Search results for: virtual purchase decision

Authors: Aylin Hasbay Büyükkaragöz, Zehra Büyüktuncer, Tuğçe Nur Balcı, Nevin Ergun

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Purpose: Nutritional supplement usage is widespread among athletes all over the world. However, the usage among disabled athletes is not well-known. This study aimed to evaluate dietary supplement use in disabled athletes, their motivation for consuming supplements, sources of information, and their side effect. Methods: A total of 75 Turkish National Team's disabled athletes (38 female, 37 male) from 5 sport branches (soccer, weight lifting, shooting, table tennis and basketball), aged 13- 55 years, were participated in the study. Nutritional supplement usage was inquired using a questionnaire by a dietitian at their preparation camps. Results: A total of 22.7% of the athletes (18.4% and 27% of, respectively females and males) used some type of dietary supplements. Protein (35.3%), amino acid (29.4%), carnitine (29.4%), creatine (23.5%) and glucosamine (23.5%) were mostly preferred nutritional supplements by all athletes. The most common supplements use was obtained among weightlifters (71.4%), followed by the athletes of soccer (23.5%), table tennis (15.4%), and basketball (6.7%). No nutritional supplement usage was observed among shooters. Total of 41.2% consumers declared more than one reason for taking nutritional supplements. The main motivation for supplement usage was improving athletic performance (63.5%). Other reasons were weight loss, weight gain, muscle development, health protection and nutritional support. Athletes were more likely to get recommendation about nutritional supplement usage from team coaches (48.9%). Of 35.6% athletes reported that they made their own decision about using supplements. Other information sources were health professional, family member, friend and sale manager of sport retail store. Only 3 of 17 athletes reported side effects which were increased urine output, weight gain, loss of appetite and intestinal gas. Conclusions: Nutritional supplement usage was not common among disabled athletes. However, getting information from incompetent sources is disquieting. Considering their health problems, accurate information from competent sources should be provided to disabled athletes. Moreover, long term effects of nutritional supplements among disabled athletes should be examined in further studies.

Keywords: disabled athletes, ergogenic aid, nutritional supplement, vitamin supplementation

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Authors: Venkateswar Pujari

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This study tries to investigate the complex interplay between control, awareness, and attention in human cognitive processes. The fundamental elements of cognitive functioning that play a significant role in influencing perception, decision-making, and behavior are attention, awareness, and control. Understanding how they interact can help us better understand how our minds work and may even increase our understanding of cognitive science and its therapeutic applications. The study uses an empirical methodology to examine the relationships between attention, awareness, and control by integrating different experimental paradigms and neuropsychological tests. To ensure the generalizability of findings, a wide sample of participants is chosen, including people with various cognitive profiles and ages. The study is structured into four primary parts, each of which focuses on one component of how attention, awareness, and control interact: 1. Evaluation of Attentional Capacity and Selectivity: In this stage, participants complete established attention tests, including the Stroop task and visual search tasks. 2. Evaluation of Awareness Degrees: In the second stage, participants' degrees of conscious and unconscious awareness are assessed using perceptual awareness tasks such as masked priming and binocular rivalry tasks. 3. Investigation of Cognitive Control Mechanisms: In the third phase, reaction inhibition, cognitive flexibility, and working memory capacity are investigated using exercises like the Wisconsin Card Sorting Test and the Go/No-Go paradigm. 4. Results Integration and Analysis: Data from all phases are integrated and analyzed in the final phase. To investigate potential links and prediction correlations between attention, awareness, and control, correlational and regression analyses are carried out. The study's conclusions shed light on the intricate relationships that exist between control, awareness, and attention throughout cognitive function. The findings may have consequences for cognitive psychology, neuroscience, and clinical psychology by providing new understandings of cognitive dysfunctions linked to deficiencies in attention, awareness, and control systems.

Keywords: attention, awareness, control, cognitive functioning, neuropsychological assessment

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Authors: Shanika Y. Koreshi

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Sri Lanka housed the lingerie product development and manufacturing subsidiary to renowned brands such as La Senza, Marks & Spencer, H&M, Etam, Lane Bryant, and George. Over the last few years, they have produced local brands such as Amante to cater to the local and regional customers. Past research has identified factors such as quality, price, and design to be vital when marketing lingerie to consumers. However, there has been minimum research that looks into the ethnically targeted market and skin colour within the Asian population. Therefore, the main aim of the research was to identify whether consumer preference for lingerie is influenced by the skin tone of the model wearing it. Moreover, the secondary aim was to investigate if the consumer preference for lingerie is influenced by the consumer’s ethnic identification with the skin tone of the model. An experimental design was used to explore the above aims. The participants constituted of 66 females residing in the western province of Sri Lanka and were gathered via convenience sampling. Six computerized images of a real model were used in the study, and her skin tone was digitally manipulated to express three different skin tones (light, tan and dark). Consumer preferences were measured through a ranking order scale that was constructed via a focus group discussion and ethnic identity was measured by the Multigroup Ethnic Identity Measure-Revised. Wilcoxon signed-rank test, Friedman test, and chi square test of independence were carried out using SPSS version 20. The results indicated that majority of the consumers ethnically identified and preferred the tan skin over the light and dark skin tones. The findings support the existing literature that states there is a preference among consumers when models have a medium skin tone over a lighter skin tone. The preference for a tan skin tone in a model is consistent with the ethnic identification of the Sri Lankan sample. The study implies that lingerie brands should consider the model's skin tones when marketing the brand to different ethnic backgrounds.

Keywords: consumer preference, ethnic identification, lingerie, skin tone

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Authors: Mohammed S. Mohammed, Asmaa M. S. Mohammed

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Background: To achieve the quality of cancer care, the oncologic academic programs should be continuously developed with establishing new ones. We highlighted three disciplines, Clinical nutrition, medical biophysics and radiobiology and Psycho-oncology programs; without a doubt, the Egyptian National Cancer Institute, in ‎the accreditation era, will be establishing them ‎ due to their importance in improving the skills of cancer practitioners. Methods: The first suggested program in Clinical Nutrition that is dealing with the assessment of the patient's well-being before, during and after treatment to avoid the defects in the metabolism resulting from the cancer disease and its treatment by giving the supplements in the patient's diet. The second program is Medical Biophysics and Radiobiology, which there's no denying that it ‎is ‎provided ‎in Cairo University as a good program in the faculty of science but lacks the clinical ‎practice. Hence, it is probably better to establish this program in our institute to ‎improve the ‎practitioner skills and introduce a tailored radiation therapy regimen for every patient according to ‎their characteristic profile.‎ While patients are receiving their treatment, the risk of post-traumatic stress disorder arises, so the importance of the third program, Psycho-Oncology, is clearly obtained. This program is concerned with the psychological, social, behavioral, and ethical aspects of cancer. The area of multi-disciplinary interest has boundaries with the major specialties in oncology: the clinical disciplines (surgery, medicine, pediatrics, and radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. Results: It is a prospective academic plan which is compatible with the institutional vision and its strategic plan. Conclusion: In this context, evaluating and understanding the suggested academic programs has become a mandatory part of cancer care. And it is essential to be provided by the NCI.

Keywords: clinical nutrition, psycho-oncology, medical biophysics and radiobiology, medical education

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Authors: Diksha Sapkota, Kathleen Baird, Amornrat Saito, Debra Anderson

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Background: Violence during pregnancy is global public health problem incurring huge amount of social, economic and human costs. It is of particular concern as it affects health of mother, neonates and also disrupt family functioning. Mental illness is one of its commonest consequences affecting both mother and baby and likely to be chronic if left unattended. Past decade has seen advances in knowledge about different forms of violence, its health impacts and intervention/s helping to confront the violence. However, limited range and lack of consistency in measurable outcomes undermine overall effect of interventions, and available evidence are largely slanted towards high-income countries. Despite recognition of integrating screening and counselling for abused pregnant women in health settings, there is a dearth of evidence on its effectiveness from developing countries limiting its applicability and feasibility. This study intends to summarise the high-quality evidence on intimate partner violence interventions in reducing violence and improving mental health and implement the promising intervention in our context. Methods: Quantitative systematic review will be done using PRISMA statement and based on its finding; randomised controlled intervention will be carried out. The study will be conducted among women attending ANC clinic of Dhulikhel Hospital, Nepal. Being the pilot study, samples just adequate to draw the inferences i.e. not less than 30 in each arm will be taken. Phenomological approach will be used to explore the strengths and weaknesses of tested intervention and recommendations for better planning in future. Conclusion: This study intends to provide concrete evidence on what works best in our context and will assist policymakers, programme planners, donors in informed decision making.

Keywords: intimate partner violence/prevention and control, mental health, Nepal, pregnant

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Authors: Bahram Soltani, Louai Ghazieh

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The responsibility has a big importance further to the financial crisis and the various pressures, which companies face their duties. The main objective of this study is to explain the variation of mechanisms of the responsibility of the manager in the company among the advanced capitalist economies. Then we study the impact of these mechanisms on the performance and the value creation in European companies. To reach our goal, we established a final sample composed on average of 284 French, British and German companies quoted in stock exchanges with 2272 annual reports examined during the period from 2005 to 2012. We examined at first the link of causalities between the determining-mechanisms bound to the company such as the characteristics of the board of directors, the composition of the shareholding and the ethics of the company on one side and the profitability of the company on the other side. The results show that the smooth running of the board of directors and its specialist committees are very important determinants of the responsibility of the managers who impact positively the performance and the value creation in the company. Furthermore, our results confirm that the presence of a solid ethical environment within the company will be effective to increase the probability that the managers realize ethical choices in the organizational decision-making. At the second time, we studied the impact of the determining mechanisms bound to the function and to the profile of manager to know its relational links, his remuneration, his training, his age and his experiences about the performance and the value creation in the company. Our results highlight the existence of a negative relation between the relational links of the manager, his very high remuneration and the general profitability of the company. This study is a contribution to the literature on the determining mechanisms of company director's responsibility (Accountability). It establishes an empirical and comparative analysis between three influential countries of Europe, to know France, the United Kingdom and Germany.

Keywords: leaders, company’s performance, accountability mechanisms, corporate governance, value creation of firm, financial crisis

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Authors: Rui Wu

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In the volatile modern manufacturing environment, new orders randomly occur at any time, while the pre-emptive methods are infeasible. This leads to a real-time scheduling method that can produce a reasonably good schedule quickly. The dynamic Flexible Job Shop problem is an NP-hard scheduling problem that hybrid the dynamic Job Shop problem with the Parallel Machine problem. A Flexible Job Shop contains different work centres. Each work centre contains parallel machines that can process certain operations. Many algorithms, such as genetic algorithms or simulated annealing, have been proposed to solve the static Flexible Job Shop problems. However, the time efficiency of these methods is low, and these methods are not feasible in a dynamic scheduling problem. Therefore, a dynamic rule selection scheduling system based on the reinforcement learning method is proposed in this research, in which the dynamic Flexible Job Shop problem is divided into several parallel machine problems to decrease the complexity of the dynamic Flexible Job Shop problem. Firstly, the features of jobs, machines, work centres, and flexible job shops are selected to describe the status of the dynamic Flexible Job Shop problem at each decision point in each work centre. Secondly, a framework of reinforcement learning algorithm using a double-layer deep Q-learning network is applied to select proper composite dispatching rules based on the status of each work centre. Then, based on the selected composite dispatching rule, an available operation is selected from the waiting buffer and assigned to an available machine in each work centre. Finally, the proposed algorithm will be compared with well-known dispatching rules on objectives of mean tardiness, mean flow time, mean waiting time, or mean percentage of waiting time in the real-time Flexible Job Shop problem. The result of the simulations proved that the proposed framework has reasonable performance and time efficiency.

Keywords: dynamic scheduling problem, flexible job shop, dispatching rules, deep reinforcement learning

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Authors: Lakhoua Najeh

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Introduction: In most situations, an industrial system already existing, conditioned by its history, its culture and its context are in difficulty facing the necessity to restructure itself in an organizational and technological environment in perpetual evolution. This is why all operations of restructuring first of all require a diagnosis based on a functional analysis. After a presentation of the functionality of a supervisory system for complex processes, we present the concepts of industrial automation and supervisory control and data acquisition (SCADA). Methods: This global analysis exploits the various available documents on the one hand and takes on the other hand in consideration the various testimonies through investigations, the interviews or the collective workshops; otherwise, it also takes observations through visits as a basis and even of the specific operations. The exploitation of this diagnosis enables us to elaborate the project of restructuring thereafter. Leaving from the system analysis for the restructuring of industrial systems, and after a technical diagnosis based on visits, an analysis of the various technical documents and management as well as on targeted interviews, a focusing retailing the various levels of analysis has been done according a general methodology. Results: The methodology adopted in order to contribute to the restructuring of industrial systems by its participative and systemic character and leaning on a large consultation a lot of human resources that of the documentary resources, various innovating actions has been proposed. These actions appear in the setting of the TQM gait requiring applicable parameter quantification and a treatment valorising some information. The new management environment will enable us to institute an information and communication system possibility of migration toward an ERP system. Conclusion: Technological advancements in process monitoring, control and industrial automation over the past decades have contributed greatly to improve the productivity of virtually all industrial systems throughout the world. This paper tries to identify the principles characteristics of a process monitoring, control and industrial automation in order to provide tools to help in the decision-making process.

Keywords: automation, supervision, SCADA, TQM

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Authors: Malik Imtiaz Ahmad

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The prime sources of Islamic Law or Shariah are Quran and Sunnah and is applied to the personal and public affairs of Muslims. Islamic law is deemed to be divine and furnishes a complete code of conduct based upon universal values to build honesty, trust, righteousness, piety, charity, and social justice. The primary focus of this paper was to examine the development of Islamic jurisprudence (Fiqh) over time and its relevance to the field of Islamic finance. This encompassed a comprehensive analysis of the historical context, key legal principles, and their application in contemporary financial systems adhering to Islamic principles. This study aimed to elucidate the deep-rooted connection between Islamic law and finance, offering valuable insights for practitioners and policymakers in the Islamic finance sector. Understanding the historical context and legal underpinnings is crucial for ensuring the compliance and ethicality of modern financial systems adhering to Islamic principles. Fintech solutions are developing fields to accelerate the digitalization of Islamic finance products and services for the harmonization of global investors' mandate. Through this study, we focus on institutional governance that will improve Sharia compliance, efficiency, transparency in decision-making, and Islamic finance's contribution to humanity through the SDGs program. The research paper employed an extensive literature review, historical analysis, examination of legal principles, and case studies to trace the evolution of Islamic law and its contemporary application in Islamic finance, providing a concise yet comprehensive understanding of this intricate relationship. Through these research methodologies, the aim was to provide a comprehensive and insightful exploration of the historical evolution of Islamic law and its relevance to contemporary Islamic finance, thereby contributing to a deeper understanding of this unique and growing sector of the global financial industry.

Keywords: sharia, sequencing Islamic jurisprudence, Islamic congruent marketing, social development goals of Islamic finance

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Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Shu-I Chin, Wen-Ju Yang, Wan Ming-Shang, Chien-Ying Wang

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Background: Upon recovery from critical condition, patients are normally transferred from the intensive care units (ICUs) to the general wards. However, transferring patients to a new environment causes stressful experiences for both patients and their families. Therefore, there is a necessity to communicate with the patients and their families to reduce psychological stress and unplanned return. Methods: This study was performed in the general ICUs from January 1, 2021, to December 31, 2021, in Taipei Veteran General Hospital. The patients who were evaluated by doctors and liaison nurses transferred to the general wards were selected as the research objects and ranked by the Critical Care Transition Program (CCTP). The plan was applied to 40 patients in a study group and usual care support for a control group of 40 patients. The psychological condition of patients was evaluated by a migration stress scale and a hospital anxiety and depression scale. In addition, the rate of return to ICU was also measured. Results: A total of 63 patients out of 80 (78.8%) experienced moderate to severe degrees of anxiety, and 42 patients (52.6%) experienced moderate to severe degrees of depression before being transferred. The difference between anxiety and depression changed more after the transfer; moreover, when a transition program was applied, it was lower than without a transition program. The return to ICU rate in the study group was lower than in the usual transition group, with an adjusted odds ratio of 0.21 (95% confidence interval: 0.05-0.888, P=0.034). Conclusion: Our study found that the transfer program could reduce the anxiety and depression of patients and the associated stress on their families during the transition from ICU. Before being transferred out of ICU, the healthcare providers need to assess the needs of patients to set the goals of the care plan and perform patient-centered decision-making with multidisciplinary support.

Keywords: ICU, critical care transition program, healthcare, transition program

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Authors: Robin Molinier

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Industrial symbiosis (I.S) rely on two basic modes of cooperation between organizations that are infrastructure/service sharing and resource substitution (the use of waste materials, fatal energy and recirculated utilities for production). The former consists in the intensification of use of an asset and thus requires to compare the incremental investment cost to be incurred and the stand-alone cost faced by each potential participant to satisfy its own requirements. In order to investigate the way such a cooperation mode can be implemented we formulate a game theoretic model integrating the grassroot investment decision and the ex-post access pricing problem. In the first period two actors set cooperatively (resp. non-cooperatively) a level of common (resp. individual) infrastructure capacity oversizing to attract ex-post a potential entrant with a plug-and-play offer (available capacity, tariff). The entrant’s requirement is randomly distributed and known only after investments took place. Capacity cost exhibits sub-additive property so that there is room for profitable overcapacity setting in the first period under some conditions that we derive. The entrant willingness-to-pay for the access to the infrastructure is driven by both her standalone cost and the complement cost to be incurred in case she chooses to access an infrastructure whose the available capacity is lower than her requirement level. The expected complement cost function is thus derived, and we show that it is decreasing, convex and shaped by the entrant’s requirements distribution function. For both uniform and triangular distributions optimal capacity level is obtained in the cooperative setting and equilibrium levels are determined in the non-cooperative case. Regarding the latter, we show that competition is deterred by the first period investor with the highest requirement level. Using the non-cooperative game outcomes which gives lower bounds for the profit sharing problem in the cooperative one we solve the whole game and describe situations supporting sharing agreements.

Keywords: capacity, cooperation, industrial symbiosis, pricing

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Authors: Shobhit Mittal

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Headcount budgeting stands as a pivotal element in organizational financial management, extending beyond traditional budgeting to encompass strategic resource allocation for workforce-related expenses. This process is integral to maintaining financial stability and fostering a productive workforce, requiring a comprehensive analysis of factors such as market trends, business growth projections, and evolving workforce skill requirements. It demands a collaborative approach, primarily involving Human Resources (HR) and finance departments, to align workforce planning with an organization's financial capabilities and strategic objectives. The dynamic nature of headcount budgeting necessitates continuous monitoring and adjustment in response to economic fluctuations, business strategy shifts, technological advancements, and market dynamics. Its significance in talent management is also highlighted, aligning financial planning with talent acquisition and retention strategies to ensure a competitive edge in the market. The consequences of incorrect headcount budgeting are explored, showing how it can lead to financial strain, operational inefficiencies, and hindered strategic objectives. Examining case studies like IBM's strategic workforce rebalancing and Microsoft's shift for long-term success, the importance of aligning headcount budgeting with organizational goals is underscored. These examples illustrate that effective headcount budgeting transcends its role as a financial tool, emerging as a strategic element crucial for an organization's success. This necessitates continuous refinement and adaptation to align with evolving business goals and market conditions, highlighting its role as a key driver in organizational success and sustainability.

Keywords: strategic planning, fiscal budget, headcount planning, resource allocation, financial management, decision-making, operational efficiency, risk management, headcount budget

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Authors: Ayman M. Mansour, Bilal Hawashin, Hesham Alsalem

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Faster delivery of laboratory test results is one of the most noticeable signs of good laboratory service and is often used as a key performance indicator of laboratory performance. Despite the availability of technology, the delivery time of clinical laboratory test results continues to be a cause of customer dissatisfaction which makes patients feel frustrated and they became careless to get their laboratory test results. The Medical Clinical Laboratory test results are highly sensitive and could harm patients especially with the severe case if they deliver in wrong time. Such results affect the treatment done by physicians if arrived at correct time efforts should, therefore, be made to ensure faster delivery of lab test results by utilizing new trusted, Robust and fast system. In this paper, we proposed a distributed Multi-Agent System to enhance and faster the process of laboratory test results delivery using SMS. The developed system relies on SMS messages because of the wide availability of GSM network comparing to the other network. The software provides the capability of knowledge sharing between different units and different laboratory medical centers. The system was built using java programming. To implement the proposed system we had many possible techniques. One of these is to use the peer-to-peer (P2P) model, where all the peers are treated equally and the service is distributed among all the peers of the network. However, for the pure P2P model, it is difficult to maintain the coherence of the network, discover new peers and ensure security. Also, security is a quite important issue since each node is allowed to join the network without any control mechanism. We thus take the hybrid P2P model, a model between the Client/Server model and the pure P2P model using GSM technology through SMS messages. This model satisfies our need. A GUI has been developed to provide the laboratory staff with the simple and easy way to interact with the system. This system provides quick response rate and the decision is faster than the manual methods. This will save patients life.

Keywords: multi-agent system, delivery process, GSM technology, clinical laboratory results

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Authors: Farzam Fatolazadeh, Kalifa Goita, Mehdi Eshagh, Shusen Wang

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The Gravity Recovery and Climate Experiment (GRACE) is a satellite mission with twin satellites for the precise determination of spatial and temporal variations in the Earth’s gravity field. The products of this mission are monthly global gravity models containing the spherical harmonic coefficients and their errors. These GRACE models can be used for estimating terrestrial water storage (TWS) variations across the globe at large scales, thereby offering an opportunity for surface and groundwater storage (GWS) assessments. Yet, the ability of GRACE to monitor changes at smaller scales is too limited for local water management authorities. This is largely due to the low spatial and temporal resolutions of its models (~200,000 km2 and one month, respectively). High-resolution GRACE data products would substantially enrich the information that is needed by local-scale decision-makers while offering the data for the regions that lack adequate in situ monitoring networks, including northern parts of Canada. Such products could eventually be obtained through downscaling. In this study, we extended the spectral combination theory to simultaneously downscale spatiotemporally the 3o spatial coarse resolution of GRACE to 0.25o degrees resolution and monthly coarse resolution to daily resolution. This method combines the monthly gravity field solution of GRACE and daily hydrological model products in the form of both low and high-frequency signals to produce high spatiotemporal resolution TWSA and GWSA products. The main contribution and originality of this study are to comprehensively and simultaneously consider GRACE and hydrological variables and their uncertainties to form the estimator in the spectral domain. Therefore, it is predicted that we reach downscale products with an acceptable accuracy.

Keywords: GRACE satellite, groundwater storage, spectral combination, terrestrial water storage

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Authors: Md Motibur Rahman

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The present paper attempts to study the electoral politics and voting behavior of 2011 assembly election of West Bengal state in India. Electoral geography is considered as the study of geographical aspects of the organization, conduct, and result of elections. It deals with the spatial voting patterns/behaviour or the study of the spatial distribution of political phenomena of voting. Voting behavior is a form of political psychology which played a great role in political decision-making process. The voting behavior of the electorates is largely influenced by their perception that existing during the time of election. The main focus of the study will be to analyze the electoral politics of the party organizations and political profile of the electorates. The principle objectives of the present work are i) to study the spatial patterns of voting behavior in 2011 assembly election in West Bengal, ii) to analysis the result and finding of 2011 assembly election. The whole study based on the secondary source of data. The electoral data have taken from Election Commission of India, New Delhi and Centre for the study of Developing Societies (CSDS) in New Delhi. In the battle of 2011 Assembly election in West Bengal, the two major parties were Left Front and Trinamool Congress. This election witnessed the remarkable successes of Trinamool Congress and decline of 34 years longest ruler party that is Left Front. Trinamool Congress won a majority of seats that 227 out of 294 but Left Front won only 62 seats out of 294 seats. The significance of the present study is that it helps in understanding the voting pattern, voting behaviour, trends of voting and also helps for further study of electoral geography in West Bengal. The study would be highly significant and helpful to the planners, politicians, and administrators who are involved in the formulation of development plans and programmes for the people of the state.

Keywords: assembly election, electoral geography, electoral politics, voting behaviour

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Authors: A. Camões, M. Ferreira Dias, M. Amorim

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In recent years, the social economy is increasingly seen as a viable means to address social problems. Social enterprises, as well as public projects and initiatives targeted to meet social purposes, offer organizational models that assume heterogeneity, flexibility and adaptability to the ‘real world and real problems’. Despite the growing popularity of social initiatives, decision makers still face a paucity in what concerns the available models and tools to adequately assess its sustainability, and its impacts, notably the nature of its contribution to economic growth. This study was carried out at the local level, by analyzing the social impact initiatives and projects promoted by the Municipality of Albergaria-a-Velha (Câmara Municipal de Albergaria-a-Velha -CMA), a municipality of 25,000 inhabitants in the central region of Portugal. This work focuses on the challenges related to the qualifications and employability of citizens, which stands out as one of the key concerns in the Portuguese economy, particularly expressive in the context of small-scale cities and inland territories. The study offers a characterization of the Municipality, its socio-economic structure and challenges, followed by an exploratory analysis of multiple sourced data, collected from the CMA's documental sources as well as from privileged informants. The purpose is to conduct detailed analysis of the CMA's social projects, aimed at characterizing its potential impact for the model of qualifications and employability of the citizens of the Municipality. The study encompasses a discussion of the socio-economic profile of the municipality, notably its asymmetries, the analysis of the social projects and initiatives, as well as of data derived from inquiry actors involved in the implementation of the social projects and its beneficiaries. Finally, the results obtained with the Better Life Index will be included. This study makes it possible to ascertain if what is implicit in the literature goes to the encounter of what one experiences in reality.

Keywords: measurement, municipalities, social economy, social impact

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Authors: Mohadese Oghbaee, Borna Firouzi

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The emergence of the Internet and more specifically the formation of social media has provided the ground for paying attention to new types of content dissemination. In recent years, Social media users share information, communicate with others, and exchange opinions on social events in this space. Many of the information published in this space are suspicious and produced with the intention of deceiving others. These contents are often called "fake news". Fake news, by disrupting the circulation of the concept and similar concepts such as fake news with correct information and misleading public opinion, has the ability to endanger the security of countries and deprive the audience of the basic right of free access to real information; Competing governments, opposition elements, profit-seeking individuals and even competing organizations, knowing about this capacity, act to distort and overturn the facts in the virtual space of the target countries and communities on a large scale and influence public opinion towards their goals. This process of extensive de-truthing of the information space of the societies has created a wave of harm and worries all over the world. The formation of these concerns has led to the opening of a new path of research for the timely containment and reduction of the destructive effects of fake news on public opinion. In addition, the expansion of this phenomenon has the potential to create serious and important problems for societies, and its impact on events such as the 2016 American elections, Brexit, 2017 French elections, 2019 Indian elections, etc., has caused concerns and led to the adoption of approaches It has been dealt with. In recent years, a simple look at the growth trend of research in "Scopus" shows an increasing increase in research with the keyword "false information", which reached its peak in 2020, namely 524 cases, reached, while in 2015, only 30 scientific-research contents were published in this field. Considering that one of the capabilities of social media is to create a context for the dissemination of news and information, both true and false, in this article, the classification of strategies for spreading fake news in social networks was investigated in social events. To achieve this goal, thematic analysis research method was chosen. In this way, an extensive library study was first conducted in global sources. Then, an in-depth interview was conducted with 18 well-known specialists and experts in the field of news and media in Iran. These experts were selected by purposeful sampling. Then by analyzing the data using the theme analysis method, strategies were obtained; The strategies achieved so far (research is in progress) include unrealistically strengthening/weakening the speed and content of the event, stimulating psycho-media movements, targeting emotional audiences such as women, teenagers and young people, strengthening public hatred, calling the reaction legitimate/illegitimate. events, incitement to physical conflict, simplification of violent protests and targeted publication of images and interviews were introduced.

Keywords: fake news, social network, social events, thematic analysis

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Authors: Imen Soltani, Takoua Soltani, Taoufik Aguili

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Metamaterials crossover classic physical boundaries and gives rise to new phenomena and applications in the domain of beam steering and shaping. Where electromagnetic near and far field manipulations were achieved in an accurate manner. In this sense, 3D imaging is one of the beneficiaries and in particular Denis Gabor’s invention: holography. But, the major difficulty here is the lack of a suitable recording medium. So some enhancements were essential, where the 2D version of bulk metamaterials have been introduced the so-called metasurface. This new class of interfaces simplifies the problem of recording medium with the capability of tuning the phase, amplitude, and polarization at a given frequency. In order to achieve an intelligible wavefront control, the electromagnetic properties of the metasurface should be optimized by means of solving Maxwell’s equations. In this context, integral methods are emerging as an important method to study electromagnetic from microwave to optical frequencies. The method of moment presents an accurate solution to reduce the problem of dimensions by writing its boundary conditions in the form of integral equations. But solving this kind of equations tends to be more complicated and time-consuming as the structural complexity increases. Here, the use of equivalent circuit’s method exhibits the most scalable experience to develop an integral method formulation. In fact, for allaying the resolution of Maxwell’s equations, the method of Generalised Equivalent Circuit was proposed to convey the resolution from the domain of integral equations to the domain of equivalent circuits. In point of fact, this technique consists in creating an electric image of the studied structure using discontinuity plan paradigm and taken into account its environment. So that, the electromagnetic state of the discontinuity plan is described by generalised test functions which are modelled by virtual sources not storing energy. The environmental effects are included by the use of an impedance or admittance operator. Here, we propose a tunable metasurface composed of graphene-based elements which combine the advantages of reflectarrays concept and graphene as a pillar constituent element at Terahertz frequencies. The metasurface’s building block consists of a thin gold film, a dielectric spacer SiO₂ and graphene patch antenna. Our electromagnetic analysis is based on the method of moment combined with generalised equivalent circuit (MoM-GEC). We begin by restricting our attention to study the effects of varying graphene’s chemical potential on the unit cell input impedance. So, it was found that the variation of complex conductivity of graphene allows controlling the phase and amplitude of the reflection coefficient at each element of the array. From the results obtained here, we were able to determine that the phase modulation is realized by adjusting graphene’s complex conductivity. This modulation is a viable solution compared to tunning the phase by varying the antenna length because it offers a full 2π reflection phase control.

Keywords: graphene, method of moment combined with generalised equivalent circuit, reconfigurable metasurface, reflectarray, terahertz domain

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Authors: Claudio L. M. Souza, Milton Erthal, Aldo Shimoya, Elias R. Goncalves, Igor C. Rangel, Allysson R. T. Tavares, Elias G. Figueira

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The process of choosing a region for the implementation of wind farms involves factors such as the wind regime, economic viability, land value, topography, and accessibility. This work presents results obtained by multi-criteria decision analysis, and it establishes a hierarchy, regarding the installation of wind farms, among geopolicy regions in the state of ‘Rio de Janeiro’, Brazil: ‘Regiao Norte-RN’, ‘Regiao dos Lagos-RL’ and ‘Regiao Serrana-RS’. The wind regime map indicates only these three possible regions with an average annual wind speed of above of 6.0 m/s. The method applied was the Analytical Hierarchy Process-AHP, designed to prioritize and rank the three regions based on four criteria as follows: 1) potential of the site and average wind speeds of above 6.0 ms-¹, 2) average land value, 3) distribution and interconnection to electric network with the highest number of electricity stations, and 4) accessibility with proximity and quality of highways and flat topography. The values of energy generation were calculated for wind turbines 50, 75, and 100 meters high, considering the production of site (GWh/Km²) and annual production (GWh). The weight of each criterion was attributed by six engineers and by analysis of Road Map, the Map of the Electric System, the Map of Wind Regime and the Annual Land Value Report. The results indicated that in 'RS', the demand was estimated at 2,000 GWh, so a wind farm can operate efficiently in 50 m turbines. This region is mainly mountainous with difficult access and lower land value. With respect to ‘RL’, the wind turbines have to be installed at a height of 75 m high to reach a demand of 6,300 GWh. This region is very flat, with easy access, and low land value. Finally, the ‘NR’ was evaluated as very flat and with expensive lands. In this case, wind turbines with 100 m can reach an annual production of 19,000 GWh. In this Region, the coast area was classified as of greater logistic, productivity and economic potential.

Keywords: AHP, renewable energy, wind energy

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Authors: A. Gonzalez Aguna, J. M. Santamaria Garcia, J. L. Gomez Gonzalez, R. Barchino Plata, M. Fernandez Batalla, S. Herrero Jaen

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Background: Computer Science is a field that transcends other disciplines of knowledge because it allows to support all kinds of physical and mental tasks. Health centres have a greater number and complexity of technological devices and the population consume and demand services derived from technology. Also, nursing education plans have included competencies related to and, even, courses about new technologies are offered to health professionals. However, nurses still limit their performance to the use and evaluation of products previously built. Objective: Develop a teaching-learning methodology for acquiring skills on designing applications for care. Methodology: Blended learning teaching with a group of graduate nurses through official training within a Master's Degree. The study sample was selected by intentional sampling without exclusion criteria. The study covers from 2015 to 2017. The teaching sessions included a four-hour face-to-face class and between one and three tutorials. The assessment was carried out by written test consisting of the preparation of an IEEE 830 Standard Specification document where the subject chosen by the student had to be a problem in the area of care. Results: The sample is made up of 30 students: 10 men and 20 women. Nine students had a degree in nursing, 20 diploma in nursing and one had a degree in Computer Engineering. Two students had a degree in nursing specialty through residence and two in equivalent recognition by exceptional way. Except for the engineer, no subject had previously received training in this regard. All the sample enrolled in the course received the classroom teaching session, had access to the teaching material through a virtual area and maintained at least one tutoring. The maximum of tutorials were three with an hour in total. Among the material available for consultation was an example of a document drawn up based on the IEEE Standard with an issue not related to care. The test to measure competence was completed by the whole group and evaluated by a multidisciplinary teaching team of two computer engineers and two nurses. Engineers evaluated the correctness of the characteristics of the document and the degree of comprehension in the elaboration of the problem and solution elaborated nurses assessed the relevance of the chosen problem statement, the foundation, originality and correctness of the proposed solution and the validity of the application for clinical practice in care. The results were of an average grade of 8.1 over 10 points, a range between 6 and 10. The selected topic barely coincided among the students. Examples of care areas selected are care plans, family and community health, delivery care, administration and even robotics for care. Conclusion: The applied methodology of learning-teaching for the design of technologies demonstrates the success in the training of nursing professionals. The role of expert is essential to create applications that satisfy the needs of end users. Nursing has the possibility, the competence and the duty to participate in the process of construction of technological tools that are going to impact in care of people, family and community.

Keywords: care, learning, nursing, technology

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Authors: Ermias A. Tegegn, Million Meshesha

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Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS) is a major cause of death for most African countries. Ethiopia is one of the seriously affected countries in sub Saharan Africa. Previously in Ethiopia, having HIV/AIDS was almost equivalent to a death sentence. With the introduction of Antiretroviral Therapy (ART), HIV/AIDS has become chronic, but manageable disease. The study focused on a data mining technique to predict future living status of HIV/AIDS patients at the time of drug regimen change when the patients become toxic to the currently taking ART drug combination. The data is taken from University of Gondar Hospital ART program database. Hybrid methodology is followed to explore the application of data mining on ART program dataset. Data cleaning, handling missing values and data transformation were used for preprocessing the data. WEKA 3.7.9 data mining tools, classification algorithms, and expertise are utilized as means to address the research problem. By using four different classification algorithms, (i.e., J48 Classifier, PART rule induction, Naïve Bayes and Neural network) and by adjusting their parameters thirty-two models were built on the pre-processed University of Gondar ART program dataset. The performances of the models were evaluated using the standard metrics of accuracy, precision, recall, and F-measure. The most effective model to predict the status of HIV patients with drug regimen substitution is pruned J48 decision tree with a classification accuracy of 98.01%. This study extracts interesting attributes such as Ever taking Cotrim, Ever taking TbRx, CD4 count, Age, Weight, and Gender so as to predict the status of drug regimen substitution. The outcome of this study can be used as an assistant tool for the clinician to help them make more appropriate drug regimen substitution. Future research directions are forwarded to come up with an applicable system in the area of the study.

Keywords: HIV drug regimen, data mining, hybrid methodology, predictive model

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Authors: Louis Hickman

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Stakeholder theory is a powerful conception of the firm based on the notion that a primary focus on shareholders is inadequate and, in fact, detrimental to the long-term health of the firm. As such it represents a departure from prevalent business school teachings with their focus on accounting and cost controls. Herein, it is argued that stakeholder theory can be better conceptualized as a critical theory, or one which represents a fundamental change in business behavior and can transform the behavior of businesses if accepted. By arguing that financial interests underdetermine the success of the firm, stakeholder theory further democratizes business by endorsing an increased awareness of the importance of non-shareholder stakeholders. Stakeholder theory requires new, non-financial, measures of success that provide a new consciousness for management and businesses when conceiving their actions and place in society. Thereby, stakeholder theory can show individuals through self-reflection that the capitalist impulses to generate wealth cannot act as primary drivers of business behavior, but rather, that we would choose to support interests outside ourselves if we made the decision in free discussion. This is due to the false consciousness embedded in our capitalism that the firm’s finances are the foremost concern of modern organizations at the expense of other goals. A focus on non-shareholder stakeholders in addition to shareholders generates greater benefits for society by improving the state of customers, employees, suppliers, the community, and shareholders alike. These positive effects generate further positive gains in well-being for stakeholders and translate into increased health for the future firm. Additionally, shareholders are the only stakeholder group that does not provide long-term firm value since there are not always communities with qualified employees, suppliers capable of providing the quality of product needed, or persons with purchasing power for all conceivable products. Therefore, the firm’s long-term health is benefited most greatly by improving the greatest possible parts of the society in which it inhabits, rather than solely the shareholder.

Keywords: capitalism, critical theory, self-reflection, stakeholder theory

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Authors: Naif A. Haddad

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Greek, Hellenistic and Roman theatre heritage are exposed to multiple risks at varied times or simultaneously. There is no single reason why a theatre building becomes ‘at risk’, as each case has different circumstances which have led to the theatre building decay. There are complicated processes of destruction and distress that show divergence in theatre building materials' decay. Theatre modern use for cultural performances causes much of the risks concerning the physical structure and authenticity of theatre sites. In addition, there are some deterioration and deformations due to previous poor quality restorations and interventions through related excavation and conservation programmes as also risks to authenticity due to new additions. For preventive conservation, theatre natural and anthropogenic risks management can provide a framework for decision making. These risks to ancient theatre heritage may stem from exposure to one or more risk or synergy of many factors. We, therefore, need to link the theatre natural risks to the risks that come from anthropogenic factors associated with social and economic development. However, this requires a holistic approach, and systematic methodology for understanding these risks from various sources while incorporating specific actions, planning and strategies for each specific risk. Elaborating on recent relevant studies, and ERATO and ATHENA EU projects for ancient theaters and odea and general surveys, this paper attempts to discuss the main aspects of the ancient Greek, Hellenistic and Roman theatres risk related issues. Relevant case studies shall also be discussed and investigated to examine frameworks for risk mitigation, and related guidelines and recommendations that provide a systematic approach for sustainable management and planning in relation mainly to ‘compatible use’ of theatre sites.

Keywords: cultural heritage management, European ancient theatres projects, Anthropogenic risks mitigation, sustainable management and planning, preventive conservation, modern use, compatible use

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Authors: Rahma Fitriani, Eni Sumarminingsih, Suci Astutik

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In a fast growing region, conversion of agricultural lands which are surrounded by some new development sites will occur sooner than expected. This phenomenon has been experienced by many regions in Indonesia, especially the fringe of Jakarta (BoDeTaBek). Being Indonesia’s capital city, rapid conversion of land in this area is an unavoidable process. The land conversion expands spatially into the fringe regions, which were initially dominated by agricultural land or conservation sites. Without proper control or growth management, this activity will invite greater costs than benefits. The current land use is the use which maximizes its value. In order to maintain land for agricultural activity or conservation, some efforts are needed to keep the land value of this activity as high as possible. In this case, the knowledge regarding the functional relationship between land value and its driving forces is necessary. In a fast growing region, development externalities are the assumed dominant driving force. Land value is the product of the past decision of its use leading to its value. It is also affected by the local characteristics and the observed surrounded land use (externalities) from the previous period. The effect of each factor on land value has dynamic and spatial virtues; an empirical spatial dynamic land value model will be more useful to capture them. The model will be useful to test and to estimate the extent of land use externalities on land value in the short run as well as in the long run. It serves as a basis to formulate an effective urban growth management’s policy. This study will apply the model to the case of land value in the fringe of Jakarta Metropolitan. The model will be used further to predict the effect of externalities on land value, in the form of prediction map. For the case of Jakarta’s fringe, there is some evidence about the significance of neighborhood urban activity – negative externalities, the previous land value and local accessibility on land value. The effects are accumulated dynamically over years, but they will fully affect the land value after six years.

Keywords: growth management, land use externalities, land value, spatial panel dynamic

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Authors: Riccardo Patriarca, Giulio Di Gravio, Francesco Costantino, Massimo Tronci

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An accurate inventory management policy acquires a crucial role in the several high-availability sectors. In these sectors, due to the high-cost of spares and backorders, an (S-1, S) replenishment policy is necessary for high-availability items. The policy enables the shipment of a substitute efficient item anytime the inventory size decreases by one. This policy can be modelled following the Multi-Echelon Technique for Recoverable Item Control (METRIC). The METRIC is a system-based technique that allows defining the optimum stock level in a multi-echelon network, adopting measures in line with the decision-maker’s perspective. The METRIC defines an availability-cost function with inventory costs and required service levels, using as inputs data about the demand trend, the supplying and maintenance characteristics of the network and the budget/availability constraints. The traditional METRIC relies on the hypothesis that a Poisson distribution well represents the demand distribution in case of items with a low failure rate. However, in this research, we will explore the effects of using a Poisson distribution to model the demand of low failure rate items characterized by an irregular demand trend. This characteristic of a demand is not included in the traditional METRIC formulation leading to the need of revising its traditional formulation. Using the CV (Coefficient of Variation) and ADI (Average inter-Demand Interval) classification, we will define the inherent flaws of Poisson-based METRIC for irregular demand items, defining an innovative ad hoc distribution which can better fit the irregular demands. This distribution will allow defining proper stock levels to reduce stocking and backorder costs due to the high irregularities in the demand trend. A case study in the aviation domain will clarify the benefits of this innovative METRIC approach.

Keywords: METRIC, inventory management, irregular demand, spare parts

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Authors: Francisco Domingos Francisco

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Tropical forests are key providers of many Ecosystem Services (ES), contributing to human wellbeing on a global and local scale. Communities around and within Moribane Forest Reserve (MFR), Manica Province - Mozambique, benefit from ES through the exploitation of non-wood and wood forest products. The objective was to assess the provisioning capacity of the MFR in woody forest products in species and profiles of interest to local communities in the main sources of extraction. Social data relating to the basic needs of local communities for these products were captured through an exploratory study before this one. From that study, it became known about the most collected wood species, the sources of collection, and their availability in the profiles of greatest interest to them. A field survey through 39 rectangular 50mx20m plots was conducted with 13 plots established in each of the three land-use types (LUT), namely Restricted Forest, Unrestricted Forest, and Disturbed areas. The results show that 89 species were identified, of which 28 (31.4%) are assumed to be the most used by the communities. The number of species of local interest does not vary across the LUT (p>0.05). The most used species (MUS) is distributed in 82% in Restricted Forest, 75% in Unrestricted, and also 75% in Disturbed. Most individuals of both general and MUS found in Unrestricted Forest, and Degraded areas have lower end profiles (5-7 cm), representing 0.77 and 0.26%, respectively. The profile of individuals of species of local interest varies by LUT (p<0.05), and their greatest proportion (0.51%) outside the lower end is found in Restricted Forest. There were no similarities between the LUT for the species in general (JCI <0.5) but between the MUS (JCI >0.5). Conclusion, the areas authorized for the exploitation of wood forest products in the MFR tend to reduce their ability to provide local communities with forest products in species and profiles of their interest. This reduction item is a serious threat to the biodiversity of the Restricted Forest. The study can help the academic community in future studies by replicating the methodology used for monitoring purposes or conducting studies in other similar areas, and the results may support decision-makers in designing better strategies for sustainability.

Keywords: ecosystem services, land-use types, local communities, species profile, wellbeing, wood forest product

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Authors: Kebron Asnake

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Water security and transboundary issues are critical concerns for countries, particularly in regions where shared water resources are significant. This Research focuses on exploring the challenges and opportunities related to water security and transboundary issues in Ethiopia, using the case of the Nile River. Ethiopia, as a riparian country of the Nile River, faces complex water security issues due to its dependence on this transboundary water resource. This abstract aims to analyze the various factors that affect water security in Ethiopia, including population growth, climate change, and competing water demands. The Study examines the challenges linked to transboundary water management of the Nile River. It delves into the complexities of negotiating water allocations and addressing potential conflicts among the downstream riparian countries. The paper also discusses the role of international agreements and cooperation in promoting sustainable water resource management. Additionally, the paper highlights the opportunities for collaboration and sustainable development that arise from transboundary water management. It explores the potential for joint investments in water infrastructure, hydropower generation, and irrigation systems that can contribute to regional economic growth and water security. Furthermore, the study emphasizes the need for integrated water management approaches in Ethiopia to ensure the equitable and sustainable use of the Nile River's waters. It highlights the importance of involving stakeholders from diverse sectors, including agriculture, energy, and environmental conservation, in decision-making processes. By presenting the case of the Nile River in Ethiopia, this Abstract contributes to the understanding of water security and transboundary issues. It underscores the significance of regional cooperation and informed policy-making to address the challenges and opportunities presented by transboundary water resources. The paper serves as a foundation for further research and policy in water management in Ethiopia and other regions facing similar challenges.

Keywords: water, health, agriculture, medicine

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Authors: Abdolamir Allameh, Seyyed Mortaza Haghgoo, Adnan Khosravi, Esmaeil Mortaz, Mihan Pourabdollah-Toutkaboni, Sharareh Seifi

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Non-Small Cell Lung Carcinoma (NSCLC) is associated with a number of gene mutations in epidermal growth factor receptor (EGFR). The prognostic significance of mutations in exons 19 and 21, together with serum levels of EGFR, amphiregulin (AR), and Transforming Growth Factor-alpha (TGF-α) are implicated in diagnosis and treatment. The aim of this study was to examine the relationship of EGFR mutations in selected exons with the expression of relevant ligands in sera samples of NSCLC patients. For this, a group of NSCLC patients (n=98) referred to the hospital for lung surgery with a mean age of 59±10.5 were enrolled (M/F: 75/23). Blood specimen was collected from each patient. Besides, formalin fixed paraffin embedded tissues were processed for DNA extraction. Gene mutations in exons 19 and 21 were detected by direct sequencing, following DNA amplification which was done by PCR (Polymerase Chain Reaction). Also, serum levels of EGFR, AR, and TGF-α were measured by ELISA. The results of our study show that EGFR mutations were present in 37% of Iranian NSCLC patients. The most frequently identified mutations were deletions in exon 19 (72.2%) and substitutions in exon 21 (27.8%). The most frequently identified alteration, which is considered as a rare mutation, was the E872K mutation in exon 21, which was found in 90% (9 out of 10) cases. EGFR mutation detected in exon 21 was significantly (P<0.05) correlated with the levels of its ligands, EGFR and TGF-α in serum samples. Furthermore, it was found that increased serum AR (>3pg/ml) and TGF-α (>10.5 pg/ml) were associated with shorter overall survival (P<0.05). The results clearly showed a close relationship between EGFR mutations and serum EGFR and serum TGF-α. Increased serum EGFR was associated with TGF-α and AR and linked to poor prognosis of NSCLC. These findings are implicated in clinical decision-making related to EGFR-Tyrosine kinase inhibitors (TKIs).

Keywords: lung cancer, Iranian patients, epidermal growth factor, mutation, prognosis

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Authors: Wade Ghribi, Abdelmoty M. Ahmed, Ahmed Said Badawy, Belgacem Bouallegue

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In higher education institutions, the most pressing priority is to improve student performance and retention. Large volumes of student data are used in Educational Data Mining techniques to find new hidden information from students' learning behavior, particularly to uncover the early symptom of at-risk pupils. On the other hand, data with noise, outliers, and irrelevant information may provide incorrect conclusions. By identifying features of students' data that have the potential to improve performance prediction results, comparing and identifying the most appropriate ensemble learning technique after preprocessing the data, and optimizing the hyperparameters, this paper aims to develop a reliable students' performance prediction model for Higher Education Institutions. Data was gathered from two different systems: a student information system and an e-learning system for undergraduate students in the College of Computer Science of a Saudi Arabian State University. The cases of 4413 students were used in this article. The process includes data collection, data integration, data preprocessing (such as cleaning, normalization, and transformation), feature selection, pattern extraction, and, finally, model optimization and assessment. Random Forest, Bagging, Stacking, Majority Vote, and two types of Boosting techniques, AdaBoost and XGBoost, are ensemble learning approaches, whereas Decision Tree, Support Vector Machine, and Artificial Neural Network are supervised learning techniques. Hyperparameters for ensemble learning systems will be fine-tuned to provide enhanced performance and optimal output. The findings imply that combining features of students' behavior from e-learning and students' information systems using Majority Vote produced better outcomes than the other ensemble techniques.

Keywords: educational data mining, student performance prediction, e-learning, classification, ensemble learning, higher education

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Authors: Kunal K. S., Shwetashri K. R., Keerthan G., Ajinkya R.

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Background: Normal pressure hydrocephalus is a condition caused by abnormal accumulation of cerebrospinal fluid (CSF) within the brain resulting in enlarged cerebral ventricles due to a disruption of CSF formation, absorption, or flow. Over the course of time, ventriculoperitoneal shunt under general anesthesia has become a standard of care. Yet only a finite number of centers have started the inclusion of regional anesthesia techniques for the such patient cohort. Stem Case: We report a case of a 75-year-old male with underlying aortic sclerosis and cardiomyopathy who presented with complaints of confusion, forgetfulness, and difficulty in walking. Neuro-imaging studies revealed disproportionally enlarged subarachnoid space hydrocephalus (DESH). The baseline blood pressure was 116/67 mmHg with a heart rate of 106 beats/min and SpO2 of 96% on room air. The patient underwent smooth induction followed by sonographically guided superficial cervical plexus block and transverse abdominis plane block. Intraoperative pain indices were monitored with Analgesia nociceptive index monitor (ANI, MdolorisTM) and surgical plethysmographic index (SPI, GE Healthcare, Helsinki, FinlandTM). These remained stable during the application of the block and the entire surgical duration. No significant hemodynamic response was observed during the tunneling of the skin by the surgeon. The patient underwent a smooth recovery and emergence. Conclusion: Our decision to incorporate peripheral nerve blockade in conjunction with general anesthesia resulted in opioid-sparing anesthesia and decreased post-operative analgesic requirement by the patient. This blockade was successful in suppressing intraoperative stress responses. Our patient recovered adequately and underwent an uncomplicated post-operative stay.

Keywords: desh, NPH, VP shunt, cervical plexus block, transversus abdominis plane block

Procedia PDF Downloads 81