Search results for: Hayatabad Medical Complex

Authors: Juan Manuel Brito-Diaz

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The emergence of urban environmentalism in Spain is related to the processes of economic transformation and growing urbanization that occurred during the end of the Franco regime and the democratic transition. This paper analyzes the urban environmental mobilizations and their impacts as relevant democratizing agents in the processes of political change in cities. It’s an under-researched topic and studies on environmental movements in Spain have paid little attention to it. This research takes as its starting point the close link between democratization and environmentalism, since it considers that environmental conflicts are largely a consequence of democratic problems, and that the impacts of environmental movements are directly linked to the democratization. The study argues that the environmental movements that emerged in Spain at the end of the dictatorship and the democratic transition are an important part of the broad and complex associative fabric that promoted the democratization process. The research focuses on investigating the environmental protest in Las Palmas de Gran Canaria—the most important city in the Canary Islands—between 1970 and 1983, concurrently with the last local governments of the dictatorship and the first democratic city councils. As it is a case study, it opens up the possibility to ask multiple specific questions and assess each of the responses obtained. Although several research methodologies have been applied, such as the analysis of historical archives documentation or oral history interviews, mainly a very widespread methodology in the sociology of social movements, although very little used by social historians, has been used: the Protest Event Analysis (PEA). This methodology, which consists of generating a catalog of protest events by coding data around previously established variables, has allowed me to map, analyze and interpret the occurrence of protests over time and space, and associated factors, through content analysis. For data collection, news from local newspapers have provided a large enough sample to analyze the properties of social protest -frequency, size, demands, forms, organizers, etc.—and relate them to another type of information related to political structures and mobilization repertoires, encouraging the establishment of connections between the protest and the political impacts of urban movements. Finally, the study argues that the environmental movements of this period were essential to the construction of the new democratic city in Spain, not only because they established the issues of sustainability and urban environmental justice on the public agenda, but also because they proposed that conflicts derived from such matters should ultimately be resolved through public deliberation and citizen participation.

Keywords: democratization, environmental movements, political impacts, social movements

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Authors: Shirin Sarejloo

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Background: Electrophysiological-related manifestation of COVID-19 is a matter of debate in the literature nowadays. A wide spectrum of arrhythmias was observed among patients who have been infected with COVID-19. Objectives: This study discussed the prevalence of arrhythmias and conduction system disease in patients with COVID-19. Method: In this retrospective study, demographic and electrocardiographic data of 432 expired COVID-19 patients who had been admitted to Faghihi Hospital of Shiraz University of Medical Sciences from August2020 until December 2020 were reviewed. Results: Atrioventricular nodal block (AVB) was found in 40(9.3%) patients. Furthermore, 28(6.5%) of them suffered from the first degree of AVB, and 12(2.8%) suffered from complete heart block (CHB). Among 189 cases (59.0%), ST-T changes agreed with myocardial infarction or localized myocarditis. Findings of myocardial injury, including fragmented QRS and prolonged QTc were observed among 91 (21.1%) and 28 (6.5%), respectively. In victims of COVID-19, conduction disease was not related to any comorbidities. Fragmented QRS, axis deviation, presence of S1Q3T3, and poor R wave progression were significantly related to conduction system abnormalities in victims of COVID-19 (P-value > 0.05). Conclusion: Our findings can serve in future studies that aim to develop a risk stratification method for susceptible COVID-19 patients. The myocardial injury appears to role significantly in COVID-19 morbidity and mortality. Consequently, we recommend health policymakers consider separate catheterization laboratories that provide service only to COVID-19 patients.

Keywords: COVID-19, conduction system, ECG, atrioventricular block

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Authors: Mohsin Ali Baloch, Saira Baloch

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Objective: The aim of this study was to evaluate the levels of serum lipid profiles in Urban and Rural Population of Sindh, to indicate the existing risk of cardiovascular diseases. Material and Methods: Study was conducted at Liaquat University of Medical & Health Sciences, in the cities of Jamshoro and Hyderabad of Sindh. Blood samples from 300 healthy individuals were collected in fasting condition, out them 100 were from rural population, 100 were urban while 100 were used as control group. The biochemistry of these samples was obtained by the analysis of total Cholesterol, high density lipoprotein Cholesterol (HDL), low-density lipoprotein Cholesterol (LDL) and Triglycerides using kit method on Analyzer Clinical Chemistry. Results and Conclusion: Serum levels of total cholesterol, Triglycerides, and LDL cholesterol were significantly raised in the rural and urban males, whereas HDL cholesterol was decreased as compared to the Healthy controls that indicated significant risk of CVD. Urban population was with more risk of CVD and male gender in both groups was at more risk. The worst lipid profile in gender wise distribution was observed in male gender of urban population with highest Total Cholesterol/HDL Ratio while female gender also shown moderate risk of CVD with highest LDL/HDL Ratio.

Keywords: cardiovascular diseases, lipid profiles, urban and rural population, LDL/HDL Ratio

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Authors: Shoury Gupta

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Chatbots are a rapidly growing technological trend that has revolutionized the way businesses interact with their customers. With the advancements in artificial intelligence, chatbots can now mimic human-like conversations and provide instant and efficient responses to customer inquiries. In this research paper, we aim to explore the implications of chatbots on the future of globalization for both businesses and consumers. The paper begins by providing an overview of the current state of chatbots in the global market and their growth potential in the future. The focus is on how chatbots have become a valuable tool for businesses looking to expand their global reach, especially in areas with high population density and language barriers. With chatbots, businesses can engage with customers in different languages and provide 24/7 customer service support, creating a more accessible and convenient customer experience. The paper then examines the impact of chatbots on cross-cultural communication and how they can help bridge communication gaps between businesses and consumers from different cultural backgrounds. Chatbots can potentially facilitate cross-cultural communication by offering real-time translations, voice recognition, and other innovative features that can help users communicate effectively across different languages and cultures. By providing more accessible and inclusive communication channels, chatbots can help businesses reach new markets and expand their customer base, making them more competitive in the global market. However, the paper also acknowledges that there are potential drawbacks associated with chatbots. For instance, chatbots may not be able to address complex customer inquiries that require human input. Additionally, chatbots may perpetuate biases if they are programmed with certain stereotypes or assumptions about different cultures. These drawbacks may have significant implications for businesses and consumers alike. To explore the implications of chatbots on the future of globalization in greater detail, the paper provides a thorough review of existing literature and case studies. The review covers topics such as the benefits of chatbots for businesses and consumers, the potential drawbacks of chatbots, and how businesses can mitigate any risks associated with chatbot use. The paper also discusses the ethical considerations associated with chatbot use, such as privacy concerns and the need to ensure that chatbots do not discriminate against certain groups of people. The ethical implications of chatbots are particularly important given the potential for chatbots to be used in sensitive areas such as healthcare and financial services. Overall, this research paper provides a comprehensive analysis of chatbots and their implications for the future of globalization. By exploring both the potential benefits and drawbacks of chatbot use, the paper aims to provide insights into how businesses and consumers can leverage this technology to achieve greater global reach and improve cross-cultural communication. Ultimately, the paper concludes that chatbots have the potential to be a powerful tool for businesses looking to expand their global footprint and improve their customer experience, but that care must be taken to mitigate any risks associated with their use.

Keywords: chatbots, conversational AI, globalization, businesses

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Authors: Zoi Konsoula

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The increasing prevalence of Alzheimer’s disease (AD) and diabetes mellitus (DM) constitutes them major global health problems. Recently, the inhibition of key enzyme activity is considered a potential treatment of both diseases. Specifically, inhibition of acetylcholinesterase (AChE), the key enzyme involved in the breakdown of the neurotransmitter acetylcholine, is a promising approach for the treatment of AD, while inhibition of α-amylase retards the hydrolysis of carbohydrates and, thus, reduces hyperglycemia. Unfortunately, commercially available AChE and α-amylase inhibitors are reported to possess side effects. Consequently, there is a need to develop safe and effective treatments for both diseases. In the present study, pomegranate peel (PP) was extracted using various solvents of increasing polarity, while two extraction methods were employed, the conventional maceration and the ultrasound assisted extraction (UAE). The concentration of bioactive phytoconstituents, such as total phenolics (TPC) and total flavonoids (TFC) in the prepared extracts was evaluated by the Folin-Ciocalteu and the aluminum-flavonoid complex method, respectively. Furthermore, the anti-neurodegenerative and anti-hyperglycemic activity of all extracts was determined using AChE and α-amylase inhibitory activity assays, respectively. The inhibitory activity of the extracts against AChE and α-amylase was characterized by estimating their IC₅₀ value using a dose-response curve, while galanthamine and acarbose were used as positive controls, respectively. Finally, the kinetics of AChE and α-amylase in the presence of the most inhibitory potent extracts was determined by the Lineweaver-Burk plot. The methanolic extract prepared using the UAE contained the highest amount of phytoconstituents, followed by the respective ethanolic extract. All extracts inhibited acetylcholinesterase in a dose-dependent manner, while the increased anticholinesterase activity of the methanolic (IC₅₀ = 32 μg/mL) and ethanolic (IC₅₀ = 42 μg/mL) extract was positively correlated with their TPC content. Furthermore, the activity of the aforementioned extracts was comparable to galanthamine. Similar results were obtained in the case of α-amylase, however, all extracts showed lower inhibitory effect on the carbohydrate hydrolyzing enzyme than on AChE, since the IC₅₀ value ranged from 84 to 100 μg/mL. Also, the α-amylase inhibitory effect of the extracts was lower than acarbose. Finally, the methanolic and ethanolic extracts prepared by UAE inhibited both enzymes in a mixed (competitive/noncompetitive) manner since the Kₘ value of both enzymes increased in the presence of extracts, while the Vmax value decreased. The results of the present study indicate that PP may be a useful source of active compounds for the management of AD and DM. Moreover, taking into consideration that PP is an agro-industrial waste product, its valorization could not only result in economic efficiency but also reduce the environmental pollution.

Keywords: acetylcholinesterase, Alzheimer’s disease, α-amylase, diabetes mellitus, pomegranate

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Authors: Novutry Siregar, Afdal, Emilzon Taslim

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Hyaline Membrane Disease (HMD) is the main cause of respiratory failure in preterm neonates caused by surfactant deficiency. Nasal Continuous Positive Airway Pressure (NCPAP) is the therapy for HMD. The success of therapy is determined by gestational age, birth weight, HMD grade, time of NCAP administration, and time of breathing frequency recovery. The aim of this research is to identify the predictive factor of NCPAP therapy success in preterm neonates with HMD. This study used a cross-sectional design by using medical records of patients who were treated in the Perinatology of the Pediatric Department of Dr. M. Djamil Padang Central Hospital from January 2015 to December 2017. The samples were eighty-two neonates that were selected by using the total sampling technique. Data analysis was done by using the Chi-Square Test and the Multiple Logistic Regression Prediction Model. The results showed the success rate of NCPAP therapy reached 53.7%. Birth weight (p = 0.048, OR = 3.34 95% CI 1.01-11.07), HMD grade I (p = 0.018, OR = 4.95 CI 95% 1.31-18.68), HMD grade II (p = 0.044, OR = 5.52 95% CI 1.04-29.15), and time of breathing frequency recovery (p = 0,000, OR = 13.50 95% CI 3.58-50, 83) are the predictive factors of NCPAP therapy success in preterm neonates with HMD. The most significant predictive factor is the time of breathing frequency recovery.

Keywords: predictive factors, the success of therapy, NCPAP, preterm neonates, HMD

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Authors: Balogun R. Ayodeji, Adefisan E. Adesanya, Adeyewa Z. Debo, E. C. Okogbue

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The need to investigate diurnal weather circles in West Africa is coined in the fact that complex interactions often results from diurnal weather patterns. This study investigates diurnal circles of wind, rainfall and convective properties using six (6) hour interval data from the ERA-Interim and the Tropical Rainfall Measurement Mission (TRMM). The seven distinct zones, used in this work and classified as rainforest (west-coast, dry, Nigeria-Cameroon), Savannah (Nigeria, and Central Africa and South Sudan (CASS)), Sudano-Sahel, and Sahel, were clearly indicated by the rainfall pattern in each zones. Results showed that the land‐ocean warming contrast was more strongly sensitive to seasonal cycle and has been very weak during March-May (MAM) but clearly spelt out during June-September (JJAS). Dipoles of wind convergence/divergence and wet/dry precipitation, between CASS and Nigeria Savannah zones, were identified in morning and evening hours of MAM, whereas distinct night and day anomaly, in the same location of CASS, were found to be consistent during the JJAS season. Diurnal variation of convective properties showed that stratiform precipitation, due to the extremely low occurrence of flashcount climatology, was dominant during morning hours for both MAM and JJAS than other periods of the day. On the other hand, diurnal variation of the system sizes showed that small system sizes were most dominant during the day time periods for both MAM and JJAS, whereas larger system sizes were frequent during the evening, night, and morning hours. The locations of flashcount and system sizes agreed with earlier results that morning and day-time hours were dominated by stratiform precipitation and small system sizes respectively. Most results clearly showed that the eastern locations of Sudano and Sahel were consistently dry because rainfall and precipitation features were predominantly few. System sizes greater than or equal to 800 km² were found in the western axis of the Sudano and Sahel zones, whereas the eastern axis, particularly in the Sahel zone, had minimal occurrences of small/large system sizes. From the results of locations of extreme systems, flashcount greater than 275 in one single system was never observed during the morning (6Z) diurnal, whereas, the evening (18Z) diurnal had the most frequent cases (at least 8) of flashcount exceeding 275 in one single system. Results presented had shown the importance of diurnal variation in understanding precipitation, flashcount, system sizes patterns at diurnal scales, and understanding land-ocean contrast, precipitation, and wind field anomaly at diurnal scales.

Keywords: convective properties, diurnal circle, flashcount, system sizes

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Authors: Yaser Meeralam, Walaa Alharthi, Hadeel Ashi, Alaa Bakhsh, Kholood Aljabri, Ebtihal Bin Salim

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Background:Basidiobolusranrum causes one of the rare fungal diseases that infects mainly immunocompetent individuals. Gastrointestinal Basidiobolomycosis (GIB) is a rare and uncommon form of this fungal infection. It’s still ambiguous how this fungus is reaching the gastrointestinal tract leading to Gastrointestinal Basidiobolomycosis. Objective: To summarize the clinical features, imaging, and histopathological of patients diagnosed with GIB in our institution. Patients and methods: A series of five cases of patients who diagnosed by basidiobolomycosis in King Abdullah Medical City, Makkah, Saudi Arabia, which reviewed by latest literature related to diagnosis and treatment. Results: Most of the patients were externally evaluated and were initially misdiagnosed. Some of them were suspected of colonic malignancy, other presumed to have hepatic hemangioma and fistulizing crohn’s disease. The definitive diagnosis is often based on histopathological examination and fungal culture of the surgically resected mass. An optimum standardized treatment of basidiobolomycosis has not yet been established. Conclusion: Deeper knowledge of clinical characteristics, diagnosis, and treatment of basidiobolomycosis will allow early initiating of treatment with a subsequent positive impact on the patients’ outcome. More studies are needed to establish a definite treatment.

Keywords: gastrointestinal infection, crohn's mimics, malignancy mimics, fungal infection

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Authors: Luay Jum'a

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Many challenges are facing third-party logistics (3PL) providers in the domestic and global markets which create a volatile decision making environment. All these challenges such as managing changes in consumer behaviour, demanding expectations from customers and time compressions have turned into complex problems for 3PL providers. Since the movement towards increased outsourcing outpaces movement towards insourcing, the need to achieve a competitive advantage over competitors in 3PL market increases. This trend continues to grow over the years and as a result, areas of strengths and improvements are highlighted through the analysis of the LSQ factors that lead to B2B customers’ satisfaction which become a priority for 3PL companies. Consequently, 3PL companies are increasingly focusing on the most important issues from the perspective of their customers and relying more on this value of information in making their managerial decisions. Therefore, this study is concerned with providing guidance for improving logistics service quality (LSQ) levels in the context of 3PL industry in Jordan. The study focused on the most important factors in LSQ and used a managerial tool that guides 3PL companies in making LSQ improvements based on a quadrant analysis of two main dimensions: LSQ declared importance and LSQ inferred importance. Although, a considerable amount of research has been conducted to investigate the relationship between logistics service quality (LSQ) and customer satisfaction, there remains a lack of developing managerial tools to aid in the process of LSQ improvement decision-making. Moreover, the main advantage for the companies to use 3PL service providers as a trend is due to the realised percentage of cost reduction on the total cost of logistics operations and the incremental improvement in customer service. In this regard, having a managerial tool that help 3PL service providers in managing the LSQ factors portfolio effectively and efficiently would be a great investment for service providers. One way of suggesting LSQ improvement actions for 3PL service providers is via the adoption of analysis tools that perform attribute categorisation such as Importance–Performance matrix. In mind of the above, it can be stated that the use of quadrant analysis will provide a valuable opportunity for 3PL service providers to identify improvement opportunities as customer service attributes or factors importance are identified in two different techniques that complete each other. Moreover, the data were collected through conducting a survey and 293 questionnaires were returned from business-to-business (B2B) customers of 3PL companies in Jordan. The results showed that the LSQ factors vary in their importance and 3PL companies should focus on some LSQ factors more than other factors. Moreover, ordering procedures, timeliness/responsiveness LSQ factors considered being crucial in 3PL businesses and therefore they need to have more focus and development by 3PL service providers in the Jordanian market.

Keywords: logistics service quality, managerial decisions, quadrant analysis, third party logistics service provider

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Authors: Javad Vaezi, Ashraf Mohammadzadeh, Behjatalomoluk Ajami, Azin Vaezi, Aradokht Vaezi

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Introduction: Neonatal period is the first developing phase after birth, followed by different developmental processes up to the age of puberty. A neonate may be born with different oral lesions. The aim of this study was to evaluate oral lesions in newborns at Mashhad Imam Reza Hospital, which belongs to Mashhad University of Medical Sciences. Materials and Methods: In this cross–sectional descriptive study, 600 newborns were observed during 2.5 months in 2001. The total oral cavity, including the soft palate, hard palate, tongue, alveolar ridge, and oral cavity floor, was examined with a tongue blade and light. Results: Results showed that 52.6% of newborns (316 cases) had oral lesions. 0.66% cases had natal and neonatal teeth, 0.5% cases had congenital epulis, 1.8% cases were with ankyloglossia, 41.5% cases with Epstein’s pearls, 22.3% cases with Bohn nodules and 0.16% case with exostosis. There were no cases of cleft lip or cleft palate. The most frequent oral lesion observed was Epstein’s pearls. Conclusion: Our study showed that the prevalence of natal teeth in the city of Mashhad was more than in other countries except for Bohn nodule and Epstein’s pearls, which occurred less frequently than in other countries.

Keywords: newborn, oral lesion, epidemiology, frequency

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Authors: G. Zakharov, Z. Aslamazashvili, M. Chikhradze, D. Kvaskhvadze, N. Khidasheli, S. Gvazava

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Traditional technologies for processing iron-containing industrial waste, including steel-rolling production, are associated with significant energy costs, the long duration of processes, and the need to use complex and expensive equipment. Waste generated during the industrial process negatively affects the environment, but at the same time, it is a valuable raw material and can be used to produce new marketable products. The study of the effectiveness of self-propagating high-temperature synthesis (SHS) methods, which are characterized by the simplicity of the necessary equipment, the purity of the final product, and the high processing speed, is under the wide scientific and practical interest to solve the set problem. The work presents technological aspects of the production of Ferro boron by the method of SHS - metallurgy from iron-containing wastes of rolled production for alloying of cast iron and results of the effect of alloying element on the degree of boron assimilation with liquid cast iron. Features of Fe-B system combustion have been investigated, and the main parameters to control the phase composition of synthesis products have been experimentally established. Effect of overloads on patterns of cast ligatures formation and mechanisms structure formation of SHS products was studied. It has been shown that an increase in the content of hematite Fe₂O₃ in iron-containing waste leads to an increase in the content of phase FeB and, accordingly, the amount of boron in the ligature. Boron content in ligature is within 3-14%, and the phase composition of obtained ligatures consists of Fe₂B and FeB phases. Depending on the initial composition of the wastes, the yield of the end product reaches 91 - 94%, and the extraction of boron is 70 - 88%. Combustion processes of high exothermic mixtures allow to obtain a wide range of boron-containing ligatures from industrial wastes. In view of the relatively low melting point of the obtained SHS-ligature, the positive dynamics of boron absorption by liquid iron is established. According to the obtained data, the degree of absorption of the ligature by alloying gray cast iron at 1450°C is 80-85%. When combined with the treatment of liquid cast iron with magnesium, followed by alloying with the developed ligature, boron losses are reduced by 5-7%. At that, uniform distribution of boron micro-additives in the volume of treated liquid metal is provided. Acknowledgment: This work was supported by Shota Rustaveli Georgian National Science Foundation of Georgia (SRGNSFG) under the GENIE project (grant number № CARYS-19-802).

Keywords: self-propagating high-temperature synthesis, cast iron, industrial waste, ductile iron, structure formation

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Authors: Begum Koru, Isik Aybay, Demet Celik Ulusoy

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The discipline of law is quite complex and has its own terminology. Apart from written legal rules, there is also living law, which refers to legal practice. Basic legal rules aim at the happiness of individuals in social life and have different characteristics in different branches such as public or private law. On the other hand, law is a national phenomenon. The law of one nation and the legal system applied on the territory of another nation may be completely different. People who are experts in a particular field of law in one country may have insufficient expertise in the law of another country. Today, in addition to the local nature of law, international and even supranational law rules are applied in order to protect basic human values and ensure the protection of human rights around the world. Systems that offer algorithmic solutions to legal problems using artificial intelligence (AI) tools will perhaps serve to produce very meaningful results in terms of human rights. However, algorithms to be used should not be developed by only computer experts, but also need the contribution of people who are familiar with law, values, judicial decisions, and even the social and political culture of the society to which it will provide solutions. Otherwise, even if the algorithm works perfectly, it may not be compatible with the values of the society in which it is applied. The latest developments involving the use of AI techniques in legal systems indicate that artificial law will emerge as a new field in the discipline of law. More AI systems are already being applied in the field of law, with examples such as predicting judicial decisions, text summarization, decision support systems, and classification of documents. Algorithms for legal systems employing AI tools, especially in the field of prediction of judicial decisions and decision support systems, have the capacity to create automatic decisions instead of judges. When the judge is removed from this equation, artificial intelligence-made law created by an intelligent algorithm on its own emerges, whether the domain is national or international law. In this work, the aim is to make a general analysis of this new topic. Such an analysis needs both a literature survey and a perspective from computer experts' and lawyers' point of view. In some societies, the use of prediction or decision support systems may be useful to integrate international human rights safeguards. In this case, artificial law can serve to produce more comprehensive and human rights-protective results than written or living law. In non-democratic countries, it may even be thought that direct decisions and artificial intelligence-made law would be more protective instead of a decision "support" system. Since the values of law are directed towards "human happiness or well-being", it requires that the AI algorithms should always be capable of serving this purpose and based on the rule of law, the principle of justice and equality, and the protection of human rights.

Keywords: AI and law, artificial law, protection of human rights, AI tools for legal systems

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Authors: Lynda Golea, Rachid Chebaki

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Schiff bases contain heterocyclic structural units with N and O donor atoms which plays an important role in coordination chemistry. Azomethine groups are a broad class of widely used compounds with applications in many fields, including analytical, inorganic chemistry and biological. Schiff's base is of promising research interest due to the widespread antibacterial resistance in medical science. In addition, the research is essential to generate Schiff base metal complexes with various applications. Schiff complexes have been used as drugs and have antibacterial, antifungal, antiviral, and anti-inflammatory properties. The various donor atoms they contain offer a special ability for metal binding. In this research on the physicochemical properties of azomethine groups, we synthesized and studied the Schiff base compounds by a condensation reaction of tryptamines and acetophenone in ethanol. The structure of the prepared compound was interpreted using 1H NMR, 13C NMR, UV-vis and FT-IR. A computational analysis at the level of DFT with functional B3LYP in conjunction with the base 6-311+G (d, p) was conducted to study its electronic and molecular structure. The biological study was performed on three bacterial strains usually causing infection, including Gram-positive and Gram-negative, for antibacterial activity. Results showed moderate biological activity and proportional activity with increasing concentration.

Keywords: azomethine, HOMO, LUMO, RMN, molecular docking

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Authors: R. Domínguez, A. Castro, N. Fernandez, F. Hidalgo, F. Ortiz

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Aims: Study musculoskeletal disorders produced by excess physical exertion in marines Introduction: Musculoskeletal injuries during military training are an important medical problem faced by military organizations throughout the world. Military occupations are physically demanding, which represents a high risk of injury "and subsequent disability, these injuries represent important risk factors for hospitalization, disability, and discharge Methodology: This is a causal correlational study in which data were collected in order to find a cause-effect relationship between the physical effort in marines during their career in the Chilean Navy and the musculoskeletal disorders that occur in some from them. Results:100% had experienced musculoskeletal pain in some part of the body and 73.52% of the respondents had experienced limitations in the ability to work, as a consequence forced to change jobs due to musculoskeletal pain. The neck, shoulders and the lumbar dorsal region were the regions with the highest prevalence of pain, as well as pain that limit the ability to work. Conclusion: Musculoskeletal injuries and illnesses related to injuries are common in marines, both in those who operate in campus Charles, as in another operational unit due to the nature of the work. Many of these injuries occur during physical training and sports and various studies have dealt with the descriptive epidemiology of musculoskeletal injuries in military personnel.

Keywords: physical effort, marines, musculoskeletal disorders produced (MSD), training

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Authors: Ishara Madusanka, So Morikawa

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Natural disasters, particularly floods, pose severe challenges globally, affecting both developed and developing countries. In many regions, especially Asia, riverine floods are prevalent and devastating. Integrated flood management incorporates structural and non-structural measures, with preventive relocation emerging as a cost-effective and proactive strategy for areas repeatedly impacted by severe flooding. However, preventive relocation is often hindered by economic, psychological, social, and institutional barriers. This study investigates the factors influencing resistance to preventive relocation and evaluates the role of flood risk information in shaping relocation decisions through risk perception. A conceptual model was developed, incorporating variables such as Flood Risk Information (FRI), Place Attachment (PA), Good Living Conditions (GLC), and Adaptation to Flooding (ATF), with Flood Risk Perception (FRP) serving as a mediating variable. The research was conducted in Welipitiya in the Polwatta river basin, Matara district, Sri Lanka, a region experiencing recurrent flood damage. For this study, an experimental design involving a structured questionnaire survey was utilized, with 185 households participating. The treatment group received flood risk information, including flood risk maps and historical data, while the control group did not. Data were collected in 2023 and analyzed using independent sample t-tests and Partial Least Squares Structural Equation Modeling (PLS-SEM). PLS-SEM was chosen for its ability to model latent variables, handle complex relationships, and suitability for exploratory research. Multi-group Analysis (MGA) assessed variations across different flood risk areas. Findings indicate that flood risk information had a limited impact on flood risk perception and relocation decisions, though its effect was significant in specific high-risk areas. Place attachment was a significant factor influencing relocation decisions across the sample. One potential reason for the limited impact of flood risk information on relocation decisions could be the lack of specificity in the information provided. The results suggest that while flood risk information alone may not significantly influence relocation decisions, it is crucial in specific contexts. Future studies and practitioners should focus on providing more detailed risk information and addressing psychological factors like place attachments to enhance preventive relocation efforts.

Keywords: flood risk communication, flood risk perception, place attachment, preventive relocation, structural equation modeling

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Authors: E. Gaury, P. Mandausch, O. Picot, A. R. Thomas, L. Veisblat, L. Ralambozanany, C. Delsart

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In Dakar, demographic and spatial growth was accompanied by a 50% increase in household waste between 1988 and 2008 in the city. In addition, a change in the nature of household waste was observed between 1990 and 2007. The share of plastic increased by 15% between 2004 and 2007 in Dakar. Plastics represent the seventh category of household waste, the most produced per year in Senegal. The share of plastic in household and similar waste is 9% in Senegal. Waste management in the city of Dakar is a complex process involving a multitude of formal and informal actors with different perceptions and objectives. The objective of this study was to understand the motivations that could lead to sorting action, as well as the perception of plastic waste sorting within the Dakar population (households and institutions). The problematic of this study was as follows: what may be the factors playing a role in the sorting action? In an attempt to answer this, two approaches have been developed: (1) An exploratory qualitative study by semi-structured interviews with two groups of individuals concerned by the sorting of plastic waste: on the one hand, the experts in charge of waste management and on the other the households-producers of waste plastics. This study served as the basis for formulating the hypotheses and thus for the quantitative analysis. (2) A quantitative study using a questionnaire survey method among households producing plastic waste in order to test the previously formulated hypotheses. The objective was to have quantitative results representative of the population of Dakar in relation to the behavior and the process inherent in the adoption of the plastic waste sorting action. The exploratory study shows that the perception of state responsibility varies between institutions and households. Public institutions perceive this as a shared responsibility because the problem of plastic waste affects many sectors (health, environmental education, etc.). Their involvement is geared more towards raising awareness and educating young people. As state action is limited, the emergence of private companies in this sector seems logical as they are setting up collection networks to develop a recycling activity. The state plays a moral support role in these activities and encourages companies to do more. The study of the understanding of the action of sorting plastic waste by the population of Dakar through a quantitative analysis was able to demonstrate the attitudes and constraints inherent in the adoption of plastic waste sorting.Cognitive attitude, knowledge, and visible consequences have been shown to correlate positively with sorting behavior. Thus, it would seem that the population of Dakar is more sensitive to what they see and what they know to adopt sorting behavior.It has also been shown that the strongest constraints that could slow down sorting behavior were the complexity of the process, too much time and the lack of infrastructure in which to deposit plastic waste.

Keywords: behavior, Dakar, plastic waste, waste management

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Authors: Wasmi Woishi

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Smart card technology is a secure and safe technology that is expanding its capabilities day by day in terms of holding important information without alteration. It is readily available, and its ease of portability makes it more efficient in terms of its usage. The smart card is in use by many industries such as financial, insurance, governmental industries, personal identification, to name a few. Smart card technology is popular for its wide familiarity, adaptability, accessibility, benefits, and portability. This research aims to find out the perception toward the application of a cloud-based healthcare system through a smart card in KSA. The research has compiled the countries using a smart card or smart healthcare card and indicated the potential benefits of implementing smart healthcare cards. 120 participants from Riyadh city were surveyed by the means of a closed-ended questionnaire. Data were analyzed through SPSS. This research extends the research body in the healthcare system. Empirical evidence regarding smart healthcare cards is scarce and hence undertaken in this study. The study provides a useful insight into collecting, storing, analyzing, manipulating, and accessibility of medical information regarding smart healthcare cards. Research findings can help achieve KSA's Vision 2030 goals in terms of the digitalization of healthcare systems in improving its efficiency and effectiveness in storing and accessing healthcare data.

Keywords: smart card technology, healthcare using smart cards, smart healthcare cards, KSA healthcare information system, cloud-based healthcare cards

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Authors: Zoe Boon Suan Loy

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An exploratory research undertaken in 2000 at the beginning of the COVID-19 pandemic examined the changing roles of Singapore school leaders as they lead teachers in developing future-ready learners. While it is evident that ‘LEADER’ qualities epitomize the knowledge, competencies, and skills required, recent events in an increasing VUCA and BANI world characterized by massively disruptive Ukraine -Russian war, unabating tense US-Sino relations, issues related to sustainability, and rapid ageing will have an impact on school leadership. As an increasingly complex endeavour, this requires a relook as they lead teachers in nurturing holistically-developed future-ready students. Digitalisation, new technology, and the push for a green economy will be the key driving forces that will have an impact on job availability. Similarly, the rapid growth of artificial intelligence (AI) capabilities, including ChatGPT, will aggravate and add tremendous stress to the work of school leaders. This paper seeks to explore the key school leadership shifts required beyond the ‘LEADER’ qualities as school leaders respond to the changes, challenges, and opportunities in the 21st C new normal. The research findings for this paper are based on an exploratory qualitative study on the perceptions of 26 school leaders (vice-principals) who were attending a milestone educational leadership course at the National Institute of Education, Nanyang Technological University, Singapore. A structured questionnaire is designed to collect the data, which is then analysed using coding methodology. Broad themes on key competencies and skills of future-ready leaders in the Singapore education system are then identified. Key Findings: In undertaking their leadership roles as leaders of future-ready learners, school leaders need to demonstrate the ‘LEADER’ qualities. They need to have a long-term view, understand the educational imperatives, have a good awareness of self and the dispositions of a leader, be effective in optimizing external leverages and are clear about their role expectations. These ‘LEADER’ qualities are necessary and relevant in the post-Covid era. Beyond this, school leaders with ‘LEADER’ qualities are well supported by the Ministry of Education, which takes cognizance of emerging trends and continually review education policies to address related issues. Concluding Statement: Discussions within the education ecosystem and among other stakeholders on the implications of the use of artificial intelligence and ChatGPT on the school curriculum, including content knowledge, pedagogy, and assessment, are ongoing. This augurs well for school leaders as they undertake their responsibilities as leaders of future-ready learners.

Keywords: Singapore education system, ‘LEADER’ qualities, school leadership, future-ready leaders, future-ready learners

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Authors: Natasha Mandal, Rakesh Singh Moirangthem

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The present work reports a theoretical model to develop a plasmonic biosensor for the detection of glucose concentrations in human blood and urine as the abnormality of glucose label is the major cause of diabetes which becomes a life-threatening disease worldwide. This study is based on the surface plasmon resonance (SPR) sensor applications which is a well-established, highly sensitive, label-free, rapid optical sensing tool. Here we have introduced a sandwich assay of two dielectric spacer layers of MgF2 and BaTiO3which gives better performance compared to commonly used SiO2 and TiO2 dielectric spacers due to their low dielectric loss and higher refractive index. The sensitivity of our proposed sensor was found as 3242 nm/RIU approximately, with an excellent linear response of 0.958, which is higher than the conventional single-layer Au SPR sensor. Further, the sensitivity enhancement is also optimized by coating a few layers of two-dimensional (2D) nanomaterials (e.g., Graphene, h-BN, MXene, MoS2, WS2, etc.) on the sensor chip. Hence, our proposed SPR sensor has the potential for the detection of glucose concentration in blood and urine with enhanced sensitivity and high affinity and could be utilized as a reliable platform for the optical biosensing application in the field of medical diagnosis.

Keywords: biosensor, surface plasmon resonance, dielectric spacer, 2D nanomaterials

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Authors: Patcharaporn Sudchada, Nuntika Prommee

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Background: Herbal medicines constitute a vital component of Thailand's healthcare system and possess significant potential for international recognition. However, the absence of standardized clinical research guidelines aligned with international standards, coupled with unique local challenges, has hindered the development and registration of Thai herbal medicines in the global market. Objective: To establish comprehensive research and development guidelines for herbal medicine formulations that comply with international standards, with particular emphasis on enhancing research quality, scientific credibility, and facilitating both domestic registration and international market acceptance. Methods: The research methodology comprised eight sequential phases: (1) systematic collection and review of relevant documentation and regulatory frameworks; (2) development of preliminary content structure and template designs; (3) systematic analysis and synthesis of scientific evidence and regulatory data; (4) creation of detailed research guidelines and accompanying templates; (5) execution of domestic and international consultation meetings and study visits involving nine stakeholder groups; (6) systematic expert review of the draft guidelines; (7) incorporation of feedback from relevant regulatory and research agencies; and (8) finalization and validation of the comprehensive guidelines. Results: The study produced comprehensive research and development guidelines for herbal medicines that meet international standards, encompassing the complete development pathway from initial concept through pre-clinical studies, product development, preparation protocols, clinical trial conduct, and product registration procedures. The guidelines include standardized templates and forms specifically designed for clinical research documentation. Conclusion: The established guidelines represent a significant advancement in standardizing clinical research for Thai herbal medicines, enhancing their scientific credibility and potential for international acceptance. Nevertheless, Thailand continues to face specific challenges, including insufficient specialized personnel in herbal research (particularly in clinical trials), challenges in integrating traditional Thai medicine principles with modern scientific methodology, limited research infrastructure, inadequate funding mechanisms, complex registration procedures, and public skepticism toward herbal products. The policy recommendations outlined in this research provide a strategic framework for addressing these challenges and promoting sustainable development of Thai herbal medicines within the national context.

Keywords: herbal medicine, clinical research, international standards, research guidelines, drug development, traditional thai medicine, regulatory compliance

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Authors: Seyed Aliasghar Mosavi, Mostafa Naderi, Khosrow Jadidi, Amir Hashem Mohammadi

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To study the measurement of intraocular pressure (IOP) before and after implantation of intrastromal corneal ring (MyoRing) in patients with keratoconus. Setting: Baqiyatallah University of Medical Sciences, Tehran, Iran. Methods: We compared the IOP of 13 eyes which underwent MyoRing implantation prior and six months post operation using Goldman applanation (as gold standard), Icare, and Corvis ST (uncorrected, corrected and corrected with cornea biomechanics). Results: The resulting intraocular pressure measurements prior to surgery, Icare, Corvis (corrected with cornea biomechanics) overestimated the IOP, however measurements by Corvis uncorrected underestimate the IOP. The resulting intraocular pressure measurements after surgery, Icare, Corvis (corrected with cornea biomechanics) overestimated the IOP but measurements by Corvis uncorrected underestimate the IOP. Conclusion: Consistent intraocular pressure measurements on eyes with Myoring in keratoconus can be obtained with the Goldman applanation tonometer as the gold standard measurement. We were not able to obtain consistent results when we measured the IOP by Icare and Corvis prior and after surgery.

Keywords: intraocular pressure, MyoRing, Keratoconus, Goldmann applanation, Icare, Corvis ST

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Authors: Oswaldo Otero, Eduardo A. Orozco, Ana M. Herrera

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In this work, we present results from analytical and numerical studies of the electron acceleration by a TE₀₁₁ cylindrical microwave mode in a static homogeneous magnetic field under electron cyclotron resonance (ECR) condition. The stability of the orbits is analyzed using the particle orbit theory. In order to get a better understanding of the interaction wave-particle, we decompose the azimuthally electric field component as the superposition of right and left-hand circular polarization standing waves. The trajectory, energy and phase-shift of the electron are found through a numerical solution of the relativistic Newton-Lorentz equation in a finite difference method by the Boris method. It is shown that an electron longitudinally injected with an energy of 7 keV in a radial position r=Rc/2, being Rc the cavity radius, is accelerated up to energy of 90 keV by an electric field strength of 14 kV/cm and frequency of 2.45 GHz. This energy can be used to produce X-ray for medical imaging. These results can be used as a starting point for study the acceleration of electrons in a magnetic field changing slowly in time (GYRAC), which has some important applications as the electron cyclotron resonance ion proton accelerator (ECR-IPAC) for cancer therapy and to control plasma bunches with relativistic electrons.

Keywords: Boris method, electron cyclotron resonance, finite difference method, particle orbit theory, X-ray

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Authors: Osman Adiguzel

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Shape memory effect is a peculiar property exhibited by certain alloy systems and based on martensitic transformation, and shape memory properties are closely related to the microstructures of the material. Shape memory effect is linked with martensitic transformation, which is a solid state phase transformation and occurs with the cooperative movement of atoms by means of lattice invariant shears on cooling from high-temperature parent phase. Lattice twinning and detwinning can be considered as elementary processes activated during the transformation. Thermally induced martensite occurs as martensite variants, in self-accommodating manner and consists of lattice twins. Also, this martensite is called the twinned martensite or multivariant martensite. Deformation of shape memory alloys in martensitic state proceeds through a martensite variant reorientation. The martensite variants turn into the reoriented single variants with deformation, and the reorientation process has great importance for the shape memory behavior. Copper based alloys exhibit this property in metastable β- phase region, which has DO3 –type ordered lattice in ternary case at high temperature, and these structures martensiticaly turn into the layered complex structures with lattice twinning mechanism, on cooling from high temperature parent phase region. The twinning occurs as martensite variants with lattice invariant shears in two opposite directions, <110 > -type directions on the {110}- type plane of austenite matrix. Lattice invariant shear is not uniform in copper based ternary alloys and gives rise to the formation of unusual layered structures, like 3R, 9R, or 18R depending on the stacking sequences on the close-packed planes of the ordered lattice. The unit cell and periodicity are completed through 18 atomic layers in case of 18R-structure. On the other hand, the deformed material recovers the original shape on heating above the austenite finish temperature. Meanwhile, the material returns to the twinned martensite structures (thermally induced martensite structure) in one way (irreversible) shape memory effect on cooling below the martensite finish temperature, whereas the material returns to the detwinned martensite structure (deformed martensite) in two-way (reversible) shape memory effect. Shortly one can say that the microstructural mechanisms, responsible for the shape memory effect are the twinning and detwinning processes as well as martensitic transformation. In the present contribution, x-ray diffraction, transmission electron microscopy (TEM) and differential scanning calorimetry (DSC) studies were carried out on two copper-based ternary alloys, CuZnAl, and CuAlMn.

Keywords: shape memory effect, martensitic transformation, twinning and detwinning, layered structures

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Authors: M. Khaledi Pour, P. Akbartehrani, M. Amini, M. Khani, M. Mohajeri Tehrani, R. Radi, B. Shokri

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Diabetic Foot Ulcer (DFU) is one of the costly severe complications of diabetes. Neuropathy and Peripheral Arterial Disease (PAD) due to diabetes are significant causes of this complication. In 10 years the patients with DFUs are twice as likely to die as patients without DFUs. Cold Atmospheric Plasma (CAP) is a promising tool for medical purposes. CAP generate reactive species at room temperature and are effective in killing bacteria and fibroblast proliferation. These CAP-based tools produce NO, which has bactericidal and angiogenesis properties. It also showed promising effects in the DFUs surface reduction and the time to wound closure. In this paper, we evaluated the effect of the Argon Plasma Jet (APJ) on the healing process of the Wagner Grade 2 DFUs in a randomized clinical trial. The 20 kHz sinusoidal voltage frequency derives the APJ. Patients (n=20) were randomly double-blinded assigned into two groups. These groups receive the standard care (SC, n=10) and the standard care with APJ treatment (SC+APJ, n=10) for five sessions in four weeks. The results showed that the APJ treatment along standard care could reduce the wound surface by 20 percent more than the standard care. Also, It showed a more influential role in controlling wound infection.

Keywords: argon plasma jet, cold atmospheric plasma, diabetes, diabetic foot ulcer

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Authors: Stephanie A. Schauder, Gosia Sylwestrzak

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Overweight and obese women report avoiding preventive care due to fear of weight-related bias from medical professionals. Gynecological exams, due to their sensitive and personally invasive nature, are especially susceptible to avoidance. This research investigates the association between body mass index (BMI) and screening rates for breast and cervical cancer using claims data from 1.3 million members of a large health insurance company. Because obesity is associated with increased cancer risk, screenings for these cancers should increase as BMI increases. However, this paper finds that the distribution of cancer screening rates by BMI take an inverted U-shape with underweight and obese members having the lowest screening rates. For cervical cancer screening, those in the target population with a BMI of 23 have the highest screening rate at 68%, while Obese Class III members have a screening rate of 50%. Those in the underweight category have a screening rate of 58%. This relationship persists even after controlling for health and demographic covariates in regression analysis. Interestingly, there is no association between BMI and BRCA (BReast CAncer gene) genetic testing. This is consistent with the narrative that stigma causes avoidance because genetic testing does not involve any assessment of a person’s body. More work must be done to determine how to increase cancer screening rates in those who may feel stigmatized due to their weight.

Keywords: cancer screening, cervical cancer, breast cancer, weight stigma, avoidance of care

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Authors: V. Bezverbny

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The actuality of the project deals with stable growing of deviant behavior’ statistics among Moscow citizens. During the recent years the socioeconomic health, wealth and life expectation of Moscow residents is regularly growing up, but the limits of crime and drug addiction have grown up seriously. Another serious Moscow problem has been economical stratification of population. The cost of identical residential areas differs at 2.5 times. The project is aimed at complex research and the development of methodology for main factors and reasons evaluation of deviant behavior growing in Moscow. The main project objective is finding out the links between the urban environment quality and dynamics of citizens’ deviant behavior in regional and municipal aspect using the statistical research methods and GIS modeling. The conducted research allowed: 1) to evaluate the dynamics of deviant behavior in Moscow different administrative districts; 2) to describe the reasons of crime increasing, drugs addiction, alcoholism, suicides tendencies among the city population; 3) to develop the city districts classification based on the level of the crime rate; 4) to create the statistical database containing the main indicators of Moscow population deviant behavior in 2010-2015 including information regarding crime level, alcoholism, drug addiction, suicides; 5) to present statistical indicators that characterize the dynamics of Moscow population deviant behavior in condition of expanding the city territory; 6) to analyze the main sociological theories and factors of deviant behavior for concretization the deviation types; 7) to consider the main theoretical statements of the city sociology devoted to the reasons for deviant behavior in megalopolis conditions. To explore the level of deviant behavior’ factors differentiation, the questionnaire was worked out, and sociological survey involved more than 1000 people from different districts of the city was conducted. Sociological survey allowed to study the socio-economical and psychological factors of deviant behavior. It also included the Moscow residents’ open-ended answers regarding the most actual problems in their districts and reasons of wish to leave their place. The results of sociological survey lead to the conclusion that the main factors of deviant behavior in Moscow are high level of social inequality, large number of illegal migrants and bums, nearness of large transport hubs and stations on the territory, ineffective work of police, alcohol availability and drug accessibility, low level of psychological comfort for Moscow citizens, large number of building projects.

Keywords: deviant behavior, megapolis, Moscow, urban environment, social stratification

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Authors: Šárka Hradilová, Aleš Panáček, Radek Zbořil

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Nanotechnologies are considered the most promising fields with high added value, brings new possibilities in various sectors from industry to medicine. With the growing of interest in nanomaterials and their applications, increasing nanoparticle production leads to increased exposure of people and environment with ‘human made’ nanoparticles. Nanoparticles (NPs) are clusters of atoms in the size range of 1–100 nm. Metal nanoparticles represent one of the most important and frequently used types of NPs due to their unique physical, chemical and biological properties, which significantly differ from those of bulk material. Biological properties including toxicity of metal nanoparticles are generally determined by their size, size distribution, shape, surface area, surface charge, surface chemistry, stability in the environment and ability to release metal ions. Therefore, the biological behavior of NPs and their possible adverse effect cannot be derived from the bulk form of material because nanoparticles show unique properties and interactions with biological systems just due to their nanodimensions. Silver and gold NPs are intensively studied and used. Both can be used for instance in surface enhanced Raman spectroscopy, a considerable number of applications of silver NPs is associated with antibacterial effects, while gold NPs are associated with cancer treatment and bio imaging. Antibacterial effects of silver ions are known for centuries. Silver ions and silver-based compounds are highly toxic to microorganisms. Toxic properties of silver NPs are intensively studied, but the mechanism of cytoxicity is not fully understood. While silver NPs are considered toxic, gold NPs are referred to as toxic but also innocuous for eukaryotic cells. Therefore, gold NPs are used in various biological applications without a risk of cell damaging, even when we want to suppress the growth of cancer cells. Thus, gold NPs are toxic or harmless. Because most studies comparing particles of various sizes prepared in various ways, and testing is performed on different cell lines, it is very difficult to generalize. The novelty and significance of our research is focused to the complex biological effects of silver and gold NPs prepared by the same method, have the same parameters and the same stabilizer. That is why we can compare the biological effects of pure nanometals themselves based on their chemical nature without the influence of other variable. Aim of our study therefore is to compare the cytotoxic effect of two types of noble metal NPs focusing on the mechanisms that contribute to cytotoxicity. The study was conducted on murine fibroblasts by selected common used tests. Each of these tests monitors the selected area related to toxicity and together provides a comprehensive view on the issue of interactions of nanoparticles and living cells.

Keywords: cytotoxicity, gold nanoparticles, mechanism of cytotoxicity, silver nanoparticles

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Authors: Amirul Adlan, Robert A McCulloch, Neil Jenkins, MIchael Parry, Jonathan Stevenson, Lee Jeys

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Background and Objectives: The current antibiotic prophylaxis for oncological patients is based upon evidence from primary arthroplasty despite significant differences in both patient group and procedure. The aim of this study was to compare the microbiology organisms responsible for PJI in patients who underwent two-stage revision for infected primary knee replacement with those of infected oncological endoprostheses of the lower limb in a single institution. This will subsequently guide decision making regarding antibiotic prophylaxis at primary implantation for oncological procedures and empirical antibiotics for infected revision procedures (where the infecting organism(s) are unknown). Patient and Methods: 118 patients were treated with two-stage revision surgery for infected knee arthroplasty and lower limb endoprostheses between 1999 and 2019. 74 patients had two-stage revision for PJI of knee arthroplasty, and 44 had two-stage revision of lower limb endoprostheses. There were 68 males and 50 females. The mean age for the knee arthroplasty cohort and lower limb endoprostheses cohort were 70.2 years (50-89) and 36.1 years (12-78), respectively (p<0.01). Patient host and extremity criteria were categorised according to the MSIS Host and Extremity Staging System. Patient microbiological culture, the incidence of polymicrobial infection and multi-drug resistance (MDR) were analysed and recorded. Results: Polymicrobial infection was reported in 16% (12 patients) from knee arthroplasty PJI and 14.5% (8 patients) in endoprostheses PJI (p=0.783). There was a significantly higher incidence of MDR in endoprostheses PJI, isolated in 36.4% of cultures, compared to knee arthroplasty PJI (17.2%) (p=0.01). Gram-positive organisms were isolated in more than 80% of cultures from both cohorts. Coagulase-negative Staphylococcus (CoNS) was the commonest gram-positive organism, and Escherichia coli was the commonest Gram-negative organism in both groups. According to the MSIS staging system, the host and extremity grade of knee arthroplasty PJI cohort were significantly better than endoprostheses PJI(p<0.05). Conclusion: Empirical antibiotic management of PJI in orthopaedic oncology is based upon PJI in arthroplasty despite differences in both host and microbiology. Our results show a significant increase in MDR pathogens within the oncological group despite CoNS being the most common infective organism in both groups. Endoprosthetic patients presented with poorer host and extremity criteria. These factors should be considered when managing this complex patient group, emphasising the importance of broad-spectrum antibiotic prophylaxis and preoperative sampling to ensure appropriate perioperative antibiotic cover.

Keywords: microbiology, periprosthetic Joint infection, knee arthroplasty, endoprostheses

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Authors: Christofas Stergianos, Jason Atkin, Herve Morvan

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As air traffic increases, more airports are interested in utilizing optimization methods. Many processes happen in parallel at an airport, and complex models are needed in order to have a reliable solution that can be implemented for ground movement operations. The ground movement for aircraft in an airport, allocating a path to each aircraft to follow in order to reach their destination (e.g. runway or gate), is one process that could be optimized. The Quickest Path Problem with Time Windows (QPPTW) algorithm has been developed to provide a conflict-free routing of vehicles and has been applied to routing aircraft around an airport. It was subsequently modified to increase the accuracy for airport applications. These modifications take into consideration specific characteristics of the problem, such as: the pushback process, which considers the extra time that is needed for pushing back an aircraft and turning its engines on; stand holding where any waiting should be allocated to the stand; and runway sequencing, where the sequence of the aircraft that take off is optimized and has to be respected. QPPTW involves searching for the quickest path by expanding the search in all directions, similarly to Dijkstra’s algorithm. Finding a way to direct the expansion can potentially assist the search and achieve a better performance. We have further modified the QPPTW algorithm to use a heuristic approach in order to guide the search. This new algorithm is based on the A-star search method but estimates the remaining time (instead of distance) in order to assess how far the target is. It is important to consider the remaining time that it is needed to reach the target, so that delays that are caused by other aircraft can be part of the optimization method. All of the other characteristics are still considered and time windows are still used in order to route multiple aircraft rather than a single aircraft. In this way the quickest path is found for each aircraft while taking into account the movements of the previously routed aircraft. After running experiments using a week of real aircraft data from Zurich Airport, the new algorithm (A-star QPPTW) was found to route aircraft much more quickly, being especially fast in routing the departing aircraft where pushback delays are significant. On average A-star QPPTW could route a full day (755 to 837 aircraft movements) 56% faster than the original algorithm. In total the routing of a full week of aircraft took only 12 seconds with the new algorithm, 15 seconds faster than the original algorithm. For real time application, the algorithm needs to be very fast, and this speed increase will allow us to add additional features and complexity, allowing further integration with other processes in airports and leading to more optimized and environmentally friendly airports.

Keywords: a-star search, airport operations, ground movement optimization, routing and scheduling

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Authors: Jared Beard, Ali Baheri

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As autonomous systems become more prominent in society, ensuring their safe application becomes increasingly important. This is clearly demonstrated with autonomous cars traveling through a crowded city or robots traversing a warehouse with heavy equipment. Human environments can be complex, having high dimensional state and action spaces. This gives rise to two problems. One being that analytic solutions may not be possible. The other is that in simulation based approaches, searching the entirety of the problem space could be computationally intractable, ruling out formal methods. To overcome this, approximate solutions may seek to find failures or estimate their likelihood of occurrence. One such approach is adaptive stress testing (AST) which uses reinforcement learning to induce failures in the system. The premise of which is that a learned model can be used to help find new failure scenarios, making better use of simulations. In spite of these failures AST fails to find particularly sparse failures and can be inclined to find similar solutions to those found previously. To help overcome this, multi-fidelity learning can be used to alleviate this overuse of information. That is, information in lower fidelity can simulations can be used to build up samples less expensively, and more effectively cover the solution space to find a broader set of failures. Recent work in multi-fidelity learning has passed information bidirectionally using “knows what it knows” (KWIK) reinforcement learners to minimize the number of samples in high fidelity simulators (thereby reducing computation time and load). The contribution of this work, then, is development of the bidirectional multi-fidelity AST framework. Such an algorithm, uses multi-fidelity KWIK learners in an adversarial context to find failure modes. Thus far, a KWIK learner has been used to train an adversary in a grid world to prevent an agent from reaching its goal; thus demonstrating the utility of KWIK learners in an AST framework. The next step is implementation of the bidirectional multi-fidelity AST framework described. Testing will be conducted in a grid world containing an agent attempting to reach a goal position and adversary tasked with intercepting the agent as demonstrated previously. Fidelities will be modified by adjusting the size of a time-step, with higher-fidelity effectively allowing for more responsive closed loop feedback. Results will compare the single KWIK AST learner with the multi-fidelity algorithm with respect to number of samples, distinct failure modes found, and relative effect of learning after a number of trials.

Keywords: multi-fidelity reinforcement learning, multi-fidelity simulation, safety validation, falsification

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