Search results for: clinical advice services
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7418

Search results for: clinical advice services

3818 Research on Load Balancing Technology for Web Service Mobile Host

Authors: Yao Lu, Xiuguo Zhang, Zhiying Cao

Abstract:

In this paper, Load Balancing idea is used in the Web service mobile host. The main idea of Load Balancing is to establish a one-to-many mapping mechanism: An entrance-mapping request to plurality of processing node in order to realize the dividing and assignment processing. Because the mobile host is a resource constrained environment, there are some Web services which cannot be completed on the mobile host. When the mobile host resource is not enough to complete the request, Load Balancing scheduler will divide the request into a plurality of sub-requests and transfer them to different auxiliary mobile hosts. Auxiliary mobile host executes sub-requests, and then, the results will be returned to the mobile host. Service request integrator receives results of sub-requests from the auxiliary mobile host, and integrates the sub-requests. In the end, the complete request is returned to the client. Experimental results show that this technology adopted in this paper can complete requests and have a higher efficiency.

Keywords: Dinic, load balancing, mobile host, web service

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3817 An Interpretable Data-Driven Approach for the Stratification of the Cardiorespiratory Fitness

Authors: D.Mendes, J. Henriques, P. Carvalho, T. Rocha, S. Paredes, R. Cabiddu, R. Trimer, R. Mendes, A. Borghi-Silva, L. Kaminsky, E. Ashley, R. Arena, J. Myers

Abstract:

The continued exploration of clinically relevant predictive models continues to be an important pursuit. Cardiorespiratory fitness (CRF) portends clinical vital information and as such its accurate prediction is of high importance. Therefore, the aim of the current study was to develop a data-driven model, based on computational intelligence techniques and, in particular, clustering approaches, to predict CRF. Two prediction models were implemented and compared: 1) the traditional Wasserman/Hansen Equations; and 2) an interpretable clustering approach. Data used for this analysis were from the 'FRIEND - Fitness Registry and the Importance of Exercise: The National Data Base'; in the present study a subset of 10690 apparently healthy individuals were utilized. The accuracy of the models was performed through the computation of sensitivity, specificity, and geometric mean values. The results show the superiority of the clustering approach in the accurate estimation of CRF (i.e., maximal oxygen consumption).

Keywords: cardiorespiratory fitness, data-driven models, knowledge extraction, machine learning

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3816 Toba Batak Education Stakeholders' Perspectives towards Education of Children with Disabilities in Toba Samosir North Sumatra Indonesia

Authors: Tryastuti I. B. Manullang, Juang Sunanto

Abstract:

This study aimed to find the perspectives of the Toba Batak education stakeholders towards the education of children with disabilities in Toba Samosir North Sumatra Indonesia. The education stakeholders consist of a head of the education department in Toba Samosir, head of the H foundation, two principals and three teachers from the Special Primary Schools. This study uses qualitative a descriptive approach and research data obtained through interviews. The results of this study demonstrate that the education stakeholders knowledge about disabilities needs improvement in accordance with the development of science. The cultural views towards disability and its implications, and the education services available for children with disabilities, in addition, to encountered its problem in Toba Samosir are known. The education concept considered appropriate is the special school and the CBR (Community Based Rehabilitation) strategy, also inclusive education because it represents the Toba Batak philosophy.

Keywords: community based rehabilitation, education concept, education stakeholders, inclusive education

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3815 How Obesity Sparks the Immune System and Lessons from the COVID-19 Pandemic

Authors: Husham Bayazed

Abstract:

Purpose of Presentation: Obesity and overweight are among the biggest health challenges of the 21st century, according to the WHO. Obviously, obese individuals suffer different courses of disease – from infections and allergies to cancer- and even respond differently to some treatment options. Of note, obesity often seems to predispose and triggers several secondary diseases such as diabetes, arteriosclerosis, or heart attacks. Since decades it seems that immunological signals gear inflammatory processes among obese individuals with the aforementioned conditions. This review aims to shed light how obesity sparks or rewire the immune system and predisposes to such unpleasant health outcomes. Moreover, lessons from the Covid-19 pandemic ascertain that people living with pre-existing conditions such as obesity can develop severe acute respiratory syndrome (SARS), which needs to be elucidated how obesity and its adjuvant inflammatory process distortion contribute to enhancing severe COVID-19 consequences. Recent Findings: In recent clinical studies, obesity was linked to alter and sparks the immune system in different ways. Adipose tissue (AT) is considered as a secondary immune organ, which is a reservoir of tissue-resident of different immune cells with mediator release, making it a secondary immune organ. Adipocytes per se secrete several pro-inflammatory cytokines (IL-6, IL-4, MCP-1, and TNF-α ) involved in activation of macrophages resulting in chronic low-grade inflammation. The correlation between obesity and T cells dysregulation is pivotal in rewiring the immune system. Of note, autophagy occurrence in adipose tissues further rewire the immune system due to flush and outburst of leptin and adiponectin, which are cytokines and influencing pro-inflammatory immune functions. These immune alterations among obese individuals are collectively incriminated in triggering several metabolic disorders and playing role in increasing cancers incidence and susceptibility to different infections. During COVID-19 pandemic, it was verified that patients with pre-existing obesity being at greater risk of suffering severe and fatal clinical outcomes. Beside obese people suffer from increased airway resistance and reduced lung volume, ACE2 expression in adipose tissue seems to be high and even higher than that in lungs, which spike infection incidence. In essence, obesity with pre-existence of pro-inflammatory cytokines such as LI-6 is a risk factor for cytokine storm and coagulopathy among COVID-19 patients. Summary: It is well documented that obesity is associated with chronic systemic low-grade inflammation, which sparks and alter different pillars of the immune system and triggers different metabolic disorders, and increases susceptibility of infections and cancer incidence. The pre-existing chronic inflammation in obese patients with the augmented inflammatory response against the viral infection seems to increase the susceptibility of these patients to developing severe COVID-19. Although the new weight loss drugs and bariatric surgery are considered as breakthrough news for obesity treatment, but preventing is easier than treating it once it has taken hold. However, obesity and immune system link new insights dispute the role of immunotherapy and regulating immune cells treating diet-induced obesity.

Keywords: immunity, metabolic disorders, cancer, COVID-19

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3814 South Africa and U.S. AFRICOM: Reflections on a Lukewarm Relationship

Authors: Theo Neethling

Abstract:

The United States Africa Command (AFRICOM) was established in 2007 as a military and diplomatic entity and is intended to assist African states and military actors to address their security needs. At the same time, AFRICOM is clearly an extension of US strategic interests on the African continent. The challenge for the US Department of Defence is to project AFRICOM as a cooperative and willing partner. This implies a partner that offers needed services and resources, and supports African security and military priorities with no presumption of having a privileged role in defining the African future. However, one of AFRICOM’s main challenges relates to the point that it has not been able to secure a firm partnership with South Africa as a key player on the continent: South Africa has continuously taken a lukewarm, if not cold, approach towards AFRICOM since its formation. The main aim of this article is to examine and discuss South Africa’s political-military relations with AFRICOM and to assess the underlying reasons currently inhibiting AFRICOM from achieving a fully productive relationship with the South African government.

Keywords: AFRICOM, South African foreign policy, US interests, defence capabilities in Africa, US-Africa relations

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3813 Decomposing the Socio-Economic Inequalities in Utilization of Antenatal Care in South Asian Countries: Insight from Demographic and Health Survey

Authors: Jeetendra Yadav, Geetha Menon, Anita Pal, Rajkumar Verma

Abstract:

Even after encouraging maternal and child wellness programs at worldwide level, lower-middle income nations are not reached the goal set by the UN yet. This study quantified the contribution of socioeconomic determinants of inequality to the utilization of Antenatal Care in South Asian Countries. This study used data from Demographic Health Survey (DHS) of the selected countries were used, and Oaxaca decomposing were applied for socioeconomic inequalities in utilization of antenatal care. Finding from the multivariate analysis shows that mother’s age at the time of birth, birth order and interval, mother’s education, mass media exposure and economic status were significant determinants of the utilization of antenatal care services in South Asian countries. Considering, concentration index curve, the line of equity was greatest in Pakistan which followed by India and Nepal.

Keywords: antenatal care, decomposition, inequalities, South Asian countries

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3812 Epidemiological Patterns of Pediatric Fever of Unknown Origin

Authors: Arup Dutta, Badrul Alam, Sayed M. Wazed, Taslima Newaz, Srobonti Dutta

Abstract:

Background: In today's world, with modern science and contemporary technology, a lot of diseases may be quickly identified and ruled out, but children's fever of unknown origin (FUO) still presents diagnostic difficulties in clinical settings. Any fever that reaches 38 °C and lasts for more than seven days without a known cause is now classified as a fever of unknown origin (FUO). Despite tremendous progress in the medical sector, fever of unknown origin, or FOU, persists as a major health issue and a major contributor to morbidity and mortality, particularly in children, and its spectrum is sometimes unpredictable. The etiology is influenced by geographic location, age, socioeconomic level, frequency of antibiotic resistance, and genetic vulnerability. Since there are currently no known diagnostic algorithms, doctors are forced to evaluate each patient one at a time with extreme caution. A persistent fever poses difficulties for both the patient and the doctor. This prospective, observational study was carried out in a Bangladeshi tertiary care hospital from June 2018 to May 2019 with the goal of identifying the epidemiological patterns of fever of unknown origin in pediatric patients. Methods: It was a hospital-based prospective observational study carried out on 106 children (between 2 months and 12 years) with prolonged fever of >38.0 °C lasting for more than 7 days without a clear source. Children with additional chronic diseases or known immunodeficiency problems were not allowed. Clinical practices that helped determine the definitive etiology were assessed. Initial testing included a complete blood count, a routine urine examination, PBF, a chest X-ray, CRP measurement, blood cultures, serology and additional pertinent investigations. The analysis focused mostly on the etiological results. The standard program SPSS 21 was used to analyze all of the study data. Findings: A total of 106 patients identified as having FUO were assessed, with over half (57.5%) being female and the majority (40.6%) falling within the 1 to 3-year age range. The study categorized the etiological outcomes into five groups: infections, malignancies, connective tissue conditions, miscellaneous, and undiagnosed. In the group that was being studied, infections were found to be the main cause in 44.3% of cases. Undiagnosed cases came in at 31.1%, cancers at 10.4%, other causes at 8.5%, and connective tissue disorders at 4.7%. Hepato-splenomegaly was seen in people with enteric fever, malaria, acute lymphoid leukemia, lymphoma, and hepatic abscesses, either by itself or in combination with other conditions. About 53% of people who were not diagnosed also had hepato-splenomegaly at the same time. Conclusion: Infections are the primary cause of PUO (pyrexia of unknown origin) in children, with undiagnosed cases being the second most common cause. An incremental approach is beneficial in the process of diagnosing a condition. Non-invasive examinations are used to diagnose infections and connective tissue disorders, while invasive investigations are used to diagnose cancer and other ailments. According to this study, the prevalence of undiagnosed diseases is still remarkable, so extensive historical analysis and physical examinations are necessary in order to provide a precise diagnosis.

Keywords: children, diagnostic challenges, fever of unknown origin, pediatric fever, undiagnosed diseases

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3811 Good Marketing is an Important Factor for the Success of the Institution

Authors: Maamar Moumena

Abstract:

the Follower of the movement of international competition finds that the success of Japanese companies to break into global markets and win a competitive edge and meet the challenges of this competition, due primarily to the adoption of these companies to the modern concept of marketing, and possession of sophisticated marketing systems, with a focus on pricing policy. The institution's ability to produce goods and services be limited unless accompanied by an effective marketing effort. So the satisfaction of the consumer needs efficiently and effectiveness are unwarranted economic and social presence in the market, and ensure the continuity and achieve their goals, and this can only be achieved through marketing activity, where he activity facet which translates the output of the institution and its presence in the form of financial compensation, and that the inclusion of and marketing function within the functions of the institution and awarded each of gravity reflects the extent of their importance in the conduct of the future of the institution, and depending on excellence in performance and a good application of the basic concepts of marketing and primarily make the consumer focus of attention, so the pleasing of the consumer and earn his allegiance reflects the success of an organization.

Keywords: competition, marketing, institution, consumer

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3810 Modeling Influence on Petty Corruption Attitudes

Authors: Nina Bijedic, Drazena Gaspar, Mirsad Hadzikadic

Abstract:

Corruption is an influential and widespread problem. One part of it is so-called petty corruption, related to large-scale bribe giving by ordinary citizens trying to influence the works of public administration or public services. As it is with all means of corruption, petty corruption is related to the level of democracy (or administration efficiency) in a society. The developed model captures some of the factors related to corruptive behavior, as well as people’s attitude towards petty corruption. It has four basic elements: user’s perception of corruption in the society of interest, the influence of social interactions, the influence of penalizing mechanism, and influence of campaigns against petty corruption. The model is agent-based, developed in NetLogo, with a lot of random settings that provide a wider scope of responses. Interactions of different settings for variables of elements provide insight into the influence of each element on attitude towards petty corruption, as well as petty corruptive behavior.

Keywords: agent-based model, attitude, influence, petty corruption, society

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3809 Big Data Analytics and Data Security in the Cloud via Fully Homomorphic Encyption Scheme

Authors: Victor Onomza Waziri, John K. Alhassan, Idris Ismaila, Noel Dogonyara

Abstract:

This paper describes the problem of building secure computational services for encrypted information in the Cloud. Computing without decrypting the encrypted data; therefore, it meets the yearning of computational encryption algorithmic aspiration model that could enhance the security of big data for privacy or confidentiality, availability and integrity of the data and user’s security. The cryptographic model applied for the computational process of the encrypted data is the Fully Homomorphic Encryption Scheme. We contribute a theoretical presentations in a high-level computational processes that are based on number theory that is derivable from abstract algebra which can easily be integrated and leveraged in the Cloud computing interface with detail theoretic mathematical concepts to the fully homomorphic encryption models. This contribution enhances the full implementation of big data analytics based on cryptographic security algorithm.

Keywords: big data analytics, security, privacy, bootstrapping, Fully Homomorphic Encryption Scheme

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3808 Parkinson's Disease and Musculoskeletal Problems

Authors: Ozge Yilmaz Kusbeci, Ipek Inci

Abstract:

Aim: Musculoskeletal problems are very common in Parkinson’s disease (PD). They affect quality of life and cause disabilities. However they are under-evaluated, and under-treated. The aim of this study is to evaluate the prevalence and clinical features of musculoskeletal problems in patients with Parkinson disease (PD) compared to controls. Methods: 50 PD patients and 50 age and sex matched controls were interviewed by physicians about their musculoskeletal problems. Results: The prevalence of musculoskeletal problems was significantly higher in the PD group than in the control group (p < 0.05). Commonly involved body sites were the shoulder, low back, and knee. The shoulder and low back was more frequently involved in the PD group than in the control group. However, the knee was similarly involved in both groups. Among the past diagnoses associated with musculoskeletal problems, frozen shoulder, low back pain and osteoporosis more common in the PD group than in the control group (p < 0.05). Furthermore, musculoskeletal problems in the PD group tended to receive less treatment than that of the control group. Conclusion: Musculoskeletal problems were more common in the PD group than in the controls. Therefore assessment and treatment of musculoskeletal problems could improve quality of life in PD patients.

Keywords: parkinson disease, musculoskeletal problems, quality of life, PD disease

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3807 Customer Expectation on Service Quality in Bed and Breakfast Establishments in Johannesburg Metropolitan

Authors: Chiedza Lebogang Gutu, Nester Rufaro Manuwa, Jean-Marie Mbuya

Abstract:

In Johannesburg, Metropolitan customer expectations in the hospitality industry have rapidly been increasing which has lead to the need of improving service quality to help satisfy customer expectations. Businesses need to make sure that customer expectations are met, or find ways to control customer expectations. Therefore the purpose of the study is to investigate how customer expectations of services in bed and breakfast establishments affect the perceived quality of service. A quantitative approach was used through random sampling to collect descriptive and correlation study between customer expectations and perceived quality. Findings of the study indicated that customers at bed and breakfast generally expect a clean, friendly and safe environment that has a homely feel, while they are away from home. In addition, findings of the study also emphasised that the age-groups between 20 and 35 are more likely to travel, for business and vacation purposes, staying for more or less 3, have high expectations towards modern facilities and extras in the room such as coffee machines, and are more concerned about the service being provided quickly and right, and taking extra care to deal with problems promptly.

Keywords: Customer satisfaction, Service quality, Bed and breakfast, Customer retention

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3806 The Relationship between Transcendence and Psychological Well-Being: A Systematic Scientific Literature Review

Authors: Monir Ahmed

Abstract:

The main purpose of this literature review was to investigate the existing quantitative clinical studies on the relationship between transcendence and psychological well-being. The primary objective of the literature review is to determine whether the existing studies adequately demonstrate the relationship between transcendence and psychological well-being, including spiritual well-being. A further objective of this literature review is to see if the ‘creatio ex nihilo’ doctrine is necessary to understand transcendence and its relationship with psychological well-being. Systematic literature review methods including studies identified from search engines, extracting data from the studies and assessing their quality for the planned review were used. The outcome of this literature review indicates that self-transcendence (STa), spiritual transcendence (STb) are positively related to psychological well-being. However, such positive relationships present limited scope for understanding transcendence and its relationship with well-being. The findings of this review support the need for further research in the area of transcendence and well-being. This literature review reveals the importance of developing a new transcendence tool for determining an individual’s ability to transcend and the relationship between his/her ability for transcendence and psychological well-being. The author of this paper proposes that the inclusion of the theological doctrine (‘creatio ex nihilo’) in understanding transcendence and psychological well-being is crucial, necessary and unavoidable.

Keywords: transcendence, psychological well-being, self-transcendence, spiritual transcendence, ‘creatio ex nihilo’

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3805 An Investigation the Effectiveness of Emotion Regulation Training on the Reduction of Cognitive-Emotion Regulation Problem in Patients with Multiple Sclerosis

Authors: Mahboobeh Sadeghi, Zahra Izadi Khah, Mansour Hakim Javadi, Masoud Gholamali Lavasani

Abstract:

Background: Since there is a relation between psychological and physiological factors, the aim of this study was to examine the effect of Emotion Regulation training on cognitive emotion regulation problem in patients with Multiple Sclerosis(MS) Method: In a randomized clinical trial thirty patients diagnosed with Multiple Sclerosis referred to state welfare organization were selected. The sample group was randomized into either an experimental group or a nonintervention control group. The subjects participated in 75-minute treatment sessions held three times a week for 4weeks (12 sessions). All 30 individuals were administered with Cognitive Emotion Regulation questionnaire (CERQ). Participants completed the questionnaire in pretest and post-test. Data obtained from the questionnaire was analyzed using Mancova. Results: Emotion Regulation significantly decreased the Cognitive Emotion Regulation problems patients with Multiple sclerosis (p < 0.001). Conclusions: Emotion Regulation can be used for the treatment of cognitive-emotion regulation problem in Multiple sclerosis.

Keywords: Multiple Sclerosis, cognitive-emotion regulation, emotion regulation, MS

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3804 A Comparative Study on South-East Asian Leading Container Ports: Jawaharlal Nehru Port Trust, Chennai, Singapore, Dubai, and Colombo Ports

Authors: Jonardan Koner, Avinash Purandare

Abstract:

In today’s globalized world international business is a very key area for the country's growth. Some of the strategic areas for holding up a country’s international business to grow are in the areas of connecting Ports, Road Network, and Rail Network. India’s International Business is booming both in Exports as well as Imports. Ports play a very central part in the growth of international trade and ensuring competitive ports is of critical importance. India has a long coastline which is a big asset for the country as it has given the opportunity for development of a large number of major and minor ports which will contribute to the maritime trades’ development. The National Economic Development of India requires a well-functioning seaport system. To know the comparative strength of Indian ports over South-east Asian similar ports, the study is considering the objectives of (I) to identify the key parameters of an international mega container port, (II) to compare the five selected container ports (JNPT, Chennai, Singapore, Dubai, and Colombo Ports) according to user of the ports and iii) to measure the growth of selected five container ports’ throughput over time and their comparison. The study is based on both primary and secondary databases. The linear time trend analysis is done to show the trend in quantum of exports, imports and total goods/services handled by individual ports over the years. The comparative trend analysis is done for the selected five ports of cargo traffic handled in terms of Tonnage (weight) and number of containers (TEU’s). The comparative trend analysis is done between containerized and non-containerized cargo traffic in the five selected five ports. The primary data analysis is done comprising of comparative analysis of factor ratings through bar diagrams, statistical inference of factor ratings for the selected five ports, consolidated comparative line charts of factor rating for the selected five ports, consolidated comparative bar charts of factor ratings of the selected five ports and the distribution of ratings (frequency terms). The linear regression model is used to forecast the container capacities required for JNPT Port and Chennai Port by the year 2030. Multiple regression analysis is carried out to measure the impact of selected 34 explanatory variables on the ‘Overall Performance of the Port’ for each of the selected five ports. The research outcome is of high significance to the stakeholders of Indian container handling ports. Indian container port of JNPT and Chennai are benchmarked against international ports such as Singapore, Dubai, and Colombo Ports which are the competing ports in the neighbouring region. The study has analysed the feedback ratings for the selected 35 factors regarding physical infrastructure and services rendered to the port users. This feedback would provide valuable data for carrying out improvements in the facilities provided to the port users. These installations would help the ports’ users to carry out their work in more efficient manner.

Keywords: throughput, twenty equivalent units, TEUs, cargo traffic, shipping lines, freight forwarders

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3803 Isolation and Identification of Fungal Pathogens in Palm Groves of Oued Righ

Authors: Lakhdari Wassima, Ouffroukh Ammar, Dahliz Abderrahmène, Soud Adila, Hammi Hamida, M’lik Randa

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Prospected palm groves of Oued Righ regions (Ouargla, Algeria) allowed us to observe sudden death of palm trees aged between 05 and 70 years. Field examinations revealed abnormal clinical signs with sometimes a quick death of affected trees. Entomologic investigations have confirmed the absence of phytophagous insects on dead trees. Further investigations by questioning farmers on the global management of palm groves visited (Irrigation, water quality used, soil type, etc.) did not establish any relationship between these aspects and the death of palm trees, which naturally pushed us to focus our investigations for research on fungal pathogens. Thus, laboratory studies were conducted to know the real causes of this phenomenon, 13 fungi were found on different parts of the dead palm trees. The flowing fungal types were identified: 1-Diplodia phoenicum, 2-Theilaviopsis paradoxa, 3-Phytophthora sp, 4-Helminthosporium sp, 5-Stemphylium botryosum, 6-Alternaria sp, 7-Aspergillus niger, 8-Aspergillus sp.

Keywords: palm tree, death, fungal pathogens, Oued Righ

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3802 Impact of E-Commerce Logistics Service Quality on Online Customer Satisfaction in UAE

Authors: Leena Wanganoo

Abstract:

In this digital age with the mushrooming of online companies across the globe has led to an unprecedented new business model. The frequency of online purchasing varies across the globe, but trend shows a steep upward movement. From Generation X to the Millennial the consumer not only wants to order the product with the click of mouse but also very demanding service quality during pre to post-transaction stage. The existing research examines the impact of website quality on the on behavioral intentions in e-services customers and has not adequately recognized the quality of e-commerce logistics perceived by the customer.In order to address this gap, this study examines the relationship among the logistics service quality, satisfaction, and loyalty. Drawing upon a sample of 350 millennial customers from various regions of UAE will work within the framework of structural equation modeling (SEM). Finally, the study would use Importance-Performance analysis (IPA) to discuss the relations of the level of customers’ expected logistics service quality and level of customers’ perceived logistics serviced quality.

Keywords: logistics service quality, customer satisfaction, loyalty, electronic commerce

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3801 Emotional Intelligence: A Panacea in the Management and Marketing of Hospitality and Tourism Good and Services

Authors: M. Azugama, P. Okoro Ugo Chigozie, A. O. Nnamocha

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Emotional Intelligence constitutes powerful psychological forces that can strongly influence performance in behaviour, interaction and relationship management. Surprisingly how emotions are interpreted and employed in marketing of hospitality experience have had limited comprehension. Marketing of hospitality experiences have important emotional dimensions which the traditional marketing techniques tend to underplay. Guest and host relationship are challenged by mutual hospitableness obligations; suggesting that the commercial practice of delivering satisfactory guest experience has much to gain from traditional understanding of hospitality. By understanding the emotion-based hospitality transaction between guests and hosts, customers’ experiences can be delivered over and against competitor pressure. In this paper, marketing strategies and tactics in hospitality and tourism are principally concerned with adjusting each of the 6P & T elements (i.e. product, place, price and promotion; and adding people, processes and Time in service contexts), to provide a competitive offer (experience) to customers.

Keywords: Emotional intelligence, hospitality and tourism, relationship management, marketing

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3800 Implementing a Comprehensive Emergency Care and Life Support Course in a Low- and Middle-Income Country Setting: A Survey of Learners in India

Authors: Vijayabhaskar Reddy Kandula, Peter Provost Taillac, Balasubramanya M. A., Ram Krishnan Nair, Gokul Toshnival, Vibhu Dhawan, Vijaya Karanam, Buffy Cramer

Abstract:

Introduction: The lack of Emergency Care Services (ECS) is a cause of extensive and serious public health problems in low- and middle-income countries (LMIC), Many LMIC countries have ambulance services that allow timely transfer of ill patients but due to poor care during the ‘Golden Hour’ many deaths occur which are otherwise preventable. Lack of adequate training as evidenced by a study in India is a major reason for poor care during the ‘Golden Hour’. Adapting developed country models which includes staffing specialty-trained doctors in emergency care, is neither feasible nor guarantees cost-effective ECS. Methods: Based on our assessment and felt needs by first-line doctors providing emergency care in 2014, Rajiv Gandhi Health Sciences University’s JeevaRaksha Trust in partnership with the University of Utah, USA, designed, piloted and successfully implemented a 4-day Comprehensive-Emergency Care and Life Support course (C-ECLS) for allopathic doctors. 1730 doctors completed the 4-day course between June 2014 and December- 2020. Subsequently, we conducted a survey to investigate the utilization rates and usefulness of the training. 1662 were contacted but only 309 completed the survey. The respondents had the following designations: Senior faculty (33%), junior faculty (25), Resident (16%), Private-Practitioners (8%), Medical-Officer (16%) and not-working (11%). 51% were generalists (51%) and the rest were specialists (>30 specialties). Results: 97% (271/280) felt they are better doctors because of C-ECLS. 79% (244/309) reported that training helped to save life- specialists more likely than generalists (91% v/s 68%. P<0.05). 64% agreed that they were confident of managing COVID-19 symptomatic patients better because of C-ECLS. 27% (77) were neutral; 9% (24) disagreed. 66% agreed that training helps to be confident in managing COVID-19 critically ill patients. 26% (72) were neutral; 8% (23) disagreed. Frequency of use of C-ECLS skills: Hemorrhage-control (70%), Airway (67%), circulation skills (62%), Safe-transport and communication (60%), managing critically ill patients (58%), cardiac arrest (51%), Trauma (49%), poisoning/animal bites/stings (44%), neonatal-resuscitation (39%), breathing (36%), post-partum-hemorrhage and eclampsia (35%). Among those who used the skills, the majority (ranging from (88%-94%) reported that they were able to apply the skill more effectively because of ECLS training. Conclusion: JeevaRaksha’s C-ECLS is the world’s first comprehensive training. It improves the confidence of front-line doctors and enables them to provide quality care during the ‘Golden Hour’ of emergency. It also prepares doctors to manage unknown emergencies (e.g., COVID-19). C-ECLS was piloted in Morocco, and Uzbekistan and implemented countrywide in Bhutan. C-ECLS is relevant to most settings and offers a replicable model across LMIC.

Keywords: comprehensive emergency care and life support, training, capacity building, low- and middle-income countries, developing countries

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3799 Clostridium Glycolicum Abdominal Infection in a Patient with Small Bowel Obstruction

Authors: Benedikt Munzar, Jagraj Singh, Alice Mei, David Musheyev, Sandeep Gandhi

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Clostridium glycolicum is a gram-positive, anaerobic, spore-forming rod that is not commonly identified as a primary human pathogen. Here is a case of a 60-year-old patient with a history of opioid use disorder who underwent a number of abdominal surgeries for small bowel obstruction. His hospital course was complicated by Clostridium glycolicum infection resulting in an acute abdomen. The patient clinically improved with antibiotic therapy. A thorough review of the National Institute of Health database revealed that only a small number of cases have been reported since 2007, with the last postsurgical cases documented in 2009 and the last clinical case documented in 2012. Clostridium glycolicum infections have been noted in patients with immunosuppressive conditions or those undergoing medical treatments that compromise immune function. This case was unusual due to the patient being immunocompetent. We suggest that a case of an acute abdomen should consider this organism as an etiological agent.

Keywords: acute abdomen, bacterial infection, clostridium glycolicum, meckel’s diverticulum, pneumoperitoneum, small bowel obstruction

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3798 From 'Tabung Haji' to Fully Islamic Bank: Analysis of the Twenty Years of Creating Alternative Banking System in Malaysia

Authors: Maulana Ayoub Ali

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Malayan Pilgrims Savings Corporation was introduced in 1963. Six years later, Malaysian Pilgrims Fund Board (Tabung Haji) was formed. The board used to collect funds from pilgrims who expected to perform pilgrimage in the future dates. Money was collected and kept as per given rules and procedures emanated from Islamic sources of law. Twenty years later, the country was ready to run a fully fledged Islamic bank where the Bank Islam Malaysia Berhad (BIMB) came into existence in the year 1983. This paper investigates stages of development of Islamic banking system in Malaysia from 1983 to date. This study discovered that Malaysia had enough time to make Islamic banking system works alongside conventional banking system and for sure, has successfully managed to come up with the comprehensive and workable financial system which accommodates both the conventional and Islamic banking. As a result, Malaysia stands to be the hub of Islamic banking products and services in the world today.

Keywords: Tabung Haji, Islamic Banks, conventional law, Malaysia

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3797 The Effect of Simultaneous Application of Laser Beam and Magnet in Treatment of Intervertebral Disc Herniation

Authors: Alireza Moghtaderi, Negin Khakpour

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Disc Herniation is a common complication in the society and it is one of the main reasons for referring to physical medicine and rehabilitation clinics. Despite of various methods proposed for treatingthis disease, still there is disagreement on success of these methods especially in non-surgical methods, and thus current study aims at determining effect of laser beam and magnet on treatment of Intervertebral Disc Herniation. During a clinical trial study, 80 patients with Intervertebral Disc Herniation underwent a combined package of treatment including magnet, laser beam, PRP and Prolotherapy during 6 months. Average age of patients was 51.25 ± 10.7 with range of 25 – 71 years. 30 men (37.5%) and 50 women (62.5%) took part in the study. average weight of patients was 64.3 ± 7.2 with range of 49 – 79 kg. highest level of Disc Herniation was L5 – S1 with frequency of 17 cases (21.3%). Disc Herniation was severe in 30 cases before treatment, but it reduced to 3 casesafter treatment. This study indicates effect of combined treatment using non-invasive laser beam and magnet therapy on disco genic diseases and mechanical pains of spine is highly effective.

Keywords: hallux, valgus, botulinum toxin a, pain

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3796 “MaxSALIVA-II” Advancing a Nano-Sized Dual-Drug Delivery System for Salivary Gland Radioprotection, Regeneration and Repair in a Head and Neck Cancer Pre-Clinical Murine Model

Authors: Ziyad S. Haidar

Abstract:

Background: Saliva plays a major role in maintaining oral, dental, and general health and well-being; where it normally bathes the oral cavity acting as a clearing agent. This becomes more apparent when the amount and quality of saliva are significantly reduced due to medications, salivary gland neoplasms, disorders such as Sjögren’s syndrome, and especially ionizing radiation therapy for tumors of the head and neck, the 5th most common malignancy worldwide, during which the salivary glands are included within the radiation field/zone. Clinically, patients affected by salivary gland dysfunction often opt to terminate their radiotherapy course prematurely as they become malnourished and experience a significant decrease in their QoL. Accordingly, the formulation of a radio-protection/-prevention modality and development of an alternative Rx to restore damaged salivary gland tissue is eagerly awaited and highly desirable. Objectives: Assess the pre-clinical radio-protective effect and reparative/regenerative potential of layer-by-layer self-assembled lipid-polymer-based core-shell nanocapsules designed and fine-tuned for the sequential (ordered) release of dual cytokines, following a single local administration (direct injection) into a murine sub-mandibular salivary gland model of irradiation. Methods: The formulated core-shell nanocapsules were characterized by physical-chemical-mechanically pre-/post-loading with the drugs, followed by optimizing the pharmaco-kinetic profile. Then, nanosuspensions were administered directly into the salivary glands, 24hrs pre-irradiation (PBS, un-loaded nanocapsules, and individual and combined vehicle-free cytokines were injected into the control glands for an in-depth comparative analysis). External irradiation at an elevated dose of 18Gy was exposed to the head-and-neck region of C57BL/6 mice. Salivary flow rate (un-stimulated) and salivary protein content/excretion were regularly assessed using an enzyme-linked immunosorbent assay (3-month period). Histological and histomorphometric evaluation and apoptosis/proliferation analysis followed by local versus systemic bio-distribution and immuno-histochemical assays were then performed on all harvested major organs (at the distinct experimental end-points). Results: Monodisperse, stable, and cytocompatible nanocapsules capable of maintaining the bioactivity of the encapsulant within the different compartments with the core and shell and with controlled/customizable pharmaco-kinetics, resulted, as is illustrated in the graphical abstract (Figure) below. The experimental animals demonstrated a significant increase in salivary flow rates when compared to the controls. Herein, salivary protein content was comparable to the pre-irradiation (baseline) level. Histomorphometry further confirmed the biocompatibility and localization of the nanocapsules, in vivo, into the site of injection. Acinar cells showed fewer vacuoles and nuclear aberration in the experimental group, while the amount of mucin was higher in controls. Overall, fewer apoptotic activities were detected by a Terminal deoxynucleotidyl Transferase (TdT) dUTP Nick-End Labeling (TUNEL) assay and proliferative rates were similar to the controls, suggesting an interesting reparative and regenerative potential of irradiation-damaged/-dysfunctional salivary glands. The Figure below exemplifies some of these findings. Conclusions: Biocompatible, reproducible, and customizable self-assembling layer-by-layer core-shell delivery system is formulated and presented. Our findings suggest that localized sequential bioactive delivery of dual cytokines (in specific dose and order) can prevent irradiation-induced damage via reducing apoptosis and also has the potential to promote in situ proliferation of salivary gland cells; maxSALIVA is scalable (Good Manufacturing Practice or GMP production for human clinical trials) and patent-pending.

Keywords: cancer, head and neck, oncology, drug development, drug delivery systems, nanotechnology, nanoncology

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3795 Accelerating Mobile Innovation, Adoption, and Translational Science within a Large Research Enterprise and Healthcare System

Authors: Stephen Wheat

Abstract:

Institutional mobile application governance and distribution processes are essential to mobile app innovation. The absence of effective processes poses a significant barrier to the development and adoption of mobile apps for use within a research enterprise and also impedes the translational science of applying research apps in clinical and engineering settings. To accelerate mobile app innovation and adoption, Emory University and Emory Healthcare implemented a three-pronged strategy including. I) Mobile app review and distribution policies and processes. II) Mobile app management infrastructure and mobile app foundation components. III) A strategic sourcing strategy based on preferred mobile app development firms. The results have been an increase from five to 56 mobile apps in the pipeline over three years; increased engagement from technology transfer, legal counsel, compliance, and information security; articulation of a coordinated mobile app strategy; and allocation of more institutional resources toward specific mobile technology and mobile application goals.

Keywords: mobile app management, governance, distribution, information security

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3794 Genistein Suppresses Doxorubicin Associated Genotoxicity in Human Lymphocytes

Authors: Tanveer Beg, Yasir H. Siddique, Gulshan Ara, Asfar S. Azmi, Mohammad Afzal

Abstract:

Doxorubicin is a well-known DNA intercalating chemotherapy drug that is widely used for treatment of different cancers. Its clinical utility is limited due to the observed genotoxic side effects on healthy cells suggesting that newer combination and genoprotective regimens are urgently needed for the management of doxorubicin chemotherapy. Some dietary phytochemicals are well known for their protective mechanism of action and genistein from soy is recognized as an anti-oxidant with similar properties. Therefore, the present study investigates the effect of genistein against the genotoxic doses of doxorubicin by assessing chromosomal aberrations, sister chromatid exchanges, cell cycle kinetics, cell viability, apoptosis, and DNA damage markers in cultured human lymphocytes. Our results reveal that genistein treatment significantly suppresses genotoxic damage induced by doxorubicin. It is concluded that genistein has the potential to reduce the genotoxicity induced by anti-cancer drugs, thereby reducing the chances of developing secondary tumors during the therapy.

Keywords: apoptosis, DNA damage markers, doxorubicin, genistein, genotoxicity, human lymphocyte culture

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3793 Attributes of Ethical Leadership and Ethical Guidelines in Malaysian Public Sector

Authors: M. Norazamina, A. Azizah, Y. Najihah Marha, A. Suraya

Abstract:

Malaysian Public Sector departments or agencies are responsible to provide efficient public services with zero corruption. However, corruption continues to occur due to the absence of ethical leadership and well-execution of ethical guidelines. Thus, the objective of this paper is to explore the attributes of ethical leadership and ethical guidelines. This study employs a qualitative research by analyzing data from interviews with key informers of public sector using conceptual content analysis (NVivo11). The study reveals eight attributes of ethical leadership which are role model, attachment, ethical support, knowledgeable, discipline, leaders’ spirituality encouragement, virtue values and shared values. Meanwhile, five attributes (guidelines, communication, check and balance, concern on stakeholders and compliance) of ethical guidelines are identified. These identified attributes should become the ethical identity and ethical direction of Malaysian Public Sector. This could enhance the public trust as well as the international community trust towards the public sector.

Keywords: check and balance, ethical guidelines, ethical leadership, public sector, spirituality encouragement

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3792 Nigerian Football System: Examining Micro-Level Practices against a Global Model for Integrated Development of Mass and Elite Sport

Authors: Iorwase Derek Kaka’an, Peter Smolianov, Steven Dion, Christopher Schoen, Jaclyn Norberg, Charles Gabriel Iortimah

Abstract:

This study examines the current state of football in Nigeria to identify the country's practices, which could be useful internationally, and to determine areas for improvement. Over 200 sources of literature on sport delivery systems in successful sports nations were analyzed to construct a globally applicable model of elite football integrated with mass participation, comprising of the following three levels: macro (socio-economic, cultural, legislative, and organizational), meso (infrastructures, personnel, and services enabling sports programs) and micro level (operations, processes, and methodologies for the development of individual athletes). The model has received scholarly validation and has shown to be a framework for program analysis that is not culturally bound. It has recently been utilized for further understanding such sports systems as US rugby, tennis, soccer, swimming, and volleyball, as well as Dutch and Russian swimming. A questionnaire was developed using the above-mentioned model. Survey questions were validated by 12 experts including academicians, executives from sports governing bodies, football coaches, and administrators. To identify best practices and determine areas for improvement of football in Nigeria, 116 coaches completed the questionnaire. Useful exemplars and possible improvements were further identified through semi-structured discussions with 10 Nigerian football administrators and experts. Finally, a content analysis of the Nigeria Football Federation's website and organizational documentation was conducted. This paper focuses on the micro level of Nigerian football delivery, particularly talent search and development as well as advanced athlete preparation and support. Results suggested that Nigeria could share such progressive practices as the provision of football programs in all schools and full-time coaches paid by governments based on the level of coach education. Nigerian football administrators and coaches could provide better football services affordable for all, where success in mass and elite sports is guided by science focused on athletes' needs. Better implemented could be international best practices such as lifelong guidelines for health and excellence of everyone and integration of fitness tests into player development and ranking as done in best Dutch, English, French, Russian, Spanish, and other European clubs; integration of educational and competitive events for elite and developing athletes as well as fans as done at the 2018 World Cup Russia; and academies with multi-stage athlete nurturing as done by Ajax in Africa as well as Barcelona FC and other top clubs expanding across the world. The methodical integration of these practices into the balanced development of mass and elite football will help contribute to international sports success as well as national health, education, crime control, and social harmony in Nigeria.

Keywords: football, high performance, mass participation, Nigeria, sport development

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3791 Detecting Model Financial Statement Fraud by Auditor Industry Specialization with Fraud Triangle Analysis

Authors: Reskino Resky

Abstract:

This research purposes to create a model to detecting financial statement fraud. This research examines the variable of fraud triangle and auditor industry specialization with financial statement fraud. This research used sample of company which is listed in Indonesian Stock Exchange that have sanctions and cases by Financial Services Authority in 2011-2013. The number of company that were became in this research were 30 fraud company and 30 non-fraud company. The method of determining the sample is by using purposive sampling method with judgement sampling, while the data processing methods used by researcher are mann-whitney u and discriminants analysis. This research have two from five variable that can be process with discriminant analysis. The result shows the financial targets can be detect financial statement fraud, while financial stability can’t be detect financial statement fraud.

Keywords: fraud triangle analysis, financial targets, financial stability, auditor industry specialization, financial statement fraud

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3790 The Efficacy of Psycho-Education in Improving the Emotional Well-Being of Visually Impaired Adolescents in Nigeria

Authors: Janet Tolulope Olaseni

Abstract:

Emotional well-being in adolescents is an important psychological factor that can enhance positive living, but if it is not well groomed, it can have adverse impacts on their development. Therefore, the present study examined the efficacy of psycho-education on the emotional well-being of adolescents who are visually impaired in Nigeria. A total of twenty-eight (28) participants, which comprisednineteen (19) males and nine (9) females (M=15.82, SD=2.23) from a Nigerian School for the Blind, participated in the quasi-experimental study. Randomized clinical trial designwas used to assigned the participants into three (Complete Psycho-education, Incomplete Psycho-education, and No Psycho-education) groups. Standardized scales were used to gather data from the respondents. The formulated hypotheses were tested using Dependent T-Test and Analysis of Co-Variance. The results showed that there was a significant effect of Psycho-education on the emotional well-being of the Visually Impaired Adolescents. Those who received complete Psycho-educationhad the highest level of emotional well-being compared to those in the other groups. In order to enhance the emotional well-being of the Visually Impaired Adolescents, the study recommended that complete Psycho-education programme should be incorporated into the school activities of the Visually Impaired Adolescents.

Keywords: emotional well-being, psycho-education, visually impaired adolescents, Nigeria

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3789 Ten Minutes Neighbourhood as a Basic PlanningUnit for Happiness in Egypt

Authors: Abeer Elshater

Abstract:

This paper pursues the relationship between the inhabitants’ happiness and the right to the city in an Egyptian neighbourhood status quo. Although the optimum of getting the services comes from ten mints walking in a suitable ambiance, the happiness is not acquired. The research objective is, first, to review the literature that get a guideline of 10 minutes neighbourhoods. Second make a comparative content analysis to recent online articles to the right to the city. Third is to test the concluded principles in Egyptian neighbourhood settings. The idea of ten minutes neighbourhood is manageable. The hypothesis concerns a compliant design. The logic of people who live close to within ten minutes’ walk to essential settings in their area can minimize several problems and maximize a healthy lifestyle. The supposed issue makes the right to the city affect the relationship between ten minutes neighbourhood and citizen happiness. This assumption can be intervention through site observation and oriented questionnaire. The contribution comes from presenting new planning units in away suits the current context of the old cities in MENA region based on ten-minute walking or less distance with a reference to the right to the city. This planning unit can find it way to citizens' happiness.

Keywords: happiness, ten-minute neighbourhood, urban design, well-being

Procedia PDF Downloads 397