Search results for: public hospital

Authors: Yen-Sheng Ho

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It is important to actively adjust the legal system of land use in archaeological sites and the reward system to meet the needs of modern society and to solve the dilemma of government management. Under the principle of administration according to law and the principle of the clarity of law, human rights, legal orders and legitimate expectation shall be regulated. The Cultural Heritage Preservation Act has many norms related to archaeological sites in Taiwan. However, in practice, the preservation of archaeological sites still encounters many challenges. For instance, some archaeological sites have ‘management and maintenance plans’. The restrictions of land uses are not clearly defined making it difficult to determine how planting types and cultivation methods will impact the underground relics. In addition, there are questions as follows. How to coordinate the ‘site preservation plan’ with the Regional Planning Act and the Urban Planning Act? How to define preservation of land, preservation area and other uses of land or area? How to define land use in practice? How to control land use? After selecting three sites for the case investigation, this study will analyze the site’s land use status and propose the direction of land use and control methods. This study suggests that the prerequisite to limit the use of land is to determine the public interest in the preservation of the site. Another prerequisite is to establish a mechanism for permitting the use of the site and for setting the site preservation and zoning maintenance practices according to the Regional Planning Act, Urban Planning Act and other relevant rules, such as, land use zoning, land use control, land management, land maintenance, regional development and management and etc.

Keywords: archaeological site, land use and site preservation plan, regional planning, urban planning

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Authors: Yeukai Mupangavanhu

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The paper examines the concept of ubuntu and the extent to which it can play a role in ensuring fairness and justice in contractual relationships. Courts are expected to balance sanctity of contract and fairness. Public policy is currently a mechanism which is used by courts when balancing the above two competing interests. It, however, generally favours the freedom and sanctity of contract. The question which is addressed in this paper is whether the concept of ubuntu is an alternative mechanism that may be used to mitigate the sometimes harsh and unfair consequences of the doctrine of freedom and sanctity of contract. A comparative study and case analysis is the methodology that is used in this article. Unfairness in contracts is generally related to the problem of inequality in bargaining power underscored by deeply entrenched social and economic inequalities that are a consequence of apartheid and patriarchy. The transformative nature of the constitution demands the inclusion of African legal ideas and values in the legal order. There is a need for the harmonisation of western ideals which are based on the classical model of law of contract with relevant African principles. In order to attain a transformative legal order that promotes a societal transformation and enhances the lives of everyone courts cannot continue to frown upon African values. Ubuntu has the potential of steering the law of contract in a more equitable direction. The substantive rules of contract law undoubtedly need to be infused with the notion of ubuntu. The reconciliation of Western and African values is at the heart of legal transformation.

Keywords: fairness, sanctity of contract, contractual justice, transformative constitutionalism

Procedia PDF Downloads 248

Authors: Ehsan Ahmed Yahia

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Introduction: The nursing role in nutrition screening and assessing hospitalized patients is important. Malnutrition is a common and costly problem, particularly among hospitalized patients, and can have an adverse effect on the healing process. The study's goal is to assess the prevalence of malnutrition among adult hospitalized orthopedic patients and to detect the barriers to the nutrition screening process. Aim of the study: This study aimed to (a) assess the prevalence of malnutrition in hospitalized orthopedic patients and (b) evaluate the relationship between malnutrition and selected clinical outcomes. Material and Methods: This prospective field study was conducted for three months between 03/2022 and 06/2022 in the selected orthopedic departments in a teaching hospital affiliated withCairo University, Egypt. with a total number of one hundred twenty (120) patients. Patients' assessment included checking for malnutrition using the Nutritional Risk Screening Questionnaire. Patients at risk for malnourishment were defined as NRS score ≥ 3. Clinical outcomes under consideration included 1) length of hospitalization, 2) mobilization after surgery and conservative treatment, and 3) rate of adverse events. Results: This study found that malnutrition is a significant problem among patients hospitalized in an orthopedic ward. The prevalence of malnutrition was the highest in patients with lumbar spine and pelvis fractures, followed by the proximal femur and proximal humerus fractures. Patients at risk for malnutrition had significantly prolonged hospitalization, delayed postoperative mobilization, and increased incidence of adverse events.27.8% of the study sample were at risk for malnutrition. The highest prevalence of malnourishment was found in Septic Surgery with 32%, followed by Traumatology with 19.6% and Arthroplasty with 15.3%. A higher prevalence of malnutrition was detected among patients with typical fractures, such as lumbar spine and pelvis (46.7%), proximal femur (34.4%), and proximal humeral (23.7%) fractures. Additionally, patients at risk for malnutrition showed prolonged hospitalization (14.7 ± 11.1 vs. 21.2 ± 11.7 days), delayed postoperative mobilization (2.3 ± 2.9 vs. 4.1 ± 4.9 days), and delayed to mobilize after conservative treatment (1.1 ± 2.7 vs. 1.8 ± 1.9 days). A significant statistical correlation of NRS with individual parameters (Spearman's rank correlation, p < 0.05) was observed. The rate of adverse incidents in patients at risk for malnutrition was significantly higher than that of patients with a regular nutritional status (37.2% vs. 21.1%, p < 0.001). Conclusions: Our results indicate that the prevalence of malnutrition in surgical patients is significant. The nutritional status of patients with typical fractures is especially at risk. Prolonged hospitalization, delayed postoperative mobilization, and delayed mobilization after conservative treatment is significantly associated with malnutrition. In addition, the incidence of adverse events in patients at risk for malnutrition is significantly higher.

Keywords: malnutrition, nutritional risk screening, surgery, nursing, orthopedic nurse

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Authors: Farah Ali, Laeeq Akbar Lodhi, Riaz Hussain, Muhammad Sufyan

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The present study was conducted to determine the macro mineral profile and biomarkers of oxidative stress in Cholistani cattle kept at a public farm and various villages in district Bahawalpur. For this purpose 90 blood samples were collected each from estrual, anestrous and repeat breeding cattle having different age and lactation number. Reproductive tract examination of all the cattle was carried out to determine the reproductive status. Blood samples without EDTA were collected for serum separation at day of estrus (normal cyclic), repeat breeder and anestrous cows. The serum calcium levels were significantly decreased (P<0.05) in anestrous (7.31±0.02 mg/dl) cattle as compared to estrus. However, these values were non-significantly different between repeat breeder and cattle having estrus phase. The concentrations of serum phosphorus were significantly higher (P<0.01) in normal estrual (4.99±0.08 mg/dl) as compared torepeat breeder (3.90±0.06 mg/dl) and anestrous (3.82±0.04 mg/dl) Cholistani cattle. Mean serum MDA (nmol/ml) levels of repeat breeder (2.68±0.18) and anestrous (2.54±0.22) were significantly(P<0.01) higher than the estrous (1.71±0.03) cattle. Moreover, the serum nitric oxide levels(µmol/L) were also increased significantly (P<0.01) in repeat breeder(58.28±4.01)and anestrous (61.40±9.40) than the normalestrous (31.67±6.71) cattle. The ratio of Ca: P in normal cyclic animals was lower (1.73:1) as compared to the anestrous animals (1.92:1). It can be concluded from the present study that the level of Ca: P should also be near to 1.5:1 for better reproductive performance.

Keywords: anestrus, cholistani cattle, minerals, oxidative stress, repeat breeder

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Authors: D. M. Lewis, L. Frisby, U. Stead

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Objective: Many patients are receiving invasive treatments in acute care or are dying in hospital without having had comprehensive goals of care conversations. Some of these treatments may not align with the patient’s wishes, may be futile, and may cause unnecessary suffering. While many staff may recognize the benefits of engaging patients and families in Serious Illness Conversations (a goal of care framework developed by Ariadne Labs in Boston), few staff feel confident and/or competent in having these conversations in acute care. Another barrier to having these conversations may be due to a lack of incorporation in the current workflow. An educational exercise, titled the Two Question Challenge, was initiated on four medical units across two Vancouver Coastal Health (VCH) hospitals in attempt to engage the entire interdisciplinary team in asking patients and families questions around goals of care and to improve the documentation of these expressed wishes and preferences. Methods: Four acute care units across two separate hospitals participated in the Two Question Challenge. On each unit, over the course of two eight-hour shifts, all members of the interdisciplinary team were asked to select at least two questions from a selection of nine goals of care questions. They were asked to pose these questions of a patient or family member throughout their shift and then asked to document their conversations in a centralized Advance Care Planning/Goals of Care discussion record in the patient’s chart. A visual representation of conversation outcomes was created to demonstrate to staff and patients the breadth of conversations that took place throughout the challenge. Staff and patients were interviewed about their experiences throughout the challenge. Two palliative approach leads remained present on the units throughout the challenge to support, guide, or role model these conversations. Results: Across four acute care medical units, 47 interdisciplinary staff participated in the Two Question Challenge, including nursing, allied health, and a physician. A total of 88 questions were asked of patients, or their families around goals of care and 50 newly documented goals of care conversations were charted. Two code statuses were changed as a result of the conversations. Patients voiced an appreciation for these conversations and staff were able to successfully incorporate these questions into their daily care. Conclusion: The Two Question Challenge proved to be an effective way of having teams explore the goals of care of patients and families in an acute care setting. Staff felt that they gained confidence and competence. Both staff and patients found these conversations to be meaningful and impactful and felt they were notably different from their usual interactions. Documentation of these conversations in a centralized location that is easily accessible to all care providers increased significantly. Application of the Two Question Challenge in non-medical units or other care settings, such as long-term care facilities or community health units, should be explored in the future.

Keywords: advance care planning, goals of care, interdisciplinary, palliative approach, serious illness conversations

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Authors: Ali Alotaibi, Francis Edum-Fotwe, Andrew Price /

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Mega construction projects create buildings and major infrastructure to respond to work and life requirements while playing a vital role in promoting any nation’s economy. However, the industry is often criticised for not balancing economic, environmental and social dimensions of their projects, with emphasis typically on one aspect to the detriment of the others. This has resulted in many negative impacts including environmental pollution, waste throughout the project lifecycle, low productivity, and avoidable accidents. The identification of comprehensive Social Responsibility (SR) indicators, which combine social, environmental and economic aspects, is urgently needed. This is particularly the case in the context of the Kingdom of Saudi Arabia (KSA), which often has mega public construction projects. The aim of this paper is to develop a set of wide-ranging SR indicators which encompass social, economic and environmental aspects unique to the KSA. A qualitative approach was applied to explore relevant indicators through a review of the existing literature, international standards and reports. A list of appropriate indicators was developed, and its comprehensiveness was corroborated by interviews with experts on mega construction projects working with SR concepts in the KSA. The findings present 39 indicators and their metrics, covering 10 economic, 12 environmental and 17 social aspects of SR mapped against their references. These indicators are a valuable reference for decision-makers and academics in the KSA to understand factors related to SR in mega construction projects. The indicators are related to mega construction projects within the KSA and require validation in a real case scenario or within a different industry to demonstrate their generalisability.

Keywords: social responsibility, construction projects, economic, social, environmental, indicators

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Authors: Aidan N. Smallwood, Celestine R. Weegenaar, Jack N. Evans

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The intensive care unit (ICU) is a particularly resource heavy environment, in terms of staff, drugs and equipment required. Whilst many areas of the hospital are attempting to cut down on plastic use and minimise their impact on the environment, this has proven challenging within the confines of intensive care. Concurrently, as globalization has progressed over recent decades, there has been a tendency towards centralised manufacturing with international distribution networks for products, often covering large distances. In this study, we have modelled the standard consumption of plastic single-use items over the course of the first 24-hours of an average individual patient’s stay in a 12 bed ICU in the United Kingdom (UK). We have identified the country of manufacture and calculated the minimum possible distance travelled by each item from factory to patient. We have assumed direct transport via the shortest possible straight line from country of origin to the UK and have not accounted for transport within either country. Assuming an intubated patient with invasive haemodynamic monitoring and central venous access, there are a total of 52 distincts, largely plastic, disposable products which would reasonably be required in the first 24-hours after admission. Each product type has only been counted once to account for multiple items being shipped as one package. Travel distances from origin were summed to give the total distance combined for all 52 products. The minimum possible total distance travelled from country of origin to the UK for all types of product was 273,353 km, equivalent to 6.82 circumnavigations of the globe, or 71% of the way to the moon. The mean distance travelled was 5,256 km, approximately the distance from London to Mecca. With individual packaging for each item, the total weight of consumed products was 4.121 kg. The CO2 produced shipping these items by air freight would equate to 30.1 kg, however doing the same by sea would produce 0.2 kg CO2. Extrapolating these results to the 211,932 UK annual ICU admissions (2018-2019), even with the underestimates of distance and weight of our assumptions, air freight would account for 6586 tons CO2 emitted annually, approximately 130 times that of sea freight. Given the drive towards cost saving within the UK health service, and the decline of the local manufacturing industry, buying from intercontinental manufacturers is inevitable However, transporting all consumables by sea where feasible would be environmentally beneficial, as well as being less costly than air freight. At present, the NHS supply chain purchases from medical device companies, and there is no freely available information as to the transport mode used to deliver the product to the UK. This must be made available to purchasers in order to give a fuller picture of life cycle impact and allow for informed decision making in this regard.

Keywords: CO2, intensive care, plastic, transport

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Authors: Syeda Mainaaz Unnisa, Deepa Suresh

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Due to the increase in usage of public domain channels, such as the internet, and communication technology, there is a concern about the protection of intellectual property and security threats. This interest has led to growth in researching and implementing techniques for information hiding. Steganography is the art and science of hiding information in a private manner such that its existence cannot be recognized. Communication using steganographic techniques makes not only the secret message but also the presence of hidden communication, invisible. Steganalysis is the art of detecting the presence of this hidden communication. Parallel to steganography, steganalysis is also gaining prominence, since the detection of hidden messages can prevent catastrophic security incidents from occurring. Steganalysis can also be incredibly helpful in identifying and revealing holes with the current steganographic techniques, which makes them vulnerable to attacks. Through the formulation of new effective steganalysis methods, further research to improve the resistance of tested steganography techniques can be developed. Feature-based steganalysis method for JPEG images calculates the features of an image using the L1 norm of the difference between a stego image and the calibrated version of the image. This calibration can help retrieve some of the parameters of the cover image, revealing the variations between the cover and stego image and enabling a more accurate detection. Applying this method to various steganographic schemes, experimental results were compared and evaluated to derive conclusions and principles for more protected JPEG steganography.

Keywords: cover image, feature-based steganalysis, information hiding, steganalysis, steganography

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Authors: Liudmila A.Guzikova

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Being federative state Russia includes more than 80 subjects which are widely diverse by climatic conditions, demographic characteristics, cultural traditions, intensity of migration, economic development and investment attraction and other parameters. Now, in the regions of the country all forms of housing problem are present - housing mismatch to sanitary and hygienic standards, overcrowding, forced residence in financially burdensome housing, homelessness, -although the extent of these symptoms varies widely. Heterogeneity of regional conditions in combination with specifics of regional housing situation requires to concentrate the study of housing problem on the regional level. Traditionally housing market and mortgage are considered as the instruments of housing problem solving. The question arises how the housing market and mortgage market contribute to solving the housing problem in the regions of Russia. Though the purchase of dwelling in ownership should not be regarded as a universal method of the housing problem solving, the purchase of dwelling both by own funds or by use of mortgage can reduce the problem and enhance public satisfaction of living conditions. The aim of the study is to identify differences and similarities in the development of regional housing markets and mortgage lending in the regions of Russia and to evaluate their impact on the status of the housing problem. To achieve the aim of the study the methods of correlation and regression analysis are used. The data of federal statistics constitutes the information base of research. The results of the study contribute to better understanding of the interrelations in housing sphere and can be used to work out social and economic development programs in the regions.

Keywords: housing market, housing problem, mortgage, regional economy

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Authors: Işılay Tiarnagh Sheridan

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World EXPO, short version for the “exposition”, is a large universal public exhibition held since 1851. Within the 164 years, it was organized 34 times in 22 cities and as a result it has given birth to its very own culture unlike most of other international events. It has an outstanding power in transforming the places, in which it is held, into trademarks via changes in their urban tissues. For that, it is widely remembered with its cities instead of its countries. Within the scope of this change, some constructions were planned to be temporary, some planned to be permanent and some were thought to be temporary but kept afterwards becoming important monuments such as the Crystal Palace of London (though it was destroyed later by a fire) and the Eiffel Tower of Paris. These examples are the most prominent names upon considering World EXPOs. Yet, there are so many other legacies of these events within modern city fabric today that we don’t usually associate with its Expo history. Some of them are leading figures not only for the housing city but for other cities also, such as the first Metro line of Paris during 1900 World EXPO; some of them are listed as monuments of the cities such as Saint Louis Art Museum of 1904 World EXPO; some of them, like Melbourne Royal Exhibition Building of 1880 World’s EXPO, are among UNESCO World Heritage Sites and some of them are the masterpieces of modern architecture such as the famous Barcelona Pavilion, German pavilion of the 1929 World’s EXPO, of Ludwig Mies van der Rohe. Thus, the aim of this paper is to analyze the history of World’s EXPO and its eventual results in the birth of its own cultural heritage. Upon organizing these results, the paper aims to create a brief list of EXPO heritage monuments and sites so as to form a database for their further conservation needs.

Keywords: expo, heritage, world's fair, legacy

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Authors: Pinyada Santisarun, Yaowaret Tharawoot, Songyut Akkakoson

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This paper reports on a literature review sub-study of a larger research project which has been designed to identify the rhetorical organization of a travel writing genre, together with the use of lexical choices, syntactical structures, and graphological features, based on a randomly-selected corpus of Thailand travel listicles. Conducted as a library-based overview, this study aims to specify theoretical and practical elements for the said larger study. The materials for the review have been retrieved from various Internet sources, covering both public search engines and library databases. Generally, the article focuses on answering questions about the ‘what’ and the ‘how’ of such background elements widely discussed in the literature as the meaning of listicles, how the travel listicles’ patterns and regularities can be categorized to form a new genre, the effect of computer-mediated communication on the travel world, the travel language, and the current situation concerning the importance of travel listicles. The theoretical and practical data derived from this study provide valuable insights into the way in which the genre analysis and lexico-syntactical examination of Thailand travel listicles in the present authors’ larger research project can be properly conducted. The data gained can be added to the expanding body of knowledge in the field of the ESP genre.

Keywords: computer-mediated communication, digital writing, genre-based analysis, online travel writing, tourism language

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Authors: Nurul Hidayati

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Increasing public awareness of environmental pollution influences the search and development of technologies that help in clean up of organic and inorganic contaminants such as metals. Sludge waste of paper industries as toxic and hazardous material from specific source contains Pb, Zn, and Cu metal from waste soluble ink. An alternative and eco-friendly method of remediation technology is the use of biosurfactants and biosurfactant-producing microorganisms. Soil washing is among the methods available to remove heavy metal from sediments. The purpose of this research is to study effectiveness of biosurfactant with concentration = CMC for the removal of heavy metals, lead, zinc and copper in batch washing test under four different biosurfactant production by microbial origin. Pseudomonas putida T1(8), Bacillus subtilis 3K, Acinetobacter sp, and Actinobacillus sp was grown on mineral salt medium that had been already added with 2% concentration of molasses that it is a low cost application. The samples were kept in a shaker 120 rpm at room temperature for 3 days. Supernatants and sediments of sludge were separated by using a centrifuge and samples from supernatants were measured by atomic absorption spectrophotometer. The highest removal of Pb was up to 14,04% by Acinetobacter sp. Biosurfactant of Pseudomonas putida T1(8) have the highest removal for Zn and Cu up to 6,5% and 2,01% respectively. Biosurfactants have a role for removal process of the metals, including wetting, contact of biosurfactant to the surface of the sediments and detachment of the metals from the sediment. Biosurfactant has proven its ability as a washing agent in heavy metals removal from sediments, but more research is needed to optimize the process of removal heavy metals.

Keywords: biosurfactant, removal of heavy metals, sludge waste, paper industries

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Authors: Mpai Mokoena, Nsenda Lukumwena

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South Africa is one of the driest countries in the world and is facing a water crisis. In addition to inadequate infrastructure and poor planning, the country is experiencing high rates of water wastage due to pipe leaks. This study outlines the level of water wastage and develops a smart solution to efficiently manage and reduce the effects of pipe leaks, while monitoring the situation before and after fixing the pipe leaks. To understand the issue in depth, a literature review of journal papers and government reports was conducted. A questionnaire was designed and distributed to the general public. Additionally, the municipality office was contacted from a managerial perspective. The analysis from the study indicated that the majority of the citizens are aware of the water crisis and are willing to participate positively to decrease the level of water wasted. Furthermore, the response from the municipality acknowledged that more practical solutions are needed to reduce water wastage, and resources to attend to pipe leaks swiftly. Therefore, this paper proposes a specific solution for municipalities, local plumbers and citizens to minimize the effects of pipe leaks. The solution provides web and mobile application platforms to report and manage leaks swiftly. The solution is beneficial to the country in achieving water security and would promote a culture of responsibility toward water usage.

Keywords: urban distribution networks, leak management, mobile application, responsible citizens, water crisis, water security

Procedia PDF Downloads 138

Authors: Ki-Yeo Kim

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Trends in genetics are transforming in order to identify differential coexpressions of correlated gene expression rather than the significant individual gene. Moreover, it is known that a combined biomarker pattern improves the discrimination of a specific cancer. The identification of the combined biomarker is also necessary for the early detection of invasive oral squamous cell carcinoma (OSCC). To identify the combined biomarker that could improve the discrimination of OSCC, we explored an appropriate number of genes in a combined gene set in order to attain the highest level of accuracy. After detecting a significant gene set, including the pre-defined number of genes, a combined expression was identified using the weights of genes in a gene set. We used the Principal Component Analysis (PCA) for the weight calculation. In this process, we used three public microarray datasets. One dataset was used for identifying the combined biomarker, and the other two datasets were used for validation. The discrimination accuracy was measured by the out-of-bag (OOB) error. There was no relation between the significance and the discrimination accuracy in each individual gene. The identified gene set included both significant and insignificant genes. One of the most significant gene sets in the classification of normal and OSCC included MMP1, SOCS3 and ACOX1. Furthermore, in the case of oral dysplasia and OSCC discrimination, two combined biomarkers were identified. The combined genomic expression achieved better performance in the discrimination of different conditions than in a single significant gene. Therefore, it could be expected that accurate diagnosis for cancer could be possible with a combined biomarker.

Keywords: oral squamous cell carcinoma, combined biomarker, microarray dataset, correlated genes

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Authors: Murniwati, Nurul Khairiyah, Putri Ovieza Maizar

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The association between general and oral health is clearly important, particularly in adults with medical conditions. Many of the medical systemic conditions are either caused or aggravated by poor oral hygiene and vice versa. Hypertension is one of common medical systemic problem which has been a public health concern worldwide due to its known consequences. Those consequences must be related to oral health status as well, whether it may cause or worsen the oral health conditions. The objective of this study was to find out the association between hypertension and oral health status in adults. This study was an analytical observational study by using cross-sectional method. A total of 42 adults both male and female in Padusunan Village, Pariaman, West Sumatra, Indonesia were selected as subjects by using purposive sampling. Manual sphygmomanometer was used to measure blood pressure and dental examination was performed to calculate the decayed, missing, and filled teeth (DMFT) scores in order to represent oral health status. The data obtained was analyzed statistically using One Way ANOVA to determine the association between hypertensive adults and their oral health status. The result showed that majority age of the subjects was ranging from 51-70 years (40.5%). Based on blood pressure examination, 57.1% of subjects were classified to prehypertension. Overall, the mean of DMFT score calculated in normal, prehypertension and hypertension group was not considered statistically significant. There was no significant association (p>0.05) between hypertension and oral health status in adults.

Keywords: blood pressure, hypertension, DMFT, oral health status

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Authors: Pedro Batista, André Vinha, Filipe Castelo, Bárbara Costa, Ricardo Sousa, Raquel Ricardo, André Pinto

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Background: Septic arthritis is a diagnosis that must be considered in any patient presenting with acute joint swelling and fever. Among the several risk factors for septic arthritis, such as age, rheumatoid arthritis, recent surgery, or skin infection, diabetes mellitus can sometimes be the main risk factor. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, it is uncommon in monomicrobial necrotizing fasciitis. Objectives: A case report of concomitant septic arthritis and necrotizing fasciitis in a patient with undiagnosed diabetes based on clinical history. Study Design & Methods: We report a case of a 58-year-old Portuguese previously healthy man who presented to the emergency department with fever and left knee swelling and pain for two days. The blood work revealed ketonemia of 6.7 mmol/L and glycemia of 496 mg/dL. The vital signs were significant for a temperature of 38.5 ºC and 123 bpm of heart rate. The left knee had edema and inflammatory signs. Computed tomography of the left knee showed diffuse edema of the subcutaneous cellular tissue and soft tissue air bubbles. A diagnosis of septic arthritis and necrotising fasciitis was made. He was taken to the operating room for surgical debridement. The samples collected intraoperatively were sent for microbiological analysis, revealing infection by multi-sensitive Staphylococcus aureus. Given this result, the empiric flucloxacillin (500 mg IV) and clindamycin (1000 mg IV) were maintained for 3 weeks. On the seventh day of hospitalization, there was a significant improvement in subcutaneous and musculoskeletal tissues. After two weeks of hospitalization, there was no purulent content and partial closure of the wounds was possible. After 3 weeks, he was switched to oral antibiotics (flucloxacillin 500 mg). A week later, a urinary infection by Pseudomonas aeruginosa was diagnosed and ciprofloxacin 500 mg was administered for 7 days without complications. After 30 days of hospital admission, the patient was discharged home and recovered. Results: The final diagnosis of concomitant septic arthritis and necrotizing fasciitis was made based on the imaging findings, surgical exploration and microbiological tests results. Conclusions: Early antibiotic administration and surgical debridement are key in the management of septic arthritis and necrotizing fasciitis. Furthermore, risk factors control (euglycemic blood glucose levels) must always be taken into account given the crucial role in the patient's recovery.

Keywords: septic arthritis, Necrotizing fasciitis, diabetes, Staphylococcus Aureus

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Authors: Y. B. Kirankumar, J. D. Mallapur

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Wireless Sensor Network (WSN) is an emerging technology, which has great invention for various low cost applications both for mass public as well as for defence. The wireless sensor communication technology allows random participation of sensor nodes with particular applications to take part in the network, which results in most of the uncovered simulation area, where fewer nodes are located at far distances. The drawback of such network would be that the additional energy is spent by the nodes located in a pattern of dense location, using more number of nodes for a smaller distance of communication adversely in a region with less number of nodes and additional energy is again spent by the source node in order to transmit a packet to neighbours, thereby transmitting the packet to reach the destination. The proposed work is intended to develop Energy Efficient Node Placement Algorithm (EENPA) in order to place the sensor node efficiently in simulated area, where all the nodes are equally located on a radial path to cover maximum area at equidistance. The total energy consumed by each node compared to random placement of nodes is less by having equal burden on fewer nodes of far location, having distributed the nodes in whole of the simulation area. Calculating the network lifetime also proves to be efficient as compared to random placement of nodes, hence increasing the network lifetime, too. Simulation is been carried out in a qualnet simulator, results are obtained on par with random placement of nodes with EENP algorithm.

Keywords: energy, WSN, wireless sensor network, energy approach

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Authors: Josiel Delgadillo, Johnson Kinyua, Charles Mutigwe

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The purpose of sentiment analysis is to determine the sentiment strength (e.g., positive, negative, neutral) from a textual source for good decision-making. Natural language processing in domains such as financial markets requires knowledge of domain ontology, and pre-trained language models, such as BERT, have made significant breakthroughs in various NLP tasks by training on large-scale un-labeled generic corpora such as Wikipedia. However, sentiment analysis is a strong domain-dependent task. The rapid growth of social media has given users a platform to share their experiences and views about products, services, and processes, including financial markets. StockTwits and Twitter are social networks that allow the public to express their sentiments in real time. Hence, leveraging the success of unsupervised pre-training and a large amount of financial text available on social media platforms could potentially benefit a wide range of financial applications. This work is focused on sentiment analysis using social media text on platforms such as StockTwits and Twitter. To meet this need, SkyBERT, a domain-specific language model pre-trained and fine-tuned on financial corpora, has been developed. The results show that SkyBERT outperforms current state-of-the-art models in financial sentiment analysis. Extensive experimental results demonstrate the effectiveness and robustness of SkyBERT.

Keywords: BERT, financial markets, Twitter, sentiment analysis

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Authors: İlknur Gökşin, Sultan Ayaz Alkaya

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Objective: Progressive muscle relaxation (PMR) include the deliberate stretching and relaxation of the major muscle groups of the human body. This study was conducted to evaluate the effect of PMR applied in women on the postpartum depression and general comfort level. Methods: The study population of this quasi-experimental study with pre-test, post-test and control group consisted of primipara women who had vaginal delivery in the obstetric service of a university hospital. The experimental and control groups consisted of 35 women each. The data were collected by questionnaire, the Edinburgh Postnatal Depression Scale (EPDS) and the General Comfort Questionnaire (GCQ). The women were matched according to their age and education level and divided into the experimental and control groups by simple random selection. Postpartum depression risk and general comfort was evaluated at the 2nd and 5th days, 10th and 15th days, fourth week and eighth week after birth. The experimental group was visited at home and PMR was applied. After the first visit, women were asked to apply PMR regularly three times a week for eight weeks. During the application, the researcher called the participants twice a week to follow up the continuity of the application. No intervention was performed in the control group. For data analysis, descriptive statistics such as number, percentage, mean, standard deviation, significance test of difference between two means and ANOVA were used. Approval of the ethics committee and permission of the institution were obtained for the study. Results: There were no significant differences between the women in the experimental and control groups in terms of age, education status and employment status (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of EPDS pre-test, 1st, 2nd and 3rd follow-up mean scores (p>0.05). There was a statistically significant difference between EPDS pre-test and 3rd follow-up scores of the experimental group (p<0.05), whereas there was no such difference in the control group (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of mean GCQ pre-test scores (p>0.05), whereas in the 1st, 2nd and 3rd follow-ups there was a statistically significant difference between the mean GCQ scores (p<0.05). It was found that there was a significant increase in the GCQ physical, psychospiritual and sociocultural comfort sub-scales, relief and relaxation levels of the experimental group between the pre-test and 3rd follow-ups scores (p<0.05). And, a significant decrease was found between pre-test and 3rd follow-up GCQ psychospiritual, environmental and sociocultural comfort sub-scale, relief, relaxation and superiority levels (p<0.05). Conclusion: Progressive muscle relaxation was effective on reducing the postpartum depression risk and increasing general comfort. It is recommended to provide progressive muscle relaxation training to women in the postpartum period as well as ensuring the continuity of this practice.

Keywords: general comfort, postpartum depression, postpartum period, progressive muscle relaxation

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Authors: Tamar Grdzelishvili, Zaza Sinauridze

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Introduction: Preeclampsia is a complication of the second trimester of pregnancy, which is characterized by high morbidity and multiorgan damage. Many complex pathogenic mechanisms are now implicated to be responsible for this disease (1). Preeclampsia is one of the leading causes of maternal mortality worldwide. Statistics are enough to convince you of the seriousness of this pathology: about 100,000 women die of preeclampsia every year. It occurs in 3-14% (varies significantly depending on racial origin or ethnicity and geographical region) of pregnant women, in 75% of cases - in a mild form, and in 25% - in a severe form. During severe pre-eclampsia-eclampsia, perinatal mortality increases by 5 times and stillbirth by 9.6 times. Considering that the only way to treat the disease is to end the pregnancy, the main thing is timely diagnosis and prevention of the disease. Identification of high-risk pregnant women for PE and giving prophylaxis would reduce the incidence of preterm PE. First-trimester screening model developed by the Fetal Medicine Foundation (FMF), which uses the Bayes-theorem to combine maternal characteristics and medical history together with measurements of mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor, has been proven to be effective and have superior screening performance to that of traditional risk factor-based approach for the prediction of PE (2) Methods: Retrospective single center screening study. The study population consisted of women from the Tbilisi maternity hospital “Pineo medical ecosystem” who met the following criteria: they spoke Georgian, English, or Russian and agreed to participate in the study after discussing informed consent and answering questions. Prior to the study, the informed consent forms approved by the Institutional Review Board were obtained from the study subjects. Early assessment of preeclampsia was performed between 11-13 weeks of pregnancy. The following were evaluated: anamnesis, dopplerography of the uterine artery, mean arterial blood pressure, and biochemical parameter: Pregnancy-associated plasma protein A (PAPP-A). Individual risk assessment was performed with performed by Fast Screen 3.0 software ThermoFisher scientific. Results: A total of 513 women were recruited and through the study, 51 women were diagnosed with preeclampsia (34.5% in the pregnant women with high risk, 6.5% in the pregnant women with low risk; P<0.000 1). Conclusions: First-trimester screening combining maternal factors with uterine artery Doppler, blood pressure, and pregnancy-associated plasma protein-A is useful to predict PE in a routine care setting. More patient studies are needed for final conclusions. The research is still ongoing.

Keywords: first-trimester, preeclampsia, screening, pregnancy-associated plasma protein

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Authors: Vani Chintapally

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The expansion of modest and minimized Global Positioning System (GPS) beneficiaries has prompted most Automatic Vehicle Location (AVL) frameworks today depending solely on satellite-based finding frameworks, as GPS is the most stable usage of these. This paper shows the attributes of a proposed framework for following and dissecting open transport in a run of the mill medium-sized city and complexities the qualities of such a framework to those of broadly useful AVL frameworks. Particular properties of the courses broke down by the AVL framework utilized for the examination of open transport in our study incorporate cyclic vehicle courses, the requirement for particular execution reports, and so forth. This paper particularly manages vehicle movement forecasts and the estimation of station landing time, combined with consequently produced reports on timetable conformance and other execution measures. Another side of the watched issue is proficient exchange of information from the vehicles to the control focus. The pervasiveness of GSM bundle information exchange advancements combined with decreased information exchange expenses have brought on today's AVL frameworks to depend predominantly on parcel information exchange administrations from portable administrators as the correspondences channel in the middle of vehicles and the control focus. This methodology brings numerous security issues up in this conceivably touchy application field.

Keywords: automatic vehicle location (AVL), expectation of landing times, AVL security, data administrations, wise transport frameworks (ITS), guide coordinating

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Authors: Maximilian A. Richter

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The public authority needs to understand the role and impacts of autonomous vehicle (AV) on the mobility system. At present, however, research shows that the impact of AV on cities varies. As a consequence, it is difficult to make recommendations to policymakers on how they should prepare for the future when so much remains unknown about this technology. The study aims to provide an overview of the literature on how autonomous vehicles will affect the cities and traffic of the future. To this purpose, the most important studies are first selected, and their results summarized. Further on, it will be clarified which advantages AV have for cities and how it can lead to an improvement in the current problems/challenges of cities. To achieve the research aim and objectives, this paper approaches a literature review. For this purpose, in a first step, the most important studies are extracted. This is limited to studies that are peer-reviewed and have been published in high-ranked journals such as the Journal of Transportation: Part A. In step 2, the most important key performance indicator (KPIs) (such as traffic volume or energy consumption) are selected from the literature research. Due to the fact that different terms are used in the literature for similar statements/KPIs, these must first be clustered. Furthermore, for each cluster, the changes from the respective studies are compiled, as well as their survey methodology. In step 3, a sensitivity analysis per cluster is made. Here, it will be analyzed how the different studies come to their findings and on which assumptions, scenarios, and methods these calculations are based. From the results of the sensitivity analysis, the success factors for the implementation of autonomous vehicles are drawn, and statements are made under which conditions AVs can be successful.

Keywords: autonomous vehicles, city of the future, literature review, traffic simulations

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Authors: Einat E. Peles, Shaul Schreiber, Miriam Adelson

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Background: Since established more than 50 years ago, methadone maintenance treatment (MMT) is the most effective treatment for opioid addiction, a chronic relapsing brain disorder that became an epidemic in western societies. Treatment includes daily individual optimal medication methadone dose (a long acting mu opioid receptor full agonist), accompanied with psychosocial therapy. It is well established that the longer retention in treatment the better outcome and survival occur. It reduces the likelihood to infectious diseases and overdose death that associated with drug injecting, enhanced social rehabilitation and eliminate criminal activity, and lead to healthy productive life. Aim: To evaluate predictors for long term retention in treatment we analyzed our prospective follow up of a major MMT clinic affiliated to a big tertiary medical center. Population Methods: Between June 25, 1993, and June 24, 2016, all 889 patients ( ≥ 18y) who ever admitted to the clinic were prospectively followed-up until May 2017. Duration in treatment from the first admission until the patient quit treatment or until the end of follow-up (24 years) was taken for calculating cumulative retention in treatment using survival analyses (Kaplan Meier) with log-rank and Cox regression for multivariate analyses. Results: Of the 889 patients, 25.2% were females who admitted to treatment at younger age (35.0 ± 7.9 vs. 40.6 ± 9.8, p < .0005), but started opioid usage at same age (22.3 ± 6.9). In addition to opioid use, on admission to MMT 58.5% had positive urine for benzodiazepines, 25% to cocaine, 12.4% to cannabis and 6.9% to amphetamines. Hepatitis C antibody tested positive in 55%, and HIV in 7.8% of the patients and 40%. Of all patients, 75.7% stayed at least one year in treatment, and of them, 67.7% stopped opioid usage (based on urine tests), and a net reduction observed in all other substance abuse (proportion of those who stopped minus proportion of those who have started). Long term retention up to 24 years was 8.0 years (95% Confidence Interval (CI) 7.4-8.6). Predictors for longer retention in treatment (Cox regression) were being older on admission ( ≥ 30y) Odds Ratio (OR) =1.4 (CI 1.1-1.8), not abusing opioids after one year OR=1.8 (CI 1.5-2.1), not abusing benzodiazepine after one year OR=1.7 (CI 1.4-2.1) and treating with methadone dose ≥ 100mg/day OR =1.8 (CI 1.5-2.3). Conclusions: Treating and following patients over 24 years indicate success of two main outcomes, high rate of retention after one year (75.7%) and high proportion of opiate abuse cessation (67.7%). As expected, longer cumulative retention was associated with patients treated with high adequate methadone dose that successfully result in opioid cessation. Based on these findings, in order to reduce morbidity and mortality, we find the establishment of more MMT clinics within a general hospital, a most urgent necessity.

Keywords: methadone maintenance treatment, epidemic, opioids, retention

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Authors: Amirreza Razzaghipour, Mahdi Khalili

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References from the World Health Organization and the Center for Disease Control for deceleration the spread of the Novel COVID-19, comprises social estrangement, frequent handwashing, and covering your mouth when around others. As hearing healthcare specialists, the influence of existenceinvoluntary to boundary social interactions on persons with hearing impairment was significant for us to understand. We found ourselves delaying cochlear implant (CI) surgeries. All children, and chiefly those with hearing loss, are susceptible to reductions in spoken communication. Hearing plans, such as cochlear implants, provide children with hearing loss access to spoken communication and provision language development. when provided early and used consistently, these supplies help children with hearing loss to engage in spoken connections. Cochlear implant (CI) is a standard medical-surgical treatment for bilateral severe to profound hearing loss with no advantage with the hearing aid. Hearing is one of the most important senses in humans. Pediatric hearing loss establishes one of the most important public health challenges. Children with hearing loss are recognized early and habilitated via hearing aids or with cochlear implants (CIs). Suitable care and maintenance as well as continuous auditory verbal therapy (AVT) are also essential in reaching for the successful attainment of language acquisition. Children with hearing loss posture important challenges to their parents, particularly when there is limited admission to their hearing care providers. The disruption in the routine of their hearing and therapy follow-up services has had substantial effects on the children as well as their parents.

Keywords: healthcare, covid-19, cochlear implants, spoken communication, hearing loss

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Authors: Rezeda Khairutdinova, Chulpan Gromova, Dina Birman

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The paper presents results of an exploratory study of teachers’ social attitudes toward ethnic and religious diversity, and variables influencing such attitudes. The study was conducted in Russia and is focused on school teachers, given their special role in culturally diverse modern societies. Using the social distance scale (adapted from Bogardus, 1926), we sampled 355 school teachers from two Russian regions known for their high cultural diversity: Moscow and Moscow region, Kazan and Republic of Tatarstan, and measured teacher attitudes toward large religious and ethnic groups (including migrants). The findings showed that teachers hold mostly tolerant attitudes with respect to members belonging to culturally and religiously diverse groups. The social distance between respondents and native residents of their region was minimal. Social distance was larger with respect to such ethnic groups as migrants from the Caucasian and Central Asian countries. The analysis of perception of different religious groups also showed positive attitudes toward these groups and readiness to interact with them. Teacher attitudes were not related to their age or ethnicity. The findings indicated that there was a significant correlation between social distance and the region of residence on the one hand, and between social distance and the degree of social interaction on the other. The results of this study will be used to develop a large-scale study to contribute to a better understanding of teacher attitudes toward immigrant students in public schools.

Keywords: attitudes of teachers, cultural diversity, migrants, social distance

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Authors: Agil Gemilang Ramadhan, Novian Triandanu

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Since 1929, the first appearance in sea level, Anak Krakatau volcano growth relatively quickly. During the 80 years up to 2010 has reached the height of 320 meter above sea level. The possibility of catastrophic explosive eruption could happen again if the chemical composition of rocks from the eruption changed from alkaline magma into acid magma. Until now Anak Krakatau volcanic activity is still quite active as evidenced by the frequency of eruptions that produced ash sized pyroclastic deposits - bomb. Purpose of this study was to identify changes in the percentage of rock geochemistry any results eruption of Anak Krakatau volcano to see consistency change the percentage content of silica in the magma that affect the type of volcanic eruptions. Results from this study will be produced in the form of a diagram the data changes the chemical composition of rocks of Anak Krakatau volcano. Changes in the composition of any silica eruption are illustrated in a graph. If the increase in the percentage of silica is happening consistently and it is assumed to increase in the time scale of a few percent, then to achieve silica content of 68 % (acid composition) that will produce an explosive eruption will know the approximate time. All aspects of the factors driving the increased threat of danger to the public should be taken into account. Catastrophic eruption katatropis mitigation can be planned early so that when these disasters happen later, casualties can be minimized.

Keywords: Krakatau volcano, rock geochemistry, catastrophic eruption, mitigation

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Authors: Matias Micheletto, Rodrigo Santos, Sergio F. Ochoa

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In developing countries, the most roads in rural areas are dirt road. They require frequent maintenance since are affected by erosive events, such as rain or wind, and the transit of heavy-weight trucks and machinery. Early detection of damages on the road condition is a key aspect, since it allows to reduce the main-tenance time and cost, and also the limitations for other vehicles to travel through. Most proposals that help address this problem require the explicit participation of drivers, a permanent internet connection, or important instrumentation in vehicles or roads. These constraints limit the suitability of these proposals when applied into developing regions, like in Latin America. This paper proposes an alternative method, based on unattended crowdsensing, to determine the quality of dirt roads in rural areas. This method involves the use of a mobile application that complements the road condition surveys carried out by organizations in charge of the road network maintenance, giving them early warnings about road areas that could be requiring maintenance. Drivers can also take advantage of the early warnings while they move through these roads. The method was evaluated using information from a public dataset. Although they are preliminary, the results indicate the proposal is potentially suitable to provide awareness about dirt roads condition to drivers, transportation authority and road maintenance companies.

Keywords: dirt roads automatic quality assessment, collaborative system, unattended crowdsensing method, roads quality awareness provision

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Authors: Nazym Zhumabayeva, Aleksandr Mezin, Alexandra Knysheva

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Women's underrepresentation in STEM is critical, worsened by ineffective engagement in educational practices. UNICEF Kazakhstan and GameLab KBTU's collaborative initiatives aim to enhance female STEM participation by fostering an inclusive environment. Learning from LEVEL UP's 2023 program, which featured a hackathon, the 2024 strategy pivots towards non-competitive gamification. Although the data from last year's project showed higher than average student engagement, observations and in-depth interviews with participants showed that the format was stressful for the girls, making them focus on points rather than on other values. This study presents a gamified educational system, DPG Lab, aimed at incentivizing young women's participation in STEM through the development of digital public goods (DPGs). By prioritizing collaborative gamification elements, the project seeks to create an inclusive learning environment that increases engagement and interest in STEM among young women. The DPG Lab aims to find a solution to minimize competition and support collaboration. The project is designed to motivate female participants towards the development of digital solutions through an introduction to the concept of DPGs. It consists of a short online course, a simulation videogame, and a real-time online quest with an offline finale at the KBTU campus. The online course offers short video lectures on open-source development and DPG standards. The game facilitates the practical application of theoretical knowledge, enriching the learning experience. Learners can also participate in a quest that encourages participants to develop DPG ideas in teams by choosing missions throughout the quest path. At the offline quest finale, the participants will meet in person to exchange experiences and accomplishments without engaging in comparative assessments: the quest ensures that each team’s trajectory is distinct by design. This marks a shift from competitive hackathons to a collaborative format, recognizing the unique contributions and achievements of each participant. The pilot batch of students is scheduled to commence in April 2024, with the finale anticipated in June. It is projected that this group will comprise 50 female high-school students from various regions across Kazakhstan. Expected outcomes include increased engagement and interest in STEM fields among young female participants, positive emotional and psychological impact through an emphasis on collaborative learning environments, and improved understanding and skills in DPG development. GameLab KBTU intends to undertake a hypothesis evaluation, employing a methodology similar to that utilized in the preceding LEVEL UP project. This approach will encompass the compilation of quantitative metrics (conversion funnels, test results, and surveys) and qualitative data from in-depth interviews and observational studies. For comparative analysis, a select group of participants from the previous year's project will be recruited to engage in the DPG Lab. By developing and implementing a gamified framework that emphasizes inclusion, engagement, and collaboration, the study seeks to provide practical knowledge about effective gamification strategies for promoting gender diversity in STEM. The expected outcomes of this initiative can contribute to the broader discussion on gamification in education and gender equality in STEM by offering a replicable and scalable model for similar interventions around the world.

Keywords: collaborative learning, competitive learning, digital public goods, educational gamification, emerging regions, STEM, underprivileged groups

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Authors: Rafael Estrada, Cristian Ruiz Rueda

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Carbapenems are last-resort antibiotics used in clinical settings to treat antibiotic-resistant bacterial infections. Thus, the emergence and spread of resistance to carbapenems is a major public health concern. Here, we have studied a carbapenem-resistant Aeromonas veronii strain previously isolated from a water sample from Sam Simeon Creek (Hearst San Simeon State Park, CA). Analysis of this isolate using disk-diffusion, CarbaNP, eCIM and mCIM assays revealed that it was resistant to amoxicillin-clavulanic acid and all carbapenems tested and that this isolate produced a potentially novel carbapenemase of the Metallo-β-lactamase family. Whole genome sequencing analysis revealed that this A. veronii isolate carries a novel variant of the blacₚₕₐ class β-carbapenemase gene that was closely related to the blacₚₕₐ₇ gene of Aeromonas jandaei. This isolate also carried a novel variant of the blaₒₓₐ class D carbapenemase gene that was most closely related to the blaₒₓₐ-₉₁₂ gene found in other Aeromonas veronii isolates. Finally, we also identified a novel class C β-lactamase gene moderately related to the blaFₒₓ-₁₇ gene of Providencia stuartii and other blaFₒₓ variants identified in Klebsiella pneumoniae, Escherichia coli and other Enterobacteriaceae. Overall, our findings reveal that environmental isolates are an important reservoir of multiple carbapenemases and other β-lactamases of clinical significance.

Keywords: β-lactamases, carbapenem, antibiotic-resistant, aeromonas veronii

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Authors: Diamantino Ribeiro, António Pedro Costa, Jorge Remondes

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Dubai and the UAE governments have been investing in technology and digital communication for a long time. These governments are pioneers in introducing innovative strategies, policies and projects. They are also recognized worldwide for defining and implementing long term public programs. In terms of eGovernment Dubai and the UAE rank among the world’s most advanced. Both governments have surprised the world a few years ago by creating a Happiness Ministry. This paper focuses on UAE’s government digital strategies and its approach to the next era. The main goal of this exploratory study is to understand the new era of eGovernment and transfer of the happiness and wellness programs. Data were collected from the corpus latente and analysis was anchored in qualitative methodology using content analysis and observation as analysis techniques. The study allowed to highlight that the 2020 government reshuffle has a strong focus on digital reorganisation and digital sustainability, one of the newest trends in sustainability. Regarding happiness and wellbeing portfolio, we were able to observe that there has been a major change within the government organisation: The Ministry of Happiness was extinct and the Ministry of Community Development will manage the so-called ‘Happiness Portfolio’. Additionally, our observation allowed to note the government dual approach to governance: one through digital transformation, thus enhancing the digital sustainability process and, the second one trough government development.

Keywords: ministry of happiness, eGovernment, communication, digital sustainability

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