Search results for: multimedia modules across a range of clinical and non-clinical areas

Authors: Bill D. Geis

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Suicide wrongful death forensic cases are the fastest rising tort in mental health law. It is estimated that suicide-related cases have accounted for 15% of U.S. malpractice claims since 2006. Most suicide-related personal injury claims fall into the legal category of “wrongful death.” Though mental health experts may be called on to address a range of forensic questions in wrongful death cases, the central consultation that most experts provide is about the negligence element—specifically, the issue of whether the clinician met the clinical standard of care in assessing, treating, and managing the deceased person’s mental health care. Standards of care, varying from U.S. state to state, are broad and address what a reasonable clinician might do in a similar circumstance. This fact leaves the issue of the suicide standard of care, in each case, up to forensic experts to put forth a reasoned estimate of what the standard of care should have been in the specific case under litigation. Because the general state guidelines for standard of care are broad, forensic experts are readily retained to provide scientific and clinical opinions about whether or not a clinician met the standard of care in their suicide assessment, treatment, and management of the case. In the past and in much of current practice, the assessment of suicide has centered on the elicitation of verbalized suicide ideation. Research in recent years, however, has indicated that the majority of persons who end their lives do not say they are suicidal at their last medical or psychiatric contact. Near-term risk assessment—that goes beyond verbalized suicide ideation—is needed. Our previous research employed structural equation modeling to predict lethal suicide risk--eight negative thought patterns (feeling like a burden on others, hopelessness, self-hatred, etc.) mediated by nine transdiagnostic clinical factors (mental torment, insomnia, substance abuse, PTSD intrusions, etc.) were combined to predict acute lethal suicide risk. This structural equation model, the Lethal Suicide Risk Pattern (LSRP), Acute model, had excellent goodness-of-fit [χ2(df) = 94.25(47)***, CFI = .98, RMSEA = .05, .90CI = .03-.06, p(RMSEA = .05) = .63. AIC = 340.25, ***p < .001.]. A further SEQ analysis was completed for this paper, adding a measure of Acute Suicide Ideation to the previous SEQ. Acceptable prediction model fit was no longer achieved [χ2(df) = 3.571, CFI > .953, RMSEA = .075, .90% CI = .065-.085, AIC = 529.550].This finding suggests that, in this additional study, immediate verbalized suicide ideation information was unhelpful in the assessment of lethal risk. The LSRP and other dynamic, near-term risk models (such as the Acute Suicide Affective Disorder Model and the Suicide Crisis Syndrome Model)—going beyond elicited suicide ideation—need to be incorporated into current clinical suicide assessment training. Without this training, the standard of care for suicide assessment is out of sync with current research—an emerging dilemma for the forensic evaluation of suicide wrongful death cases.

Keywords: forensic evaluation, standard of care, suicide, suicide assessment, wrongful death

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Authors: Melis Inalpulat, Tugce Civelek, Unal Kizil, Levent Genc

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Livestock production is one of the most important components of rural economy. Due to the urban expansion, rural areas close to expanding cities transform into urban districts during the time. However, the legislations have some restrictions related to livestock farming in such administrative units since they tend to create environmental concerns like odor problems resulted from excessive manure production. Therefore, the existing animal operations should be moved from the settlement areas. This paper was focused on determination of suitable lands for livestock production in Canakkale province of Turkey using remote sensing (RS) data and GIS techniques. To achieve the goal, Formosat 2 and Landsat 8 imageries, Aster DEM, and 1:25000 scaled soil maps, village boundaries, and village livestock inventory records were used. The study was conducted using suitability analysis which evaluates the land in terms of limitations and potentials, and suitability range was categorized as Suitable (S) and Non-Suitable (NS). Limitations included the distances from main and crossroads, water resources and settlements, while potentials were appropriate values for slope, land use capability and land use land cover status. Village-based S land distribution results were presented, and compared with livestock inventories. Results showed that approximately 44230 ha area is inappropriate because of the distance limitations for roads and etc. (NS). Moreover, according to LULC map, 71052 ha area consists of forests, olive and other orchards, and thus, may not be suitable for building such structures (NS). In comparison, it was found that there are a total of 1228 ha S lands within study area. The village-based findings indicated that, in some villages livestock production continues on NS areas. Finally, it was suggested that organized livestock zones may be constructed to serve in more than one village after the detailed analysis complemented considering also political decisions, opinion of the local people, etc.

Keywords: GIS, livestock, LULC, remote sensing, suitable lands

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Authors: Rui Miguel Costa, Jose Pestana, David Costa, Paula Mangia, Catarina Correia, Mafalda Pinto Coelho

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There is lack of studies examining the relation of different heart rate variability (HRV) parameters with the risk of erectile dysfunction (ED) in younger men. Thus, the present study aimed at examining, in a nonclinical sample of men aged 19-39 years old (mean age = 23.98 years, SD = 4.90), the relations of risk of ED with the standard deviation of the heart rate (SD of HR), high and low frequency power of HRV, and low-to-high frequency HRV ratio. Eighty-three heterosexual Portuguese men completed the 5-item version of the International Index of Erectile Function (IIEF-5) and HRV parameters were calculated from a 5-minute resting period. Risk of ED was determined by IIEF-5 scores of 21 or less. Fifteen men (18.1%) reported symptoms of ED (14 with mild and one with mild to moderate symptoms). Univariate analyses of variance revealed that risk of ED was related to lesser SD of HR and lesser low-frequency power, the two HRV parameters that express a coupling of higher vagal and sympathetic tone. Risk of ED was unrelated to high-frequency power and low-to-high frequency HRV ratio. Further, in a logistic regression, the risk of ED was independently predicted by older age and lower SD of HR, but not by low-frequency power, having a regular sexual partner, and cohabiting. The results provide preliminary evidence that, in younger men, a coupling of higher vagal and sympathetic tone, as indexed by the SD of HR, is important for erections. Greater resting SD of HR might reflect better vascular and interpersonal function via vagal tone coupled with greater motor mobilization to pursue sexual intercourse via sympathetic tone. Many interventions can elevate HRV; future research is warranted on how they can be tailored to treat ED in younger men.

Keywords: erectile dysfunction, heart rate variability, standard deviation of the heart rate, younger men

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Authors: Laid Fekih

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Background: The purpose of this paper is to examine the psychological stressors caused by urbanization, a field study conducted on a sample range of youth who live in urban areas. Some of them reside in areas with green surroundings while others reside in lack of green areas, which saw the terrible expansion of urban. The study included the impact of urbanization on the mental health of youths; select the psychological problems most commonly caused by urbanization, and the impact of green spaces in alleviating stress. Method: The method used in this research is descriptive, as the data collected from a sample of 160 young men were analyzed. The tool used is the psychological distress test. We proceeded with some statistical techniques, which provided percentages, analysis of variance, and t-tests. Results: The findings of this research were: (i) The psychological stressors caused by urban expansion are mainly in the intensity of stress, incompetence, emotional, and psychosomatic problems. (ii) There was a statistically significant difference at the level of significance 0.02 among young people who live in places in green spaces and without green space in terms of psychological stressors, in favor of young people who live in places free of greenery. (iii) The quality of this primary variable effect of housing (rental or ownership) is statistically significant in favor of young people living in rented accommodation. Conclusion: The green spaces provided by Tlemcen city are inadequate and insufficient to fulfill the population's requirements for contact with nature, leading to such effects that may negatively affect mental health, which makes it a prominent process that should not be neglected. Incorporating green spaces into the design of buildings, homes, and communities to create shared spaces, which facilitate interaction and foster well-being, becomes the main purpose. We think this approach can support the reconstruction of the built environment with green spaces by facilitating the link between psychological stress perception studies and technologies.

Keywords: psychological stressors, urbanization, psychological problems, green spaces

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Authors: Medjadj Tarek, Ghribi Hayet

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This study aims to develop a flood sensitivity assessment tool using machine learning (ML) techniques and geographic information system (GIS). The importance of this study is integrating the geographic information systems (GIS) and machine learning (ML) techniques for mapping flood risks, which help decision-makers to identify the most vulnerable areas and take the necessary precautions to face this type of natural disaster. To reach this goal, we will study the case of the city of M'sila, which is among the areas most vulnerable to floods. This study drew a map of flood-prone areas based on the methodology where we have made a comparison between 3 machine learning algorithms: the xGboost model, the Random Forest algorithm and the K Nearest Neighbour algorithm. Each of them gave an accuracy respectively of 97.92 - 95 - 93.75. In the process of mapping flood-prone areas, the first model was relied upon, which gave the greatest accuracy (xGboost).

Keywords: Geographic information systems (GIS), machine learning (ML), emergency mapping, flood disaster management

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Authors: T. G. Pathrikar, A. D. Urhekar, M. P. Bansal

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To find out S. aureus from patient samples on the basis of coagulase test. We have evaluated slide coagulase (n=46 positive), tube coagulase (n=48 positive) and DNase test (n=44, positive) , We have isolated and identified MRSA from various clinical samples and specimens by disc diffusion method determined the incidence of MRSA 50% in patients. Found out the in vitro antimicrobial susceptibility pattern of MRSA isolates and also the MIC of MRSA of oxacillin by E-Test.

Keywords: cefoxitin disc diffusion MRSA detection, e – test, S. aureus devastating pathogen, tube coagulase confirmation

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Authors: Aleksandra Majchrzak, Katarzyna Baruch, Monika Sobolewska, Bartlomiej Chojnacki, Adam Pilch

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Scaled modeling is very common in the areas of science such as aerodynamics or fluid mechanics, since defining characteristic numbers enables to determine relations between objects under test and their models. In acoustics, scaled modeling is aimed mainly at investigation of room acoustics, sound insulation and sound absorption phenomena. Despite such a range of application, there is no method developed that would enable scaling acoustical perforated panels freely, maintaining their sound absorption coefficient in a desired frequency range. However, conducted theoretical and numerical analyses have proven that it is not physically possible to obtain given sound absorption coefficient in a desired frequency range by directly scaling only all of the physical dimensions of a perforated panel, according to a defined characteristic number. This paper is a continuation of the research mentioned above and presents practical evaluation of theoretical and numerical analyses. The measurements of sound absorption coefficient of perforated panels were performed in order to verify previous analyses and as a result find the relations between full-scale perforated panels and their models which will enable to scale them properly. The measurements were conducted in a one-to-eight model of a reverberation chamber of Technical Acoustics Laboratory, AGH. Obtained results verify theses proposed after theoretical and numerical analyses. Finding the relations between full-scale and modeled perforated panels will allow to produce measurement samples equivalent to the original ones. As a consequence, it will make the process of designing acoustical perforated panels easier and will also lower the costs of prototypes production. Having this knowledge, it will be possible to emulate in a constructed model panels used, or to be used, in a full-scale room more precisely and as a result imitate or predict the acoustics of a modeled space more accurately.

Keywords: characteristic numbers, dimensional analysis, model study, scaled modeling, sound absorption coefficient

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Authors: Sarah Ekuwo Okende, Armand Lokolo

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Gradually, the recognition of wild bees in processes affecting ecosystems and as major components of biodiversity has led to their protection as well as their areas in Kinshasa. And despite their decisive role in the well-being of men, the general public and decision-makers know nothing of the consequences of the loss of these, which are nevertheless of considerable magnitude. On this, they provide the pollination of sexual plants, and they also provide us with a number of goods that have a direct economic value, such as food, medicines, etc. And yet today, more than half of these wild bee species are threatened in Kinshasa. The causes of this phenomenon are largely unknown to the general public in the Kinshasa region. The objective of this study is to find the causes leading to the disappearance of wild bee species in Kinshasa. Also, this research contributes to current knowledge of the biodiversity of wild bees in the Kinshasa region and helps the authorities to develop a good policy for the conservation or safeguarding of this biodiversity, which plays a key role in maintaining the integrity of our ecosystems. We carried out field surveys using interview sheets in the forest areas of Kinshasa where wild bees populated them. To achieve this, an interview sheet was made, and it included questions on the causes of the disappearance of wild bees and the destruction of forest areas. The interviews were carried out with the natives of these forest areas. The results of this study show us that the destruction of habitats or natural areas and the use of pesticides are the causes of the disappearance of these wild bees.

Keywords: wild bees, pollinisation, forest, biodiversity, habitats, ecosystem, destruction, pesticide

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Authors: Roni Susman, Thomas Weith

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This article explores how institutional setting, mainly from institutionalism, could clearly explain the understanding of land use conflict analysis in coastal areas and has been used in current practices. Institutional setting appears as a guideline that is committed by the stakeholders who are involved directly or indirectly in land management process. This paper is aimed to identify the setting of institutional and to measure how the conflicts occur, how the actors act and influence the process, how is the condition to apply the appropriate framework for adequate solution of land use conflict in coastal area in order to enhance better decisions. To reflect the current practice and use of theories a qualitative review of 150 scientific peer-reviewed papers regarding the issue of land use conflicts in coastal areas as well as institutional process is included. The selection of peer-reviewed papers is obtained through a structured literature survey of the recently published database in a way to investigate the variances of institutional between theory and practices specifically in the case of coastal land management.

Keywords: coastal areas, institutional settings, land use conflict, land governance, actors’ constellation, analytical framework

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Authors: Svetlana Cojocaru, Mircea Petic, Inga Titchiev

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Humanity faces more and more often with different social disasters, which in turn can generate new accidents and catastrophes. To mitigate their consequences, it is important to obtain early possible signals about the events which are or can occur and to prepare the corresponding scenarios that could be applied. Our research is focused on solving two problems in this domain: identifying signals related that an accident occurred or may occur and mitigation of some consequences of disasters. To solve the first problem, methods of selecting and processing texts from global network Internet are developed. Information in Romanian is of special interest for us. In order to obtain the mentioned tools, we should follow several steps, divided into preparatory stage and processing stage. Throughout the first stage, we manually collected over 724 news articles and classified them into 10 categories of social disasters. It constitutes more than 150 thousand words. Using this information, a controlled vocabulary of more than 300 keywords was elaborated, that will help in the process of classification and identification of the texts related to the field of social disasters. To solve the second problem, the formalism of Petri net has been used. We deal with the problem of inhabitants’ evacuation in useful time. The analysis methods such as reachability or coverability tree and invariants technique to determine dynamic properties of the modeled systems will be used. To perform a case study of properties of extended evacuation system by adding time, the analysis modules of PIPE such as Generalized Stochastic Petri Nets (GSPN) Analysis, Simulation, State Space Analysis, and Invariant Analysis have been used. These modules helped us to obtain the average number of persons situated in the rooms and the other quantitative properties and characteristics related to its dynamics.

Keywords: lexicon of disasters, modelling, Petri nets, text annotation, social disasters

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Authors: Tamar Lin, Nufar Buchshtab, Yifat Elharar, Julian Nicenboim, Rotem Edgar, Iddo Weiner, Lior Zelcbuch, Ariel Cohen, Sharon Kredo-Russo, Inbar Gahali-Sass, Naomi Zak, Sailaja Puttagunta, Merav Bassan

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Background: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disorder that is characterized by dry skin and flares of eczematous lesions and intense pruritus. Multiple lines of evidence suggest that AD is associated with increased colonization by Staphylococcus aureus, which contributes to disease pathogenesis through the release of virulence factors that affect both keratinocytes and immune cells, leading to disruption of the skin barrier and immune cell dysfunction. The aim of the current study is to develop a bacteriophage-based product that specifically targets S. aureus. Methods: For the discovery of phage, environmental samples were screened on 118 S. aureus strains isolated from skin samples, followed by multiple enrichment steps. Natural phages were isolated, subjected to Next-generation Sequencing (NGS), and analyzed using proprietary bioinformatics tools for undesirable genes (toxins, antibiotic resistance genes, lysogeny potential), taxonomic classification, and purity. Phage host range was determined by an efficiency of plating (EOP) value above 0.1 and the ability of the cocktail to completely lyse liquid bacterial culture under different growth conditions (e.g., temperature, bacterial stage). Results: Sequencing analysis demonstrated that the 118 S. aureus clinical strains were distributed across the phylogenetic tree of all available Refseq S. aureus (~10,750 strains). Screening environmental samples on the S. aureus isolates resulted in the isolation of 50 lytic phages from different genera, including Silviavirus, Kayvirus, Podoviridae, and a novel unidentified phage. NGS sequencing confirmed the absence of toxic elements in the phages’ genomes. The host range of the individual phages, as measured by the efficiency of plating (EOP), ranged between 41% (48/118) to 79% (93/118). Host range studies in liquid culture revealed that a subset of the phages can infect a broad range of S. aureus strains in different metabolic states, including stationary state. Combining the single-phage EOP results of selected phages resulted in a broad host range cocktail which infected 92% (109/118) of the strains. When tested in vitro in a liquid infection assay, clearance was achieved in 87% (103/118) of the strains, with no evidence of phage resistance throughout the study (24 hours). A S. aureus host was identified that can be used for the production of all the phages in the cocktail at high titers suitable for large-scale manufacturing. This host was validated for the absence of contaminating prophages using advanced NGS methods combined with multiple production cycles. The phages are produced under optimized scale-up conditions and are being used for the development of a topical formulation (BX005) that may be administered to subjects with atopic dermatitis. Conclusions: A cocktail of natural phages targeting S. aureus was effective in reducing bacterial burden across multiple assays. Phage products may offer safe and effective steroid-sparing options for atopic dermatitis.

Keywords: atopic dermatitis, bacteriophage cocktail, host range, Staphylococcus aureus

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Authors: Nir Nissim, Ran Yahalom, Tomer Lancewiki, Yuval Elovici, Boaz Lerner

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Background: Attackers increasingly take advantage of innocent users who tend to use USB devices casually, assuming these devices benign when in fact they may carry an embedded malicious behavior or hidden malware. USB devices have many properties and capabilities that have become the subject of malicious operations. Many of the recent attacks targeting individuals, and especially organizations, utilize popular and widely used USB devices, such as mice, keyboards, flash drives, printers, and smartphones. However, current detection tools, techniques, and solutions generally fail to detect both the known and unknown attacks launched via USB devices. Significance: We propose USBWARE, a project that focuses on the vulnerabilities of USB devices and centers on the development of a comprehensive detection framework that relies upon a crucial attack repository. USBWARE will allow researchers and companies to better understand the vulnerabilities and attacks associated with USB devices as well as providing a comprehensive platform for developing detection solutions. Methodology: The framework of USBWARE is aimed at accurate detection of both known and unknown USB-based attacks by a process that efficiently enhances the framework's detection capabilities over time. The framework will integrate two main security approaches in order to enhance the detection of USB-based attacks associated with a variety of USB devices. The first approach is aimed at the detection of known attacks and their variants, whereas the second approach focuses on the detection of unknown attacks. USBWARE will consist of six independent but complimentary detection modules, each detecting attacks based on a different approach or discipline. These modules include novel ideas and algorithms inspired from or already developed within our team's domains of expertise, including cyber security, electrical and signal processing, machine learning, and computational biology. The establishment and maintenance of the USBWARE’s dynamic and up-to-date attack repository will strengthen the capabilities of the USBWARE detection framework. The attack repository’s infrastructure will enable researchers to record, document, create, and simulate existing and new USB-based attacks. This data will be used to maintain the detection framework’s updatability by incorporating knowledge regarding new attacks. Based on our experience in the cyber security domain, we aim to design the USBWARE framework so that it will have several characteristics that are crucial for this type of cyber-security detection solution. Specifically, the USBWARE framework should be: Novel, Multidisciplinary, Trusted, Lightweight, Extendable, Modular and Updatable and Adaptable. Major Findings: Based on our initial survey, we have already found more than 23 types of USB-based attacks, divided into six major categories. Our preliminary evaluation and proof of concepts showed that our detection modules can be used for efficient detection of several basic known USB attacks. Further research, development, and enhancements are required so that USBWARE will be capable to cover all of the major known USB attacks and to detect unknown attacks. Conclusion: USBWARE is a crucial detection framework that must be further enhanced and developed.

Keywords: USB, device, cyber security, attack, detection

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Authors: Chul Hyun Park

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Background:Repair using the Achillon deviceis a representative mini-open repair technique;however, the limitations of this technique includethe need for special instruments and decreasedrepair strength.A modifiedmini-open repair using ring forcepsmight overcome these limitations. Purpose:This study was performed to compare the Achillon device with ring forceps in mini-open repairsof acute Achilles tendon rupture. Study Design:This was a retrospective cohort study, and the level of evidence was3. Methods:Fifty patients (41 men and 9 women), withacute Achilles tendon rupture on one foot, were consecutively treated using mini-open repair techniques. The first 20 patients were treated using the Achillon device (Achillon group) and the subsequent 30 patients were treated using a ring forceps (Forcep group). Clinical, functional, and isokinetic results,and postoperative complications were compared between the two groups at the last follow-up. Clinical evaluations wereperformed using the American Orthopedic Foot and Ankle Society (AOFAS) score, Achilles tendon Total Rupture Score (ATRS), length of incision, and operation time. Functional evaluationsincludedactive range of motion (ROM) of the ankle joint, maximum calf circumference (MCC), hopping test, and single limb heel-rise (SLHR) test. Isokinetic evaluations were performed using the isokinetic test for ankle plantar flexion. Results:The AOFAS score (p=0.669), ATRS (p=0.753), and length of incision (p=0.305) were not significantly different between the groups. Operative times in the Achillon group were significantly shorter than that in the Forcep group (p<0.001).The maximum height of SLHR (p=0.023) and number of SLHRs (p=0.045) in the Forcep group were significantly greater than that in the Achillon group. No significant differences in the mean peak torques for plantar flexion at angular speeds of 30°/s (p=0.219) and 120°/s (p=0.656) were detected between the groups. There was no significant difference in the occurrence of postoperative complications between the groups (p=0.093). Conclusion:The ring forceps technique is comparable with the Achillon technique with respect to clinical, functional, and isokinetic results and the postoperative complications. Given that no special instrument is required, the ring forceps technique could be a better option for acute Achilles tendon rupture repair.

Keywords: achilles tendon, acute rupture, repair, mini-open

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Authors: E. Neidhardt

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Mobility is not only an aspect of personal freedom, but for many people mobility is also a requirement to be able to satisfy the needs of daily life. They must buy food, get to work, or go to the doctor. Many people are dependent on public transport to satisfy their needs. Especially in rural areas with a low population density this is difficult. In these areas it is often not cost-effective to provide public transport with sufficient coverage and frequency. Therefore, the available public transport is unattractive. As a result, people use their own car, which is not desirable from a sustainable point of view. Children and some elderly people also do not have this option. Sometimes people organize themselves and volunteer transport services are created, which function similarly to the demand-oriented taxis. With a platform for demand-oriented transport, we want to make the available public transport more usable and attractive by linking scheduled transport with voluntary transport services.

Keywords: demand-oriented, HubChain, living lab, public transport

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Authors: Gulcan Sahal, Isil Seyis Bilkay

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Candida species which often exist as commensal microorganisms in healthy individuals are major causes of important infections, especially in AIDS and immunocompromised patients, by means of their biofilm formation abilities. Therefore, in this study, determination of biofilm formation in different clinical strains of Candida species, investigation of strong biofilm forming Candida strains, examination of clinical information of each strong and weak biofilm forming Candida strains and investigation of some plant substances’ effects on biofilm formation of strong biofilm forming strains were aimed. In this respect, biofilm formation of Candida strains was analyzed via crystal violet binding assay. According to our results, biofilm levels of strains belong to different Candida species were different from each other. Additionally, it is also found that some plant substances effect biofilm formation. All these results indicate that, as well as C. albicans strains, other non-albicans Candida species also emerge as causative agents of infections and have biofilm formation abilities. In addition, usage of some plant substances in different concentrations may provide a new treatment against biofilm related Candida infections.

Keywords: anti-biofilm, biofilm formation, Candida species, biosystems engineering

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Authors: Fahmi Hassan, Noorizan Abdul Aziz, Yahaya Hassan, Hazlinda Abu Hassan

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Sepsis incidence in critical care settings is a major problem in health care. Extended antibiotic infusion is thought to be superior to traditional dosing especially when treating critically ill patients with sepsis. We compared clinical outcomes of critically ill patients with sepsis receiving 30-minute meropenem infusion and three-hour meropenem infusion. A retrospective case-control study was conducted among septic patients treated with meropenem infusion in ICUs of three hospitals. Patients included in the study received either extended or standard meropenem infusion as per the practice of individual settings. Outcomes and clinical data were retrospectively collected from the electronic databases and patients’ files. A total of 108 patients received extended meropenem infusion while another 117 patients received standard meropenem infusion. Patients receiving the extended meropenem infusion were found to have a significantly lower shorter length of hospital and ICU stay. It was also found that among those receiving extended meropenem infusion, 54.7% (64/117) had a reduction of SAPS II score, while only 44% (48/108) of patients receiving standard meropenem infusion had reduced scores. This study will strengthen the evidence in using extended meropenem infusion as a standard practice in critical care settings. As this is the first study of its kind done in Malaysia, it proves that prolonged meropenem infusion may be beneficial to critically ill patients with sepsis. However, randomized clinical trials with large sample size should be carried out in local settings in order to minimize other confounders that may influence with the result of the study.

Keywords: antibiotics, beta lactams, critical care, extended infusion, meropenem

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Authors: Shuo Mu, Guangzhi Jiang, Jinsa Chen

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The analysis of Indel for RNA sequencing of clinical samples is easily affected by sequencing experiment errors and software selection. In order to improve the efficiency and accuracy of analysis, we developed an automatic reporting system for Indel recognition and annotation based on image snapshot of transcriptome reads alignment. This system includes sequence local-assembly and realignment, target point snapshot, and image-based recognition processes. We integrated high-confidence Indel dataset from several known databases as a training set to improve the accuracy of image processing and added a bioinformatical processing module to annotate and filter Indel artifacts. Subsequently, the system will automatically generate data, including data quality levels and images results report. Sanger sequencing verification of the reference Indel mutation of cell line NA12878 showed that the process can achieve 83% sensitivity and 96% specificity. Analysis of the collected clinical samples showed that the interpretation accuracy of the process was equivalent to that of manual inspection, and the processing efficiency showed a significant improvement. This work shows the feasibility of accurate Indel analysis of clinical next-generation sequencing (NGS) transcriptome. This result may be useful for RNA study for clinical samples with microsatellite instability in immunotherapy in the future.

Keywords: automatic reporting, indel, next-generation sequencing, NGS, transcriptome

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Authors: Lazzat M. Zhamaliyeva, Nurgul A. Abenova, Gauhar S. Dilmagambetova, Ziyash Zh. Tanbetova, Moldir B. Ahmetzhanova, Tatyana P. Ostretcova, Aliya A. Yegemberdiyeva

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Introduction: There are many reasons for the weak training of family doctors in Kazakhstan: the unified national educational program is not focused on competencies, the role of a general practitioner (GP) is not clear, poor funding for the health care and education system, outdated teaching and assessment methods, inefficient management. We highlight two issues in particular. Firstly, academic teachers of family medicine (FM) in Kazakhstan do not practice as family doctors; most of them are narrow specialists (pediatricians, therapists, surgeons, etc.); they usually hold one-time consultations; clinical mentors from practical healthcare (non-academic teachers) do not have the teaching competences, and the vast majority of them are also narrow specialists. Secondly, clinical sites (polyclinics) are unprepared for general practice and do not follow the principles of family medicine; residents do not like to be in primary health care (PHC) settings due to the chaos that is happening there, as well as due to the lack of the necessary equipment for mastering and consolidating practical skills. Aim: We present the concept of the family physicians’ training office (FPTO), which is being created as a friendly learning environment for young general practitioners and for the involvement of academic teachers of family medicine in the practical work and innovative development of PHC. Methodology: In developing the conceptual framework and identifying practical activities, we drew on literature and expert input, and interviews. Results: The goal of the FPTO is to create a favorable educational and clinical environment for the development of the FM residents’ competencies, in which the residents with academic teachers and clinical mentors could understand and accept the principles of family medicine, improve clinical knowledge and skills, and gain experience in improving the quality of their practice in scientific basis. Three main areas of office activity are providing primary care to the patients, improving educational services for FM residents and other medical workers, and promoting research in PHC and innovations. The office arranges for residents to see outpatients at least 50% of the time, and teachers of FM departments at least 1/4 of their working time conduct general medical appointments next to residents. Taking into account the educational and scientific workload, the number of attached population for one GP does not exceed 500 persons. The equipment of the office allows FPTO workers to perform invasive and other manipulations without being sent to other clinics. In the office, training for residents is focused on their needs and aimed at achieving the required level of competence. International methodologies and assessment tools are adapted to local conditions and evaluated for their effectiveness and acceptability. Residents and their faculty actively conduct research in the field of family medicine. Conclusions: We propose to change the learning environment in order to create teams of like-minded people, to unite residents and teachers even more for the development of family medicine. The offices will also invest resources in developing and maintaining young doctors' interest in family medicine.

Keywords: educational environment, family medicine residents, family physicians’ training office, primary care research

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Authors: Camilo Andrés Agudelo Vélez, Lina María Martínez Sánchez, Isabel Cristina Ortiz Trujillo, Evert Armando Jiménez Cotes, Natalia Perilla Hernández, María de los Ángeles Rodríguez Gázquez, Daniel Duque Restrepo, Felipe Hernández Restrepo, Dayana Andrea Quintero Moreno, Juan José Builes Gómez, Camilo Ruiz Mejía, Ana Lucia Arango Gómez

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Preeclampsia is a clinical complication during pregnancy with high incidence in Colombia; therefore, it is important to evaluate the influence of external conditions and medical interventions, in order to promote measures that encourage improvements in the quality of life. Objective: Determine clinical and sociodemographic variables in women with preeclampsia. Methods: This cross-sectional study enrolled 50 patients with the diagnosis of preeclampsia, from a private institution in Medellin, during 2015. We used the software SPSS ver.20 for statistical analysis. For the qualitative variables, we calculated the mean and standard deviation, while, for ordinal and nominal levels of quantitative variables, ratios were estimated. Results: The average age was 26.8±5.9 years. The predominant characteristics were socioeconomic stratum 2 (48%), students (55%), mixed race (46%) and middle school as level of education (38%). As for clinical features, 72% of the cases were mild preeclampsia, and 22% were severe forms. The most common clinical manifestations were edema (46%), headache (62%), and proteinuria (55%). As for the Gyneco-obstetric history, 8% reported previous episodes of this disease and it was the first pregnancy for 60% of the patients. Conclusions: Preeclampsia is a frequent condition in young women; on the other hand, headache and edema were the most common reasons for consultation, therefore, doctors need to be aware of these symptoms in pregnant women.

Keywords: pre-eclampsia, hypertension, pregnancy complications, pregnancy, abdominal, edema

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Authors: Odinah Cuartero-Enteria, Aive Pecasales, Jhadly Philip Buniel, Christian Joy Vega, Shiela Estubo

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In the Philippines, Mindanao Island has the cheapest electricity because of the hydroelectric plants. Due to the rapid increase of the electricity consumption which the sources of electricity cannot support, it causes rotating brownout during summer season. This study investigated the household energy usage and practices in the rural areas of northern part of the Mindanao Island, Philippines. The questionnaire that includes the respondents’ profile and their common practices in energy consumptions was used as a tool in gathering the data. Several households were subjected to the survey. Results show energy consumption is not dependent on the profile of the respondents. It was observed that most of the families prefer to use energy saving methods of reducing electricity consumption. The main energy saving methods are unplugging unused home appliances, using of compact fluorescent bulb and energy-efficient gadgets, and using high electricity consumption appliances by schedule. Based on the results, the households in the rural areas know the practices of reducing electricity consumption. However, it is highly recommended that concern agencies should initiate information dissemination and strict implementation of well-formulated energy conservation practices all over the areas in Mindanao.

Keywords: Philippines, Mindanao island, rural areas, households, energy usages, practices

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Authors: Yasuyuki Takahashi, Hayato Ishimura, Masao Miyagawa, Teruhito Mochizuki

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Quantitative measurement of myocardium perfusion is possible with single photon emission computed tomography (SPECT) using a semiconductor detector. However, accumulation of ^99mTc-tetrofosmin in the liver may make it difficult to assess that accurately in the inferior myocardium. Our idea is to reduce the high accumulation in the liver by using dynamic SPECT imaging and a technique called time subtraction. We evaluated the performance of a new SPECT system with a cadmium-zinc-telluride solid-state semi- conductor detector (Discovery NM 530c; GE Healthcare). Our system acquired list-mode raw data over 10 minutes for a typical patient. From the data, ten SPECT images were reconstructed, one for every minute of acquired data. Reconstruction with the semiconductor detector was based on an implementation of a 3-D iterative Bayesian reconstruction algorithm. We studied 20 patients with coronary artery disease (mean age 75.4 ± 12.1 years; range 42-86; 16 males and 4 females). In each subject, 259 MBq of ^99mTc-tetrofosmin was injected intravenously. We performed both a phantom and a clinical study using dynamic SPECT. An approximation to a liver-only image is obtained by reconstructing an image from the early projections during which time the liver accumulation dominates (0.5~2.5 minutes SPECT image-5~10 minutes SPECT image). The extracted liver-only image is then subtracted from a later SPECT image that shows both the liver and the myocardial uptake (5~10 minutes SPECT image-liver-only image). The time subtraction of liver was possible in both a phantom and the clinical study. The visualization of the inferior myocardium was improved. In past reports, higher accumulation in the myocardium due to the overlap of the liver is un-diagnosable. Using our time subtraction method, the image quality of the ^99mTc-tetorofosmin myocardial SPECT image is considerably improved.

Keywords: 99mTc-tetrofosmin, dynamic SPECT, time subtraction, semiconductor detector

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Authors: Salami Ayobami Taofeek, Ajayi Adeola

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Rural tourism entrepreurship is a tourist industry which revolutionizes businesses and prompting economic development across the globe. It encompasses huge range activities, natural or man-made attractions, amenities and facilities, transportation, marketing and information systems. It is also an important export for 83% of the developing countries and the main export for one third of them. In 2000, developing countries recorded 142.6 million international arrivals an increase of 95% compared to the figures of 1990. However, only developing countries with effective natural and man-made tourism supporting and enhancing infrastructure have been able to develop their tourism sector and seize the attendance advantages. Rural areas of Nigeria possess some distinctive peculiarities which can be transformed into attractive tourist centers. In spite of all these, rural tourism areas are still faced with myriad problems which include poor finance inadequate awareness and education, lack of progress in developing the rural of progress in developing the rural tourism potentials inadequate legislation, insecurity, entrepreneurial inertness, over-dependent on oil among others. This paper focuses on the impact and challenges of rural tourism entrepreneurship as strategy for economic development in Nigeria. It reviews literature rural tourism, tourism entrepreneurship potentials and classifications of Nigerians tourism potential’s destinations. The paper concludes that Nigeria Government should encourage rural based tourism entrepreneurship development by addressing the challenges facing rural tourism entrepreneurship in the country.

Keywords: entrepreneurship, economic development, rural tourism, tourism destinations tourism potentials

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Authors: Maryam Azimi, Amin Banitalebi-Dehkordi, Yuanyuan Dong, Mahsa T. Pourazad, Panos Nasiopoulos

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While there exists a wide variety of Low Dynamic Range (LDR) quality metrics, only a limited number of metrics are designed specifically for the High Dynamic Range (HDR) content. With the introduction of HDR video compression standardization effort by international standardization bodies, the need for an efficient video quality metric for HDR applications has become more pronounced. The objective of this study is to compare the performance of the existing full-reference LDR and HDR video quality metrics on HDR content and identify the most effective one for HDR applications. To this end, a new HDR video data set is created, which consists of representative indoor and outdoor video sequences with different brightness, motion levels and different representing types of distortions. The quality of each distorted video in this data set is evaluated both subjectively and objectively. The correlation between the subjective and objective results confirm that VIF quality metric outperforms all to their tested metrics in the presence of the tested types of distortions.

Keywords: HDR, dynamic range, LDR, subjective evaluation, video compression, HEVC, video quality metrics

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Authors: Asaf Toker

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Matricelf developed a technology that enables the production of autologous engineered tissue composed of matrix and cells derived from patients Omentum biopsy. The platform showed remarkable pre-clinical results for several medical conditions. The company recently licensed the technology that enabled scientist at Tel Aviv university that 3D printed a human heart from human cells and matrix for the first time in human history. The company plans to conduct its first human clinical trial for Acute Spinal Cord Injury (SCI) early in 2023.

Keywords: tissue engineering, regenerative medicine, spinal Cord Injury, autologous implants, iPSC

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Authors: Hua-Shan Tai, Yu-Ting Zeng

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In modern and industrial society, enormous amounts of sludge from various of industries are constantly produced; currently, most of the sludge are treated by landfill and incineration. However, both treatments are not ideal because of the limited land for landfill and the secondary pollution caused by incineration. Consequently, treating industrial sludge appropriately has become an urgent issue of environmental protection. In order to solve the problem of the massive sludge, this study uses textile sludge which is the major source of waste sludge in Taiwan as raw material for torrefaction treatments. To investigate the feasibility of producing biofuels from textile sludge by torrefaction, the experiments were conducted with temperatures at 150, 200, 250, 300, and 350°C, with heating rates of 15, 20, 25 and 30°C/min, and with residence time of 30 and 60 minutes. The results revealed that the mass yields after torrefaction were approximately in the range of 54.9 to 93.4%. The energy densification ratios were approximately in the range of 0.84 to 1.10, and the energy yields were approximately in the range of 45.9 to 98.3%. The volumetric densities were approximately in the range of 0.78 to 1.14, and the volumetric energy densities were approximately in the range of 0.65 to 1.18. To sum up, the optimum energy yield (98.3%) can be reached with terminal temperature at 150 °C, heating rate of 20°C/min, and residence time of 30 minutes, and the mass yield, energy densification ratio as well as volumetric energy density were 92.2%, 1.07, and 1.15, respectively. These results indicated that the solid products after torrefaction are easy to preserve, which not only enhance the quality of the product, but also achieve the purpose of developing the material into fuel.

Keywords: biofuel, biomass energy, textile sludge, torrefaction

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Authors: Chibuzo Okoye Daniels, Gillian Glegg, Lynda Rodwell

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Marine debris from fishing nets to medical equipment to food packaging that play major roles in boosting the economy and protecting human health is now more than an environmental problem that can be solved by legislation, law enforcement and technical solutions. It has also been identified as a cultural problem that can only be addressed by identifying instruments that can be used to change human attitudes and behaviors. This may be through management approaches, education and involvement of all sectors/interests, including the public. To contribute to the sustainable development of coastal Nigeria, two case study areas (Ikoyi and Victoria Islands of Lagos State) were used to evaluate the socio-economic impacts of marine debris problem in coastal Nigeria. The following methods were used: (1) semi-structured interviews with key stakeholders and businesses on beaches, waterfronts and waterways within the study areas and (2) observational study of beaches, waterfronts and waterways within the study areas. The results of the study have shown that marine debris is a cultural and multi-sectoral problem that poses great threat not only to the environmental sustainability of the study areas but also to the wellbeing of its citizens and the economy of coastal Nigeria. Current solid waste and marine debris management practices are inefficient due to inadequate knowledge of how to tackle the problem. To ensure environmental sustainability in coastal Nigeria and avoid waste of scarce financial resources, adequate, appropriate and cost effective solutions to the marine debris problem need to be identified and effectively transferred for implementation in the study areas.

Keywords: sustainability, coastal Nigeria, study areas, aquaculture

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Authors: Nirmal Kumar Verma, Pallavi Jha

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Generation of the electromagnetic radiation oscillating at the frequencies in the terahertz range by propagation of two-color laser pulses in plasma is an active area of research due to its potential applications in various areas, including security screening, material characterization, and spectroscopic techniques. Due to nonionizing nature and the ability to penetrate several millimeters, THz radiation is suitable for diagnosis of cancerous cells. Traditional THz emitters like optically active crystals, when irradiated with high power laser radiation, are subject to material breakdown and hence low conversion efficiencies. This problem is not encountered in laser-plasma based THz radiation sources. The present paper is devoted to the study of the enhanced electromagnetic radiation generation by propagation of two-color, linearly polarized laser pulses through the magnetized plasma. The two lasers pulse orthogonally polarized are co-propagating along the same direction. The direction of the external magnetic field is such that one of the two laser pulses propagates in the ordinary mode, while the other pulse propagates in the extraordinary mode through the homogeneous plasma. A transverse electromagnetic wave with frequency in the THz range is generated due to the presence of the static magnetic field. It is observed that larger amplitude terahertz can be generated by mixing of ordinary and extraordinary modes of two-color laser pulses as compared with a single laser pulse propagating in the extraordinary mode.

Keywords: two-color laser pulses, electromagnetic radiation, magnetized plasma, ordinary and extraordinary modes

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Authors: Melissa Dorsey

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Moral distress and compassion fatigue plague nurses in the Cardiothoracic Intensive Care Unit (CTICU) and cause an unnecessary level of turnover. Dueling Burnout describes an initiative that was implemented in the CTICU to reduce the level of burnout the nurses endure by encouraging dual roles with collaborating departments. Purpose: Critical care nurses are plagued by burnout, moral distress, and compassion fatigue due to the intensity of care provided. The purpose of the dual role program was to decrease these issues by providing relief from the intensity of the critical care environment while maintaining full-time employment. Relevance/Significance: Burnout, moral distress, and compassion fatigue are leading causes of Cardiothoracic Critical Care (CTCU) turnover. A contributing factor to burnout is the workload related to serving as a preceptor for a constant influx of new nurses (RN). As a result of these factors, the CTICU averages 17% nursing turnover/year. The cost, unit disruption, and, most importantly, distress of the clinical nurses required an innovative approach to create an improved work environment and experience. Strategies/Implementation/Methods: In May 2018, a dual role pilot was initiated for nurses. The dual role constitutes .6 full-time equivalent hours (FTE) worked in CTICU in combination with .3 FTE worked in the Emergency Department (ED). ED nurses who expressed an interest in cross-training to CTICU were also offered the dual role opportunity. The initial hypothesis was that full-time employees would benefit from a change in clinical setting leading to increased engagement and job satisfaction. The dual role also presents an opportunity for professional development through the expansion of clinical skills in another specialty. Success of the pilot led to extending the dual role to areas beyond the ED. Evaluation/Outcomes/Results: The number of dual role clinical nurses has grown to 22. From the dual role cohort, only one has transferred out of CTICU. This is a 5% turnover rate for this group of nurses as compared to the average turnover rate of 17%. A role satisfaction survey conducted with the dual role cohort found that because of working in a dual role, 76.5% decreased their intent to leave, 100% decreased their level of burnout, and 100% reported an increase in overall job satisfaction. Nurses reported the ability to develop skills that are transferable between departments. Respondents emphasized the appreciation gained from working in multiple environments; the dual role served to transform their care. Conclusions/Implications: Dual role is an effective strategy to retain experienced nurses, decrease burnout and turnover, improve collaboration, and provide flexibility to meet staffing needs. The dual role offers RNs an expansion of skills, relief from high acuity and orientee demands, while improving job satisfaction.

Keywords: nursing retention, burnout, pandemic, strategic staffing, leadership

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Authors: Kristýna Weissová

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This study is focused on two selected model taxa of invertebrates - Hymenoptera: Aculeata and Lepidopterawithnocturnalactivity, recordedatthesitesof lignite dumps and their surroundings in the North Bohemian Lignite Basin, Czech Republic. There search was conducted on 10 landfills, 3 study areas were determined on each landfill - primary and secondary succession and recultivation. A total of 3,202 individuals belonging to 232 species and 17 families of sagebrushinsects were collected. died, 74%of the species occurred on the primary succes sionare as, that is 2x more species than on the reclaimed areas. Of the total number of species and on all areas, 60 rare species were recorded - 29 vulnerable, 21 endangered, 8 critically endangered, and 2 extinct The areas of primary succession were again confirmed to be the richest in terms of rare species, hosting 39 rare species of Hymenoptera: Aculeata. In addition, bothextinct species were represented only on plots of primary succession. The family Crabronidae had the largestre presentation of species on theareasofleft primary succession, the family Halictidae was the most represented on the reclaimed areas and areas of secondary succession. A total of 3,634 moths were collected, assigned to 262 species and 10 families. A similar number of species occurred on the primary succession and reclaimed areas, but the reclaimed area had a greater abundance. Secondary successionsiteshostedha lf as many species and alsocontainedlow abundance compared to other management types. The results show that there claimed areas host a numerically larger group and more species of moths than the successionalareas. Rare species did not occur at any site. A higher number of days in locations without water bodies, wetland vegetation, and locations with a highre presentation of woody species. It is advisable to combine individual types of landscape management in such a way as to create a colorfulmosaic that supports biodiversity. In particular, we recommend incorporating natural successionintoreclamation plans, which is a refuge for many rare species of invertebrates, which has not yetbeenroutinely and purposefully practiced.

Keywords: hymenoptera: aculeata, lepidoptera, reclamation, succession, post-mining ara

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Authors: Sarwat Jahan, Asker Rajin Rahman

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Management of offtake of any fluvial river is very sensitive in terms of long-term sustainability where the variation of water flow and sediment transport range are wide enough throughout a hydrological year. The Gorai River is a major distributary of the Ganges River in Bangladesh and is termed as a primary source of fresh water for the South-West part of the country. Every year, significant siltation of the Gorai offtake disconnects it from the Ganges during the dry season. As a result, the socio-economic and environmental condition of the downstream areas has been deteriorating for a few decades. To improve the overall situation of the Gorai offtake and its dependent areas, a study has been conducted by the Institute of Water Modelling, Bangladesh, in 2022. Using the mathematical morphological modeling tool MIKE 21C of DHI Water & Environment, Denmark, simulated results revealed the need for dredging/river training structures for offtake management at the Gorai offtake to ensure significant dry season flow towards the downstream. The dry season flow is found to increase significantly with the proposed river interventions, which also improves the environmental conditions in terms of salinity of the South-West zone of the country. This paper summarizes the primary findings of the analyzed results of the developed mathematical model for improving the existing condition of the Gorai River.

Keywords: Gorai river, mathematical modelling, offtake, siltation, salinity

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