Search results for: twin therapeutic approach

Authors: Panaya Sudta, Wanchalerm Patanacharoenwong, Prachya Bumrungkun

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As With the evolution of smart grids, ensuring the reliability and efficiency of electrical systems in smart cities has become crucial. This paper proposes a distinct approach that combines advanced machine learning techniques to accurately predict electrical failures and address voltage reliability issues. This approach aims to improve the accuracy and efficiency of reliability evaluations in smart cities. The aim of this research is to develop a comprehensive predictive model that accurately predicts electrical failures and voltage reliability in smart cities. This model integrates RFM analysis, K-means clustering, and LSTM networks to achieve this objective. The research utilizes RFM analysis, traditionally used in customer value assessment, to categorize and analyze electrical components based on their failure recency, frequency, and monetary impact. K-means clustering is employed to segment electrical components into distinct groups with similar characteristics and failure patterns. LSTM networks are used to capture the temporal dependencies and patterns in customer data. This integration of RFM, K-means, and LSTM results in a robust predictive tool for electrical failures and voltage reliability. The proposed model has been tested and validated on diverse electrical utility datasets. The results show a significant improvement in prediction accuracy and reliability compared to traditional methods, achieving an accuracy of 92.78% and an F1-score of 0.83. This research contributes to the proactive maintenance and optimization of electrical infrastructures in smart cities. It also enhances overall energy management and sustainability. The integration of advanced machine learning techniques in the predictive model demonstrates the potential for transforming the landscape of electrical system management within smart cities. The research utilizes diverse electrical utility datasets to develop and validate the predictive model. RFM analysis, K-means clustering, and LSTM networks are applied to these datasets to analyze and predict electrical failures and voltage reliability. The research addresses the question of how accurately electrical failures and voltage reliability can be predicted in smart cities. It also investigates the effectiveness of integrating RFM analysis, K-means clustering, and LSTM networks in achieving this goal. The proposed approach presents a distinct, efficient, and effective solution for predicting and mitigating electrical failures and voltage issues in smart cities. It significantly improves prediction accuracy and reliability compared to traditional methods. This advancement contributes to the proactive maintenance and optimization of electrical infrastructures, overall energy management, and sustainability in smart cities.

Keywords: electrical state prediction, smart grids, data-driven method, long short-term memory, RFM, k-means, machine learning

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Authors: Richard Vuijk, Arnoud Arntz

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Rationale: To our knowledge treatment of personality disorder comorbidity in adults with autism spectrum disorder (ASD) is understudied and is still in its infancy: We do not know if treatment of personality disorders may be applicable to adults with ASD. In particular, it is unknown whether patients with ASD benefit from experiential techniques that are part of schema therapy developed for the treatment of personality disorders. Objective: The aim of the study is to investigate the efficacy of a schema mode focused treatment with adult clients with ASD and comorbid personality pathology (i.e. at least one personality disorder). Specifically, we investigate if they can benefit from both cognitive-behavioral, and experiential interventions. Study design: A multiple baseline case series study. Study population: Adult individuals (age > 21 years) with ASD and at least one personality disorder. Participants will be recruited from Sarr expertise center for autism in Rotterdam. The study requires 12 participants. Intervention: The treatment protocol consists of 35 weekly offered sessions, followed by 10 monthly booster sessions. A multiple baseline design will be used with baseline varying from 5 to 10 weeks, with weekly supportive sessions. After baseline, a 5-week exploration phase follows with weekly sessions during which current and past functioning, psychological symptoms, schema modes are explored, and information about the treatment will be given. Then 15 weekly sessions with cognitive-behavioral interventions and 15 weekly sessions with experiential interventions will be given. Finally, there will be a 10-month follow-up phase with monthly booster sessions. Participants are randomly assigned to baseline length, and respond weekly during treatment and monthly at follow-up on Belief Strength of negative core beliefs (by VAS), and fill out SMI, SCL-90 and SRS-A 7 times during screening procedure (i.e. before baseline), after baseline, after exploration, after cognitive and behavioral interventions, after experiential interventions, and after 5- and 10- month follow-up. The SCID-II will be administered during screening procedure (i.e. before baseline), at 5- and at 10-month follow-up. Main study parameters: The primary study parameter is negative core beliefs. Secondary study parameters include schema modes, personality disorder manifestations, psychological symptoms, and social interaction and communication. Discussion: To the best of author’s knowledge so far no study has been published on the application of schema mode focused interventions in adult patients with ASD and comorbid PD(s). This study offers the first systematic test of application of schema therapy for adults with ASD. The results of this study will provide initial evidence for the effectiveness of schema therapy in treating adults with both ASD and PD(s). The study intends to provide valuable information for future development and implementation of therapeutic interventions for adults with both ASD and PD(s).

Keywords: adults, autism spectrum disorder, personality disorder, schema therapy

Procedia PDF Downloads 221

Authors: Kristyna Hrabova, Sabina Hüblova, Tomas Vymazal

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Structural design of concrete structure has the result in qualities of structural safety and serviceability, together with durability, robustness, sustainability and resilience. A sustainable approach is at the heart of the research agenda around the world, and the Fibrillation Commission is also working on a new model code 2020. Now it is clear that the effects of mechanical, environmental load and even social coherence need to be reflected and included in the designing and evaluating structures. This study aimed to present the methodology for the sustainability assessment of various concrete mixtures.

Keywords: concrete, cement, sustainability, Model Code 2020

Procedia PDF Downloads 163

Authors: Edward Holupka, John Rossman, Tye Morancy, Joseph Aronovitz, Irving Kaplan

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A common modality for the treatment of early stage prostate cancer is the implantation of radioactive seeds directly into the prostate. The radioactive seeds are positioned inside the prostate to achieve optimal radiation dose coverage to the prostate. These radioactive seeds are positioned inside the prostate using Transrectal ultrasound imaging. Once all of the planned seeds have been implanted, two dimensional transaxial transrectal ultrasound images separated by 2 mm are obtained through out the prostate, beginning at the base of the prostate up to and including the apex. A common deep neural network, called DetectNet was trained to automatically determine the position of the implanted radioactive seeds within the prostate under ultrasound imaging. The results of the training using 950 training ultrasound images and 90 validation ultrasound images. The commonly used metrics for successful training were used to evaluate the efficacy and accuracy of the trained deep neural network and resulted in an loss_bbox (train) = 0.00, loss_coverage (train) = 1.89e-8, loss_bbox (validation) = 11.84, loss_coverage (validation) = 9.70, mAP (validation) = 66.87%, precision (validation) = 81.07%, and a recall (validation) = 82.29%, where train and validation refers to the training image set and validation refers to the validation training set. On the hardware platform used, the training expended 12.8 seconds per epoch. The network was trained for over 10,000 epochs. In addition, the seed locations as determined by the Deep Neural Network were compared to the seed locations as determined by a commercial software based on a one to three months after implant CT. The Deep Learning approach was within \strikeout off\uuline off\uwave off2.29\uuline default\uwave default mm of the seed locations determined by the commercial software. The Deep Learning approach to the determination of radioactive seed locations is robust, accurate, and fast and well within spatial agreement with the gold standard of CT determined seed coordinates.

Keywords: prostate, deep neural network, seed implant, ultrasound

Procedia PDF Downloads 181

Authors: L. Della Ragione, G. Meccariello

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In recent years the progress of the automobile industry in Italy in the field of reduction of emissions values is very remarkable. Nevertheless, their evaluation and reduction is a key problem, especially in the cities, which account for more than 50% of world population. In this paper we dealt with the problem of describing a quantitative approach for the reconstruction of GPS coordinates and altitude, in the context of correlation study between driving cycles / emission / geographical location, during an experimental campaign realized with some instrumented cars.

Keywords: air pollution, driving cycles, GPS signal, vehicle location

Procedia PDF Downloads 414

Authors: Anetta Caplanova, Eva Sirakovova, Estera Szakadatova

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Non-payment of taxes and fees represents a problem, which occurs at national and local government levels in many countries. An effective tax collection is key for generating government and local government budget revenues to finance public services and infrastructure; thus, there is the need to address this problem. The standard approach considers as a solution raising taxes/fees to boost public revenues, which may be politically challenging and time-consuming to implement. An alternative approach is related to using behavioral interventions. These can be usually implemented relatively quickly, and in most cases, they are associated with low cost. In the paper, we present the results of the behavioral experiment focused on raising the level of compliance with the payment of garbage collection fees in a selected municipality in the Slovak Republic. The experiment was implemented using the leaflets sent to residential households together with the invoice for the garbage collection in the municipality Hlohovec, Western Slovakia, in Spring 2021. The sample of about 10000 households was divided into three random groups, a control group and two intervention groups. Households in intervention group 1 were sent a leaflet using the social norm nudge, while households in intervention group 2 were sent a leaflet using the deterrence nudge. The social norm framing leaflet pointed out that in the municipality, the prevailing majority of people paid the garbage collection fee and encouraged recipients to join this majority. The deterrent leaflet reminded the recipients that if they did not pay the fee on time, enforcement proceedings would follow. This was aimed to increase the subjective perception of citizens of the enforcement proceedings in case of noncompliance. In the paper, we present and discuss the results from the experiment and formulate relevant generalizations for other municipalities.

Keywords: municipal governments, garbage fee collection, behavioural intervention, social norm, deterrence nudge

Procedia PDF Downloads 172

Authors: Anjalika Fernando, Banuka Athuraliya

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This paper presents a comprehensive approach for converting Sinhala Sign Language (SSL) into grammatically correct sentences using Natural Language Processing (NLP) techniques in real-time. While previous studies have explored various aspects of SSL translation, the research gap lies in the absence of grammar checking for SSL. This work aims to bridge this gap by proposing a two-stage methodology that leverages deep learning models to detect signs and translate them into coherent sentences, ensuring grammatical accuracy. The first stage of the approach involves the utilization of a Long Short-Term Memory (LSTM) deep learning model to recognize and interpret SSL signs. By training the LSTM model on a dataset of SSL gestures, it learns to accurately classify and translate these signs into textual representations. The LSTM model achieves a commendable accuracy rate of 94%, demonstrating its effectiveness in accurately recognizing and translating SSL gestures. Building upon the successful recognition and translation of SSL signs, the second stage of the methodology focuses on improving the grammatical correctness of the translated sentences. The project employs a Neural Machine Translation (NMT) architecture, consisting of an encoder and decoder with LSTM components, to enhance the syntactical structure of the generated sentences. By training the NMT model on a parallel corpus of Sinhala wrong sentences and their corresponding grammatically correct translations, it learns to generate coherent and grammatically accurate sentences. The NMT model achieves an impressive accuracy rate of 98%, affirming its capability to produce linguistically sound translations. The proposed approach offers significant contributions to the field of SSL translation and grammar correction. Addressing the critical issue of grammar checking, it enhances the usability and reliability of SSL translation systems, facilitating effective communication between hearing-impaired and non-sign language users. Furthermore, the integration of deep learning techniques, such as LSTM and NMT, ensures the accuracy and robustness of the translation process. This research holds great potential for practical applications, including educational platforms, accessibility tools, and communication aids for the hearing-impaired. Furthermore, it lays the foundation for future advancements in SSL translation systems, fostering inclusive and equal opportunities for the deaf community. Future work includes expanding the existing datasets to further improve the accuracy and generalization of the SSL translation system. Additionally, the development of a dedicated mobile application would enhance the accessibility and convenience of SSL translation on handheld devices. Furthermore, efforts will be made to enhance the current application for educational purposes, enabling individuals to learn and practice SSL more effectively. Another area of future exploration involves enabling two-way communication, allowing seamless interaction between sign-language users and non-sign-language users.In conclusion, this paper presents a novel approach for converting Sinhala Sign Language gestures into grammatically correct sentences using NLP techniques in real time. The two-stage methodology, comprising an LSTM model for sign detection and translation and an NMT model for grammar correction, achieves high accuracy rates of 94% and 98%, respectively. By addressing the lack of grammar checking in existing SSL translation research, this work contributes significantly to the development of more accurate and reliable SSL translation systems, thereby fostering effective communication and inclusivity for the hearing-impaired community

Keywords: Sinhala sign language, sign Language, NLP, LSTM, NMT

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Authors: Vahid Ebrahimipour

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Word representation and context meaning of text-based documents play an essential role in knowledge modeling. Business procedures written in natural language are meant to store technical and engineering information, management decision and operation experience during the production system life cycle. Context meaning representation is highly dependent upon word sense, lexical relativity, and sematic features of the argument. This paper proposes a method for lexical semantic analysis and context meaning representation of maintenance activity in a mass production system. Our approach constructs a straightforward lexical semantic approach to analyze facilitates semantic and syntactic features of context structure of maintenance report to facilitate translation, interpretation, and conversion of human-readable interpretation into computer-readable representation and understandable with less heterogeneity and ambiguity. The methodology will enable users to obtain a representation format that maximizes shareability and accessibility for multi-purpose usage. It provides a contextualized structure to obtain a generic context model that can be utilized during the system life cycle. At first, it employs a co-occurrence-based clustering framework to recognize a group of highly frequent contextual features that correspond to a maintenance report text. Then the keywords are identified for syntactic and semantic extraction analysis. The analysis exercises causality-driven logic of keywords’ senses to divulge the structural and meaning dependency relationships between the words in a context. The output is a word contextualized representation of maintenance activity accommodating computer-based representation and inference using OWL/RDF.

Keywords: lexical semantic analysis, metadata modeling, contextual meaning extraction, ontology modeling, knowledge representation

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Authors: A. M. Tarola, R. Preti, A. M. Girelli, P. Campana

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Goat dairy products are gaining popularity worldwide. In developing countries, but also in many marginal regions of the Mediterranean area, goats represent a great part of the economy and ensure food security. In fact, these small ruminants are able to convert efficiently poor weedy plants and small trees into traditional products of high nutritional quality, showing great resilience to different climatic and environmental conditions. In developed countries, goat milk is appreciated for the presence of health-promoting compounds, bioactive compounds such as conjugated linoleic acids, oligosaccharides, sphingolipids and polyammines. This paper focuses on the recent advances in literature on the nutritional properties of goat milk and on innovative techniques to improve its quality as to become a promising functional food. The environmental sustainability of different methodologies of production has also been examined. Goat milk is valued today as a food of high nutritional value and functional properties as well as small environmental footprint. It is widely consumed in many countries due to high nutritional value, lower allergenic potential, and better digestibility when compared to bovine milk, that makes this product suitable for infants, elderly or sensitive patients. The main differences in chemical composition between a cow and goat milk rely on fat globules that in goat milk are smaller and in fatty acids that present a smaller chain length, while protein, fat, and lactose concentration are comparable. Milk nutritional properties have demonstrated to be strongly influenced by animal diet, genotype, and welfare, but also by season and production systems. Furthermore, there is a growing interest in the dairy industry in goat milk for its relatively high concentration of prebiotics and a good amount of probiotics, which have recently gained importance for their therapeutic potential. Therefore, goat milk is studied as a promising matrix to develop innovative functional foods. In addition to the economic and nutritional value, goat milk is considered a sustainable product for its small environmental footprint, as they require relatively little water and land, and less medical treatments, compared to cow, these characteristics make its production naturally vocated to organic farming. Organic goat milk production has becoming more and more interesting both for farmers and consumers as it can answer to several concerns like environment protection, animal welfare and economical sustainment of rural populations living in marginal lands. These evidences make goat milk an ancient food with novel properties and advantages to be valorized and exploited.

Keywords: goat milk, nutritional quality, bioactive compounds, sustainable production, animal welfare

Procedia PDF Downloads 133

Authors: Niyongabo Elyse

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Prefabricated building construction is a pioneering approach that combines design, production, and assembly to attain energy efficiency, environmental sustainability, and economic feasibility. Despite continuous development in the industry in China, the low technical maturity of standardized design, factory production, and construction assembly introduces uncertainties affecting prefabricated component production and on-site assembly processes. This research focuses on enhancing project management performance under uncertainty to help enterprises navigate these challenges and optimize project resources. The study introduces a perspective on how uncertain factors influence the implementation of prefabricated building construction projects. It proposes a theoretical model considering project process management ability, adaptability to uncertain environments, and collaboration ability of project participants. The impact of uncertain factors is demonstrated through case studies and quantitative analysis, revealing constraints on implementation time, cost, quality, and safety. To address uncertainties in prefabricated component production scheduling, a fuzzy model is presented, expressing processing times in interval values. The model utilizes a cooperative co-evolution evolution algorithm (CCEA) to optimize scheduling, demonstrated through a real case study showcasing reduced project duration and minimized effects of processing time disturbances. Additionally, the research addresses on-site assembly construction scheduling, considering the relationship between task processing times and assigned resources. A multi-objective model with fuzzy activity durations is proposed, employing a hybrid cooperative co-evolution evolution algorithm (HCCEA) to optimize project scheduling. Results from real case studies indicate improved project performance in terms of duration, cost, and resilience to processing time delays and resource changes. The study also introduces a multistage dynamic process control model, utilizing IoT technology for real-time monitoring during component production and construction assembly. This approach dynamically adjusts schedules when constraints arise, leading to enhanced project management performance, as demonstrated in a real prefabricated housing project. Key contributions include a fuzzy prefabricated components production scheduling model, a multi-objective multi-mode resource-constrained construction project scheduling model with fuzzy activity durations, a multi-stage dynamic process control model, and a cooperative co-evolution evolution algorithm. The integrated mathematical model addresses the complexity of prefabricated building construction project management, providing a theoretical foundation for practical decision-making in the field.

Keywords: prefabricated construction, project management performance, uncertainty, fuzzy scheduling

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Authors: Qi Jing

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This paper examines and defends Jürgen Habermas’s claim that law is the other side of democracy. It is believed that law and democracy are related, for Habermas, through the mediation of communicative rationality and discourse ethics. These ground a procedural conception of democracy, which legitimizes and rationalizes legal codes in a robust public sphere, linking the exercise of democratic political power to the form of law. The strengths of Habermas’s approach lie, it should be claimed, in its overcoming of relativism, its combination of democratically-enacted law with post-conventional morality, and its correction of the one-sided emphasis on private and public autonomy in Kant and Rousseau, respectively.

Keywords: habermas, law, democracy, reason, public sphere

Procedia PDF Downloads 57

Authors: Maria Lucia G. Lourenco, Keylla H. N. P. Pereira, Vivane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Neonatal sepsis is a systemic response to the acute generalized infection caused by one or more bacterial agents, representing the main infectious cause of neonatal mortality in dogs during the first three weeks of life. This study aims to describe the incidence of sepsis in neonate dogs, as well as the main clinical signs and mortality rates. The study included 735 neonates admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, between January 2018 and November 2019. Seven hundred thirty-five neonates, 14% (98/703) presented neonatal sepsis. The main sources of infection for the neonates were intrauterine (72.5%, 71/98), lactogenic (13.2%, 13/98), umbilical (5.1%, 5/98) and unidentified sources (9.2%, 9/98). The main non-specific clinical signs observed in the newborns were weakness, depression, impaired or absent reflexes, hypothermia, hypoglycemia, dehydration, reduced muscle tonus and diarrhea. The newborns also manifested clinical signs of severe infection, such as hyperemia in the abdominal and anal regions, omphalitis, hematuria, abdomen and extremities with purplish-blue coloration necrosing injuries in the pads, bradycardia, dyspnea, epistaxis, hypotension and evolution to septic shock. Infections acquired during intrauterine life led to the onset of the clinical signs at the time of birth, with fast evolution during the first hours of life. On the other hand, infections acquired via milk or umbilical cord presented clinical signs later. The total mortality rate was 5.4% (38/703) and the mortality rate among the neonates with sepsis was 38.7% (38/98). The early mortality rate (0 to 2 days) accounted for 86.9% (33/38) and the late mortality rate (3 to 30 days) for 13.1% (5/38) of the deaths among the newborns with sepsis. The main bacterial agents observed were Staphylococcus spp., Streptococcus spp., Proteus spp. Mannheimia spp. and Escherichia coli. Neonatal sepsis evolves quickly and may lead to high mortality in a litter. The prognosis is usually favorable if the diagnosis is reached early and the antibiotic therapy instituted as soon as possible, even before the results of blood cultures and antibiograms. The therapeutic recommendations should meet the special physiological conditions of a neonate in terms of metabolism and excretion of medication. Therefore, it is of utmost importance that the veterinarian is knowledgeable regarding neonatology to provide effective intervention and improve the survival rates of these patients.

Keywords: Neonatal infection , bacteria, puppies, newborn

Procedia PDF Downloads 95

Authors: Hamid Abbasi, Neda Jourabchi, Ranasadat Abedi, Kiarash Tajernarenj, Mehdi Farhoudi, Sarvin Sanaie

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Background: Alpha lipoic acid (ALA), fat- and water-soluble, coenzyme with sulfuret content, has received considerable attention for its potential therapeutic role in diabetes, cardiovascular diseases, cancers, and central nervous disease. This investigation aims to evaluate the probable protective effects of ALA in stroke patients. Methods: Based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, This meta-analysis was performed. The PICO criteria for this meta-analysis were as follows: Population/Patients (P: stroke patients); Intervention (I: ALA); Comparison (C: control); Outcome (O: blood glucose, lipid profile, oxidative stress, inflammatory factors).In addition, Studies that were excluded from the analysis consisted of in vitro, in vivo, and ex vivo studies, case reports, quasi-experimental studies. Scopus, PubMed, Web of Science, EMBASE databases were searched until August 2023. Results: Of 496 records that were screened in the title/abstract stage, 9 studies were included in this meta-analysis. The sample sizes in the included studies vary between 28 and 90. The result of risk of bias was performed via risk of bias (RoB) in randomized-controlled trials (RCTs) based on the second version of the Cochrane RoB assessment tool. 8 studies had a definitely high risk of bias. Discussion: To the best of our knowledge, The present meta-analysis is the first study addressing the effectiveness of ALA supplementation in enhancing post-stroke metabolic markers, including lipid profile, oxidative stress, and inflammatory indices. It is imperative to acknowledge certain potential limitations inherent in this study. First of all, type of treatment (oral or intravenous infusion) could alter the bioavailability of ALA. Our study had restricted evidence regarding the impact of ALA supplementation on included outcomes. Therefore, further research is warranted to develop into the effects of ALA specifically on inflammation and oxidative stress. Funding: The research protocol was approved and supported by the Student Research Committee, Tabriz University of Medical Sciences (grant number: 72825). Registration: This study was registered in the International prospective register of systematic reviews (PROSPERO ID: CR42023461612).

Keywords: alpha-lipoic acid, lipid profile, blood glucose, inflammatory factors, oxidative stress, meta-analysis, post-stroke

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Authors: Mehar Pruthi, Manjula V.

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For the longest time, Indian households have been hosts to a variety of domestic evils such as intimate partner violence, physical abuse, sexual assaults, and more commonly gender-based violence. The prevalence of such heinous acts against women is often swept under the carpet of patriarchy and leaves women scarred. Many times, these wounds are caused by more insidious and subtle acts of violence. For this study, the choice of term for these acts is Emotional Abuse. The ill effects of emotional abuse on the victim’s sense of self and psychological health have been widely established. The current study takes a qualitative approach to explore women’s experiences at the brunt of emotional abuse. To this end, six participants (N=6) were identified using purposive and snowball sampling which was followed by a pre-screening form to assess for the presence of emotional abuse. A semi-structured interview guide was employed to investigate the victim’s perception of emotional abuse, the manifestation of emotional abuse in a patriarchal society, and the reasons women remain in abusive relationships. Each interview lasted about 50-60 mins and was accompanied by extensive note-making. A preliminary analysis of the interviews was done using the Interpretative Phenomenological Approach. Initial findings reveal the emergence of themes such as feelings of loneliness, intergenerational transmission of violence, denial, justifying the partner’s behavior, staying because of children, hoping things would change, and faith in God. The study is instrumental in conceptualizing the patterns of emotional abuse keeping in mind the patriarchal context of the Indian society. It has implications for professionals in the mental health field who work with this population so they can better understand their plight. Future research could focus on rebuilding relationships for those partners who decide to sustain such relationships and focus on various coping mechanisms with special emphasis on religious beliefs.

Keywords: emotional abuse, gender-based violence, intimate partner violence, marriage, patriarchy

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Authors: Laura Álvarez Antón, Joaquín Díaz

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The construction industry is turning towards sustainability. It is a well-known fact that sustainability is based on a balance between environmental, social and economic aspects. In order to achieve sustainability efficiently, these three criteria should be taken into account in the initial project phases, since that is when a project can be influenced most effectively. Thus the aim must be to integrate important tools like BIM and LCA at an early stage in order to make full use of their potential. With the synergies resulting from the integration of BIM and LCA, a wider approach to sustainability becomes possible, covering the three pillars of sustainability.

Keywords: building information modeling (BIM), construction industry, design phase, life cycle assessment (LCA), sustainability

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Authors: Alexander Huang

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Online learning sessions have become an indispensable complement to in-classroom-learning sessions in the past two years due to the emergence of Covid-19. Due to social distance requirements, many courses and interaction-intensive sessions, ranging from music classes to debate camps, are online. However, online learning imposes a significant challenge for engaging students effectively during the learning sessions. To resolve this problem, Project PWR, a non-profit organization formed by high school students, developed an online kid-teach-kid learning environment to boost students' learning interests and further improve students’ engagement during online learning. Fundamentally, the kid-teach-kid learning model creates an affinity space to form learning groups, where like-minded peers can learn and teach their interests. The role of the teacher can also help a kid identify the instructional task and set the rules and procedures for the activities. The approach also structures initial discussions to reveal a range of ideas, similar experiences, thinking processes, language use, and lower student-to-teacher ratio, which become enriched online learning experiences for upcoming lessons. In such a manner, a kid can practice both the teacher role and the student role to accumulate experiences on how to convey ideas and questions over the online session more efficiently and effectively. In this research work, we conducted two case studies involving a 3D-Design course and a Speech and Debate course taught by high-school kids. Through Project PWR, a kid first needs to design the course syllabus based on a provided template to become a student-teacher. Then, the Project PWR academic committee evaluates the syllabus and offers comments and suggestions for changes. Upon the approval of a syllabus, an experienced and voluntarily adult mentor is assigned to interview the student-teacher and monitor the lectures' progress. Student-teachers construct a comprehensive final evaluation for their students, which they grade at the end of the course. Moreover, each course requires conducting midterm and final evaluations through a set of surveyed replies provided by students to assess the student-teacher’s performance. The uniqueness of Project PWR lies in its established kid-teach-kids affinity space. Our research results showed that Project PWR could create a closed-loop system where a student can help a teacher improve and vice versa, thus improving the overall students’ engagement. As a result, Project PWR’s approach can train teachers and students to become better online learners and give them a solid understanding of what to prepare for and what to expect from future online classes. The kid-teach-kid learning model can significantly improve students' engagement in the online courses through the Project PWR to effectively supplement the traditional teacher-centric model that the Covid-19 pandemic has impacted substantially. Project PWR enables kids to share their interests and bond with one another, making the online learning environment effective and promoting positive and effective personal online one-on-one interactions.

Keywords: kid-teach-kid, affinity space, online learning, engagement, student-teacher

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Authors: El Harraj Abdeslam, Raissouni Naoufal

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The detection of moving objects from a video image sequences is very important for object tracking, activity recognition, and behavior understanding in video surveillance. The most used approach for moving objects detection / tracking is background subtraction algorithms. Many approaches have been suggested for background subtraction. But, these are illumination change sensitive and the solutions proposed to bypass this problem are time consuming. In this paper, we propose a robust yet computationally efficient background subtraction approach and, mainly, focus on the ability to detect moving objects on dynamic scenes, for possible applications in complex and restricted access areas monitoring, where moving and motionless persons must be reliably detected. It consists of three main phases, establishing illumination changes in variance, background/foreground modeling and morphological analysis for noise removing. We handle illumination changes using Contrast Limited Histogram Equalization (CLAHE), which limits the intensity of each pixel to user determined maximum. Thus, it mitigates the degradation due to scene illumination changes and improves the visibility of the video signal. Initially, the background and foreground images are extracted from the video sequence. Then, the background and foreground images are separately enhanced by applying CLAHE. In order to form multi-modal backgrounds we model each channel of a pixel as a mixture of K Gaussians (K=5) using Gaussian Mixture Model (GMM). Finally, we post process the resulting binary foreground mask using morphological erosion and dilation transformations to remove possible noise. For experimental test, we used a standard dataset to challenge the efficiency and accuracy of the proposed method on a diverse set of dynamic scenes.

Keywords: video surveillance, background subtraction, contrast limited histogram equalization, illumination invariance, object tracking, object detection, behavior understanding, dynamic scenes

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Authors: Nourah Almulhim

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This paper takes a critical discourse analysis (CDA) approach to investigate discourse and ideology in political blogs, focusing in particular on the Conservative Home blog from the UK’s current governing party. The Conservative party member’s discourse strategies as the blogger, alongside the discourse used by members of the public who reply to the blog in the below-the-lines comments, will be examined. The blog discourse reflects the writer's political identity and authorial voice. The analysis of the below-the-lines comments enables members of the public to engage in creating adversative positions, introducing different language users who bring their own individual and collective identities. These language users can play the role of news reporters, political analysts, protesters or supporters of a specific agenda and current socio-political topics or events. This study takes a qualitative approach to analyze the discriminatory context towards Islam/Muslims in ' The Conservative Home' blog. A cognitive approach is adopted and an analysis of dominant discourses in the blog text and the below-the-line comments is used. The focus of the study is, firstly, on the construction of self/ collective national identity in comparison to Muslim identity, highlighting the in-group and out-group construction. Second, the type of attitudes, whether feelings or judgments, related to these social actors as they are explicated to draw on the social values. Third, the role of discursive strategies in justifying and legitimizing those Islamophobic discriminatory practices. Therefore, the analysis is based on the systematic analysis of social actors drawing on actors, actions, and arguments to explicate identity construction and its development in the different discourses. A socio-semantic categorization of social actors is implemented to draw on the discursive strategies in addition to using literature to understand these strategies. An appraisal analysis is further used to classify attitudes and elaborate on core values in both genres. Finally, the grammar of othering is applied to explain how discriminatory dichotomies of 'Us' Vs. ''Them' actions are carried in discourse. Some of the key findings of the analysis can be summarized in two main points. First, the discursive practice used to represent Muslims/Islam as different from ‘Us’ are different in both genres as the blogger uses a covert voice while the commenters generally use an overt voice. This is to say that the blogger uses a mitigated strategy to represent the Muslim identity, for example, using the noun phrase ‘British Muslim’ but then representing them as ‘radical’ and ‘terrorists'. Contrary to this is in below the lines comments, where a direct strategy with an active declarative voice is used to negatively represent the Muslim identity as ‘oppressors’ and ‘terrorists’ with no inclusion of the noun phrase ‘British Muslims’. Second, the negotiation of the ‘British’ identity and values, such as culture and democracy, are prominent in the comment section as being unique and under threat by Muslims, while in the article, these standpoints are not represented.

Keywords: xenophobia, blogs, identity, critical discourse analysis

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Authors: Shivayogi Charantimath

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Radiotherapy and chemotherapy are effective for treating malignancies but are associated with side effects like oral mucositis. Chlorhexidine gluconate is one of the most commonly used mouthwash in prevention of signs and symptoms of mucositis. Evidence shows that chlorhexidine gluconate has side effects in terms of colonization of bacteria, bad breadth and less healing properties. Thus, it is essential to find a suitable alternative therapy which is more effective with minimal side effects. Curcumin, an extract of turmeric is gradually being studied for its wide-ranging therapeutic properties such as antioxidant, analgesic, anti-inflammatory, antitumor, antimicrobial, antiseptic, chemo sensitizing and radio sensitizing properties. The present study was conducted to evaluate the efficacy and safety of topical curcumin gel on radio-chemotherapy induced oral mucositis in cancer patients. The aim of the study is to evaluate the efficacy and safety of curcumin gel in the management of oral mucositis in cancer patients undergoing radio chemotherapy and compare with chlorhexidine. The study was conducted in K.L.E. Society’s Belgaum cancer hospital. 40 oral cancer patients undergoing the radiochemotheraphy with oral mucositis was selected and randomly divided into two groups of 20 each. The study group A [20 patients] was advised Cure next gel for 2 weeks. The control group B [20 patients] was advised chlorhexidine gel for 2 weeks. The NRS, Oral Mucositis Assessment scale and WHO mucositis scale were used to determine the grading. The results obtained were calculated by using SPSS 20 software. The comparison of grading was done by applying Mann-Whitney U test and intergroup comparison was calculated by Wilcoxon matched pairs test. The NRS scores observed from baseline to 1^st and 2^nd week follow up in both the group showed significant difference. The percentage of change in erythema in respect to group A was 63.3% for first week and for second week, changes were 100.0% with p = 0.0003. The changes in Group A in respect to erythema was 34.6% for 1^st week and 57.7% in second week. The intergroup comparison was significant with p value of 0.0048 and 0.0006 in relation to group A and group B respectively. The size of the ulcer score was measured which showed 35.5% [P=0.0010] of change in Group A for 1^st and 2^nd week showed totally reduction i.e. 103.4% [P=0.0001]. Group B showed 24.7% change from baseline to 1^st week and 53.6% for 2^nd week follow up. The intergroup comparison with Wilcoxon matched pair test was significant with p=0.0001 in group A. The result obtained by WHO mucositis score in respect to group A shows 29.6% [p=0.0004] change in first week and 75.0% [p=0.0180] change in second week which is highly significant in comparison to group B. Group B showed minimum changes i.e. 20.1% in 1^st week and 33.3% in 2^nd week. The p value with Wilcoxon was significant with 0.0025 in Group A for 1^st week follow up and 0.000 for 2^nd week follow up. Curcumin gel appears to an effective and safer alternative to chlorhexidine gel in treatment of oral mucositis.

Keywords: curcumin, chemotheraphy, mucositis, radiotheraphy

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Authors: Ma'ruf

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Pilgrimage has a universal value, founded in every religion. No exception to Islam, has a ritual value, and became part of the religion, as well as the procession of a social culture in nature. The tradition of pilgrimage, especially in Indonesia, rooted in the society, because the Islam that entered into the archipelago through Sufism (tasawuf). In the Sufi tradition, the interconnecty of the human spirit (ruh) to the spirit (ruh) of God, must go through a guardian (wasilah) appointed by God himself ,the prophet Muhammad and wali. In the process of pilgrimage rituals usually by reading the prayer to praise God, the prophet and wali, then convey intent (hajat). In the pilgrimage procession, usually not only done in the house, but aslo completed the process by direct pilgrimage visiting the tombs of saints. The tradition of pilgrimage, especially in Indonesia continues to be maintained, and still attached to the traditions in Nahdiyin (NU followers). The relationship with God manifested in wasilah prayer to God, the prophet Muhammad, the best companions of the Prophet and Nine wali (Songo), who had been influential in spreading Islam in Java. The tradition of pilgrimage in Indonesia is also linked to the Shia community in Indonesia, along with a growing number of followers of the Shia in Indonesia, especially after the Islamic revolution of Iran after the 1979. Pilgrimage in the Shia community, Likewise NU members also pray with supplication of tawasul to the Prophet and Shia Imams. If NU members to make improvements pilgrimage to visit the tomb wali Songo in Java, residents Shia pilgrimage rituals abroad, usually one package with umrah trip, with a pilgrimage to the tomb of the prophet, proceed to the tomb of the Imam Shia, in Iran and Iraq. Trends of pilgrimage as a ritual in the Indonesian Shia tradition, together with the growing number of Shia residents increased, followed by increasing the awareness (syi’isme) - bond with the Imam, Shia. In every certain months (arbaeen, asyuro) Shia pilgrims routinely perform pilgrimage, along with increasing number spiritual travel.

Keywords: traditional approach, religious experience, culture, religion, pilgrimage, Syria

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Authors: Martin Arguelles Perez, Woosoon Yim, Alexander Barzilov

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High-fidelity radiation monitoring is an essential component in the enhancement of the situational awareness capabilities of the Department of Energy’s Office of Environmental Management (DOE-EM) personnel. In this paper, multiple units of unmanned aerial vehicles (UAVs) each equipped with a cadmium zinc telluride (CZT) gamma-ray sensor are used for radiation source localization, which can provide vital real-time data for the EM tasks. To achieve this goal, a fully autonomous system of multicopter-based UAV swarm in 3D tetrahedron formation is used for surveying the area of interest and performing radiation source localization. The CZT sensor used in this study is suitable for small-size multicopter UAVs due to its small size and ease of interfacing with the UAV’s onboard electronics for high-resolution gamma spectroscopy enabling the characterization of radiation hazards. The multicopter platform with a fully autonomous flight feature is suitable for low-altitude applications such as radiation contamination sites. The conventional approach uses a single UAV mapping in a predefined waypoint path to predict the relative location and strength of the source, which can be time-consuming for radiation localization tasks. The proposed UAV swarm-based approach can significantly improve its ability to search for and track radiation sources. In this paper, two approaches are developed using (a) 2D planar circular (3 UAVs) and (b) 3D tetrahedron formation (4 UAVs). In both approaches, accurate estimation of the gradient vector is crucial for heading angle calculation. Each UAV carries the CZT sensor; the real-time radiation data are used for the calculation of a bulk heading vector for the swarm to achieve a UAV swarm’s source-seeking behavior. Also, a spinning formation is studied for both cases to improve gradient estimation near a radiation source. In the 3D tetrahedron formation, a UAV located closest to the source is designated as a lead unit to maintain the tetrahedron formation in space. Such a formation demonstrated a collective and coordinated movement for estimating a gradient vector for the radiation source and determining an optimal heading direction of the swarm. The proposed radiation localization technique is studied by computer simulation and validated experimentally in the indoor flight testbed using gamma sources. The technology presented in this paper provides the capability to readily add/replace radiation sensors to the UAV platforms in the field conditions enabling extensive condition measurement and greatly improving situational awareness and event management. Furthermore, the proposed radiation localization approach allows long-term measurements to be efficiently performed at wide areas of interest to prevent disasters and reduce dose risks to people and infrastructure.

Keywords: radiation, unmanned aerial system(UAV), source localization, UAV swarm, tetrahedron formation

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Authors: Abhijit Trailokya

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Background: Cardiovascular diseases (CVD’s) are the major cause of morbidity and mortality in both developed and developing countries. Many clinical trials have demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering, reduces the incidence of coronary and cerebrovascular events across a broad spectrum of patients at risk. Guidelines for the management of patients at risk have been established in Europe and North America. The guidelines have advocated progressively lower LDL-C targets and more aggressive use of statin therapy. In Indian patients, comprehensive data on dyslipidemia management and its treatment outcomes are inadequate. There is lack of information on existing treatment patterns, the patient’s profile being treated, and factors that determine treatment success or failure in achieving desired goals. Purpose: The present study was planned to determine the lipid control status in high-risk dyslipidemic patients treated with lipid-lowering therapy in India. Methods: This cross-sectional, non-interventional, single visit program was conducted across 483 sites in India where male and female patients with high-risk dyslipidemia aged 18 to 65 years who had visited for a routine health check-up to their respective physician at hospital or a healthcare center. Percentage of high-risk dyslipidemic patients achieving adequate LDL-C level (< 70 mg/dL) on lipid-lowering therapy and the association of lipid parameters with patient characteristics, comorbid conditions, and lipid lowering drugs were analysed. Results: 3089 patients were enrolled in the study; of which 64% were males. LDL-C data was available for 95.2% of the patients; only 7.7% of these patients achieved LDL-C levels < 70 mg/dL on lipid-lowering therapy, which may be due to inability to follow therapeutic plans, poor compliance, or inadequate counselling by physician. The physician’s lack of awareness about recent treatment guidelines also might contribute to patients’ poor adherence, not explaining adequately the benefit and risks of a medication, not giving consideration to the patient’s life style and the cost of medication. Statin was the most commonly used anti-dyslipidemic drug across population. The higher proportion of patients had the comorbid condition of CVD and diabetes mellitus across all dyslipidemic patients. Conclusion: As per the European Society of Cardiology guidelines the ideal LDL-C levels in high risk dyslipidemic patients should be less than 70%. In the present study, 7.7% of the patients achieved LDL-C levels < 70 mg/dL on lipid lowering therapy which is very less. Most of high risk dyslipidemic patients in India are on suboptimal dosage of statin. So more aggressive and high dosage statin therapy may be required to achieve target LDLC levels in high risk Indian dyslipidemic patients.

Keywords: cardiovascular disease, diabetes mellitus, dyslipidemia, LDL-C, lipid lowering drug, statins

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Authors: Maria Ghorbanian, Mohammad Ghahramani, Mahmood Abolghasemi

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Universities and institutions of higher education in Iran, like other higher education institutions in the world, have a heavy mission and task to educate students based on the needs of the country. Taking on such a serious responsibility requires having a good governance system for planning, formulating executive plans, evaluating, and finally modifying them in accordance with the current conditions and challenges ahead. In this regard, the present study was conducted with the aim of identifying the components of good governance in the Iranian higher education system by survey method and with a quantitative approach. In order to collect data, a researcher-made questionnaire was used, which includes two parts: personal and professional characteristics (5 questions) and the three components of good governance in the Iranian higher education system, including good management and leadership (8 items), continuous evaluation and effective (university performance, finance, and university appointments) (8 items) and civic responsibility and sustainable development (7 items). These variables were measured and coded in the form of a five-level Likert scale from "Very Low = 1" to "Very High = 5". First, the validity and reliability of the research model were examined. In order to calculate the reliability of the questionnaire, two methods of Cronbach's alpha and combined reliability were used. Fornell-Larker interaction and criterion were also used to determine the degree of diagnostic validity. The statistical population of this study included all faculty members of public universities in Tehran (N = 4429). The sample size was estimated to be 340 using the Cochran's formula. These numbers were studied using a randomized method with a proportional assignment. The data were analyzed by the structural equation method with the least-squares approach. The results showed that the component of civil responsibility and sustainable development with a factor load of 0.827 is the most important element of good governance.

Keywords: good governance, higher education, sustainable, development

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Authors: Konja Knüppel, Gerrit Meyer, Peter Nyhuis

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The increasing interconnectedness and complexity of production processes raise the susceptibility of production systems to failure. Therefore, the ability to respond quickly to failures is increasingly becoming a competitive factor. The research project "Sustainable failure management in manufacturing SMEs" is developing a methodology to identify failures in the production and select preventive and reactive measures in order to correct failures and to establish sustainable failure management systems.

Keywords: failure categorization, failure management, logistic performance, production optimization

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Authors: Ayesha Agha Shah

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The purpose of a mosque or a place of worship is to build a spiritual relation with God. If the sense of spirituality is not achieved, then sacred architecture appears to be lacking depth. Form and space play a significant role to enhance the architectural quality to impart a divine feel to a place. To achieve this divine feeling, form and space, and unity of opposites, either abstract or symbolic can be employed. It is challenging to imbue the emptiness of a space with qualitative experience. Mosque architecture mostly entails traditional forms and design typology. This approach for Muslim worship produces distinct landmarks in the urban neighborhoods of Muslim societies, while creating a great sense of spirituality. The universal symbolic characters in the mosque architecture had prototype geometrical forms for a long time in history. However, modern mosques have deviated from this approach to employ different built elements and symbolism, which are often hard to be identified as related to mosques or even as Islamic. This research aims to explore the sense of spirituality in modern mosques and questions whether the modification of geometrical features produce spirituality in the same manner. The research also seeks to investigate the role of ‘geometry’ in the modern mosque architecture. The research employs the analytical study of some modern mosque examples in the Kingdom of Bahrain, reflecting on the geometry and symbolism adopted in the new mosque architecture design. It buttresses the analysis by the engagement of people’s perceptions derived using a survey of opinions. The research expects to see the significance of geometrical architectural elements in the mosque designs. It will find answers to the questions such as; what is the role of the form of the mosque, interior spaces and the effect of the modified symbolic features in the modern mosque design? How can the symbolic geometry, forms and spaces of a mosque invite a believer to leave the worldly environment behind and move towards spirituality?

Keywords: geometry, mosque architecture, spirituality, symbolism

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Authors: Satria B. Mahathma, Asri Hendrawati

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Background: Diabetes mellitus (DM) is a metabolic disorder syndrome characterized by chronic hyperglycemia. The number of people with diabetes rose from 108 million in 1980 to 422 million in 2014. In general, almost 90% of the prevalence of DM is type 2 DM which marked by insulin resistance and decreased receptor sensitivity. Aside from conventional antidiabetic therapy, the utilization of medicinal plants as alternative medicine has beneficial effects in diabetic patients. Flavonoid contents in radish leaves such as quercetin, pelargonidin, and kaempferol are thought to have antidiabetic activity on decreasing blood glucose levels by tricyclic nucleotide modulation of pancreatic beta cells and ameliorating insulin resistance. This study aimed to determine the effect of variant concentration of radish leaves ethanol extract on blood glucose levels in diabetic rats. Method: This study used pretest-posttest control group design by using 16 male Wistar rats which were induced type-2 diabetic by streptozotocin 60 mg/kg BW-nicotinamide 120 mg/kg BW intraperitoneally. Rats who had developed type-2 DM later divided randomly into 4 groups; negative control received placebo, positive control received glibenclamide 5 mg/kg BW/day, rats intervention I and intervention II received 100% and 50% of radish leaves ethanol extract, respectively. Treatments were administered orally for four weeks. The blood glucose levels were measured using the Enzymatic Colorimetric Test “GOD-PAP”. Data were analyzed by the dependent t-test for pretest-posttest intervention difference and one-way ANOVA followed by post hoc test to determine the significant difference of each treatment to obtain the significant data. Result: The result revealed that intervention group had lower blood glucose levels mean than control group which the lowest was intervention II group (negative control: 540,9 ± 191,7 mg/dl, positive control: 494, 97 ± 64,91 mg/dl, intervention I: 301,92 ± 165,70 mg/dl, and intervention II group: 276,1 ± 139,02 mg/dl. Intervention II group had the highest antidiabetic activity, followed by the intervention I group with the amount of decrease in blood glucose levels were -151,85 ± 77,43 mg/dl and -11,08 ± 186,62 mg/dl, however negative and positive control group didn’t have antidiabetic activity. The dependent t-test result showed there is a significant difference in decreasing blood glucose levels in the intervention II pretest-posttest intervention (p=0,03) while the other group didn’t. Data analyzed by one-way ANOVA also revealed the intervention II group significantly declined blood glucose levels compared to the negative and positive control group (p = 0,033 and p=0,032, respectively). Conclusion: There is a significant effect of radish leaves ethanol extract on blood glucose levels in streptozotocin-nicotinamide-induced diabetic rats with the optimal therapeutic effect at a concentration of 50%.

Keywords: blood glucose levels, medicinal plant, radish leaves, type-2 diabetes mellitus

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Authors: Lisa Tragbar

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Since the Rio declaration, the agreement resulting from the Earth Summit in 1992, the UN member states acknowledge that peace and environmental protection are deeply linked to each other. It has also been made clear by Contemporary Peace research since the early 2000 that the lack of natural resources increases conflicts, as well as potential war conflicts (general environmental conflict thesis). I argue that peace ethics need to reconsider the role of the environment in peace ethics, from conflict prevention to peacebuilding. Sumak kawsay is a concept that offers a non-anthropocentric perspective on the subject. Several Contemporary Peace Ethicists don’t take environmental peace sufficiently into account. 1. The Peace theorist Johan Galtung famously argues that positive peace depends mostly on social, economic and political factors, as institutional structures establish peace. Galtung has a relational approach to peace, yet only between human interactors. 2. Michael Fox claims in his anti-war argument to consider nonhuman entities in conflicts. Because of their species interrelation, humans cannot decide on the fate of other species. 3. Although Mark Woods considers himself a peace ecologist, following Reichberg and Syse, and argues from a duty-based perspective towards nature, he mostly focuses on the protection of the environment during war conflicts. I want to focus on a non-anthropocentric view to argue that the environment is an entity of human concern in order to construct peace. Based on the premises that the lack of natural resources create tensions that play a significant part in international conflicts and these conflicts are potential war conflicts, I argue that a non-anthropocentric account to peace ethics is an indispensable perspective towards the recovery of these resources and therefore the reduction of war conflicts. Sumak kawsay is an approach contributing to a peaceful environment, which can play a crucial role in international peacekeeping operations. To emphasize sumak kawsay in peace ethics, it is necessary to explain what this principle includes and how it renews Contemporary Peace ethics. The indigenous philosophy of life of the Andean Quechua philosophy in Ecuador and varities from other countries from the Global South include a holistic real-world vision that contains concepts like the de-hierarchization of humans and nature as well as the reciprocity principle towards nature. Sumak kawsay represents the idea of the intrinsic value of nature and an egalitarian way of life and interconnectedness between human and nonhuman entities, which has been widely neglected in Traditional War and Peace Ethics. If sumak kawsay is transferred to peacekeeping practices, peacekeepers have restorative duties not only towards humans, but also towards nature. Resource conservation and environmental protection are the first step towards a positive peace. By recognising that healthy natural resources contribute to peacebuilding, by restoring balance through compensatory justice practices like recovery, by fostering dialogue between peacekeeping forces and by entitling ecosystems with rights natural resources and environmental conflicts are more unlikely to happen. This holistic approach pays nature sufficient attention and can contribute to a positive peace.

Keywords: environment, natural resources, peace, Sumak Kawsay

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Authors: Malab Sana Balouch, Meenakshi Nayar

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Hemispatial Neglect is a common disorder primarily associated with right hemispheric stroke, in the acute phase of which it can occur up to 82% of the time. Such individuals fail to acknowledge or respond to people and objects in their left field of vision due to deficits in attention and awareness. Persistent hemispatial neglect significantly impedes post-stroke recovery, leading to longer hospital stays post-stroke, increased functional dependency, longer-term disability in ADLs and increased risk of falls. Recently, evidence has emerged for the use of dopamine agonist Rotigotine in neglect. The aim of our Quality Improvement Project (QIP) is to evaluate and better the current protocols and practice in assessment, documentation and management of neglect and rotigotine use at the Neurorehabilitation unit at Charing Cross Hospital (CNRU). In addition, it brings light to rotigotine use in the management of hemispatial neglect and paves the way for future research in the field. Our QIP was based in the CNRU. All patients admitted to the CNRU suffering from a right-sided stroke from 2nd of February 2018 to the 2nd of February 2021 were included in the project. Each patient’s multidisciplinary team report and hospital notes were searched for information, including bio-data, fulfilment of the inclusion criteria (having hemispatial neglect) and data related to rotigotine use. This includes whether or not the drug was administered, any contraindications to drug in patients that did not receive it, and any therapeutic benefits(subjective or objective improvement in neglect) in those that did receive the rotigotine. Data was simultaneously entered into excel sheet and further statistical analysis was done on SPSS 20.0. Out of 80 patients suffering from right sided strokes, 72.5% were infarcts and 27.5% were hemorrhagic strokes, with vast majority of both types of strokes were in the middle cerebral artery territory (MCA). A total of 31 (38.8%) of our patients were noted to have hemispatial neglect, with the highest number of cases being associated with MCA strokes. Almost half of our patients with MCA strokes suffered from neglect. Neglect was more common in male patients. Out of the 31 patients suffering from visuospatial neglect, only 16% actually received rotigotine and 80% of them were noted to have an objective improvement in their neglect tests and 20% revealed subjective improvement. After thoroughly going through neglect-associated documentation, the following recommendations/plans were put in place for the future. We plan to liaise with the occupational therapy team at our rehab unit to set a battery of tests that would be done on all patients presenting with neglect and recommend clear documentation of outcomes of each neglect screen under it. Also to create two proformas; one for the therapy team to aid in systematic documentation of neglect screens done prior to and after rotigotine administration and a second proforma for the medical team with clear documentation of rotigotine use, its benefits and any contraindications if not administered.

Keywords: hemispatial Neglect, right hemispheric stroke, rotigotine, neglect, dopamine agonist

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Authors: Vanessa Bennemann, Gabriela Laste, Márcia Inês Goettert

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The gestational period is a phase in which the pregnant woman undergoes constant physiological and hormonal changes, which are part of the woman’s biological cycle, the development of the fetus, childbirth, and lactation. These are factors of response to the immunological adaptation of the human reproductive process that is directly related to the pregnancy’s well-being and development. Although most pregnancies occur without complications, about 15% of pregnant women will develop potentially fatal complications, implying maternal and fetal risk. Therefore, requiring specialized care for high-risk pregnant women (HRPW) with obstetric interventions for the survival of the mother and/or fetus. Among the risk factors that characterize HRPW are the women's age, gestational diabetes mellitus (GDM), autoimmune diseases, infectious diseases such as syphilis and HIV, hypertension (SAH), preeclampsia, eclampsia, HELLP syndrome, uterine contraction abnormalities, and premature placental detachment (PPD), thyroid disorders, among others. Thus, pregnancy has an impact on the thyroid gland causing changes in the functioning of the mother's thyroid gland, altering the thyroid hormone (TH) profiles and production as pregnancy progresses. Considering, throughout the gestational period, the interpretation of the results of the tests to evaluate the thyroid functioning depends on the stage in which the pregnancy is. Thyroid disorders are directly related to adverse obstetric outcomes and in child development. Therefore, the adequate release of TH is important for a pregnancy without complications and optimal fetal growth and development. Objective: Investigate the physiological effects caused by thyroid disorders in the gestational period. Methods: A search for articles indexed in PubMed, Scielo, and MDPI databases, was performed using the term “AND”, with the descriptors: Pregnancy, Thyroid. With several combinations that included: Melatonin, Thyroidopathy, Inflammatory processes, Cytokines, Anti-inflammatory, Antioxidant, High-risk pregnancy. Subsequently, the screening was performed through the analysis of titles and/or abstracts. The criteria were: including clinical studies in general, randomized or not, in the period of 10 years prior to the research, in the English literature; excluded: experimental studies, case reports, research in the development phase. Results: In the preliminary results, a total of studies (n=183) were found, (n=57) excluded, such as studies of cancer, diabetes, obesity, and skin diseases. Conclusion: To date, it has been identified that thyroid diseases can impair the fetus’s brain development. Further research is suggested on this matter to identify new substances that may have a potential therapeutic effect to aid the gestational period with thyroid diseases.

Keywords: pregnancy, thyroid, melatonin, high-risk pregnancy

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Authors: Yibo Shao, Jiajie Liu

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This article uncovers the practice of pragmatism of Singaporean foreign policy by analyzing its foreign diplomatic behavior. It also points out the Singapore’s hedging strategy on the relations between China and American and how to balance these two greater powers in Southeast Asian. This paper used qualitative approach by reviewing literature and policy documents intensively to find out the responses to our research questions.

Keywords: hedging, pragmatism, Sino-Singapore relations, South China Sea

Procedia PDF Downloads 347