three days later to have the endotracheal tube removed from the patient and let her die a natural death. Suggestion: An advance directive (AD) can be created beforehand. Once the patient is in a special clinical state (e.g., terminal illness, permanent vegetative state, etc.), the AD can determine whether to sustain the patient’s life through ‘medical intervention’ or to respect the patient’s rights to choose a peaceful end and receive palliative care. Through the expression of self-determination, it is possible to respect the patient’s medical practice autonomy and protect the patient’s dignity and right to a peaceful end, thereby respecting and supporting the patient’s decision. This also allows the three sides: the patient, the family and the medical team to understand the patient’s true wish in the process of advance care planning (ACP) and thereby promote harmony in the HCP-patient relationship.

Keywords: intensive care unit patient, cardiovascular surgery, self-determination, advance directive

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Authors: Vaida Zemlickiene

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Scientists around the world and practitioners are working to identify the factors that influence the results of technology commercialization and to propose the ideal model for the technology commercialization process. In other words, all stakeholders of technology commercialization seek to find a formula or set of rules to succeed in commercializing technologies in order to avoid unproductive investments. In this article, the process of commercialization technology is understood as the process of transforming inventions into marketable products, services, and processes, or the path from the idea of using an invention to a product that incorporates process from 1 to 9 technology readiness level (TRL). There are many publications in the field of management literature, which are aimed at managing the commercialization process. However, there is an apparent lack of research for communication in decision-making in the process of technology commercialization. Works were done in the past, and the last decade's global research analysis led to the unambiguous conclusion that the methodological framework is not mature enough to be of practical use in business. The process of technology commercialization and the decisions made in the process should be explored in-depth. An archival analysis is performed to find insights into decision-making communication in the process of technologies commercialization, to find out the content of technology commercialization process: decision-making stages and participants, to analyze the internal factors of technology commercialization, to perform their critical analysis, to analyze the concept of successful/unsuccessful technology commercialization.

Keywords: the process of technology commercialization, communication in decision-making process, the content of technology commercialization process, successful/unsuccessful technology commercialization

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Authors: Med. A. Djeridane, M. Ferhat, H. A. Benhorma, O. Bouledroua

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This research is dedicated to exploring the failure of a turbine blade within a gas transportation plant, with a primary focus on conducting a comprehensive examination through advanced metallurgical and mechanical analyses of the identified failed blade. Crafted from the nickel superalloy Inconel IN738LC, the turbine engine had accumulated approximately 61,000 operational hours before the blades failed, causing severe damage to the transportation plant and necessitating a prolonged shutdown. The investigative procedure commenced with an in-depth visual inspection of the blade surfaces, succeeded by fractography analysis of the fracture surfaces, microstructural investigations, chemical analysis, and hardness measurements. The findings unveiled distinctive fatigue marks on the fracture surface. Critical microstructural changes were identified as a consequence of the blade's operation at high temperatures. The investigation determined that the crack initiation resulted from coating damage at the leading edge, subsequently propagating through fatigue. Ultimately, due to a reduction in cross-sectional area, the fracture was completed. This comprehensive analysis sheds light on the intricate factors contributing to turbine blade failure and offers valuable insights for enhancing operational reliability in similar environments.

Keywords: gas turbine, blade failure, TCP phases, fatigue, quantitative analysis

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Authors: P. Satish Kumar, K. Ramakrishna, Ch. Lokeshwar Reddy, G. Sridhar

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This paper presents two different sequential switching hybrid-modulation strategies and implemented for cascaded multilevel inverters. Hybrid modulation strategies represent the combinations of Fundamental-Frequency Pulse Width Modulation (FFPWM) and Multilevel Sinusoidal-Modulation (MSPWM) strategies, and are designed for performance of the well-known Alternative Phase Opposition Disposition (APOD), Phase Shifted Carrier (PSC). The main characteristics of these modulations are the reduction of switching losses with good harmonic performance, balanced power loss dissipation among the devices with in a cell, and among the series-connected cells. The feasibility of these modulations is verified through spectral analysis, power loss analysis and simulation.

Keywords: cascaded multilevel inverters, hybrid modulation, power loss analysis, pulse width modulation

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Authors: Josiah Damisa, Michelle Louise Richardson, Morenike Adewuyi

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Lower back pain is a significant cause of disability worldwide and associated with great implications in terms of the well-being of affected individuals and society as a whole due to its undeniable socio-economic impact. With its prevalence on the increase as a result of an aging global population, the need for novel forms of pain management is ever paramount. This review aims to provide further insight into current research regarding a role for the endocannabinoid signaling pathway as a target in the treatment of chronic pain, with particular emphasis on its potential use as part of the treatment of lower back pain. Potential advantages and limitations of cannabis-based medicines over other forms of analgesia currently licensed for medical use are discussed in addition to areas that require ongoing consideration and research. To evaluate the efficacy of cannabis-based medicines in chronic pain, studies pertaining to the role of medical cannabis in chronic disease were reviewed. Standard searches of PubMed, Google Scholar and Web of Science databases were undertaken with peer-reviewed journal articles reviewed based on the indication for pain management, cannabis treatment modality used and study outcomes. Multiple studies suggest an emerging role for cannabis-based medicines as therapeutic agents in the treatment of chronic back pain. A potential synergistic effect has also been purported if these medicines are co-administered with opiate analgesia due to the similarity of the opiate and endocannabinoid signaling pathways. However, whilst recent changes to legislation in the United Kingdom mean that cannabis is now licensed for medicinal use on NHS prescription for a number of chronic health conditions, concerns remain as to the efficacy and safety of cannabis-based medicines. Research is lacking into both their side effect profiles and the long-term effects of cannabis use. Legal and ethical considerations to the use of these products in standardized medical practice also persist due to the notoriety of cannabis as a drug of abuse. Despite this, cannabis is beginning to gain traction as an alternative or even complementary drug to opiates, with some preclinical studies showing opiate-sparing effects. Whilst there is a paucity of clinical trials in this field, there is scope for cannabinoids to be successful anti-nociceptive agents in managing chronic back pain. The ultimate aim would be to utilize cannabis-based medicines as alternative or complementary therapies, thereby reducing opiate over-reliance and providing hope to individuals who have exhausted all other forms of standard treatment.

Keywords: endocannabinoids, cannabis-based medicines, chronic pain, lower back pain

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