Search results for: real-time data acquisition and reporting

Authors: Ivana Knezevic, Kenneth D. Candido, N. Nick Knezevic

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Background: While pain intensity scales remain generally accepted assessment tool, and the numeric pain rating score is highly subjective, we nevertheless rely on them to make a judgment about treatment effects. Misinterpretation of pain can lead practitioners to underestimate or overestimate the patient’s medical condition. The purpose of this study was to analyze how the numeric rating pain scores given by patients with low back pain correlate with their functional activity levels. Methods: We included 100 consecutive patients with radicular low back pain (LBP) after the Institutional Review Board (IRB) approval. Pain scores, numeric rating scale (NRS) responses at rest and in the movement,Oswestry Disability Index (ODI) questionnaire answers were collected 10 times through 12 months. The ODI questionnaire is targeting a patient’s activities and physical limitations as well as a patient’s ability to manage stationary everyday duties. Statistical analysis was performed by using SPSS Software version 20. Results: The average duration of LBP was 14±22 months at the beginning of the study. All patients included in the study were between 24 and 78 years old (average 48.85±14); 56% women and 44% men. Differences between ODI and pain scores in the range from -10% to +10% were considered “normal”. Discrepancies in pain scores were graded as mild between -30% and -11% or +11% and +30%; moderate between -50% and -31% and +31% and +50% and severe if differences were more than -50% or +50%. Our data showed that pain scores at rest correlate well with ODI in 65% of patients. In 30% of patients mild discrepancies were present (negative in 21% and positive in 9%), 4% of patients had moderate and 1% severe discrepancies. “Negative discrepancy” means that patients graded their pain scores much higher than their functional ability, and most likely exaggerated their pain. “Positive discrepancy” means that patients graded their pain scores much lower than their functional ability, and most likely underrated their pain. Comparisons between ODI and pain scores during movement showed normal correlation in only 39% of patients. Mild discrepancies were present in 42% (negative in 39% and positive in 3%); moderate in 14% (all negative), and severe in 5% (all negative) of patients. A 58% unknowingly exaggerated their pain during movement. Inconsistencies were equal in male and female patients (p=0.606 and p=0.928).Our results showed that there was a negative correlation between patients’ satisfaction and the degree of reporting pain inconsistency. Furthermore, patients talking opioids showed more discrepancies in reporting pain intensity scores than did patients taking non-opioid analgesics or not taking medications for LBP (p=0.038). There was a highly statistically significant correlation between morphine equivalents doses and the level of discrepancy (p<0.0001). Conclusion: We have put emphasis on the patient education in pain evaluation as a vital step in accurate pain level reporting. We have showed a direct correlation with patients’ satisfaction. Furthermore, we must identify other parameters in defining our patients’ chronic pain conditions, such as functionality scales, quality of life questionnaires, etc., and should move away from an overly simplistic subjective rating scale.

Keywords: pain score, functionality scales, low back pain, lumbar

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Authors: Varsha Puri, Sharon Hudson, Ian Kim

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Background: Incest-related childhood sexual abuse (IRCSA) is challenging to study due to the shame and secrecy experienced by its survivors. Ramifications of IRCSA worsen when it is unidentified, and interventions are not made. IRCSA perspectives are essential for future prevention and intervention strategies. However, there is limited understanding of this population’s experiences, perspectives, and long-term struggles. To date, research for IRCSA has utilized data from treatment programs and qualitative research with cohorts of 10-20 people, much of the data is from 10-40 years prior. Methods. In June 2018, an anonymous online survey was posted to multiple social media sites (e.g., Facebook IRCSA groups) and sexual abuse resource sites. Survey responses were collected for a year. The survey collected non-identifying demographics, IRCSA experiences, and outcomes data. Results: We obtained 1310 completed surveys. Demographics of all ages, racial backgrounds, financial backgrounds, and genders were obtained; the majority identified as white (81%) and female (76%). Childhood sexual abuse (CSA) started before the age of 6 in 49% and was endured for more than one year in 84% of respondents, and 39% reported ten or more years of abuse. CSA by multiple perpetrators occurred in 58%, while 8% had ten or more perpetrators. CSA by perpetrators under 21 years old was reported by 46%. Female perpetrators were reported by 28% of respondents. Fathers were the highest reported sexual abusers at 60%, and mothers were reported at 17%. Only 16% reported that at least one of their perpetrators was prosecuted for sexual abuse of a minor. Respondents confirmed that 54% of the time, they informed an adult of the abuse; only 2% agreed that “an intervention was made by the family that protected me.” A majority reported that IRCSA has negatively impacted their intimate/sexual relationships (96%) and mental health (96%). A majority reported negative impacts on biological family relationships (88%), physical health (73%), finances (59%), educational achievement (57%), and employment (56%). When asked about suffering from addiction, 85% of respondents answered yes. Prevention strategies selected most by respondents include early school education around CSA prevention (67%), removing the statute of limitations for reporting CSA (69%), and improved laws protecting IRCSA survivors (63%). Conclusion: The data document that IRCSA can be pervasive, and the dearth of intervention and support for survivors have major lasting impacts. Survivors have a unique and valuable perspective on what interventions are needed to prevent IRCSA and support survivors; their voice has long been unheard in crafting prevention and intervention policies and services. These results thus provide an important call to action from these critical stakeholders. Pediatricians should recognize that perpetrators can be pediatric patients, women, and parents. Pediatricians can advocate for more early CSA prevention education and policy changes that remove the statute of limitations for reporting CSA.

Keywords: incest, childhood sexual abuse, incest-related childhood sexual abuse, incest survivor

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Authors: T. Elrazaz

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This paper examines accrual and real earnings management by publicly listed targets around mergers and acquisitions. Prior literature shows that earnings management around mergers and acquisitions can have a significant economic impact because of the associated wealth transfers among stakeholders. More importantly, acting on behalf of their shareholders or pursuing their self-interests, managers of both targets and acquirers may be equally motivated to manipulate earnings prior to an acquisition to generate higher gains for their shareholders or themselves. Building on the grounds of information asymmetry, agency conflicts, stewardship theory, and the revelation principle, this study addresses the question of whether takeover targets employ accrual and real earnings management in the periods prior to the announcement of Mergers and Acquisitions (M&A). Additionally, this study examines whether acquirers are able to detect targets’ earnings management, and in response, adjust the acquisition premium paid in order not to face the risk of overpayment. This study uses an aggregate accruals approach in estimating accrual earnings management as proxied by estimated abnormal accruals. Additionally, real earnings management is proxied for by employing widely used models in accounting and finance literature. The results of this study indicate that takeover targets manipulate their earnings using accruals in the second year with an earnings release prior to the announcement of the M&A. Moreover, in partitioning the sample of targets according to the method of payment used in the deal, the results are restricted only to targets of stock-financed deals. These results are consistent with the argument that targets of cash-only or mixed-payment deals do not have the same strong motivations to manage their earnings as their stock-financed deals counterparts do additionally supporting the findings of prior studies that the method of payment in takeovers is value relevant. The findings of this study also indicate that takeover targets manipulate earnings upwards through cutting discretionary expenses the year prior to the acquisition while they do not do so by manipulating sales or production costs. Moreover, in partitioning the sample of targets according to the method of payment used in the deal, the results are restricted only to targets of stock-financed deals, providing further robustness to the results derived under the accrual-based models. Finally, this study finds evidence suggesting that acquirers are fully aware of the accrual-based techniques employed by takeover targets and can unveil such manipulation practices. These results are robust to alternative accrual and real earnings management proxies, as well as controlling for the method of payment in the deal.

Keywords: accrual earnings management, acquisition premium, real earnings management, takeover targets

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Authors: Halima Musa Kamilu

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This paper discusses the effective strategies for teaching English language to learners in primary schools in Nigeria. English language development is the systematic use of instructional strategies designed to promote the acquisition of English by pupils in primary schools whose primary language is not English. Learning a second language is through total immersion. These strategies support this learning method, allowing pupils to have the knowledge of English language in a pattern similar to the way they learned their native language through regular interaction with others who already know the language. The focus is on fluency and learning to speak English in a social context with native speakers. The strategies allow for effective acquisition. The paper also looked into the following areas: visuals that reinforce spoken or written words, employ gestures for added emphasis, adjusting of speech, stressing of high-frequency vocabulary words, use of fewer idioms and clarifying the meaning of words or phrases in context, stressing of participatory learning and maintaining a low anxiety level and boosting of enthusiasm. It recommended that the teacher include vocabulary words that will make the content more comprehensible to the learner.

Keywords: effective, strategies, teaching, beginners and primary schools

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Authors: Muhammad Abba Jallo, Fred Fudah Moveh

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This study addresses the challenges faced by Nigerian law enforcement agencies due to the lack of an integrated crime management system. While various agencies use ICT-based systems, the absence of interoperability creates barriers to effective collaboration and information sharing. The research proposes the development of an Interagency Crime Management System (ICMS), which integrates the Crime Management Systems (CMS) of different agencies through an Application Program Interface (API). The system is designed to allow all law enforcement agencies to input data using a standardized format, improving crime tracking, reporting, and management across Nigeria. This paper details the design and implementation process, highlighting the benefits of enhanced collaboration for crime management.

Keywords: crime management, Nigeria, law enforcement, ICT

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Authors: T. Sanches, K. Bousson

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As part of the development of a 4D autopilot system for unmanned aerial vehicles (UAVs), i.e. a time-dependent robust trajectory generation and control algorithm, this work addresses the problem of optimal path control based on the flight sensors data output that may be unreliable due to noise on data acquisition and/or transmission under certain circumstances. Although several filtering methods, such as the Kalman-Bucy filter or the Linear Quadratic Gaussian/Loop Transfer Recover Control (LQG/LTR), are available, the utter complexity of the control system, together with the robustness and reliability required of such a system on a UAV for airworthiness certifiable autonomous flight, required the development of a proper robust filter for a nonlinear system, as a way of further mitigate errors propagation to the control system and improve its ,performance. As such, a nonlinear algorithm based upon the LQG/LTR, is validated through computational simulation testing, is proposed on this paper.

Keywords: autonomous flight, LQG/LTR, nonlinear state estimator, robust flight control

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Authors: Ahmad Javid Habib, Tetsuo Kidokoro

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There is an increasing demand for developing urban land to provide better living conditions for all citizens in Afghanistan. Most of the development will involve the acquisition of land. And the current land acquisition method practiced by central government is expropriation, which is a cash-based transaction method that imposes heavy fiscal burden on local municipalities and central government, and it does not protect ownership rights and social equity of landowners besides it relocates the urban poor to remote areas with limited access to jobs and public services. The questionnaire analysis, backed by observations of different case studies in countries where land readjustment is used as a collaborative land development tool indicates that the method plays a key role in valuing landowners’ rights, giving other community members and stakeholders the opportunity to collaboratively implement urban development projects. The practice of the method is reducing the heavy fiscal burden on the local and central governments and is a better option to deal with the current development challenges in Afghanistan.

Keywords: collaboration, land readjustment, master plan, expropriation

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Authors: Jessica Kate Simonds

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The last successful hijacking perpetrated by Somali pirates in 2012 represented a critical turning point for the identity and brand of Indian Ocean (IO) insecurity, coined in this paper as the era of the post-piratical. This paper explores the broadening of the PMSC business model to account and contribute to the design of a new IO security environment that prioritises foreign and insurgency drone activity and Houthi rebel operations as the main threat to merchant shipping in the post-2012 era. This study is situated within a longer history of analysing maritime insecurity and also contributes a bespoke conceptual framework that understands the sea as a space that is produced and reproduced relative to existing and emerging threats to merchant shipping based on bespoke models of information sharing and intelligence acquisition. This paper also makes a prominent empirical contribution by drawing on a post-positivist methodology, data drawn from original semi-structured interviews with senior maritime insurers and active merchant seafarers that is triangulated with industry-produced guidance such as the BMP series as primary data sources. Each set is analysed through qualitative discourse and content analysis and supported by the quantitative data sets provided by the IMB Piracy Reporting center and intelligence networks. This analysis reveals that mechanisms such as the IGP&I Maritime Security Committee and intelligence divisions of PMSC’s have driven the exchanges of knowledge between land and sea and thus the reproduction of the maritime security environment through new regulations and guidance to account dones, rebels and bombs as the key challenges in the IO, beyond piracy. A contribution of this paper is the argument that experts who may not be in the highest-profile jobs are the architects of maritime insecurity based on their detailed knowledge and connections to vessels in transit. This paper shares the original insights of those who have served in critical decision making spaces to demonstrate that the development and refinement of industry produced deterrence guidance that has been accredited to the mitigation of piracy, have shaped new editions such as BMP 5 that now serve to frame a new security environment that prioritises the mitigation of risks from drones and WBEID’s from both state and insurgency risk groups. By highlighting the experiences and perspectives of key players on both land and at sea, the key finding of this paper is outlining that as pirates experienced a financial boom by profiteering from their bespoke business model during the peak of successful hijackings, the private security market encountered a similar level of financial success and guaranteed risk environment in which to prospect business. Thus, the reproduction of the Indian Ocean as a maritime security environment reflects a new found purpose for PMSC’s as part of the broader conglomerate of maritime insurers, regulators, shipowners and managers who continue to redirect the security consciousness and IO brand of insecurity.

Keywords: maritime security, private security, risk intelligence, political geography, international relations, political economy, maritime law, security studies

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Authors: Shereen Kamel

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This study explores the recent application of bilingual education in Egyptian public schools. It aims to provide an overall picture of bilingual education programs globally and examine its adequacy to the Egyptian social and cultural context. The study also assesses the current application process of teaching English as a Second Language in public schools from the early childhood education stage and onwards, instead of starting it from middle school; as a strategy that promotes English language proficiency and equity among students. The theoretical framework is based on Jim Cummins’ bilingual education theories and on recent trends adopting different developmental theories and perspectives, like Stephen Crashen’s theory of Second Language Acquisition that calls for communicative and meaningful interaction rather than memorization of grammatical rules. The question posed here is whether bilingual education, with its peculiar nature, could be a good chance to reach out to all Egyptian students and prepare them to become global citizens. In addition to this, a more specific question is related to the extent to which social and cultural variables can affect the young learners’ second language acquisition. This exploratory analytical study uses mixed-methods research design to examine the application of bilingual education in Egyptian public schools. The study uses a cluster sample of schools in Egypt from different social and cultural backgrounds to assess the determining variables. The qualitative emphasis is on interviewing teachers and reviewing students’ achievement documents. The quantitative aspect is based on observations of in-class activities through tally sheets and checklists. Having access to schools and documents is authorized by governmental and institutional research bodies. Data sources will comprise achievement records, students’ portfolios, parents’ feedback and teachers’ viewpoints. Triangulation and SPSS will be used for analysis. Based on the gathered data, new curricula have been assigned for elementary grades and teachers have been required to teach the newly developed materials all of a sudden without any prior training. Due to shortage in the teaching force, many assigned teachers have not been proficient in the English language. Hence, teachers’ incompetency and unpreparedness to teach this grade specific curriculum constitute a great challenge in the implementation phase. Nevertheless, the young learners themselves as well as their parents seem to be enthusiastic about the idea itself. According to the findings of this research study, teaching English as a Second Language to children in public schools can be applicable and is culturally relevant to the Egyptian context. However, there might be some social and cultural differences and constraints when it comes to application in addition to various aspects regarding teacher preparation. Therefore, a new mechanism should be incorporated to overcome these challenges for better results. Moreover, a new paradigm shift in these teacher development programs is direly needed. Furthermore, ongoing support and follow up are crucial to help both teachers and students realize the desired outcomes.

Keywords: bilingual education, communicative approach, early childhood education, language and culture, second language acquisition

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Authors: Y. Z. Gad

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Disorders of Sex Development (DSD) are defined as congenital conditions in which development of chromosomal, gonadal or anatomical sex is atypical. The DSD are relatively prevalent in Egypt. In spite of that, the relative rarity of the individual disease types or their molecular pathologies frequently resulted in reporting on single or few cases. This augmented the challenging nature of phenotype-genotype correlation in this disease group and its utilization in the management of such medical emergency. Through critical assessment of the published DSD reports, the current review aims at analyzing the clinical characteristics of the various DSD forms in relation to the underlying molecular pathologies. A systematic literature search was done in Pubmed, using relevant keywords (Egypt versus DSD, genital ambiguity or ambiguous genitalia, the old terms of 'intersex, hermaphroditism and pseudohermaphroditism', and a list of the DSD entities and their related genes). The search yielded 24 reports of molecular data in Egyptian patients presenting with ambiguous genitalia. However, only 21 publications fulfilled the criteria of inclusion of detailed clinical descriptions and definitive molecular diagnoses of individual patients. Curation of the data yielded a total of 53 cases that were ascertained from 40 families. Fifty-one patients present with ambiguous genitalia only while 2 had multiple congenital anomalies. Parental consanguinity was noted in 60% of cases. Sex of rearing at initial presentation was female in 75% and 60% in 46,XY and 46,XX DSD cases, respectively. The external genital phenotype in 2/3 of the 46,XY DSD cases showed moderate undermasculinization [Quigley scores 3 & 4] and 1/3 had severe presentations [scores 5 & 6]. For 46,XX subjects, 1 had severe virilization of the external genitalia while 8 had moderate phenotype. Hormonal data were inconclusive or contradictory to final diagnosis in a forth of cases. Collectively, 31 families [31/40, 77.5%] with 46,XY DSD had molecular defects in the genes, 5 alpha reductase 2 (SRD5A2) [12/31], 17 beta-hydroxysteroid dehydrogenase 3 [8/31], androgen receptor [7/31], Steroidogenic factor 1 [2/31], luteinizing hormone receptor [1/31], and fibroblast growth factor receptor 1 [1/31]. In a multiethnic study, 9 families afflicted with 46,XX DSD due to 11 beta hydroxylase (CYP11B1) deficiency were documented. Two recurrent mutations, G34R and N160D, in SRD5A2 were present, respectively, in 42 and 17% of cases. Similarly, 4 recurrent mutations resulted in 89% of the CYP11B1 presentations. In conclusion, this analysis highlights the importance of autosomal recessive inheritance and inbreeding among DSD presentations, the importance of founder effect in at least 2 disorders, the difficulties in relating the genotype with the indeterminate genital phenotype, the under-reporting of some DSD subtypes, and the notion that the reported mutational profiles among Egyptian DSD cases are relatively different from those reported in other ethnic groups.

Keywords: disorders of sex development, genital ambiguity, mutation, molecular diagnosis, Egypt

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Authors: Prateep Wajeetongratana

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This study investigates the management accountant’s roles that link with the creation of corporate shared value to enable more effective decision-making and improve the information needs of stakeholders. Mixed method is employed to collect using triangulation for credibility. A quantitative approach is employed to conduct a survey of 200 Thai companies providing annual reports in the Stock Exchange of Thailand. The results of the study reveal that environmental and social data incorporated in a corporate social responsibility (CSR) disclosure are based on the indicators of the Global Reporting Initiatives (GRI) at a statistically significant level of 0.01. Environmental and social indicators in CSR are associated with environmental and social data disclosed in the annual report to support stakeholders’ and the public’s interests that are addressed and show that a significant relationship between environmental and social in CSR disclosures and the information in annual reports is statistically significant at the 0.01 level.

Keywords: corporate social responsibility, creating shared value, management accountant’s roles, stock exchange of Thailand

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Authors: J. C. Cabanillas-Noris, M. I. Martínez-Hernández, I. León-Monzón

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The selection of diffractive events in the ALICE experiment during the first data taking period (RUN-I) of the Large Hadron Collider (LHC) was limited by the range over which rapidity gaps occur. It would be possible to achieve better measurements by expanding the range in which the production of particles can be detected. For this purpose, the ALICE Diffractive (AD0) detector has been installed and commissioned for the second phase (RUN-II). Any new detector should be able to take the data synchronously with all other detectors and be operated through the ALICE central systems. One of the key elements that must be developed for the AD0 detector is the Detector Control System (DCS). The DCS must be designed to operate safely and correctly this detector. Furthermore, the DCS must also provide optimum operating conditions for the acquisition and storage of physics data and ensure these are of the highest quality. The operation of AD0 implies the configuration of about 200 parameters, from electronics settings and power supply levels to the archiving of operating conditions data and the generation of safety alerts. It also includes the automation of procedures to get the AD0 detector ready for taking data in the appropriate conditions for the different run types in ALICE. The performance of AD0 detector depends on a certain number of parameters such as the nominal voltages for each photomultiplier tube (PMT), their threshold levels to accept or reject the incoming pulses, the definition of triggers, etc. All these parameters define the efficiency of AD0 and they have to be monitored and controlled through AD0 DCS. Finally, AD0 DCS provides the operator with multiple interfaces to execute these tasks. They are realized as operating panels and scripts running in the background. These features are implemented on a SCADA software platform as a distributed control system which integrates to the global control system of the ALICE experiment.

Keywords: AD0, ALICE, DCS, LHC

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Authors: Michael C. Nwaohia

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Whereas anecdotal evidence supports the notion that increase in information technology (IT) know-how may enhance output of professionals in the accounting sector, this has not been systematically explored in the Nigerian context. Against this background, this paper examines the correlation between knowledgeability of IT and level of performance at everyday auditing and accounting tasks. It utilizes primary and secondary data from selected business organizations in Lagos, Nigeria. Accounting staff were administered structured questionnaires which, amongst other things, sought to examine knowledge and exposure to information technology prior to joining the firms and current level of performance based on self-reporting and supervisor comments. In addition, exposure to on-the-job IT training and current level of performance was examined. The statistical analysis of the data was done using the SPSS package. The results strongly suggest that prior exposure to IT skills enabled accounting professionals to better flexibly fit into the dynamic environment in which contemporary business takes place. Ultimately, the paper attempts to explicate some of the implications of these findings for individuals and business firms.

Keywords: accounting, firms, information technology, professional behavior

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Authors: Ikawati Wulandari

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Acquisition of geomagnetic field has been done at Geothermal manifestation Candi Umbul, Grabag, Magelang, Central Java Province on 10-12 May 2013. The purpose of this research to study sub-surface structure condition and the structure which control the hot springs manifestation. The research area have size of 1,5 km x 2 km and measurement spacing of 150 m. Total magnetic field data, the position, and the north pole direction have acquired by Proton Precession Magnetometer (PPM), Global Positioning System (GPS), and of geology compass, respectively. The raw data has been processed and performed using IGRF (International Geomagnetics Reference Field) correction to obtain total field magnetic anomaly. Upward continuation was performed at 100 meters height using software Magpick. Analysis conclude horizontal position of the body causing anomaly which is located at hot springs manifestation, and it stretch along Northeast - Southwest, which later interpreted as normal fault. This hotsprings manifestation was controlled by the downward fault which becomes a weak zone where hot water from underground the geothermal reservoir leakage

Keywords: PPM, Geothermal, Fault, Grabag

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Authors: Ramanen Sugunesegran, Michael L. Williams

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Over the past two decades surgical approaches for mitral valve (MV) disease have evolved with the advent of minimally invasive techniques. Robotic mitral valve repair (RMVr) safety and efficacy has been well documented, however, mid- to long-term data are limited. The aim of this review was to provide a comprehensive analysis of the available mid- to long-term term data for RMVr. Electronic searches of five databases were performed to identify all relevant studies reporting minimum 5-year data on RMVr. Pre-defined primary outcomes of interest were overall survival, freedom from MV reoperation and freedom from moderate or worse mitral regurgitation (MR) at 5-years or more post-RMVr. A meta-analysis of proportions or means was performed, utilizing a random effects model, to present the data. Kaplan-Meier curves were aggregated using reconstructed individual patient data. Nine studies totaling 3,300 patients undergoing RMVr were identified. Rates of overall survival at 1-, 5- and 10-years were 99.2%, 97.4% and 92.3%, respectively. Freedom from MV reoperation at 8-years post RMVr was 95.0%. Freedom from moderate or worse MR at 7-years was 86.0%. Rates of early post-operative complications were low with only 0.2% all-cause mortality and 1.0% cerebrovascular accident. Reoperation for bleeding was low at 2.2% and successful RMVr was 99.8%. Mean intensive care unit and hospital stay were 22.4 hours and 5.2 days, respectively. RMVr is a safe procedure with low rates of early mortality and other complications. It can be performed with low complication rates in high volume, experienced centers. Evaluation of available mid-term data post-RMVr suggests favorable rates of overall survival, freedom from MV reoperation and freedom from moderate or worse MR recurrence.

Keywords: mitral valve disease, mitral valve repair, robotic cardiac surgery, robotic mitral valve repair

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Authors: Giulia Bonaldo, Alberto Vaccheri, Ottavio D'Annibali, Domenico Motola

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The Human Papilloma Virus (HPV) was shown to be the cause of different types of carcinomas, first of all of the cervical intraepithelial neoplasia. Since the early 80s to today, thanks first to the preventive screening campaigns (pap-test) and following to the introduction of HPV vaccines on the market; the number of new cases of cervical cancer has decreased significantly. The HPV vaccines currently approved are three: Cervarix® (HPV2 - virus type: 16 and 18), Gardasil® (HPV4 - 6, 11, 16, 18) and Gardasil 9® (HPV9 - 6, 11, 16, 18, 31, 33, 45, 52, 58), which all protect against the two high-risk HPVs (6, 11) that are mainly involved in cervical cancers. Despite the remarkable effectiveness of these vaccines has been demonstrated, in the recent years, there have been many complaints about their risk-benefit profile due to Adverse Events Following Immunization (AEFI). The purpose of this study is to provide a support about the ongoing discussion on the safety profile of HPV vaccines based on real life data deriving from spontaneous reports of suspected AEFIs collected in the Vaccine Adverse Events Reporting System (VAERS). VAERS is a freely-available national vaccine safety surveillance database of AEFI, co-administered by the Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA). We collected all the reports between January 2007 to December 2017 related to the HPV vaccines with a brand name (HPV2, HPV4, HPV9) or without (HPVX). A disproportionality analysis using Reporting Odds Ratio (ROR) with 95% confidence interval and p value ≤ 0.05 was performed. Over the 10-year period, 54889 reports of AEFI related to HPV vaccines reported in VAERS, corresponding to 224863 vaccine-event pairs, were retrieved. The highest number of reports was related to Gardasil (n = 42244), followed by Gardasil 9 (7212) and Cervarix (3904). The brand name of the HPV vaccine was not reported in 1529 cases. The two events more frequently reported and statistically significant for each vaccine were: dizziness (n = 5053) ROR = 1.28 (CI95% 1.24 – 1.31) and syncope (4808) ROR = 1.21 (1.17 – 1.25) for Gardasil. For Gardasil 9, injection site pain (305) ROR = 1.40 (1.25 – 1.57) and injection site erythema (297) ROR = 1.88 (1.67 – 2.10) and for Cervarix, headache (672) ROR = 1.14 (1.06 – 1.23) and loss of consciousness (528) ROR = 1.71 (1.57 – 1.87). In total, we collected 406 reports of death and 2461 cases of permanent disability in the ten-year period. The events consisting of incorrect vaccine storage or incorrect administration were not considered. The AEFI analysis showed that the most frequently reported events are non-serious and listed in the corresponding SmPCs. In addition to these, potential safety signals arose regarding less frequent and severe AEFIs that would deserve further investigation. This already happened with the referral of the European Medicines Agency (EMA) for the adverse events POTS (Postural Orthostatic Tachycardia Syndrome) and CRPS (Complex Regional Pain Syndrome) associated with anti-papillomavirus vaccines.

Keywords: adverse drug reactions, pharmacovigilance, safety, vaccines

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Authors: Mahdi Farajzadeh Ajirlou

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Prior evidence of normal cardiac anatomy is desirable to relieve the anxiety of cases with a family history of congenital heart disease or to offer the option of early gestation termination or close follow-up should a cardiac anomaly be proved. Fetal heart discovery plays an important part in the opinion of the fetus, and it can reflect the fetal heart function of the fetus, which is regulated by the central nervous system. Acquisition of ventricular volume and inflow data would be useful to quantify more valve regurgitation and ventricular function to determine the degree of cardiovascular concession in fetal conditions at threat for hydrops fetalis. This study discusses imaging the fetal heart with transvaginal ultrasound, Doppler ultrasound, three-dimensional ultrasound (3DUS) and four-dimensional (4D) ultrasound, spatiotemporal image correlation (STIC), glamorous resonance imaging and cardiac catheterization. Doppler ultrasound (DUS) image is a kind of real- time image with a better imaging effect on blood vessels and soft tissues. DUS imaging can observe the shape of the fetus, but it cannot show whether the fetus is hypoxic or distressed. Spatiotemporal image correlation (STIC) enables the acquisition of a volume of data concomitant with the beating heart. The automated volume accession is made possible by the array in the transducer performing a slow single reach, recording a single 3D data set conforming to numerous 2D frames one behind the other. The volume accession can be done in a stationary 3D, either online 4D (direct volume scan, live 3D ultrasound or a so-called 4D (3D/ 4D)), or either spatiotemporal image correlation-STIC (off-line 4D, which is a circular volume check-up). Fetal cardiovascular MRI would appear to be an ideal approach to the noninvasive disquisition of the impact of abnormal cardiovascular hemodynamics on antenatal brain growth and development. Still, there are practical limitations to the use of conventional MRI for fetal cardiovascular assessment, including the small size and high heart rate of the mortal fetus, the lack of conventional cardiac gating styles to attend data accession, and the implicit corruption of MRI data due to motherly respiration and unpredictable fetal movements. Fetal cardiac MRI has the implicit to complement ultrasound in detecting cardiovascular deformations and extracardiac lesions. Fetal cardiac intervention (FCI), minimally invasive catheter interventions, is a new and evolving fashion that allows for in-utero treatment of a subset of severe forms of congenital heart deficiency. In special cases, it may be possible to modify the natural history of congenital heart disorders. It's entirely possible that future generations will ‘repair’ congenital heart deficiency in utero using nanotechnologies or remote computer-guided micro-robots that work in the cellular layer.

Keywords: fetal, cardiac MRI, ultrasound, 3D, 4D, heart disease, invasive, noninvasive, catheter

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Authors: Cachanda K. Orellana

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This study examined preservice teachers’ perceptions of their role in digital citizenship education. Data was gathered via surveys and coursework from the preservice teachers’ instructional technology course. Pre-service teachers were asked about their role in digital citizenship education during a unit on digital dilemmas. Findings suggest that teacher education programs should consider digital citizenship education as more than the acquisition of a set of skills and behaviors and prepare preservice teachers to support students’ ability to engage in ethical decision-making in digital spaces.

Keywords: digital citizenship, digital dilemmas, pre-service teachers, teacher education

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Authors: Daniel F. Bohorquez, Luis M. Agudelo, Henry H. León

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Heart rate variability (HRV) is defined as the temporary variation between heartbeats or RR intervals (distance between R waves in an electrocardiographic signal). This distance is currently a recognized biomarker. With the analysis of the distance, it is possible to assess the sympathetic and parasympathetic nervous systems. These systems are responsible for the regulation of the cardiac muscle. The analysis allows health specialists and researchers to diagnose various pathologies based on this variation. For the acquisition and analysis of HRV taken from a cardiac electrical signal, electronic equipment and analysis software that work independently are currently used. This complicates and delays the process of interpretation and diagnosis. With this delay, the health condition of patients can be put at greater risk. This can lead to an untimely treatment. This document presents a single portable device capable of acquiring electrocardiographic signals and calculating a total of 19 HRV metrics. This reduces the time required, resulting in a timelier intervention. The device has an electrocardiographic signal acquisition card attached to a microcontroller capable of transmitting the cardiac signal wirelessly to a mobile device. In addition, a mobile application was designed to analyze the cardiac waveform. The device calculates the RR and different metrics. The application allows a user to visualize in real-time the cardiac signal and the 19 metrics. The information is exported to a cloud database for remote analysis. The study was performed under controlled conditions in the simulated hospital of the Universidad de la Sabana, Colombia. A total of 60 signals were acquired and analyzed. The device was compared against two reference systems. The results show a strong level of correlation (r > 0.95, p < 0.05) between the 19 metrics compared. Therefore, the use of the portable system evaluated in clinical scenarios controlled by medical specialists and researchers is recommended for the evaluation of the condition of the cardiac system.

Keywords: biological signal análisis, heart rate variability (HRV), HRV metrics, mobile app, portable device.

Procedia PDF Downloads 184

Authors: Almoutassem Bellah Nasser

Abstract:

This paper is aimed at calculating the intangible assets of Jordanian economy. This effort is a response to the demand from corporations for these services which reflects a perceived gap in internal and external financial reporting on intangible investments. The main conclusion of the paper is to suggest that the way forward to a standardized, more comparable approach to measuring intangible capital is to employ CIV method of valuation. Published macroeconomic data traditionally exclude most intangible investment from measured GDP. This situation is beginning to change as some attempts have been made to measure the amount of intangible assets. It was found that intangible assets account for $164.20 million in all the listed companies of Jordan. All this money does not appear on the balance sheets of these companies and hence requires special attention of policy makers for better utilization.

Keywords: intangible capital, stock prices, Amman Stock Exchange

Procedia PDF Downloads 378

Authors: Shivaram P. Arunachalam, Mustafa Y. Sir, Andy Boggust, David M. Nestler, Thomas R. Hellmich, Kalyan S. Pasupathy

Abstract:

Emergency departments (EDs) provide urgent care to patients throughout the day in a complex and chaotic environment. Real-time location systems (RTLS) are increasingly being utilized in healthcare settings, and have shown to improve safety, reduce cost, and increase patient satisfaction. Radio Frequency Identification Device (RFID) data in an ED has been shown to compute variables such as patient-provider contact time, which is associated with patient outcomes such as 30-day hospitalization. These variables can provide avenues for improving ED operational efficiency. A major challenge with ED financial operations is under-coding of critical care services due to physicians’ difficulty reporting accurate times for critical care provided under Current Procedural Terminology (CPT) codes 99291 and 99292. In this work, the authors propose a framework to optimize ED critical care billing using RFID data. RFID estimated physician-patient contact times could accurately quantify direct critical care services which will help model a data-driven approach for ED critical care billing. This paper will describe the framework and provide insights into opportunities to prevent under coding as well as over coding to avoid insurance audits. Future work will focus on data analytics to demonstrate the feasibility of the framework described.

Keywords: critical care billing, CPT codes, emergency department, RFID

Procedia PDF Downloads 131

Authors: Mehdi Homayouni, Karim Adinehvand, Bakhtiar Azadbakht

Abstract:

In this study, we used Monte Carlo code (MCNP4C) that is a general method, for simulation, electron source and electric field, a disc source with 0.05 cm radius in direct of anode are used, radius of disc source show focal spot of X-ray tube that here is 0.05 cm. In this simulation, the anode is from tungsten with 18.9 g/cm3 density and angle of the anode is 18°. We simulated X-ray tube for 140 kv. For increasing of speed data acquisition, we use F5 tally. With determination the exact position of F5 tally in the program, outputs are acquired. In this spectrum the start point is about 0.02 Mev, the absorption edges are about 0.06 Mev and 0.07 Mev, and average energy is about 0.05 Mev.

Keywords: X-spectrum, simulation, Monte Carlo, tube

Procedia PDF Downloads 722

Authors: Abdulaziz Alakeel, Roaa Alamri, Abdulrahman Alomair, Mohammed Fouda

Abstract:

Introduction: Ibrutinib is a selective, potent, and irreversible small-molecule inhibitor of Bruton's tyrosine kinase (BTK). It forms a covalent bond with a cysteine residue (CYS-481) at the active site of Btk, leading to inhibition of Btk enzymatic activity. The drug is indicated to treat certain type of cancers such as mantle cell lymphoma (MCL), chronic lymphocytic leukaemia and Waldenström's macroglobulinaemia (WM). Cardiac failure is a condition referred to inability of heart muscle to pump adequate blood to human body organs. There are multiple types of cardiac failure including left and right-sided heart failure, systolic and diastolic heart failures. The aim of this review is to evaluate the risk of cardiac failure associated with the use of ibrutinib and to suggest regulatory recommendations if required. Methodology: Signal Detection team at the National Pharmacovigilance Center (NPC) of Saudi Food and Drug Authority (SFDA) performed a comprehensive signal review using its national database as well as the World Health Organization (WHO) database (VigiBase), to retrieve related information for assessing the causality between cardiac failure and ibrutinib. We used the WHO- Uppsala Monitoring Centre (UMC) criteria as standard for assessing the causality of the reported cases. Results: Case Review: The number of resulted cases for the combined drug/adverse drug reaction are 212 global ICSRs as of July 2020. The reviewers have selected and assessed the causality for the well-documented ICSRs with completeness scores of 0.9 and above (35 ICSRs); the value 1.0 presents the highest score for best-written ICSRs. Among the reviewed cases, more than half of them provides supportive association (four probable and 15 possible cases). Data Mining: The disproportionality of the observed and the expected reporting rate for drug/adverse drug reaction pair is estimated using information component (IC), a tool developed by WHO-UMC to measure the reporting ratio. Positive IC reflects higher statistical association while negative values indicates less statistical association, considering the null value equal to zero. The results of (IC=1.5) revealed a positive statistical association for the drug/ADR combination, which means “Ibrutinib” with “Cardiac Failure” have been observed more than expected when compared to other medications available in WHO database. Conclusion: Health regulators and health care professionals must be aware for the potential risk of cardiac failure associated with ibrutinib and the monitoring of any signs or symptoms in treated patients is essential. The weighted cumulative evidences identified from causality assessment of the reported cases and data mining are sufficient to support a causal association between ibrutinib and cardiac failure.

Keywords: cardiac failure, drug safety, ibrutinib, pharmacovigilance, signal detection

Procedia PDF Downloads 129

Authors: Zhao Hong

Abstract:

When international students study Chinese as a foreign or second language, it is important for them to form constructive viewpoints and possess an open mindset on Chinese culture. This helps them to make faster progress in their language acquisition. Observations from African students at Liaoning Institute of Science and Technology show that by integrating video-focused social networking apps such as Tiktok (“Douyin”) on a controlled basis, students raise their interest not only in making an effort in learning the Chinese language, but also in the understanding of the Chinese culture. During the last twelve months, our research group explored a teaching model using selected contents in certain classroom settings, including virtual classrooms during lockdown periods due to the COVID-19 pandemic. Using interviews, a survey was conducted on international students from African countries at the Liaoning Institute of Science and Technology in Chinese language courses. Based on the results, a teaching model was built for Chinese language acquisition by entering the "mobile Chinese culture".

Keywords: Chinese as a foreign language, cultural education, social networking apps, teaching model

Procedia PDF Downloads 74

Authors: Faith Fang Xi Ooi, Kam-Fong Lee

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Headlines are generally the summary of the content of news articles. With the added influence of hectic lifestyles, readers may rely solely on the headlines for information. In the media, what is reported concerning health issues are government responses and community involvement. There is a need for a call to action to curb health issues and not just reporting on what the government is doing about these health-related issues. In other words, linguistic elements of persuasive communicative function should be realized when reporting on health issues. Hence, this paper aims at identifying and analyzing the transitivity, Mood and Modality systems in two hundred news headlines from two Malaysian online news portals, namely The Star Online and New Straits Times. This study employs the purposive sampling method to obtain the news headlines on healthy eating using the search keyword ‘healthy eating’ and is based on Halliday’s Systemic Functional Linguistics (SFL) framework. The results show that the Material process dominates the process types along with its participants of Scope and Goal. The mood type that constitutes most of the headlines in the two newspapers is the declarative mood. Moreover, for Modality, the median Probability constitutes the highest in the headlines on healthy eating. This study contributes to the implications of being a source of reference for news writers and producers in constructing news headlines and for health campaign strategists to realize the persuasive appeals to influence behaviors and attitudes of the public towards healthy eating.

Keywords: healthy eating, modality, mood, news headlines, SFL

Procedia PDF Downloads 172

Authors: Sarai Alvarado Pineda, Ricardo Maldonado Soto

Abstract:

The acquisition of Verb Particle Constructions is a challenge for Spanish speakers learning English. The acquisition is particularly difficult for speakers of languages with no verb particle constructions. The purpose of the current study is to define the procedural steps in the acquisition of constructions with the particle on. There are three outstanding meanings for the particle on; Surface: The movie is based on a true story, Activation: John turn on the light, Continuity: The band played on all night. The central aim of this study is to measure how Mexican Spanish participants respond to both the three meanings mentioned above and the degree of meaning transparency/opacity of on verb particle constructions. Forty Mexican Spanish learners of English (20 basic and 20 advanced) are compared against a control group of 20 American native English speakers through a reaction time test (PsychoPy2 2015). The participants were asked to discriminate 90 items based on their knowledge of these constructions. There are 30 items per meaning divided into two groups of transparent and opaque meaning. Results revealed three major findings: Advanced students have a reaction time similar to that of native speakers (advanced 4.5s versus native 3.7s), while students with a lower level of English proficiency, show a high reaction time (7s). Likewise, there is a shorter reaction time in constructions with lower opacity in the three groups of participants, with differences between each level (basic 6.7s, advanced 4.3s, and native 3.4s). Finally, a difference in reaction time can be identified according to the meaning provided by the construction. The reaction time for the activation category (5.27s) is greater than continuity (5.04s), and this category is also slower than the surface (4.94s). The study shows that the level of sensitivity of English learners increases significantly aiming towards native speaker patterns as determined by the level of transparency of meaning of each construction as well as the degree of entrenchment of each constructional meaning.

Keywords: meaning of the particle, opacity, reaction time, verb particle constructions

Procedia PDF Downloads 265

Authors: Amin Sahebnasagh, Karim Adinehvand, Bakhtiar Azadbakht

Abstract:

In this study, we used Monte Carlo code (MCNP4C) that is a general method, for simulation, electron source and electric field, a disc source with 0.05 cm radius in direct of anode are used, radius of disc source show focal spot of x-ray tube that here is 0.05 cm. In this simulation, anode is from tungsten with 18.9 g/cm3 density and angle of anode is 180. we simulated x-ray tube for 140 kv. For increasing of speed data acquisition we use F5 tally. With determination the exact position of F5 tally in program, outputs are acquired. In this spectrum the start point is about 0.02 Mev, the absorption edges are about 0.06 Mev and 0.07 Mev and average energy is about 0.05 Mev.

Keywords: x-spectrum, simulation, Monte Carlo, MCNP4C code

Procedia PDF Downloads 646

Authors: Elena Krutskikh, Elena Khvatova

Abstract:

In tertiary settings expanding students’ vocabulary and teaching discursive competence is seen as one of the chief goals of a professional development course. However, such a focus often is detrimental to students’ cognitive competences, such as analysis, synthesis, and creative processing of information, and deprives students of motivation for self-improvement and self-development of language skills. The presentation is going to argue that in an ESP course special attention should be paid to reading/listening which can promote understanding and using the language as a tool for solving significant real world problems, including professional ones. It is claimed that in the learning process it is necessary to maintain a balance between the content and the linguistic aspect of the educational process as language acquisition is inextricably linked with mental activity and the need to express oneself is a primary stimulus for using a language. A study conducted among undergraduates indicates that they place a premium on quality materials that motivate them and stimulate their further linguistic and professional development. Thus, more demands are placed on study materials that should contain new information for students and serve not only as a source of new vocabulary but also prepare them for real tasks related to professional activities.

Keywords: critical reading, english for professional development, english for specific purposes, high order thinking skills, lexical approach, vocabulary acquisition

Procedia PDF Downloads 167

Authors: S. H. Iranmanesh, L. Aliabadi, A. Mollajan

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Integrated resilience engineering (IRE) is capable of returning banking systems to the normal state in extensive economic circumstances. In this study, information system of a large bank (with several branches) is assessed and optimized under severe economic conditions. Data envelopment analysis (DEA) models are employed to achieve the objective of this study. Nine IRE factors are considered to be the outputs, and a dummy variable is defined as the input of the DEA models. A standard questionnaire is designed and distributed among executive managers to be considered as the decision-making units (DMUs). Reliability and validity of the questionnaire is examined based on Cronbach's alpha and t-test. The most appropriate DEA model is determined based on average efficiency and normality test. It is shown that the proposed integrated design provides higher efficiency than the conventional RE design. Results of sensitivity and perturbation analysis indicate that self-organization, fault tolerance, and reporting culture respectively compose about 50 percent of total weight.

Keywords: banking system, Data Envelopment Analysis (DEA), Integrated Resilience Engineering (IRE), performance evaluation, perturbation analysis

Procedia PDF Downloads 188

Authors: Aya Al Masri, Naima Oubenali, Safoin Aktaou, Thibault Julien, Malorie Martin, Fouad Maaloul

Abstract:

Introduction: The increased number of performed 'Computed Tomography (CT)' examinations raise public concerns regarding associated stochastic risk to patients. In its Publication 102, the ‘International Commission on Radiological Protection (ICRP)’ emphasized the importance of managing patient dose, particularly from repeated or multiple examinations. We developed a Dose Archiving and Communication System that gives multiple dose indexes (organ dose, effective dose, and skin-dose mapping) for patients undergoing radiological imaging exams. The aim of this study is to compare the organ dose values given by our software for patients undergoing CT exams with those of another software named "VirtualDose". Materials and methods: Our software uses Monte Carlo simulations to calculate organ doses for patients undergoing computed tomography examinations. The general calculation principle consists to simulate: (1) the scanner machine with all its technical specifications and associated irradiation cases (kVp, field collimation, mAs, pitch ...) (2) detailed geometric and compositional information of dozens of well identified organs of computational hybrid phantoms that contain the necessary anatomical data. The mass as well as the elemental composition of the tissues and organs that constitute our phantoms correspond to the recommendations of the international organizations (namely the ICRP and the ICRU). Their body dimensions correspond to reference data developed in the United States. Simulated data was verified by clinical measurement. To perform the comparison, 270 adult patients and 150 pediatric patients were used, whose data corresponds to exams carried out in France hospital centers. The comparison dataset of adult patients includes adult males and females for three different scanner machines and three different acquisition protocols (Head, Chest, and Chest-Abdomen-Pelvis). The comparison sample of pediatric patients includes the exams of thirty patients for each of the following age groups: new born, 1-2 years, 3-7 years, 8-12 years, and 13-16 years. The comparison for pediatric patients were performed on the “Head” protocol. The percentage of the dose difference were calculated for organs receiving a significant dose according to the acquisition protocol (80% of the maximal dose). Results: Adult patients: for organs that are completely covered by the scan range, the maximum percentage of dose difference between the two software is 27 %. However, there are three organs situated at the edges of the scan range that show a slightly higher dose difference. Pediatric patients: the percentage of dose difference between the two software does not exceed 30%. These dose differences may be due to the use of two different generations of hybrid phantoms by the two software. Conclusion: This study shows that our software provides a reliable dosimetric information for patients undergoing Computed Tomography exams.

Keywords: adult and pediatric patients, computed tomography, organ dose calculation, software comparison

Procedia PDF Downloads 162