Search results for: community based development

Authors: Neslihan Sahin Celik, Ali Eraslan

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As a result of PISA (Program for International Student Assessments) survey that tests how well students can apply the knowledge and skills they have learned at school to real-life challenges, the new and redesigned mathematics education programs in many countries emphasize the necessity for the students to face complex and multifaceted problem situations and gain experience in this sense allowing them to develop new skills and mathematical thinking to prepare them for their future life after school. At this point, mathematical models and modeling approaches can be utilized in the analysis of complex problems which represent real-life situations in which students can actively participate. In particular, model eliciting activities that bring about situations which allow the students to create solutions to problems and which involve mathematical modeling must be used right from primary school years, allowing them to face such complex, real-life situations from early childhood period. A qualitative study was conducted in a university foundation primary school in the city center of a big province in 2013-2014 academic years. The participants were 4th grade students in a primary school. After a four-week preliminary study applied to a fourth-grade classroom, three students included in the focus group were selected using criterion sampling technique. A focus group of three students was videotaped as they worked on the Crime Problem. The conversation of the group was transcribed, examined with students’ written work and then analyzed through the lens of Blum and Ferri’s modeling processing cycle. The results showed that primary fourth-grade students can successfully work with model eliciting problem while they encounter some difficulties in the modeling processes. In particular, they developed new ideas based on different assumptions, identified the patterns among variables and established a variety of models. On the other hand, they had trouble focusing on problems and occasionally had breaks in the process.

Keywords: primary school, modeling, mathematical modeling, crime problem

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Authors: R. Estrada, A. Henriquez, R. Becerra, C. Laguna

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Spatial Augmented Reality is a variation of Augmented Reality where the Head-Mounted Display is not required. This variation of Augmented Reality is useful in cases where the need for a Head-Mounted Display itself is a limitation. To achieve this, Spatial Augmented Reality techniques substitute the technological elements of Augmented Reality; the virtual world is projected onto a physical surface. To create an interactive spatial augmented experience, the application must be aware of the spatial relations that exist between its core elements. In this case, the core elements are referred to as a projection system and an input system, and the process to achieve this spatial awareness is called system calibration. The Spatial Augmented Reality system is considered calibrated if the projected virtual world scale is similar to the real-world scale, meaning that a virtual object will maintain its perceived dimensions when projected to the real world. Also, the input system is calibrated if the application knows the relative position of a point in the projection plane and the RGB-depth sensor origin point. Any kind of projection technology can be used, light-based projectors, close-range projectors, and screens, as long as it complies with the defined constraints; the method was tested on different configurations. The proposed procedure does not rely on a physical marker, minimizing the human intervention on the process. The tests are made using a Kinect V2 as an input sensor and several projection devices. In order to test the method, the constraints defined were applied to a variety of physical configurations; once the method was executed, some variables were obtained to measure the method performance. It was demonstrated that the method obtained can solve different arrangements, giving the user a wide range of setup possibilities.

Keywords: color depth sensor, human computer interface, interactive surface, spatial augmented reality

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Authors: Sadeq Al Yaari, Muhammad Alkhunayn, Adham Al Yaari, Ayah Al Yaari, Ayman Al Yaari, Montaha Al Yaari, Sajedah Al Yaari, Fatehi Eissa

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The recent rise of smart educational aids and the move away from traditional listening aids are leading to a fundamental shift in the way in which individuals with attention and listening problems (ALP) manipulate listening inputs and/or act appropriately to the spoken information presented to them. A total sample of twenty-six ALP pupils (m=20 and f=6) between 7-12 years old was selected from different strata based on gender, region and school. In the sample size, thirteen (10 males and 3 females) received the treatment in terms of smart classes provided with smart educational aids in a listening course that lasted for four months, while others did not (they studied the same course by the same instructor but in ordinary class). A pretest was administered to assess participants’ levels, and a posttest was given to evaluate their attention and listening comprehension performance, namely in phonetic and phonological tests with sociolinguistic themes that have been designed for this purpose. Test results were analyzed both psychoneurolinguistically and statistically. Results reveal a remarkable change in pupils’ behavioral listening where scores witnessed a significant difference in the performance of the experimental ALP group in the pretest compared to the posttest (Pupils performed better at the pretest-posttest on phonetics than at the two tests on phonology). It is concluded that smart educational aids designed for listening skills help not only increase the listening command of pupils with ALP to understand what they listen to but also develop their interactive listening capability and, at the same rate, are responsible for increasing concentrated and in-depth listening capacity. Plus, ALP pupils become able to grasp the audio content of text recordings, including educational audio recordings, news, oral stories and tales, views, spiritual/religious text and general knowledge. However, the pupils have not experienced individual smart audio-visual aids that connect listening to other language receptive and productive skills, which could be the future area of research.

Keywords: smart educational aids, listening attention, pupils, problems

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Authors: L. A. Ostrovsky, Yu. A. Stepanyants

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Effect of Earth rotation on nonlinear waves is a practically important and theoretically challenging problem of fluid mechanics and geophysics. Whereas the large-scale, geostrophic processes such as Rossby waves are a classical object of oceanic and atmospheric physics, rotation effects on mesoscale waves are not well studied. In particular, the Coriolis force can radically modify the behavior of nonlinear internal gravity waves in the ocean having spatial scales of 1-10 kilometers and time durations of few hours. In the last decade, such a non-trivial behavior was observed more than once. Similar effects are possible for magnetic sound in the ionosphere. Here we outline the main physical peculiarities in the behavior of nonlinear internal waves due to the rotation effect and present some results of our recent studies. The consideration is based on the fourth-order equation derived by one of the authors as a rotation-modified Korteweg–de Vries (rKdV) equation which includes two types of dispersion: one is responsible for the finiteness of depth as in the classical KdV equation; another is due to the Coriolis effect. This equation is, in general, non-integrable; moreover, under the conditions typical of oceanic waves (positive dispersion parameter), it does not allow solitary solutions at all. In the opposite case (negative dispersion) which is possible for, e.g., magnetic sound, solitary solutions do exist and can form complex bound states (multisoliton). Another non-trivial properties of nonlinear internal waves with rotation include, to name a few, the ‘terminal’ damping of the initial KdV soliton disappearing in a finite time due to radiation losses caused by Earth’s rotation, and eventual transformation of a KdV soliton into a wave packet (an envelope soliton). The new results to be discussed refer to the interaction of a soliton with a long background wave. It is shown, in particular, that in this case internal solitons can exist since the radiation losses are compensated by energy pumping from the background wave. Finally, the relevant oceanic observations of rotation effect on internal waves are briefly described.

Keywords: Earth rotation, internal waves, nonlinear waves, solitons

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Authors: Marta Skwarecka, Patrycja Bloch, Rafal Walkusz, Oliwia Urbanowicz, Grzegorz Zielinski, Sabina Zoledowska, Dawid Nidzworski

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Upper respiratory tract infections are one of the most common reasons for visiting a general doctor. Streptococci are the most common bacterial etiological factors in these infections. There are many different types of Streptococci and infections vary in severity from mild throat infections to pneumonia. For example, S. pyogenes mainly contributes to acute pharyngitis, palatine tonsils and scarlet fever, whereas S. Streptococcus pneumoniae is responsible for several invasive diseases like sepsis, meningitis or pneumonia with high mortality and dangerous complications. There are only a few diagnostic tests designed for detection Streptococci from the infected throat of patients. However, they are mostly based on lateral flow techniques, and they are not used as a standard due to their low sensitivity. The diagnostic standard is to culture patients throat swab on semi selective media in order to multiply pure etiological agent of infection and subsequently to perform antibiogram, which takes several days from the patients visit in the clinic. Therefore, the aim of our studies is to develop and implement to the market a Point of Care device for the rapid identification of Streptococcus pyogenes and Streptococcus pneumoniae with simultaneous identification of antibiotic resistance genes. In the course of our research, we successfully selected genes for to-species identification of Streptococci and genes encoding antibiotic resistance proteins. We have developed a reaction to amplify these genes, which allows detecting the presence of S. pyogenes or S. pneumoniae followed by testing their resistance to erythromycin, chloramphenicol and tetracycline. What is more, the detection of β-lactamase-encoding genes that could protect Streptococci against antibiotics from the ampicillin group, which are widely used in the treatment of this type of infection is also developed. The test is carried out directly from the patients' swab, and the results are available after 20 to 30 minutes after sample subjection, which could be performed during the medical visit.

Keywords: antibiotic resistance, Streptococci, respiratory infections, diagnostic test

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Authors: Layaly Ayoub, Mariana Ribeiro

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Introduction: Breast cancer is currently considered the leading cause of cancer-related deaths among women in Brazil. Mastectomy, essential in this treatment, often necessitates subsequent breast reconstruction to restore physical appearance and aid in the emotional and psychological recovery of patients. The choice between immediate or delayed reconstruction is influenced by factors such as the type and stage of cancer, as well as the patient's overall health. The decision between autologous breast reconstruction or implant-based reconstruction requires a detailed analysis of individual conditions and needs. Objectives: This study analyzes the techniques and indications used in post-mastectomy breast reconstruction. Methodology: Literature review conducted in the PubMed and SciELO databases, focusing on articles that met the inclusion and exclusion criteria and descriptors. Results: After mastectomy, breast reconstruction is commonly performed. It is necessary to determine the type of technique to be used in each case depending on the specific characteristics of each patient. The tissue expander technique is indicated for patients with sufficient skin and tissue post-mastectomy, who do not require additional radiotherapy, and who opt for a less complex surgery with a shorter recovery time. This procedure promotes the gradual expansion of soft tissues where the definitive implant will be placed. Both temporary and permanent expanders offer flexibility, allowing for adjustment in the expander size until the desired volume is reached, enabling the skin and tissues to adapt to the breast implant area. Conversely, autologous reconstruction is indicated for patients who will undergo radiotherapy, have insufficient tissue, and prefer a more natural solution. This technique uses the transverse rectus abdominis muscle (TRAM) flap, the latissimus dorsi muscle flap, the gluteal flap, and local muscle flaps to shape a new breast, potentially combined with a breast implant. Conclusion: In this context, it is essential to conduct a thorough evaluation regarding the technique to be applied, as both have their benefits and challenges.

Keywords: indications, post-mastectomy, breast reconstruction, techniques

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Authors: Pranita Shivankar, Arun Suryawanshi, Prabodhachandra Deshmukh, S. V. C. Kameswara Rao

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Many undesirable significant changes in landscapes and the regions in the vicinity of historically important structures occur as impacts due to anthropogenic activities over a period of time. A better understanding of such influences using recently developed satellite remote sensing techniques helps in planning the strategies for minimizing the negative impacts on the existing environment. In 1982, a fossilized hominid skull cap was discovered at a site located along the northern bank of the east-west flowing river Narmada in the village Hathnora. Close to the same site, the presence of Late Acheulian and Middle Palaeolithic tools have been discovered in the immediately overlying pebbly gravel, suggesting that the ‘Narmada skull’ may be from the Middle Pleistocene age. The reviews of recently carried out research studies relevant to hominid remains all over the world from Late Acheulian and Middle Palaeolithic sites suggest succession and contemporaneity of cultures there, enhancing the importance of Hathnora as a rare precious site. In this context, the maximum likelihood classification using digital interpretation techniques was carried out for this study area using the satellite imagery from Landsat ETM+ for the year 2006 and Landsat TM (OLI and TIRS) for the year 2016. The overall accuracy of Land Use Land Cover (LULC) classification of 2016 imagery was around 77.27% based on ground truth data. The significant reduction in the main river course and agricultural activities and increase in the built-up area observed in remote sensing data analysis are undoubtedly the outcome of human encroachments in the vicinity of the eminent heritage site.

Keywords: cultural succession, digital interpretation, Hathnora, Homo Sapiens, Late Acheulian, Middle Palaeolithic

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Authors: Hafiz Atif Iqbal

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It is a confirmed historical fact that Pakistan is an ideological state, and religion has played a very important and vital role in the establishment of Pakistan. This is the reason why the slogan "What does Pakistan mean is "la ilaha illa Allah" is embedded in the heart of every Muslim. This slogan became so popular in the dimensions of India that Movement of Pakistan and this slogan became inseparable, and that is why Quaid-e-Azam said: "Twenty-five percent share in Movement of Pakistan belongs to the creator of this slogan, Asghar Soudai Sialkoti." This slogan later formed the basis of the two-nation theory, whereby the Hindus and Muslims of the sub-continent were declared to be two separate and complete nations, completely different from each other in terms of their religion, affairs, dress, lifestyle, and values. In this regard, on March 23, 1940, at the historic meeting of the Muslim League in Lahore, in which the Lahore Resolution was passed, Quaid-e-Azam said: Islam and Hinduism are not just religions, but actually two different social systems. Therefore, this desire should be called a dream and a dream that Hindus and Muslims will be able to create a common nationality together. These people do not marry each other, nor do they eat at the same table. I say in a nutshell that they belong to two different civilizations, and these civilizations are based on concepts and facts that contradict each other and are against each other. Quaid-e-Azam, while addressing Peshawar in January 1948, said: "We did not demand Pakistan just to get a separate piece of land, but we wanted to get a laboratory where we can test the principles of Islam. The distinction of the concept of Islamic government should be kept in mind that the authority of obedience and loyalty in it is God Almighty, whose practical means of compliance are the rules and principles of the Holy Quran. Only the rules of the Holy Quran can determine the limits of our freedom and restrictions in the state and society. In other words, the Islamic government is the government of Quranic principles and rules. All these facts make it clear that religion has played a fundamental and important role in the establishment of Pakistan.

Keywords: la ilaha illa allah, asghar soudai sialkoti, lahore resolution, quaid-e-azam

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Authors: Sheikh Omar Sillah

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Introduction: Monitoring is an important means of ensuring the smooth implementation and quality of clinical trials. For many years, traditional site monitoring approaches have been critical in detecting data errors but not optimal in identifying fabricated and implanted data as well as non-random data distributions that may significantly invalidate study results. The objective of this paper was to provide recommendations based on best statistical monitoring practices for detecting data-integrity issues suggestive of fabrication and implantation early in the study conduct to allow implementation of meaningful corrective and preventive actions. Methodology: Electronic bibliographic databases (Medline, Embase, PubMed, Scopus, and Web of Science) were used for the literature search, and both qualitative and quantitative studies were sought. Search results were uploaded into Eppi-Reviewer Software, and only publications written in the English language from 2012 were included in the review. Gray literature not considered to present reproducible methods was excluded. Results: A total of 18 peer-reviewed publications were included in the review. The publications demonstrated that traditional site monitoring techniques are not efficient in detecting data anomalies. By specifying project-specific parameters such as laboratory reference range values, visit schedules, etc., with appropriate interactive data monitoring, statistical monitoring can offer early signals of data anomalies to study teams. The review further revealed that statistical monitoring is useful to identify unusual data patterns that might be revealing issues that could impact data integrity or may potentially impact study participants' safety. However, subjective measures may not be good candidates for statistical monitoring. Conclusion: The statistical monitoring approach requires a combination of education, training, and experience sufficient to implement its principles in detecting data anomalies for the statistical aspects of a clinical trial.

Keywords: statistical monitoring, data anomalies, clinical trials, traditional monitoring

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Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

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It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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Authors: Miriam Fahmy, Shalini Fernando

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Educational links between teaching hospitals and universities can provide visits with great impact for both sides. As a visitor, one is responsible for the content, respecting current practice while offering guidance from a completely different perspective. There is little documented guidance for establishing links with universities in developing countries and providing meaningful teaching and exchange programmes. An initial contact retrieved one response with regards to written curriculum. The otolaryngology department from a Swansea teaching hospital visited a university in the Gambia. A consultant and clinical fellow visited with medical students to deliver lectures, clinical skills and informal teaching such as bedside and small group teaching. Students who had participated in teaching provided by the visiting university were asked to give feedback. This information was collated and used to evaluate the impact, and to guide future visits, including thinking of establishing a curriculum tailored to the West Africa region. The students felt they gained the most from informal sessions such as bedside teaching and felt that more practical experience on real patients and pathology would be most beneficial to them. Given that internet is poor, they also suggested a video library for their reference. Many of them look forward to visiting Swansea and are interested in the differences in practice and technologies. The findings are limited to little previous literature and student feedback. Student feedback sparked further questions and careful contemplation. There is great scope for introducing a range of teaching resources but it is important to avoid assumptions and imposition of a western curriculum and education system, a larger sample is needed with input from lecturers and curriculum writers in leading universities. In conclusion, more literature and guidance needs to be established for future visitors contemplating an educational link.

Keywords: education, impact, West Africa, university links

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Authors: Lindy Adoma Dampare, Marina Aferiba Tandoh

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Sickle cell disease (SCD) is an inherited blood disorder that mostly affects individuals in sub-Saharan Africa. Nutritional deficiencies have been well established in SCD patients. In Ghana, studies have revealed the prevalence of malnutrition, especially amongst children with SCD and hence the need to develop an evidence-based comprehensive nutritional therapy for SCD to improve their nutritional status. The aim of the study was to develop and assess the effect of a nutrition education material on the nutritional status of SCD patients in Ghana. This was a pre-post interventional study. Patients between the ages of 2 to 60 years were recruited from the Tema General Hospital. Following a baseline nutrition knowledge (NK), beliefs, sanitary practice and dietary consumption pattern assessment, a twice-monthly nutrition education was carried out for 3 months, followed by a post-intervention assessment. Nutritional status of SCD patients was assessed using a 3-days dietary recall and anthropometric measurements. Nutrition education (NE) was given to SCD adults and caregivers of SCD children. Majority of the caregivers (69%) and SCD adult (82%) at baseline had low NK. The level of NK improved significantly in SCD adults (4.18±1.83 vs. 10.00±1.00, p<0.001) and caregivers (5.58 ± 2.25 vs.10.44± 0.846, p<0.001) after NE. Increase in NK improved dietary intake and dietary consumption pattern of SCD patients. Significant increase in weight (23.2±11.6 vs. 25.9±12.1, p=0.036) and height (118.5±21.9 vs. 123.5±22.2, p=0.011) was observed in SCD children at post intervention. Stunting (10.5% vs. 8.6%, p=0.62) and wasting (22.1% vs. 14.4%, p=0.30) reduced in SCD children after NE although not statistically significant. Reduction (18.2% vs. 9.1%) in underweight and an increase (18.2% vs. 27.3%) in overweight SCD adults was recorded at post intervention. Fat mass remained the same while high muscle mass increased (18.2% vs. 27.3%) at post intervention in SCD adult. Anaemic status of SCD patients improved at post intervention and the improvement was statistically significant amongst SCD children. Nutrition education improved the NK of SCD caregivers and adults hence, improving the dietary consumption pattern and nutrient intake of SCD patients. Overall, NE improved the nutritional status of SCD patients. This study shows the potential of nutrition education in improving the nutritional knowledge, dietary consumption pattern, dietary intake and nutritional status of SCD patients, and should be further explored.

Keywords: sickle cell disease, nutrition education, dietary intake, nutritional status

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Authors: Sehrish Qayyum

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In this age of constant technology, asymmetrical warfare could not be won. Attuned psychometric study confirms that screaming sometimes is more productive than active retaliation against strong adversaries. Asymmetric warfare is a game of nerves and thoughts with least vigorous participation for large anticipated losses. It creates the condition of paraplegia with partial but permanent immobility, which effects the core warfare operations, being screams rather than active retaliation. When one’s own power is doubted, it gives power to one’s own doubt to ruin all planning either done with superlative cost-benefit analysis. Strategically calculated estimation of asymmetric warfare since the early WWI to WWII, WWII-to Cold War, and then to the current era in three chronological periods exposits that courage makes nations win the battle of warriors to battle of comrades. Asymmetric warfare has been most difficult to fight and survive due to unexpectedness and being lethal despite preparations. Thoughts before action may be the best-assumed strategy to mix Regional Security Complex Theory and OODA loop to develop the Paraplegic Resilience Policy Plan (PRPP) to win asymmetric warfare. PRPP may serve to control and halt the ongoing wave of terrorism, guerilla warfare, and insurgencies, etc. PRPP, along with a strategic work plan, is based on psychometric analysis to deal with any possible war condition and tactic to save millions of innocent lives such that lost in Christchurch New Zealand in 2019, November 2015 Paris attacks, and Berlin market attacks in 2016, etc. Getting tangled into self-imposed epistemic dilemmas results in regret that becomes the only option of performance. It is a descriptive psychometric analysis of war conditions with generic application of probability tests to find the best possible options and conditions to develop PRPP for any adverse condition possible so far. Innovation in technology begets innovation in planning and action-plan to serve as a rheostat approach to deal with asymmetric warfare.

Keywords: asymmetric warfare, psychometric analysis, PRPP, security

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Authors: Chairun Wiedyaningsih, Sri Suryawati, Yati Soenarto, Muhammad Hakimi

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Background: Many drugs used in paediatrics are not commercially available in suitable dosage forms. Therefore, the drugs often prescribed in extemporaneous compounding dosage form. Compounding can pose health risks include poor quality and unsafe products. Studies of compounding dosage form have primarily focused on prescription profiles, reasons of prescribing never be explored. Objectives: The study was conducted to identify factors influencing physicians’ decision to prescribe extemporaneous compounding dosage form for paediatric outpatients. Setting: Daerah Istimewa Yogyakarta (DIY) province, Indonesia. Method: Qualitative semi-structured interviews were conducted with 15 general physicians and 7 paediatricians to identify the reason of prescribing extemporaneous compounding dosage form. The interviews were transcribed and analysed using thematic analysis. Results: Factors underlying prescribing of compounding could be categorized to therapy, healthcare system, patient and past experience. The primary reasons of therapy factors were limited availability of drug compositions, dosages or formulas specific for children. Beliefs in efficacy of the compounding forms were higher when the drugs used primarily to overcome complex cases. Physicians did not concern about compounding form containing several active substances because manufactured syrups may also contain several active substances. Although medicines were available in manufactured syrups, limited institutional budget was healthcare system factor of compounding prescribing. The prescribing factors related to patients include easy to use, efficient and lower price. The prescribing factors related to past experience were physicians’ beliefs to the progress of patient's health status. Conclusions: Compounding was prescribed based on therapy-related factors, healthcare system factors, patient factors and past experience.

Keywords: compounding dosage form, interview, physician, prescription

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Authors: P. V. Pramila , V. Mahesh

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Pulmonary Function Tests are important non-invasive diagnostic tests to assess respiratory impairments and provides quantifiable measures of lung function. Spirometry is the most frequently used measure of lung function and plays an essential role in the diagnosis and management of pulmonary diseases. However, the test requires considerable patient effort and cooperation, markedly related to the age of patients esulting in incomplete data sets. This paper presents, a nonlinear model built using Multivariate adaptive regression splines and Random forest regression model to predict the missing spirometric features. Random forest based feature selection is used to enhance both the generalization capability and the model interpretability. In the present study, flow-volume data are recorded for N= 198 subjects. The ranked order of feature importance index calculated by the random forests model shows that the spirometric features FVC, FEF 25, PEF,FEF 25-75, FEF50, and the demographic parameter height are the important descriptors. A comparison of performance assessment of both models prove that, the prediction ability of MARS with the `top two ranked features namely the FVC and FEF 25 is higher, yielding a model fit of R2= 0.96 and R2= 0.99 for normal and abnormal subjects. The Root Mean Square Error analysis of the RF model and the MARS model also shows that the latter is capable of predicting the missing values of FEV1 with a notably lower error value of 0.0191 (normal subjects) and 0.0106 (abnormal subjects). It is concluded that combining feature selection with a prediction model provides a minimum subset of predominant features to train the model, yielding better prediction performance. This analysis can assist clinicians with a intelligence support system in the medical diagnosis and improvement of clinical care.

Keywords: FEV, multivariate adaptive regression splines pulmonary function test, random forest

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Authors: S. C. Lin, W. F. Hung, W. W. Cheng

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Teacher empowerment was regarded as investing teachers with the right to participate in the determination of school goals and policies and to exercise professional judgment about what and how to teach. Professional commitment was considered as a person’s belief in and acceptance of the values of his or her chosen occupation or line of work, and a willingness to maintain membership in that occupation. An effective school has been defined as one in which students’ progress further than might be expected from consideration of its intake. An effective school thus adds extra value to its students' outcomes, in comparison with other schools serving similar intakes. A number of literature from various countries explored that teacher empowerment and professional commitment significantly influenced school effectiveness. However, there lacked more empirical studies to examine the relationships among them. Hence, this study was to explore the relationships among teacher empowerment, professional commitment and school effectiveness in junior high schools in Taiwan. Samples were seven hundred and five junior high school teachers selected from Taichung City, Changhua County and Nantou County. Questionnaire was applied to collect data. Data were analyzed by using descriptive statistics, t-test, one-way ANOVA, Pearson’s product-moment correlation, and multiple regression analysis. The findings of this study were as follows: First, the overall performances of teachers’ perceptions of teacher empowerment, teacher professional commitment and school effectiveness were above average. Second, the teachers’ perceptions of teacher empowerment were significant different in gender, designated duty, and school size. Third, the teachers’ perceptions of teacher professional commitment were significant different in gender, designated duty, and school size. Fourth, the teachers’ perceptions of school effectiveness were significant different in designated duty. Fifth, teacher empowerment was mid-positively correlation by teacher professional commitment. Sixth, there was mid-positively correlation between teacher empowerment and school effectiveness. Seventh, there was mid-positively correlation between teacher professional commitment and school effectiveness. Eighth, Teacher empowerment and professional commitment could significantly predict school effectiveness. Based on the findings of this study, the study proposed some suggestions for educational authorities, schools, teachers, and future studies as well.

Keywords: junior high school teacher, teacher empowerment, teacher professional commitment, school effectiveness

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Authors: Lokman Gozcu, Sule Deniz Gozcu

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This study aims to analyze the skills of speaking in the acquisition of Turkish as a foreign language. One of the most important things for the individual who learns a foreign language is to be successful in the oral communication (speaking) skills and to interact in an understandable way. Speech skill requires much more time and effort than other language skills. In this direction, it is necessary to make an analysis of these oral communication skills, which is important in Turkish language acquisition as a foreign language and to draw out a road map according to the result. The aim of this study is to determine the competence and attitudes of speaking competence according to the individuals who learn Turkish as a foreign language and to be considered as speaking skill elements; Grammar, emphasis, intonation, body language, speed, ranking, accuracy, fluency, pronunciation, etc. and the results and suggestions based on these determinations. A mixed method has been chosen for data collection and analysis. A Likert scale (for competence and attitude) was applied to 190 individuals who were interviewed face-to-face (for speech skills) with a semi-structured interview form about 22 participants randomly selected. In addition, the observation form related to the 22 participants interviewed were completed by the researcher during the interview, and after the completion of the collection of all the voice recordings, analyses of voice recordings with the speech skills evaluation scale was made. The results of the research revealed that the speech skills of the individuals who learned Turkish as a foreign language have various perspectives. According to the results, the most inadequate aspects of the participants' ability to speak in Turkish include vocabulary, using humorous elements while speaking Turkish, being able to include items such as idioms and proverbs while speaking Turkish, Turkish fluency respectively. In addition, the participants were found not to feel comfortable while speaking Turkish, to feel ridiculous and to be nervous while speaking in formal settings. There are conclusions and suggestions for the situations that arise after the have been analyses made.

Keywords: learning Turkish as a foreign language, proficiency criteria, phonetic (modalities), speaking skills

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Authors: S. P. Singh, Priya, Komal Sajwan

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With the increasing spread of organic farming in India, costs, returns, efficiency, and social and environmental sustainability of organic vis-a-vis conventional farming systems have become topics of interest among agriculture scientists, economists, and policy analysts. A study on technical efficiency estimation under these farming systems, particularly in the Ganga River Basin, where the promotion of organic farming is incentivized, can help to understand whether the inputs are utilized to their maximum possible level and what measures can be taken to improve the efficiency. This paper, therefore, analyses the technical efficiency of wheat farms operating under organic and conventional farming systems. The study is based on a primary survey of 600 farms (300 organic ad 300 conventional) conducted in 2021 in two districts located in the Middle Ganga River Basin, India. Technical, managerial, and scale efficiencies of individual farms are estimated by applying the data envelopment analysis (DEA) methodology. The per hectare value of wheat production is taken as an output variable, and values of seeds, human labour, machine cost, plant nutrients, farm yard manure (FYM), plant protection, and irrigation charges are considered input variables for estimating the farm-level efficiencies. The post-DEA analysis is conducted using the Tobit regression model to know the efficiency determining factors. The results show that technical efficiency is significantly higher in conventional than organic farming systems due to a higher gap in scale efficiency than managerial efficiency. Further, 9.8% conventional and only 1.0% organic farms are found operating at the most productive scale size (MPSS), and 99% organic and 81% conventional farms at IRS. Organic farms perform well in managerial efficiency, but their technical efficiency is lower than conventional farms, mainly due to their relatively lower scale size. The paper suggests that technical efficiency in organic wheat can be increased by upscaling the farm size by incentivizing group/collective farming in clusters.

Keywords: organic, conventional, technical efficiency, determinants, DEA, Tobit regression

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Authors: Kanika Kalra, Harmeet Kaur, Dinesh Goyal

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Total phenolics were extracted from waste orange peels by solvent extraction and alkali hydrolysis method. The most efficient solvents for extracting phenolic compounds from waste biomass were methanol (60%) > dimethyl sulfoxide > ethanol (60%) > distilled water. The extraction yields were significantly impacted by solvents (ethanol, methanol, and dimethyl sulfoxide) due to varying polarity and concentrations. Extraction of phenolics using 60% methanol yielded the highest phenolics (in terms of gallic acid equivalent (GAE) per gram of biomass) in orange peels. Alkali hydrolyzed extract from orange peels contained 7.58±0.33 mg GAE g⁻¹. By using the solvent extraction technique, it was observed that 60% methanol is comparatively the best-suited solvent for extracting polyphenolic compounds and gave the maximum yield of 4.68 ± 0.47 mg GAE g⁻¹ in orange peel extracts. DPPH radical scavenging activity and reducing the power of orange peel extract were checked, where 60% methanolic extract showed the highest antioxidant activity, 85.50±0.009% for DPPH, and dimethyl sulfoxide (DMSO) extract gave the highest yield of 1.75±0.01% for reducing power ability of the orange peels extract. Characterization of the polyphenolic compounds was done by using Fourier transformation infrared (FTIR) spectroscopy. Solvent and alkali hydrolysed extracts were evaluated for antibacterial activity using the agar well diffusion method against Gram-positive Bacillus subtilis MTCC441 and Gram-negative Escherichia coli MTCC729. Methanolic extract at 300µl concentration showed an inhibition zone of around 16.33±0.47 mm against Bacillus subtilis, whereas, for Escherichia coli, it was comparatively less. Broth-based turbidimetric assay revealed the antibacterial effect of different volumes of orange peel extracts against both organisms.

Keywords: orange peels, total phenolic content, antioxidant, antibacterial

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Authors: Atikah Nurhayati, Asep A. Handaka

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Indonesia is a world’s major fish producer which can feed not only its citizens but also the people of the world. Currently, the total annual production is 11 tons and expected to double by the year of 2050. Given the potential, fishery has been an important part of the national food security system in Indonesia. Despite such a potential, a big challenge is facing the Indonesians in making fish the reliable source for their food, more specifically source of protein intake. The long geographic distance between the fish production centers and the consumer concentrations has prevented effective supply chain from producers to consumers and therefore demands a good logistic system. This paper is based on our research, which aimed at analyzing the fish supply chain and is to suggest relevant improvement to the chain. The research was conducted in the Year of 2016 in selected locations of Java Island, where intensive transaction on fishery commodities occur. Data used in this research comprises secondary data of time series reports on production and distribution and primary data regarding distribution aspects which were collected through interviews with purposively selected 100 respondents representing fishers, traders and processors. The data were analyzed following the supply chain management framework and processed following logistic regression and validity tests. The main findings of the research are as follows. Firstly, it was found that improperly managed connectivity and logistic chain is the main cause for insecurity of availability and affordability for the consumers. Secondly, lack of quality of most local processed products is a major obstacle for improving affordability and connectivity. The paper concluded with a number of recommended strategies to tackle the problem. These include rationalization of the length of the existing supply chain, intensification of processing activities, and improvement of distribution infrastructure and facilities.

Keywords: fishery, food security, logistic, supply chain

Procedia PDF Downloads 241

Authors: Kristina Rosengren, Petra Brannefors, Eric Carlstrom

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Background: Implementation and use of person-centered care (PCC) is increasing worldwide, and why the current study intends to increase knowledge regarding how PCC is used in different European countries. Purpose: To describe the extent of person-centred care in 23 European countries in relation to use specific countries healthcare system (Beveridge, Bismarck, Mixed/OOP). Methods: The study was conducted by literature review inspired by Spice, both scientific empirical studies (Cinahl, Medline, Scopus) as well as grey literature (Google) were used. Totally 1194 documents were included divided into Cinahl n=139, Medline n=245, Scopus n=493 and Google n=317. Data were analysed with descriptive (percentage, range) regarding content and scope of PCC/country according to content and scope of PCC in each country, grouped into the healthcare system (Beveridge, Bismarck, Mixed/OOP) and geographic placement. Results: PCC were most common in UK (England, Scotland, Wales, North Ireland), n=481, 40.3%, Sweden (n=231, 19.3%), The Netherlands (n=80, 6.7%), Ireland (n=79, 6.6%) and Norway (n=61, 5.1%); and less common in Poland (0.6%), Hungary (0.5%), Greece (0.4%), Latvia (0.4%) and Serbia (0%). Beveridge healthcare system (12/23=0.5217, 52.2%) show 85 percent of documents with advantage of scientific literature valued 2.92 (n=999, 0.55-4.07), compare to advantage of grey literature in Bismarck (10/23=0.4347, 43.5%) with 15 percentage valued 2.35 (n=190, 0-3.27) followed by Mixed/OOP (1/23=4%) with 0.4 valued 2.25. Conclusions: Seven out of 10 countries with Beveridge health system used PCC compare to less-used PCC in countries with the Bismarck system. Research, as well as national regulations regarding PCC, are important tools to motivate the advantage of PCC in clinical practice. Moreover, implementation of PCC needs a systematic approach, from national (politicians), regional (guideline) and local (specific healthcare settings) levels visualized by decision-making as law, mission, policies, and routines in clinical practice to establish a well-integrated phenomenon in Europe.

Keywords: Beveridge, Bismarck, Europe, evidence-based, literature review, person-centered care

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Authors: Naser Ebadati

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introductory statement: Drilling operations in oil wells often involve significant risks due to varying azimuths, slopes, and the passage through layers with different lithological properties. As a result, maintaining well stability is crucial. Instability in wells can lead to costly well losses, interrupted drilling operations, and halted production from reservoirs. Objective: One of the key challenges in drilling operations is ensuring the stability of the wellbore, particularly in loose and low-resistance formations. These factors make the analysis and evaluation of well stability essential. Therefore, building a geo mechanical model for a hydrocarbon field or reservoir requires both a stress field model and a mechanical properties model of the geological formations. Numerous studies have focused on analyzing the stability of well walls, an issue known as well instability. This study aims to analyze the stability and the safe mud weight window for drilling in one of the oil fields in southern Iran. Methodology: In wellbore stability analysis, it is essential to consider the stress field model, which includes values and directions of the three principal stresses, and the mechanical properties model, which covers elastic properties and rock fracture characteristics. Wellbore instability arises from mechanical failure of the rock. Well stability can be maintained by adjusting the drilling mud weight. This study investigates wellbore stability using field data. The lithological characteristics of the well mainly consist of limestone, dolomite, and shale, as determined from log data. Wellbore logging was conducted throughout the well to calculate the required drilling mud pressure using the Mohr-Coulomb criterion. Findings: The results indicate that the safe and stable drilling mud window ranges between 17.13 MPa and 27.80 MPa. By comparing and calculating induced stresses, it was determined that the wellbore wall primarily exhibits shear fractures in the form of wide shear fractures and tensile fractures in the form of radial tensile fractures.

Keywords: drilling mud weight, formation evaluation, sheer strees, safe window

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Authors: Monish Sengupta, Benjamin Heydecker, Daniel Woodland

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New train control systems rely mainly on Automatic Train Protection (ATP) and Automatic Train Operation (ATO) dynamically to control the speed and hence performance. The ATP and the ATO form the vital element within the CBTC (Communication Based Train Control) and within the ERTMS (European Rail Traffic Management System) system architectures. Reliable and accurate measurement of train location, speed and acceleration are vital to the operation of train control systems. In the past, all CBTC and ERTMS system have deployed a balise or equivalent to correct the uncertainty element of the train location. Typically a CBTC train is allowed to miss only one balise on the track, after which the Automatic Train Protection (ATP) system applies emergency brake to halt the service. This is because the location uncertainty, which grows within the train control system, cannot tolerate missing more than one balise. Balises contribute a significant amount towards wayside maintenance and studies have shown that balises on the track also forms a constraint for future track layout change and change in speed profile.This paper investigates the causes of the location uncertainty that is currently experienced and considers whether it is possible to identify an effective filter to ascertain, in conjunction with appropriate sensors, more accurate speed, distance and location for a CBTC driven train without the need of any external balises. An appropriate sensor fusion algorithm and intelligent sensor selection methodology will be deployed to ascertain the railway location and speed measurement at its highest precision. Similar techniques are already in use in aviation, satellite, submarine and other navigation systems. Developing a model for the speed control and the use of Kalman filter is a key element in this research. This paper will summarize the research undertaken and its significant findings, highlighting the potential for introducing alternative approaches to train positioning that would enable removal of all trackside location correction balises, leading to huge reduction in maintenances and more flexibility in future track design.

Keywords: ERTMS, CBTC, ATP, ATO

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Authors: Jia-Lien Hsu, Chiung-Wen Chang

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Research articles may follow a simple and succinct structure of organizational patterns, called move. For example, considering extended abstracts, we observe that an extended abstract usually consists of five moves, including Background, Aim, Method, Results, and Conclusion. As another example, when publishing articles in PubMed, authors are encouraged to provide a structured abstract, which is an abstract with distinct and labeled sections (e.g., Introduction, Methods, Results, Discussions) for rapid comprehension. This paper introduces a method for computational analysis of move structures (i.e., Background-Purpose-Method-Result-Conclusion) in abstracts and introductions of research documents, instead of manually time-consuming and labor-intensive analysis process. In our approach, sentences in a given abstract and introduction are automatically analyzed and labeled with a specific move (i.e., B-P-M-R-C in this paper) to reveal various rhetorical status. As a result, it is expected that the automatic analytical tool for move structures will facilitate non-native speakers or novice writers to be aware of appropriate move structures and internalize relevant knowledge to improve their writing. In this paper, we propose a Bayesian approach to determine move tags for research articles. The approach consists of two phases, training phase and testing phase. In the training phase, we build a Bayesian model based on a couple of given initial patterns and the corpus, a subset of CiteSeerX. In the beginning, the priori probability of Bayesian model solely relies on initial patterns. Subsequently, with respect to the corpus, we process each document one by one: extract features, determine tags, and update the Bayesian model iteratively. In the testing phase, we compare our results with tags which are manually assigned by the experts. In our experiments, the promising accuracy of the proposed approach reaches 56%.

Keywords: academic English writing, assisted writing, move tag analysis, Bayesian approach

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Authors: John Ahluwalia

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As an affluent first-world nation, Canada took swift and comprehensive action during the outbreak of the SARS-CoV-2 (COVID-19) pandemic compared to other countries in the same socio-economic cohort. The United States has stumbled to overcome obstacles most developed nations have faced, which has led to significantly more per capita cases and deaths. The initial outbreaks of COVID-19 occurred in the US and Canada within days of each other and posed similar potentially catastrophic threats to public health, the economy, and governmental stability. On a macro level, events that take place in the US have a direct impact on Canada. For example, both countries tend to enter and exit economic recessions at approximately the same time, they are each other’s largest trading partners, and their currencies are inexorably linked. Why is it that Canada has not shared the same fate as the US (and many other nations) that have realized much worse outcomes relative to the COVID-19 pandemic? Variables intrinsic to Canada’s national infrastructure have been instrumental in the country’s efforts to flatten the curve of COVID-19 cases and deaths. Canada’s coordinated multi-level governmental effort has allowed it to create and enforce policies related to COVID-19 at both the national and provincial levels. Canada’s policy of universal healthcare is another variable. Health care and public health measures are enforced on a provincial level, and it is within each province’s jurisdiction to dictate standards for public safety based on scientific evidence. Rather than introducing confusion and the possibility of competition for resources such as PPE and vaccines, Canada’s multi-level chain of government authority has provided consistent policies supporting national public health and local delivery of medical care. This paper will demonstrate that the coordinated efforts on provincial and federal levels have been the linchpin in Canada’s relative success in containing the deadly spread of the COVID-19 virus.

Keywords: COVID-19, Canada, GIS, temporal analysis, ESRI

Procedia PDF Downloads 147

Authors: Violina Angelova

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A comparative study has been carried out into the impact of organic meliorants on the uptake of heavy metals, micro and macroelements and the phytoremediation potential of enhanced tobacco BAC F3. The soil used as part of this experiment was sampled from the vicinity of the Non-Ferrous-Metal Works near Plovdiv, Bulgaria. The pot experiment carried out consisted of a randomized, complete block design containing nine treatments and three replications (27 pots). The treatments consisted of a control (with no organic meliorants) and compost and vermicompost meliorants (added at 5%, 10%, 15%, and 30%, and recalculated based on their dry soil weight). Upon reaching commercial ripeness, the tobacco plants were gathered. Heavy metals, micro and macroelement contents in roots, stems, and leaves of tobacco were analyzed by the method of the microwave mineralization. To determine the elements in the samples, inductively coupled emission spectrometry (Jobin Yvon Emission - JY 38 S, France) was used. The distribution of the heavy metals, micro, and macroelements in the organs of the enhanced tobacco has a selective character and depended above all on the parts of the plants and the element that was examined. Pb, Zn, Cu, Fe, Mn, P and Mg distribution in tobacco decreases in the following order: roots > leaves > stems, and for Cd, K, and Ca - leaves > roots > stems. The high concentration of Cd in the leaves and the high translocation factor indicate the possibility of enhanced tobacco to be used in phytoextraction. Tested organic amendments significantly influenced the uptake of heavy metals, micro and macroelements by the roots, stems, and leaves of tobacco. A correlation was found between the quantity of the mobile forms and the uptake of Pb, Zn, and Cd by the enhanced tobacco. The compost and vermicompost treatments significantly reduced heavy metals concentration in leaves and increased uptake of K, Ca and Mg. The 30% compost and 30% vermicompost treatments led to the maximal reduction of heavy metals in enhanced tobacco BAC F3. The addition of compost and vermicompost further reduces the ability to digest the heavy metals in the leaves, and phytoremediation potential of enhanced tobacco BAC F3. Acknowledgment: The financial support by the Bulgarian National Science Fund Project DFNI Н04/9 is greatly appreciated.

Keywords: heavy metals, micro and macroelements, enhanced tobacco BAC F3, phytoremediation, organic meliorants

Procedia PDF Downloads 156

Authors: Weichao Yu, Kai Wen, Weihe Huang, Yang Yang, Jing Gong

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Metal-loss corrosion is a major threat to the safety and integrity of gas pipelines as it may result in the burst failures which can cause severe consequences that may include enormous economic losses as well as the personnel casualties. Therefore, it is important to ensure the corroding pipeline integrity and efficiency, considering the value of wall thickness, which plays an important role in the failure probability of corroding pipeline. Actually, the wall thickness is controlled during pipe purchase stage. For example, the API_SPEC_5L standard regulates the allowable tolerance of the wall thickness from the specified value during the pipe purchase. The allowable wall thickness tolerance will be used to determine the wall thickness distribution characteristic such as the mean value, standard deviation and distribution. Taking the uncertainties of the input variables in the burst limit-state function into account, the reliability approach rather than the deterministic approach will be used to evaluate the failure probability. Moreover, the cost of pipe purchase will be influenced by the allowable wall thickness tolerance. More strict control of the wall thickness usually corresponds to a higher pipe purchase cost. Therefore changing the wall thickness tolerance will vary both the probability of a burst failure and the cost of the pipe. This paper describes an approach to optimize the wall thickness tolerance considering both the safety and economy of corroding pipelines. In this paper, the corrosion burst limit-state function in Annex O of CSAZ662-7 is employed to evaluate the failure probability using the Monte Carlo simulation technique. By changing the allowable wall thickness tolerance, the parameters of the wall thickness distribution in the limit-state function will be changed. Using the reliability approach, the corresponding variations in the burst failure probability will be shown. On the other hand, changing the wall thickness tolerance will lead to a change in cost in pipe purchase. Using the variation of the failure probability and pipe cost caused by changing wall thickness tolerance specification, the optimal allowable tolerance can be obtained, and used to define pipe purchase specifications.

Keywords: allowable tolerance, corroding pipeline segment, operation cost, production cost, reliability approach

Procedia PDF Downloads 396

Authors: Luvindran Sugumaran, Mohd Nashrul Mohd Zubir, Kazi Md Salim Newaz, Tuan Zaharinie Tuan Zahari, Suazlan Mt Aznam, Aiman Mohd Halil

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Due to the rapid advancement of integrated circuits and the increasing trend towards miniaturizing electronic devices, the amount of heat produced by electronic devices has consistently exceeded the maximum limit for heat dissipation. Currently, the two-phase cooling technique based on phase change pool boiling heat transfer has received a lot of attention because of its potential to fully utilize the latent heat of the fluid and produce a highly effective heat dissipation capacity while keeping the equipment's operating temperature within an acceptable range. There are numerous strategies available for the alteration of heating surfaces, but to find the best, simplest, and most dependable one remains a challenge. Lately, surface texturing via laser ablation has been used in a variety of investigations, demonstrating its significant potential for enhancing the pool boiling heat transfer performance. In this research, the nucleate pool boiling heat transfer performance of laser-textured copper surfaces of different patterns was investigated. The bare copper surface serves as a reference to compare the performance of laser-structured surfaces. It was observed that the heat transfer coefficients were increased with the increase of surface area ratio and the ratio of the peak-to-valley height of the microstructure. Laser machined grain structure produced extra nucleation sites, which ultimately caused the improved pool boiling performance. Due to an increase in nucleation site density and surface area, the enhanced nucleate boiling served as the primary heat transfer mechanism. The pool boiling performance of the laser-textured copper surfaces is superior to the bare copper surface in all aspects.

Keywords: heat transfer coefficient, laser texturing, micro structured surface, pool boiling

Procedia PDF Downloads 92

Authors: Fiona Bei Na Tan, Glen Wen Kiat Ho, Ee Leen Liow, Li Yin Tan, Sean Wei Loong Ho

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Background: Shoulder arthroscopy is an increasingly common procedure. Pneumothorax post-shoulder arthroscopy is a rare complication. Objectives: Our aim is to highlight a case report of pneumothorax post shoulder arthroscopy and to conduct a literature review to evaluate the possible risk factors associated with developing a pneumothorax during or after shoulder arthroscopy. Case Report: We report the case of a 75-year-old male non-smoker who underwent left shoulder arthroscopy without regional anaesthesia and in the left lateral position. The general anaesthesia and surgery were uncomplicated. The patient was desaturated postoperatively and was found to have a pneumothorax on examination and chest X-ray. A chest tube drain was inserted promptly into the right chest. He had an uncomplicated postoperative course. Methods: PubMed Medline and Cochrane database search was carried out using the terms shoulder arthroplasty, pneumothorax, pneumomediastinum, and subcutaneous emphysema. We selected full-text articles written in English. Results: Thirty-two articles were identified and thoroughly reviewed. Based on our inclusion and exclusion criteria, 14 articles, which included 20 cases of pneumothorax during or after shoulder arthroscopy, were included. Eighty percent (16/20) of pneumothoraxes occurred postoperatively. In the articles that specify the side of pneumothorax, 91% (10/11) occur on the ipsilateral side of the arthroscopy. Eighty-eight percent (7/8) of pneumothoraxes occurred when subacromial decompression was performed. Fifty-six percent (9/16) occurred in patients placed in the lateral decubitus position. Only 30% (6/20) occurred in current or ex-smokers, and only 25% (5/20) had a pre-existing lung condition. Overall, of the articles that posit a mechanism, 75% (9/12) deem the pathogenesis to be multifactorial. Conclusion: The exact mechanism of pneumothorax is currently unknown. Awareness of this complication and timely recognition are important to prevent life-threatening sequelae. Surgeons should have a low threshold to obtain diagnostic plain radiographs in the event of clinical suspicion.

Keywords: rotator cuff repair, decompression, pressure, complication

Procedia PDF Downloads 67

Authors: M. G. Cattaneo

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The non-effectiveness of certain codified human rights is particularly apparent with reference to the lack of access to essential drugs in developing countries, which represents a breach of the human right to receive adequate health assistance. This paper underlines the conflict and the legal contradictions between human rights, namely health rights, international Intellectual Property Rights, in particular patent law, as well as international trade law. The paper discusses the crucial links between R&D costs for innovation, patents and new medical drugs, with the goal of reformulating the hierarchies of priorities and of interests at stake in the international intellectual property (IP) law system. Different from what happens today, International patent law should be a legal instrument apt at rebalancing an axiological asymmetry between the (conflicting) needs at stake The core argument in the paper is the proposal of an alternative pathway, namely a feasible proposal for a patent law reform. IP laws tend to balance the benefits deriving from innovation with the costs of the provided monopoly, but since developing countries and industrialized countries are in completely different political and economic situations, it is necessary to (re)modulate such exchange according to the different needs. Based on this critical analysis, the paper puts forward a proposal, called Trading Time for Space (TTS), whereby a longer time for patent exclusive life in western countries (Time) is offered to the patent holder company, in exchange for the latter selling the medical drug at cost price in developing countries (Space). Accordingly, pharmaceutical companies should sell drugs in developing countries at the cost price, or alternatively grant a free license for the sale in such countries, without any royalties or fees. However, such social service shall be duly compensated. Therefore, the consideration for such a service shall be an extension of the temporal duration of the patent’s exclusive in the country of origin that will compensate the reduced profits caused by the supply at the price cost in developing countries.

Keywords: global health, global justice, patent law reform, access to drugs

Procedia PDF Downloads 246