Search results for: integrated report

Authors: Muhammad Afzal, Shahbaz Mushtaq, Duc-Anh-An-Vo, Kathryn Reardon Smith, Thanh Ma

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Climate change has become one of the most challenging environmental issues in the 21st century. Climate change-induced natural disasters, especially floods, are the major factors of livelihood vulnerability, impacting millions of individuals worldwide. Evaluating and mitigating the effects of floods requires an in-depth understanding of the relationship between vulnerability and livelihood capital assets. Using an integrated approach, sustainable livelihood framework, and system thinking approach, the study developed a conceptual model of a generalized livelihood system in District Rajanpur, Pakistan. The model visualizes the livelihood vulnerability system as a whole and identifies the key feedback loops likely to influence the livelihood vulnerability. The study suggests that such conceptual models provide effective communication and understanding tools to stakeholders and decision-makers to anticipate the problem and design appropriate policies. It can also serve as an evaluation technique for rural livelihood policy and identify key systematic interventions. The key finding of the study reveals that household income, health, and education are the major factors behind the livelihood vulnerability of the rural poor of District Rajanpur. The Pakistani government tried to reduce the livelihood vulnerability of the region through different income, health, and education programs, but still, many changes are required to make these programs more effective especially during the flood times. The government provided only cash to vulnerable and marginalized families through income support programs, but this study suggests that along with the cash, the government must provide seed storage facilities and access to crop insurance to the farmers. Similarly, the government should establish basic health units in villages and frequent visits of medical mobile vans should be arranged with advanced medical lab facilities during and after the flood.

Keywords: livelihood vulnerability, rural communities, flood, sustainable livelihood framework, system dynamics, Pakistan

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Authors: Ana Maria Igual-Munoz, Juan Gilabert, Marta Garcia, Alfredo Quijano-Lopez

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Nowadays, several lithium-ion battery technologies are being commercialized. These chemistries present different properties that make them more suitable for different purposes. However, comparative studies showing the advantages and disadvantages of different chemistries are incomplete or scarce. Different non-destructive techniques are currently being employed to detect how ageing affects the active materials of lithium-ion batteries (LIBs). For instance, electrochemical impedance spectroscopy (EIS) is one of the most employed ones. This technique allows the user to identify the variations on the different resistances present in LIBs. On the other hand, differential voltage analysis (DVA) has shown to be a powerful technique to detect the processes affecting the different capacities present in LIBs. This technique shows variations in the state of health (SOH) and the capacities for one or both electrodes depending on their chemistry. Finally, incremental capacity analysis (ICA) is a widely known technique for being capable of detecting phase equilibria. It reminds of the commonly used cyclic voltamperometry, as it allows detecting some reactions taking place in the electrodes. In these studies, a set of ageing procedures have been applied to commercial batteries of different chemistries (NCA, NMC, and LFP). Afterwards, results of EIS, DVA, and ICA have been used to correlate them with the processes affecting each cell. Ciclability, overpotential, and temperature cycling studies envisage how the charge-discharge rates, cut-off voltage, and operation temperatures affect each chemistry. These studies will serve battery pack manufacturers, as for common battery users, as they will determine the different conditions affecting cells for each of the chemistry. Taking this into account, each cell could be adjusted to the final purpose of the battery application. Last but not least, all the degradation parameters observed are focused to be integrated into degradation models in the future. This fact will allow the implementation of the widely known digital twins to the degradation in LIBs.

Keywords: lithium ion batteries, non-destructive analysis, different chemistries, ante-mortem studies, ICA, DVA, EIS

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Authors: Pankaj Kumar Jha, Mahendra Singh Hada, Brijendra Singh, Sandeep Yadav

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Protective relays are commonly connected to the secondary windings of instrument transformers, i.e., current transformers (CTs) and/or capacitive voltage transformers (CVTs). The purpose of CT and CVT is to provide galvanic isolation from high voltages and reduce primary currents and voltages to a nominal quantity recognized by the protective relays. Selecting the correct instrument transformers for an application is imperative: failing to do so may compromise the relay’s performance, as the output of the instrument transformer may no longer be an accurately scaled representation of the primary quantity. Having an accurately rated instrument transformer is of no use if these devices are not properly connected. The performance of the protective relay is reliant on its programmed settings and on the current and voltage inputs from the instrument transformers secondary. This paper will help in understanding the fundamental concepts of the connections of Instrument Transformers to the protection relays and the effect of incorrect connection on the performance of protective relays. Multiple case studies of protection system mal-operations due to incorrect connections of instrument transformers will be discussed in detail in this paper. Apart from the connection issue of instrument transformers to protective relays, this paper will also discuss the effect of multiple earthing of CTs and CVTs secondary on the performance of the protection system. Case studies presented in this paper will help the readers to analyse the problem through real-world challenges in complex power system networks. This paper will also help the protection engineer in better analysis of disturbance records. CT and CVT connection errors can lead to undesired operations of protection systems. However, many of these operations can be avoided by adhering to industry standards and implementing tried-and-true field testing and commissioning practices. Understanding the effect of missing neutral of CVT, multiple earthing of CVT secondary, and multiple grounding of CT star points on the performance of the protection system through real-world case studies will help the protection engineer in better commissioning the protection system and maintenance of the protection system.

Keywords: bus reactor, current transformer, capacitive voltage transformer, distance protection, differential protection, directional earth fault, disturbance report, instrument transformer, ICT, REF protection, shunt reactor, voltage selection relay, VT fuse failure

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Authors: Santimoy Khilari, Debabrata Pradhan

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Ever−increasing energy demand and growing energy crisis along with environmental issues emphasize the research on sustainable energy conversion and storage systems. Recently, supercapacitors or electrochemical capacitors emerge as a promising energy storage technology for future generation. The activity of supercapacitors generally depends on the efficiency of its electrode materials. So, the development of cost−effective efficient electrode materials for supercapacitors is one of the challenges to the scientific community. Transition metal oxides with spinel crystal structure receive much attention for different electrochemical applications in energy storage/conversion devices because of their improved performance as compared to simple oxides. In the present study, we have synthesized polypyrrole (PPy) supported manganese cobaltite nanorods (MnCo2O4 NRs) hybrid electrode material for supercapacitor application. The MnCo2O4 NRs were synthesized by a simple hydrothermal and calcination approach. The MnCo2O4 NRs/PPy hybrid was prepared by in situ impregnation of MnCo2O4 NRs during polymerization of pyrrole. The surface morphology and microstructure of as−synthesized samples was characterized by scanning electron microscopy and transmission electron microscopy, respectively. The crystallographic phase of MnCo2O4 NRs, PPy and hybrid was determined by X-ray diffraction. Electrochemical charge storage activity of MnCo2O4 NRs, PPy and MnCo2O4 NRs/PPy hybrid was evaluated from cyclic voltammetry, chronopotentiometry and electrochemical impedance spectroscopy. Significant improvement of specific capacitance was achieved in MnCo2O4 NRs/PPy hybrid as compared to the individual components. Furthermore, the mechanically mixed MnCo2O4 NRs, and PPy shows lower specific capacitance as compared to MnCo2O4 NRs/PPy hybrid suggesting the importance of in situ hybrid preparation. The stability of as prepared electrode materials was tested by cyclic charge-discharge measurement for 1000 cycles. Maximum 94% capacitance was retained with MnCo2O4 NRs/PPy hybrid electrode. This study suggests that MnCo2O4 NRs/PPy hybrid can be used as a low cost electrode material for charge storage in supercapacitors.

Keywords: supercapacitors, nanorods, spinel, MnCo2O4, polypyrrole

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Authors: Lucie Matricon, Anne Roubaud, Geert Haarlemmer, Christophe Geantet

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Introduction: This case discusses the management of two floor of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. Case Report: A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Discussion: Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk, and second primary cancer development.

Keywords: microalgae, biofuels, hydrothermal liquefaction, biomass

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Authors: Giselle Tran, Ralitza Parina, Phuong T. Nguyen

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Background/Aims: Pancreatic cysts (PC) have recently become an increasingly common entity, often diagnosed as incidental findings on cross-sectional imaging. Clinically, management of the lesions is difficult because of uncertainties in their potential for malignant degeneration. Prior series have reported that carcinoembryonic antigen (CEA), a biomarker collected from cyst fluid aspiration, has a high diagnostic accuracy for discriminating between mucinous and non-mucinous lesions, at the patient’s initial presentation. To the author’s best knowledge, no prior studies have reported PC CEA levels obtained from endoscopic ultrasound fine-needle aspiration (EUS-FNA) over years of serial EUS surveillance imaging. Methods: We report a consecutive retrospective series of 624 patients who underwent EUS evaluation for a PC between 11/20/2009 and 11/13/2018. Of these patients, 401 patients had CEA values obtained at the point of entry. Of these, 157 patients had two or more CEA values obtained over the course of their EUS surveillance. Of the 157 patients (96 F, 61 M; mean age 68 [range, 62-76]), the mean interval of EUS follow-up was 29.7 months [3.5-128]. The mean number of EUS procedures was 3 [2-7]. To assess CEA value fluctuations, we defined an appreciable increase in CEA as "spikes" – two-times increase in CEA on a subsequent EUS-FNA of the same cyst, with the second CEA value being greater than 1000 ng/mL. Using this definition, cysts with a spike in CEA were compared to those without a spike in a bivariate analysis to determine if a CEA spike is associated with poorer outcomes and the presence of high-risk features. Results: Of the 157 patients analyzed, 29 had a spike in CEA. Of these 29 patients, 5 had a cyst with size increase >0.5cm (p=0.93); 2 had a large cyst, >3cm (p=0.77); 1 had a cyst that developed a new solid component (p=0.03); 7 had a cyst with a solid component at any time during surveillance (p=0.08); 21 had a complex cyst (p=0.34); 4 had a cyst categorized as "Statistically Higher Risk" based on molecular analysis (p=0.11); and 0 underwent surgical resection (p=0.28). Conclusion: With serial EUS imaging in the surveillance of PC, an increase in CEA level defined as a spike did not predict poorer outcomes. Most notably, a spike in CEA did not correlate with the number of patients sent to surgery or patients with an appreciable increase in cyst size. A spike in CEA did not correlate with the development of a solid nodule within the PC nor progression on molecular analysis. Future studies should focus on the selected use of CEA analysis when patients undergo EUS surveillance evaluation for PCs.

Keywords: carcinoembryonic antigen (CEA), endoscopic ultrasound (EUS), fine-needle aspiration (FNA), pancreatic cyst, spike

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Authors: Tara Moore

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Madagascar is one of the regions of the world with the highest biodiversity, with more than 600 new species discovered in just the last decade. In parallel with its record-breaking biodiversity, Madagascar is also the tenth poorest country in the world. The resultant socio-economic pressures are leading to a highly threatened environment. In particular, deforestation is at the core of biodiversity and ecosystem loss, primarily from slash and burn agriculture and illegal rosewood tree harvesting. Effective policy response is imperative for improved conservation in Madagascar. However, these changes cannot come from the current, unstable government institutions. After a violent and politically turbulent coup in 2009, any effort to defend Madagascar's biodiversity has been eclipsed by the high corruption of government bodies. This paper presents three policy options designed for a private donor to invest in conservation in Madagascar. The first proposed policy consists of payments for ecosystem services model, which involves paying local Malagasy women to reforest nearby territories. The second option is a micro-irrigation system proposal involving relocating local Malagasy out of the threatened forest region. The final proposition is captive breeding funding for the Madagascar Fauna and Flora Group, which could then lead to new reintroductions in the threatened northeastern rainforests. In the end, all three options present feasible, impactful options for a conservation-minded major donor. Ideally, the policy change would involve a combination of all three options, as each provides necessary development and conservation re-structuring goals. Option one, payments for ecosystem services, would be the preferred choice if there were only enough funding for one project. The payments for ecosystem services project both support local populations and promotes sustainable development while reforesting the threatened Marojejy National Park. Regardless of the chosen policy solution, any support from a donor will make a huge impact if it supports both sustainable development and biodiversity conservation.

Keywords: captive breeding, cnservation policy, lemur conservation, Madagascar conservation, payments for ecosystem services

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Authors: Lucas Paganin, Viliam Makis

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With the advent of globalization, the market competition has become a major issue for most companies. One of the main strategies to overcome this situation is the quality improvement of the product at a lower cost to meet customers’ expectations. In order to achieve the desired quality of products, it is important to control the process to meet the specifications, and to implement the optimal maintenance policy for the machines and the production lines. Thus, the overall objective is to reduce process variation and the production and maintenance costs. In this paper, an integrated model involving Statistical Process Control (SPC) and maintenance is developed to achieve this goal. Therefore, the main focus of this paper is to develop the jointly optimal maintenance and statistical process control policy minimizing the total long run expected average cost per unit time. In our model, the production process can go out of control due to either the deterioration of equipment or other assignable causes. The equipment is also subject to failures in any of the operating states due to deterioration and aging. Hence, the process mean is controlled by an Xbar control chart using equidistant sampling epochs. We assume that the machine inspection epochs are the times when the control chart signals an out-of-control condition, considering both true and false alarms. At these times, the production process will be stopped, and an investigation will be conducted not only to determine whether it is a true or false alarm, but also to identify the causes of the true alarm, whether it was caused by the change in the machine setting, by other assignable causes, or by both. If the system is out of control, the proper actions will be taken to bring it back to the in-control state. At these epochs, a maintenance action can be taken, which can be no action, or preventive replacement of the unit. When the equipment is in the failure state, a corrective maintenance action is performed, which can be minimal repair or replacement of the machine and the process is brought to the in-control state. SMDP framework is used to formulate and solve the joint control problem. Numerical example is developed to demonstrate the effectiveness of the control policy.

Keywords: maintenance, semi-Markov decision process, statistical process control, Xbar control chart

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Authors: Chante J. De Klerk

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The potential of music to facilitate superior performance during high to elite level gymnastics conditioning instigated this research. A team of seven gymnasts completed a fixed conditioning programme eight times, alternating the two variable conditions. Four sessions of each condition were conducted: without music (session 1), with music (session 2), without music (3), with music (4), without music (5), and so forth. Quantitative data were collected in both conditions through physiological monitoring of the gymnasts, and administration of the Situational Motivation Scale (SIMS). Statistical analysis of the physiological data made it possible to quantify the presence as well as the magnitude of the musical intervention’s impact on various aspects of the gymnasts' physiological functioning during conditioning. The SIMS questionnaire results were used to evaluate if their motivation towards conditioning was altered by the intervention. Thematic analysis of qualitative data collected through semi-structured interviews revealed themes reflecting the gymnasts’ sentiments towards the data collection process. Gymnast-specific descriptions and experiences of the team as a whole were integrated with the quantitative data to facilitate greater dimension in establishing the impact of the intervention. The results showed positive physiological, motivational, and emotional effects. In the presence of music, superior sympathetic nervous activation, and energy efficiency, with more economic breathing, dominated the physiological data. Fatigue and arousal levels (emotional and physiological) were also conducive to improved conditioning outcomes compared to conventional conditioning (without music). Greater levels of positive affect and motivation emerged in analysis of both the SIMS and interview data sets. Overall, the intervention was found to promote psychophysiological coherence during the physical activity. In conclusion, a strategically constructed musical intervention, designed to accompany a gymnastics conditioning session for high to elite level gymnasts, has ergogenic potential.

Keywords: arousal, fatigue, gymnastics conditioning, motivation, musical intervention, psychophysiological coherence

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Authors: Joshua Russell, Omar Zubair, Reuben Ndegwa

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Introduction: Mesenteric ischemia is an uncommon condition that can be challenging to diagnose in the acute setting, with the potential for significant morbidity and mortality. Very rarely has acute acalculous cholecystitis been described in the setting of mesenteric ischemia. Case: This was the case in a 78-year-old male, who initially presented with clinical and radiological evidence of small bowel obstruction, thought likely secondary to malignancy. The patient had a 6-week history of anorexia, worsening lower abdominal pain, and ~30kg of unintentional weight loss over a 12-month period and a CT- scan demonstrated a transition point in the distal ileum. The patient became increasingly hemodynamically unstable and peritonitic, and an emergency laparotomy was performed. Intra-operatively, however, no obvious transition point was identified, and instead, the gallbladder was markedly gangrenous and oedematous, consistent with acalculous cholecystitis. An open total cholecystectomy was subsequently performed. The patient was admitted to the Intensive Care Unit post-operatively and continued to deteriorate over the proceeding 48 hours, with two re-look laparotomies demonstrating progressively worsening bowel ischemia, initially in the distribution of the superior mesenteric artery and then the coeliac trunk. On review, the patient was found to have an aberrant right hepatic artery arising from the superior mesenteric artery. The extent of ischemia was considered non-survivable, and the patient was palliated. Discussion: Multiple theories currently exist for the underlying pathophysiology of acalculous cholecystitis, including biliary stasis, sepsis, and ischemia. This case lends further support to ischemia as the underlying etiology of acalculous cholecystitis. This is particularly the case when considered in the context of the patient’s aberrant right hepatic artery arising from the superior mesenteric artery, which occurs in 11-14% of patients. Conclusion: This case report adds further insight to the debate surrounding the pathophysiology of acalculous cholecystitis. It also presents acalculous cholecystitis as a complication of mesenteric ischemia that should always be considered, especially in the elderly patient and in the context of relatively common anatomical variations. Furthermore, the case brings to attention the importance of maintaining dynamic working diagnoses in the setting of evolving pathophysiology and clinical presentations.

Keywords: acalculous cholecystitis, anatomical variation, general surgery, mesenteric ischemia

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Authors: Sanchari Mukhopadhyay

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Today, almost the entire realm of human activities are becoming increasingly dependent on the power of information, where through ICTs it is now possible to cater distances and avail various services at a few clicks. In principle, ICTs are thus expected to blur location-specific differences and affiliations of development and bring in an inclusive society at the wake of globalization. However, eventually researchers and policy analysts realized that ICTs are also generating inequality in spite of the hope for an integrated world and widespread social well-being. Regarding this unevenness, location plays a major role as often ICT development is seen to be concentrated into pockets, leaving behind large tracks as underprivileged. Thus, understanding the spatial pattern of ICT development and distribution is significant in relation to exploring the extent to which ICTs are fulfilling the promises or reassuring the existing divisions. In addition, it is also profoundly crucial to investigate how regions are connecting and competing both locally and globally. The focus of the research paper is to evaluate the spatial structure of ICT led development in India. Thereby, it attempts to understand the state level (four selected states) pattern of ICT penetration, the pattern of diffusion across districts with respect to large urban centres and the rural-urban disparity of technology adoption. It also tries to assess the changes in access dynamisms of ICTs as one move away from a large metropolitan city towards the periphery. In brief, the analysis investigates into the tendency towards the uneven growth of development through the identification of the core areas of ICT advancement within the country and its diffusion from the core to the periphery. In order to assess the level of ICT development and rural-urban disparity across the districts of selected states, two indices named ICT Development Index and Rural-Urban Digital Divide Index have been constructed. The study mostly encompasses the latest Census (2011) of the country and TRAI (Telecom Regulatory Authority of India) in some cases.

Keywords: ICT development, diffusion, core-periphery, digital divide

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Authors: Nor Hafizah Selamat, Intan Hashima Mohd Hashim, Noraida Endut, Shariffah Suraya Syed Jamaludin, Sharifah Zahhura Syed Abdullah, Suziana Mat Yasin, Nurul Jannah Ambak

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In Malaysia, report on discrimination against pregnant women at work does exist, and this issue should be taken seriously as large proportion of women in the workforce in Malaysia are of reproductive age. It has been well established that women tend to leave the workforce because of their responsibility in raising the family, to care for family members and, also due to lack of work-life balance. In this case, women find themselves disadvantaged in career and job advancements due to gender roles and expectations connected with maternity. This maternity discrimination have pushed women out of work although The Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), to which Malaysia is a party, considers discrimination on the ground of maternity is a form of gender discrimination because it hinders women of their effective right to work and requires that special protection be provided for women during maternity to ensure their ability to enjoy the right to work (Article 11(2). What factors prevent women from returning to work and at the same time performing their gender roles expectations? Using semi-structured in-depth interviews this paper explores the experiences of maternity discrimination and their perspectives towards their work employment. 15 women employees who were pregnant or had given birth during her employment period in public and private organizations in Malaysia were participated in this study. While data were analyzed using narrative analysis, respondents were asked on issues related to managing pregnancy, maternity leave and returning to work. The findings revealed that several respondents from private companies stated that they were either dismissed or forced to take unpaid leave due to the company policies. In some cases, respondents also shared how they were treated poorly that they felt that they had to leave their jobs. However, in public organization, the maternity policy implemented showed the support that the employees received from their employer. Study shows that supportive family and employers will encourage employees to return to work. Reasonable adjustments in terms of maternity policies at workplace such as allowing sufficient time in postnatal appointments, offering clear explanation on maternity issues at workplace are something that employees expected from their employers.

Keywords: maternity discrimination, women and work, gender, maternity protection, Malaysia

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Authors: Livingstone Makondo

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This ongoing research explores what could be the components of a comprehensive First-Year Student Experience (FYSE) at the Durban University of Technology (DUT) and the preferred implementation modalities. In light of the Siyaphumelela project, this interrogation is premised on the need to glean data for the institution that could be used to ascertain the role of FYSE towards enhancing student success. The research proceeds by examining prevalent models from other South African Universities and beyond in its quest to get at pragmatic comprehensive FYSE programme for DUT. As DUT is a student centered institution and amidst the ever shrinking economy, this research would aid higher education practitioners to ascertain if the hard earned finances are being channelled to a worthy academic venture. This research seeks to get inputs from a) students who participated in FYSE and are now in second and third years at DUT b) students who are currently participating in FYSE c) former and present Tutors d) departmental coordinators e) academics and support staff working with the participating students. This exploratory approach is preferred since 2010 DUT has grappled with how to implement an integrated institution-wide FYSE. This findings of this research could provide the much-needed data to ascertain if the current FYSE package is pivotal towards attainment of DUT Strategic Focus Area 1: Building sustainable student communities of living and learning. The ideal is to have DUT FYSE programme become an institution-wide programme that lays the foundation for consolidated and focused student development programmes for subsequent undergraduate and postgraduate levels of study. Also, armed with data from this research, DUT could develop the capacity and systems to ensure that all students get diverse on-time support to enhance their retention and academic success in their tertiary studies. In essence, the preferred FYSE curriculum woven around DUT graduate attributes should contribute towards the reduction in the first-year students’ dropout rates and subsequently in undergraduate studies. Therefore, this on-going research will feed into Siyaphumelela project and would help position 2018-2020 FYSE initiatives at DUT.

Keywords: challenges, comprehensive, dropout, transition

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Authors: Atif Alenezi

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The low global oil price poses economic challenges for Saudi Arabia, as oil revenues still make up a great percentage of its Gross Domestic Product (GDP). At the end of 2014, the Consultative Assembly considered a report from the Committee on Economic Affairs and Energy which highlights that the economy had not been successfully diversified. There thus exist ample reasons for modernising the Foreign Direct Investment (FDI) regime, primarily to achieve and maintain prosperity and facilitate peace in the region. Therefore, this paper aims at identifying specific problems with the existing FDI regime in Saudi Arabia and subsequently some solutions to those problems. Saudi Arabia adopted its first specific legislation in 1956, which imposed significant restrictions on foreign ownership. Since then, Saudi Arabia has modernised its FDI framework with the passing of the Foreign Capital Investment Act 1979 and the Foreign Investment Law2000 and the accompanying Executive Rules 2000 and the recently adopted Implementing Regulations 2014.Nonetheless, the legislative provisions contain various gaps and the failure to address these gaps creates risks and uncertainty for investors. For instance, the important topic of mergers and acquisitions has not been addressed in the Foreign Investment Law 2000. The circumstances in which expropriation can be considered to be in the public interest have not been defined. Moreover, Saudi Arabia has not entered into many bilateral investment treaties (BITs). This has an effect on the investment climate, as foreign investors are not afforded typical rights. An analysis of the BITs which have been entered into reveals that the national treatment standard and stabilisation, umbrella or renegotiation provisions have not been included. This is problematic since the 2000 Act does not spell out the applicable standard in accordance with which foreign investors should be treated. Moreover, the most-favoured-nation (MFN) or fair and equitable treatment (FET) standards have not been put on a statutory footing. Whilst the Arbitration Act 2012 permits that investment disputes can be internationalised, restrictions have been retained. The effectiveness of international arbitration is further undermined because Saudi Arabia does not enforce non-domestic arbitral awards which contravene public policy. Furthermore, the reservation to the Convention on the Settlement of Investment Disputes allows Saudi Arabia to exclude petroleum and sovereign disputes. Interviews with foreign investors, who operate in Saudi Arabia highlight additional issues. Saudi Arabia ought not to procrastinate far-reaching structural reforms.

Keywords: FDI, Saudi, BITs, law

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Authors: L. Tonia, I. Daglis, W. Kurth

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The sound of the universe creates an affinity with the sounds of music. The analysis of the sound of space focuses on the existence of a tone material, the microstructure and macrostructure, and the form of the sound through the signals recorded during the flight of the spacecraft Van Allen Probes and Cassini’s mission. The sound becomes from the frequencies that belong to electromagnetic waves. Plasma Wave Science Instrument and Electric and Magnetic Field Instrument Suite and Integrated Science (EMFISIS) recorded the signals from space. A transformation of that signals to audio gave the opportunity to study and analyze the sound. Due to the fact that the musical tone pitch has a frequency and every electromagnetic wave produces a frequency too, the creation of a musical score, which appears as the sound of space, can give information about the form, the symmetry, and the harmony of the sound. The conversion of space radio emissions to audio provides a number of tone pitches corresponding to the original frequencies. Through the process of these sounds, we have the opportunity to present a music score that “composed” from space. In this score, we can see some basic features associated with the music form, the structure, the tone center of music material, the construction and deconstruction of the sound. The structure, which was built through a harmonic world, includes tone centers, major and minor scales, sequences of chords, and types of cadences. The form of the sound represents the symmetry of a spiral movement not only in micro-structural but also to macro-structural shape. Multiple glissando sounds in linear and polyphonic process of the sound, founded in magnetic fields around Earth, Saturn, and Jupiter, but also a spiral movement appeared on the spectrogram of the sound. Whistles, Auroral Kilometric Radiations, and Chorus emissions reveal movements similar to musical excerpts of works by contemporary composers like Sofia Gubaidulina, Iannis Xenakis, EinojuhamiRautavara.

Keywords: space sound analysis, spiral, space music, analysis

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Authors: Francesca Croce

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Governmental development strategies aimed at entrepreneurship as a major resource for economic development and poverty reduction of indigenous people. As initiatives and programs are local based, there is a need to better understand the contextual factors of indigenous entrepreneurial models. The purpose of this paper is, therefore, to analyze and integrated the indigenous entrepreneurship literature in order to identify the main models of indigenous entrepreneurship. To answer this need, a systematic literature review was conducted. Relevant articles were identified in selected electronic databases (ABI/Inform Global, Business Source Premier, Web of Science; International Bibliography of the Social Sciences, Academic Search, Sociological Abstract, Entrepreneurial Studies Sources and Bibliography of Native North America) and in selected electronic review. Beginning to 1st January 1995 (first International Day of the World’s Indigenous People), 59 academic articles were selected from 1411. Through systematic analysis of the cultural, social and organizational variables, the paper highlights that a typology of indigenous entrepreneurial models is possible thought the concept of entrepreneurial ecosystem, which includes the geographical position and the environment of the indigenous communities. The results show three models of indigenous entrepreneurship: the urban indigenous entrepreneurship, the semi-urban indigenous entrepreneurship, and rural indigenous entrepreneurship. After the introduction, the paper is organized as follows. In the first part theoretical and practical needs of a systematic literature review on indigenous entrepreneurship are provided. In the second part, the methodology, the selection process and evaluation of the articles are explained. In the third part, findings are presented and each indigenous entrepreneurial model characteristics are discussed. The results of this study bring a new theorization about indigenous entrepreneurship and may be useful for scientists in the field in search of overcoming the cognitive border of Indigenous business models still too little known. Also, the study is addressed to policy makers in charge of indigenous entrepreneurial development strategies more focused on contextual factors studies.

Keywords: community development, entrepreneurial ecosystem, indigenous entrepreneurship model, indigenous people, systematic literature review

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Authors: David Onen

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Staff exchanges amongst different work organizations are a growing international phenomenon. In higher education in particular, it is not only the staff participating on international exchange programs, but their students as well. The practice of exchanging staff is premised on the belief that participating members of staff would not only get the chance to network with colleagues from partner institutions but also gain the opportunity for knowledge sharing and skills development. As a result, it would not only benefit the participating individual staff but their institutions too. However, in practice, staff exchange programs everywhere are not all ‘a bed of roses’. In fact, some of the programs seem to be laden with unapparent source of trouble or danger for the participating staff. This paper is a report on an on-going study investigating the experiences of members of academic staff of Makerere University in Uganda who have ever participated on international staff exchange programs. The study is aimed at documenting individual experiences in order to stimulate, not only a debate, but practical ways of enriching the experiences of staff who engage on well-meant international staff exchange programs. The study has employed an exploratory survey research design in which self-administered questionnaire and interview guide are being used to collect data from university academic staff respondents selected through snow-ball and purposive sampling techniques. Data have been analysed with the use of appropriate descriptive and inferential statistics as well as content analysis techniques. Preliminary study findings reveal that the majority of the respondents (95.5%) were, to a large extent, fully satisfied with their participation on the staff exchange programs. Many attested to gaining new experience (97%), networking (75%), gaining new knowledge (94%), acquiring new skills (88%), and therefore bringing to their institutions something ‘new’ and ‘beneficial’. However, a reasonably large percentage (57%) of the participants too expressed dissatisfaction in the institutional support that Makerere University gave them during their participation on the exchange programs. Some respondents reported about the ‘unfriendly welcome’ they received upon returning ‘home’ because colleagues detested how they were chosen to participate on such programs. The researcher thus concluded that international staff exchange programs are truly beneficial to both the participating staff and their institutions though with pitfalls. The researcher thus recommended for mutual and preferably equal engagement of the participating institutions on staff exchange programs if such programs are to benefit both the participating staff and institutions. Besides, exchange programs require clear terms of cooperation including on how staff are selected, facilitated and what are expected of the sending and host institutions as well as the concerned staff.

Keywords: gains, exchange programs, higher education, pitfalls

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Authors: C. M. Choi, H. C. Tsang, W. K. Fong, Y. K. Cheng, T. K. Chui, L. Y. Chan, K. W. Lee, C. K. Yuen, P. W. Lau, Y. L. To, K. C. Chow

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Six-minute walk test (6MWT) is a sub-maximal exercise test to assess aerobic capacity and exercise tolerance of patients with chronic respiratory disease and heart failure. This has been proven to be a reliable and valid tool and commonly used in clinical situations. Traditional 6MWT is labour-intensive and time-consuming especially for patients who require assistance in ambulation and oxygen use. When performing the test with these patients, one staff will assist the patient in walking (with or without aids) while another staff will need to manually record patient’s oxygen saturation, heart rate and walking distance at every minute and/or carry oxygen cylinder at the same time. Physiotherapist will then have to document the test results in bed notes in details. With the use of electronic 6MWT (E-6MWT), patients wear a wireless oximeter that transfers data to a tablet PC via Bluetooth. Real-time recording of oxygen saturation, heart rate, and distance are displayed. No manual work on recording is needed. The tablet will generate a comprehensive report which can be directly attached to the patient’s bed notes for documentation. Data can also be saved for later patient follow up. This study was carried out in North District Hospital. Patients who followed commands and required 6MWT assessment were included. Patients were assigned to study or control groups. In the study group, patients adopted the E-6MWT while those in control group adopted the traditional 6MWT. Manpower and time consumed were recorded. Physiotherapists also completed a questionnaire about the use of E-6MWT. Total 12 subjects (Study=6; Control=6) were recruited during 11-12/2017. An average number of staff required and time consumed in traditional 6MWT were 1.67 and 949.33 seconds respectively; while in E-6MWT, the figures were 1.00 and 630.00 seconds respectively. Compared to traditional 6MWT, E-6MWT required 67.00% less manpower and 50.10% less in time spent. Physiotherapists (n=7) found E-6MWT is convenient to use (mean=5.14; satisfied to very satisfied), requires less manpower and time to complete the test (mean=4.71; rather satisfied to satisfied), has better data management (mean=5.86; satisfied to very satisfied) and is recommended to be used clinically (mean=5.29; satisfied to very satisfied). It is proven that E-6MWT requires less manpower input with higher efficiency and better data management. It is welcomed by the clinical frontline staff.

Keywords: electronic, physiotherapy, six-minute walk test, 6MWT

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Authors: Marta Fonseca, Pedro Marvão, Beatriz Oliveira, Bruno Heleno, Pedro Carreiro-Martins, Nuno Neuparth, António Rendas

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Background: Concept maps (CMs) visually represent hierarchical connections among related ideas. They foster logical organization and clarify idea relationships, potentially aiding medical students in critical thinking (to think clearly and rationally about what to do or what to believe). However, there are inconsistent claims about the use of CMs in undergraduate medical education. Our three research questions are: 1) What studies have been published on concept mapping in undergraduate medical education? 2) What was the impact of CMs on students’ critical thinking? 3) How and why have these interventions had an educational impact? Methods: Eight databases were systematically searched (plus a manual and an additional search were conducted). After eliminating duplicate entries, titles, and abstracts, and full-texts were independently screened by two authors. Data extraction and quality assessment of the studies were independently performed by two authors. Qualitative and quantitative data were integrated using mixed-methods. The results were reported using the structured approach to the reporting in healthcare education of evidence synthesis statement and BEME guidance. Results: Thirty-nine studies were included from 26 journals (19 quantitative, 8 qualitative and 12 mixed-methods studies). CMs were considered as a tool to promote critical thinking, both in the perception of students and tutors, as well as in assessing students’ knowledge and/or skills. In addition to their role as facilitators of knowledge integration and critical thinking, CMs were considered both teaching and learning methods. Conclusions: CMs are teaching and learning tools which seem to help medical students develop critical thinking. This is due to the flexibility of the tool as a facilitator of knowledge integration, as a learning and teaching method. The wide range of contexts, purposes, and variations in how CMs and instruments to assess critical thinking are used increase our confidence that the positive effects are consistent.

Keywords: concept map, medical education, undergraduate, critical thinking, meaningful learning

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Authors: Tuji Jemal Ahmed

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Food security and utilization are critical aspects of ensuring the well-being and prosperity of a nation. This paper examines the current state of food security and utilization in Ethiopia, focusing on the challenges, opportunities, and strategies employed to address the issue. Ethiopia, a country in East Africa, has made significant progress in recent years to improve food security and utilization for its population. However, persistent challenges such as recurrent droughts, limited access to resources, and low agricultural productivity continue to pose obstacles to achieving sustainable food security. The paper begins by providing an overview of the concept of food security, emphasizing its multidimensional nature and the importance of access, availability, utilization, and stability. It then explores the specific factors influencing food security and utilization in Ethiopia, including natural resources, climate variability, agricultural practices, infrastructure, and socio-economic factors. Furthermore, the paper highlights the initiatives and interventions implemented by the Ethiopian government, non-governmental organizations, and international partners to enhance food security and utilization. These efforts include agricultural extension programs, irrigation projects, investments in rural infrastructure, and social safety nets to protect vulnerable populations. The study also examines the role of technology and innovation in improving food security and utilization in Ethiopia. It explores the potential of sustainable agricultural practices, such as conservation agriculture, improved seed varieties, and precision farming techniques. Additionally, it discusses the role of digital technologies in enhancing access to market information, financial services, and agricultural inputs for smallholder farmers. Finally, the paper discusses the importance of collaboration and partnerships between stakeholders, including government agencies, development organizations, research institutions, and communities, in addressing food security and utilization challenges. It emphasizes the need for integrated and holistic approaches that consider both production and consumption aspects of the food system.

Keywords: food security, utilization, Ethiopia, challenges

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Authors: Tuji Jemal Ahmed

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Food security and utilization are critical aspects of ensuring the well-being and prosperity of a nation. This paper examines the current state of food security and utilization in Ethiopia, focusing on the challenges, opportunities, and strategies employed to address the issue. Ethiopia, a country in East Africa, has made significant progress in recent years to improve food security and utilization for its population. However, persistent challenges such as recurrent droughts, limited access to resources, and low agricultural productivity continue to pose obstacles to achieving sustainable food security. The paper begins by providing an overview of the concept of food security, emphasizing its multidimensional nature and the importance of access, availability, utilization, and stability. It then explores the specific factors influencing food security and utilization in Ethiopia, including natural resources, climate variability, agricultural practices, infrastructure, and socio-economic factors. Furthermore, the paper highlights the initiatives and interventions implemented by the Ethiopian government, non-governmental organizations, and international partners to enhance food security and utilization. These efforts include agricultural extension programs, irrigation projects, investments in rural infrastructure, and social safety nets to protect vulnerable populations. The study also examines the role of technology and innovation in improving food security and utilization in Ethiopia. It explores the potential of sustainable agricultural practices, such as conservation agriculture, improved seed varieties, and precision farming techniques. Additionally, it discusses the role of digital technologies in enhancing access to market information, financial services, and agricultural inputs for smallholder farmers. Finally, the paper discusses the importance of collaboration and partnerships between stakeholders, including government agencies, development organizations, research institutions, and communities, in addressing food security and utilization challenges. It emphasizes the need for integrated and holistic approaches that consider both production and consumption aspects of the food system.

Keywords: food security, utilization, Ethiopia, challenges

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Authors: M. J. Alcedo, K. Ito, K. Maeda

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A stockperson has a significant influence on the productivity and welfare of their animals. This influence may be good or bad depending on their stockmanship competence. In this study, stockmanship competence (SC) is defined as the capacity of the stockperson to ensure the welfare of their animals by providing their animal’s needs. The study was conducted to evaluate the stockmanship competence of backyard goat raisers and to examine its relationship to productivity and economic profitability. This was made possible by interviewing 101 backyard goat raisers who have undergone farmer livestock school on integrated goat management (FLS IGM) in Region I, Philippines on September 3-30, 2012 and March 4-17, 2013. Secondary data needed were gathered from the local government agencies involved. Data on stockmanship, goat productivity and farmer’s income before and after attending FLS-IGM were gathered through a semi-structured interview. Questions for stockamnship were based on the Philippine recommends on goat production, tips on goat raising and other scientific literature. Stockmanship competence index score (SCIS) was computed by summing the raw scores derived from each components of SC divided by the total number of components. Pearson correlation through SPSS was used to see the relationship between SC, productivity and income. Result showed that majority raised native and upgraded goats. The computed mean SCIS before and after undergoing FLS-IGM was 38.53% and 75.81%, respectively, an improvement of 49.17%. Both index scores resulted in significant differences in productivity and income. The median mature weight and mortality rate of goats before FLS-IGM, where SC was low, was 14 kg and 50% respectively. On the other hand, after stockmanship had improved, the median mature weight increased to 19 kgs and mortality rate decreased to 11.11%. Likewise, fewer goat diseases were observed by farmers as compared before. With regards to income, there was 127.34% difference on the median net income derived by farmers. Result implies that improved stockmanship competence can lead not only to increased productivity and income of backyard goat raisers but also welfare of the animal.

Keywords: stockmanship, backyard goat production, animal welfare, Philippines

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Authors: Francesca Nicolosi, Teresa Cosola

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Climate changes in Mediterranean areas, such as the increase of average seasonal temperatures, the urban heat island phenomenon, the intensification of solar radiation and the extreme weather threats, cause disruption events, so that climate adaptation has become a pressing issue. Due to the strategic role that the built heritage holds in terms of environmental impact and energy waste and its potentiality, it is necessary to assess the vulnerability and the adaptive capacity of the existing building to climate change, in order to define different mitigation scenarios. The aim of this research work is to define an optimized and integrated methodology for the assessment of resilience levels and adaptation scenarios for existing buildings in Mediterranean urban areas. Moreover, the study of resilience indicators allows us to define building environmental and energy performance in order to identify the design and technological solutions for the improvement of the building and its urban area potentialities. The methodology identifies step-by-step different phases, starting from the detailed study of characteristic elements of urban system: climatic, natural, human, typological and functional components are analyzed in their critical factors and their potential. Through the individuation of the main perturbing factors and the vulnerability degree of the system to the risks linked to climate change, it is possible to define mitigation and adaptation scenarios. They can be different, according to the typological, functional and constructive features of the analyzed system, divided into categories of intervention, and characterized by different analysis levels (from the single building to the urban area). The use of software simulations allows obtaining information on the overall behavior of the building and the urban system, to generate predictive models in the medium and long-term environmental and energy retrofit and to make a comparative study of the mitigation scenarios identified. The studied methodology is validated on a case study.

Keywords: climate impact mitigation, energy efficiency, existing building heritage, resilience

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Authors: Taiwo Olusoji Lawrence, Peace Mawo Aaron

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Seismic analysis of bedforms has proven to be one of the best ways to study deepwater sedimentary features. Canyons are known to be sediment transportation conduit. Sediment wave are large-scale depositional bedforms in various parts of the world's oceans formed predominantly by suspended load transport. These undulating objects usually have tens of meters to a few kilometers in wavelength and a height of several meters. Cyclic steps have long long-wave upstream-migrating bedforms confined by internal hydraulic jumps. They usually occur in regions with high gradients and slope breaks. Cyclic steps and migrating sediment waves are the most common bedform on the seafloor. Cyclic steps and related sediment wave bedforms are significant to the morpho-dynamic evolution of deep-water depositional systems architectural elements, especially those located along tectonically active margins with high gradients and slope breaks that can promote internal hydraulic jumps in turbidity currents. This report examined sedimentary activities and sediment transportation in submarine canyons and provided distinctive insight into factors that created a complex seabed canyon system in the Ceara Fortaleza basin Brazilian Equatorial Margin (BEM). The growing importance of cyclic steps made it imperative to understand the parameters leading to their formation, migration, and architecture as well as their controls on sediment transport in canyon thalweg. We extracted the parameters of the observed bedforms and evaluated the aspect ratio and asymmetricity. We developed a relationship between the hydraulic jump magnitude, depth of the hydraulic fall and the length of the cyclic step therein. It was understood that an increase in the height of the cyclic step increases the magnitude of the hydraulic jump and thereby increases the rate of deposition on the preceding stoss side. An increase in the length of the cyclic steps reduces the magnitude of the hydraulic jump and reduces the rate of deposition at the stoss side. Therefore, flat stoss side was noticed at most preceding cyclic step and sediment wave.

Keywords: Ceara Fortaleza, submarine canyons, cyclic steps, sediment wave

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Authors: Dovile Petkeviciute-Barysiene

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Legal technologies not only create new ways for accessing and providing legal services but also transform the role of legal practitioners. Both lawyers and users of legal services expect automated solutions to outperform people with objectivity and impartiality. Although fairness of the automated decisions is crucial, research on assessing various characteristics of automated processes related to the perceived fairness has only begun. One of the major obstacles to this research is the lack of comprehensive understanding of what legal actions are automated and could be meaningfully automated, and to what extent. Neither public nor legal practitioners oftentimes cannot envision technological input due to the lack of general without illustrative examples. The aim of this study is to map decision making stages and automation levels which are and/or could be achieved in legal actions related to pre-trial and trial processes. Major legal decisions and judgments are identified during the consultations with legal practitioners. The dual-process model of information processing is used to describe cognitive processes taking place while making legal decisions and judgments during pre-trial and trial action. Some of the existing legal technologies are incorporated into the analysis as well. Several published automation level taxonomies are considered because none of them fit well into the legal context, as they were all created for avionics, teleoperation, unmanned aerial vehicles, etc. From the information processing perspective, analysis of the legal decisions and judgments expose situations that are most sensitive to cognitive bias, among others, also help to identify areas that would benefit from the automation the most. Automation level analysis, in turn, provides a systematic approach to interaction and cooperation between humans and algorithms. Moreover, an integrated map of legal decisions and judgments, information processing characteristics, and automation levels all together provide some groundwork for the research of legal technology perceived fairness and acceptance. Acknowledgment: This project has received funding from European Social Fund (project No 09.3.3-LMT-K-712-19-0116) under grant agreement with the Research Council of Lithuania (LMTLT).

Keywords: automation levels, information processing, legal judgment and decision making, legal technology

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Authors: Miroslava Markovic, Snezana Rajkovic, Ljubinko Rakonjac, Aleksandar Lucic

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Oak powdery mildew is a serious problem on seedlings in nurseries as well as on naturally and artificially introduced progeny. The experiments were set on oak seedlings in two nurseries located in Central Serbia, where control of oak powdery mildew Microsphaera alphitoides Griff. et Maubl. had been conducted through alternative protection measures by means of various dosages of AQ-10 biofungicide, with and without added polymer (which has so far never been used in this country for control of oak powdery mildew). Simultaneous testing was conducted on the efficiency of a chemical sulphur-based preparation (used in this area for many years as a measure of suppression of powdery mildews, without the possibility of developing resistance of the pathogen to the active matter). To date, the Republic of Serbia has registered no fungicides for suppression of pathogens in the forest ecosystems. In order to introduce proper use of new disease-fighting agents into a country, certain relevant principles, requirements and criteria prescribed by the Forest Stewardship Council (FSC) must be observed, primarily with respect to measures of assessment and mitigation of risks, the list of dangerous and highly dangerous pesticides with the possibility of alternative protection. One of the main goals of the research was adjustment of the protective measures to the FSC policy through selection of eco-toxicologically favourable fungicides, given the fact that only preparations named on the list of permitted active matters are approved for use in certified forests. The results of the research have demonstrated that AQ-10 biofungicide can be used as a part of integrated disease management programmes as an alternative, through application of several treatments during vegetation and combination with other active matters registered for these purposes, so as to curtail the use of standard fungicides for control of powdery mildews on oak seedlings in nurseries. The best results in suppression of oak powdery mildew were attained through use of AQ-10 biofungicide (dose 50 or 70g/ha) with added polymer Nu Film-17 (dose 1.0 or 1.5 l/ha). If the treatment is applied at the appropriate time, even fewer number of treatments and smaller doses will be just as efficient.

Keywords: oak powdery mildew, biofungicides, polymers, Microsphaera alphitoides

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Authors: Chia-Ying Lin

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This paper explains how to enhance doctor-patient communication and nurse-patient communication through multiple intelligence signing methods and user-centered. It is hoped that through the implementation of the "electronic consent", the problems faced by the paper consent can be solved: storage methods, resource utilization, convenience, correctness of information, integrated management, statistical analysis and other related issues. Make better use and allocation of resources to provide better medical quality. First, invite the ｍedical records department to assist in the inventory of paper consent in the hospital: organising, classifying, merging, coding, and setting. Second, plan the electronic consent configuration file: set the form number, consent form group, fields and templates, and the corresponding doctor's order code. Next, Summarize four types of rapid methods of electronic consent: according to the doctor's order, according to the medical behavior, according to the schedule, and manually generate the consent form. Finally, system promotion and adjustment: form an "electronic consent promotion team" to improve, follow five major processes: planning, development, testing, release, and feedback, and invite clinical units to raise the difficulties faced in the promotion, and make improvements to the problems. The electronic signature rate of the whole hospital will increase from 4% in January 2022 to 79% in November 2022. Use the saved resources more effectively, including: reduce paper usage (reduce carbon footprint), reduce the cost of ink cartridges, re-plan and use the space for paper medical records, and save human resources to provide better services. Through the introduction of information technology and technology, the main spirit of "lean management" is implemented. Transforming and reengineering the process to eliminate unnecessary waste is also the highest purpose of this project.

Keywords: smart signature, electronic consent, electronic medical records, user-centered, doctor-patient communication, nurse-patient communication

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Authors: Madhusudana S. N., Reeta Mani, Ashwini S. Satishchandra P., Netravati, Udhani V., Fiaz A., Karande S.

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Rabies is an acute encephalitis which is considered 100% fatal despite occasional reports of survivors. However, in recent times more cases of human rabies survivors are being reported. In the last 5 years, there are six laboratories confirmed human rabies survivors in India alone. All cases were children below 15 years and all contracted the disease by dog bites. All of them also had received the full or partial course of rabies vaccination and 4 out of 6 had also received rabies immunoglobulin. All cases were treated in intensive care units in hospitals at Bangalore, Mumbai, Chandigarh, Lucknow and Goa. We report here the results of immunological and virological studies conducted at our laboratory on these patients. The clinical samples that were obtained from these patients were Serum, CSF, nuchal skin biopsy and saliva. Serum and CSF samples were subjected to standard RFFIT for estimation of rabies neutralizing antibodies. Skin biopsy, CSF and saliva were processed by TaqMan real-time PCR for detection of viral RNA. CSF, saliva and skin homogenates were also processed for virus isolation by inoculation of suckling mice. The PBMCs isolated from fresh blood was subjected to ELISPOT assay to determine the type of immune response (Th1/Th2). Both CSF and serum were also investigated for selected cytokines by Luminex assay. The level of antibodies to virus G protein and N protein were determined by ELISA. All survivors had very high titers of RVNA in serum and CSF 100 fold higher than non-survivors and vaccine controls. A five-fold rise in titer could be demonstrated in 4 out of 6 patients. All survivors had a significant increase in antibodies to G protein in both CSF and serum when compared to non-survivors. There was a profound and robust Th1 response in all survivors indicating that interferon gamma could play an important factor in virus clearance. We could isolate viral RNA in only one patient four years after he had developed symptoms. The partial N gene sequencing revealed 99% homology to species I strain prevalent in India. Levels of selected cytokines in CSF and serum did not reveal any difference between survivors and non-survivors. To conclude, survival from rabies is mediated by virus-specific immune responses of the host and clearance of rabies virus from CNS may involve the participation of both Th2 and Th1 immune responses.

Keywords: rabies, rabies treatment, rabies survivors, immune reponse in rabies encephalitis

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Authors: Jo Angouri, Charlotte Kennedy, Shawnea Ting, David Rawlinson, Matthew Booker, Nigel Rees

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Ambulance services need to balance the large volume of emergency (999 in the UK) calls they receive (e.g., West Midlands Ambulance Service reports per day about 4,000 999 calls; about 679,000 calls per year are received in Wales), with dispatching limited resource for on-site intervention to the most critical cases. The process by which Emergency Medical Dispatch (EMD) decisions are made is related to risk assessment and involves the caller and call-taker as well as clinical teams negotiating risk levels on a case-by-case basis. Medical Priority Dispatch System (MPDS – also referred to as Advanced Medical Priority Dispatch System AMPDS) are used in the UK by NHS Trusts (e.,g WAST) to process and prioritise 999 calls. MPDS / AMPDS provide structured protocols for call prioritisation and call management. Protocols/policy frameworks have not been examined before in the way we propose in our project. In more detail, the risk factors that play a role in the EMD negotiation between the caller and call-taker have been analysed in both medical and social science research. Research has focused on the structural, morphological and phonological aspects that could improve, and train, human-to-human interaction or automate risk detection, as well as the medical factors that need to be captured from the caller to inform the dispatch decision. There are two significant gaps in our knowledge that we address in our work: 1. the role of backstage clinical teams in translating the caller/call-taker interaction in their internal risk negotiation and, 2. the role of policy frameworks, protocols and regulations in the framing of institutional priorities and resource allocation. We take a multi method approach and combine the analysis of 999 calls with the analysis of policy documents. We draw on interaction analysis, corpus methodologies and thematic analysis. In this paper, we report on our preliminary findings and focus in particular on the risk factors we have identified and the relationship with the regulations that create the frame within which teams operate. We close the paper with implications of our study for providing evidence-based policy intervention and recommendations for further research.

Keywords: emergency (999) call, interaction analysis, discourse analysis, ambulance dispatch, medical discourse

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Authors: Neuma Chaveiro, Juliana Guimarães Faria

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Introduction: The thematic that guides this study is teacher training for the teaching of sign language in a perspective of bilingual education – specifically aimed at Brazilian public schools that offer inclusive education, and that have, among its students, deaf children who use Brazilian Sign Language as a means of communication and expression. In the Teacher Training Course for Letters/Libras at the Universidade Federal de Goiás/UFG, we developed a bilingual education project for the deaf, linked to PIBID (Institutional Scholarship for Teaching Initiation Program), funded by the Brazilian Federal Government through CAPES (Coordination for the Improvement of Higher Education Personnel). Goals: to provide the education of higher education teachers to work in public schools in basic education and to insert students from the UFG’s Letters/Libras course in the school’s daily life, giving them the opportunity for the creation and participation in methodological experiences and of teaching practices in order to overcome the problems identified in the teaching-learning process of deaf students, in a bilingual perspective, associating Libras (Brazilian Sign Language) and Portuguese. Methodology: qualitative approach and research-action, prioritizing action – reflection – action of the people involved. The Letters-Libras PIBID of the College of Letters/UFG, in this qualitative context, is guided by the assumptions of investigation-action to contribute to the education of the Libras teacher. Results: production of studies and researches in the area of education, professionalization and teaching practice for the degree holder in Letters: Libras; b) studies, research and training in bilingual education; c) clarification and discussion of the myths that permeate the reality of users of sign languages; d) involving students in the development of didactic materials for bilingual education. Conclusion: the PIBID Project Letters/Libras allows, both to the basic education school and to the teachers in training for the teaching of Libras, an integrated and collective work partnership, with discussions and changes in relation to bilingual education for the deaf and the teaching of Libras.

Keywords: deaf, sign language, teacher training, educacion

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