Search results for: international patient safety goals

Authors: Yananda Siraphatthada

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The current study was the succession of a previous study on value added of recycling business management. Its aims are to 1) explore conditions on how to increasing value add of Thai recycling business, and 2) exam the implementation of the 3-staged plan (short, medium, and long term), suggested by the former study, to increase value added of the recycling business as immediate mechanisms to accelerate government operation. Quantitative and qualitative methods were utilized in this research. A qualitative research consisted of in-depth interviews and focus group discussions. Responses were obtained from owners of the waste separation plants, and recycle shops, as well as officers in relevant governmental agencies. They were randomly selected via Quota Sampling. Data was analyzed via content analysis. The sample used for quantitative method consisted of 1,274 licensed recycling operators in eight provinces. The operators were randomly stratified via sampling method. Data were analyzed via descriptive statistics frequency, percentage, average (mean), and standard deviation. The study recommended three-staged plan: short, medium, and long terms. The plan included the development of logistics, the provision of quality market/plants, the amendment of recycling rules/regulation, the restructuring recycling business, the establishment of green-purchasing recycling center, support for the campaigns run by the International Green Purchasing Network (IGPN), conferences/workshops as a public forum to share insights among experts/concern people.

Keywords: strategies, value added, recycle, business

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Authors: Joshna Rani S., Ahmadi Banu

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Artificial Intelligence (AI) has a significant task to carry out in the medical care contributions of things to come. As AI, it is the essential capacity behind the advancement of accuracy medication, generally consented to be a painfully required development in care. Albeit early endeavors at giving analysis and treatment proposals have demonstrated testing, we anticipate that AI will at last dominate that area too. Given the quick propels in AI for imaging examination, it appears to be likely that most radiology, what's more, pathology pictures will be inspected eventually by a machine. Discourse and text acknowledgment are now utilized for assignments like patient correspondence and catch of clinical notes, and their utilization will increment. The best test to AI in these medical services areas isn't regardless of whether the innovations will be sufficiently skilled to be valuable, but instead guaranteeing their appropriation in day by day clinical practice. For far reaching selection to happen, AI frameworks should be affirmed by controllers, coordinated with EHR frameworks, normalized to an adequate degree that comparative items work likewise, instructed to clinicians, paid for by open or private payer associations, and refreshed over the long haul in the field. These difficulties will, at last, be survived, yet they will take any longer to do as such than it will take for the actual innovations to develop. Therefore, we hope to see restricted utilization of AI in clinical practice inside 5 years and more broad use inside 10 years. It likewise appears to be progressively evident that AI frameworks won't supplant human clinicians for a huge scope, yet rather will increase their endeavors to really focus on patients. Over the long haul, human clinicians may advance toward errands and work plans that draw on remarkably human abilities like sympathy, influence, and higher perspective mix. Maybe the lone medical services suppliers who will chance their professions over the long run might be the individuals who will not work close by AI

Keywords: artificial intellogence, health care, breast cancer, AI applications

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Authors: Petronella Lunda, Catharina Susanna Minnie, Welma Lubbe

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Background This review aimed to provide healthcare professionals with a scientific summary of the best available research evidence on factors influencing respectful perinatal care. The review question was ‘What were the perceptions of midwives and doctors on factors that influence respectful perinatal care?’ Methods A detailed search was done on electronic databases: EBSCOhost: Medline, OAlster, Scopus, SciELO, Science Direct, PubMed, Psych INFO, and SocINDEX. The databases were searched for available literature using a predetermined search strategy. Reference lists of included studies were analysed to identify studies missing from databases. The phenomenon of interest was factors influencing maternity care practices according to midwives and doctors. Pre-determined inclusion and exclusion criteria were used during the selection of potential studies. In total, 13 studies were included in the data analysis and synthesis. Three themes were identified and a total of nine sub-themes. Results Studies conducted in various settings were included in the study. Multiple factors influencing respectful perinatal care were identified. During data synthesis, three themes emerged: healthcare institution, healthcare professionals, and women-related factors. Alongside the themes were sub-themes human resources, medical supplies, norms and practices, physical infrastructure, healthcare professional competencies and attributes, women’s knowledge, and preferences. The three factors influence the provision of respectful perinatal care; addressing them might improve the provision of the care. Conclusion Addressing factors that influence respectful perinatal care is vital towards the prevention of compromised patient care during the perinatal period as these factors have the potential to accelerate or hinder provision of respectful care.

Keywords: doctors, maternity care, midwives, obstetrician, perceptions, perinatal care, respectful care

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Authors: Ekaterina Lukianchenko

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This article sums up a six-year experience of teaching English as a foreign language to over 900 university students at MGIMO (Moscow University of International Relations, Russia), all of them native speakers of Russian aged 16 to 23. By combining modern communicative approach to teaching with cognitive linguistics theories, one can deal more effectively with deeply rooted mistakes which particular students have of which conventional methods have failed to eliminate. If language items are understood as concepts and frames, and classroom activities as meaningful parts of language competence development, this might help to solve such problems as incorrect use of words, unsuitable register, and confused tenses - as well as logical or structural mistakes, and even certain psychological issues concerning essay writing. Along with classic teaching methods, such classroom practice includes plenty of interaction between students - playing special classroom games aimed at eliminating particular mistakes, working in pairs and groups, integrating all skills in one class. The main conclusions that the author of the experiment makes consist in an assumption that academic essay writing classes demand a balanced plan. This should not only include writing as such, but additionally feature elements of listening, reading, speaking activities specifically chosen according to the skills and language students will need to write the particular type of essay.

Keywords: academic essay writing, creative teaching, cognitive linguistics, competency-based approach, communicative language teaching, frame, concept

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Authors: Arman Kishan, Mark Haft, Steve Li, Duc Nguyen, Dawn Laporte

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Objective: Patients with Type 2 diabetes (T2DM) often face higher postoperative complication rates. Limited data exist on outcomes in T2DM patients undergoing carpal tunnel release (CTR). This study aims to compare complication rates between endoscopic CTR (ECTR) and open CTR (OCTR) in patients with T2DM. Methods: This was a retrospective cohort study using the TriNetX database of 56741 patients with T2DM undergoing ECTR (N= 14,949) or OCTR (N= 41,792). Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complication rates between the two treatment methods in patients with T2DM. Results: Patients with T2DM undergoing ECTR had a significantly lower incidence of 90-day wound infection (p < 0.001), 90-day wound dehiscence (p < 0.001), and nerve injury (p < 0.001) when compared to patients who underwent OCTR. After matching, there was a significantly higher number of T2DM patients undergoing ECTR who had peripheral vascular disease (p = 0.045) and hypertension (p = 0.020) when compared to the OCTR group. These patients also had a lower incidence of fluid and electrolyte disorders (p = 0.002) and chronic blood loss anemia (p = 0.025). Conclusion: ECTR presents a superior choice for T2DM patients undergoing CTR, yielding significantly lower rates of wound infection, wound dehiscence, and nerve injury within 90 days post-surgery—reducing the risk by 31%, 48%, and 59%, respectively. These findings support the adoption of ECTR as the preferred method in this patient population, potentially leading to improved postoperative outcomes.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, carpal tunnel syndrome, postoperative complications in patients with diabetes mellitus

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Authors: Afsaneh Jasmine Majidi

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Language testing is an important part of language teaching experience and language learning process as it presents assessment strategies for teachers to evaluate the efficiency of teaching and for learners to examine their outcomes. However, language testing is demanding and challenging because it should provide the opportunity for proper and objective decision. In addition to all the efforts test designers put to design valid and reliable tests, there are some other determining factors which are even more complex and complicated. These factors affect the educational system, individuals, and society, and the impact of the tests vary according to the scope of the test. Seemingly, the impact of a simple classroom assessment is not the same as that of high stake tests such as International English Language Testing System (IELTS). As the importance of the test increases, it affects wider domain. Accordingly, the impacts of high stake tests are reflected not only in teaching, learning strategies but also in society. Testing experts use the term ‘washback’ or ‘impact’ to define the different effects of a test on teaching, learning, and community. This paper first looks at the theoretical background of ‘washback’ and ‘impact’ in language testing by reviewing of relevant literature in the field and then investigates washback effects of IELTS test of on Iranian IELTS teachers and students. The study found significant relationship between the washback effect of IELTS test and teaching strategies of Iranian IELTS teachers as well as performance of Iranian IELTS candidates and their community.

Keywords: high stake tests, IELTS, Iranian Candidates, language testing, test impact, washback

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Authors: Iwona Kasior

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Purpose: Pelvic organ prolapse is the descent of pelvic organs into the vaginal opening. Currently, few trials have been conducted to determine the influence of pelvic floor muscle training in decreasing stage or symptoms associated with pelvic organ prolapse. The purpose of this case study is to determine whether pelvic floor muscle training can decrease the stage of pelvic organ prolapse and related symptoms. Case Presentation: This is the case of a 55-year-old female; recently diagnosed with midline cystocele, stage three. She has undergone corrective surgery that failed. She has now resorted to managing the condition with a home exercise regimen of voluntary pelvic floor muscle contractions, topical vaginal crème prescribed by her gynecologist, and slight lifestyle modifications. Methods: The patient was treated by a physical therapist for evaluation, vaginal exam, and educated in the ‘knack’ maneuver, lifestyle modifications, and proper technique of performing pelvic floor muscle contractions. The subject continued with a home exercise program with a specific regimen of pelvic floor muscle contractions and topical vaginal crème. Outcome: As determined by her physical therapist and the subject, her pelvic floor muscle strength had increased following the pelvic floor muscle training regimen and the use of the ‘knack’ maneuver. The subject reported a small decrease in the size of bulging prolapse and related symptoms of dryness, odor, vaginal discomfort, and the sensation of descent. Conclusion: Pelvic floor muscle training helped to lessen the degree of the prolapse, but not significantly enough to decrease the diagnosed stage.

Keywords: Kegel exercises, pelvic floor, pelvic organ prolapse, physical therapy

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Authors: Marcin Szlachetka, Rafal Sochaczewski, Lukasz Grabowski

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This paper presents the results of the load simulations of main bearings in a two-stroke Diesel engine. A model of an engine lubrication system with connections of its main lubrication nodes, i.e., a connection of its main bearings in the engine block with the crankshaft, a connection of its crankpins with its connecting rod and a connection of its pin and its piston has been created for our calculations performed using the AVL EXCITE Designer. The analysis covers the loads given as a pressure distribution in a hydrodynamic oil film, a temperature distribution on the main bush surfaces for the specified radial clearance values as well as the impact of the force of gas on the minimum oil film thickness in the main bearings depending on crankshaft rotational speeds and temperatures of oil in the bearings. One of the main goals of the research has been to determine whether the minimum thickness of the oil film at which fluid friction occurs can be achieved for each value of crankshaft speed. Our model calculates different oil film parameters, i.e., its thickness, a pressure distribution there, the change in oil temperature. Additional enables an analysis of an oil temperature distribution on the surfaces of the bearing seats. It allows verifying the selected clearances in the bearings of the main engine under normal operation conditions and extremal ones that show a significant increase in temperature above the limit value. The research has been conducted for several engine crankshaft speeds ranging from 1000 rpm to 4000 rpm. The oil pressure in the bearings has ranged 2-5 bar according to engine speeds and the oil temperature has ranged 90-120 °C. The main bearing clearance has been adopted for the calculation and analysis as 0.025 mm. The oil classified as SAE 5W-30 has been used for the simulations. The paper discusses the selected research results referring to several specific operating points and different temperatures of the lubricating oil in the bearings. The received research results show that for the investigated main bearing bushes of the shaft, the results fall within the ranges of the limit values despite the increase in the oil temperature of the bearings reaching 120˚C. The fact that the bearings are loaded with the maximum pressure makes no excessive temperature rise on the bush surfaces. The oil temperature increases by 17˚C, reaching 137˚C at a speed of 4000 rpm. The minimum film thickness at which fluid friction occurs has been achieved for each of the operating points at each of the engine crankshaft speeds. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK ‘PZL-KALISZ’ S.A.’ and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.

Keywords: diesel engine, main bearings, opposing pistons, two-stroke

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Authors: Sejin Jung, Dongho Kang, Byungsik Kim

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Assessing the impact of climate change requires the use of a multi-model ensemble (MME) to quantify uncertainties between scenarios and produce downscaled outlines for simulation of climate under the influence of different factors, including topography. This study decreases climate change scenarios from the 13 global climate models (GCMs) to assess the impacts of future climate change. Unlike South Korea, North Korea lacks in studies using climate change scenarios of the CoupledModelIntercomparisonProject (CMIP5), and only recently did the country start the projection of extreme precipitation episodes. One of the main purposes of this study is to predict changes in the average climatic conditions of North Korea in the future. The result of comparing downscaled climate change scenarios with observation data for a reference period indicates high applicability of the Multi-Model Ensemble (MME). Furthermore, the study classifies climatic zones by applying the Köppen-Geiger climate classification system to the MME, which is validated for future precipitation and temperature. The result suggests that the continental climate (D) that covers the inland area for the reference climate is expected to shift into the temperate climate (C). The coefficient of variation (CVs) in the temperature ensemble is particularly low for the southern coast of the Korean peninsula, and accordingly, a high possibility of the shifting climatic zone of the coast is predicted. This research was supported by a grant (MOIS-DP-2015-05) of Disaster Prediction and Mitigation Technology Development Program funded by Ministry of Interior and Safety (MOIS, Korea).

Keywords: MME, North Korea, Koppen–Geiger, climatic zones, coefficient of variation, CV

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Authors: Suprit Pradhan, Sushil Pradhan

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Photosynthesis is a physiological process where green plants prepare their food from carbon dioxide from the atmosphere and water being absorbed from the soil in presence of sun light and chlorophyll. From this definition it is clear that four reactants (Carbon Dioxide, Water, Light and Chlorophyll) are essential for the process to proceed and the product is a sugar or carbohydrate ultimately stored as starch. The entire process has “Light Reaction” (Photochemical) and “Dark Reaction” (Biochemical). Biochemical reactions are very much complicated being catalysed by various enzymes and the path of carbon is known as “Calvin Cycle” according to the name of its discover. The overall reaction which is now universally accepted can be explained like this. Six molecules of carbon dioxide react with twelve molecules of water in presence of chlorophyll and sun light to give only one molecule of sugar (Carbohydrate) six molecules of water and six molecules of oxygen is being evolved in gaseous form. This is the accepted equation and also chemically balanced. However while teaching the subject the author came across a new balanced equation from among the students who happened to be the daughter of the author. In the new balanced equation in place of twelve water molecules in the reactant side seven molecules can be expressed and accordingly in place of six molecules of water in the product side only one molecule of water is produced. The energetics of the photosynthesis as related to the environment and the newly reported balanced chemical equation has been discussed in detail in the present research paper presentation in this international conference on energy, environmental and chemical engineering.

Keywords: biochemistry, enzyme , isotope, photosynthesis

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Authors: Ravi Patel, Ravisinh Solanki, Dignesh Khunt

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A stability-indicating reverse phase high performance liquid chromatography (RP-HPLC) method was developed and validated for estimating Nirmatrelvir in its self-emulsifying drug delivery system (SEDDS). The separation of Nirmatrelvir and its degradation products was accomplished by employing an Agilent Zorbax Eclipse plus C18 (250 mm x 4.6 mm, 5 µm) column, through which the mobile phase 5 mM phosphate buffer (pH 4.0) as mobile phase A and Acetonitrile as mobile phase B in a ratio of (40:60 % v/v) was pumped at a flow rate of 1.0 mL/min, through the HPLC system. Chromatographic separation and elution were monitored by a photo-diode array detector at 210 nm. Stress studies have been employed to evaluate this method's ability to indicate stability. Nirmatrelvir was exposed to several stress conditions, such as acid, alkali, oxidative, photolytic, and thermal degradations. Significant degradation was observed during acid and alkali hydrolysis, and the resulting degradation product was successfully separated from the Nirmatrelvir peak, preventing any interference. Furthermore, the primary degradant produced under alkali degradation conditions was identified using UPLC-ESI-TQ-MS/MS. The method was validated in accordance with the International Council on Harmonization (ICH) and found to be selective, precise, accurate, linear, and robust. The apparent permeability of Nirmatrelvir SEDDS was 4.20 ± 0.21×10-6 cm/sec, and the average proportion of free drug recovered was 0.5%. The method developed in this study was feasible and accurate for routine quality control evaluation of Nirmatrelvir SEDDS.

Keywords: Nirmatrelvir, SEDDS, degradation study, HPLC, LC-MS/MS

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Authors: Yun Wang, Ruoyu Wang, Tuo Chen, Guangxiu Liu, Guodong Chen, Wei Zhang

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Tuberculosis (TB) is a major public health problem in China. China has the world's second largest tuberculosis epidemic (after India). Xinjiang almost has the highest annual attendance rate of TB in China, and the province is also famous because of its severe dust storms. The epidemic timing starts in February and ends in July, and the dust storm mainly distribute throughout the spring and early summer, which strongly indicate a close linkage between causative agent of TB and dust storm events. However, mechanisms responsible for the observed patterns are still not clearly indentified. By comparing the information on cases of TB from Centers for Disease Control of China annual reports with dust storm atmosphere datasets, we constructed the relationship between the large scale annual occurrence of TB in Xinjiang, a Northwest province of China, and dust storm occurrence. Regional atmospheric indexes of dust storm based on surface wind speed show a clear link between population dynamics of the disease and the climate disaster: the onset of epidemics and the dust storm defined by the atmospheric index share the same mean year. This study is the first that provides a clear demonstration of connections that exist between TB epidemics and dust storm events in China. The development of this study will undoubtedly help early warning for tuberculosis epidemic onset in China and help nationwide and international public health institutions and policy makers to better control TB disease in Norwest China.

Keywords: dust storm, tuberculosis, Xinjiang province, epidemic

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Authors: Marjone Van Der Bank, C. M. Van Der Bank

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This paper presents an overview of the foundation and evolution of environmental related problems in local governments with specific reference on air pollution in South Africa. Local government has a direct mandate in terms of the Constitution of the Republic of South Africa, 1996 (hereafter, the Constitution). This mandate to protect, fulfil, respect and promote the Bill of Rights by local governments in respect of the powers and functions creates confusion around the role of where a local government fits in, in addressing the problem of climate change in South Africa. A reflection of the evolving legislations, developments, and processes regarding climate change that shaped local government dispensation in South Africa is addressed by the notion of developmental local governments. This paper seeks to examine the advances for mitigation and adaptation regulation of air pollution and application in South Africa. This study involves a qualitative approach that will involve South African national legislation as well as an interpretation of international strategies. A literature review study was conducted to undertake the various aspects of law in order to support the argument undertaken of mitigation and adaptation strategies. The paper presents a detailed discussion of the current legislation and the position as it currently stands, as well as the relevant protections as outlined in the National Environmental Management Act and the National Environmental Management: Air Quality Act. It then proceeds to outline the responsibilities of local governments in South Africa to mitigate and adapt to air pollution strategies.

Keywords: adaptation, climate change, disaster, local governments and mitigation

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Authors: Lavanya Annadi, Fahimeh Jafari

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Transportation brings immense benefits to society, but it also has its costs. Costs include such as the cost of infrastructure, personnel and equipment, but also the loss of life and property in traffic accidents on the road, delays in travel due to traffic congestion and various indirect costs in terms of air transport. More research has been done to identify the various factors that affect road accidents, such as road infrastructure, traffic, sociodemographic characteristics, land use, and the environment. The aim of this research is to predict the probabilistic crash prediction of vehicles using machine learning due to natural and structural reasons by excluding spontaneous reasons like overspeeding etc., in the United States. These factors range from weather factors, like weather conditions, precipitation, visibility, wind speed, wind direction, temperature, pressure, and humidity to human made structures like road structure factors like bump, roundabout, no exit, turning loop, give away, etc. Probabilities are dissected into ten different classes. All the predictions are based on multiclass classification techniques, which are supervised learning. This study considers all crashes that happened in all states collected by the US government. To calculate the probability, multinomial expected value was used and assigned a classification label as the crash probability. We applied three different classification models, including multiclass Logistic Regression, Random Forest and XGBoost. The numerical results show that XGBoost achieved a 75.2% accuracy rate which indicates the part that is being played by natural and structural reasons for the crash. The paper has provided in-deep insights through exploratory data analysis.

Keywords: road safety, crash prediction, exploratory analysis, machine learning

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Authors: Ipek Krom, Nurdan Tumbek Tekeoglu

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In our globalizing world increased competition between cities have resulted in expanding investments in marketing activities. In order to promote tourism and reinvestments, the cities have been using marketing activities to create more attractive sites and make use of their resources more efficiently. In becoming a branded city marketing activities play a major role in building brand value, which in turn results in the attraction of newcomers, revisits, settlements, reinvestments and the development of the city. This paper focuses on the Istanbul brand, which carries an important role in the promotion of Turkey as being its cultural, economic and financial center. As one of the most historical and appealing metropolitans in the world with remains of ancient civilizations, Istanbul has attracted 11 million 843 thousand tourists in 2014. Increasing number of marketing activities developed by numerous actors of private and public sector are among the reasons why tourists prefer Istanbul. Among these reasons we can list the increasing number of hotels, developed infrastructure and better transportation, modern shopping malls, international festivals, exportation of Turkish TV series, gastronomy investments, congress tourism, health tourism, student exchange programs, expatriation opportunities, recreational activities and new tourism destinations. In this paper we explore the marketing activities in Istanbul in order to make the city of the most visited metropolitans in the world. Decision making people in the tourism sector have been interviewed to provide better insight to the addressed topics.

Keywords: brand cities, marketing, tourism in istanbul, tourism marketing

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Authors: Luksanaporn Krungkraipetch

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Pterygium is a frequent ocular surface lesion that begins in the limbal conjunctiva within the palpebral fissure and spreads to the cornea. The lesion is more common in the nasal limbus than in the temporal, and it has a wing-like aspect. Indications for surgery, in decreasing order of significance, are growth over the corneal center, decreased vision due to corneal deformation, documented growth, sensations of discomfort, and esthetic concerns. The aim of this study is twofold: first, to determine the frequency of pterygium recurrence after surgery at the mentioned hospital, and second, to identify the factors that influence the recurrence of pterygium. The research design is a retrospective examination of 164 patient samples in an eastern Thai university hospital (Code 13766). Data analysis is descriptive statistics analysis, i.e., basic data details about pterygium surgery and the risk of recurrent pterygium, and for factor analysis, the inferential statistics chi-square and ANOVA are utilized. Twenty-four of the 164 patients who underwent surgery exhibited recurrent pterygium. Consequently, the incidence of recurrent pterygium after surgery was 14.6%. There were an equal number of men and women present. The participants' ages ranged from 41 to 60 years (62, 8 percent). According to the findings, the majority of patients were female (60.4%), over the age of 60 (51.2%), did not live near the beach (83.5%), did not have an underlying disease (92.1%), and 95.7% did not have any other eye problems. Gender (X² = 1.26, p = .289), age (X² = 5.86, p = .119), an address near the sea (X² = 3.30, p = .081)), underlying disease (X² = 0.54, p = .694), and eye disease (X² = 0.00, p = 1.00) had no effect on pterygium recurrence. Recurrences occurred in 79.1% of all surgical procedures and 11.6% of all patients using the bare sclera technique. The recurrence rate for conjunctival autografts was 20.9% for all procedures and 3.0% for all participants. Mitomycin-C and amniotic membrane transplant techniques had no recurrence following surgery. Comparing the surgeries done on people with recurrent pterygium did not show anything important (F = 1.13, p = 0.339). In conclusion, the prevalence of pterygium recurrence following pterygium, 14.6%, does not differ from earlier research. Underlying disease, other eye conditions, and surgical procedures such as pterygium recurrence are unaffected by pterygium surgery.

Keywords: pterygium, recurrence pterygium, pterygium surgery, excision pterygium

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Authors: Danila Zuffetti, Lorenzo Chiesa

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

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

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Authors: Abdullah M. Alzahrani, Abdel Halim Boussabaine

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There is an international consensus on the climate change in the entire world and this is as a result of the combination of the natural factors, such as volcanoes and hurricanes with increased of human activity on the earth, such as industrial renaissance. Where this solidarity increases emissions of greenhouse gases GHGs that considered as the main driver of climate change scenarios and related emerging risks and impacts on buildings. These climatic risks including damages, disruption and disquiet are set to increase and it is considered as the main challenges and difficulties facing built environment due to major implications on assets sector. Consequently, the threat from climate change patterns has a significant impact on a variety of complex human decisions, which affect all aspects of living. Understanding the relationship between buildings and such risks arising from climate change scenarios on buildings are the key in insuring the optimal timing and design of policies and systems, which affect all aspects of the built environment. This paper will uncovering this correlation between emerging climate change risks and the building assets. In addition, how these emerging risks can be classified in practical way in terms of their impact type on buildings. Hence, this mapping will assist professionals and interested parties in the building sector to cope with such risks in several systematic ways including development and designing of mitigation and adaptation strategies and processes of design, specification, construction, and operation; all these leads to successful management of assets.

Keywords: climate change, climate change risks, built environment, building sector, impacts

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Authors: Mohammad Ghahramani, Fahimeh Saei Manesh

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Winning a soccer game is based on thorough and deep analysis of the ongoing match. On the other hand, giant gambling companies are in vital need of such analysis to reduce their loss against their customers. In this research work, we perform deep, real-time analysis on every soccer match around the world that distinguishes our work from others by focusing on particular seasons, teams and partial analytics. Our contributions are presented in the platform called “Analyst Masters.” First, we introduce various sources of information available for soccer analysis for teams around the world that helped us record live statistical data and information from more than 50,000 soccer matches a year. Our second and main contribution is to introduce our proposed in-play performance evaluation. The third contribution is developing new features from stable soccer matches. The statistics of soccer matches and their odds before and in-play are considered in the image format versus time including the halftime. Local Binary patterns, (LBP) is then employed to extract features from the image. Our analyses reveal incredibly interesting features and rules if a soccer match has reached enough stability. For example, our “8-minute rule” implies if 'Team A' scores a goal and can maintain the result for at least 8 minutes then the match would end in their favor in a stable match. We could also make accurate predictions before the match of scoring less/more than 2.5 goals. We benefit from the Gradient Boosting Trees, GBT, to extract highly related features. Once the features are selected from this pool of data, the Decision trees decide if the match is stable. A stable match is then passed to a post-processing stage to check its properties such as betters’ and punters’ behavior and its statistical data to issue the prediction. The proposed method was trained using 140,000 soccer matches and tested on more than 100,000 samples achieving 98% accuracy to select stable matches. Our database from 240,000 matches shows that one can get over 20% betting profit per month using Analyst Masters. Such consistent profit outperforms human experts and shows the inefficiency of the betting market. Top soccer tipsters achieve 50% accuracy and 8% monthly profit in average only on regional matches. Both our collected database of more than 240,000 soccer matches from 2012 and our algorithm would greatly benefit coaches and punters to get accurate analysis.

Keywords: soccer, analytics, machine learning, database

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Authors: Ali Saleh Al-Rafedah, Ahmed Mohammed Al-Quthami, Tariq Jalal Al-Ashawi, Talal Nasser Motar Al-Enez

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Introduction: Barodontalgia is essentially dental pain provoked by changes in atmospheric pressure which usually disappear when the affected person reaches normal pressure zone. Barodontalgia has been recognized as a potential cause of aircrew-member vertigo and sudden incapacitation, which could jeopardize the safety of flight. Objective: The current study aimed to investigate the incidence of this phenomena among aircrews in Kingdom of Saudi Arabia. It also aimed to assess the knowledge of dental interns toward this phenomena. Material and Method: A 120 questionnaire consists of 17 questions were distributed to different of Aircrews working in commercial and governmental centers in different areas of KSA. Another questionnaire also distributed to 240 interns in different institutes in KSA. Results: Out of 120 questionnaire distributed to aircrews, 48 has been returned back (40%) and the participants were mainly pilots. The results showed that about 33% of the participants had this pain at least once during flying and the incidence of this pain was not associated with any age group. Most of the pain experience were during descending and at altitude between 10.000-20.000 feet (63%). The pain completely relieved after landing in most of the cases. Regarding pain scores, the majority of the participants reported moderate scores of severity (%65) and about 85% of them had visited the physician or dentist to investigate the existing oral problem. Among dental interns in KSA, our finding indicated lack of knowledge regarding this phenomena since only 23 % of the participants have an idea about this phenomena. Conclusion and recommendation: The incidence of Barodontalgia among aircrews in Saudi Arabia is considerably high and further studies should be carried out for better understanding of this phenomena. Significant lack of knowledge among dental interns about the Barodontalgia has been highlighted and inclusion of it in the teaching of clinical and preclinical curriculum is recommended.

Keywords: Barodontalgia/dental, atmospheric pressure, incapacitation, Saudi Arabia

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Authors: Ayeshmanthe Rathnayake, Siew Goh, Carmel Fenton, Ashutosh Hardikar

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Post-Operative Atrial Fibrillation (POAF) is the most frequent complication of cardiac surgery and is associated with reduced survival, increased rates of cognitive changes and cerebrovascular accident, heart failure, renal dysfunction, infection and length of stay, and hospital costs. Cardiac tamponade, although less common, carries high morbidity and mortality. Shed mediastinal blood in the pericardial space is a major source of intrapericardial oxidative stress and inflammation that triggers POAF. The utilisation of a left posterior pericardiotomy aims to shunt blood from the pericardium into the pleural space and have a role in the prevention of POAF as well as cardiac tamponade. 2118 patients had undergone isolated Coronary Artery Bypass Graft (CABG) at Royal Hobart Hospital from 2008-2021. They were divided into pericardiotomy vs control group. Patient baseline demographics, intraoperative data, and post-operative outcomes were reviewed retrospectively. Total incidence of new POAF and cardiac tamponade was 26.1% and 0.75%, respectively. Primary outcome of both the incidence of POAF(22.9% vs27.8%OR 0.77 p<0.05) and Cardiac Tamponade (0% vs 1.1% OR 0.85 p<0.05) were less in the pericardiotomy group.Increasing age, BMI, poor left ventricular function (EF <30%), and return to theatre were independent predictors of developing POAF. There were similar rates of return to theatre for bleeding however, no cases of tamponade in the pericardiotomy group. There were no complications attributable to left posterior pericardiotomy and the time added to the duration of surgery was minimal. Left posterior pericardiotomy is associated with a significant reduction in the incidence of POAFand cardiac tamponade and issafe and efficient.

Keywords: cardiac surgery, pericardiotomy, post-operative atrial fibrillation, cardiac tamponade

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Authors: Shahinaz El-Shourbagy El-Shourbagy, Ahmed M. E Ossman Ossman, Ashraf El-Mohamady El-Mohamady

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Objective: To investigate if there is a role of sildenafil citrate (Viagra) in the treatment of infertile couples for idiopathic cause. Design: An observational study. Setting: Infertility outpatient clinic of Tanta University Hospital Egypt. Patient(s): 50 unexplained infertility women {endometrial thickness (EM) and the mean resistance index (RI)} compared to 50 fertile control group attended for check-up in the same period and receiving no treatment. Intervention(s): unexplained infertility women were given 25 mg of sildenafil citrate suppositories four times per day for seven days starting from the 5th day of the menstrual cycle for three cycles. Main Outcome Measures: EM and RI of endometrial spiral artery were assessed by transvaginal color-pulsed Doppler ultrasound in unexplained infertility women before and after sildenafil citrate treatment and compared with control. The conception rate and pregnancy outcome were recorded in the two groups. Result(s): Women with unexplained infertility had significantly thinner endometrium and a higher spiral artery resistance index, meaning lower peri-implantation blood flow than the fertile controls. Sildenafil citrate treated women showed a statistically significant increase in endometrial thickness (p < 0.001) and a significant decrease in the mean spiral artery resistance index (p < 0.001) giving a better conception rate. Conclusion: Sildenafil citrate suppositories treatment enhance the endometrial blood flow through decreasing spiral artery resistance index 'RI' and consequently improve endometrial growth and receptivity in cases of unexplained infertility thus giving a better conception rate.

Keywords: Unexplained infertility, endometrial blood flow, endome¬trial receptivity, color-pulsed Doppler ultrasound; RI (resis¬tance index, Sildenafil citrate (Viagra)

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Authors: Myung-Soo Lee, Sun-Jin Jo, Kyoung-Sae Na, Joo-Eon Park

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Early intervention after a disaster is important for recovery of disaster victims and each country has its own professional mental health service system such as Disaster Psychiatric Assistant Team in Japan and Crisis Counseling Program in the USA. The purpose of this study was to determine key prior components of the Korean Disaster Psychiatric Assistant Team (K-DPAT) for building up Korean disaster mental health service system. We conducted an Analytic Hierarchy Process(AHP) with disaster mental health experts using pairwise comparison questionnaire which compares the relative importance of the key components of Korean disaster mental health service system. Forty-one experts answered the first online survey, and among them, 36 responded to the second. Ten experts were participated in panel meeting and discussed the results of the survey and AHP process. Participants decided the relative importance of the Korean disaster mental health service system regarding initial professional intervention as follows. K-DPAT could be organized at a national level (43.0%) or regional level (40.0%). K-DPAT members should be managed (59.0%) and educated (52.1%) by national level than regional or local level. K-DPAT should be organized independent of the preexisting mental health system (70.1%). Funding for K-DPAT should be from the Ministry of Public Safety and the system could be managed by Ministry of Health (65.8%). Experts agreed K-DPAT leader is suitable for key decision maker for most types of disaster except infectious disease. We expect new model for disaster mental health services can improve insufficiency of the system such as fragmentation and decrease the unmet needs of early professional intervention for the disaster victims.

Keywords: analytic hierarchy process, decision making, disaster, DPAT, mental health services

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Authors: Mara Balestrieri

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Climate change has long been the focus of attention for the growing impact of extreme weather events and global warming in many areas of the planet and the evidence of economic, social, and environmental damage caused by global warming. Nowadays, climate change is recognized as a critical global problem. Several initiatives have been undertaken over time to enhance the long theoretical debate and field experience in order to reduce Co2 emissions and contain climate alteration. However, the awareness that climate change is already taking place has led to a growing demand for adaptation. It is certainly a matter of anticipating the negative effects of climate change but, at the same time, implementing appropriate actions to prevent climate change-related damage, minimize the problems that may result, and also seize any opportunities that may arise. Consequently, adaptation has become a core element of climate policy and research. However, the attention to this issue has not developed in a uniform manner across countries. Some countries are further ahead than others. This paper examines the literature on climate change adaptation developed until 2018 in Italy, considering the urban dimension, to provide a framework for it, and to identify main topics and features. The papers were selected from Scopus and were analyzed through a matrix that we propose. Results demonstrate that adaptation to climate change studies attracted increasing attention from Italian scientific communities in the last years, although Italian scientific production is still quantitatively lower than in other countries and describes strengths and weaknesses in line with international panorama with respect to objectives, sectors, and problems.

Keywords: adaptation, bibliometric literature, climate change, urban studies

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Authors: My Ha, Suwei Lin, Huiying Zou

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This study aimed at investigating the association between teacher support and academic resilience in a developing country. Using the data from PISA 2018 Student Questionnaire and Cognitive Tests, the study provided evidence of the significant impact teacher support had on reading literacy among 15-year-old students from low socio-economic status (SES) homes in Vietnam. From a total of 5773 Vietnamese participants from all backgrounds, a sample of 1765 disadvantaged students was drawn for analysis. As a result, 32 percent of the low SES sample was identified as resilient. Through their response to the PISA items regarding the frequency of support they received from teachers, the result of Latent Class Analysis (LCA) divides children into three subgroups: High Support (74.6%), Fair Support (21.6%), and Low Support (3.8%). The high support group reported the highest proportion of resilient students. Meanwhile, the low support group scored the lowest mean on reading test and had the lowest rate of resilience. Also, as the level of support increases, reading achievement becomes less dependent on socioeconomic status, reflected by the decrease in both the slope and magnitude of their correlation. Logistic regression revealed that 1 unit increase in standardized teacher support would lead to an increase of 29.1 percent in the odds of a student becoming resilient. The study emphasizes the role of supportive teachers in promoting resilience, as well as lowering educational inequity in general.

Keywords: academic resilience, disadvantaged students, teacher support, inequity, PISA

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Authors: Zahra Bakhtiari

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Middle East countries confront a multitude of main environmental challenges which are inevitable. The unstable economic and political structure which dominates numerous middle East countries makes it difficult to react effectively to unfavorable climate change impacts. This study applies a qualitative methodology and relies on secondary literature aimed to investigate how countries in the Middle East are balancing economic security and climatic security in terms of budgeting, infrastructure investment, political engagement (domestically through discourses or internationally in terms of participation in international organizations or bargaining, etc.) There has been provided an outline of innovative measures in both economic and environmental fields that are in progress in the Middle East countries and what capacity they have for economic development and environmental adaptation, as well as what has already been performed. The primary outcome is that countries that rely more on infrastructure investment such as negative emissions technologies (NET) through green social capital enterprises and political engagement, especially nationally determined contributions (NDCs) commitments and United Nations Framework Convention on Climate Change (UNFCCC), experience more economic and climatological security balance in the Middle East. Since implementing these measures is not the same in all countries in the region, we see different levels of balance between climate security and economic security. The overall suggestion is that the collaboration of both the bottom-up and top-down approaches helps create strategic environmental strategies which are in line with the economic circumstances of each country and creates the desired balance.

Keywords: climate change, economic growth, sustainability, the Middle East, green economy, renewable energy

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Authors: Akash Soogumbur

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Tourniquets are commonly used in orthopaedic surgery to provide hemostasis during procedures on the upper and lower limbs. However, there is a risk of complications associated with tourniquet use, such as nerve damage, skin necrosis, and compartment syndrome. The British Orthopaedic Association (BOAST) guidelines recommend the use of tourniquets at a pressure of 300 mmHg or less for a maximum of 2 hours. Research Aim: The aim of this study was to evaluate the effectiveness of a tourniquet checklist in improving compliance with the BOAST guidelines. Methodology: This was a retrospective study of all orthopaedic procedures performed at a single institution over a 12-month period. The study population included patients who had a tourniquet applied during surgery. Data were collected from the patients' medical records, including the duration of tourniquet use, the pressure used, and the method of exsanguination. Findings: The results showed that the use of the tourniquet checklist significantly improved compliance with the BOAST guidelines. Prior to the introduction of the checklist, compliance with the guidelines was 83% for the duration of tourniquet use and 73% for pressure used. After the introduction of the checklist, compliance increased to 100% for both duration of tourniquet use and pressure used. Theoretical Importance: The findings of this study suggest that the use of a tourniquet checklist can be an effective way to improve compliance with the BOAST guidelines. This is important because it can help to reduce the risk of complications associated with tourniquet use. Data Collection: Data were collected from the patients' medical records. The data included the following information: Patient demographics, procedure performed, duration of tourniquet use, pressure used, method of exsanguination. Analysis Procedures: The data were analyzed using descriptive statistics. The compliance with the BOAST guidelines was calculated as the percentage of patients who met the guidelines for the duration of tourniquet use and pressure used. Question Addressed: The question addressed by this study was whether the use of a tourniquet checklist could improve compliance with the BOAST guidelines. Conclusion: The results of this study suggest that the use of a tourniquet checklist can be an effective way to improve compliance with the BOAST guidelines. This is important because it can help to reduce the risk of complications associated with tourniquet use.

Keywords: tourniquet, pressure, duration, complications, surgery

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Authors: Cai Yiting

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As China's globalization has accelerated, Chinese films have begun to explore and express foreign cultures with greater frequency while simultaneously disseminating Chinese culture. Films shot abroad, including Finding Mr. Right (2013), Somewhere Only We Know (2015), and Wolf Warrior 2 (2017), and others, can be viewed as a reflection of how Chinese cinema conceptualizes and represents foreign countries in the context of globalization. Furthermore, they facilitate the exchange of Chinese and foreign cultures in the context of China's ‘going out’ policy and the Belt and Road Initiative. Nevertheless, it is apparent that these films are primarily motivated by commercial considerations with regard to their initial release. The consistent placement of the Chinatown Detective' film series in the Chinese New Year slot is indicative of the significant influence of the cultural industry on the series' creation. Moreover, the series represents Chen Sicheng's inaugural venture into filming in a multitude of international locations. This paper examines the film series Detective Chinatown through the lens of the cultural industry, analyzing how its production and presentation cater to the demands of the cultural industry by presenting Orientalism and contributing new connotations to it. The series, a product of standardized mass production, commodification and global appeal, reflects Orientalist representations through the exoticization of Chinese culture and the stereotypical and commercial-oriented imagination of Bangkok, New York and Tokyo. This study provides an understanding of the film series' role in contributing to contemporary Orientalism in the context of the culture industry.

Keywords: orientalism, culture industry, Chinese globalisation, Detective Chinatown

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Authors: Yvette Reisinger

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Relatively little is known about the Arab travel market, especially the outbound travel market from Arab countries in the Middle East. The Kuwaiti travel market is the smallest yet fastest growing in the Gulf Cooperation Council (GCC) region. The Kuwaiti travel market represents a great potential for the international tourism industry. Kuwaiti nationals have a very high spending power due to the Kuwaiti dinar being the highest-valued currency unit in the world. Although Europe, North America, and Asia/Pacific try to attract the Arab tourist market the number of Kuwaiti travellers attracted to these destinations is very low. The success in attracting the Kuwaiti travel market to Western countries must be guided by an analysis of the factors that affect its travel decisions. The objective of the study is to identify major factors that influence Kuwaiti nationals’ intentions to travel to Western countries. A model is developed and empirically tested on a sample of 343 Kuwaiti nationals. A series of regression analyses are run to determine the effects of different factors on Kuwaiti’s travel decisions. A Herman’s single factor test and Durbin-Watson test are used to assess the validity of the regression model. Analysis is controlled for socio-demographics. The results show that the Muslim friendly amenities and destination cognitive image exert significant effects on Kuwaiti nationals’ intentions to travel to Western countries. The study provides a better understanding of the factors that attract Kuwaiti tourists to Western countries. By knowing what encourages Kuwaitis to travel to Western countries marketers can plan and promote these countries accordingly. The study provides a foundation of future empirical research into the Kuwaiti/Arab travel market.

Keywords: Kuwaiti travel market, travel decisions, Western countries

Procedia PDF Downloads 192

Authors: Fani Sakellariadou

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The Blue Economy includes all marine-based and marine-related activities. They correspond to established, emerging as well as unborn ocean-based industries. Seabed mining is an emerging marine-based activity; its operations depend particularly on cutting-edge science and technology. The 21st century will face a crisis in resources as a consequence of the world’s population growth and the rising standard of living. The natural capital stored in the global ocean is decisive for it to provide a wide range of sustainable ecosystem services. Seabed mineral deposits were identified as having a high potential for critical elements and base metals. They have a crucial role in the fast evolution of green technologies. The major categories of marine mineral deposits are deep-sea deposits, including cobalt-rich ferromanganese crusts, polymetallic nodules, phosphorites, and deep-sea muds, as well as shallow-water deposits including marine placers. Seabed mining operations may take place within continental shelf areas of nation-states. In international waters, the International Seabed Authority (ISA) has entered into 15-year contracts for deep-seabed exploration with 21 contractors. These contracts are for polymetallic nodules (18 contracts), polymetallic sulfides (7 contracts), and cobalt-rich ferromanganese crusts (5 contracts). Exploration areas are located in the Clarion-Clipperton Zone, the Indian Ocean, the Mid Atlantic Ridge, the South Atlantic Ocean, and the Pacific Ocean. Potential environmental impacts of deep-sea mining include habitat alteration, sediment disturbance, plume discharge, toxic compounds release, light and noise generation, and air emissions. They could cause burial and smothering of benthic species, health problems for marine species, biodiversity loss, reduced photosynthetic mechanism, behavior change and masking acoustic communication for mammals and fish, heavy metals bioaccumulation up the food web, decrease of the content of dissolved oxygen, and climate change. An important concern related to deep-sea mining is our knowledge gap regarding deep-sea bio-communities. The ecological consequences that will be caused in the remote, unique, fragile, and little-understood deep-sea ecosystems and inhabitants are still largely unknown. The blue economy conceptualizes oceans as developing spaces supplying socio-economic benefits for current and future generations but also protecting, supporting, and restoring biodiversity and ecological productivity. In that sense, people should apply holistic management and make an assessment of marine mining impacts on ecosystem services, including the categories of provisioning, regulating, supporting, and cultural services. The variety in environmental parameters, the range in sea depth, the diversity in the characteristics of marine species, and the possible proximity to other existing maritime industries cause a span of marine mining impact the ability of ecosystems to support people and nature. In conclusion, the use of the untapped potential of the global ocean demands a liable and sustainable attitude. Moreover, there is a need to change our lifestyle and move beyond the philosophy of single-use. Living in a throw-away society based on a linear approach to resource consumption, humans are putting too much pressure on the natural environment. Applying modern, sustainable and eco-friendly approaches according to the principle of circular economy, a substantial amount of natural resource savings will be achieved. Acknowledgement: This work is part of the MAREE project, financially supported by the Division VI of IUPAC. This work has been partly supported by the University of Piraeus Research Center.

Keywords: blue economy, deep-sea mining, ecosystem services, environmental impacts

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