Search results for: code blue response time

Authors: Stephen Verderber

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The World Health Organization (WHO) calls for research and development on ecologically sustainable, resilient structures capable of effectively responding to disaster events globally, in response to climate change, politically based diasporas, earthquakes, and other adverse events upending the rhythms of everyday life globally. By 2050, nearly 80% of the world’s population will reside in coastal zones, and this, coupled with the increasingly dire impacts of climate change, constitute a recipe for further chaos and disruption, and in light of these events, architects have yet to rise up to meet the challenge. In the arena of healthcare, rapidly deployable clinics and field hospitals can provide immediate assistance in medically underserved disaster strike zones. Transportable facilities offer multiple advantages over conventional, fixed-site hospitals, as lightweight, comparatively unencumbered alternatives. These attributes have been proven repeatedly in 20th century vehicular and tent-based structures deployed in frontline combat theaters and in prior natural disasters. Prefab transportable clinics and trauma centers recently responded adroitly to medical emergencies in the aftermath of the Haitian (2010) and Ecuadorian (2016) earthquakes, and in North American post-hurricane relief efforts (2017) while architects continue to be castigated by their engineer colleagues as chronically poor first responders. Architecturally based portable structures for healthcare currently include Redeployable Health Centers (RHCs), Redeployable Trauma Centers (RTCs), and Permanent Modular Installations (PMIs). Five tectonic variants within this typology have recently been operationalized in the field: 1. Vehicular-based Nomadics: Prefab modules installed on a truck chassis with interior compartments dropped in prior to final assembly. Alternately, a two-component apparatus is preferred, with a truck cab pulling a modular medical unit, with independent transiting component; 2. Tent and Pneumatic Systems: Tent/yurt precursors and inflatable systems lightweight and responsive to topographically challenging terrain and diverse climates; 3. Containerized Systems: The standard modular intermodal-shipping container affords structural strength, resiliency in difficult transiting conditions, and can be densely close-packed and these can be custom-built or hold flat-pack systems; 4. Flat-Packs and Pop-Up Systems: These kit-of-part assemblies are shipped in standardized or specially-designed ISO containers; and 5. Hybrid Systems: These consist of composite facilities representing a synthesis of mobile vehicular components and/or tent or shipping containers, fused with conventional or pneumatically activated tent systems. Hybrids are advantageous in many installation contexts from an aesthetic, fabrication, and transiting perspective. Advantages/disadvantages of various modular systems are comparatively examined, followed by presentation of a compendium of 80 evidence (research)-based planning and design considerations addressing site/context, transiting and commissioning, triage, decontamination/intake, diagnostic and treatment, facility tectonics, and administration/total environment. The benefits of offsite pre-manufactured fabrication are examined, as is anticipated growth in international demand for transportable healthcare facilities to meet the challenges posed by accelerating global climate change and global conflicts. This investigation into rapid response facilities for pre and post-disaster zones is drawn from a recent book by the author, the first on architecture on this topic (Innovations in Transportable Healthcare Architecture).

Keywords: disaster mitigation, rapid response healthcare architecture, offsite prefabrication

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Authors: Kishor P. Kadam

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Foreign direct investment policy (FDI) is defined as an investment involving a long term relationship and reflecting a long duration interest and control of a resident entity in the home country (foreign direct investor or parent firm) in the host country. India has been one of the most translucent and open-minded FDI regimes among the emerging and developing economies. There is clear cut mentioned about the sectoral caps for foreign investment. The policy problems that have been identified by time to time surveys as acting as additional hurdles for FDI are laws, regulatory systems and government monopolies that do not have contemporary relevance. Foreign investment policies in the post-reforms period have emphasized greater encouragement and mobilization of non-debt creating private inflows for plunging reliance on debt flows. This paper will focus on how foreign direct investment policy changed from 1990-91 up to now. A time series data of 25 years is used for analysing the policy changes. It is observed that India has more liberal policy. The growth in number of Greenfield investments in India has been more impressive than the number of M&A deals whereas equity capital for incorporated bodies FDI inflows has been increased continuously 2014-15. India has made major changes in FDI Policy, and it has positive impact on economic development.

Keywords: FDI, India, economic development, government

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Authors: Getaye Fisseha Gelaw

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The purpose of this study was to investigate the key physical and physiological characteristics of 16 elite male Ethiopian national team distance runners, who have an average age of 28.1±4.3 years, a height of 175.0 ±5.6 cm, a weight of 59.1 ±3.9 kg, a BMI of 19.6 ±1.5, and training age of 10.1 ±5.1 yrs. The average weekly distance is 196.3±13.8 km, the average 10,000m time is 27:14±0.5 min sec, the average half marathon time is 59:30±0.6 min sec, the average marathon time is 2hr 03min 39sec±0.02. In addition, the average Cooper test (12-minute run test) is 4525.4±139.7 meters, and the average VO2 max is 90.8±3.1ml/kg/m. All athletes have a high profile and compete on the international label, and according to the World Athletics athletes' ranking system in 2021, 56.3% of the 16 participants were platinum label status, while the remaining 43.7 % were gold label status-completed an incremental treadmill test for the assessment of VO2peak, submaximal running, lactate threshold and test during which they ran continuously at 21 km/h. The laboratory determined VO2peak was 91.4 ± 1.7 mL/kg/min with anaerobic threshold of 74.2±1.6 mL/min/Kg and VO2max 81%. The speed at the AT is 15.9 ±0.6 Kmh and the altitude is 4,0%. The respiratory compensation RC point was reached at 88.7±1.1 mL/min/Kg and 97% of VO2 max. On RCP, the speed is 17.6 ±0.4 km/h and the altitude/slope are 5.5% percent, and the speed at Maximum effort is 19.5 ±1.5 and the elevation is 6.0%. The data also suggest that Ethiopian distance top athletes have considerably higher VO2 max values than those found in earlier research.

Keywords: long-distance running, Ethiopians, VO2 max, world athletics, anthropometric

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Authors: Alina Beraudi, Simona Catalani, Dalila De Pasquale, Eva Bianconi, Umberto Santoro, Susanna Stea, Pietro Apostoli

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Recently the European Community, in line with the international scientific community such as with the Consensus Statement, has determined to stop the use of metal-on-metal big head stemmed hip prosthesis. Among the factors accounted as responsible for the high failure rates of these hip implants are the release and accumulation of metal ions. Many studies have correlated the presence of these ions, besides other factors, with the induction of oxidative stress response. In our study on 12 subjects, we observed the patient specific capability to eliminate metal ions after revision surgery. While for cobalt all the patients were able to completely excrete cobalt ions within 5-7 months after metal-on-metal bearing removal, for chromium ions it didn’t happen. If on the one hand the toxicokinetic differences between the two types of ions are confirmed by toxicological and occupational studies, on the other hand, this peculiar way of exposition represents a novel and important point of view. Thus, two different approaches were performed to better understand the subject specific capability to transport metal ions (albumin study) and to manage the response to them (heme-oxygenase-1 study): - a mutational screening of ALBUMIN gene was conducted in 30 MoM prosthetic patients resulting in the absence of nucleotidic changes compared with the ALB reference sequence. To this study was also added the analysis of expression of modified albumin protein; - a gene and protein expression study on 44 patients of heme-oxygenase-1, that is one of the most important antioxidant enzyme induced by metallic ions, was performed. This study resulted in no statistically significant differences in the expression of the gene and protein heme-oxygenase-1 between prosthetic and non-prosthetic patients, as well as between patients with high and low ions levels. Our results show that the protein studied (albumin and heme-oxygenase-1) seem to be not involved in determining chromium and cobalt ions level. On the other hand, achromium and cobalt elimination rates are different, but similar in all patients analyzed, suggesting that this process could be not patient-related. We support the importance of researching more about ions transport within the organism once released by hip prosthesis, about the chemical species involved, the districts where they are contained and the mechanisms of elimination, not excluding the existence of a subjective susceptibility to these metals ions.

Keywords: chromium, cobalt, hip prosthesis, individual susceptibility

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Authors: Seyedahmad Hosseini, Mohammadjavad Sotoudeheian

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Introduction: Allergic asthma is a heterogeneous immuno-inflammatory disease based on Th-2-mediated inflammation. Histopathologic abnormalities of the airways characteristic of asthma include epithelial damage and subepithelial collagen deposition. Objectives: Human bronchial epithelial cell genome expression of TNF‑α, IL‑6, ICAM‑1, VCAM‑1, nuclear factor (NF)‑κB signaling pathways up-regulate during inflammatory cascades. Moreover, immunofluorescence assays confirmed the nuclear translocation of NF‑κB p65 during inflammatory responses. An absolute LDH leakage assays suggestedLPS-inducedcells injury, and the associated mechanisms are co-incident events. LPS-induced phosphorylation of ERKand JNK causes inflammation in epithelial cells through inhibition of ERK and JNK activation and NF-κB signaling pathway. Furthermore, the inhibition of NF-κB mRNA expression and the nuclear translocation of NF-κB lead to anti-inflammatory events. Likewise, activation of SUMF2 which inhibits IL-13 and reduces Th2-cytokines, NF-κB, and IgE levels to ameliorate asthma. On the other hand, TNFα-induced mucus production reduced NF-κB activation through inhibition of the activation status of Rac1 and IκBα phosphorylation. In addition, bradykinin B2 receptor (B2R), which mediates airway remodeling, regulates through NF-κB. Bronchial B2R expression is constitutively elevated in allergic asthma. In addition, certain NF-κB -dependent chemokines function to recruit eosinophils in the airway. Besides, bromodomain containing 4 (BRD4) plays a significant role in mediating innate immune response in human small airway epithelial cells as well as transglutaminase 2 (TG2), which is detectable in saliva. So, the guanine nucleotide-binding regulatory protein α-subunit, Gα16, expresses a κB-driven luciferase reporter. This response was accompanied by phosphorylation of IκBα. Furthermore, expression of Gα16 in saliva markedly enhanced TNF-α-induced κB reporter activity. Methods: The applied method to form NF-κB activation is the electromobility shift assay (EMSA). Also, B2R-BRD4-TG2 complex detection by immunoassay method within saliva with EMSA of NF-κB activation may be a novel biomarker for asthma diagnosis and follow up. Conclusion: This concept introduces NF-κB signaling pathway as potential asthma biomarkers and promising targets for the development of new therapeutic strategies against asthma.

Keywords: NF-κB, asthma, saliva, T-helper

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Authors: H. Ferfera-Harrar, T. Benhalima, D. Lerari

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Contamination of water, due to the discharge of untreated industrial wastewaters into the ecosystem, has become a serious problem for many countries. In this study, bioadsorbents based on chitosan-g-poly(acrylamide) and montmorillonite (MMt) clay (CTS-g-PAAm/MMt) hydrogel nanocomposites were prepared via free‐radical grafting copolymerization and crosslinking of acrylamide monomer (AAm) onto natural polysaccharide chitosan (CTS) as backbone, in presence of various contents of MMt clay as nanofiller. Then, they were hydrolyzed to obtain highly functionalized pH‐sensitive nanomaterials with uppermost swelling properties. Their structure characterization was conducted by X-Ray Diffraction (XRD) and Scanning Electron Microscopy (SEM) analyses. The adsorption performances of the developed nanohybrids were examined for removal of methylene blue (MB) cationic dye from aqueous solutions. The factors affecting the removal of MB, such as clay content, pH medium, adsorbent dose, initial dye concentration and temperature were explored. The adsorption process was found to be highly pH dependent. From adsorption kinetic results, the prepared adsorbents showed remarkable adsorption capacity and fast adsorption rate, mainly more than 88% of MB removal efficiency was reached after 50 min in 200 mg L^-1 of dye solution. In addition, the incorporating of various content of clay has enhanced adsorption capacity of CTS-g-PAAm matrix from 1685 to a highest value of 1749 mg g^-1 for the optimized nanocomposite containing 2 wt.% of MMt. The experimental kinetic data were well described by the pseudo-second-order model, while the equilibrium data were represented perfectly by Langmuir isotherm model. The maximum Langmuir equilibrium adsorption capacity (q_m) was found to increase from 2173 mg g⁻¹ until 2221 mg g⁻¹ by adding 2 wt.% of clay nanofiller. Thermodynamic parameters revealed the spontaneous and endothermic nature of the process. In addition, the reusability study revealed that these bioadsorbents could be well regenerated with desorption efficiency overhead 87% and without any obvious decrease of removal efficiency as compared to starting ones even after four consecutive adsorption/desorption cycles, which exceeded 64%. These results suggest that the optimized nanocomposites are promising as low cost bioadsorbents.

Keywords: chitosan, clay, dye adsorption, hydrogels nanocomposites

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Authors: Cyrus Addy, Venkata Sriram Siddhardh Nadendla, Kwame Awuah-Offei

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Surface robots in modern underground mine rescue operations suffer from several limitations in enabling a prompt self-rescue. Therefore, the possibility of designing and deploying in-mine robots to expedite miner self-rescue can have a transformative impact on miner safety. These in-mine robots for miner self-rescue can be envisioned to carry out diverse tasks such as object detection, autonomous navigation, and payload delivery. Specifically, this paper investigates the challenges in the design of object detection algorithms for in-mine robots using thermal images, especially to detect people in real-time. A total of 125 thermal images were collected in the Missouri S&T Experimental Mine with the help of student volunteers using the FLIR TG 297 infrared camera, which were pre-processed into training and validation datasets with 100 and 25 images, respectively. Three state-of-the-art, pre-trained real-time object detection models, namely YOLOv5, YOLO-FIRI, and YOLOv8, were considered and re-trained using transfer learning techniques on the training dataset. On the validation dataset, the re-trained YOLOv8 outperforms the re-trained versions of both YOLOv5, and YOLO-FIRI.

Keywords: miner self-rescue, object detection, underground mine, YOLO

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Authors: Surangrat Srisurapanon, Chatchawal Wongjitrat, Navin Horthongkham, Ruengpung Sutthent

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HBV infection causes a potential serious public health problem. The ability to detect the HBV DNA concentration is of the importance and improved continuously. By using quantitative Polymerase Chain Reaction (qPCR), several factors in standardized; source of material, calibration standard curve and PCR efficiency are inconsistent. Digital PCR (dPCR) is an alternative PCR-based technique for absolute quantification using Poisson's statistics without requiring a standard curve. Therefore, the aim of this study is to compare the data set of HBV DNA generated between dPCR and qPCR methods. All samples were quantified by Abbott’s real time PCR and 54 samples with 2 -6 log10 HBV DNA were selected for comparison with dPCR. Of these 54 samples, there were two outlier samples defined as negative by dPCR. Of these two, samples were defined as negative by dPCR, whereas 52 samples were positive by both the tests. The difference between the two assays was less than 0.25 log IU/mL in 24/52 samples (46%) of paired samples; less than 0.5 log IU/mL in 46/52 samples (88%) and less than 1 log in 50/52 samples (96%). The correlation coefficient was r=0.788 and P-value <0.0001. Comparison to qPCR, data generated by dPCR tend to be the overestimation in the sample with low HBV DNA concentration and underestimated in the sample with high viral load. The variation in DNA by dPCR measurement might be due to the pre-amplification bias, template. Moreover, a minor drawback of dPCR is the large quantity of DNA had to be used when compare to the qPCR. Since the technology is relatively new, the limitations of this assay will be improved.

Keywords: hepatitis B virus, real time PCR, digital PCR, DNA quantification

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Authors: Chao Wang

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Under rapid innovation of information technology, the media plays a very important role in the dissemination of information, and it has a totally different analogy generations face. However, the involvement of narrative images provides more possibilities of narrative text. "Images" through the process of aperture, a camera shutter and developable photosensitive processes are manufactured, recorded and stamped on paper, displayed on a computer screen-concretely saved. They exist in different forms of files, data, or evidence as the ultimate looks of events. By the interface of media and network platforms and special visual field of the viewer, class body space exists and extends out as thin as sebum layer, extremely soft and delicate with real full tension. The physical space of sebum layer of confuses the fact that physical objects exist, needs to be established under a perceived consensus. As at the scene, the existing concepts and boundaries of physical perceptions are blurred. Sebum layer physical simulation shapes the “Topical-Similarity" immersing, leading the contemporary social practice communities, groups, network users with a kind of illusion without the presence, i.e. a non-real illusion. From the investigation and discussion of literatures, digital movies editing manufacture and produce the variability characteristics of time (for example, slices, rupture, set, and reset) are analyzed. Interactive eBook has an unique interaction in "Waiting-Greeting" and "Expectation-Response" that makes the operation of image narrative structure more interpretations functionally. The works of digital editing and interactive technology are combined and further analyze concept and results. After digitization of Interventional Imaging and interactive technology, real events exist linked and the media handing cannot be cut relationship through movies, interactive art, practical case discussion and analysis. Audience needs more rational thinking about images carried by the authenticity of the text.

Keywords: sebum layer, topical and similarity, interactive technology, image narrative

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Authors: Sajida Rasheed, Imran Hashmi, Luiza Campos, Qizhi Zhou, Kim Keu

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A quadratic model (p ˂ 0.0001) was developed by using central composite design of 50 experimental runs (42 non-center + 8 center points) to assess efficiency of background chlorine residuals in combating accidental microbial episode in a prototype distribution network (DN) (rig). A known amount of background chlorine residuals were maintained in DN and a required number of bacteria, Escherichia coli K-12 strain were introduced by an injection port in the pipe loop system. Samples were taken at various time intervals at different pipe lengths. Spread plate count was performed to count bacterial number. The model developed was significant. With microbial concentration and time (p ˂ 0.0001), pipe length (p ˂ 0.022), background chlorine residuals (p ˂ 0.07) and time^2 (p ˂ 0.09) as significant factors. The ramp function of variables shows that at the microbial count of 10^6, at 0.76 L/min, and pipe length of 133 meters, a background residual chlorine 0.16 mg/L was enough for complete inactivation of microbial episode in approximately 18 minutes.

Keywords: central composite design (CCD), distribution network, Escherichia coli, residual chlorine

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Authors: Tan Xin Zhong Timothy, Chang Chen Jie Victor, Yew Kwan Tong, Lim Geok Peng Sandy

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Background: Leaders in crisis response teams such as Trauma Teams in hospitals are essential to the effective coordination and direction of the team. The response to emergency trauma situations must be accurate, rapid, and well executed. To this end, the team leader’s social, technical and leadership skills are essential factors that implicate the success of an emergency trauma intervention. While each emergency trauma case varies in severity and complexity, and the experience and expertise of team leaders may vary, it would be productive to identify certain coordinative and directive functions that improve the capacity for leading a team. Methods: This qualitative study of Trauma Team physicians in Singapore General Hospital (SGH) involved 50 in-depth interviews with doctors and nurses involved in Trauma Team activations, observations of Trauma Teams managing emergency patients, and reviews of audio/video recordings of 65 trauma activations. The interviews were conducted with doctors of various ranks across the relevant departments, 12 from the Emergency Department (ED), 11 from General Surgery (GS) and 8 from Orthopaedics, while the 6 nurses were from ED. In accordance with the grounded theory approach, the content of the interviews was coded and analysed in order to derive broad leadership themes that corresponded with certain behavioural traits exhibited by trauma team leaders, supplemented with the observational and audio/video data. Results: The leadership behaviours of the team leaders could be typified into three broad categories: team orientation, engagement and activeness. Team orientation corresponds with the source and form of cognitive responsibility, decision-making and informational contributions, divisible into individualistic and consultative sub-categories. Engagement refers to the type of activity that leaders prefer to engage in, and which implicates their attentional focus, divisible into participatory and supervisory sub-categories. Activeness is a function of the leader’s attitudes towards the behavioural regulation of the team, which manifests in inactivity or activity to augment or merely align with protocol. These factors are not exhaustive and are contextually sensitive, but collectively implicate a significant portion of the leadership activity observed in trauma teams.

Keywords: trauma team activations, critical event management, leadership, teamwork

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Authors: Jeannette Anniés, Panagiotis Michalis, Chrysoula Papathanasiou, Selby Knudsen

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RiskPACC project aims to bring together researchers, practitioners, and first responders from nine European countries following a co-creation approach aiming to develop customised solutions to meet the needs of end-users. The co-creation workshops target to enhance the communication pathways between local civil protection authorities (CPAs) and citizens, in an effort to close the risk perception-action gap (RPAG). The participants in the workshops include a variety of stakeholders, as well as citizens, fostering the dialogue between the groups and supporting citizen participation in disaster risk management (DRM). The co-creation methodology in place implements co-design elements due to the integration of four ICT tools. Such ICT tools include web-based and mobile application technical solutions in different development stages, ranging from formulation and validation of concepts to pilot demonstrations. In total, seven different case studies are foreseen in RiskPACC. The workflow of the workshops is designed to be adaptive to every of the seven case study countries and their cultures’ particular needs. This work aims to provide an overview of the the preparation and the conduction of the workshops in which researchers and practitioners focused on mapping these different needs from the end users. The latter included first responders but also volunteers and citizens who actively participated in the co-creation workshops. The strategies to improve communication between CPAs and citizens themselves differ in the countries, and the modules of the co-creation methodology are adapted in response to such differences. Moreover, the project partners experienced how the structure of such workshops is perceived differently in the seven case studies. Therefore, the co-creation methodology itself is a design method underlying several iterations, which are eventually shaped by cross-cultural collaboration. For example, some case studies applied other modules according to the participatory group recruited. The participants were technical experts, teachers, citizens, first responders, or volunteers, among others. This work aspires to present the divergent approaches of the seven case studies implementing the co-creation methodology proposed, in response to different perceptions of the modules. An analysis of the adaptations and implications will also be provided to assess where the case studies’ objective of improving disaster resilience has been obtained.

Keywords: citizen participation, co-creation, disaster resilience, risk perception, ICT tools

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Authors: Claire Harrison, Raajit K. Rampal, Vikas Gupta, Srdan Verstovsek, Moshe Talpaz, Jean-Jacques Kiladjian, Ruben Mesa, Andrew Kuykendall, Alessandro Vannucchi, Francesca Palandri, Sebastian Grosicki, Timothy Devos, Eric Jourdan, Marielle J. Wondergem, Haifa Kathrin Al-Ali, Veronika Buxhofer-Ausch, Alberto Alvarez-Larrán, Sanjay Akhani, Rafael Muñoz-Carerras, Yury Sheykin, Gozde Colak, Morgan Harris, John Mascarenhas

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Myelofibrosis (MF) is characterized by bone marrow fibrosis, anemia, splenomegaly and constitutional symptoms. Progressive bone marrow fibrosis results from aberrant megakaryopoeisis and expression of proinflammatory cytokines, both of which are heavily influenced by bromodomain and extraterminal domain (BET)-mediated gene regulation and lead to myeloproliferation and cytopenias. Pelabresib (CPI-0610) is an oral small-molecule investigational inhibitor of BET protein bromodomains currently being developed for the treatment of patients with MF. It is designed to downregulate BET target genes and modify nuclear factor kappa B (NF-κB) signaling. MANIFEST-2 was initiated based on data from Arm 3 of the ongoing Phase 2 MANIFEST study (NCT02158858), which is evaluating the combination of pelabresib and ruxolitinib in Janus kinase inhibitor (JAKi) treatment-naïve patients with MF. Primary endpoint analyses showed splenic and symptom responses in 68% and 56% of 84 enrolled patients, respectively. MANIFEST-2 (NCT04603495) is a global, Phase 3, randomized, double-blind, active-control study of pelabresib and ruxolitinib versus placebo and ruxolitinib in JAKi treatment-naïve patients with primary MF, post-polycythemia vera MF or post-essential thrombocythemia MF. The aim of this study is to evaluate the efficacy and safety of pelabresib in combination with ruxolitinib. Here we report updates from a recent protocol amendment. The MANIFEST-2 study schema is shown in Figure 1. Key eligibility criteria include a Dynamic International Prognostic Scoring System (DIPSS) score of Intermediate-1 or higher, platelet count ≥100 × 10^9/L, spleen volume ≥450 cc by computerized tomography or magnetic resonance imaging, ≥2 symptoms with an average score ≥3 or a Total Symptom Score (TSS) of ≥10 using the Myelofibrosis Symptom Assessment Form v4.0, peripheral blast count <5% and Eastern Cooperative Oncology Group performance status ≤2. Patient randomization will be stratified by DIPSS risk category (Intermediate-1 vs Intermediate-2 vs High), platelet count (>200 × 10^9/L vs 100–200 × 10^9/L) and spleen volume (≥1800 cm^3 vs <1800 cm^3). Double-blind treatment (pelabresib or matching placebo) will be administered once daily for 14 consecutive days, followed by a 7 day break, which is considered one cycle of treatment. Ruxolitinib will be administered twice daily for all 21 days of the cycle. The primary endpoint is SVR35 response (≥35% reduction in spleen volume from baseline) at Week 24, and the key secondary endpoint is TSS50 response (≥50% reduction in TSS from baseline) at Week 24. Other secondary endpoints include safety, pharmacokinetics, changes in bone marrow fibrosis, duration of SVR35 response, duration of TSS50 response, progression-free survival, overall survival, conversion from transfusion dependence to independence and rate of red blood cell transfusion for the first 24 weeks. Study recruitment is ongoing; 400 patients (200 per arm) from North America, Europe, Asia and Australia will be enrolled. The study opened for enrollment in November 2020. MANIFEST-2 was initiated based on data from the ongoing Phase 2 MANIFEST study with the aim of assessing the efficacy and safety of pelabresib and ruxolitinib in JAKi treatment-naïve patients with MF. MANIFEST-2 is currently open for enrollment.

Keywords: CPI-0610, JAKi treatment-naïve, MANIFEST-2, myelofibrosis, pelabresib

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Authors: Moise Alin Ionuț Cornel

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In a pilot lesson of prevention of consumption drugs in a classroom of teenager`s where the school want them to know how to manage their thoughts and emotions to protect themself an to be strong in an possible environment of drugs consumption. At this classroom was applied the RAIN(Recognize, Accept, Investigation,Non-identify) spiritual method and the balance model from positive and transcultural psychotherapy (PPT) in a manner of a game play for them to understand the methods in an individual experience. The balance model from PPT with his 4 parts and used in 3 ways, and the RAIN spiritual method was used to see how the teenager`s can bring clarity about theirs individual self and how they spend the time and energy in the daily life. The 3 ways of how they can used this model was explained like a analogy with the 3 periods of the SAKURA (Japanese cherry) flourish (kaika, mankai and chiru). The teenager`s received a new perspective and in the same time new tools from the spiritual point of view combined with the psychotherapeutic point of view to manage their thoughts, emotions, time and energy in the form of a psychoeducational game to be able to prevent the use of drugs.

Keywords: addiction, drugs consumption prevention education, psychotherapy, Self, Spirituality, teenagers

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Authors: Andrei Pomana, Graham Brewer

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Autism is a lifelong developmental disorder that affects verbal and non-verbal communication, behaviour and sensory processing. As a result, people on the autism spectrum have a difficult time when confronted with environments that have high levels of sensory stimulation. This is often compounded by the inability to properly communicate their wants and needs to caregivers. The capacity for people with autism to integrate depends on their ability to at least tolerate highly stimulating public environments for short periods of time. The overall challenges that people on the spectrum and their caregivers face need to be established in order to properly create and assess methods to mitigate the effects of high stimulus public spaces. The paper aims to identify the challenges that people on the autism spectrum and their caregivers face in typical public environments. Nine experienced autism therapists have participated in a semi-structured interview regarding the challenges that people with autism and their caregivers face in public environments. The qualitative data shows that the unpredictability of events and the high sensory stimulation present in public environments, especially auditory, are the two biggest contributors to the difficulties that people on the spectrum face. If the stimuli are not removed in a short period of time, uncontrollable behaviours or 'meltdowns' can occur, which leave the person incapacitated and unable to respond to any outside input. Possible solutions to increase integration in public spaces for people with autism revolve around removing unwanted sensory stimulus, creating personalized barriers for certain stimuli, equipping people with autism with better tools to communicate their needs or to orient themselves to a safe location and providing a predictable pattern of events that would prepare individuals for tasks ahead of time.

Keywords: autism, built environment, meltdown, public environment, sensory processing disorders

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Authors: Jing Zhang, Daniel Nikovski

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We propose an approximation algorithm called LINKUMP to compute the Pan Matrix Profile (PMP) under the unnormalized l∞ distance (useful for value-based similarity search) using double-ended queue and linear interpolation. The algorithm has comparable time/space complexities as the state-of-the-art algorithm for typical PMP computation under the normalized l₂ distance (useful for shape-based similarity search). We validate its efficiency and effectiveness through extensive numerical experiments and a real-world anomaly detection application.

Keywords: pan matrix profile, unnormalized euclidean distance, double-ended queue, discord discovery, anomaly detection

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Authors: Lavanya Mohan, Suneha Sethi

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This paper seeks to study the concept of existential anguish and its relation to personal growth. Generally, existential anguish is taken to be an all-pervading negative feeling arising from an individual’s knowledge of their absolute freedom. However, this paper investigates the possible positive impact of this sense of anguish, such as its role in commencing an individual’s journey towards authentic living, characterized by an internal locus of will, and acceptance of absolute freedom. This journey towards authentic living is what is referred to as personal growth, in this paper, in the context of existential philosophy. The work of four prominent existentialists has been used to elucidate existential anguish. A human’s scope for personal growth in the existential framework has been compared to that in the teleological framework of religion. In the latter, individuals must abide by the moral code of an external authority and work towards a pre-ordained purpose of life. This is illustrated by the examination of Hinduism, Christianity, and Islam. To test people’s levels of existential anguish, religiosity, and personal growth, a survey using an originally constructed questionnaire has been undertaken. Simple and partial correlation analyses have been used to ascertain the relationships between these three variables. Contrary to the hypothesis, the results indicate that existential anguish has a detrimental effect on personal growth, while religiosity does not affect it at all. Through their responses, it was also evident that the respondents do not adhere to teleological concepts of morality, despite a belief in God. This study has further scope in determining how variations in sample demography may influence the relationship of existential anguish with personal growth.

Keywords: existential anguish, existentialism, personal growth, religiosity, teleology

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Authors: Rami Faraj, Cezary Graczykowski, Błażej Popławski, Grzegorz Mikułowski, Rafał Wiszowaty

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Progress in the field of sensors, electronics and computing results in more and more often applications of adaptive techniques for dynamic response mitigation. When it comes to systems excited with mechanical impacts, the control system has to take into account the significant limitations of actuators responsible for system adaptation. The paper provides a comprehensive discussion of the problem of appropriate design and implementation of adaptation techniques and mechanisms. Two case studies are presented in order to compare completely different adaptation schemes. The first example concerns a double-chamber pneumatic shock absorber with a fast piezo-electric valve and parameters corresponding to the suspension of a small unmanned aerial vehicle, whereas the second considered system is a safety air cushion applied for evacuation of people from heights during a fire. For both systems, it is possible to ensure adaptive performance, but a realization of the system’s adaptation is completely different. The reason for this is technical limitations corresponding to specific types of shock-absorbing devices and their parameters. Impact mitigation using a pneumatic shock absorber corresponds to much higher pressures and small mass flow rates, which can be achieved with minimal change of valve opening. In turn, mass flow rates in safety air cushions relate to gas release areas counted in thousands of sq. cm. Because of these facts, both shock-absorbing systems are controlled based on completely different approaches. Pneumatic shock-absorber takes advantage of real-time control with valve opening recalculated at least every millisecond. In contrast, safety air cushion is controlled using the semi-passive technique, where adaptation is provided using prediction of the entire impact mitigation process. Similarities of both approaches, including applied models, algorithms and equipment, are discussed. The entire study is supported by numerical simulations and experimental tests, which prove the effectiveness of both adaptive impact mitigation techniques.

Keywords: adaptive control, adaptive system, impact mitigation, pneumatic system, shock-absorber

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Authors: Jaroslav Masek, Juraj Camaj, Eva Nedeliakova

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The paper is focused on the operational model for transport the single wagon consignments on railway network by using two different models of train formation. The paper gives an overview of possibilities of improving the quality of transport services. Paper deals with two models used in problematic of train formatting - time continuously and time discrete. By applying these models in practice, the transport company can guarantee a higher quality of service and expect increasing of transport performance. The models are also applicable into others transport networks. The models supplement a theoretical problem of train formation by new ways of looking to affecting the organization of wagon flows.

Keywords: train formation, wagon flows, marshalling yard, railway technology

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Authors: Femi Elegbeleye, Omobayo Esan, Muienge Mbodila, Patrick Bowe

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This paper focused on cost effective storage architecture using fog and cloud data storage gateway and presented the design of the framework for the data privacy model and data analytics framework on a real-time analysis when using machine learning method. The paper began with the system analysis, system architecture and its component design, as well as the overall system operations. The several results obtained from this study on data privacy model shows that when two or more data privacy model is combined we tend to have a more stronger privacy to our data, and when fog storage gateway have several advantages over using the traditional cloud storage, from our result shows fog has reduced latency/delay, low bandwidth consumption, and energy usage when been compare with cloud storage, therefore, fog storage will help to lessen excessive cost. This paper dwelt more on the system descriptions, the researchers focused on the research design and framework design for the data privacy model, data storage, and real-time analytics. This paper also shows the major system components and their framework specification. And lastly, the overall research system architecture was shown, its structure, and its interrelationships.

Keywords: IoT, fog, cloud, data analysis, data privacy

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Authors: James Boag

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The needs of people with a diagnosis of dementia and their carers and families are physical, psychosocial, and psychological and begin at the time of diagnosis. There is frequently a lack of emotional support and counselling. Care- giving support is required from the presentation of the first symptoms of dementia until death. Alzheimer's disease begins decades before the clinical symptoms begin to appear, and in many cases, it remains undiagnosed, or diagnosed too late for any possible interventions to have any effect. However, if an incorrect diagnosis is given, it may result in a person being treated, without effect, for a type of dementia they do not have and delaying the interventions they should have received. Being diagnosed with dementia can cause emotional distress to the person, and physical and emotional support is needed, which will become more important as the disease progresses. The severity of the patient's dementia and their symptoms has a bearing of the impact on the carer and the support needed. A lack of insight and /or a denial of the diagnosis, grief, reacting to anticipated future losses, and coping methods to maximise the disease outcome, are things that should be addressed. Because of the stigma, it is important for carers not to lose contact with family and others because social isolation leads to depression and burnout. The impact on a carer's well- being and quality of life can be influenced by the severity of the illness, its type of dementia, its symptoms, healthcare support, financial and social status, career, age, health, residential setting, and relationship to the patient. Carer burnout due to lack of support leads to people diagnosed with dementia being put into residential care prematurely. Often dementia is not recognised as a terminal illness, limiting the ability of the person diagnosed with dementia and their carers to work on advance care planning and getting access to palliative and other support. Many carers have been satisfied with the physical support they were given in their everyday life, however, it was agreed that there was an immense unmet need for psychosocial support, especially after diagnosis and approaching end of life. Providing continuity and coordination of care is important. Training is necessary for providers to understand that every case is different, and they should understand the complexities. Grief, the emotional response to loss, is suffered during the progression of the disease and long afterwards, and carers should continue to be supported after the death of the person they were caring for.

Keywords: dementia, caring, challenges, needs

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Authors: An-Shik Yang, Chin-Ting Kuo, Yung-Chun Yang, Wen-Hsin Hsieh, Chiang-Ho Cheng

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Optical biosensors have become a powerful detection and analysis tool for wide-ranging applications in biomedical research, pharmaceuticals and environmental monitoring. This study carried out the computational fluid dynamics (CFD)-based simulations to explore the dispersion phenomenon in the microchannel of a optical biosensor. The predicted time sequences of concentration contours were utilized to better understand the dispersion development occurred in different geometric shapes of microchannels. The simulation results showed the surface concentrations at the sensing probe (with the best performance of a grating coupler) in respect of time to appraise the dispersion effect and therefore identify the design configurations resulting in minimum dispersion.

Keywords: CFD simulations, dispersion, microfluidic, optical waveguide sensors

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Authors: J. Adeppa, S. Samanta, O. K. Raina

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Fasciolosis is a widespread economically important parasitic infection throughout the world caused by Fasciola hepatica and F. gigantica. In order to identify novel immunogen conferring significant protection against fasciolosis, currently, research has been focused on the defined antigens viz. glutathione S-transferase, fatty acid binding protein, cathepsin-L, fluke hemoglobin, paramyosin, myosin and F. hepatica- Kunitz Type Molecule. Among various antigens, GST which plays a crucial role in detoxification processes, i.e. phase II defense mechanism of this parasite, has a unique position as a novel vaccine candidate and a drug target in the control of this disease. For producing the antigens in large quantities and their purification to complete homogeneity, the recombinant DNA technology has become an important tool to achieve this milestone. RT- PCR was carried out using F. gigantica total RNA as template, and an amplicon of 657 bp GST gene was obtained. TA cloning vector was used for cloning of this gene, and the presence of insert was confirmed by blue-white selection for recombinant colonies. Sequence analysis of the present isolate showed 99.1% sequence homology with the published sequence of the F. gigantica GST gene of cattle origin (accession no. AF112657), with six nucleotide changes at 72, 74, 423, 513, 549 and 627th bp found in the present isolate, causing an overall change of 4 amino acids. The 657 bp GST gene was cloned at BamH1 and HindIII restriction sites of the prokaryotic expression vector pPROEXHTb in frame with six histidine residues and expressed in E. coli DH5α. Recombinant protein was purified from the bacterial lysate under non-denaturing conditions by the process of sonication after lysozyme treatment and subjecting the soluble fraction of the bacterial lysate to Ni-NTA affinity chromatography. Western blotting with rabbit hyper-immune serum showed immuno-reactivity with 25 kDa recombinant GST. Recombinant protein detected F. gigantica experimental as well as field infection in buffaloes by dot-ELISA. However, cross-reactivity studies on Fasciola gigantica GST antigen are needed to evaluate the utility of this protein in the serodiagnosis of fasciolosis.

Keywords: fasciola gigantic, fasciola hepatica, GST, RT- PCR

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Authors: Gabriel Andrade

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Background: Ramadan is a time of intense religious salience in the Islamic world. Apart from ritual engagement, it is also a time for reflection on devotion and shared humanity. This prompts the issue if Ramadan has an effect on moral integrity and decision-making. Methods: The present study seeks to answer that question. A group of Muslim students in the United Arab Emirates (UAE) were assessed on moral integrity both during and after Ramadan. Results: Results came out showing that Ramadan has no significant effect on participants’ moral integrity. Conclusion: It is concluded that Ramadan has no effect on participants’ moral behavior, and this is potentially explained by the UAE’s increased secularization in recent decades.

Keywords: Ramadan, United Arab Emirates, moral integrity, secularization, trolley dilemmas

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Authors: Sara Fine-Meltzer

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An obvious, but ill-addressed hindrance to reading comprehension in academic English is poor vocabulary. Unfortunately, dealing with the problem is usually delayed until university entrance. It is the contention of this paper that the chore should be confronted much earlier and by using a very old-fashioned method. This presentation is accompanied by vocabulary lists for advanced level university students with explanations concerning the content and justification for the 500-word lists: how they change over time in accordance with evolving styles of academic writing. There are also sample quizzes and methods to ensure that the words are “absorbed” over time. There is a discussion of other vocabulary acquisition methods and conclusions drawn from the drawbacks of such methods. The paper concludes with the rationale for beginning the study of “academic” vocabulary earlier than is generally acceptable.

Keywords: academic vocabulary, old-fashioned methods, quizzes, vocabulary lists

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Authors: Sulaem Musaddiq Laskar, Sudip Talukdar

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Sustainable supplementary cementitious material is the prime need in the construction industry. Geopolymer has strong potential for replacing the conventional Portland cement used in mortar and concrete in the industry. This study deals with experimental investigations performed on geopolymer mixes prepared from both ultra-fine ground granulated blast furnace slag and fly ash in a certain proportion. Geopolymer mixes were prepared with alkali activator composed of sodium hydroxide solution and varying amount of superplasticizer. The mixes were tested to study fresh and hardened state properties such as setting time, workability and compressive strength. Influence of concentration of alkali activator on effectiveness of superplasticizer in modifying the properties of geopolymer mixes was also investigated. Results indicated that addition of superplasticizer to ultra-fine slag-fly ash based geopolymer is advantageous in terms of setting time, workability and strength performance but up to certain dosage level. Higher concentration of alkali activator renders ineffectiveness in superplasticizer in improving the fresh and hardened state properties of geopolymer mixes.

Keywords: ultra-fine slag, fly ash, superplasticizer, setting time, workability, compressive strength

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Authors: Kirsi Korkealehto

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The purpose of this research was to investigate how the peer evaluation concept was perceived by language teachers developing online language courses. The online language courses in question were developed in language teacher teams within a nationwide KiVAKO-project funded by the Finnish Ministry of Education and Culture. The participants of the project were 86 language teachers of 26 higher education institutions in Finland. The KiVAKO-project aims to strengthen the language capital at higher education institutions by building a nationwide online language course offering on a shared platform. All higher education students can study the courses regardless of their home institutions. The project covers the following languages: Chinese, Estonian, Finnish Sign Language, French, German, Italian, Japanese, Korean, Portuguese, Russian, and Spanish on the levels CEFR A1-C1. The courses were piloted in the autumn term of 2019, and an online peer evaluation session was organised for all project participating teachers in spring 2020. The peer evaluation utilised the quality criteria for online implementation, which was developed earlier within the eAMK-project. The eAMK-project was also funded by the Finnish Ministry of Education and Culture with the aim to improve higher education institution teachers’ digital and pedagogical competences. In the online peer evaluation session, the teachers were divided into Zoom breakout rooms, in each of which two pilot courses were presented by their teachers dialogically. The other language teachers provided feedback on the course on the basis of the quality criteria. Thereafter good practices and ideas were gathered to an online document. The breakout rooms were facilitated by one teacher who was instructed and provided a slide-set prior to the online session. After the online peer evaluation sessions, the language teachers were asked to respond to an online questionnaire for feedback. The questionnaire included three multiple-choice questions using the Likert-scale rating and two open-ended questions. The online questionnaire was answered after the sessions immediately, the questionnaire link and the QR-code to it was on the last slide of the session, and it was responded at the site. The data comprise online questionnaire responses of the peer evaluation session and the researcher’s observations during the sessions. The data were analysed with a qualitative content analysis method with the help of Atlas.ti programme, and the Likert scale answers provided results per se. The observations were used as complementary data to support the primary data. The findings indicate that the working in the breakout rooms was successful, and the workshops proceeded smoothly. The workshops were perceived as beneficial in terms of improving the piloted courses and developing the participants’ own work as teachers. Further, the language teachers stated that the collegial discussions and sharing the ideas were fruitful. The aspects to improve the workshops were to give more time for free discussions and the opportunity to familiarize oneself with the quality criteria and the presented language courses beforehand. The quality criteria were considered to provide a suitable frame for self- and peer evaluations.

Keywords: higher education, language learning, online learning, peer-evaluation

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Authors: A. I. A. Rahman, Sh-Hussain Salleh, K. Ahmad, K. Anuar

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Analysis of vocal fold vibration is essential for understanding the mechanism of voice production and for improving clinical assessment of voice disorders. This paper presents a Dynamic Time Warping (DTW) based approach to analyze and objectively classify vocal fold vibration patterns. The proposed technique was designed and implemented on a Glottal Area Waveform (GAW) extracted from high-speed laryngeal images by delineating the glottal edges for each image frame. Feature extraction from the GAW was performed using Linear Predictive Coding (LPC). Several types of voice reference templates from simulations of clear, breathy, fry, pressed and hyperfunctional voice productions were used. The patterns of the reference templates were first verified using the analytical signal generated through Hilbert transformation of the GAW. Samples from normal speakers’ voice recordings were then used to evaluate and test the effectiveness of this approach. The classification of the voice patterns using the technique of LPC and DTW gave the accuracy of 81%.

Keywords: dynamic time warping, glottal area waveform, linear predictive coding, high-speed laryngeal images, Hilbert transform

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Authors: Zhao Xinlei

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In general, interstate relations are diverse and include economic, political, military, and diplomatic. Therefore, by analyzing the development of the relationship between Malaysia and China, we can better verify how the Hirschman effect works between small countries and great powers. This paper mainly adopts qualitative research methods and uses Malaysia's 2020-2022 political crisis as a specific case to verify the practice of the Hirschman effect between small and large countries. In particular, the interest groups in small countries that are closely related to trade with extraordinary abilities, as the primary beneficiaries in the development of trade between the two countries, although they may use their resources to a certain extent to influence the decisions of small countries towards great powers, they do not fundamentally determine the small countries' response to large countries. In this process, the relative power asymmetry between states plays a dominant role, as small states lack trust and suspicion in political diplomacy towards large states based on the perception of threat arising from the relative power asymmetry. When developing bilateral relations with large countries, small states seek practical cooperation to promote economic and trade development but become more cautious in their political ties to avoid being caught in power struggles between large states or being controlled by them. The case of Malaysia-China relations also illustrates that despite the ongoing political crisis in Malaysia, which saw the country go through the transition from (Perikatan Nasional) PN to (Barisan Nasional) BN, different governments have maintained a pragmatic and proactive economic policy towards China to reduce suspicion and mistrust between the two countries in political and diplomatic affairs, thereby enhancing cooperation and interactions between the two countries. At the same time, the Malaysian government is developing multi-dimensional foreign relations and actively participating in multilateral, regional organizations and platforms, such as those organized by the United States, to maintain a relative balance in the influence of the US and China on Malaysia.

Keywords: Hirschman effect, interest groups, Malaysia, China, bilateral relations

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Authors: Adinarayana Badveeti, Mohammad Shafi Mir

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In Srinagar City, in India, traffic congestion is a condition on transport networks that occurs as use increases and is characterized by slower speeds, longer trip times, and increased vehicular queuing. Traffic congestion is conventionally measured using indicators such as roadway level-of-service, the Travel Time Index and their variants. Several measures have been taken in order to counteract congestion like road pricing, car pooling, improved traffic management, etc. While new road construction can temporarily relieve congestion in the longer term, it simply encourages further growth in car traffic through increased travel and a switch away from public transport. The full paper report, on which this abstract is based, aims to provide policymakers and technical staff with the real-time data, conceptual framework and guidance on some of the engineering tools necessary to manage congestion in such a way as to reduce its overall impact on individuals, families, communities, and societies dynamic, affordable, liveable and attractive urban regions will never be free of congestion. Road transport policies, however, should seek to manage congestion on a cost-effective basis with the aim of reducing the burden that excessive congestion imposes upon travellers and urban dwellers throughout the urban road network.

Keywords: traffic congestion, modeling, traffic management, travel time index

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