Search results for: naira notes

Authors: Linda Dusman, Linda Baker

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The Bearman Study of Audience Engagement examined the potential for real-time music education during online symphony orchestra concerts. It follows on the promising results of a preliminary study of STEAM (Science, Technology, Engineering, Arts, and Mathematics) education during live concerts, funded by the National Science Foundation with the Baltimore Symphony Orchestra. For the Bearman Study, audience groups were recruited to attend two previously recorded concerts of the National Orchestral Institute (NOI) in 2020 or the Utah Symphony in 2021. They used a smartphone app called EnCue to present real-time program notes about the music being performed. Short notes along with visual information (photos and score fragments) were designed to provide historical, cultural, biographical, and theoretical information at specific moments in the music where that information would be most pertinent, generally spaced 2-3 minutes apart to avoid distraction. The music performed included Dvorak Symphony No. 8 and Mahler Symphony No. 5 at NOI, and Mendelssohn Scottish Symphony and Richard Strauss Metamorphosen with the Utah Symphony, all standard repertoire for symphony orchestras. During each phase of the study (2020 and 2021), participants were randomly assigned to use the app to view program notes during the first concert or to use the app during the second concert. A total of 139 participants (67 in 2020 and 72 in 2021) completed three online questionnaires, one before attending the first concert, one immediately after the concert, and the third immediately after the second concert. Questionnaires assessed demographic background, expertise in music, engagement during the concert, learning of content about the composers and the symphonies, and interest in the future use of the app. In both phases of the study, participants demonstrated that they learned content presented on the app, evidenced by the fact that their multiple-choice test scores were significantly higher when they used the app than when they did not. In addition, most participants indicated that using the app enriched their experience of the concert. Overall, they were very positive about their experience using the app for real-time learning and they expressed interest in using it in the future at both live and streaming concerts. Results confirmed that informal real-time learning during concerts is possible and can generate enhanced engagement and interest in classical music.

Keywords: audience engagement, informal education, music technology, real-time learning

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Authors: Rachel M. Lørum, Henrik Eriksson, Frida Smith

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Purpose: In recent years, the use of benchmarks for the improvement of healthcare has become increasingly common. There has been an increasing interest in why improvement initiatives so often fail to eliminate the problems they aspire to solve. Benchmarking comes with its fair share of challenges and problems, such as capturing the dynamics and complexities of the care environments, among others. In this study, we demonstrate how learning-oriented, voluntary benchmarks in the complex environment of public healthcare could be designed. Findings: Our four most important findings were the following: first, important organizational learning (OL) regarding the complexity of the service and implications on how to design a benchmark for learning and improvement occurred during the process. Second, participation by a wide range of professionals and stakeholders was crucial for capturing the complexity of people and organizations and increasing the quality of the template. Third, the continuous dialogue between all organizations involved was an important tool for ongoing organizational learning throughout the process. The last important finding was the impact of the facilitator’s role through supporting progress, coordination, and dialogue. Design: We chose participatory design as the research design. Data were derived from written materials such as e-mails, protocols, observational notes, and reflection notes collected during a period of 1.5 years. Originality: Our main contributions are the identification of important strategies, initiatives, and actors to involve when designing voluntary benchmarks for learning and improvement.

Keywords: organizational learning, quality improvement, learning-oriented benchmark, healthcare, patient safety

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Authors: Akachi Odoemene

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Climate change and land grabbing are tightly interconnected in ways that are both diverse and complex. They have impacted each other in significant ways too. Both phenomena are not only a political reality, but have diverse dire implications, especially for food and livelihood security of vulnerable populations in developing economies. The critical nexus and interactions of climate change and land grabbing remain one of the challenges of sustainable development in modern times. The nuanced understanding of the nexus, importance and implications of climate change and land grabbing are the primary focus of this chapter. It begins with conceptual clarifications, particularly arguing that the absence of some important principles of engagement underline and define a land grab. It also analyses and notes a good number of contemporary land deals as 'one-sided', in which wealthy entities connive with local elites to exploit and disposes rural poor populations. The paper not only examines both global and local factors that drive land grabbing and, in some cases, their connections with the incidence of climate change, but also explores their crucial links with such sector as agriculture. It is argued and exhibited in the paper why certain societies are susceptible to the incidence of climate change and land grabbing, while the overall consequences of these phenomena on the affected societies are further interrogated. The paper concludes that the lack of political will by global political leaders to effectively combat and resolve critical issues associated with both climate change and land grabbing remains a daunting challenge. It notes that these phenomena – climate change and land grabbing – if not abated, will certainly become another set of global tragic episodes to be regretted in the future.

Keywords: climate change, land grabbing, global governance, developing economies

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Authors: Karolina Wieczorek, Sophie Wiliams

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Introduction: Patient data is often collected in Electronic Health Record Systems (EHR) for purposes such as providing care as well as reporting data. This information can be re-used to validate data models in clinical trials or in epidemiological studies. Manual validation of automated tools is vital to pick up errors in processing and to provide confidence in the output. Mentioning a disease in a discharge letter does not necessarily mean that a patient suffers from this disease. Many of them discuss a diagnostic process, different tests, or discuss whether a patient has a certain disease. The COVID-19 dataset in this study used natural language processing (NLP), an automated algorithm which extracts information related to COVID-19 symptoms, complications, and medications prescribed within the hospital. Free-text patient clinical patient notes are rich sources of information which contain patient data not captured in a structured form, hence the use of named entity recognition (NER) to capture additional information. Methods: Patient data (discharge summary letters) were exported and screened by an algorithm to pick up relevant terms related to COVID-19. Manual validation of automated tools is vital to pick up errors in processing and to provide confidence in the output. A list of 124 Systematized Nomenclature of Medicine (SNOMED) Clinical Terms has been provided in Excel with corresponding IDs. Two independent medical student researchers were provided with a dictionary of SNOMED list of terms to refer to when screening the notes. They worked on two separate datasets called "A” and "B”, respectively. Notes were screened to check if the correct term had been picked-up by the algorithm to ensure that negated terms were not picked up. Results: Its implementation in the hospital began on March 31, 2020, and the first EHR-derived extract was generated for use in an audit study on June 04, 2020. The dataset has contributed to large, priority clinical trials (including International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) by bulk upload to REDcap research databases) and local research and audit studies. Successful sharing of EHR-extracted datasets requires communicating the provenance and quality, including completeness and accuracy of this data. The results of the validation of the algorithm were the following: precision (0.907), recall (0.416), and F-score test (0.570). Percentage enhancement with NLP extracted terms compared to regular data extraction alone was low (0.3%) for relatively well-documented data such as previous medical history but higher (16.6%, 29.53%, 30.3%, 45.1%) for complications, presenting illness, chronic procedures, acute procedures respectively. Conclusions: This automated NLP algorithm is shown to be useful in facilitating patient data analysis and has the potential to be used in more large-scale clinical trials to assess potential study exclusion criteria for participants in the development of vaccines.

Keywords: automated, algorithm, NLP, COVID-19

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Authors: Sheikh Shams Azam, Manoj Raju, Venkatesh Pagidimarri, Vamsi Kasivajjala

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Over the past decade, there has been a steep rise in the data-driven analysis in major areas of medicine, such as clinical decision support system, survival analysis, patient similarity analysis, image analytics etc. Most of the data in the field are well-structured and available in numerical or categorical formats which can be used for experiments directly. But on the opposite end of the spectrum, there exists a wide expanse of data that is intractable for direct analysis owing to its unstructured nature which can be found in the form of discharge summaries, clinical notes, procedural notes which are in human written narrative format and neither have any relational model nor any standard grammatical structure. An important step in the utilization of these texts for such studies is to transform and process the data to retrieve structured information from the haystack of irrelevant data using information retrieval and data mining techniques. To address this problem, the authors present Q-Map in this paper, which is a simple yet robust system that can sift through massive datasets with unregulated formats to retrieve structured information aggressively and efficiently. It is backed by an effective mining technique which is based on a string matching algorithm that is indexed on curated knowledge sources, that is both fast and configurable. The authors also briefly examine its comparative performance with MetaMap, one of the most reputed tools for medical concepts retrieval and present the advantages the former displays over the latter.

Keywords: information retrieval, unified medical language system, syntax based analysis, natural language processing, medical informatics

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Authors: Olasunkanmi G. Jeje, John G. Laah, Eunice S. A. Jeje

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In recent times Nigeria has been bedeviled with political, religious and ethnic crises such as indigene/settler phenomena, Boko Haram etc. resulting in the emergence of internally displaced persons(IDPs), this has been a hunch on national development. Most states of the federation have had their share of one crisis or the other such as Jos, Yobe, Borno etc thereby affecting the economy of the country. These persons are uprooted from their residential locations of which they are active contributors to the national GDP. In addition, the attempt to rehabilitate them has gulped billions of naira for feeding, shelter and medicals etc., which is not adequate for such. However, the financing could have been used for projects such as capacity building and infrastructural development. Similarly, traumatic experience by this group of people is overwhelming as most of them are mainly the aged, women and children. Importantly, the active roles of youths that constitute the productive sector of the economy have also been truncated. Therefore, it is the prerogative of this research to examine the effect of IDP's on National Development and also to recommend solutions.

Keywords: development, implication, internally displaced persons, Nigeria

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Authors: Raja Ezman Raja Shariff

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Acute kidney injury (AKI) is commonly seen in inpatients, and places a great cost on the NHS and patients. Timely and appropriate management is both nephron sparing and potentially life-saving. Ultrasound scanning (USS) is a well-recognised method for stratifying patients. Subsequently, the NICE AKI guidance has defined groups in whom scanning is recommended within 6 hours of request (pyonephrosis), within 24 hours (obstruction/cause unknown), and in whom routine scanning isn't recommended (cause for AKI identified). The audit looks into whether Stockport NHS Trust USS practice was in line with such recommendations. The audit evaluated 92 patients with AKI who had USS, between 01/01/14 to 30/04/14. Data collection was divided into 2 parts. Firstly, radiology request cards and the online imaging software (PACS) were evaluated. Then, the electronic case notes (ADVANTIS) was evaluated further. Based on request cards, 10% of requests were for pyonephrosis. Only 33% were scanned within 6hours and a further 33% within 24hours. 75% were requested for possible obstructions and unknown cause collectively. Of those due to possible obstruction, 71% of patients were scanned within 24 hours. Of those with unknown cause, 50% were scanned within 24 hours. 15% of requests had a cause declared and so potentially did not require scanning. Evaluation of the patients’ notes suggested further interesting findings. Firstly, potentially 39% of patients had a known cause for AKI, therefore, did not need USS. Subsequently, the cohort of unknown cause and possible obstruction was collectively reduced to 45%. Alarmingly the patient cohort with possible pyonephrosis went up to 16%, suggesting an under-recognition of this life-threatening condition. We plan to highlight these findings within our institution and make changes to encourage more appropriate requesting and timely scanning. Time will tell if we manage to save or increase our costs in this cost-conscious NHS. Patient benefits, though, seem to be guaranteed.

Keywords: AKI, ARF, kidney, renal

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Authors: Baoshan Wang

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The present study investigates how music theory has developed across different countries due to their diverse histories, religions, and cultural differences. It is unknown how these various factors may contribute to differences in music theory across countries. Therefore, we examine the differences between China and Greece, which have developed unique music theories over time. Specifically, our analysis looks at musical notation and scales. For example, Tonal music originates from Greece, which harbors quite complex notation and scaling. There exist seven notes in each scale within seven modes of scales. Each mode of the diatonic scale has a unique temperament, two of which are most commonly used in modern music. In contrast, we find that Chinese music has only five notes in its scales. Interestingly, a unique feature of Chinese music theory is that there is no half-step, resulting in a highly divergent and culture-specific sound. Fascinatingly, these differences may arise from the contrasting ways that Western and Eastern musicians perceive music. While Western musicians tend to believe in music “without borders,” Eastern musicians generally embrace differing perspectives. Yet, the vast majority of colleges or music conservatories teach the borderless theory of Western music, which renders the music educational system incomplete. This is critically important because learning music is not simply a profession for musicians. Rather, it is an intermediary to facilitate understanding and appreciation for different countries’ cultures and religions. Education is undoubtedly the optimal mode to promote different countries’ music theory so people across the world can learn more about music and, in turn, each other. Even though Western music theory is predominantly taught, it is crucial we also pursue an understanding of other countries’ music because their unique aspects contribute to the systematic completeness of Music Theory in its entirety.

Keywords: culture, development, music theory, music history, religion, western music

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Authors: Feride Sumbul

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Drama is a literary genre that mirrors the people and society and transfers the human nature and life to the reader or the audience within its own social-cultural structure. Each play takes on a new reality in the time and culture of the staging, and each performance actually brings a new interpretation to the play. Similarly, each translation adds a new meaning to the source text. In other words, the translated theatrical text transcends the boundaries of its language and culture and finds a new interpretation. Thus the translation of drama takes place as a transfer from one culture to another as a cross cultural communication. In this context, translating culture specific references play a key role in terms of reflecting cultural aspects of a target society. This study aims to explore the use of Venuti's translation principles of domestication and foreignization in the transfer of culture specific references in the Turkish translation of Shakespeare's Macbeth. Macbeth is to be compared with its Turkish version in terms of the transference of culture specific references such as religious, witchcraft, and mythological, which have no equivalent in the target language and culture. To evaluate these principles of Venuti, Davies’s translation strategies are also conducted. As a method, for the most part, he predominantly uses Davies’ method of ‘addition’ through adding extra information in the notes. For instance, rather than finding the Turkish renderings of them, the translator mostly chooses to transfer witchcraft references through retaining them in the target text, but he mainly adds extra information about the references in the notes. Therefore, the translator Nutku mostly uses Venuti’s translation principle of foreignization so that he preserves the foreignness of the theatrical text.

Keywords: drama translation, theatrical texts, culture specific references, Macbeth

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Authors: Davina Von Hagt, Genevieve Gibbons, Matt Henderson, Tom Bowles

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Purpose: Food bolus obstructions are common emergency surgical presentations, but there is no established management guideline in a rural setting. Intervention usually involves endoscopic removal after initial medical management has failed. Within a rural setting, this falls upon the general surgeon. There are varied endoscopic techniques that may be used. Methodology: A review of the past fifty cases of food bolus obstruction managed at Albany Health Campus was retrospectively reviewed to assess endoscopic findings and techniques. Operation notes, histopathology, imaging, and patient notes were reviewed. Results: 50 patients underwent gastroscopy for food bolus obstruction from August 2017 to March 2021. Ages ranged from 11 months to 95 years, with the majority of patients aged between 30-70 years. 88% of patients were male. Meat was the most common bolus (20% unspecified, 20% steak, 10% chicken, 6% lamb, 4% sausage, 2% pork). At endoscopy, 12% were found not to have a food bolus obstruction. Two patients were found to have oesophageal cancer, and four patients had a stricture and required dilatation. A variety of methods were used to relieve oesophageal obstruction ranging from pushing through to stomach (24 patients), using an overtube (10 patients), raptor (13 patients), and less common instruments such as Roth net, basket, guidewire, and pronged grasper. One patient had an unsuccessful endoscopic retrieval and required theatre for laparoscopic assisted removal with rendezvous endoscopic piecemeal removal via oesophagus and gastrostomy. Conclusion: Food bolus obstruction is a common emergency presentation. Within the rural setting, management requires innovation and teamwork within the safety of the local experience.

Keywords: food bolus obstruction, regional hospital, surgical management, innovative surgical treatment

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Authors: Ivy Chumo, Sheillah Simiyu, Hellen Gitau, Isaac Kisiangani, Caroline Kabaria Kanyiva Muindi, Blessing Mberu

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The global sanitation workforce bridges the gap between sanitation infrastructure and the provision of sanitation services through essential public service work. Manual pit emptiers often perform the work at the cost of their dignity, safety, and health as their work requires repeated heavy physical activities such as lifting, carrying, pulling, and pushing. This exposes them to occupational and environmental health hazards and risking illness, injury, and death. The study will extend the studies by presenting occupational health risks and suggestions for improvement in informal settlements of Nairobi, Kenya. This is a qualitative study conducted among sanitation stakeholders in Korogocho, Mukuru and Kibera informal settlements in Nairobi. Data were captured using digital voice recorders, transcribed and thematically analysed. The discussion notes were further supported by observational notes made during the interviews. These formed the basis for a robust picture of occupational health of manual pit emptiers; a lack or inappropriate use of protective clothing, and prolonged duration of working hours were described to contribute to the occupational health hazard. To continue working, manual pit emptiers had devised coping strategies which include working in groups, improvised protective clothing, sharing the available protective clothing, working at night and consuming alcohol drinks while at work. Many of these strategies are detrimental to their health. Occupational health hazards among pit emptiers are key for effective working and is as a result of a lack of collaboration amongst stakeholders linked to health, safety and lack of PPE of pit emptiers. Collaborations amongst sanitation stakeholders is paramount for health, safety, and in ensuring the provision and use of personal protective devices.

Keywords: sanitation, occupational health, manual emptiers, informal settlements

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Authors: L. O'Sullivan, C. Murphy

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This study examined the impact, if any, of mobile technology on the achievement of United Nations Sustainable Development Goal 4: Quality Education for All. It focused specifically on teachers and their practice, in a school with large class sizes and limited teaching resources. Teachers in third grade in a large public school in Mozambique were provided with an iPad connected to a projector, powered by a mobile solar-panel. Teachers also participated in ten days of professional development workshops over thirteen months. Teacher discussions, micro-teaching sessions and classes in the school were video-recorded, and data was triangulated using surveys and additional documents including class plans, digital artifacts created by teachers, workshop notes and researcher field notes. The catalyst for teachers’ creativity development was to use the photographic capabilities of the iPad to capture the local context and make lessons relevant to the lived experience of the students. In the transition stage, teachers worked with lesson plans and support from the professional development workshops to make small incremental changes to their practice, which scaffolded their growing competence in the creative use of the technology as a tool for teaching and developing new teaching resources. Over the full period of the study, these small changes in practice resulted in a cultural shift in how teachers approached all lessons, even those in which they were not using the technology. They developed into working as a community of practice. The digital lessons created were re-used and further developed by other teachers, providing a relevant and valuable bank of content in a context lacking in books and other teaching resources. This study demonstrated that mobile technology proved to be a successful catalyst for impacting creative teaching practice in this context, and supports the Quality Education for All Sustainable Development Goal.

Keywords: mobile technology, creative teaching, sub-Saharan Africa, quality education for all

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Authors: Rena Upitis, Philip C. Abrami, Karen Boese

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The success of one-on-one music study relies heavily on the ability of the teacher to provide sufficient direction to students during weekly lessons so that they can successfully practice from one lesson to the next. Traditionally, these instructions are given in a paper notebook, where the teacher makes notes for the students after describing a task or demonstrating a technique. The ability of students to make sense of these notes varies according to their understanding of the teacher’s directions, their motivation to practice, their memory of the lesson, and their abilities to self-regulate. At best, the notes enable the student to progress successfully. At worst, the student is left rudderless until the next lesson takes place. Digital notebooks have the potential to provide a more interactive and effective bridge between music lessons than traditional pen-and-paper notebooks. One such digital notebook, Cadenza, was designed to streamline and improve teachers’ instruction, to enhance student practicing, and to provide the means for teachers and students to communicate between lessons. For example, Cadenza contains a video annotator, where teachers can offer real-time guidance on uploaded student performances. Using the checklist feature, teachers and students negotiate the frequency and type of practice during the lesson, which the student can then access during subsequent practice sessions. Following the tenets of self-regulated learning, goal setting and reflection are also featured. Accordingly, the present paper addressed the following research questions: (1) How does the use of the Cadenza digital music notebook engage students and their teachers?, (2) Which features of Cadenza are most successful?, (3) Which features could be improved?, and (4) Is student learning and motivation enhanced with the use of the Cadenza digital music notebook? The paper describes the results 10 months of field-testing of Cadenza, structured around the four research questions outlined. Six teachers and 65 students took part in the study. Data were collected through video-recorded lesson observations, digital screen captures, surveys, and interviews. Standard qualitative protocols for coding results and identifying themes were employed to analyze the results. The results consistently indicated that teachers and students embraced the digital platform offered by Cadenza. The practice log and timer, the real-time annotation tool, the checklists, the lesson summaries, and the commenting features were found to be the most valuable functions, by students and teachers alike. Teachers also reported that students progressed more quickly with Cadenza, and received higher results in examinations than those students who were not using Cadenza. Teachers identified modifications to Cadenza that would make it an even more powerful way to support student learning. These modifications, once implemented, will move the tool well past its traditional notebook uses to new ways of motivating students to practise between lessons and to communicate with teachers about their learning. Improvements to the tool called for by the teachers included the ability to duplicate archived lessons, allowing for split screen viewing, and adding goal setting to the teacher window. In the concluding section, proposed modifications and their implications for self-regulated learning are discussed.

Keywords: digital music technologies, electronic notebooks, self-regulated learning, studio music instruction

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Authors: Mohsen Rezaee

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Although robust security softwares, including anti-viruses, anti-spywares, anti-spam and firewalls are amalgamated with new technologies such as safe zone, hybrid cloud, sand box and etc., and although it can be said that they have managed to prepare highest level of security against viruses, spywares and other malwares in 2012, in fact, hacker attacks to websites are increasingly becoming more and more complicated. Because of security matters developments it can be said it was expected to happen so. Here in this work we try to point out some functional and vital notes to enhance security on the web, enabling the user to browse safely in unlimited web world and to use virtual space securely.

Keywords: firewalls, security, web services, computer science

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Authors: Ezeoke Callistus Obiora, Ezeoke Nneka Angela

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The study investigated the effect of deficit financing on macroeconomic variables in Nigeria. The specific objectives included to find out the relationship between deficit financing and GDP, interest rate, inflation rate, money supply, exchange rate and private investment respectively on a time series covering a period of 44 years (1970 – 2013). The Ordinary Least Square multiple regression produced statistics for the coefficient of determination (R2), F-test, t-test used for the interpretation of the study. The findings revealed that Deficit financing has significant positive effect on GDP and exchange rate. Again, deficit financing has a positive and insignificant relationship inflation, money supply and investment. Only interest rate recorded negative yet insignificant relationship with deficit financing. The implications of the findings are that deficit financing can be a veritable tool for boosting economic development in Nigeria, but the influential positively rising exchange rate implies that deficit financing devalues the Naira exchange rate to other currencies indicating that deficit financing can affect Nigerians competitive advantage at the world market. Thus, the study concludes that deficit financing has not encouraged economic growth in Nigeria.

Keywords: deficit financing, money supply, exchange rate, inflation, GDP, investment, Nigeria

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Authors: Majid Azarniush, Soroush Mokallaei

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Although robust security software, including anti-viruses, anti spy wares, anti-spam and firewalls, are amalgamated with new technologies such as Safe Zone, Hybrid Cloud, Sand Box etc., and it can be said that they have managed to prepare highest level of security against viruses, spy wares and other malwares in 2012, but in fact hackers' attacks to websites are increasingly becoming more and more complicated. Because of security matters and developments, it can be said that it was expected to happen so. Here in this work, we try to point out to some functional and vital notes to enhance security on the web enabling the user to browse safely in no limit web world and to use virtual space securely.

Keywords: firewalls, security, web services, software

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Authors: Richa Sinha, Mohammad Irfan Javed, Sanjay Singh

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Introduction: Good antimicrobial prescribing reduces length of stay in hospital, risk of adverse events, antimicrobial resistance, and unnecessary hospital expenditure. The aim of this prospective audit was to identify any problems with antimicrobial prescribing including documentation of the relevant aspects as well as appropriateness of antibiotics use. The audit was conducted on the surgical wards in a teaching hospital in the UK. Methods: Standards included the indication, duration, choice, and prescription of antibiotic should be in line with current Regional Guidelines and should be clearly documented on the prescription chart. There should be an entry in each patients’ medical record of the diagnosis and indication for each acute antibiotic prescription issued. All prescriptions should clearly document the route, frequency and dose of antibiotic. Data collection was done for 2 weeks in the month of March 2014. A proforma including all the questions above was completed for all the patients. The results were analysed using Excel. Results: 35 patients in total were selected for the audit. 85.7% of patients had indication of antibiotic documented on the prescription chart and 68.5% of patients had indication documented in the notes. The antibiotic used was in line with hospital guidelines in 45.7% of patients, however, in a further 28.5% of patients the reason for the antibiotic prescription was microbiology approved. Therefore, in total 74.2% of patients had been prescribed appropriate antibiotics. The duration of antibiotic was documented in 68.6% of patients and the antibiotic was reviewed in 37.1% of patients. The dose, frequency and route was documented clearly in 100% of patients. Conclusion: Overall, prescribing can be improved on the surgical wards in this hospital. Only 37.1% of patients had clear documentation of a review of antibiotics. It may be that antibiotics have been reviewed but this should be clearly highlighted on the prescription chart or the notes. Failure to review antibiotics can lead to poor patient care and antimicrobial resistance and therefore it is important to address this. It is also important to address the appropriateness of antibiotics as inappropriate antibiotic prescription can lead to failure of treatment as well as antimicrobial resistance. The good points from the audit was that all patients had clear documentation of dose, route and frequency which is extremely important in the administration of antibiotics. Recommendations from this audit included to emphasize good antimicrobial prescribing at induction (twice yearly), an antimicrobial handbook for junior doctors, and re-audit in 6 months time.

Keywords: prescribing, antimicrobial, indication, duration

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Authors: T. S. Beerenahally, S. Amruthavalli, C. M. Munegowda, Leelavathi, Nagarathna

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Introduction: In majority of urban India, the health system is split between different authorities being responsible for the health care of urban population. We believe that, apart from poor awareness and financial barriers to care, there are other health system barriers which affect quality and access to care for people with diabetes. In this paper, we attempted to identify health system complexity that determines access to public health system for diabetes care in KG Halli, a poor urban neighborhood in Bengaluru. The KG Halli has been a locus of a health systems research from 2009 to 2015. Methodology: The source of data is from the observational field-notes written by research team as part of urban health action research project (UHARP). Field notes included data from the community and the public primary care center. The data was generated by the community health assistants and the other research team members during regular home visits and interaction with individuals who self-reported to be diabetic over four years as part of UHARP. Results: It emerged during data analysis that the patients were not keen on utilizing primary public health center for many reasons. Patient has felt that the service provided at the center was not integrated. There was lack of availability of medicines, with a regular stock out of medicines in a year and laboratory service for investigation was limited. Many of them said that the time given by the providers was not sufficient and there was also a feeling of providers not listening to them attentively. The power dynamics played a huge role in communication. Only the consultation was available for free of cost at the public primary care center. The patient had to spend for the investigations and the major portion for medicine. Conclusion: Diabetes is a chronic disease that poses an important emerging public health concern. Most of the financial burden is borne by the family as the public facilities have failed to provide free care in India. Our study indicated various factors including individual beliefs, stigma and financial constraints affecting compliance to diabetes care.

Keywords: diabetes care, disintegrated health system, quality of care, urban health

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Authors: Mohammad Talebi

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Supply chain administration could be a concern for all the countries within the world, whereas there's no special approach towards supportability. Generally, for one decade, manufactured insights applications in keen supply chains have found a key part. In this paper, applications of artificial intelligence in supply chain management have been clarified, and towards Canadian plans for smart supply chain management (SCM), a few notes have been suggested. A hierarchical framework for smart SCM might provide a great roadmap for decision-makers to find the most appropriate approach toward smart SCM. Within the system of decision-making, all the levels included in the accomplishment of smart SCM are included. In any case, more considerations are got to be paid to available and needed infrastructures.

Keywords: smart SCM, AI, SSCM, procurement

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Authors: C. M. Choi, H. C. Tsang, W. K. Fong, Y. K. Cheng, T. K. Chui, L. Y. Chan, K. W. Lee, C. K. Yuen, P. W. Lau, Y. L. To, K. C. Chow

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Six-minute walk test (6MWT) is a sub-maximal exercise test to assess aerobic capacity and exercise tolerance of patients with chronic respiratory disease and heart failure. This has been proven to be a reliable and valid tool and commonly used in clinical situations. Traditional 6MWT is labour-intensive and time-consuming especially for patients who require assistance in ambulation and oxygen use. When performing the test with these patients, one staff will assist the patient in walking (with or without aids) while another staff will need to manually record patient’s oxygen saturation, heart rate and walking distance at every minute and/or carry oxygen cylinder at the same time. Physiotherapist will then have to document the test results in bed notes in details. With the use of electronic 6MWT (E-6MWT), patients wear a wireless oximeter that transfers data to a tablet PC via Bluetooth. Real-time recording of oxygen saturation, heart rate, and distance are displayed. No manual work on recording is needed. The tablet will generate a comprehensive report which can be directly attached to the patient’s bed notes for documentation. Data can also be saved for later patient follow up. This study was carried out in North District Hospital. Patients who followed commands and required 6MWT assessment were included. Patients were assigned to study or control groups. In the study group, patients adopted the E-6MWT while those in control group adopted the traditional 6MWT. Manpower and time consumed were recorded. Physiotherapists also completed a questionnaire about the use of E-6MWT. Total 12 subjects (Study=6; Control=6) were recruited during 11-12/2017. An average number of staff required and time consumed in traditional 6MWT were 1.67 and 949.33 seconds respectively; while in E-6MWT, the figures were 1.00 and 630.00 seconds respectively. Compared to traditional 6MWT, E-6MWT required 67.00% less manpower and 50.10% less in time spent. Physiotherapists (n=7) found E-6MWT is convenient to use (mean=5.14; satisfied to very satisfied), requires less manpower and time to complete the test (mean=4.71; rather satisfied to satisfied), has better data management (mean=5.86; satisfied to very satisfied) and is recommended to be used clinically (mean=5.29; satisfied to very satisfied). It is proven that E-6MWT requires less manpower input with higher efficiency and better data management. It is welcomed by the clinical frontline staff.

Keywords: electronic, physiotherapy, six-minute walk test, 6MWT

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Authors: Michael Lognoul

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In April 2021, the European Commission released its AI Act Proposal, which is the first policy proposal at the European Union level to target AI systems comprehensively, in a horizontal manner. This Proposal notably aims to achieve an ecosystem of trust in the European Union, based on the respect of fundamental rights, regarding AI. Among many other requirements, the AI Act Proposal aims to impose several generic transparency obligationson all AI systems to the benefit of natural persons facing those systems (e.g. information on the AI nature of systems, in case of an interaction with a human). The Proposal also provides for more stringent transparency obligations, specific to AI systems that qualify as high-risk, to the benefit of their users, notably on the characteristics, capabilities, and limitations of the AI systems they use. Against that background, this research firstly presents all such transparency requirements in turn, as well as related obligations, such asthe proposed obligations on record keeping. Secondly, it focuses on a legal analysis of their scope of application, of the content of the obligations, and on their practical implications. On the scope of transparency obligations tailored for high-risk AI systems, the research notably notes that it seems relatively narrow, given the proposed legal definition of the notion of users of AI systems. Hence, where end-users do not qualify as users, they may only receive very limited information. This element might potentially raise concern regarding the objective of the Proposal. On the content of the transparency obligations, the research highlights that the information that should benefit users of high-risk AI systems is both very broad and specific, from a technical perspective. Therefore, the information required under those obligations seems to create, prima facie, an adequate framework to ensure trust for users of high-risk AI systems. However, on the practical implications of these transparency obligations, the research notes that concern arises due to potential illiteracy of high-risk AI systems users. They might not benefit from sufficient technical expertise to fully understand the information provided to them, despite the wording of the Proposal, which requires that information should be comprehensible to its recipients (i.e. users).On this matter, the research points that there could be, more broadly, an important divergence between the level of detail of the information required by the Proposal and the level of expertise of users of high-risk AI systems. As a conclusion, the research provides policy recommendations to tackle (part of) the issues highlighted. It notably recommends to broaden the scope of transparency requirements for high-risk AI systems to encompass end-users. It also suggests that principles of explanation, as they were put forward in the Guidelines for Trustworthy AI of the High Level Expert Group, should be included in the Proposal in addition to transparency obligations.

Keywords: aI act proposal, explainability of aI, high-risk aI systems, transparency requirements

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Authors: Narine Ghazaryan, Joana Catarina Macedo, Sara Vaz, Naira Ayvazyan, Elsa Logarinho

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Macrovipera lebetina obtusa (MLO) is a poisonous snake in Armenia. Obtustatin represents the shortest known monomeric disintegrin, isolated from the snake venom of MLO, and is known to specifically inhibit α1β1 integrin. Its oncostatic effect is due to the inhibition of angiogenesis, which likely arises from α1β1 integrin inhibition in the endothelial cells. To explore the therapeutic potential of the MLO snake venom and obtustatin, we studied activity of obtustatin and MLO venom in vitro, by testing their efficacy in human dermal microvascular endothelial cells (HMVEC-D) and in vivo, using chick embryo chorioallantoic membrane assay (CAM assay). Our in vitro results showed that obtustatin in comparison with MLO venom did not exhibit cytotoxic activity in HMVEC-D cells in comparison to MLO venom. But in vivo results have shown that 4µg /embryo (90 µM) of obtustatin inhibited angiogenesis induced by FGF2 by 17% while MLO snake venom induced 22% reduction of the angiogenic index. The concentration of obtustatin in the crude MLO venom was 0.3 nM, which is 300.000 times less than the concentration of the obtustatin itself. Given this enormous difference in concentration, it is likely that some components of the crude venom contribute to the observed anti-angiogenic effect. Hypotheses will be ascertained to justify this action: components in the MLO venom may increase obtustatin efficacy or have independent but synergic anti-angiogenic activities.

Keywords: angiogenesis, alpa1 beta 1 integrin, Macrovipera lebetina obtusa, obtustatin

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Authors: Naira Ghambaryan, Gagik Hakobyan

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Purpose:The study was to evaluate the survival rate of short implants (5-6 mm) functionalized with UV radiation placed in the posterior segments of the atrophied maxilla. Materials and Methods:The study included 47 patients with unilateral/bilateral missing teeth and vertical atrophy of the posterior maxillary area. A total of 64 short UV-functionalized implants and 62 standard implants over 10 mm in length were placed in patients. The clinical indices included the following parameters: ISQБ MBL, OHIP-G scale. Results: For short implants, the median ISQ at placement was 62.2 for primary stability, and the median ISQ at 5 months was 69.6 ISQ. For standart implant, the mean ISQ at placement was 64.3 ISQ, and ISQ after 5 months was 71.6 ISQ. Аfter 6 months mean MBL short implants 0.87 mm, after 1 year, 1.13 mm, after 5 year was 1.48 mm. Аfter 6 months, mean MBL standard implants 0.84 mm, after 1 year, 1.24 mm, after 5 year was 1.58 mm. Mean OHIP-G scores -patients satisfaction with the implant at 4.8 ± 0.3, satisfaction with the operation 4.6 ± 0.4; satisfaction with prosthetics 4.7 ± 0.5. Cumulative 5-year short implants rates was 96.7%, standard implants was 97.4%, and prosthesis cumulative survival rate was 97.2%. Conclusions: Short implants with ultraviolet functionalization for prosthetic rehabilitation of the posterior resorbed maxilla region is a reliable, reasonable alternative to sinus lift, demonstrating fewer complications, satisfactory survival of a 5-year follow-up period, and reducing the number of additional surgical interventions and postoperative complications.

Keywords: short implant, ultraviolet functionalization, atrophic posterior maxilla, prosthodontic rehabilitation

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Authors: Shams Alyusof

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This work is to enrich the studies of the frames due to their prominent role in pure mathematics as well as in applied mathematics and many applications in computer science and engineering. Recently, there are remarkable studies of operators that preserve frames on some spaces, and this research could be considered as an extension of such studies. Indeed, this paper is to we characterize weighted composition operators that preserve frames in weighted Hardy spaces on the open unit disk. Moreover, it shows that this characterization does not apply to generalized weighted composition operators on such spaces. Nevertheless, this study could be extended to provide more specific characterizations.

Keywords: frames, generalized weighted composition operators, weighted Hardy spaces, analytic functions

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Authors: Faris Algahtani

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The COVID 19 pandemic and associated public health measures have disrupted the lives of peoplearound the world, including children. There is little knowledge about how pandemic measures have affected children in the Kingdom of Saudi Arabia (KSA). The aim and objectives of this qualitative study was to learn about the outcomes and impacts of the pandemic on children ages 0-8 in KSA. The study was based on 40 in-depth interviews that were conducted with experts in health, social protection, education, and early learning, children with special needs, and economics, including decision makers as well as specialists in service provision. The interviews were recorded and translated from Arabic to English into summary notes. The narrative was coded and analyzed following a thematic analysis.

Keywords: disabilities, COVID-19, families, children

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Authors: Susan Corby, Pete Burgess, Armin Hoeland, Helene Michel, Laurent Willemez

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In German 1st instance labour courts, lay judges always sit with a professional judge and in British and French 1st instance labour courts, lay judges sometimes sit with a professional judge. The lay judges’ main contribution is their workplace knowledge, but they act in a juridical setting where legal norms prevail. Accordingly, the research question is: does the professional judge dominate the lay judges? The research, funded by the Hans-Böckler-Stiftung, is based on over 200 qualitative interviews conducted in France, Germany and Great Britain in 2016-17 with lay and professional judges. Each interview lasted an hour on average, was audio-recorded, transcribed and then analysed using MaxQDA. Status theories, which argue that external sources of (perceived) status are imported into the court, and complementary notions of informational advantage suggest professional judges might exercise domination and control. Furthermore, previous empirical research on British and German labour courts, now some 30 years old, found that professional judges dominated. More recent research on lay judges and professional judges in criminal courts also found professional judge domination. Our findings, however, are more nuanced and distinguish between the hearing and deliberations, and also between the attitudes of judges in the three countries. First, in Germany and Great Britain the professional judge has specialist knowledge and expertise in labour law. In contrast, French professional judges do not study employment law and may only seldom adjudicate on employment law cases. Second, although the professional judge chairs and controls the hearing when he/she sits with lay judges in all three countries, exceptionally in Great Britain lay judges have some latent power as they have to take notes systematically due to the lack of recording technology. Such notes can be material if a party complains of bias, or if there is an appeal. Third, as to labour court deliberations: in France, the professional judge alone determines the outcome of the case, but only if the lay judges have been unable to agree at a previous hearing, which only occurs in 20% of cases. In Great Britain and Germany, although the two lay judges and the professional judge have equal votes, the contribution of British lay judges’ workplace knowledge is less important than that of their German counterparts. British lay judges essentially only sit on discrimination cases where the law, the purview of the professional judge, is complex. They do not sit routinely on unfair dismissal cases where workplace practices are often a key factor in the decision. Also, British professional judges are less reliant on their lay judges than German professional judges. Whereas the latter are career judges, the former only become professional judges after having had several years’ experience in the law and many know, albeit indirectly through their clients, about a wide range of workplace practices. In conclusion, whether or if the professional judge dominates lay judges in labour courts varies by country, although this is mediated by the attitudes of the interactionists.

Keywords: cross-national comparisons, labour courts, professional judges, lay judges

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Authors: Alina Rahim, Joanne Moffatt, Jessica Taylor, Joseph Hartland, Tamer Abdelrazik

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Background: In 2011, 15% of maternal deaths in Uganda were due to hypertensive disorders (pre-eclampsia and eclampsia). The majority of these deaths are avoidable with optimum antenatal care. The aim of the study was to evaluate how antenatal monitoring of pre-eclampsia was carried out in a low resource setting and to identify barriers to best practice as recommended by the World Health Organisation (WHO) as part of a 4th year medical student External Student Selected component field trip. Method: Women admitted to hospital with pre-eclampsia in rural Uganda (Villa Maria and Kitovu Hospitals) over a year-long period were identified using the maternity register and antenatal record book. It was not possible to obtain notes for all cases identified on the maternity register. Therefore a total of thirty sets of notes were reviewed. The management was recorded and compared to Ugandan National Guidelines and WHO recommendations. Additional qualitative information on routine practice was established by interviewing staff members from the obstetric and midwifery teams. Results: From the records available, all patients in this sample were managed according to WHO recommendations during labour. The rate of Caesarean section as a mode of delivery was noted to be high in this group of patients; 56% at Villa Maria and 46% at Kitovu. Antenatally two WHO recommendations were not routinely met: aspirin prophylaxis and calcium supplementation. This was due to lack of resources, and lack of attendance at antenatal clinic leading to poor detection of high-risk patients. Medical management of pre-eclampsia varied between individual patients, overall 93.3% complied with Ugandan national guidelines. Two patients were treated with diuretics, which is against WHO guidance. Discussion: Antenatal monitoring of pre-eclampsia is important in reducing severe morbidity, long-term disability and mortality amongst mothers and their babies 2 . Poor attendance at antenatal clinic is a barrier to healthcare in low-income countries. Increasing awareness of the importance of these visits for women should be encouraged. The majority of cases reviewed in this sample of women were treated according to Ugandan National Guidelines. It is recommended to commence the use of aspirin prophylaxis for women at high-risk of developing pre-eclampsia and the creation of detailed guidelines for Uganda which would allow for standardisation of care county-wide.

Keywords: antenatal monitoring, low resource setting, pre-eclampsia, Uganda

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Authors: Lucas A. Silva, Carla R. Aguiar

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This work presents a proposal to perform contextual sentiment analysis using a supervised learning algorithm and disregarding the extensive training of annotators. To achieve this goal, a web platform was developed to perform the entire procedure outlined in this paper. The main contribution of the pipeline described in this article is to simplify and automate the annotation process through a system of analysis of congruence between the notes. This ensured satisfactory results even without using specialized annotators in the context of the research, avoiding the generation of biased training data for the classifiers. For this, a case study was conducted in a blog of entrepreneurship. The experimental results were consistent with the literature related annotation using formalized process with experts.

Keywords: sentiment analysis, untrained annotators, naive bayes, entrepreneurship, contextualized classifier

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Authors: Iman Ali Ahmed Al-Rashed

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This paper directs attention to the limitations of the teacher-centered strategy in teaching. The aim of this study is to draw more educational attention to learner-centered strategy in order to shift the emphasis from the traditional concept of teaching to a new concept in teaching. To begin bridging the traditional concept of teaching and the new concept, the study will explore the new concept of teaching to support teaching in Arab World generally and in Iraq specifically. A qualitative case study orientation was used to collect data in the form of classroom observations, interviews and field notes. The teaching practices used by three university instructors are investigated and according to the findings, some explanations and recommendations are made.

Keywords: case study, learner-centered strategy, qualitative study, teacher-centered strategy, traditional teaching

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Authors: Kurt S. Candilas

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This expressive critical study is an effort to bring in light new interpretation of Robert Frost poem 'The Road Not Taken' as a reflection of his indecisiveness in life. Specifically, it aims at examining Frost’s inner being, emphasizing his own self and experiences in the poem or text. The study employs the qualitative research design which made use of discourse analysis using the critical theory of expressivism as the main guide. In acquiring the data of the study, the art of historiography is used such as autobiographical and/or biographical notes, sources documents, and web information. In executing the methods involved in this study, it is observed that the poem shows a naturalist implicatures, expressing Frost’s strong feelings and emotions being devoid of free will and a narrow bit of confusions and ambiguities with his indecisions in life.

Keywords: The Road Not Taken, expressivism, indecisiveness, naturalist implicatures

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