Search results for: critical care

Authors: Fabiana Lucena Oliveira, Aristides da Rocha Oliveira Junior

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This article discusses the dependence on air transport mode of agile supply chains. The agile supply chains are the result of the analysis of the uncertainty supply chain model, which ranks the supply chain, according to the respective product. Thus, understanding the Uncertainty Model and life cycle of products considered standard and innovative is critical to understanding these. The innovative character in the intersection of supply chains arising from the uncertainty model with its most appropriate transport mode. Consider here the variables availability, security and freight as determinants for choosing these modes. Therefore, the research problem is: How agile supply chains maintains logistics competitiveness, as these are dependent on air transport mode? A case study in Manaus Industrial Pole (MIP), an agglomeration model that includes six hundred industries from different backgrounds and billings, located in the Brazilian Amazon. The sample of companies surveyed include those companies whose products are classified in agile supply chains , as innovative and therefore live with the variable uncertainty in the demand for inputs or the supply of finished products. The results confirm the hypothesis that the dependency level of air transport mode is greater than fifty percent. It follows then, that maintain agile supply chain away from suppliers base is expensive (1) , and continuity analysis needs to be remade on each twenty four months (2) , consider that additional freight, handling and storage as members of the logistics costs (3) , and the comparison with the upcoming agile supply chains the world need to consider the location effect (4).

Keywords: uncertainty model, air transport mode, competitiveness, logistics

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Authors: Tomas Trainys, Algimantas Venckauskas

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Application of biometric features to the cryptography for human identification and authentication is widely studied and promising area of the development of high-reliability cryptosystems. Biometric cryptosystems typically are designed for patterns recognition, which allows biometric data acquisition from an individual, extracts feature sets, compares the feature set against the set stored in the vault and gives a result of the comparison. Preprocessing and fusion of biometric data are the most important phases in generating a feature vector for key generation or authentication. Fusion of biometric features is critical for achieving a higher level of security and prevents from possible spoofing attacks. The paper focuses on the tasks of initial processing and fusion of multiple representations of finger vein modality patterns. These tasks are solved by applying conventional image preprocessing methods and machine learning techniques, Convolutional Neural Network (SVM) method for image segmentation and feature extraction. An article presents a method for generating sets of biometric features from a finger vein network using several instances of the same modality. Extracted features sets were fused at the feature level. The proposed method was tested and compared with the performance and accuracy results of other authors.

Keywords: bio-cryptography, biometrics, cryptographic key generation, data fusion, information security, SVM, pattern recognition, finger vein method.

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Authors: Sri Wartini

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Based on the sovereignty over natural resources principle, the Indonesian government has an authority to exploit the natural resources within a national jurisdiction of Indonesia. The forest is one of the natural resources which is very valuable for Indonesia. It becomes the source of raw material for many industrial activities, such as pharmaceutical industry, pulp industry, and household furniture industry. Hence, it contributes to the economic development of Indonesia. However, the exploitation of the forest may cause negative impacts, such as environmental pollution and environmental degradation. The implementation of the sovereignty over natural resources principle in Indonesia may jeopardize the forest and affect the sustainability of the forest if there is no appropriate policy of the government to exploit the forest in a sustainable manner. The exploitation of the forest in Indonesia, in some extent, has caused serious impact to environment and biodiversity. Hence, in order to sustain and to maintain the forest as the valuable resources to the future generation, the government of Indonesia has already adopted many programmes and action plans. The aim of the research is to undertake a critical examination of the issues relating to the the implementation of sovereignty over natural resources to the exploitation of the forest in Indonesia. It is a normative research and the methodology employed in this research is library research. While the approaches employed in the research are conceptual approach., statutory approach, and comparative approach. The research finds that the implementation of sovereignty over natural resources principle in the exploitation of the forest in Indonesia is limited by other principles of international environmental law, such as sustainable development principle, intergenerational principle and common concern principle which have been adopted in the government policy and various regulations regarding the exploitation of the forest in Indonesia.

Keywords: Environmental damage, negative impacts, pollution, the sovereignty over natural resources

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Authors: Rosalina Penaloza, Joanna Navarro, Pauline Jolly, Anna Junkins, Carlos Seas, Larissa Otero

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Background: Tuberculosis (TB) case detection in Peru relies on passive case finding. This strategy relies on the assumption that the community is aware that a persistent cough is a possible symptom of TB and that formal health care needs to be sought. Despite its importance, health knowledge specific to TB is underexplored in Peru. This study aimed to assess health literacy and level of TB knowledge among outpatients attending a referral hospital in Lima, Peru. The goal was to ascertain knowledge gaps in key areas relating to TB, to identify and prioritize subgroups for intervention, and to provide insight for policy and community interventions considering health literacy. Methods: An observational cross-sectional study was conducted using a survey to measure sociodemographic factors, tuberculosis knowledge, and health literacy. Bivariate and Multivariate logistic regression was performed to study the associations between variables and to account for potential confounders. The study was conducted at Hospital Cayetano Heredia in Lima, Peru from June – August 2017. Results: 272 participants were included in the analysis. 57.7% knew someone who had had TB before, 9% had had TB in the past. Two weeks a cough was correctly identified as a symptom that could be TB by 69.1%. High TB knowledge was found among 149 (54.8%) participants. High health literacy was found among 193 (71.0%) participants. Health literacy and TB knowledge were not significantly associated (OR 0.9 (95%CI 0.5-1.5)). After controlling for sex, age, district, education, health insurance, frequency of hospital visits and previous TB diagnosis: High TB knowledge was associated with knowing someone with TB (aOR 2.7 (95%CI 1.6-4.7)) and being a public transport driver, (aOR 0.2 (95%CI 0.05-0.9)). Not being poor was the single factor associated with high health literacy (aOR 3.8 (95%CI 1.6-8.9)). Conclusions: TB knowledge was fair, though 30% did not know the most important symptom of TB. Tailoring educational strategies to risk groups may enhance passive case detection especially amongst transport workers in Lima, Peru.

Keywords: health literacy, Peru, tuberculosis, tuberculosis knowledge

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Authors: Kishore Kumar R., Kaustav Sengupta, Shalini Sood Sehgal, Poornima Santhanam

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Fashion is a human expression that is constantly changing. One of the prime factors that consistently influences fashion is the change in colour preferences. The role of colour in our everyday lives is very significant. It subconsciously explains a lot about one’s mindset and mood. Analyzing the colours by extracting them from the outfit images is a critical study to examine the individual’s/consumer behaviour. Several research works have been carried out on extracting colours from images, but to the best of our knowledge, there were no studies that extract colours to specific apparel and identify colour patterns geographically. This paper proposes a framework for accurately extracting colours from T-shirt images and predicting dominant colours geographically. The proposed method consists of two stages: first, a U-Net deep learning model is adopted to segment the T-shirts from the images. Second, the colours are extracted only from the T-shirt segments. The proposed method employs the iMaterialist (Fashion) 2019 dataset for the semantic segmentation task. The proposed framework also includes a mechanism for gathering data and analyzing India’s general colour preferences. From this research, it was observed that black and grey are the dominant colour in different regions of India. The proposed method can be adapted to study fashion’s evolving colour preferences.

Keywords: colour analysis in t-shirts, convolutional neural network, encoder-decoder, k-means clustering, semantic segmentation, U-Net model

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Authors: Getaneh Berie Tarekegn

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A precise localization system is crucial for many artificial intelligence Internet of Things (AI-IoT) applications in the era of smart cities. Their applications include traffic monitoring, emergency alarming, environmental monitoring, location-based advertising, intelligent transportation, and smart health care. The most common method for providing continuous positioning services in outdoor environments is by using a global navigation satellite system (GNSS). Due to nonline-of-sight, multipath, and weather conditions, GNSS systems do not perform well in dense urban, urban, and suburban areas.This paper proposes a generative AI-based positioning scheme for large-scale wireless settings using fingerprinting techniques. In this article, we presented a semi-supervised deep convolutional generative adversarial network (S-DCGAN)-based radio map construction method for real-time device localization. It also employed a reliable signal fingerprint feature extraction method with t-distributed stochastic neighbor embedding (t-SNE), which extracts dominant features while eliminating noise from hybrid WLAN and long-term evolution (LTE) fingerprints. The proposed scheme reduced the workload of site surveying required to build the fingerprint database by up to 78.5% and significantly improved positioning accuracy. The results show that the average positioning error of GAILoc is less than 0.39 m, and more than 90% of the errors are less than 0.82 m. According to numerical results, SRCLoc improves positioning performance and reduces radio map construction costs significantly compared to traditional methods.

Keywords: location-aware services, feature extraction technique, generative adversarial network, long short-term memory, support vector machine

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Authors: E. Xavier, B. Nandita

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Rohingyas are an ethnic and religious minority that resides in the Rakhine State of Myanmar. Post the military coup in 1962, Rohingyas have not been recognized as one of the ethnic tribes of Burma under the legislation. They have lost citizenship, education, health care rights, and instantly became illegal immigrants. While the historicization of this conflict is crucial, this paper wants to humanize the Rohingya population’s embodiment of violence on three different levels – individual, social, and political. In addition, the study focuses on their liminal existence in refugee camps in Bangladesh and in other parts of the world, such as Malaysia and the United States of America. A multi-medium study, it includes first-hand interviews with the Rohingya community in Wisconsin and Chicago, second-hand interviews from documentaries and past ethnographies from scholars to draw meaningful conclusions about their experience as a community. In the end, it focuses on the group of Rohingyas who have managed to resettle in another country and their transitioning experience. Rohingyas embody violence on their individual, social, and political bodies in different ways. Along with rape, murder, and physical harm, the community also encounters sexually transmitted infections, post-traumatic stress disorder symptoms, and poor mental health. On a social level, they encounter heightened gender discrimination, work industry shifting, and immense, shared emotional pain. As for their political body, the news media and journalism industry uses their bodies for purposes that benefit both parties and flirts with a tone of sensationalism in their reporting. In addition, the Rohingya community fluctuates with the concept of nationality, patriotism, citizenship, and refugee when they think about the future. This study provides a framework that future aid or health programs can use to determine the type of community need and its significance in the Rohingya community.

Keywords: embodiment, liminal, refugee, Rohingya

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Authors: Richard S. Jatau, Kankanala Venkateswarlu, Bulus Kpame

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The purpose of this critical review is to find out what is known and what is unknown about the effects of aging on endurance performance, especially on ultra- triathlon performance. It has been shown that among master’s athlete’s peak levels of performance decreased by 50% by age 50 it has also been clearly revealed that age associated atrophy, weakness and fatigability cannot be halted, although year round athletic training can slow down this age associated decline. Studies have further revealed that 30% to 50% decrease in skeletal muscle mass between ages 40 and 80 years, which is accompanied by an equal or even greater decline in strength and power and an increase in muscle weakness and fatigability. Studies on ultra- triathlon athletes revealed that 30 to 39 year old showed fastest time, with athletes in younger and older age groups were slower. It appears that the length of the endurance performance appears to influence age related endurance performance decline in short distance triathlons. A significant decline seems to start at the age of 40 to 50 years, whereas in long distance triathlons this decline seems to start after the age of 65 years. However, it is not clear whether this decline is related in any way to the training methods used, the duration of training, or the frequency of training. It’s also not clear whether the triathlon athletes experience more injuries due to long hours of training. It’s also not clear whether these athletes used performance enhancing drugs to enhance their performance. It’s not also clear whiles there has been tremendous increase in the number of athletes specializing in triathlon. On the basis of our experience and available research evidence we have provided answers to some of these questions. We concluded that aging associated decline in ultra–endurance performance is inevitable although it can be slowed down.

Keywords: aging, triathlon, atrophy, endurance

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Authors: Mohamad Reza Asariha

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The development and extension of modern communication innovations at an extraordinary speed has caused crucial changes in all financial, social, social and political areas of the world. The improvement of toady and cable innovations, in expansion to expanding the generation and dissemination needs of worldwide programs; the financial defense made it more appealing. The alter of the administration of mechanical economy to data economy and benefit economy in created nations brought approximately uncommon advancements within the standards of world exchange and as a result, it caused the extension of media organizations in outside measurements, and the advancement of financial speculations in many Asian nations, beside the worldwide demand for the utilization of media merchandise, made new markets, and the media both within the household scene of the nations and within the universal field. Universal and financial are of great significance and have and viable and compelling nearness within the condition of picking up, keeping up and expanding financial control and riches within the world. Moreover, mechanical progresses and mechanical joining are critical components in media auxiliary alter. This auxiliary alter took put beneath the impact of digitalization. That’s, the method that broke the boundaries between electronic media administrations. Until presently, the direction of mass media was totally subordinate on certain styles of data transmission that were for the most part utilized. Digitization made it conceivable for any content to be effortlessly transmitted through distinctive electronic transmission styles, and this media merging has had clear impacts on media approaches and the way mass media are controlled.

Keywords: media, digital era, digital ages, media convergence

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Authors: Sankalpa Satapathy

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The stigma attached to disability is very high in India and given its patriarchal society women and their interests have always been pushed to the background. The identity of disabled women is compromised under the social construction of disability which lowers their self-esteem and hampers their development. Disability policies in India have focused on provision of educational and employment opportunities to make them economically productive members of the society. This preoccupation with the materialistic spheres of lives of the disabled has led to a neglect of the private sphere concerning intimate social relationships and motherhood. This paper seeks to bring to forefront the private lives of disabled women. Semi-structured in-depth interviews were conducted with twenty seven women with physical disability (congenital/acquired) from Odisha, a state in India. Sampling was done in a manner to include women from various strata of the society to allow meaningful analysis. In a society where paramount importance is attached to wifehood and motherhood, the chances of marriage for disabled women were very low compared to disabled men. Majority believed that marriage and having a family was meant for non disabled women and had decided against getting married. Socialization process was found to be a major factor in determining the ideas and aspirations of disabled women. They were clearly sidelined by their families on the issue of marriage. Education and employment levels did not seem to increase the appeal of disabled women to prospective suitors. But not all the women interviewed were closed to the idea of intimate relationships and marriage. Disabled women who were married or hoped to get married in future were found to have a better body image and greater self motivation. It is interesting to understand the means by which these women, who have been brought up to internalize ideas of their unattractiveness, undesirability, asexuality and inability to care, established identities which have so long been denied to them. With these stories of personal triumphs an attempt is made for reclamation of private spheres which have been abandoned by disability policies and make them gender sensitive.

Keywords: disability, gender, marriage, relationships

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Authors: Bilal Zubair

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In a constantly challenging internal security environment, Pakistan is making ways to improvise and respond to the new variations in the pervasive phenomenon of terrorism. The state’s endeavors towards securitizing terrorism as an existential threat are both extensive and intensive which have systematically incorporated both military and non-military means. Since 2007, the military has been conducting intermittent operations and by 2014 has successfully neutralized the terrorist ability to target vital security installations and security personal. The terrorists have responded by targeting communities which are soft targets and extremely vulnerable to organized assaults. Within this context, the study aims to explain the emerging trends of terrorism in Pakistan, which multi-layered and complex developments are having far-reaching implications for state and society. With a view to explore the underlining reasons, present trends and ensuing ramifications of the emerging trends in terrorism, this study would examine the following: First, the historical processes and development of Terrorism in Pakistan; secondly the processes of securitization which include political consensus, legal frameworks and military operations against the terrorist groups; thirdly , the socio-cultural dimensions and geopolitical influences on the transforming nature of sectarian terrorism. The study will also highlight the grey areas and weak links in the ongoing securitization process. Finally, the study will thoroughly explore the societal insecurity which is manifested in internal displacements, identity crisis and weakening the socio-political fabric of the state.

Keywords: counter-terrorism, terrorism, sectarianism, securitizing

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Authors: Vinay Mishra, Meena Malkani

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Objectives: To study the effect of physical maternal nutritional markers (viz. weight, height, gestational weight gain, BMI) and third-trimester haemoglobin concentration on anthropometry and cord blood haemoglobin of their newborn. Methods: Study area: Post-natal ward of a tertiary care hospital in an urban area. Study population: All post-partum women and their newborns. Sample size: 100. Maternal and neonatal data and anthropometric measurements were recorded in semi-structured case proforma. Data analysis: The data obtained was analysed using SPSS 20 software.The comparison between the groups was done using One-Way Analysis of Variance for two groups. For more than two groups comparisons further posthoc analysis was done using Tukey test. Pearson correlation coefficient was used for correlating the variables. A P value less than 0.05 was considered significant. Results: 1. Out of the 100 studied mothers, 52% were anaemic. 2. Cord blood haemoglobin values decreased significantly with the order of birth. 3. Cord blood haemoglobin of normal-weight newborns is significantly higher as compared to that of LBW newborns. 4. Cord blood haemoglobin has strong statistical significance with maternal anaemia. 5. Pre-pregnancy weight and gestational weight gain significantly influence the neonates anthropometry. Conclusions: 1. Birth order has a prominent inverse effect on the cord blood haemoglobin. 2. Majority of the expectant mothers are anaemic and give birth to LBW babies with reduced anthropometric markers. 3. Pre-pregnancy weight, height and gestational weight gain has a very significant impact on the neonatal anthropometry. 4. Thus, maternal nutrition during gestation and during the crucial periods of growth in the pre-child bearing age group has a very significant impact on foetal development.

Keywords: maternal nutrition, anthropometry, cord blood hemoglobin, newborn

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Authors: Saeeda Batool, Ather Maqsood Ahmed

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This study investigates the impact of public healthcare facilities and socio-economic circumstances on the status of child health in Pakistan. The complete analysis is carried out in correspondence with fourth and sixth millennium development goals. Further, the health variables chosen are also inherited from targeted indicators of the mentioned goals (MDGs). Trends in the Human Opportunity Index (HOI) for both health inequalities and coverage are analyzed using the Pakistan Social and Living Standards Measurement (PLSM) data set for 2001-02 to 2012-13 at the national and provincial level. To reveal the relative importance of each circumstance in achieving the targeted values for child health, Shorrocks decomposition is applied on HOI. The annual point average growth rate of HOI is used to simulate the time period for the achievement of target set by MDGs and universal access also. The results indicate an improvement in HOI for a reduction in child mortality rates from 52.1% in 2001-02 to 67.3% in 2012-13, which confirms the availability of healthcare opportunities to a larger segment of society. Similarly, immunization against measles and other diseases such as Diphtheria, Polio, Bacillus Calmette-Guerin (BCG), and Hepatitis has also registered an improvement from 51.6% to 69.9% during the period of study at the national level. On a positive note, no gender disparity has been found for child health indicators and that health outcome is mostly affected by the parental and geographical features and availability of health infrastructure. However, the study finds that this achievement has been uneven across provinces. Pakistan is not only lagging behind in achieving its health goals, disappointingly with the current rate of health care provision, but it will take many additional years to achieve its targets.

Keywords: socio-economic circumstances, unmet MDGs, public healthcare services, child and infant mortality

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Authors: Chhavi Rana, Sanjay K Jain

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All sides of every education debate agree that quality learning happens when knowledgeable, caring teachers use sound pedagogy. Many deliberations of pedagogy make the fault of considering it as principally being about teaching. There has been lot of research about how to build a positive climate for learning, improve student curiosity, and enhance classroom association. However, these things can only be facilitated when teachers are equipped with better teaching techniques that use sound and accurate pedagogy. Pedagogy is the science and art of education. Its aims range from the full development of the human being to skills acquisition. In India, a project named Mission 10 x has been started by an esteemed IT Corporation Wipro as a faculty development programme (FDP) that particularly focus on elements that facilitated teachers in developing curriculum and new pedagogies that can lead to improvement in student engagement. This paper presents a study of these FDPs and examines (1) the parameters that help teachers in building new pedagogies (2) the extent to which appropriate usage of pedagogy is improved after the conduct of Mission 10 x FDPs, and (3) whether institutions differ in terms of their ability to convert usage of improved pedagogy into academic performance via these FDPs. The sample consisted of 2,236 students at 6 four-year engineering colleges and universities that completed several FDPs during 2012-2014. Many measures of usage of better pedagogy were linked positively with such FDPs, although some of the relationships were weak in strength. The results suggest that the usage of pedagogy were more benefited after conducting these FDPs and application of novel approaches in conducting classes.

Keywords: student engagement, critical thinking; achievement, student learning, pedagogy

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Authors: Brandon Foggo, Nanpeng Yu

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Power distribution circuits undergo frequent network topology changes that are often left undocumented. As a result, the documentation of a circuit’s connectivity becomes inaccurate with time. The lack of reliable circuit connectivity information is one of the biggest obstacles to model, monitor, and control modern distribution systems. To enhance the reliability and efficiency of electric power distribution systems, the circuit’s connectivity information must be updated periodically. This paper focuses on one critical component of a distribution circuit’s topology - the secondary transformer to phase association. This topology component describes the set of phase lines that feed power to a given secondary transformer (and therefore a given group of power consumers). Finding the documentation of this component is call Phase Identification, and is typically performed with physical measurements. These measurements can take time lengths on the order of several months, but with supervised learning, the time length can be reduced significantly. This paper compares several such methods applied to Phase Identification for a large range of real distribution circuits, describes a method of training data selection, describes preprocessing steps unique to the Phase Identification problem, and ultimately describes a method which obtains high accuracy (> 96% in most cases, > 92% in the worst case) using only 5% of the measurements typically used for Phase Identification.

Keywords: distribution network, machine learning, network topology, phase identification, smart grid

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Authors: Danila Zuffetti, Lorenzo Chiesa

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Background: A hospice narrative interview aims at putting the sick at the core of disease and treatment allowing them to explore their most intimate facets. The aim of this work is to favor authentic narration by leading towards awareness and acceptance of terminality and to face death with serenity. Narration in palliative care aims at helping to reduce the chaos generated by the disease and to elaborate interpretations on the course of reality, besides, the narration delivered to the doctor is fundamental and communicates the meaning given to symptoms. Methods: The narrative interview has become a regular activity in the Castellini Foundation since 2017. Patients take part every week, and for more days, in one hour sessions, in a welcoming and empathic setting and the interaction with the operator leads to a gradual awareness of their terminality. Patients are submitted with free answer questions with the purpose of facilitating and stimulating self-narration. Narration has not always been linear, but patients are left free to shift in time to revisit their disease process by making use of different tools, such as digital storytelling. Results: The answers provided by the patients show to which extent the narrative interview is an instrument allowing the analysis of the stories and gives the possibility to better understand and deepen the different implications of patient and caregiver’s background. Conclusion: The narration work in the hospice demonstrates that narrative medicine is an added value. This instrument has proven useful not only in the support of patients but also for the palliative doctor to identify wishes for accompanying them to the end with dignity and serenity. The narrative interview favors the construction of an authentic therapeutic relationship. The sick are taken wholly in charge, and they are guaranteed a high quality of life until their very last instant.

Keywords: construction of an authentic therapy relationship, gradual awareness of their terminality, narrative interview, reduce the chaos generated by the desease

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Authors: Marine Kobalava

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Introduction. The paper substantiates the crucial role of anti-crisis PR in managing the image and reputation of companies. The critical situation caused by the Covid-19 virus in various countries of the world and the actions taken have had a significant negative impact on the image of companies and public groups. The mentioned circumstance has caused some problems for companies’ products in terms of customer demand. Accordingly, the main goal of PR has become to achieve the optimal relationship between companies and society with effective management. It should also be taken into account that the range of action of PR in crisis situations is much wider than that of advertising. In the paper, Public Relations is evaluated as a determining factor of the companies' prestige, its reliability, which has a decisive effect on the goodwill, trust, and general reputation of the public towards the company. The purpose of the study is to reveal the challenges of anti-crisis PR in Georgian companies and to develop recommendations on effective management mechanisms. Methodologies. Analysis, induction, synthesis, and other methods are used in the paper; Matrix and SWOT analysis are constructed. Ways of establishing and implementing an anti-crisis PR system in companies are proposed. The main aspects of anti-crisis management are identified by using the matrix of the choice of diversification strategy of the companies' activities, the possibilities of making adequate decisions using PR are studied according to the characteristics of the companies' activities and priority directions. Conclusion. The paper draws conclusions on modern problems of anti-crisis PR, offers recommendations on ways to solve it through PR strategies.

Keywords: anti-crisis PR, effective management, company, PR strategy

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Authors: Sanjeev Singh

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Background: Obstructed total anomalous pulmonary venous connection (OTAPVC) typically presents with severe cardiovascular decompensation and requires urgent surgical management. Pulmonary arterial hypertension (PAH) is a major risk factor affecting mortality. Perioperative management focuses on providing inotropic support and managing potential pulmonary hypertensive episodes. The aim of this study was to determine the outcome of patients with high pulmonary arterial pressure (PAP) with milrinone alone and a combination of milrinone and inhaled nitric oxide (INO). Material and Methods: After the approval of the ethical committee, this single-center prospective randomized and observational study was conducted over a period of two years among eighty-six patients with obstructed TAPVC repair with severe PAH. Group-I patients received milrinone, and Group-II patients received both milrinone (after aortic cross-clamp removal) and INO during the post-operative period at the cardiac care unit (CCU). Clinical outcomes such as ventilation time, length of stay (LOS) in the CCU, LOS in the hospital, complications, and hospital mortality were compared between the two groups. Result: The average ventilation time, LOS in CCU, and LOS in hospital for group I were 96.82 ± 19.46 hours, 10.91 ± 7.53 days, and 14.46 ± 7.58 days, respectively, and for group II, it was 85.14 ± 15.79 hours, 7.28 ± 3.68 days, and 10.21 ± 3.14 days, respectively, which was statistically significantly lower for group II. Reintubation, RV dysfunction, and hospital mortality were 16.3%, 37.2%, and 6.9% in group I, and 4.8%, 14.6%, and 2.4% in group II, respectively. The P value for each variable was significant < 0.05 (except mortality). Conclusion: Preoperative obstruction is a risk factor for postoperative obstruction, as 235 patients with obstructed TAPVC had severe PAH (39.98%) in this study. Management of severe PAH with a combination of milrinone and INO had a better outcome than milrinone alone.

Keywords: inhaled nitric oxide, milrinone, pulmonary artery hypertension, total anomalous pulmonary venous connection

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Authors: Daniel Afolayan, Christina Olawepo, Francis Olowookanga, Nguhemen Tingir, Olawale Fadare, John Oko

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In Nigeria, traditional birth attendants (TBAs) can play an important role in the prevention of mother-to-child transmission of HIV. However, their role in improving access to antiretroviral therapy (ART) is unclear. Catholic Caritas Foundation of Nigeria (Caritas Nigeria) is an implementing agency supporting increased access to HIV testing and treatment services in Lagos state through health facilities including Mother Theresa Hospital. Despite intra-facility testing and community outreaches, ART uptake at Mother Theresa Hospital, Lagos was low with 6 individuals on antiretroviral drugs 3 months post-activation. This study explored improving access to ART through linkages with TBAs for ART uptake at the facility. Plan-Do-Study-Act model was used. The goal was to improve uptake of ART from 6 to 80 in 5 months (end of project year). Scanning revealed a network of 15 TBAs with potential as satellites for HIV testing. Caritas Nigeria linked the facility with 15 TBAs who were provided with HIV test kits and trained on HIV testing services for provider-initiated testing and outreaches. Weekly reports and referrals of positives were received, tracked and feedback given on testing yield. These TBAs serve individuals of various age and gender at their trado-medical centres. At the end of 5 months, HIV testing increased by 10,575 (78% from TBAs) and HIV positives obtained improved by 77 (44.2% from TBAs). 55 new individuals were enrolled and commenced on ART (61.8% from TBAs). There was a successful linkage of all clients with escort services due to incentives. Total uptake of ART was 61 (76.3% of target). Structured partnerships between TBAs and HIV care and treatment centers should be strengthened to improve access to ART.

Keywords: access improvement, antiretroviral therapy, traditional birth attendants, uptake

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Authors: Mohamed Elkoushy, Sameer Munshi, Waseem Tayeb

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Background: Flexible ureteroscopy (fURS) has dramatically improved the minimally invasive management of complex nephrolithiasis. fUR is increasingly being used as the first-line treatment for patients with renal stones. Stone-free status (SFS) is the primary goal in the management of patients with urolithiasis. However, substantial variations exist in the reported SFS following fURS. Objectives: This study determines the predictors of SFS after a single session of fURS with holmium laser lithotripsy (HLL) for renal calculi. Methods: A retrospective review of prospectively collected data was performed for all consecutive patients undergoing fURS and HLL for renal calculi at a tertiary care center. Patients with previous ipsilateral URS for the same stones were excluded. All patients underwent JJ ureteral stent insertion at the end of the procedure. SFS was defined as the presence of no residuals or ≤4-mm non-obstructing stone and was assessed by CT/KUB imaging after 3-4 weeks post-operatively. Multivariate logistic regression was used to detect possible predictors of SFS. Results: A total of 212 patients were included with a mean age of 52.3±8.3 years and a stone burden <20 mm (49.1%), 20-30 mm (41.0%) and >30 mm (9.9%). Overall SFS after a single session of fURS was 71.7%, 92% and 52% for stones less and larger than 20 mm, respectively. Patients with stones> 20 mm need retreatment with a mean number of 1.8 (1.3-2.7) fURS. SFS was significantly associated with male gender, stone bulk <20 mm (95.7% vs. 56.2%), non-lower pole stones, hydronephrotic kidney, low stone intensity, ureteral access sheath, and preoperative stenting. SFS was associated with a lower readmission rate (5.9% vs. 38.9%) and urinary tract infections (3.8% vs. 25.9%). In multivariate regression analysis, SFS maintains its significant association with low stone burden of <20 mm (OR: 5.21), stone intensity <600 HFU (OR: 2.87), and non-lower caliceal stones (OR: 3.84). Conclusion: Best results after a single-session fURS for renal stone were obtained for the stone burden of less than 20 mm and low stone attenuation. Lower calyceal stones may influence stone clearance and need a different approach than fURS, especially for higher stone burden.

Keywords: ureteroscopy, kidney stone, lithotripsy, stone-free, predictors

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Authors: Laura M. Schwarz

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WebQuests are an internet-based interactive teaching/learning tool and utilize a scaffolded methodology. WebQuests employ critical thinking, afford inquiry-based constructivist learning, and readily employ Bloom’s Taxonomy. WebQuests have generally been used as instructional technology tools in primary and secondary education and have more recently grown in popularity in higher education. The study of the efficacy of WebQuests as an instructional approach to learning, however, has been limited, particularly in the nursing education arena. The purpose of this mixed-methods study was to determine nursing students’ perceptions of the effectiveness of the Nursing WebQuest as a teaching/learning strategy for holistic nursing-related content. Quantitative findings (N=42) suggested that learners were active participants, used reflection, thought of new ideas, used analysis skills, discovered something new, and assessed the worth of something while taking part in the WebQuests. Qualitative findings indicated that participants found WebQuest positives as easy to understand and navigate; clear and organized; interactive; good alternative learning format, and used a variety of quality resources. Participants saw drawbacks as requiring additional time and work; and occasional failed link or link causing them to lose their location in the WebQuest. Recommendations include using larger sample size and more diverse populations from various programs and universities. In conclusion, WebQuests were found to be an effective teaching/learning tool as positively assessed by study participants.

Keywords: holistic nursing, nursing education, teaching/learning strategy, WebQuests

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Authors: David Maman, David E. Rothem, Merav Ben Natan, Yaron Berkovich

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Introduction: Hip fractures are a major health concern due to their impact on disability, independence, and mortality. Timely rehabilitation is crucial for improving patient outcomes and reducing healthcare costs, yet delays in rehabilitation, often due to challenges in discharge processes, can lead to adverse events and increased healthcare burdens. Aim: The study aimed to investigate two primary aspects related to hip fracture older adults patients: firstly, identifying subgroups more prone to delayed discharge for further rehabilitation; and secondly, exploring the consequences of this delay on short-term outcomes and the incidence of adverse events. Methods: Conducting a retrospective analysis, we examined the medical records of 474 patients aged 65 and older, hospitalized for hip fractures between 2018 and 2022 in a major hospital in the north-central region of Israel. All patients were eligible for further rehabilitation, including options for in-patient or home-based care. Results: Of the studied patients, 61.4% experienced delayed discharge, with an average waiting period of 3.5 days. Factors such as older age, prolonged hospital stay, and the need for in-patient rehabilitation were associated with a higher likelihood of delayed discharge. Those promptly discharged demonstrated lower rates of infections, falls, and mortality. Furthermore, delayed discharge to further rehabilitation correlated with elevated hospitalization costs. Notably, no significant differences were observed in re-hospitalization or repeat surgery rates. Conclusion: This study underscores the pressing need for efficient strategies to ensure timely rehabilitation, particularly for older adults. Implementing such strategies can optimize outcomes, mitigate adverse events, and contribute to a reduction in healthcare costs.

Keywords: hip fracture rehabilitation, delayed discharge, older adults, healthcare coordination, adverse events

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Authors: Roel Guinto Jr, John Peter Dacanay, Edison Ramos

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The Philippines now has the fastest-growing HIV epidemic in the entire Asia-Pacific region. According to the January 2023 HIV/AIDS Registry of the Philippines of the Department of Health (DOH), there were 86 newly reported HIV cases involving 19 years old and below. A cure for HIV is not yet readily available but effective preventive measures to prevent its transmission. Pre-Exposure Prophylaxis is a biomedical intervention for HIV infection in the form of a pill. Students play a significant role in identifying solutions to preventing the transmission of HIV Infection, making it critical to assess their Knowledge, Attitude, and Practice of Pre-Exposure Prophylaxis on HIV Infection. A study was conducted among 390 regular students from different college departments at National University – Manila. A structured questionnaire was used to collect data and other statistical tools were used to analyze data. The findings reveal that most students had no knowledge or idea about PreExposure Prophylaxis before being interviewed. It also shows that students have a positive attitude toward the practice of Pre-Exposure Prophylaxis. The study revealed that there is also a significant relationship between the Knowledge and the Socio-demographic profile of the respondents. Knowledge, Attitude, and Practices on PrEP of students were overall identified, and areas of improvement were also recognized. Sex Education and Sexual Health Awareness should be implemented to enhance students’ knowledge of practicing safe sex to help prevent HIV Transmission.

Keywords: HIV, cure, biomedical intervention, pre-exposure prophylaxis, pill, knowledge, attitude, practice, sex education, sexual health awareness

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Authors: Nashalla Gwyn Nyinda

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The ancient system of Tibetan Medicine, known as Sowa Rigpa across the Himalayan regions, is a systematic system of healing encouraging balance primarily through diet and behavior modifications. With the rise of the popularity of Tibetan Medicine, compliance is critical to successful treatment outcomes. As patients learn more about who they are as individuals and how their elemental balances or imbalances affect disorders and mental-emotional balance, they develop faith and dedication to their healing process. Specifically, regarding diet and behavior and the basic principles of the medical system, patient compliance increases dramatically in all treatment areas when they understand why a treatment or dietary prescription guidance is effective. Successful responses to Tibetan treatment rely on a buy-in from the patient. Trust between the slower process of Traditional medicine treatments, the Tibetan physician and the patient is a cornerstone of treatment. The resulting decrease in the use of allopathic medicine and better health outcomes for acute and chronic disorders are well documented. This paper addresses essential points of the Tibetan Medicine system, dialogue between doctor and patient focused on appropriate and seasonal changing dietetics. Such fluctuating treatment approaches, based on external elemental factors, dramatically increase treatment outcomes. Specifically, this work addresses why allopathic medicine models may need more trust development between practitioner and patient.

Keywords: compliancy in treatment, diet and lifestyle medicine, nature and elements as medicine, seasonal diets, Sowa Rigpa, traditional Tibetan medicine, treatment outcomes

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Authors: Reham H. Diab, Amira A. A. Abdallah, Eman A. Embaby

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Background: The effectiveness of bracing on preventing spino-pelvic alignment deterioration in idiopathic scoliosis has been extensively studied especially in the frontal plane. Yet, there is lack of knowledge regarding the effect of soft braces on spino-pelvic alignment in the sagittal plane. Achieving harmonious sagittal plane spino-pelvic balance is critical for the preservation of physiologic posture and spinal health. Purpose: This study examined the kyphotic angle, lordotic angle and pelvic inclination in the sagittal plane and trunk imbalance in the frontal plane before and after a six-month rehabilitation period. Methods: Nineteen patients with idiopathic scoliosis participated in the study. They were divided into two groups; experimental and control. The experimental group (group I) used the SpineCor brace in addition to a rehabilitation exercise program while the control group (group II) had the exercise program only. The mean ±SD age, weight and height were 16.89±2.15 vs. 15.3±2.5 years; 59.78±6.85 vs. 62.5±8.33 Kg and 162.78±5.76 vs. 159±5.72 cm for group I vs. group II. Data were collected using for metric Π system. Results: Mixed design MANOVA showed that there were significant (p < 0.05) decreases in all the tested variables after the six-month period compared with “before” in both groups. Moreover, there was a significant decrease in the kyphotic angle in group I compared with group II after the six-month period. Interpretation and conclusion: SpineCor brace is beneficial in reducing spino-pelvic alignment deterioration in both sagittal and frontal planes.

Keywords: adolescent idiopathic scoliosis, SpineCor, spino-pelvic alignment, biomechanics

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Authors: Sarinra Thongmee, Krittaporn Prakobsaeng, Adithep Mingsuan, Chanyapak Polkhet, Supattra Wongsuk

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The purposes of this research and developmentwasto develop and evaluation of the clinical nursingpractice guideline (CNPG) for the prevention infection during intubation in patient with suspected or confirmedCOVID-19 patient. This study was developed by using the evidencebased practice model of Soukup (2000) asa conceptual framework. The study consisted of 4 steps: 1) situational analysis of intubation service in patientswith confirmed COVID-19; 2) development of the CNPG; 3) apply the NPG to trial; and 4) evaluation of the CNPG. The sample consisted of 52 nurse anesthetists and 25 infected or suspected COVID-19 patients. The research instrument consisted of 1) the CNPG, which was developed by the researchers; 2) the nurses anesthetist opinion questionnaire to the guideline; 3) the evaluation practice form; and 4) the nurse anesthetist knowledge test on nursing care of patients infected with COVID-19. Data were analyzed by using descriptive statistics, and Wilcoxon matched-pairs signed rank test. The results revealed this developed CNPG consists of 4 sections: 1)the CNPG for airborne precautions2) the preparation of anesthetic and intubation equipments3) the roles and duties of the intubation team, 4) the guidelines for intubation in suspected or confirmed COVID-19 patients. The results of CNPG use found that 1)the provider: using NPG in providers revealed that nurse anesthetist had a higher mean of knowledge scores than before using CNPG statistically significant at the 0.05 level (p<0.01) and able to follow the NPG 100% inall activities. The anesthetic team was not infected with COVID-19 from intubation outside the operating room. 2)the client: the patient was safe, with no complications from intubation. Summary CNPG to prevent infection during reintubation of suspected or confirmedCOVID-19patient was appropriate and applicable to practice.

Keywords: clinical nursing practice guideline, prevention of infection, endotracheal intubation, COVID-19

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Authors: Tais Silva Lopes, Danilo Caneppele, Elizabeth Romagosa

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Surubim-do-Paraíba, Steindachneridion parahybae is a species of South American fish in critical conditions of extinction. Researches have been developed with the objective of conserving the biological material of this species. We evaluated the cooling of mature oocytes in the cryoprotective solutions containing the following alcohols: methanol, Propylene glycol and DMSO, each at concentrations of 1M, 2M and 4M, totaling nine treatments. After being submitted to treatments, the oocytes were maintained for 120 minutes in cooling to -5.52±2.58⁰C. A sample of oocytes was submitted to negative control (NC), kept in 90% L-15 solution, and positive control (PC), fertilized and taken directly to the incubator. Fertilization and hatching rates were evaluated. In order to compare the sensitivity of oocytes to embryos of the same species, the embryos maintained as CP in the previous assay were used in the free-flow stage (about 22 hours post fertilization) and submitted to the same treatments (prepared in distilled water) and also cooled for 120 min. The evaluation was done by the hatch rate. There was no fertilization rate of the oocytes submitted to the cooling with propylene glycol; the other cryoprotectants presented values of at most 3.7% of fertilization (Methanol 1M), and no treatment completed development until hatching. The cooled embryos had a significant percentage of normal larvae in all treatments, but inversely proportional to the increase in the concentration of the alcohols. DMSO 1M was the most promising treatment for embryo cooling, with 41.7% ± 20.2 of normal larvae, while mature oocytes were highly sensitive to cold.

Keywords: cryoconservation, cooling, embryos, freezing, oocytes, south American fish

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Authors: Shreyansh Singh, Afroz Ahmed

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Sentiment Analysis intends to naturally reveal the hidden mentality that we hold towards an entity. The total of this assumption over a populace addresses sentiment surveying and has various applications. Current text-based sentiment analysis depends on the development of word embeddings and Machine Learning models that take in conclusion from enormous text corpora. Sentiment Analysis from text is presently generally utilized for consumer loyalty appraisal and brand insight investigation. With the expansion of online media, multimodal assessment investigation is set to carry new freedoms with the appearance of integral information streams for improving and going past text-based feeling examination using the new transforms methods. Since supposition can be distinguished through compelling follows it leaves, like facial and vocal presentations, multimodal opinion investigation offers good roads for examining facial and vocal articulations notwithstanding the record or printed content. These methodologies use the Recurrent Neural Networks (RNNs) with the LSTM modes to increase their performance. In this study, we characterize feeling and the issue of multimodal assessment investigation and audit ongoing advancements in multimodal notion examination in various spaces, including spoken surveys, pictures, video websites, human-machine, and human-human connections. Difficulties and chances of this arising field are additionally examined, promoting our theory that multimodal feeling investigation holds critical undiscovered potential.

Keywords: sentiment analysis, RNN, LSTM, word embeddings

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Authors: É. Kónya, E. Szabó, I. Bata-Vidács, T. Deák, M. Ottucsák, N. Adányi, A. Székács

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Spice paprika is a major spice commodity in the European Union (EU), produced locally and imported from non-EU countries, reported not only for chemical and microbiological contamination, but also for fraud. The effective interaction between producers’ quality management practices and government and EU activities is described on the example of spice paprika production and control in Hungary, a country of leading spice paprika producer and per capita consumer in Europe. To demonstrate the importance of various contamination factors in the Hungarian production and EU trade of spice paprika, several aspects concerning food safety of this commodity are presented. Alerts in the Rapid Alert System for Food and Feed (RASFF) of the EU between 2005 and 2013, as well as Hungarian state inspection results on spice paprika in 2004 are discussed, and quality non-compliance claims regarding spice paprika among EU member states are summarized in by means of network analysis. Quality assurance measures established along the spice paprika production technology chain at the leading Hungarian spice paprika manufacturer, Kalocsai Fűszerpaprika Zrt. are surveyed with main critical control points identified. The structure and operation of the Hungarian state food safety inspection system is described. Concerted performance of the latter two quality management systems illustrates the effective interaction between internal (manufacturer) and external (state) quality control measures.

Keywords: spice paprika, quality control, reporting mechanisms, RASFF, vulnerable points, HACCP

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Authors: Safwat Mohamed, Rasha Metawi, Hadeel Khalil, Hussein Kamal

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This paper discusses and reveals the manufacturing techniques of the leather scale armour of Tutankhamun. This armour was in critical condition and went under many conservation procedures as it suffered from some serious deterioration aspects including fragmentation. In addition, its original shape was lost, the leather scales were found scattered in the box and separated from the linen basis, and hence its outlines were blurred and incomprehensible. In view of this, the leather scale armour of Tutankhamun was desperate for urgent conservation and reconstruction interventions. Documentation measures were done before conservation. Several re-treatable conservation procedures were applied seeking for stabilizing the armour and reaching sustainable condition. The conservation treatments included many investigations and analyses that helped in revealing materials and techniques of making the armour. The leather scale armour of Tutankhamun consisted of leather scales attached to a linen support. This linen support consisted of several layers. Howard Carter assumed that the linen support consisted of 6 layers. The undertaken conservation treatments helped in revealing the actual number of layers of the linen support as well as in reaching the most sustainable condition. This paper views the importance of the conservation procedures, which were recently carried out on Tutankhamun’s leather scale armour, in identifying and revealing all materials and techniques used in its manufacturing. The collected data about manufacturing techniques were used in making a replica of the leather scale armour with the same methods and materials.

Keywords: leather scales armours, conservation, manufacturing techniques, Tutankhamun, producing a replica

Procedia PDF Downloads 91