Search results for: waiting period

Authors: Lara A. Alshawawreh, R. Sean Smith, John B. Wood

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This study focuses on the sheltering response in the Middle East, specifically through reviewing two Syrian refugee camps in Jordan, involving Zaatari and Azraq. Zaatari camp involved the rapid deployment of tents and shelters over a very short period of time and Azraq was purpose built and pre-planned over a longer period. At present, both camps collectively host more than 133,000 occupants. Field visits were taken to both camps and the main issues and problems in the sheltering response were highlighted through focus group discussions with camp occupants and inspection of shelter habitats. This provided both subjective and objective research data sources. While every case has its own significance and deployment to meet humanitarian needs, there are some common requirements irrespective of geographical region. The results suggest that there is a gap in the suitability of the required habitat needs and what has been provided. It is recommended that the global international response and support could be improved in relation to the habitat form, construction type, layout, function and critically the cultural aspects. Services, health and hygiene are key elements to the shelter habitat provision. The study also identified the amendments to shelters undertaken by the beneficiaries providing insight into their key main requirements. The outcomes from this study could provide an important learning opportunity to develop improved habitat response for future shelters.

Keywords: culture, post-disaster, refugees, shelters

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Authors: T. Garba, Y. Y. Sabo A. Babanyara, K. G. Ilellah, A. K. Mutari

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This study used the Normalized Difference Vegetation Index (NDVI) and maps compiled from the classification of Landsat TM and Landsat ETM images of 1986 and 1999 respectively and Nigeria sat 1 images of 2007 to quantify changes in land use and land cover in selected areas of Nigeria covering 143,609 hectares that are threatened by the encroaching Sahara desert. The results of this investigation revealed a decrease in natural vegetation over the three time slices (1986, 1999 and 2007) which was characterised by an increase in high positive pixel values from 0.04 in 1986 to 0.22 and 0.32 in 1999 and 2007 respectively and, a decrease in natural vegetation from 74,411.60ha in 1986 to 28,591.93ha and 21,819.19ha in 1999 and 2007 respectively. The same results also revealed a periodic trend in which there was progressive increase in the cultivated area from 60,191.87ha in 1986 to 104,376.07ha in 1999 and a terminal decrease to 88,868.31ha in 2007. These findings point to expansion of vegetated and cultivated areas in in the initial period between 1988 and 1996 and reversal of these increases in the terminal period between 1988 and 1996. The study also revealed progressive expansion of built-up areas from 1, 681.68ha in 1986 to 2,661.82ha in 1999 and to 3,765.35ha in 2007. These results argue for the urgent need to protect and conserve the depleting natural vegetation by adopting sustainable human resource use practices i.e. intensive farming in order to minimize persistent depletion of natural vegetation.

Keywords: changes, classification, desertification, vegetation changes

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Authors: H. Noureddine, P. Rao, R. Guru, A. Chandratreya

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The nice guidance for elective total knee replacements states that patients should be given mechanical thrombo-prophylaxis, and if no contraindications chemical thromboprophylaxis in the form of Dabigatran etexilate, Rivaroxiban, UFH, LMWH, or Fondaparinux sodium (CG92, 1.5.14, January 2010). In Practice administering oral agents has been the dominant practice as it reduces the nursing needs, and shortens hospital stay and is generally received better by patients. However, there are well documented associated bleeding risks, and their effects are difficult to reverse in case of major bleeding. Our experience with oral factor 10 inhibitors used for thromboprophylaxis was marked with several patients developing complications necessitating return to the theatre for wound washouts. This has led us to try a different protocol for thromboprophylaxis that we applied on our patients undergoing total and unicondylar knee replacements. We applied mechanical thromboprophylaxis in the form of intermittent pneumatic pressure devices, and chemical thromboprophylaxis in the form of a dose of prophylactic LMWH pre-op, then 150 mg of Aspirin to start 24 hours after the surgery and to continue for 6 weeks, alongside GI cover with PPIs or antihistamines. We also administered local anaesthetics intra-operatively in line with the ERAS protocol thus encouraging early mobilization. We have identified a cohort of 133 patients who underwent one of the aforementioned procedures in the same trust, and by the same surgeon, where this protocol was applied and examined their medical notes retrospectively with a mean follow-up period of 14 months, to identify the rate and percentage of patients who had thrombo-embolic events in the post-operative period.

Keywords: aspirin, heparin, knee arthroplasty, thromboprophylaxis

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Authors: Alexander Zotov, Ilkin Osmanov, Emil Sakharov, Oleg Shelest, Aleksander Troitskiy, Robert Khabazov

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Objective: Thoracoscopic surgical ablation of atrial fibrillation (AF) includes two technologies in performing of operation. 1st strategy used is the AtriCure device (bipolar, nonirrigated, non clamping), 2nd strategy is- the Medtronic device (bipolar, irrigated, clamping). The study presents a comparative analysis of clinical outcomes of two strategies in thoracoscopic ablation of AF using AtriCure vs. Medtronic devices. Methods: In 2 center study, 123 patients underwent thoracoscopic ablation of AF for the period from 2016 to 2020. Patients were divided into two groups. The first group is represented by patients who applied the AtriCure device (N=63), and the second group is - the Medtronic device (N=60), respectively. Patients were comparable in age, gender, and initial severity of the condition. Among the patients, in group 1 were 65% males with a median age of 57 years, while in group 2 – 75% and 60 years, respectively. Group 1 included patients with paroxysmal form -14,3%, persistent form - 68,3%, long-standing persistent form – 17,5%, group 2 – 13,3%, 13,3% and 73,3% respectively. Median ejection fraction and indexed left atrial volume amounted in group 1 – 63% and 40,6 ml/m2, in group 2 - 56% and 40,5 ml/m2. In addition, group 1 consisted of 39,7% patients with chronic heart failure (NYHA Class II) and 4,8% with chronic heart failure (NYHA Class III), when in group 2 – 45% and 6,7%, respectively. Follow-up consisted of laboratory tests, chest Х-ray, ECG, 24-hour Holter monitor, and cardiopulmonary exercise test. Duration of freedom from AF, distant mortality rate, and prevalence of cerebrovascular events were compared between the two groups. Results: Exit block was achieved in all patients. According to the Clavien-Dindo classification of surgical complications fraction of adverse events was 14,3% and 16,7% (1st group and 2nd group, respectively). Mean follow-up period in the 1st group was 50,4 (31,8; 64,8) months, in 2nd group - 30,5 (14,1; 37,5) months (P=0,0001). In group 1 - total freedom of AF was in 73,3% of patients, among which 25% had additional antiarrhythmic drugs (AADs) therapy or catheter ablation (CA), in group 2 – 90% and 18,3%, respectively (for total freedom of AF P<0,02). At follow-up, the distant mortality rate in the 1st group was – 4,8%, and in the 2nd – no fatal events. Prevalence of cerebrovascular events was higher in the 1st group than in the 2nd (6,7% vs. 1,7% respectively). Conclusions: Despite the relatively shorter follow-up of the 2nd group in the study, applying the strategy using the Medtronic device showed quite encouraging results. Further research is needed to evaluate the effectiveness of this strategy in the long-term period.

Keywords: atrial fibrillation, clamping, ablation, thoracoscopic surgery

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Authors: Ramesh Kumar, Rajesh Kumar, Shaktiman Singh, Atar Singh, Anshuman Bhardwaj, Ravindra Kumar Sinha, Anupma Kumari

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A detailed study of the ion chemistry of the Shaune Garnag glacier meltwater has been carried out to assess the role of active glacier in the chemical denudation rate. The chemical compositions of various ions in meltwater of the Shaune Garang glacier were analyzed during the melting period 2015 and 2016. Total 112 of melt water samples twice in a day were collected during ablation season of 2015 and 2016. To identify various factors controlling the dissolved ionic strength of Shaune Garang Glacier meltwater statistical analysis such as correlation matrix, Principle Component Analysis (PCA) and factor analysis were applied to deduce the result. Cation concentration for Ca²⁺ > Mg²⁺ > Na⁺ > K⁺ in the meltwater for both the years can be arranged in the order as Ca²⁺ > Mg²⁺ > Na⁺ > K⁺. Study showed that Ca²⁺ and HCO₃⁻ found to be dominant on the both melting period. Carbonate weathering identified as the dominant process controlling the dissolved ion chemistry of meltwater due to the high ratios of (Ca²⁺ + Mg²⁺) versus TZ+ and (Ca²⁺ + Mg²⁺) versus (Na⁺ + K⁺) in the study area. The cation denudation rate of the Shaune Garnag catchment is 3412.2 m⁻² a⁻¹, i.e. higher than the other glacierised catchment in the Himalaya, indicating intense chemical erosion in this catchment.

Keywords: Shaune Garang glacier, Hydrochemistry, chemical composition, cation denudation rate, carbonate weathering

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Authors: Masoud Rabbani, Majede Smizadeh, Hamed Farrokhi-Asl

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We study jointly determining prices and production in a multiple period horizon under a general non-stationary stochastic demand with continuous prices. In some periods we need to increase capacity of production to satisfy demand. This paper presents a model to aid multi-period production capacity planning by quantifying the trade-off between product quality and production cost. The product quality is estimated as the statistical variation from the target performances obtained from the output tolerances of the production machines that manufacture the components. We consider different tolerance for different machines that use to increase capacity. The production cost is estimated as the total cost of owning and operating a production facility during the planning horizon.so capacity planning has cost that impact on price. Pricing products often turns out to be difficult to measure them because customers have a reservation price to pay that impact on price and demand. We decide to determine prices and production for periods after enhance capacity and consider reservation price to determine price. First we use an algorithm base on fuzzy set of the optimal objective function values to determine capacity planning by determine maximize interval from upper bound in minimum objectives and define weight for objectives. Then we try to determine inventory and pricing policies. We can use a lemma to solve a problem in MATLAB and find exact answer.

Keywords: price policy, inventory policy, capacity planning, product quality, epsilon -constraint

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Authors: Awais Naeem, Osama Shakeel, Faizan Ullah, Abdul Wahid Anwer

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Introduction: To study the clinic-pathological factors, diagnostic factors and survival of extra-pulmonary small cell carcinoma. Methodology: From 1995 to 2017 all patients with a diagnosis of extra-pulmonary small cell carcinoma were included in the study. Demographic variables and clinic-pathological factors were collected. Management of disease was recorded. Short and long term oncological outcomes were recorded. All data was entered and analyzed in SPSS version 21. Results: A total of 14 patients were included in the study. Median age was 53.42 +/- 16.1 years. There were 5 male and 9 female patients. Most common presentation was dysphagia in 16 patient among esophageal small cell carcinoma and while other patient had pain in abdomen. Mean duration of symptoms was 4.23+/-2.91 months .Most common site is esophagus (n=6) followed by gall bladder(n=3). Almost all of the patients received chemo-radiotherapy. Majority of the patient presented with extensive disease. Five patients (35.7%) died during the follow up period, two (14.3%) were alive and rest of the patients were lost to follow up. Mean follow up period was 22.92 months and median follow up was 15 months. Conclusion: Extra-pulmonary small cell carcinoma is rare and needs to be managed aggressively. All patients should be treated with both systemic and local therapies.

Keywords: small cell carcinoma of esophagus, extrapulmonary small cell carcinoma, small cell carcinoma of gall bladder, small cell carcinoma of rectum, small cell carcinoma of stomach

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Authors: Kuang-Chi Pan, Shu-Jen Tuan

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Scolothrips takahashii Priesner (Thysanoptera: Thripidae) is a common predatory thrips which feeds on spider mites; it is considered an important natural enemy and a potential biological control agent against spider mites. In order to evaluate the efficacy of S. takahashii against tetranychid mites, life table and functional response study were conducted at 25±1°C, with Tetranychus urticae Priesner as prey. The intrinsic rate of increase (r), finite rate of increase (λ), net reproduction rate (R₀), mean generation time (T) were 0.1674 d⁻¹, 1.1822d⁻¹, 62.26 offspring/individual, and 24.68d. The net consumption rate (C₀) was 846.15, mean daily consumption rate was 51.92 eggs for females and 19.28 eggs for males. S. takahashii exhibited type III functional response when offered T. urticae deutonymphs. Based on the random predator equation, the estimated maximum attack rate (a) and handling time (Th) were 0.1376h⁻¹ and 0.7883h. In addition, a life table experiment was conducted to evaluate the offspring sex allocation and population dynamic of Tetranychus ludeni Zacher under group-rearing conditions with different sex ratios. All bisexual groups produced offspring with similar sex allocation patterns, which started with the majority of females, then transited during the middle of the oviposition period and turned male-biased at the end of the oviposition period.

Keywords: Scolothrips takahashii, Tetranychus urticae, Tetranychus ludeni, two-sex life table, functional response, sex allocation

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Authors: Teresa Azevedo PerdicoúLis, Paulo Lopes Dos Santos

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The conceptualisation of the problem of network optimisation as a noncooperative game sets up a holistic interactive approach that brings together different network features (e.g., com-pressor stations, sources, and pipelines, in the gas context) where the optimisation objectives are different, and a single optimisation procedure becomes possible without having to feed results from diverse software packages into each other. A mathematical model of this type, where independent entities take action, offers the ideal modularity and subsequent problem decomposition in view to design a decentralised algorithm to optimise the operation and management of the network. In a game framework, compressor stations and sources are under-stood as players which communicate through network connectivity constraints–the pipeline model. That is, in a scheme similar to tatonnementˆ, the players appoint their best settings and then interact to check for network feasibility. The devolved degree of network unfeasibility informs the players about the ’quality’ of their settings, and this two-phase iterative scheme is repeated until a global optimum is obtained. Due to network transients, its optimisation needs to be assessed at different points of the control interval. For this reason, the proposed approach to optimisation has two stages: (i) the first stage computes along the period of optimisation in order to fulfil the requirement just mentioned; (ii) the second stage is initialised with the solution found by the problem computed at the first stage, and computes in the end of the period of optimisation to rectify the solution found at the first stage. The liability of the proposed scheme is proven correct on an abstract prototype and three example networks.

Keywords: connectivity matrix, gas network optimisation, large-scale, noncooperative game, system decomposition

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Authors: C. Romero, R. Ortega, P. Sánchez-Camacho, P. Aguilar, V. Segur, J. Ruiz, G. Gutiérrez

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Introduction: Breast cancer is a leading cause of death in CLM. (2.8% of all deaths in women and 13,8% of deaths from tumors in womens). It is the most tumor incidence in CLM region with 26.1% from all tumours, except nonmelanoma skin (Cancer Incidence in Five Continents, Volume X, IARC). Cancer registries are a good information source to estimate cancer incidence, however the data are usually available with a lag which makes difficult their use for health managers. By contrast, mortality and survival statistics have less delay. In order to serve for resource planning and responding to this problem, a method is presented to estimate the incidence of mortality and survival data. Objectives: To estimate the incidence of breast cancer by age group in CLM in the period 1991-2013. Comparing the data obtained from the model with current incidence data. Sources: Annual number of women by single ages (National Statistics Institute). Annual number of deaths by all causes and breast cancer. (Mortality Registry CLM). The Breast cancer relative survival probability. (EUROCARE, Spanish registries data). Methods: A Weibull Parametric survival model from EUROCARE data is obtained. From the model of survival, the population and population data, Mortality and Incidence Analysis MODel (MIAMOD) regression model is obtained to estimate the incidence of cancer by age (1991-2013). Results: The resulting model is: Ix,t = Logit [const + age1*x + age2*x2 + coh1*(t – x) + coh2*(t-x)2] Where: Ix,t is the incidence at age x in the period (year) t; the value of the parameter estimates is: const (constant term in the model) = -7.03; age1 = 3.31; age2 = -1.10; coh1 = 0.61 and coh2 = -0.12. It is estimated that in 1991 were diagnosed in CLM 662 cases of breast cancer (81.51 per 100,000 women). An estimated 1,152 cases (112.41 per 100,000 women) were diagnosed in 2013, representing an increase of 40.7% in gross incidence rate (1.9% per year). The annual average increases in incidence by age were: 2.07% in women aged 25-44 years, 1.01% (45-54 years), 1.11% (55-64 years) and 1.24% (65-74 years). Cancer registries in Spain that send data to IARC declared 2003-2007 the average annual incidence rate of 98.6 cases per 100,000 women. Our model can obtain an incidence of 100.7 cases per 100,000 women. Conclusions: A sharp and steady increase in the incidence of breast cancer in the period 1991-2013 is observed. The increase was seen in all age groups considered, although it seems more pronounced in young women (25-44 years). With this method you can get a good estimation of the incidence.

Keywords: breast cancer, incidence, cancer registries, castilla-la mancha

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Authors: Nastaran Rezaei, Mohammad Saeed Mossadegh, Farhan Kocheyli, Khalil Talebi Jahromi, Aurang Kavousi

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Integrated Pest Management (IPM) aims to combine biological and chemical strategies and measures, hence highlighting the study of acute toxicity and sub-lethal effects of pesticides comprehensively. The present research focused on the side effects of thiamethoxam and pirimicarb sub-lethal concentrations on demographic parameters of Diaeretiella rapae (McIntosh Laboratory) (Hymenoptera: Braconidae). Adult parasitoids were exposed to LC₂₅ of insecticides as well as distilled water as the control. The results showed that thiamethoxam adversely affected population parameters (r, λ, R₀, T), adults' longevity, females' oviposition period and mean fecundity, and a similar trend was obtained for pirimicarb with the exception of generation time (T), the latter did not significantly change compared to the control. The intrinsic rate of increase (r) in the control and those treated with pirimicarb and thiamethoxam were 0.2801, 0.2064, 0.1525 days^-1, respectively, and the sex ratio was biased toward females in all treatments. Furthermore, none of the insecticides influenced total pre-oviposition period (TPOP) and offspring emergence rate. In general, these results indicated that both insecticides potentially distort the demographic parameters of the parasitoid even at sub-lethal concentrations, and then they should not be considered for IPM program in the presence of D. rapae.

Keywords: Diaeretiella rapae, Lipaphis erysimi, life-table study, pirimicarb, thiamethoxam

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Authors: Ender Su, Kai Wen Wong, I-Ling Ju, Ya-Ling Wang

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In this study, the systemic risk change of Taiwan’s banking sector is analyzed during the financial crisis. The risk expose of each financial institutions to the whole Taiwan banking systemic risk or vice versa under financial distress are measured by conditional Value-at-Risk (CoVaR) and conditional coherent expected shortfall (CoES). The CoVaR and CoES are estimated by using vector quantile autoregression (MVMQ-CaViaR) with the daily stock returns of each banks included domestic and foreign banks in Taiwan. The daily in-sample data covered the period from 05/20/2002 to 07/31/2007 and the out-of-sample period until 12/31/2013 spanning the 2008 U.S. subprime crisis, 2010 Greek debt crisis, and post risk duration. All banks in Taiwan are categorised into several groups according to their size of market capital, leverage and domestic/foreign to find out what the extent of changes of the systemic risk as the risk changes between the individuals in the bank groups and vice versa. The final results can provide a guidance to financial supervisory commission of Taiwan to gauge the downside risk in the system of financial institutions and determine the minimum capital requirement hold by financial institutions due to the sensibility changes in CoVaR and CoES of each banks.

Keywords: bank financial distress, vector quantile autoregression, CoVaR, CoES

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Authors: Ammar Ali Saleh Jaber, Amer Hayat Khan, Syed Azhar Syed Sulaiman

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Tuberculosis (TB) is considered as a major disease that affects daily activities and impairs health-related quality of life (HRQoL). The impact of TB on HRQoL can affect treatment outcome and may lead to treatment defaulting. Therefore, this study aims to evaluate the HRQoL of TB treatment lost to follow-up during and after treatment in Yemen. For this aim, this prospective study enrolled a total of 399 TB lost to follow-up patients between January 2011 and December 2015. By applying HRQoL criteria, only 136 fill the survey during treatment. Moreover, 96 were traced and fill out the HRQoL survey. All eight HRQol domains were categorized into the physical component score (PCS) and mental component score (MCS), which were calculated using QM scoring software. Results show that all lost to follow-up TB patients reported a score less than 47 for all eight domains, except general health (67.3) during their treatment period. Low scores of 27.9 and 29.8 were reported for emotional role limitation (RE) and mental health (MH), respectively. Moreover, the mental component score (MCS) was found to be only 28.9. The trace lost follow-up shows a significant improvement in all eight domains and a mental component score of 43.1. The low scores of 27.9 and 29.8 for role emotion and mental health, respectively, in addition to the MCS score of 28.9, show that severe emotional condition and reflect the higher depression during treatment period that can result to lost to follow-up. The low MH, RE, and MCS can be used as a clue for predicting future TB treatment lost to follow-up.

Keywords: Yemen, tuberculosis, health-related quality of life, Khat

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Authors: Kemal Kehan, Emine Aktas Bajalan

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This study was carried out to determine the burnout levels and related factors of teachers working in primary schools affiliated to the Turkish Republic of Northern Cyprus (TRNC) Ministry of National Education during the COVID-19 pandemic period. The research was conducted in descriptive cross-sectional design. The population of the research consists of 1071 teachers working in 93 primary schools in 6 central districts affiliated to the TRNC Ministry of National Education in the 2021-2022 academic year. When the sample size of the study was calculated by power analysis, it was determined that 202 teachers should be reached with 95% confidence (1-α), 95% test power (1-β) and d=0.5 effect size. Within the scope of the inclusion criteria of the research, the main sample of the study consisted of 300 teachers and the baist random sampling method was used. The data were collected using the Sociodemographic Data Form consisting of 34 questions, including the sociodemographic characteristics of the teachers and the 22-item Maslach Burnout Scale (MBS). The analysis of the data was carried out using descriptive and correlational analyzes in the SPSS 22 package program. In the study, it was determined that 65% of the teachers were women, 68% were married, 84% had a bachelor's degree, 70.33% had children, and 67.67% were dependents. Regarding how teachers evaluate the COVID-19 pandemic period; 90% of them said, “I am worried about my family's health and the risk of infection”, 80% of them, “I feel that my profession does not get the value it deserves”, 75.67% of them mentioned “My hopes for the future have started to wane”, 75.33% of them say “I am worried about my own health”. It was determined that they gave the answer of, “I am worried about the issue”. It was found that the teachers' MBS total score average was 48.63±8.01, the burnout level was moderate, and the average score they got from the sub-dimensions of the scale was also moderate. It has been found that there are negative correlations between the professional satisfaction scores of the teachers during and before the COVID-19 pandemic and the scores they received from the general and sub-dimensions of MBS. It was determined that there was a statistically significant difference (p<0.05) between the scores of teachers diagnosed with COVID-19 from the scale and its sub-dimensions. As a result, it is suggested that social activities should be increased and professional development and promotion opportunities should be offered in order to ensure that teachers are satisfied with their work areas, to reduce their burnout levels or to prevent them completely.

Keywords: teachers, burnout, maslach burnout scale, pandemic, online education

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Authors: Alvarez Magañini, María Victoria-Rubbi, Lautaro Nahuel

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At present, we are facing an unstable international context, conditioned by a relative decline of the US power, primarily in the economic sphere and, to a lesser extent, in the military sphere. This scenario of multipolarity creates tension and uncertainty in the peripheral countries when the issue of their foreign policy arises. This paper presents an analysis of the bilateral relations that were maintained by the Argentine Republic, a peripheral country, along with the United States and China during the period of 2005-2015 in matters of defense in order to identify the empirical consequences resulted from the Argentine actions. Based on the conceptual framework of Peripheral Realism, we analyze indicators related to the weapon trade, defense loans, joint exercises, and personnel training, among others. There will also be a comparative analysis of the conventional military forces of the two powers in question, United States and China. As a conclusion, the cost of having closer relations with China instead of the United States in the defense agenda has been clearly higher than the benefits obtained. The conclusions drawn are empirically aligned with the theoretical paradigm of peripheral realism. Although there are certain conceptual and methodological digressions, these conclusions they could be useful to update and adapt the theory to the current complex international scenario.

Keywords: China, United States, Argentine, peripheral country, peripheral realism

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Authors: Felipa De Mello-Sampayo

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Background: The aim of this study is to undertake, from a patient perspective, an economic analysis of presurgical teledermatology, comparing it with a conventional referral system. Store-and-forward teledermatology allows surgical planning, saving both time and number of visits involving travel, thereby reducing patients’ out-of-pocket expenses, i.e., costs that patients incur when traveling to and from health providers for treatment, visits’ fees, and the opportunity cost of time spent in visits. Method: Patients’ out-of-pocket expenses-effectiveness of presurgical teledermatology were analyzed in the setting of a public hospital during two years. The mean delay in surgery was used to measure effectiveness. The teledermatology network covering the area served by the Hospital Garcia da Horta (HGO), Portugal, linked the primary care centers of 24 health districts with the hospital’s dermatology department. The patients’ opportunity cost of visits, travel costs, and visits’ fee of each presurgical modality (teledermatology and conventional referral), the cost ratio between the most and least expensive alternative, and the incremental cost-effectiveness ratio were calculated from initial primary care visit until surgical intervention. Two groups of patients: those with squamous cell carcinoma and those with basal cell carcinoma were distinguished in order to compare the effectiveness according to the dermatoses. Results: From a patient perspective, the conventional system was 2.15 times more expensive than presurgical teledermatology. Teledermatology had an incremental out-of-pocket expenses-effectiveness ratio of €1.22 per patient and per day of delay avoided. This saving was greater in patients with squamous cell carcinoma than in patients with basal cell carcinoma. Conclusion: From a patient economic perspective, teledermatology used for presurgical planning and preparation is the dominant strategy in terms of out-of-pocket expenses-effectiveness than the conventional referral system, especially for patients with severe dermatoses.

Keywords: economic analysis, out-of-pocket expenses, opportunity cost, teledermatology, waiting time

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Authors: Guoyu Lin

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This paper explores the role investor sentiment plays in the relationship between analyst forecast dispersion and stock returns. With short sale constraints, stock prices are determined by the optimistic investors. During the high sentiment periods when investors suffer more from psychological bias, there are more optimistic investors. This is the first paper to document that following the high sentiment periods, stocks with the most analyst forecast dispersion are overpriced, earning significantly negative returns, while those with the least analyst forecast dispersion are not overpriced as the degree of belief dispersion is low. However, following the low sentiment periods, both are not overpriced. A portfolio which longs the least dispersed stocks and shorts the most dispersed stocks yields significantly positive returns only following the high sentiment periods. My findings can potentially reconcile the puzzling risk effect and mispricing effect in the literature. The risk (mispricing) effect suggests a positive (negative) relation between analyst forecast dispersion and future stock returns. Presumably, the magnitude of the mispricing effect depends on the proportion of irrational investors and their bias, which is positively related to investor sentiment. During the high sentiment period, the mispricing effect takes over and the overall effect is negative. During the low sentiment period, the percentage of irrational investors is mediate, and the mispricing effect and the risk effect counter each other, leading to insignificant relation.

Keywords: analyst forecast dispersion, short-sale constraints, investor sentiment, stock returns

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Authors: Cecilia Fagerstrom, Solve Elmstahl, Lena S. Wranker

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The conditions of increased morbidity in an aging population cause the need for family care to become more common at an advanced age. The role of family caregivers may well last for a long time but may also change over time, from being caregivers to being non-caregivers or vice versa. Although demands associated with family caring change as individuals enter into, engage with, and exit from this role, the evidence regarding the impact of family caregiving transitions on the health of older carers is still limited. This study comprised individuals (n=2294, 60+years) from the southern part of Sweden included in the project Swedish National study of Aging and Care. Caregiving transitions are discussed in the categories: enter, exit, and continuing during a six-year period. Individuals who exited caregiving during the time were older than those who continued or entered into the role of caregiving. At the six-year follow-up, caregivers who were continuing or had exited caregiving were more often worried about their own health compared to baseline. Resembling findings were not found in those who entered caregiving. Family caregiving transitions of exiting, entering or continuing had no effect on the individuals’ functional, physical and mental health expect for participants who entered in caregiving. For them, entering the role of family caregiving was associated with an improvement in physical health during the six years follow up period. Conclusion: Although the health impact of different caregiving transitions in late life does not differ, individual conditions and health at baseline are important parameters to take into consideration to improve long-term health in family caregivers.

Keywords: family caregiving, health, old age, transition

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Authors: Mequanint Birhan

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Modern urban environments present a dynamically growing field where, notwithstanding shared goals, several mutually conflicting interests frequently collide. However, it has a big impact on the city's socioeconomic standing, waiting lines and queues are common occurrences. This results in extremely long lines for both vehicles and people on incongruous routes, service coagulation, customer murmuring, unhappiness, complaints, and looking for other options sometimes illegally. The root cause of this is corruption, which leads to traffic jams, stopping, and packing vehicles beyond their safe carrying capacity, and violating the human rights and freedoms of passengers. This study focused on the optimizing time of passengers had to wait in public vehicle stations. This applied research employed both data gathering sources and mixed approaches, then 166 samples of key informants of transport station were taken by using the Slovin sampling formula. The length of time vehicles, including the drivers and auxiliary drivers ‘Weyala', had to wait was also studied. To maximize the service level at vehicle stations, a queuing model was subsequently devised ‘Menaharya’. Time, cost, and quality encompass performance, scope, and suitability for the intended purposes. The minimal response time for passengers and vehicles queuing to reach their final destination at the stations of the Tepi, Mizan, and Bonga towns was determined. A new bus station system was modeled and simulated by Arena simulation software in the chosen study area. 84% improvement on cost reduced by 56.25%, time 4hr to 1.5hr, quality, safety and designed load performance calculations employed. Stakeholders are asked to put the model into practice and monitor the results obtained.

Keywords: Arena 14 automatic rockwell, queue, transport services, vehicle stations

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Authors: Laura X. Martinez, Andrés F. Rodríguez, Ruth A. Catacoli

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One of the most important factors for air pollution is that the concentrations of PM₁₀ maintain a constant trend, with the exception of some places where that frequently surpasses the allowed ranges established by Colombian legislation. The community that surrounds the Universidad Libre Bogotá is inhabited by a considerable number of students and workers, all of whom are possibly being exposed to PM₁₀ for long periods of time while on campus. Thus, the chemical characterization of PM₁₀ found in the ambient air at the Universidad Libre Bogotá was identified as a problem. A Hi-Vol sampler and EPA Test Method 5 were used to determine if the quality of air is adequate for the human respiratory system. Additionally, quartz fiber filters were utilized during sampling. Samples were taken three days a week during a dry period throughout the months of November and December 2015. The gravimetric analysis method was used to determine PM₁₀ concentrations. The chemical characterization includes non-conventional carcinogenic pollutants. Atomic absorption spectrophotometry (AAS) was used for the determination of metals and VOCs were analyzed using the FTIR (Fourier transform infrared spectroscopy) method. In this way, concentrations of PM₁₀, ranging from values of 13 µg/m³ to 66 µg/m³, were obtained; these values were below standard conditions. This evidence concludes that the PM₁₀ concentrations during an exposure period of 24 hours are lower than the values established by Colombian law, Resolution 610 of 2010; however, when comparing these with the limits set by the World Health Organization (WHO), these concentrations could possibly exceed permissible levels.

Keywords: air quality, atomic absorption spectrophotometry, gas chromatography, particulate matter

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Authors: Doaa H. I. Mahmoud, El-Said M. Elsharkawy, Saad Z. Soliman, Soher E. Mustfa

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The opening of new promising foreign markets is one of the objectives of Egypt’s foreign trade policies, especially for agricultural exports. This study aims at the examination of the commodity structure of the Egyptian agricultural imports and exports with the COMESA countries. In addition, estimation of the surplus/deficit of the Egyptian commodities and agricultural balance with these countries is made. Time series data covering the period 2004-2016 is used. Estimation of the growth function along with the derivation of the annual growth rates of the study’s variables is made. Some of the results of the study period display the following: (1) The average total Egyptian exports to the COMESA (Common Market for Eastern and Southern Africa) countries is estimated at 1,491 million dollars, with an annual growth rate of 14.4% (214.7 million dollars). (2) The average annual Egyptian agricultural exports to these economies is estimated at 555 million dollars, with an annual growth rate of 19.4% (107.7 million dollars). (3) The average annual value of agricultural imports from the COMESA countries is set at 289 Million Dollars, with an annual growth rate of 14.4% (41.6 million dollars). (4) The study shows that there is a continuous surplus in the agricultural balance with these economies, whilst having a deficit in the raw-materials agricultural balance, as well as the balance of input requirements with these countries.

Keywords: COMESA, Egypt, growth rates, trade balance

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Authors: C. B. Masera, M. Imprialou, L. Budd, C. Morton

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Even though signalised intersections are necessary for urban road traffic management, they can act as bottlenecks and disrupt traffic operations. Interrupted traffic flow causes congestion, delays, stop-and-go conditions (i.e. excessive acceleration/deceleration) and longer journey times. Vehicle and infrastructure connectivity offers the potential to provide improved new services with additional functions of assisting drivers. This paper focuses on one of the applications of vehicle-to-infrastructure communication namely Green Light Optimal Speed Advisory (GLOSA). To assess the effectiveness of GLOSA in the urban road network, an integrated microscopic traffic simulation framework is built into VISSIM software. Vehicle movements and vehicle-infrastructure communications are simulated through the interface of External Driver Model. A control algorithm is developed for recommending an optimal speed that is continuously updated in every time step for all vehicles approaching a signal-controlled point. This algorithm allows vehicles to pass a traffic signal without stopping or to minimise stopping times at a red phase. This study is performed with all connected vehicles at 100% penetration rate. Conventional vehicles are also simulated in the same network as a reference. A straight road segment composed of two opposite directions with two traffic lights per lane is studied. The simulation is implemented under 150 vehicles per hour and 200 per hour traffic volume conditions to identify how different traffic densities influence the benefits of GLOSA. The results indicate that traffic flow is improved by the application of GLOSA. According to this study, vehicles passed through the traffic lights more smoothly, and waiting times were reduced by up to 28 seconds. Average delays decreased for the entire network by 86.46% and 83.84% under traffic densities of 150 vehicles per hour per lane and 200 vehicles per hour per lane, respectively.

Keywords: connected vehicles, GLOSA, intelligent transport systems, vehicle-to-infrastructure communication

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Authors: Ziyu Zhang, Xuanyu Ren, Fei Wu, Qinfei Lu, Yongmei Li, Xinyue Zhi

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Introduction: Adolescents experience a critical period of physical and psychological growth. Few studies focus on the influence of sleep hygiene on psychological health from the high school period to freshmen year. Also, the influence of the COVID-19 pandemic has public health significance. Methods: Totally 698 students from high school and college were included in the manuscript, and a cross-sectional procedure was conducted; the objective was to make the epidemiological comparison of the social phobia/depression prevalence and discuss the effects of potential determinants. Results: Psychological problems, including social phobia and depression, are prevalent, especially among high school students, with gender differences. The current results indicated that the association between sleep status and social phobia is most obvious among high school students, while the higher MMR risk was found both for high school social phobia students and college depressive freshmen. Moreover, the interaction between social phobia and depression was also obvious for both populations. Conclusions: Psychological problems, including social phobia and depression, are more prevalent among high school girls when compared with their male and freshmen peers. Important influenced factors for the risk of psychological problems among the two populations were different, but media multitasking status should be paid attention to for both.

Keywords: adolescence, psychological health, epidemiology, social culture

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Authors: Osagbai Joshua Eriki, Ngozi Agunwamba, Alice Hill, Lorna Almond, Maniya Duffy, Devashini Naidoo, David Ho, Raman Deo

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Aims: To evaluate the baseline eating pattern in a psychiatric hospital through quantifying purchases of food and drink items at the hospital shop and to implement a traffic light healthy eating labeling system. Method: A electronic till with reporting capabilities was purchased. A two-week period of baseline data collection was conducted. Thereafter, a system for labeling items based on the nutritional value of the food items at the hospital shop was implemented. Green labeling represented the items with the lowest calories and red the most. Further data was collated on the number and types of items purchased by patients according to the category, and the initial effectiveness of the system was evaluated. Result: Despite the implementation of the traffic light system, the red category had the highest number of items purchased by patients, highlighting the importance of promoting healthy eating choices. However, the study also showed that the system was effective in promoting healthy options, as the number of items purchased from the green category increased during the study period. Conclusion: The implementation of a traffic light labeling system for items sold at the hospital shop offers a promising approach to promoting healthy eating habits and choices. This is likely to contribute to a toolkit of measures when considering the multifactorial challenges that obesity and weight issues pose for long-stay psychiatric inpatients

Keywords: mental health, nutrition, food, healthy

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Authors: M. Walmsley, S. Elmatarri, S. Mannion

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Introduction: Self-inflicted injury is a recognised cause of major trauma in adults and is an independent indicator of a reduced functional outcome compared to non-intentional major trauma. There is little literature available on the inpatient mental health (MH) management of this vulnerable group. A retrospective review was conducted of inpatient MH management of major trauma patients admitted to a UK regional Major Trauma Centre (MTC). Their outcomes were compared to all major trauma patients. This group of patients required multiple MH interventions whilst on the Major Trauma Ward (MTW) and a had worse functional outcome compared to non-intentional trauma. Method: The national TARN (Trauma Audit and Research Network) database was used to identify patients admitted to a regional MTC over a 2-year period from June 2018 to July 2020. Patients with an ISS (Injury Severity Score) of greater than 15 with a mechanism of either self-harm or high-risk behavior were included for further analysis. Inpatient medical notes were reviewed for MH interventions on the MTW. Further outcomes, including mortality, length of stay (LOS) and Glasgow Outcome Score (GOS) were compared with all major trauma patients for the same time period. Results: A total of 60 patients were identified in the time period and of those, 27 spent time on the MTW. A total of 23 (85%) had a prior MH diagnosis, with 11 (41%) under the care of secondary MH services. Adequate inpatient records for review were available for 24 patients. During their inpatient stay, 8 (33%) were reviewed on the ward by the inpatient MH team. There were 10 interventions required for 6 (25%) patients on the MTW including, sections under the Mental Health Act, transfer to specialist MH facility, pharmacological sedation and security being called to the MTW. When compared to all major trauma patients, those admitted due to self-harm or high-risk behavior had a statistically significantly higher ISS (31.43 vs 24.22, p=0.0001) and LOS (23.51d vs 16.06d, p=0.002). Functional outcomes using the GOS were reduced in this group of patients, GOS 5 (low disability) (51.66% vs. 61.01%) and they additionally had a higher level of mortality, GOS 1 (15.00% vs 11.67%). Discussion: Intentional self-harm is a recognised cause of major trauma in adults and this patient group sustains more severe injuries, requiring a longer hospital stay with worse outcomes compared to all major trauma patients. Inpatient MH interventions are required for a significant proportion of these patients and therefore, there needs to be a close relationship with MH services. There is limited available evidence for how this patient group is best managed as an inpatient to aid their recovery and further work is needed on how outcomes in this vulnerable group can be improved.

Keywords: adult major trauma, attempted suicide, self-inflicted major trauma, inpatient management

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Authors: Kasbparast Mehdi, Hassani Zainab

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Aim: The purpose of this research was to investigate the effectiveness of therapeutical sensorimotor exercise. The statistical population of women who were diagnosed with patellofemoral pain syndrome by a doctor and were between the ages of 35 and 45 and registered for the first time in a sports club in the 4th district of Tehran, 30 people by random sampling and according to The include and exclude criteria were selected and divided into 2 equal control and experimental and homogeneous groups (in terms of height, weight and BMI).In both control and experimental groups, the pain was measured using a Visual Analog Scale(VAS) functionality was measured using the step-down test and quality of life was measured using a World Health Organization Quality of Life Scale (WHOQOL-BREF) (pre-test). Then, only the experimental group performed sensorimotor exercises for 12 weeks and 3 sessions each week, a total of 24 sessions and each session for 1 hour, and during this period, the control group only continued their daily activities. After the end of the training period, the desired factors were evaluated again (post-test) in the same way as the pre-test was done for them (experimental group and control group), with the same quality. Findings: The statistical results showed that in the experimental group, the amount of pain, function and quality of life had a statistical improvement (P≤0.05). Conclusion: In general conclusion, it can be stated that using sensorimotor exercises not only improved functionality and quality of life but also reduced the amount of pain in people with patellofemoral pain syndrome.

Keywords: pain, PFPS, sensori motor training, functionality

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Authors: Christina Knorr

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Analysis of the evacuation of occupants of a building plays a significant role in Fire Safety Engineering. One of the tools used for the analysis is the concept of the Required Safe Egress Time (RSET). It is generally accepted that RSET is measured from the time the fire ignites until the time that all occupants have evacuated to a safe location. Instructions on how RSET is determined can be found in both the International Fire Engineering Guidelines and, more recently, in the Australian Fire Engineering Guidelines. The guidelines also specify measures that could be applied to reduce the RSET and hence improve the performance of fire-safety measures of a building. Further, it is suggested that the delay period can be reduced through “training programs.” This study examined the overall level of fire-safety awareness among occupants of residential apartment buildings in Australia and investigated the possible effects of fire-safety training on the delay period and, hence, the RSET. A questionnaire, interviews, and an experiment were conducted to collect data about people’s fire-safety knowledge, people’s behaviour and nature, and the duration of activities people are likely to undertake in the event of a fire. The study led to an investigation into the delay and response time approximations and the development of a new equation to incorporate the impact of training into the RSET calculations for the general use of the fire engineering community. Regardless of the RSET, it can be concluded that fire-safety education and training for residents of apartment buildings have a direct impact on improving their behaviour and firefighting equipment usage in a fire incident.

Keywords: fire safety engineering, fire safety training, occupant evacuation behaviour, required safe egress time

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Authors: Manjunath Attibele, Alsawafi Manal, Al Dughaishi Tamima

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Introduction: The purpose of this study was to describe the clinical characteristics and types of mechanisms of injuries caused by Motor vehicle accidents (MVA) during pregnancy. To analyze the patterns of accidents during pregnancy and its adverse consequences on both maternal and fetal outcome. Methods: This was a retrospective cohort study on pregnant patients who met with MVAs The study period was from January 1, 2010, to December 31, 2019. All relevant data were retrieved from electronic patients’ records from the hospital information system and from the antenatal ward admission register Results: Out of 168 women who had motor vehicle accidents during the study period, of which, 39 (23.2%) women during pregnancy. Twenty-one (53.8%) women were over 30 years old. Thirty-five (89.7%) women were Omanis, and 27 (69.2%) were in their third trimester. Twenty-three (59%) of accidents happened at night, and 31 (79.5%) of them happened on a weekday. Twenty-two (56.4%) of women were driving themselves, and 24 (61.5%) of them were not using any seatbelt. Accident related abdominal & back pain was seen in 23(59%) women. Regarding the outcome of pregnancy, 23 (74.2%) had a normal vaginal delivery. The mean accident to delivery interval was 7 weeks. Thirty (96.7%) of involved newborns were relatively healthy. One woman (3.2%) had a ruptured uterusleading to fetal death (3.2%). Conclusion: This study showed that the incidence of motor vehicle accidents during pregnancy is around 23.2% . Majority had trauma-associated pain. One serious injury to a woman causing a ruptured uterus which lead to fetal death. Majority of involved newborns were relatively healthy. No reported maternal death.

Keywords: motor vehicle accidents, pregnancy, maternal outcome, fetal outcome

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Authors: Pedro Rubio

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Antonio Romero y Andía, was one of the most active and interesting figures in 19th century Spanish music. He was not only an exceptional clarinetist, he was also a publisher, a brilliant oboist, a music critic, and he revitalized Madrid’s musical scene by promoting orchestras and a national opera. In 1849, Romero was appointed Professor of Clarinet at the Conservatory of Madrid. Shortly after, Romero introduced to Spain the Boehm-System clarinet recently appeared in France. However, when initial interest in that system waned, he conceived his own system in 1853. The clarinet was manufactured in Paris by Lefêvre, who registered its first patent in 1862. In 1867 a second version was patented, and a year earlier, in 1866, the Romero clarinet was adopted as an official instrument for teaching the clarinet at the Conservatory of Madrid. The Romero-System clarinet mechanism has incorporated numerous additional devices and several extra keys, its skillful combination in a single instrument represents not only one of the pinnacles in the manufacture of musical instruments of the 19th century, but also an authentic synthesis of knowledge and practice in an era in which woodwind instruments were shaped as we know them today. Through the description and analysis of the data related to the aforementioned historical period, this lecture will try to show a crucial time in the history of all woodwind instruments, a period of technological effervescence in which the Romero-System clarinet emerged. The different stages of conception of the clarinet will be described, as well as its manufacturing and marketing process. Romero played with his clarinet system over twenty-five years. The research has identified the repertoire associated with this instrument whose conclusions will be presented in its case in the Congress.

Keywords: Antonio Romero, clarinet, keywork, 19th century

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Authors: Viktoriia Malinovska, Iryna Kuklina, Katerina Grabicova, Milos Buric, Pavel Kozak

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Personal care products, including organic UV filters, are considered emerging contaminants and their toxic effects have been a concern for the last decades. Sunscreen compounds continually enter the surface waters via sewage water treatment due to incomplete removal and during human recreational and laundry activities. Despite the environmental occurrence of organic UV filters in the freshwater environment, little is known about their impacts on aquatic biota. In this study, environmentally relevant concentrations of 5-Benzoyl-4-hydroxy-2-methoxybenzenesulfonic acid (BP-4, 2.5 µg/L) and 2-Phenylbenzimidazole-5-sulfonic acid (PBSA, 3 µg/L) were used to evaluate the cardiac and locomotor responses of signal crayfish Pacifastacus leniusculus during a short time period. The effects of these compounds were evident in experimental animals. Specimens exposed to both tested compounds exhibited significantly bigger changes in distance moved and time movement than controls. Significant differences in changes in mean heart rate were detected in both PBSA and BP-4 experimental groups compared to control groups. Such behavioral and physiological alterations demonstrate the ecological effects of selected sunscreen compounds during a short time period. Since the evidence of the impacts of sunscreen compounds is scarce, the knowledge of how organic UV filters influence aquatic organisms is of key importance for future research.

Keywords: aquatic pollutants, behavior, freshwaters, heart rate, invertebrate

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