Search results for: death phenomenon

Authors: W. Meron Mebrahtu, R. Absi

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Velocity distribution in turbulent open-channel flows is organized in a complex manner. This is due to the large spatial and temporal variability of fluid motion resulting from the free-surface turbulent flow condition. This phenomenon is complicated further due to the complex geometry of channels and the presence of solids transported. Thus, several efforts were made to understand the phenomenon and obtain accurate mathematical models that are suitable for engineering applications. However, predictions are inaccurate because oversimplified assumptions are involved in modeling this complex phenomenon. Therefore, the aim of this work is to study velocity distribution profiles and obtain simple, more accurate, and predictive mathematical models. Particular focus will be made on the acceptable simplification of the general transport equations and an accurate representation of eddy viscosity. Wide rectangular open-channel seems suitable to begin the study; other assumptions are smooth-wall, and sediment-free flow under steady and uniform flow conditions. These assumptions will allow examining the effect of the bottom wall and the free surface only, which is a necessary step before dealing with more complex flow scenarios. For this flow condition, two ordinary differential equations are obtained for velocity profiles; from the Reynolds-averaged Navier-Stokes (RANS) equation and equilibrium consideration between turbulent kinetic energy (TKE) production and dissipation. Then different analytic models for eddy viscosity, TKE, and mixing length were assessed. Computation results for velocity profiles were compared to experimental data for different flow conditions and the well-known linear, log, and log-wake laws. Results show that the model based on the RANS equation provides more accurate velocity profiles. In the viscous sublayer and buffer layer, the method based on Prandtl’s eddy viscosity model and Van Driest mixing length give a more precise result. For the log layer and outer region, a mixing length equation derived from Von Karman’s similarity hypothesis provides the best agreement with measured data except near the free surface where an additional correction based on a damping function for eddy viscosity is used. This method allows more accurate velocity profiles with the same value of the damping coefficient that is valid under different flow conditions. This work continues with investigating narrow channels, complex geometries, and the effect of solids transported in sewers.

Keywords: accuracy, eddy viscosity, sewers, velocity profile

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Authors: Jared Abuga, Wesley Too

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Medical error is the third leading cause of death in US, with approximately 98,000 deaths occurring every year as a result of medical errors. The world financial burden of medication errors is roughly USD 42 billion. Medication errors may lead to at least one death daily and injure roughly 1.3 million people every year. Medical error reporting is essential in creating a culture of accountability in our healthcare system. Studies have shown that attitudes and practice of healthcare workers in reporting medical errors showed that the major factors in under-reporting of errors included work stress and fear of medico-legal consequences due to the disclosure of error. Further, the majority believed that increase in reporting medical errors would contribute to a better system. Most hospitals depend on nurses to discover medication errors because they are considered to be the sources of these errors, as contributors or mere observers, consequently, the nurse’s perception of medication errors and what needs to be done is a vital feature to reducing incidences of medication errors. We sought to explore knowledge among nurses on medical errors and factors affecting or hindering reporting of medical errors among nurses working at the emergency unit, KNH. Critical care nurses are faced with many barriers to completing incident reports on medication errors. One of these barriers which contribute to underreporting is a lack of education and/or knowledge regarding medication errors and the reporting process. This study, therefore, sought to determine the availability and the use of reporting systems for medical errors in critical care unity. It also sought to establish nurses’ perception regarding medical errors and reporting and document factors facilitating timely identification and reporting of medical errors in critical care settings. Methods: The study used cross-section study design to collect data from 76 critical care nurses from Kenyatta Teaching & Research National Referral Hospital, Kenya. Data analysis and results is ongoing. By October 2022, we will have analysis, results, discussions, and recommendations of the study for purposes of the conference in 2023

Keywords: errors, medical, kenya, nurses, safety

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Authors: Keroles Akram Saed Ghatas

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The near future will bring significant changes in modern organizations and management due to the growing role of intangible assets and knowledge workers. The area of copyright, intellectual property, digital (intangible) assets and media redistribution appears to be one of the greatest challenges facing business and society in general and management sciences and organizations in particular. The proposed article examines the views and perceptions of fairness in digital media sharing among Harvard Law School's LL.M.s. Students, based on 50 qualitative interviews and 100 surveys. The researcher took an ethnographic approach to her research and entered the Harvard LL.M. in 2016. at, a Face book group that allows people to connect naturally and attend in-person and private events more easily. After listening to numerous students, the researcher conducted a quantitative survey among 100 respondents to assess respondents' perceptions of fairness in digital file sharing in various contexts (based on media price, its availability, regional licenses, copyright holder status, etc.). to understand better . .). Based on the survey results, the researcher conducted long-term, open-ended and loosely structured ethnographic interviews (50 interviews) to further deepen the understanding of the results. The most important finding of the study is that Harvard lawyers generally support digital piracy in certain contexts, despite having the best possible legal and professional knowledge. Interestingly, they are also more accepting of working for the government than the private sector. The results of this study provide a better understanding of how “fairness” is perceived by the younger generation of lawyers and pave the way for a more rational application of licensing laws.

Keywords: cognitive impairments, communication disorders, death penalty, executive function communication disorders, cognitive disorders, capital murder, executive function death penalty, egyptian law absence, justice, political cases piracy, digital sharing, perception of fairness, legal profession

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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: Begzod Nishanov, Farhod Karimov

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Globalization and the internet have completely changed the way in which businesses operate as well as has equipped customers with endless potential. Today, consumers’ product choice is not only affected by branding, price and quality of the product, but also by the country-of-origin information. Precisely, ‘Made In’ label is considered as one of the driving factors which directly impact on consumers’ preferences. Generally, it is obvious that products manufactured in less developed countries are considered to be of lower quality and riskier compared to the products made in developed countries. In this regard, it is worth to note that this phenomenon is mainly applicable to western developed countries. However, there is a lack of empirical research on underlying the influence of country-of-origin phenomenon in emerging economies such as Uzbekistan. Today, Uzbek market is being dominated by growing number of foreign made products. Uzbek manufacturers are facing intense competition not only from local producers but also from the availability of foreign goods suppliers. Consequently, consumers are given wider choice of products than ever before. In this regard, it is important to define the importance of country-of-origin information in order to understand Uzbek consumers’ preference. The methodology of the research is formulated based on the methodology of previous papers. A total 527 online questionnaires were completed. Data analysis was conducted using factor analysis and analysis of variance test (ANOVA). Findings of the research support the view that Uzbek consumers attach great importance to the country-of-origin information of products. Precisely, it can be stated that Uzbek people perceive product quality by its ‘Made in...’ label, especially when buying high involvement goods such as car or refrigerator. Another findings of the paper show that products manufactured in developed countries including Germany, Japan and USA are found to be of high quality, while products manufactured in less developed countries are considered to be of lower quality. Marketers can use this information for segmentation purposes. For example, products manufactured in less developed countries can be targeted for low-to-middle income families while goods manufactured in developed countries can be targeted for higher income families. In conclusion, it can be stated that perceived product quality of products that are made in Uzbekistan has slightly increased since 18 years. It implies that nowadays products under ‘Made in Uzbekistan’ label is continually becoming available to many consumers in foreign markets, especially among Commonwealth of Independent States (CIS) countries. Therefore, conducting further research to explore the phenomenon of country-of-origin information and perceived product quality in emerging markets is of paramount importance.

Keywords: country-of-origin, consumer behavior, product evaluation, perceived quality

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Authors: C. Chaillou

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The dominant theoretical approaches in Criminology are interested in the phenomenon of delinquency from the question of the management of the risks incurred by the population. Thus, this research advocate prevention of this phenomenon by a tracking of early disorders in children. Treatments offered to rely on medical research (genetics and biology are cited as a reference) and assuming a high naturalization of delinquent behaviour. Programs that are offered also reduce to a recovery of the deviant behaviour, and rely readily on behavioral guidelines, with an educational grant. Public policy then rely on these programs to prevent unwanted behaviour within a given population and to reduce the risk for the company. This is the case in France, with national institutes making (juvenile) violence a public health problem. We consider that other approaches, issues of sociology, are more relevant to the treatment of offenders. These approaches are moving, not on its prevention, but from its inputs and its outputs. Several modalities of entries and exits of delinquency can find and analyze in terms of process. We assume that there is a dynamic inherent in the individual and it is important to take into account the environment of the offender. These different types of processes can illuminate from the derived work of the Psychoanalytical psychopathology and lead to more effective treatment of delinquent acts. Psychoanalytic concepts have enabled us to offer a new look means to treat delinquency, placing several types of relationship with the other and relating to the clinical structure and the uniqueness of the case, we have been able to enter subjective and unconscious logics at work in delinquent acts. This research has facilitated the reduction of these types of subjective responses and proposed others, opening to a reintegration of offenders in a social link them being more favourable and in a longer term.

Keywords: delinquency, insertion, social link, unconscious

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Authors: Anny Zambrano, German Gonzalez, Yair Quintero

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The continuum damage concept is used to study the interaction between hydraulic fractures and natural fractures, the objective is representing the path and relation among this two fractures types and predict its complex behavior without the need to pre-define their direction as occurs in other finite element applications, providing results more consistent with the physical behavior of the phenomenon. The approach uses finite element simulations through Abaqus software to model damage fracturing, the fracturing process by damage propagation in a rock. The modeling the phenomenon develops in two dimensional (2D) so that the fracture will be represented by a line and the crack front by a point. It considers nonlinear constitutive behavior, finite strain, time-dependent deformation, complex boundary conditions, strain hardening and softening, and strain based damage evolution in compression and tension. The complete governing equations are provided and the method is described in detail to permit readers to replicate all results. The model is compared to models that are published and available. Comparisons are focused in five interactions between natural fractures (NF) and hydraulic fractures: Fractured arrested at NF, crossing NF with or without offset, branching at intersecting NFs, branching at end of NF and NF dilation due to shear slippage. The most significant new finding is, that is not necessary to use pre-defined addresses propagation and stress condition can be evaluated as a dominant factor in the process. This is important because it can model in a more real way the generated complex hydraulic fractures, and be a valuable tool to predict potential problems and different geometries of the fracture network in the process of fracturing due to fluid injection.

Keywords: continuum damage, hydraulic fractures, natural fractures, complex fracture network, stiffness

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Authors: Elvira Hörandl

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The term “Geographical parthenogenesis” describes the phenomenon that asexual organisms usually occupy larger and more northern distribution areas than their sexual relatives and tend to colonize previously glaciated areas. Several case studies in flowering plants confirm the geographical pattern, but the causal factors behind the phenomenon are still unclear. Previous authors regarded predominant polyploidy in asexual (apomictic) plants as the main factor. However, the geographical pattern is not the rule for sexual polyploids. Recent research confirmed a previous hypothesis of the author that a combination of factors is acting: Although uniparental reproduction provides better colonization abilities, it is most efficient in combination with polyploidy. I will present results on case studies in the genus Ranunculus of both autopolyploid and allopolyploid species and species complexes reproducing via facultative apomixis. Polyploidy seems to contribute mainly to a better tolerance of colder climates and temperate extremes, whereby epigenetic flexibility, changes in gene expression, and phenotypic plasticity play an important role in occupying ecological niches under harsh conditions. Phylogenomic studies entangle complex hybrid origins of asexual taxa, which increases intragenomic heterozygosity of asexual plants. Interestingly, our results suggest an association of sexuality with abiotic stresses, specifically with light stress, which might explain that still, most plants in high altitudes and in southern areas retain sexual reproduction despite other climatic conditions that would favor apomictic plants. We conclude that geographical parthenogenesis results from the complex interplay of the genomic constitution, mode of reproduction and environmental factors.

Keywords: apomixis, polyploidy, hybridization, abiotic stress, epigenetics, phylogenomics

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Authors: Yudo Prasetyo, Hana Sugiastu Firdaus, Diyanah Diyanah

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The phenomenon of the lack of clean water supply in several big cities in Indonesia is a major problem in the development of urban areas. Moreover, in the city of Semarang, the population density and growth of physical development is very high. Continuous and large amounts of underground water (aquifer) exposure can result in a drastically aquifer supply declining in year by year. Especially, the intensity of aquifer use in the fulfilment of household needs and industrial activities. This is worsening by the land subsidence phenomenon in some areas in the Semarang city. Therefore, special research is needed to know the spatial correlation of the impact of decreasing aquifer capacity on the land subsidence phenomenon. This is necessary to give approve that the occurrence of land subsidence can be caused by loss of balance of pressure on below the land surface. One method to observe the correlation pattern between the two phenomena is the application of remote sensing technology based on radar and optical satellites. Implementation of Differential Interferometric Synthetic Aperture Radar (DINSAR) or Small Baseline Area Subset (SBAS) method in SENTINEL-1A satellite image acquisition in 2014-2017 period will give a proper pattern of land subsidence. These results will be spatially correlated with the aquifer-declining pattern in the same time period. Utilization of survey results to 8 monitoring wells with depth in above 100 m to observe the multi-temporal pattern of aquifer change capacity. In addition, the pattern of aquifer capacity will be validated with 2 underground water cavity maps from observation of ministries of energy and natural resources (ESDM) in Semarang city. Spatial correlation studies will be conducted on the pattern of land subsidence and aquifer capacity using overlapping and statistical methods. The results of this correlation will show how big the correlation of decrease in underground water capacity in influencing the distribution and intensity of land subsidence in Semarang city. In addition, the results of this study will also be analyzed based on geological aspects related to hydrogeological parameters, soil types, aquifer species and geological structures. The results of this study will be a correlation map of the aquifer capacity on the decrease in the face of the land in the city of Semarang within the period 2014-2017. So hopefully the results can help the authorities in spatial planning and the city of Semarang in the future.

Keywords: aquifer, differential interferometric synthetic aperture radar (DINSAR), land subsidence, small baseline area subset (SBAS)

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Authors: Olga Bernikova, Oleg Redkin

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Globalization is a process of worldwide economic, political and cultural integration. Obviously, this phenomenon has both positive and negative issues. This article analyzes the impact of the modern process of globalization on the national traditions of language teaching and research. In this context, the problem of the ratio of local to global can be viewed from several sides. Firstly, since English is the language of over 80 percent of scientific and technical research worldwide, what should be the language of science in certain region? Secondly, language 'globality' is not always associated with English, because intercultural communications may have their regional peculiarities. For example, in the Arab world, Modern Standard Arabic can also be regarded as 'global' phenomenon, since the mother-tongue languages of the population are local Arabic dialects. In addition, the correlation 'local' versus 'global' is manifested not only in the linguistic sphere but also in the methodology used in language acquisition and research. Thus, the major principles of the Arabic philological tradition, which goes back to the 7th century, are still spread in the modern Arab world. At the same time, the terminology and methods of language research that are peculiar to this tradition are quite far from the issues of general linguistics that underlies the description of all the languages of the world. The present research relies on a comparative analysis of sources in Arabic linguistics, including original works in Arabic dating back to the 12th-13th centuries. As a case study, interaction of local and global is also considered on the example of the Arabic teaching and research in Russia. Speaking about the correlation between local and global it is possible to forecast development of two parallel tendencies: the spread of the phenomena of globalization on one hand, and local implementation of a language policy aimed at preserving native languages, including Arabic, on the other.

Keywords: Arabic, global, language, local, tradition

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Authors: Oleg Redkin, Olga Bernikova

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It is commonly accepted that every language is both pure linguistic phenomenon as well as socially significant communicative system, which exists on the basis of certain society - its collective 'native speaker'. Therefore the language evolution and features besides its own linguistic rules and regulations are also defined by the influence of a number of extra-linguistic factors. The above mentioned statement may be illustrated by the example of the Arabic language which may be characterized by the following peculiarities: - the inner logic of the Arabic language - the 'algebraicity' of its morphological paradigms and grammar rules; - association of the Arabic language with the sacred texts of Islam, its close ties with the pre-Islamic and Islamic cultural heritage - the pre-Islamic poetry and Islamic literature and science; - territorial distribution, which in recent years went far beyond the boundaries of its traditional realm due to the development of new technologies and the spread of mass media, and what is more important, migration processes; - association of the Arabic language with the so called 'Renaissance of Islam'. These peculiarities should be remembered while considering the status of the Modern Standard Arabic (MSA) language or the Classical Arabic (CA) language as well as the Modern Arabic (MA) dialects in synchrony or from the diachronic point of view. Continuity of any system in diachrony on the one hand depends on the level of its ability to adapt itself to changing environment and by its internal ties on the other. Structural durability of language is characterized by its inner logic, hierarchy of paradigms and its grammar rules, as well as continuity of their implementation in acts of everyday communication. Since the Arabic language is both linguistic and social phenomenon the process of the Arabic language acquisition and study should not be focused only on the knowledge about linguistic features or development of communicative skills alone, but must be supplied with the information related to culture, history and religion of peoples of certain region that will expand and enrich competences of the target audience.

Keywords: Arabic, culture, Islam, language

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Authors: Harika Atmaca, Emir Bozkurt, Latife Merve Oktay, Selim Uzunoglu, Ruchan Uslu, Burçak Karaca

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Microarrays have been developed for highly parallel enzyme-linked immunosorbent assay (ELISA) applications. The most common protein arrays are produced by using multiple monoclonal antibodies, since they are robust molecules which can be easily handled and immobilized by standard procedures without loss of activity. Protein expression profiling with protein array technology allows simultaneous analysis of the protein expression pattern of a large number of proteins. Trabectedin, a tetrahydroisoquinoline alkaloid derived from a Caribbean tunicate, Ecteinascidia turbinata, has been shown to have antitumor effects. Here, we used a novel proteomic approach to explore the mechanism of action of trabectedin in prostate cancer cell line PC-3 by apoptosis antibody microarray. XTT cell proliferation kit and Cell Death Detection Elisa Plus Kit (Roche) was used for measuring cytotoxicity and apoptosis. Human Apoptosis Protein Array (R&D Systems) which consists of 35 apoptosis related proteins was used to assess the omic protein expression pattern. Trabectedin induced cytotoxicity and apoptosis in prostate cancer cells in a time and concentration-dependent manner. The expression levels of the death receptor pathway molecules, TRAIL-R1/DR4, TRAIL R2/DR5, TNF R1/TNFRSF1A, FADD were significantly increased by 4.0-, 21.0-, 4.20- and 11.5-fold by trabectedin treatment in PC-3 cells. Moreover, mitochondrial pathway related pro-apoptotic proteins Bax, Bad, Cytochrome c, and Cleaved Caspase-3 expressions were induced by 2.68-, 2.07-, 2.8-, and 4.5-fold and the expression levels of anti-apoptotic proteins Bcl-2 and Bcl-XL were reduced by 3.5- and 5.2-fold in PC-3 cells. Proteomic (antibody microarray) analysis suggests that the mechanism of action of trabectedin may be exerted via the induction of both intrinsic and extrinsic apoptotic pathways. The antibody microarray platform can be utilised to explore the molecular mechanism of action of novel anticancer agents.

Keywords: trabectedin, prostate cancer, omic protein expression profile, apoptosis

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Authors: Natasha Correa Vitória Bandeira, Lais Cordeiro Soares, Claudineia Brazil, Luciane Teresa Salvi

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The intense rain event that occurred between February 16 and 18, 2018, in the city of Barcarena in Pará, located in the North region of Brazil, demonstrates the importance of analyzing this type of event. The metropolitan mesoregion of Belem was severely punished by rains much above the averages normally expected for that time of year; this phenomenon affected, in addition to the capital, the municipalities of Barcarena, Murucupi and Muruçambá. Resulting in a great flood in the rivers of the region, whose basins were affected with great intensity of precipitation, causing concern for the local population because in this region, there are located companies that accumulate ore tailings, and in this specific case, the dam of any of these companies, leaching the ore to the water bodies of the Murucupi River Basin. This article aims to characterize this phenomenon through a special analysis of the distribution of rainfall, using data from atmospheric soundings, satellite images, radar images and data from the GPCP (Global Precipitation Climatology Project), in addition to rainfall stations located in the study region. The results of the work demonstrated a dissociation between the data measured in the meteorological stations and the other forms of analysis of this extreme event. Monitoring carried out solely on the basis of data from pluviometric stations is not sufficient for monitoring and/or diagnosing extreme weather events, and investment by the competent bodies is important to install a larger network of pluviometric stations sufficient to meet the demand in a given region.

Keywords: extreme precipitation, great flood, GPCP, ore dam

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Authors: Uliana N. Tumanova, Viacheslav M. Lyapin, Vladimir G. Bychenko, Alexandr I. Shchegolev, Gennady T. Sukhikh

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It is well known that the gas formed as a result of postmortem decomposition of tissues can be detected already 24-48 hours after death. In addition, the conditions of keeping and storage of the corpse (temperature and humidity of the environment) significantly determine the rate of occurrence and development of posthumous changes. The presence of sepsis is accompanied by faster postmortem decomposition and decay of the organs and tissues of the body. The presence of gas in the vessels and cavities can be revealed fully at postmortem CT. Radiologists must certainly report on the detection of intraorganic or intravascular gas, wich was detected at postmortem CT, to forensic experts or pathologists before the autopsy. This gas can not be detected during autopsy, but it can be very important for establishing a diagnosis. To explore the possibility of postmortem CT for the evaluation of gas accumulations in the newborns' vessels, who died from congenital sepsis. Researched of 44 newborns bodies (25 male and 19 female sex, at the age from 6 hours to 27 days) after 6 - 12 hours of death. The bodies were stored in the refrigerator at a temperature of +4°C in the supine position. Grouped 12 bodies of newborns that died from congenital sepsis. The control group consisted of 32 bodies of newborns that died without signs of sepsis. Postmortem CT examination was performed at the GEMINI TF TOF16 device, before the autopsy. The localizations of gas accumulations in the vessels were determined on the CT tomograms. The sepsis diagnosis was on the basis of clinical and laboratory data and autopsy results. Gases in the vessels were detected in 33.3% of cases in the group with sepsis, and in the control group - in 34.4%. A group with sepsis most often the gas localized in the heart and liver vessels - 50% each, of observations number with the detected gas in the vessels. In the heart cavities, aorta and mesenteric vessels - 25% each. In control most often gas was detected in the liver (63.6%) and abdominal cavity (54.5%) vessels. In 45.5% the gas localized in the cavities, and in 36.4% in the vessels of the heart. In the cerebral vessels and in the aorta gas was detected in 27.3% and 9.1%, respectively. Postmortem CT has high diagnostic capabilities to detect free gas in vessels. Postmortem changes in newborns that died from sepsis do not affect intravascular gas production within 6-12 hours. Radiation methods should be used as a supplement to the autopsy, including as a kind of ‘guide’, with the indication to the forensic medical expert of certain changes identified during CT studies, for better definition of pathological processes during the autopsy. Postmortem CT can be recommend as a first stage of autopsy.

Keywords: congenital sepsis, gas, newborn, postmortem CT

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Authors: Swathi Ganesan, Nalinda Somasiri, Rebecca Jeyavadhanam, Gayathri Karthick

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The COVID-19 crisis presents a substantial and critical hazard to worldwide health. Since the occurrence of the disease in late January 2020 in the UK, the number of infected people confirmed to acquire the illness has increased tremendously across the country, and the number of individuals affected is undoubtedly considerably high. The purpose of this research is to figure out a predictive machine learning archetypal that could forecast COVID-19 cases within the UK. This study concentrates on the statistical data collected from 31st January 2020 to 31st March 2021 in the United Kingdom. Information on total COVID cases registered, new cases encountered on a daily basis, total death registered, and patients’ death per day due to Coronavirus is collected from World Health Organisation (WHO). Data preprocessing is carried out to identify any missing values, outliers, or anomalies in the dataset. The data is split into 8:2 ratio for training and testing purposes to forecast future new COVID cases. Support Vector Machines (SVM), Random Forests, and linear regression algorithms are chosen to study the model performance in the prediction of new COVID-19 cases. From the evaluation metrics such as r-squared value and mean squared error, the statistical performance of the model in predicting the new COVID cases is evaluated. Random Forest outperformed the other two Machine Learning algorithms with a training accuracy of 99.47% and testing accuracy of 98.26% when n=30. The mean square error obtained for Random Forest is 4.05e11, which is lesser compared to the other predictive models used for this study. From the experimental analysis Random Forest algorithm can perform more effectively and efficiently in predicting the new COVID cases, which could help the health sector to take relevant control measures for the spread of the virus.

Keywords: COVID-19, machine learning, supervised learning, unsupervised learning, linear regression, support vector machine, random forest

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Authors: Emni Omar Daw Hussin, Pathmawathi Subramanian, Wong Li Ping

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Background: To provide quality care at the end of life, nurses should possess knowledge and skills to provide effective end-of-life care, as well as develop the attitudes and interpersonal competence to provide compassionate care. Aim: This study aimed to assess nurses’ knowledge and attitude towards end of life care and caring for terminal ill patients and to examine relationships among demographic variables and nurse’s knowledge and attitudes toward end of life care and caring for terminal ill patients. Method: a cross-sectional study was conducted at 1 tertiary hospital located in Kuala Lumpur, Malaysia. Self-administrative questionnaire was used to collect data from 553 nurses from over all departments except emergency department, operation theater and outpatient clinic. Two tools were used in this study, the Frommelt’s Attitude Toward Care of the Dying (FATCOD) Scale to assess the nurses’ attitude and End of Life Knowledge Assessment to assess the nurses’ knowledge. Result: the result of this study yielded that, the majority of participants (54.8%) and (54.4%) have less positive attitude and knowledge towards end of life care and caring for terminal ill patients respectively. As well as there is no significant relationship were found between nurses’ ethnicity, religion, and the total score of FATCOD scale; End of Life Knowledge Assessment score. On other hand there is significant relationship among nurses’ age, working experience, level of education, attending any post basic courses and the total score of both FATCOD scale and End of Life Knowledge Assessment. Conclusion: A lack of education and experience and post basic course about end of life care and palliative care may contribute to the negative attitudes and poor knowledge regarding end of life care. Providing sufficient courses about end of life care could enhance the nurses’ knowledge towards end of life care, as well as providing a reflective narrative environment in which nurses can express their personal feelings about death and dying could be a potentially effective approach. Implication for Practice: This study elaborates the need for further research to develop an effective educational programs to enhance nurses’ knowledge and to promote positive attitude towards death and dying, as well as enhance communication skills, and coping strategies.

Keywords: knowledge, attitude, nurse, end of life care

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Authors: Elnaz Saeedi, Jamileh Abolaghasemi, Mohsen Nasiri Tousi, Saeedeh Khosravi

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Goals and Objectives: A typical analysis of survival data involves the modeling of time-to-event data, such as the time till death. A frailty model is a random effect model for time-to-event data, where the random effect has a multiplicative influence on the baseline hazard function. This article aims to investigate the use of gamma frailty model with concomitant variable in order to individualize the prognostic factors that influence the liver cirrhosis patients’ survival times. Methods: During the one-year study period (May 2008-May 2009), data have been used from the recorded information of patients with liver cirrhosis who were scheduled for liver transplantation and were followed up for at least seven years in Imam Khomeini Hospital in Iran. In order to determine the effective factors for cirrhotic patients’ survival in the presence of latent variables, the gamma frailty distribution has been applied. In this article, it was considering the parametric model, such as Exponential and Weibull distributions for survival time. Data analysis is performed using R software, and the error level of 0.05 was considered for all tests. Results: 305 patients with liver cirrhosis including 180 (59%) men and 125 (41%) women were studied. The age average of patients was 39.8 years. At the end of the study, 82 (26%) patients died, among them 48 (58%) were men and 34 (42%) women. The main cause of liver cirrhosis was found hepatitis 'B' with 23%, followed by cryptogenic with 22.6% were identified as the second factor. Generally, 7-year’s survival was 28.44 months, for dead patients and for censoring was 19.33 and 31.79 months, respectively. Using multi-parametric survival models of progressive and regressive, Exponential and Weibull models with regard to the gamma frailty distribution were fitted to the cirrhosis data. In both models, factors including, age, bilirubin serum, albumin serum, and encephalopathy had a significant effect on survival time of cirrhotic patients. Conclusion: To investigate the effective factors for the time of patients’ death with liver cirrhosis in the presence of latent variables, gamma frailty model with parametric distributions seems desirable.

Keywords: frailty model, latent variables, liver cirrhosis, parametric distribution

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Authors: Mei-Ling Chan, Jin-Ming Wu, Konstantin V. Kudryavtsev, Jih-Hwa Guh

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Prostate cancer is one of the most common malignant disease in men. KUD983 is an enantiomerically pure β-dipeptide derivative, which may have anti-cancer effects. In the present study, KUD983 exhibits powerful activity against hormone-refractory prostate cancer (HRPC) PC-3 and DU145 cells. The IC50 values of KUD983 in PC-3 and DU145 cells are 0.56±0.07M and 0.50±0.04 M respectively. KUD983 induced G1 arrest of the cell cycle and subsequent apoptosis associated with the down-regulation of several related proteins including cyclin D1, cyclin E and Cdk4, and the de-phosphorylation of RB. The protein expressions of nuclear and total c-Myc protein, which was able to regulate the expression of both cyclin D1 and cyclin E, were significantly suppressed by KUD983. Phosphoinositide 3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) is an important signaling pathway that influences the energy metabolism, cell cycle, proliferation, survival and apoptosis of cells, and is associated with numerous other signaling pathways. The Western Blot data revealed that KUD983 inhibited PI3K/Akt and mTOR/p70S6K/4E-BP1 pathways. The transient transfection of constitutively active myristylated Akt (myr-Akt) cDNA significantly reversed KUD983-induced caspase activation but did not abolish the suppression of mTOR/p70S6K/4E-BP1 signaling cascade indicating the presence of both Akt-dependent and -independent pathways. Moreover, KUD983-induced effect was collaborated with the down-regulation of anti-apoptotic Bcl-2 members (e.g., Bcl-2, and Mcl-1) and IAP family members (e.g., survivin). Furthermore, KUD983 induced autophagic cell death using confocal microscopic examination, investigating the level of conversion of LC3-I to LC3-II and flow cytometric detection of AVO-positive cells. Taken together, the data suggest that KUD983 is an anticancer β-dipeptide against HRPCs through the inhibition of cell proliferation and induction of apoptotic and autophagic cell death. The suppression of signaling pathways mediated by c-Myc, PI3K/Akt and mTOR/p70S6K/4E-BP1 and the collaboration with down-regulation of Mcl-1 and survivin may indicate the mechanism of KUD983 against HRPC.

Keywords: β-dipeptide, hormone-refractory prostate cancer, mTOR, PI3K/Akt

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Authors: Goldie Lynn Diaz, Ma. Teresa Tricia G. Bautista, Elisabeth Engeljakob, Mary Glaze Rosal

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Introduction: Residents are expected to convey unfavorable news, discuss prognoses, and relieve suffering, and address do-not-resuscitate orders, yet some report a lack of competence in providing this type of care. Recognizing this need, Family Medicine residency programs are incorporating end-of-life care from symptom and pain control, counseling, and humanistic qualities as core proficiencies in training. Objective: This study determined the competency of Family Medicine Residents from various institutions in Metro Manila on rendering care for the dying. Materials and Methods: Trainees completed a Palliative Care Evaluation tool to assess their degree of confidence in patient and family interactions, patient management, and attitudes towards hospice care. Results: Remarkably, only a small fraction of participants were confident in performing independent management of terminal delirium and dyspnea. Fewer than 30% of residents can do the following without supervision: discuss medication effects and patient wishes after death, coping with pain, vomiting and constipation, and reacting to limited patient decision-making capacity. Half of the respondents had confidence in supporting the patient or family member when they become upset. Majority expressed confidence in many end-of-life care skills if supervision, coaching and consultation will be provided. Most trainees believed that pain medication should be given as needed to terminally ill patients. There was also uncertainty as to the most appropriate person to make end-of-life decisions. These attitudes may be influenced by personal beliefs rooted in cultural upbringing as well as by personal experiences with death in the family, which may also affect their participation and confidence in caring for the dying. Conclusion: Enhancing the quality and quantity of end-of-life care experiences during residency with sufficient supervision and role modeling may lead to knowledge and skill improvement to ensure quality of care. Fostering bedside learning opportunities during residency is an appropriate venue for teaching interventions in end-of-life care education.

Keywords: end of life care, geriatrics, palliative care, residency training skill

Procedia PDF Downloads 245

Authors: Rossana Taravella, Gilberto M. Cellura, Giuseppe Cirrincione, Salvatore Asciutto, Marco Caruso, Massimo Benedetto, Renato Ciofalo, Giuliana Pace, Salvatore Novo

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Objectives: This retrospective analysis sought to evaluate 1-month outcomes and therapy effectiveness of a population of patients treated with MitraClip therapy. We describe in this article the preliminary results of primary effectiveness endpoint. Background: Percutaneous Mitral Repair is being developed to treat severe mitral regurgitation (MR), with increasing real-world cases of functional MR (FMR). In the EVEREST (Endovascular Valve Edge-to-Edge Repair Study)II trial, the percutaneous device showed superior safety but less reduction in MR at 1year. 4-year outcomes from EVEREST II trial showed no difference in the prevalence of moderate-severe and severe MR or mortality at 4years between surgical mitral repair and percutaneous approach. Methods: We analysed retrospectively collected data from one center experience in Italy enrolled from January 2011 to December 2016. The study included 62 patients [mean age 74±11years, 43 men (69%)] with MR of at least grade3+. Most of the patients had functional MR, were in New York Heart Association (NYHA) functional class III or IV, with a large portion (78%) of mild-to-moderate Tricuspid Regurgitation (TR). One or more clips were implanted in 67 procedures (62 patients). Results and Conclusions: Severity of MR was reduced in all successfully treated patients,54(90%) were discharged with MR≤2+ (primary effectiveness endpoint). Clinical 1-month follow-up data showed an improvement in NYHA functional class (42 patients (70%) in NYHA class I-II). 60 of 62 (97 %) successfully treated patients were free from death and mitral valve surgery at 1-month follow-up. MitraClip therapy reduces functional MR with acute MR reduction to <2+ in the great majority of patients, with a large freedom from death, surgery or recurrent MR in a great portion of patients.

Keywords: MitraClip, mitral regurgitation, heart valves, catheter-based therapy

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Authors: Hui Hsin Huang

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The downstream manufactures will order their materials from different upstream suppliers to maintain a certain level of the demand. This paper proposes a bivariate model to portray this phenomenon of material demand. We use empirical data to estimate the parameters of model and evaluate the RMSD of model calibration. The results show that the model has better fitness.

Keywords: recency, ordering time, materials demand quantity, multi-source ordering

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Authors: Sujit Kumar

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Historicity of inter-caste relations can be traced in the early stages of evolution of rural community in the Indian society. These have witnessed vicissitudes during long drawn interactions between caste groups. Inter-caste relations evolved in a more organized form in the guise of Jajmani system. This is a system of permanent and hereditary inter-caste relations and gives a kaleidoscopic view of socio-economic relations among various caste groupings. Universality of its prevalence in rural India for centuries is well recognized and documented. But it has been undergoing metamorphic change in some regions and changing at a slower pace in the others during post-independence period. An empirical study was conducted with the objectives to know whether Jajmani system is in vogue in the rural areas and type and intensity of socio-economic ties among different caste categories and to find out the change in inter-caste relations, if any owing to industrialization and modernization. Information was elicited from 225 respondents using interview schedule designed for this purpose. It is discernible that in majority of cases, inter-caste social relations which find better expression on the occasions like marriage, death, birth and festivals etc. among Brahmins and lower castes vis-à-vis other caste categories have grown weak. The data further unearth that economic relations as maintained on the occasions of marriage, sacred thread ceremony, mundan sacrament, birthday, death, yajna, katha, routine hair cut, manufacture and repair of various iron, earthen, wooden and leather articles between members of higher castes (general category) and lower castes (scheduled castes) are moderate but weak in case of Other Backward Classes vis-à-vis all other caste categories. Overwhelming majority of informants believe that decline in hereditary occupations, depreciation of old products and services and their availability from the market being made by industry are main reasons in descending order for change in inter caste relations. Modernization, westernization, industrialization, transportation and communications, growing materialism and consumerism together have brought change in relations among caste groups affecting about a billion population inhabiting rural India.

Keywords: inter-caste, Jajmani, sacrament, Yajna

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Authors: Patrick Andrew McCoy

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The intense fascination with ancient Egypt has persisted for thousands of years and across cultures globally, known popularly as Egyptomania,’ ‘Tutmania,’ ‘Mummymania,’ and ‘Orientalism. A review of the literature indicates psychological themes for its behavior are curiosity, escapism, existentialism, religiosity and spirituality, and cultural, racial, and ethnic identity. A mixed-methods study is initiated with established tools to explore these themes and discover additional motivators. Objectives: The purpose of the study is to explore the themes underlying the intense fascination of ancient Egypt. The abstract themes of the fascination of ancient Egypt are cross-cultural phenomena that motivate people in their interactions with other cultures. These interactions have both been beneficial and combative. Methodology: A mixed methods research study is designed where quantitative (QUAN) survey of participants’ strong fascination with ancient Egypt, within psychological themes derived from a review of the literature. The qualitative (QUAL) survey consists of open-ended questions to explore participants’ exposure to ancient Egypt that may have influenced their fascination and their behaviors resulting from the phenomenon. The themes are explored in QUAN data and QUAL data to discover what themes are established and inferred the psychological motivations of the phenomenon. Main Contributions: This study will provide more information on several scientific disciplines, including psychology, anthropology, Egyptology, and tourism. This study seeks to benefit the tourism industry for not only in Egypt but hopefully with generalizability of cultural tourist industries in other countries.

Keywords: cross-cultural psychology, international psychology, mixed-methods, identity, ancient Egypt, phenomenology, escapism, curiosity, existentialism, religiosity, spirituality

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Authors: Rafia S. Al-lamki, Jun Wang, Simon Pacey, Jordan Pober, John R. Bradley

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Tumor necrosis factor alpha (TNF), signaling through TNFR2, may act an autocrine growth factor for renal tubular epithelial cells. Clear cell renal carcinomas (ccRCC) contain cancer stem cells (CSCs) that give rise to progeny which form the bulk of the tumor. CSCs are rarely in cell cycle and, as non-proliferating cells, resist most chemotherapeutic agents. Thus, recurrence after chemotherapy may result from the survival of CSCs. Therapeutic targeting of both CSCs and the more differentiated bulk tumor populations may provide a more effective strategy for treatment of RCC. In this study, we hypothesized that TNFR2 signaling will induce CSCs in ccRCC to enter cell cycle so that treatment with ligands that engage TNFR2 will render CSCs susceptible to chemotherapy. To test this hypothesis, we have utilized wild-type TNF (wtTNF) or specific muteins selective for TNFR1 (R1TNF) or TNFR2 (R2TNF) to treat either short-term organ cultures of ccRCC and adjacent normal kidney (NK) tissue or cultures of CD133+ cells isolated from ccRCC and adjacent NK, hereafter referred to as stem cell-like cells (SCLCs). The effect of cyclophosphamide (CP), currently an effective anticancer agent, was tested on CD133+SCLCs from ccRCC and NK before and after R2TNF treatment. Responses to TNF were assessed by flow cytometry (FACS), immunofluorescence, and quantitative real-time PCR, TUNEL, and cell viability assays. Cytotoxic effect of CP was analyzed by Annexin V and propidium iodide staining with FACS. In addition, we assessed the effect of TNF on isolated SCLCs differentiation using a three-dimensional (3D) culture system. Clinical samples of ccRCC contain a greater number SCLCs compared to NK and the number of SCSC increases with higher tumor grade. Isolated SCLCs show expression of stemness markers (oct4, Nanog, Sox2, Lin28) but not differentiation markers (cytokeratin, CD31, CD45, and EpCAM). In ccRCC organ cultures, wtTNF and R2TNF increase CD133 and TNFR2 expression and promote cell cycle entry whereas wtTNF and R1TNF increase TNFR1 expression and promote cell death of SCLCs. Similar findings are observed in SCLCs isolated from NK but the effect was greater in SCLCs isolated from ccRCC. Application of CP distinctly triggered apoptotic and necrotic cell death in SLCSs pre-treatment with R2TNF as compared to CP treatment alone, with SCLCs from ccRCC more sensitive to CP compared to SLCS from NK. Furthermore, TNF promotes differentiation of SCLCs to an epithelial phenotype in 3D cultures, confirmed by cytokeratin expression and loss of stemness markers Nanog and Sox2. The differentiated cells show positive expression of TNF and TNFR2. These findings provide evidence that selective engagement of TNFR2 drive CSCs to cell proliferation/differentiation, and targeting of cycling cells with TNFR2 agonist in combination with anti-cancer agents may be a potential therapy for RCC.

Keywords: cancer stem cells, ccRCC, cell cycle, cell death, TNF, TNFR1, TNFR2, CD133

Procedia PDF Downloads 251

Authors: Garance Liaboeuf, Alain Le Bot, Ali Daouadji, Antoine Martinet, Mohamed Bouteldja, Nicolas Grignard, Damien Pilet

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As every French road operator, Autoroutes et Tunnel du Mont Blanc (ATMB) conducts annual inspections of its infrastructures. Significant loss of skid resistance has been observed on some sections of his network, sometimes on recent pavements. In the way of making the mechanisms and factors that can lead to this loss of grip more understandable, ATMB has launched a study aimed at identifying the causes and developing solutions to prevent this phenomenon. To quantify the deterioration of different road surfaces subjected to controlled scraping with steel blades of snow removal machines, a field campaign was conducted. These operations are carried out during the winter period according to a strict protocol. In order to correct the skid-resistance values, a control panel is set up. In this way, only the effect of the scraping is taken into account. It allows us to exclude the influence of the environment (temperature, humidity, etc.) and of the surface state on the skid resistance values measured during the different sessions. Skid measurements after eight years of scraping cycles showed a 7% to 13% decrease in microtexture and a 2% to 12% decrease in macrotexture adhesion. These reductions are attributed to the phenomenon of polishing road surfaces by using steel blades. Also, regeneration phenomena occur after a certain number of blades pass. Differences in steel scraper blade resistance appear related to the intrinsic properties of the aggregate used in the pavement formulation and its type. Finally, the results of this campaign will allow the determination of the resistance characteristics of the pavement damage by the steel blade of snow plows. An evolution law of the surface condition as a function of the scraping operations will also be developed from this study.

Keywords: pavement, skid, surface, snow plow

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Authors: B. Nazari, M. A. Mohammadifar, S. Shojaee-Aliabadi, L. Mirmoghtadaie

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Millets as a new source of plant protein were not used in food applications due to its poor functional properties. In this study, the effect of high intensity ultrasound (frequency: 20 kHz, with contentious flow) (US) in 100% amplitude for varying times (5, 12.5, and 20 min) on solubility, emulsifying activity index (EAI), emulsion stability (ES), foaming capacity (FC), and foaming stability (FS) of millet protein concentrate (MPC) were evaluated. In addition, the structural properties of best treatments such as molecular weight and surface charge were compared with the control sample to prove the US effect. The US treatments significantly (P<0.05) increased the solubility of the native MPC (65.8±0.6%) at all sonicated times with the maximum solubility that is recorded at 12.5 min treatment (96.9±0.82 %). The FC of MPC was also significantly affected by the US treatment. Increase in sonicated time up to 12.5 min significantly increased the FC of native MPC (271.03±4.51 ml), but higher increase reduced it significantly. Minimal improvements were observed in the FS of all sonicated MPC compared to the native MPC. Sonicated time for 12.5 min affected the EAI and ES of the native MPC more markedly than 5 and 20 min that may be attributed to higher increase in proteins tendency to adsorption at the oil and water interfaces after the US treatment at this time. SDS-PAGE analysis showed changes in the molecular weight of MPC that attributed to shearing forces created by cavitation phenomenon. Also, this phenomenon caused an increase in the exposure of more amino acids with negative charge in the surface of US treated MPC, that was demonstrated by Zetasizer data. High intensity ultrasound, as a green technology, can significantly increase the functional properties of MPC and can make this usable for food applications.

Keywords: functional properties, high intensity ultrasound, millet protein concentrate, structural properties

Procedia PDF Downloads 223

Authors: Agnieszka Dubiel, Artur Grabowski, Tomasz Przerywacz, Mateusz Roganowicz, Patrycja Zioty

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Food waste is one of the most significant challenges humanity is facing nowadays. Every year, reports from global organizations show the scale of the phenomenon, although society's awareness is still insufficient. One-third of the food produced in the world is wasted at various points in the food supply chain. Wastes are present from the delivery through the food preparation and distribution to the end of the sale and consumption. The first step in understanding and resisting the phenomenon is a thorough analysis of the everyday behaviors of humanity. This concept is understood as finding the correlation between the type of food and the reason for throwing it out and wasting it. Those actions were identified as a critical step in the start of work to develop technology to prevent food waste. In this paper, the problem mentioned above was analyzed by focusing on the inhabitants of Central Europe, especially Poland, aged 20-30. This paper provides an insight into collecting data through dedicated software and an organized database. The proposed database contains information on the amount, type, and reasons for wasting food in households. A literature review supported the work to answer research questions, compare the situation in Poland with the problem analyzed in other countries, and find research gaps. The proposed article examines the cause of food waste and its quantity in detail. This review complements previous reviews by emphasizing social and economic innovation in Poland's food waste management. The paper recommends a course of action for future research on food waste management and prevention related to the handling and disposal of food, emphasizing households, i.e., the last link in the supply chain.

Keywords: food waste, food waste reduction, consumer food waste, human-food interaction

Procedia PDF Downloads 103

Authors: Jacqueline Jasmine Kumar

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This paper seeks to challenge the predominate Western-centric paradigm concerning empathy by conducting an exploration of its presence within both Western and Eastern philosophical traditions. The primary focus of this inquiry is the examination of the Indian yogic tradition, encompassing the four yogas: bhakti (love/devotion), karma (action), jnāna (knowledge), and rāja (psychic control). Through this examination, it is demonstrated that empathy does not exclusively originate from Western philosophical thought. Rather than superimposing the Western conceptualization of empathy onto the tenets of Indian philosophy, this study endeavours to unearth a distinct array of ideas and concepts within the four yogas, which significantly contribute to our comprehension of empathy as a universally relevant phenomenon. To achieve this objective, an innovative approach is adopted, delving into various facets of empathy, including the propositional, affective/intuitive, perspective-taking, and actionable dimensions. This approach intentionally deviates from conventional Western frameworks, shifting the emphasis towards lived morally as opposed to engagement in abstract theoretical discourse. While it is acknowledged that the explicit term “empathy” may not be overly articulated within the yogic tradition, a scrupulous examination reveals the underlying substance and significance of this phenomenon. Throughout this comparative analysis, the paper aims to lay a robust foundation for the discourse of empathy within the contexts of the human experience. By assimilating insights gleaned from the Indian yogic tradition, it contributes to the expansion of our comprehension of empathy, enabling an exploration of its multifaceted dimensions. Ultimately, this scholarly endeavour facilitates the development of a more comprehensive and inclusive perspective on empathy, transcending cultural boundaries and enriching our collective repository of knowledge.

Keywords: Bhakti, Yogic, Jnana, Karma

Procedia PDF Downloads 59

Authors: Ching-Yi Yiu, Hui-Chen Hsu

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Objectives: Obstructive sleep apnea syndrome (OSAS) is a popular problem in the modern society. It usually leads to sleep disorder, excessive daytime sleepiness and associated with cardiovascular diseases, cognitive dysfunction and even death. The nonsurgical therapies include continuous positive airway pressure (CPAP), diet and oral appliances. The surgical approaches have nasal surgery, tonsillectomy, adenoidectomy, uvulopalatopharyngoplasty (UPPP) and transoral robotic surgery (TORS).We compare the impact of surgical treatments on these kinds of patients. Methods: Between January 2018 to September 2022, We have enrolled 125 OSAS patients including 82 male and 43 female in Chi Mei Medical Center, Liouying, Taiwan. The age distribution from 6 to 71 years old (y/o) with mean age 36.1 y/o. The averaged body mass index (BMI) is 25 kg/m2 in male and 25.5 kg/m2 in female. In this cohort, we evaluated their upper airway obstruction sites with nasopharyngoscopy and scheduled a planned surgery. Some of cases received polysomnography (PSG) preoperatively, the averaged apnea-hypopnea index (AHI) is 37.7 events/hour. We have 68 patients received tonsillectomy, 9 received UPPP, 42 received UPPP and septomeatoplasty (SMP) and 6 received adenoidectomy and tonsillectomy (A and T). The subjective daytime sleepiness was evaluated with the Epworth sleepiness scale (ESS). Results: In the 68 tonsillectomy group, the averaged BMI is 24.9 kg/m2. In the UPPP group, the averaged BMI is 28.9 kg/m2. In UPPP and SMP group, the averaged BMI is 27.9 kg/m2. In the A and T group, the averaged BMI is 17.2 kg/m2. The reduction of AHI less than 20 is 58% postoperatively. The ESS reduced from 10.9 to 4.9 after surgery. Conclusion: Obstructive sleep apnea syndrome is a common upper airway disturbance in the general population. The prevalence rate is ranging high depending on different regions, age, sex and race. It leads to severe morbidity and mortality including car accident, stroke, nocturnal desaand sudden death and should be considered to be a major public health problem. The CPAP is effective to improve daytime sleepiness but the long-term compliance is low. The surgical treatment with different modalities can produce 50% decrease in AHI and ESS after surgery in the 6 to 12 months short-term period.

Keywords: apnea-hypopnea index, obstructive sleep apnea syndrome, polysomnography, uvulopalatopharyngoplasty

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Authors: Renu Kumari

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State sovereignty refers to the ability and power of a state to be independent and not to have any interference of external actors in its internal affairs. This phenomenon has been accepted by International Law, which gives rights to the state to maintain its autonomy and territorial integrity without the interference of other actors. In of 1980’s and 1990’s the world has witnessed the worst case of human rights violence for instance, Rwanda genocide, the conflict in former Yugoslavia, Kosovo, Burundi, and Chad so and so forth. Though human rights violence is not a new phenomenon, it has been present all over the world in different time and space. But in 1990’s after the devastation of these conflicts and violence the world community came up with the notion of humanitarian intervention in which some states took the responsibility of protecting human rights violations and on the in order to protect they can intervene in the internal matters of a state specifically during civil war where state is unable to protect its people. Later on these so-called world community realized that intervention itself is a negative term that was criticized also therefore they came up with a different notion that sounded positive which known as responsibility to protect. In 2005 onwards, the notion of responsibility to protect accepted and recognized by the United Nations and states at a larger level. In the case of Syria on the name of responsibility to protect foreign interventions took place and due to the internal war Syrian people were already facing many problems, the government was not able to protect them. External invasion caused many devastating outcomes to the country. This paper is an attempt to analyze various dimensions of invasion of external affairs of a particular state and the status of sovereignty. Firstly, it lays out the notion of humanitarian intervention and then the responsibility to protect. Secondly, it looks in the case of Syria since 2011, the conflict of Syria. Thirdly it focuses on various efforts made by international organizations and other actors. Lastly, it looks why and how other actors intervene in the internal matter of Syria.

Keywords: state sovereignty, external actors, intervention, responsibility to protect

Procedia PDF Downloads 149