Search results for: civil status

Authors: Nwadioha Samuel Iheanacho, Abah Paul, Odimayo Simidele Michael

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Background: The World Health Assembly through the Global Health Sector Strategy on viral hepatitis calls for the elimination of viral hepatitis as a public health threat by 2030. All hands are on deck to actualize this goal through an effective and active vaccination and monitoring tool. Aim: To combine the Epidemiologic with Laboratory Hepatitis B Virus vaccination monitoring tools. Method: Laboratory results analysis of subjects recruited during the World Hepatitis week from July 2020 to July 2021 was done after obtaining their epidemiologic data on Hepatitis B virus risk factors, in the Medical Microbiology Laboratory of Benue State University Teaching Hospital, Nigeria. Result: A total of 500 subjects comprising males 60.0%(n=300/500) and females 40.0%(n=200/500) were recruited. A fifty-three percent majority was of the age range of 26 to 36 years. Serologic profiles were as follows, 15.0%(n=75/500) HBsAg; 7.0% (n=35/500) HBeAg; 8.0% (n=40/500) Anti-Hbe; 20.0% (n=100/500) Anti-HBc and 38.0% (n=190/500) Anti-HBs. Immune responses to vaccination were as follows, 47.0%(n=235/500) Immune naïve {no serologic marker + normal ALT}; 33%(n=165/500) Immunity by vaccination {Anti-HBs + normal ALT}; 5%(n=25/500) Immunity to previous infection {Anti-HBs, Anti-HBc, +/- Anti-HBe + normal ALT}; 8%(n=40/500) Carriers {HBsAg, Anti-HBc, Anti-HBe +normal ALT} and 7% (35/500) Anti-HBe serum- negative infections {HBsAg, HBeAg, Anti-HBc +elevated ALT}. Conclusion: The present 33.0% immunity by vaccination coverage in Central Nigeria was much lower than the 41.0% national peak in 2013, and a far cry from the global expectation of attainment of a Global Health Sector Strategy on the elimination of viral hepatitis as a public health threat by 2030. Therefore, more creative ideas and collective effort are needed to attain this goal of the World Health Assembly.

Keywords: Hepatitis B, vaccination status, laboratory tools, resource-limited settings

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Authors: Muzaffer Topgul, Hasan Atac

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In case of explaining the migration concept, although it is not a new phenomenon, it is easy to understand that communities have migrated for variety of reasons such as natural disasters, famine, wars, economic problems, and several theories have been put forth to define and find solution for migration within its changing nature. Examining of migration theories denotes that the circumstances under which they appear reflect political, social, and economic conditions of the age they appear. In this day and time, security is considered not only from military perspective but also from economic, political, sociological dimensions. Based on the changing security environment new impacts of migration has occurred; the migration is proceed to be conferred as a type of war, qualified as a transnational crime because of its outcomes and interpreted in a different dimension owing to its effects on the health and education areas. Social security dimension in the context of expanding concept of security; when dealing with the safety of people and social groups with the assumption that national unity and identity are threatened, it sees immigrants as a source of threat. The human security assesses the safety of individuals in terms of survival and quality of life. Changes in the standard of living under the influence of immigrants and possible terrorist acts can be seen as a threat source in this type of security. Economic security of the individuals and the regional changes at the micro level created by the immigrants are covered issues of economic security. Due to the factors such as terrorism and civil war, the increasing numbers of displaced people who have taken refugee status affect the countries, whether it is near or far to the crisis areas, in the new and different dimensions of security day by day. In this study, the term of immigration through the eyes of national and international law will be evaluated, the place of the irregular and illegal immigration in the changing security sphere will be revealed and the effects of the irregular migration to short-term, mid-term and long-term security issues will be assessed through human and social security aspects. In order to analyze the threats for the human security; the parameters such as living conditions of the immigrants, the ratio of the genders, birth rate occasions, the education circumstances of the immigrant children and the effects of the illegal passing on the public order will be evaluated. The outcomes of the problem areas for the human security and the demographic alteration resulting from the human flow of displaced people will be discussed thorough social security extent. The fizzling economic diversity, which has shown up by irregular migration, will be presented within the scope of economic dimension of security.

Keywords: irregular migration, the changing dimensions of security, human security, social security

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Authors: Agnes Simone

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A 52-year-old male with unknown psychiatric and medical history was brought to the Psychiatric Emergency Room by ambulance directly from jail. He had been detained for three weeks for possession of a firearm while intoxicated. On initial evaluation, the patient was unable to provide a reliable history. He presented with odd jerking movements of his extremities and catatonic features, including mutism and stupor. His vital signs were stable. Patient was transferred to the medical emergency department for work-up of altered mental status. Due to suspicion for opioid overdose, the patient was given naloxone (Narcan) with no improvement. Laboratory work-up included complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, vitamin B12, folate, magnesium, rapid plasma reagin, HIV, blood alcohol level, aspirin, and Tylenol blood levels, urine drug screen, and urinalysis, which were all negative. CT head and chest X-Ray were also negative. With this negative work-up, the medical team concluded there was no organic etiology and requested inpatient psychiatric admission. Upon re-evaluation by psychiatry, it was evident that the patient continued to have an altered mental status. Of note, the medical team did not include substance withdrawal in the differential diagnosis due to stable vital signs and a negative urine drug screen. The psychiatry team decided to check California's prescription drug monitoring program (CURES) and discovered that the patient was prescribed benzodiazepine alprazolam (Xanax) 2mg BID, a sedative-hypnotic, and hydrocodone/acetaminophen 10mg/325mg (Norco) QID, an opioid. After a thorough chart review, his daughter's contact information was found, and she confirmed his benzodiazepine and opioid use, with recent escalation and misuse. It was determined that the patient was experiencing alprazolam withdrawal, given this collateral information, his current symptoms, negative urine drug screen, and recent abrupt discontinuation of medications while incarcerated. After admission to the medical unit and two doses of alprazolam 2mg, the patient's mental status, alertness, and orientation improved, but he had no memory of the events that led to his hospitalization. He was discharged with a limited supply of alprazolam and a close follow-up to arrange a taper. Accompanying this case report, a qualitative review of presentations with alprazolam withdrawal was completed. This case and the review highlights: (1) Alprazolam withdrawal can occur at low doses and within just one week of use. (2) Alprazolam withdrawal can present without any vital sign instability. (3) Alprazolam withdrawal does not respond to short-acting benzodiazepines but does respond to certain long-acting benzodiazepines due to its unique chemical structure. (4) Alprazolam withdrawal is distinct from and more severe than other benzodiazepine withdrawals. This case highlights (1) the importance of physician utilization of drug-monitoring programs. This case, in particular, relied on California's drug monitoring program. (2) The importance of obtaining collateral information, especially in cases in which the patient is unable to provide a reliable history. (3) The importance of including substance intoxication and withdrawal in the differential diagnosis even when there is a negative urine drug screen. Toxidrome of withdrawal can be delayed. (4) The importance of discussing addiction and withdrawal risks of medications with patients.

Keywords: addiction risk of benzodiazepines, alprazolam withdrawal, altered mental status, benzodiazepines, drug monitoring programs, sedative-hypnotics, substance use disorder

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Authors: Oluwatobi Emmanuel Olaniyi, Babafemi George Ogunjemite

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The high rate of infrastructural development in Ikogosi warm spring towards harnessing her great ecotourism potentials calls for a serious concern, as more forest areas are been opened up for public access and the landscape is modified. On this note, we investigated the implication of ecotourism development on the floristic composition and forest structure in Ikogosi. The study aimed at identifying the past and present status of infrastructural development, assessing and comparing the floristic composition and structure of the built- up/ recreational areas and undisturbed forested areas, to infer on the impact of ecotourism development on the study site. We conducted stakeholder interview and field observation to identify the past and present status of infrastructural development respectively. A total of ten quadrants were employed in the vegetation assessment to characterize the woody tree species composition, diameter at breast height and height, to obtain mean indices characterizing each part of the site. These indices were compared using T – test analysis. A total of 49 different woody tree species distributed in 21 families were identified in the built-in/ recreational areas while 67 different woody tree species belonging to 25 families were recorded in the undeveloped forested areas. Although, the latter has a higher mean diameter at breast height of woody trees, it was not significantly different from the former (T-test = -0.74, p = 0.46). On the contrary, the built-up area had a higher mean trees height than the undeveloped areas, but the difference was not statistically significant (T-test= 1.04, p = 0.30). Despite these, the slight reduction in richness and diversity of the woody tree species in the built- up/ recreational areas implies mitigating the negative effects of infrastructural development on the warm spring's vegetation.

Keywords: ecosystem services, forest structure, vegetation assessment, warm-spring

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Authors: Ammar Younas

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This paper is an attempt to explore the legal progression in procedural laws related to “intellectual property protection for the autonomous output of artificial intelligence” in Post-Colonial, Post-Communist and Socialist Countries. An in-depth study of legal progression in Pakistan (Common Law), Uzbekistan (Post-Soviet Civil Law) and China (Socialist Law) has been conducted. A holistic attempt has been made to explore that how the ideological context of the legal systems can impact, not only on substantive components but on the procedural components of the formal laws related to IP Protection of autonomous output of Artificial Intelligence. Moreover, we have tried to shed a light on the prospective IP laws and AI Policy in the countries, which are planning to incorporate the concept of “Digital Personality” in their legal systems. This paper will also address the question: “How far IP of autonomous output of AI can be protected with the introduction of “Non-Human Legal Personality” in legislation?” By using the examples of China, Pakistan and Uzbekistan, a case has been built to highlight the legal progression in General Provisions of Civil Law, Artificial Intelligence Policy of the country and Intellectual Property laws. We have used a range of multi-disciplinary concepts and examined them on the bases of three criteria: accuracy of legal/philosophical presumption, applying to the real time situations and testing on rational falsification tests. It has been observed that the procedural laws are designed in a way that they can be seen correlating with the ideological contexts of these countries.

Keywords: intellectual property, artificial intelligence, digital personality, legal progression

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Authors: David Xiaoqian Sun, Khairunnisa Binti Haji Sibah, Jr., Lejak Anak Ambol

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The purpose of the study was to examine the relationships between objectively measured physical activity levels (PALs), enjoyment of physical activity (EPA), and body mass index (BMI) among adolescents. A total of 188 12-14-year-old Bruneian secondary school adolescents (88 boys and 100 girls) voluntarily took part in this study. Subjects wore the RT3 accelerometer for seven consecutive days in order to measure their PALs. Times of students’ engagement in total (TPA), light (LPA), moderate (MPV), and vigorous PA (VPA) were obtained from the accelerometer. Their BMIs were calculated from their body height and weight. Physical Activity Enjoyment Scale (PACES) was administrated to obtain their EPA levels. Four key enjoyment factors including fun factors, positive perceptions, unexciting in doing activities, and negative perceptions were identified. Subjects’ social economic status (SES) was provided by school administration. Results show that all the adolescents did not meet the recommended PA guidelines even though boys were engaged in more MVPA than girls. No relationships were found between BMI and all PALs in both boys and girls. BMI was significantly related to the PACES scores (r = -.22, p = 0.01), fun factors (r = -.20, p = 0.05) and positive perceptions (r =-.21, p < 0.05). The PACES scores were significantly related to LPA (r = .18, p = 0.01) but not related to MVPA (r = .04, p > 0.05). After controlling for age and SES, BMI was only significantly related to the PACES scores in girls (r = -.27, p < .01) but boys (r = -.06, p > 0.05). Fun factors were significantly related to LPA and MVPA (p < .01) in girls while negative perceptions were significantly related to LPA and MVPA (p < .01) in boys. This study provides evidence that enjoyment may be a trigger of LPA but MVPA and may be influenced by their BMI status particularly in girls. Based on these findings, physical and health educators are suggested to not only make PA more enjoyable, but also consider gender differences in promoting adolescents' participation in MVPA.

Keywords: accelerometer, body mass index, enjoyment of physical activity, moderate to vigorous physical activity

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Authors: S. M. Rashed Ul Islam, Shahina Tabassum, Afsana Anwar Miti

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Objective: HIV testing and counseling center (HTC) is an important component of the HIV/AIDS detection, prevention and control interventions. The service was first initiated at the Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU) since the first case detection in 1989. The present study aimed to describe the demographic profile among the attendees tested HIV positive. Methods: The present study was carried out among 219 HIV positive cases detected through screening at the Department of Virology of BSMMU during the year of 2012-2016. Data were collected through pre-structured written questionnaire during the counseling session. Data were expressed as frequency and percentages and analyzed using SPSS v20.0 program. Results: Out of 219 HIV cases detected, 77.6% were males, and 22.4% were females with a mean age (mean±SD) of 35.46±9.46 years. Among them, 70.7% belonged to the 26-45 age groups representing the sexually active age. The majority of the cases were married (86.3%) and 49.8% had primary level of education whereas, 8.7% were illiterate. Nearly 42% of cases were referred from Chittagong division (south-east part of the country) followed by Dhaka division (35.6%). The bulk of study population admitted to involvement in high-risk behaviour (90%) in the past and 42% of them had worked overseas. The Pearson Chi-square (χ2) analysis revealed significant relationship of gender with marital (χ2=7.88 at 2% level) and occupation status (χ2=120.48 at 6% level); however, no association was observed with risk behaviour and educational status. Recommendations: HIV risk behavior was found to be a prime source for HIV infection among the study population. So, there is need for health education and awareness program to bring about behavioral changes to halt the yearly increase of new cases in the country with special attention to our overseas workers on HIV/AIDS risk and safety.

Keywords: Bangladesh, health education, HIV testing and counseling (HTC), HIV/AIDS, risk behavior

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Authors: Alyaa Farouk Ibrahim, Gehan ElSayed, Ola Mamdouh, Nazek AbdelGhany

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Background: Primary health care (PHC) can be considered the first contact between the patient and the health care system. It includes all the basic health care services to be provided to the community. Patient's satisfaction regarding health care has often improved the provision of care, also considered as one of the most important measures for evaluating the health care. Objective: This study aims to identify patient’s satisfaction with services provided at the primary health care settings in Alexandria. Setting: Seven primary health care settings representing the seven zones of Alexandria governorate were selected randomly and included in the study. Subjects: The study comprised 386 patients attended the previously selected settings at least twice before the time of the study. Tools: Two tools were utilized for data collection; sociodemographic characteristics and health status structured interview schedule and patient satisfaction scale. Reliability test for the scale was done using Cronbach's Alpha test, the result of the test ranged between 0.717 and 0.967. The overall satisfaction was computed and divided into high, medium, and low satisfaction. Results: Age of the studied sample ranged between 19 and 62 years, more than half (54.2%) of them aged 40 to less than 60 years. More than half (52.8%) of the patients included in the study were diabetics, 39.1% of them were hypertensive, 19.2% had cardiovascular diseases, the rest of the sample had tumor, liver diseases, and orthopedic/neurological disorders (6.5%, 5.2% & 3.2%, respectively). The vast majority of the study group mentioned high satisfaction with overall service cost, environmental conditions, medical staff attitude and health education given at the PHC settings (87.8%, 90.7%, 86.3% & 90.9%, respectively), however, medium satisfaction was mostly reported concerning medical checkup procedures, follow-up data and referral system (41.2%, 28.5% & 28.9%, respectively). Score level of patient satisfaction with health services provided at the assessed Primary health care settings proved to be significantly associated with patients’ social status (P=0.003, X²=14.2), occupation (P=0.011, X²=11.2), and monthly income (P=0.039, X²=6.50). In addition, a significant association was observed between score level of satisfaction and type of illness (P=0.007, X²=9.366), type of medication (P=0.014, X²=9.033), prior knowledge about the health center (P=0.050, X²=3.346), and highly significant with the administrative zone (P=0.001, X²=55.294). Conclusion: The current study revealed that overall service cost, environmental conditions, staff attitude and health education at the assessed primary health care settings gained high patient satisfaction level, while, medical checkup procedures, follow-up, and referral system caused a medium level of satisfaction among assessed patients. Nevertheless, social status, occupation, monthly income, type of illness, type of medication and administrative zones are all factors influencing patient satisfaction with services provided at the health facilities.

Keywords: patient satisfaction, chronic illness, quality of health service, quality of service indicators

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Authors: Mark Joseph Quinto, Roan Beronilla, Guiller Damian, Eliza Camaso, Ronaldo Alberto

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Forest inventories are essential to assess the composition, structure and distribution of forest vegetation that can be used as baseline information for management decisions. Classical forest inventory is labor intensive and time-consuming and sometimes even dangerous. The use of Light Detection and Ranging (LiDAR) in forest inventory would improve and overcome these restrictions. This study was conducted to determine the possibility of using LiDAR derived data in extracting high accuracy forest biophysical parameters and as a non-destructive method for forest status analysis of San Manual, Pangasinan. Forest resources extraction was carried out using LAS tools, GIS, Envi and .bat scripts with the available LiDAR data. The process includes the generation of derivatives such as Digital Terrain Model (DTM), Canopy Height Model (CHM) and Canopy Cover Model (CCM) in .bat scripts followed by the generation of 17 composite bands to be used in the extraction of forest classification covers using ENVI 4.8 and GIS software. The Diameter in Breast Height (DBH), Above Ground Biomass (AGB) and Carbon Stock (CS) were estimated for each classified forest cover and Tree Count Extraction was carried out using GIS. Subsequently, field validation was conducted for accuracy assessment. Results showed that the forest of San Manuel has 73% Forest Cover, which is relatively much higher as compared to the 10% canopy cover requirement. On the extracted canopy height, 80% of the tree’s height ranges from 12 m to 17 m. CS of the three forest covers based on the AGB were: 20819.59 kg/20x20 m for closed broadleaf, 8609.82 kg/20x20 m for broadleaf plantation and 15545.57 kg/20x20m for open broadleaf. Average tree counts for the tree forest plantation was 413 trees/ha. As such, the forest of San Manuel has high percent forest cover and high CS.

Keywords: carbon stock, forest inventory, LiDAR, tree count

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Authors: Muzamil Mahmood, Afshan Naseem, Muhammad Zeeshan Mirza, Yasir Ahmad, Masood Raza

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The purpose of this research is to analyze how aviation maintenance workers’ characteristics and work demand affect their development of work-related musculoskeletal disorders (WMSDs). Guided by literature on task characteristics, work demand, and WMSDs, data is collected from 128 aviation maintenance workers of private and public airlines. Data is then analyzed through descriptive and inferential statistics. It is found that task characteristics have a significant positive effect on WMSDs and an increase in tasks performed by aviation maintenance workers leads to increase in WMSDs. Work demand did not have a significant effect on WMSDs. The task characteristics of aviation maintenance workers moderates the relationship between their work demand and WMSDs. This reveals that task characteristics of aviation maintenance workers enhance the effect of work demand on WMSDs. The task characteristics of aviation maintenance workers are challenging and unpredictable. Subsequently, WMSDs are prevalent among aviation maintenance workers. The work demand of aviation maintenance workers does not influence their development of WMSDs. Pakistan Civil Aviation Authority should minimize the intensity of tasks assigned to aviation maintenance workers by introducing work dynamisms such as task sharing, job rotation, and probably teleworking to enhance flexibility. Human Resource and Recruitment Department need to consider the ability and fitness levels of potential aviation maintenance workers during recruitment. In addition, regular physical activities and ergonomic policies should be put in place by the management of the Pakistan Civil Aviation Authority to reduce the incidences of WMSDs.

Keywords: work related musculoskeletal disorders, ergonomics, occupational health and safety, human factors

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Authors: W. C. Lucas, S. Titus, M. E. M. Young

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Gymnastics is the umbrella term that represents seven different and unique disciplines of gymnastics. Men and women of all ages and abilities practice this sport, and participation in gymnastics can develop both gross and fine motor skills, strength, flexibility, coordination and balance. There are various social factors, such as a family’s socioeconomic status or accessibility to sports facilities that may play a role in affecting levels of participation. The aim of this study is to investigate the social factors that have an influence on gymnastics participation in the Western Cape. To this end, a qualitative approach is adopted to collect data. This study also adopts the ecological systems theory as the theoretical framework, and is used to analyze and interpret current social factors that directly or indirectly influence participation in gymnastics. The study’s objectives were to ascertain which social factors hinder participation, and which social factors promote participation, thus, coaches, parents and gymnasts participated in focus group discussions. Key informant interviews took place with experts in the field of gymnastics in the Western Cape. A thematic analysis was conducted on transcriptions from the focus group discussions and key informant interviews. Social factors investigated in this study occurred in the chronosystem, macrosystem, exosystem, mesosystem, and microsystem, and had both a direct and indirect influence on the gymnast’s continued participation. These systems are defined as the environment of the individual, in which they grow and develop. The research findings of this paper are used to draw conclusions and make specific recommendations for practice and further research. The information gathered in this study can assist all stakeholders within the field of gymnastics, such as parents, judges, coaches, gymnasts, and the supporting community which surround the participating gymnast.

Keywords: developing child, ecological systems theory, facilities, federation, gymnastics, influence, participation, social factors, socioeconomic status, sport

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Authors: Sakapas Saengchai, Wilasinee Jintalikitdee, Matinee Kongsatit, Natapol Puaprasert

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The study on promotion of public participation in community planning is a qualitative research. The data collection tools included participating observation, in-depth interview and focus group of executives of sub-district administrative organizations, sub-district headmen, community leaders of 5 villages, including civil society forums for exchanging ideas of village members. The study results revealed that key promotions of public participation in community planning were as follows: 1) Perception on public authorities’ information: Public relations should be set and information on community planning, key principles of local people participation should be prepared. Collaboration with community leaders in each village via sub-district administrative organizations should be established. 2) Discussion: In civil society forums, village members should brainstorm their opinions towards community development, village development, quality of life, current situation and problems to be revolved. 3) Participation: Members of each village should jointly participate, with community leaders, in setting sub-district development policies and community development projects. 4) Collaboration: To achieve goals, communities of each member should participate in project implementation and activities of community plans. 5) People power promotion: In each stage of communication planning, community leaders, village committees, local people should jointly set directions of village development and make decisions. This will enhance their joint learning and create community driving power. Community will become strong leading to sustainable self-reliance.

Keywords: people participation, community plans, community development, community driving power

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Authors: Valeriu Mihai But, Sorana Daniela Bolboacă, Adriana Elena Bulboacă

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The nutraceutical compound Curcumin (Curcuma longa L.) is known for its anti-inflammatory, anti-cancer, and antioxidant effects. This study aimed to evaluate the antioxidative and analgesic effects of Curcumin (CC) compared to Tramadol (T) in chemical-induced nociceptive pain in rats. Thirty-five rats were randomly divided into five groups of seven rats each and were treated as follows: C group (control group): treated with saline solution 0.9%, (1 ml, i.p. administration), ethanoic acid (EA) group: pretreated with saline solution 0.9% - 30 min before EA nociceptive pain induction, (1 ml, i.p. administration), T group: pretreated with Tramadol, 10 mg/kg body weight (bw), i.p. administration - 30 min before EA nociceptive pain induction, CC1-group: pretreated with 1 mg/100g bw Curcumin i.p. administration - 2 days before EA pain induction and CC2-group: pretreated with Curcumin 2 mg/100g bw i.p. administration - 2 days before EA nociceptive pain induction. The following oxidative stress parameters were assessed: malondialdehyde (MDA), nitric oxide (NOx), total oxidative status (TOS), total antioxidative capacity (TAC), and thiol (Th). The antalgic activity was measured by the ethanoic acid writhing test. Treatment with Curcumin, both 1 mg/100g bw, and 2 mg/100g bw, showed significant differences as compared with the control group (p<0.001) regarding malondialdehyde (MDA), nitric oxide (NOx), and total oxidative status (TOS) oxidative biomarkers. Pretreatment with 2 mg/100g bw of Curcumin presented a significant decrease in MDA values compared with Tramadol (p<0.001). The TAC significantly increased in pretreatment with Curcumin compared with group control. (p<0.001) The nociceptive response to EA was significantly reduced in Curcumin and Tramadol groups. Treatment with Curcumin at a higher concentration was more effective. In an experimental pain model, this study demonstrates an important antioxidant and antinociceptive activity of Curcumin comparable with Tramadol treatment.

Keywords: curcumin, nociception, oxidative stress, pain

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Authors: Nurunnaher Nurunnaher

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This paper examines the impact of women’s participation in microcredit on women’s decision making in the slum areas of Dhaka city, Bangladesh. There is confusion in the literature about whether women’s empowerment is or is not a trickle down impact of poverty alleviation or household well-being, and the studies use more or less similar indicators to measure the status of household and the status of women. Studies very rarely conceptualize and operationalize the term ‘empowerment’ as the word is often used without proper care by policy makers and development practitioners instead of household wellbeing. Currently, decision making in many studies has been used as an indicator of women’s empowerment when assessing the impact of microcredit programs on women. Based on a qualitative and feminist study this paper operationalizes women’s empowerment through the development of a conceptual framework, the identification of assessment criteria and the development of proper indicators that guided the whole study. The testimonies of participants, both men and women, were the basis of exploration of women’s lived experiences, which is the most appropriate method to explore the impact of such programs on women’s empowerment. The study considers empowerment as a process that affects various levels of life and gender relationships. The study found that there is a positive change in women’s position in decision making when women have developed an independent economic base with credit money. However, predominantly, women’s decision making is shared with men with the final decision still in the men’s hands. It can be said that women’s microcredit participation has not significantly challenged the social norms, therefore it is not surprising that women who hand over credit to their husband rarely have any power in intra-household bargaining process. Nevertheless, overall it is evident that women are continuously struggling toward the freedom to have the authority over household, economic and personal matters. It is concluded that while making strategic choices or gaining empowerment requires several steps, women’s participation in decision-making has several implications on their lives and potentially challenges patriarchy.

Keywords: women, gender inequality/equality, decision making, empowerment, microcredit, slums, Dhaka, Bangladesh

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Authors: Dicle Aydın, Süheyla Büyükşahin Sıramkaya

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Conservation concept gained importance especially in 19th century, it found value with the change and developments lived globally. Basic values in the essence of the concept are important in the continuity of historical and cultural fabrics which have character special to them. Reuse of settlements and spaces carrying historical and cultural values in the frame of socio-cultural and socio-economic conditions is related with functional value. Functional dimension of reuse signifies interrogation of the usage potential of the building with a different aim other than its determined aim. If a building carrying historical and cultural values cannot be used with its own function because of environmental, economical, structural and functional reasons, it is advantageous to maintain its reuse from the point of environmental ecology. By giving a new function both a requirement of the society is fulfilled and a culture entity is conserved because of its functional value. In this study, functional dimension of reuse is exemplified in Antalya Kaleiçi where has a special location and importance with its natural, cultural and historical heritage characteristics. Antayla Kaleiçi settlement preserves its liveliness as a touristic urban fabric with its almost fifty thousand years of past, traditional urban form, civil architectural examples of 18th–19th century reflecting the life style of the region and monumental buildings. The civil architectural examples in the fabric have a special character formed according to Mediterranean climate with their outer sofa (open or closed), one, two or three storey, courtyards and oriels. In the study reuse of five civil architectural examples as boutique hotel by forming a whole with their environmental arrangements is investigated, it is analyzed how the spatial requirements of a boutique hotel are fulfilled in traditional dwellings. Usage of a cultural entity as a boutique hotel is evaluated under the headlines of i.functional requirement, ii.satisfactoriness of spatial dimensions, iii.functional organization. There are closed and open restaurant, kitchen, pub, lobby, administrative offices in the hotel with 70 bed capacity and 28 rooms in total. There are expansions to urban areas on second and third floors by the means of oriels in the hotel surrounded by narrow streets in three directions. This boutique hotel, formed by unique five different dwellings having similar plan scheme in traditional fabric, is different with its structure opened to outside and connected to each other by the means of courtyards, and its outside spaces which gained mobility because of the elevation differences in courtyards.

Keywords: reuse, adaptive reuse, functional dimension of reuse, traditional dwellings

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Authors: Natalia Alvarado, Myldred Hernandez-Gonzalez, Mary Laird, Madeline Phillips, Elizabeth Miller, Luis Mendez, Teresa Satterfield Linares

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Objectives: Focusing on the reported levels of depressive symptoms from Hispanic individuals in the U.S. during the ongoing COVID-19 pandemic, we analyze the psychological effects of being labeled an ‘essential worker/trabajador(a) esencial.’ We situate this attribute within the complex context of how an individual’s mental health is linked to work status and his/her community’s attitude toward such a status. Method: 336 Spanish-speaking adults (Mage = 34.90; SD = 11.00; 46% female) living in the U.S. participated in a mixed-method study. Participants completed a self-report Spanish-language survey consisting of COVID-19 prompts (e.g., Soy un trabajador esencial durante la pandemia. I am an ‘essential worker’ during the pandemic), civic engagement scale (CES) attitudes (e.g., Me siento responsable de mi comunidad. I feel responsible for my community) and behaviors (e.g., Ayudo a los miembros de mi comunidad. I help members of my community), and the Center for Epidemiological Studies Depression Scale (e.g., Me sentía deprimido/a. I felt depressed). The survey was conducted several months into the pandemic and before the vaccine distribution. Results: Regression analyses show that being labeled an essential worker was correlated to CES attitudes (b= .28, p < .001) and higher CES behaviors (b= .32, p < .001). Essential worker status also reported higher levels of depressive symptoms (b= .17, p < .05). In addition, we found that CES attitudes and CES behaviors were related to higher levels of depressive symptoms (b= .11, p <.05, b = .22, p < .001, respectively). These findings suggest that those who are on the frontlines during the COVID-19 pandemic suffer higher levels of depressive symptoms, despite their affirming community attitudes and behaviors. Discussion: Hispanics/Latinxs make up 53% of the high-proximity employees who must work in person and in close contact with others; this is the highest rate of any racial or ethnic category. Moreover, 31% of Hispanics are classified as essential workers. Our outcomes show that those labeled as trabajadores esenciales convey attitudes of remaining strong and resilient for COVID-19 victims. They also express community attitudes and behaviors reflecting a sense of responsibility to continue working to help others during these unprecedented times. However, we also find that the pressure of maintaining basic needs for others exacerbates mental health challenges and stressors, as many essential workers are anxious and stressed about their physical and economic security. As a result, community attitudes do not protect from depressive symptoms as Hispanic essential workers are failing to balance everyone’s needs, including their own (e.g., physical exhaustion and psychological distress). We conclude with a discussion on alternatives to the phrase ‘essential worker’ and of incremental steps that can be taken to address pandemic-related mental health issues targeting US Hispanic workers.

Keywords: COVID-19, essential worker, mental health, race and ethnicity

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Authors: Halkiopoulos Constantinos, Koutsopoulou Ioanna, Gkintoni Evgenia, Antonopoulou Hera

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Immunization appears to be an essential part of health care service in times of pandemics such as covid-19 and aims not only to protect the health of the population but also the health and sustainability of the economies of the countries affected. It is reported that more than 3.44 billion doses have been administered so far, which accounts for 45 doses for 100 people. Vaccination programs in various countries have been promoted and accepted by people differently and therefore they proceeded in different ways and speed; most countries directing them towards people with vulnerable chronic or recent health statuses. Large scale restriction measures or lockdown, personal protection measures such as masks and gloves and a decrease in leisure and sports activities were also implemented around the world as part of the protection health strategies against the covid-19 pandemic. This research aims to present an analysis based on variations on people’s attitudes towards vaccination based on demographic, social and epidemiological characteristics, and health status on the one hand and perception of health, health satisfaction, pain, and quality of life on the other hand. 1500 Greek e-consumers participated in the research, mainly through social media who took part in an online-based survey voluntarily. The questionnaires included demographic, social and medical characteristics of the participants, and questions asking people’s willingness to be vaccinated and their opinion on whether there should be a vaccine against covid-19. Other stressor factors were also reported in the questionnaires and participants’ loss of someone close due to covid-19, or staying at home quarantine due to being infected from covid-19. WHOQUOL-BREF and GLOBAL PSYCHOTRAUMA SCREEN- GPS were used with kind permission from WHO and from the International Society for Traumatic Stress Studies in this study. Attitudes towards vaccination varied significantly related to aging, level of education, health status and consumer behavior. Health professionals’ attitudes also varied in relation to age, level of education, profession, health status and consumer needs. Vaccines have been the most common technological aid of human civilization so far in the fight against viruses. The results of this study can be used for health managers and digital marketers of pharmaceutical companies and also other staff involved in vaccination programs and for designing health policy immunization strategies during pandemics in order to achieve positive attitudes towards vaccination and larger populations being vaccinated in shorter periods of time after the break out of pandemic. Health staff needs to be trained, aided and supervised to go through with vaccination programs and to be protected through vaccination programs themselves. Feedback in each country’s vaccination program, short backs, deficiencies and delays should be addressed and worked out.

Keywords: consumer behavior, cognitive models, vaccination policy, pandemic, Covid-19, Greece

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Authors: Halkiopoulos Constantinos, Gkintoni Evgenia, Koutsopoulou Ioanna, Antonopoulou Hera

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E-sports and e-gaming have emerged in recent years since the increase in internet use have become universal and e-gamers are the new reality in our homes. The excessive involvement of young adults with e-sports has already been revealed and the adverse consequences have been reported in researches in the past few years, but the issue has not been fully studied yet. The present research is conducted in Greece and studies the psychological profile of video game players and provides information on personality traits, habits and emotional status that affect online gamers’ behaviors in order to help professionals and policy makers address the problem. Three standardized self-report questionnaires were administered to participants who were young male and female adults aged from 19-26 years old. The Profile of Mood States (POMS) scale was used to evaluate people’s perceptions of their everyday life mood; the personality features that can trace back to people’s habits and anticipated reactions were measured by Eysenck Personality Questionnaire (EPQ), and the Trait Emotional Intelligence Questionnaire (TEIQue) was used to measure which cognitive (gamers’ beliefs) and emotional parameters (gamers’ emotional abilities) mainly affected/ predicted gamers’ behaviors and leisure time activities?/ gaming behaviors. Data mining techniques were used to analyze the data, which resulted in machine learning algorithms that were included in the software package R. The research findings attempt to designate the effect of personality traits, emotional status and emotional intelligence influence and correlation with e-sports, gamers’ behaviors and help policy makers and stakeholders take action, shape social policy and prevent the adverse consequences on young adults. The need for further research, prevention and treatment strategies is also addressed.

Keywords: e-sports, e-gamers, personality traits, POMS, emotional intelligence, data mining, R

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Authors: M. Foysul Alam

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Land diluvion is a common phenomenon in Bangladesh. According to Bangladesh land administration manual, land gained by diluvion and alluvion are considered as Khas (state) lands. Distributing khas lands to the poorest landless people was suggested as a way of improving the livelihood by mobilizing their economic activity and improving their social status in Bangladesh. The impact of this initiative, which started in 1980 as a state policy, is perhaps one of the least experimentally documented ones in the country. The primary aim of this study was to investigate the economic and social status of some landless farmers focusing on determining whether the distribution of khas lands provide part of the explanation for possible improvement of their livelihood during this period of almost four decades. If not, the secondary objective of this study was to identify the issues and challenges of this policy, whether in strategic planning or implementation efforts. Both subjectively observable and objectively measurable data were collected from 150 households from 30 villages of 6 districts worse suffering from landlessness. A well-organized questionnaire, including 10 open ended question, were used to collect specific data and experiences of the landless farmers. Special attention was given to those who left peasantry becoming involved in other economic activities. The study found that Khas lands have very nominal or even zero influence on landless farmers due to 1. Lack of Khas land inventory 2. Lack of availability of information to the farmers 3. Complexity in application procedure for demanding Khas land and 4. Political nexus of local influential farmers makes it nearly impossible for those farmers who actually deserve it. It also found that most of the lucky farmers who eventually got a piece of Khas land had links with the local elites of their community. The research concludes that it is too early to decide how good the Khas land is for the marginalized landless farmers in Bangladesh, with actually a few numbers of them given the possession of one. This document provides crucial recommendations for overcoming the prevailing challenges.

Keywords: Khas land, land distribution, marginalized farmers, rural livelihood

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Authors: Christiana Frimpong, Mpundu Makasa, Lungowe Sitali, Charles Michelo

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Background: Toxoplasmosis is a neglected zoonotic disease which is prevalent among pregnant women especially in Africa. This study aimed to determine the seroprevalence and determinants of the disease among pregnant women attending the antenatal clinic at the University Teaching Hospital (UTH). Method: A cross-sectional study was employed where 411 pregnant women attending the antenatal clinic at UTH were interviewed using closed-ended questionnaires. Their blood was also tested for Toxoplasma gondii IgG and IgM antibodies using the OnSite Toxo IgG/IgM Combo Rapid Test cassettes by CTK Biotech, Inc, USA. Result: The overall seroprevalence of the infection (IgG) was 5.87%. There was no seropositive IgM result. Contact with cats showed 7.81 times the risk of contracting the infection in the pregnant women and being a farmer/being involved in construction work showed 15.5 times likelihood of contracting the infection. Socio-economic status of the pregnant women also presented an inverse relationship (showed association) with the infection graphically. However, though there were indications of the association between contact with cats, employment type as well as the socioeconomic status of the pregnant women with the infection, there was not enough evidence to suggest these factors as significant determining factors of Toxoplasma gondii infection in our study population. Conclusion: There is a low prevalence of Toxoplasma gondii infection among pregnant women in Lusaka, Zambia. Screening for the infection among pregnant women can be done once or twice during pregnancy to help protect both mother and child from the disease. Health promotion among women of child bearing age on the subject is of immense importance in order to help curb the situation. Further studies especially that of case-control and cohort studies should be carried out in the country in order to better ascertain the extent of the condition nationwide.

Keywords: determinants, pregnant women, seroprevalence, toxoplasmosis, University Teaching Hospital (UTH), Zambia

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Authors: Mir Afzal

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Introduction: Pakistan is a country with an ever-increasing population of largely diverse ethnic, cultural, religious and sectarian divisions. Whereas diversity is seen as a strength in many societies, in Pakistan, it has become a source of conflict and more a weakness than a strength due to lack of understanding and divisions based on ethnic, cultural, political, religious, and sectarian branding. However, amid conflicts and militancy across the country, the rural, mountainous communities in the Northern Areas of Pakistan enjoy not only peace and harmony but also a continuous process of social and economic transformation supported by strong civil society institutions. These community-based institutions have organized the rural, mountainous people of diverse ethnic and religious backgrounds into village organizations, women organizations, and Local Support Organizations engaged in self-help development and peace building in the region. The Study and its Methodology: A qualitative study was conducted in one district of the Northern Pakistan to explore the contributions of the civil society institutions (CSIs) and community-based organizations to uplifting the educational and socio-economic conditions of the people with an ultimate aim of developing a thriving, peaceful and pluralistic society in this mountainous region. The study employed an eclectic set of tools, including interviews, focused group discussions, observations of CSIs’ interventions, and analysis of documents, to generate rich data on the overall role and contributions of CSIs in promoting peace and pluralism in the region. Significance of the Study: Common experiences and empirical studies reveal that such interventions by CSIs have not only contributed to the socio-economic, educational, health and cultural development of these regions but these interventions have really transformed the rural, mountainous people into organized and forward looking communities. However, how such interventions have contributed to promoting pluralism and appreciation for diversity in these regions had been an unexplored but significant area. Therefore this qualitative research study funded by the Higher Education Commission of Pakistan was carried out by the Aga Khan University Institute for Educational Development to explore the role and contributions of CSIs in promoting peace and pluralism and appreciations for diversity in one district of Northern Pakistan which is home to people of different ethnic, religious, cultural and social backgrounds. Findings and Conclusions: The study has a comprehensive list of findings and conclusions covering various aspects of CSIs and their contributions to the transformation and peaceful co-existence of rural communities in the regions. However, this paper discusses only four major contributions of CSIs, namely enhancing economic capacity, community mobilization and organization, increasing access and quality of education, and building partnerships. It also discusses the factors influencing the role of CSIs, the issues, implications, and recommendations for CSIs, policy makers, donors and development agencies, and researchers. The paper concludes that by strengthening strong networks of CSIs and community based organizations, Pakistan will not only uplift its socio-economic attainments but it will also be able to address the critical challenges of terrorism, sectarianism, and other divisions and conflicts in its various regions.

Keywords: civil society, Pakistan, peace, rural

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Authors: Lin Fu-Gong

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Background: As WHO announced, people with intellectual disability (ID) were vulnerable to mental health problems. And there were few custom-made mental health scales for those people to monitor their mental health. Those people with mental problems often accompanied worse prognosis and usually became to be a heavier burden on the caregivers. Purpose: In this study, we intend to develop a psychopathy scale as a practical tool for monitoring the mental health for people with ID living in institute. Methods: In this study, we adopt the Psychopathology Inventory for Mentally Retarded Adults developed by professor Matson with certified reliability and validity in Western countries with Dr. Matson’s agreement in advance. We first translated the inventory into Chinese validated version considering the domestic culture background in the past year. And the validity and reliability evaluation of mental health status using this inventory among the people with intellectual living in the institute were done. Results: The inventory includes eight psychiatric disorder scales as schizophrenic, affective, psychosexual, adjustment, anxiety, somatoform, personality disorders and inappropriate mental adjustment. Around 83% of 40 invested people, who randomly selected from the institute, were found to have at least one disorder who were recommended with medical help by two evaluators. Among the residents examined, somatoform disorder and inappropriate mental adjustment were most popular with 60% and 78% people respectively. Conclusion: The result showed the prevalence psychiatric disorders were relatively high among people with ID in institute and the mental problems need to be further cared and followed for their mental health. The results showed that the psychopathology inventory was a useful tool for institute caregiver, manager and for long-term care policy to the government. In the coming stage, we plan to extend the use of the valid Chinese version inventory among more different type institutes for people with ID to establish their dynamic mental health status including medical need, relapse and rehabilitation to promote their mental health.

Keywords: intellectual disability, psychiatric disorder, psychopathology inventory, mental health, the institute

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Authors: Hillary Onyeka Abugu, Valentine Chinakwugwo Ezea, Janefrances Ngozi Ihedioha, Nwachukwu Romanus Ekere

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The study assessed the spring water quality in Igbo-Etiti, Nigeria, for drinking and irrigation application using Physico-chemical parameters, water quality index, mineral and trace elements, pollution indices and risk assessment. Standard methods were used to determine the physicochemical properties of the spring water in rainy and dry seasons. Trace metals such as Pb, Cd, Zn and Cu were determined with atomic absorption spectrophotometer. The results showed that most of the physicochemical properties studied were within the guideline values set by Nigeria Standard for Drinking Water Quality (NSDWQ), WHO and US EPA for drinking water purposes. However, pH of all the spring water (4.27- 4.73; and 4.95- 5.73), lead (Pb) (0.01-1.08 mg/L) and cadmium (Cd) (0.01-0.15 mg/L) concentrations were above the guideline values in both seasons. This could be attributed to the lithography of the study area, which is the Nsukka formation. Leaching of lead and sulphides from the embedded coal deposits could have led to the increased lead levels and made the water acidic. Two-way ANOVA showed significant differences in most of the parameters studied in dry and rainy seasons. Pearson correlation analysis and cluster analysis showed strong significant positive and negative correlations in some of the parameters studied in both seasons. The water quality index showed that none of the spring water had excellent water status. However, one spring (Iyi Ase) had poor water status in dry season and is considered unsafe for drinking. Iyi Ase was also considered not suitable for irrigation application as predicted by most of the pollution indices, while others were generally considered suitable for irrigation application. Probable cancer and non-cancer risk assessment revealed a probable risk associated with the consumption of the spring in the Igbo-Ettiti area, Nigeria.

Keywords: water quality, pollution index, risk assessment, physico-chemical parameters

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Authors: Hamed D. Alsharari

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This paper first analyses the current status regarding electrical engineering higher education in Saudi Arabian public universities. The paper focuses on the two EE sub-specialties most commonly present in Saudi Arabia, power and communications and discusses recruitment in this field, showing various market and employment demand for EE.

Keywords: communications, electrical engineering, higher education, Saudi Arabia, power

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Authors: P. Gil Del Álamo, J. García Pereda, A. Castañeda De La Paz, D. Arazola Lopez, M. D. Cubiles De La Vega, A. Enguíx González, J. M. Muñoz Pichardo

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In the last decades, obesity has more than doubled and is, with overweight, the second leading cause of preventable death. Despite multiple strategies against obesity, no country to date has reduced the number of obese people. To achieve World Health Organization’s target to reverse this tendency we need dramatic and different actions to engage the civil society in creating demand for a healthy style of life. The objective of this study is to demonstrate that a social media as the television can be used to convince the civil society that a healthy nutrition and physical activity are affordable, effective and necessary to prevent and to treat the obesity. Methodology: 61 individuals (34 women and 27 men) with obesity (mean BMI 45,51) were recruited to follow during 22 weeks an intensive lifestyle intervention in order to lose weight in a healthy manner. They were not isolated or moved from their usual environment. This program included endocrinological and nutritional assessment, promotion of physical activity and psychological support. BMI was measured every week. Time to leave obesity between men and women was analyzed with a survival analysis. Results: BMI decreased in all the cases. Analysing Time to leave obesity, around the week 30, 25% of men leave the obesity and around the week 39, 25% of women leave the obesity too. Conclusion: We demonstrate the audience that improving the quality of the diet and increasing the physical activity is a realistic way to lose weight. This evidence can encourage the people to act in their own self-interest changing their style of life in order to prevent or to reduce their overweight.

Keywords: obesity epidemic, obesity prevention, obesity strategies, social media

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Authors: Helida T. G. Soares, Antonio J. P. da Silva

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As the society develops, the accumulation of solid waste in landfills, in the environment, and the depletion of the raw material increases. In this way, there is relevance in researching the interaction between the environmental management and civil construction; therefore, this project has for scope the analysis and the effects of the rubber microparticles use as a small aggregate added to the sand, producing an ecological mortar for the pavement constitution, from the mixture of a paste, composed of Portland cement and water, and its application in sports courts. It was used the detailed reutilization of micro rubber in its most primordial, micro form, highlighting the powder pattern as the additional balancing of the mortar, analyzing the evolution of the mechanical properties. Percentages of 5, 10 and 15% rubber were used based on the total mass of the trace, where there is no removal of aggregates or cement, only increment of the rubber. The results obtained through the mechanical test of simple compression showed that the rubber, added to the mortar, presents low mechanical resistance compared to the reference trait, the study of this subject is vast of possibilities to be explored. In this sense, we seek sustainability and innovation from the use of an ecological material, thus adding value and reducing the impact of this material on the environment. The manufacturing process takes place from the direct mixing of cement paste and rubber, whether manually, mechanically or industrially. It results in the production of a low-cost mortar, through the use of recycled rubber, with high efficiency in general properties, such as compressive strength and friction coefficient, allowing its use for the construction of floors for sports courts with high durability. Thus, it is possible to reuse this micro rubber residue in other applications in simple concrete artifacts.

Keywords: civil construction, ecological mortar, high efficiency, rubber

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Authors: Jiajia Peng, Jianqing Qiu, Jianjun Ren, Yu Zhao

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Background: Insufficient sleep has been focused on as a public health epidemic. However, a comprehensive analysis of disease trajectory associated with unhealthy sleep habits is still unclear currently. Objective: This study sought to comprehensively clarify the disease's trajectory in relation to the overall poor sleep pattern and unhealthy sleep behaviors separately. Methods: 410,682 participants with available information on sleep behaviors were collected from the UK Biobank at the baseline visit (2006-2010). These participants were classified as having high- and low risk of each sleep behavior and were followed from 2006 to 2020 to identify the increased risks of diseases. We used Cox regression to estimate the associations of high-risk sleep behaviors with the elevated risks of diseases, and further established diseases trajectory using significant diseases. The low-risk unhealthy sleep behaviors were defined as the reference. Thereafter, we also examined the trajectory of diseases linked with the overall poor sleep pattern by combining all of these unhealthy sleep behaviors. To visualize the disease's trajectory, network analysis was used for presenting these trajectories. Results: During a median follow-up of 12.2 years, we noted 12 medical conditions in relation to unhealthy sleep behaviors and the overall poor sleep pattern among 410,682 participants with a median age of 58.0 years. The majority of participants had unhealthy sleep behaviors; in particular, 75.62% with frequent sleeplessness, and 72.12% had abnormal sleep durations. Besides, a total of 16,032 individuals with an overall poor sleep pattern were identified. In general, three major disease clusters were associated with overall poor sleep status and unhealthy sleep behaviors according to the disease trajectory and network analysis, mainly in the digestive, musculoskeletal and connective tissue, and cardiometabolic systems. Of note, two circularity disease pairs (I25→I20 and I48→I50) showed the highest risks following these unhealthy sleep habits. Additionally, significant differences in disease trajectories were observed in relation to sex and sleep medication among individuals with poor sleep status. Conclusions: We identified the major disease clusters and high-risk diseases following participants with overall poor sleep health and unhealthy sleep behaviors, respectively. It may suggest the need to investigate the potential interventions targeting these key pathways.

Keywords: sleep, poor sleep, unhealthy sleep behaviors, disease trajectory, UK Biobank

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Authors: Rui Wu

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In the volatile modern manufacturing environment, new orders randomly occur at any time, while the pre-emptive methods are infeasible. This leads to a real-time scheduling method that can produce a reasonably good schedule quickly. The dynamic Flexible Job Shop problem is an NP-hard scheduling problem that hybrid the dynamic Job Shop problem with the Parallel Machine problem. A Flexible Job Shop contains different work centres. Each work centre contains parallel machines that can process certain operations. Many algorithms, such as genetic algorithms or simulated annealing, have been proposed to solve the static Flexible Job Shop problems. However, the time efficiency of these methods is low, and these methods are not feasible in a dynamic scheduling problem. Therefore, a dynamic rule selection scheduling system based on the reinforcement learning method is proposed in this research, in which the dynamic Flexible Job Shop problem is divided into several parallel machine problems to decrease the complexity of the dynamic Flexible Job Shop problem. Firstly, the features of jobs, machines, work centres, and flexible job shops are selected to describe the status of the dynamic Flexible Job Shop problem at each decision point in each work centre. Secondly, a framework of reinforcement learning algorithm using a double-layer deep Q-learning network is applied to select proper composite dispatching rules based on the status of each work centre. Then, based on the selected composite dispatching rule, an available operation is selected from the waiting buffer and assigned to an available machine in each work centre. Finally, the proposed algorithm will be compared with well-known dispatching rules on objectives of mean tardiness, mean flow time, mean waiting time, or mean percentage of waiting time in the real-time Flexible Job Shop problem. The result of the simulations proved that the proposed framework has reasonable performance and time efficiency.

Keywords: dynamic scheduling problem, flexible job shop, dispatching rules, deep reinforcement learning

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Authors: Eashwar V. Somasundaram, Raoul R. Wadhwa, Jacob G. Scott

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The use of radiomics in measuring geometric properties of tumor images such as size, surface area, and volume has been invaluable in assessing cancer diagnosis, treatment, and prognosis. In addition to analyzing geometric properties, radiomics would benefit from measuring topological properties using persistent homology. Intuitively, features uncovered by persistent homology may correlate to tumor structural features. One example is necrotic cavities (corresponding to 2D topological features), which are markers of very aggressive tumors. We develop a data pipeline in R that clusters tumors images based on persistent homology is used to identify meaningful clinical distinctions between tumors and possibly new relationships not captured by established clinical categorizations. A preliminary analysis was performed on 16 Magnetic Resonance Imaging (MRI) breast tissue segments downloaded from the 'Investigation of Serial Studies to Predict Your Therapeutic Response with Imaging and Molecular Analysis' (I-SPY TRIAL or ISPY1) collection in The Cancer Imaging Archive. Each segment represents a patient’s breast tumor prior to treatment. The ISPY1 dataset also provided the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status data. A persistent homology matrix up to 2-dimensional features was calculated for each of the MRI segmentation. Wasserstein distances were then calculated between all pairwise tumor image persistent homology matrices to create a distance matrix for each feature dimension. Since Wasserstein distances were calculated for 0, 1, and 2-dimensional features, three hierarchal clusters were constructed. The adjusted Rand Index was used to see how well the clusters corresponded to the ER/PR/HER2 status of the tumors. Triple-negative cancers (negative status for all three receptors) significantly clustered together in the 2-dimensional features dendrogram (Adjusted Rand Index of .35, p = .031). It is known that having a triple-negative breast tumor is associated with aggressive tumor growth and poor prognosis when compared to non-triple negative breast tumors. The aggressive tumor growth associated with triple-negative tumors may have a unique structure in an MRI segmentation, which persistent homology is able to identify. This preliminary analysis shows promising results in the use of persistent homology on tumor imaging to assess the severity of breast tumors. The next step is to apply this pipeline to other tumor segment images from The Cancer Imaging Archive at different sites such as the lung, kidney, and brain. In addition, whether other clinical parameters, such as overall survival, tumor stage, and tumor genotype data are captured well in persistent homology clusters will be assessed. If analyzing tumor MRI segments using persistent homology consistently identifies clinical relationships, this could enable clinicians to use persistent homology data as a noninvasive way to inform clinical decision making in oncology.

Keywords: cancer biology, oncology, persistent homology, radiomics, topological data analysis, tumor imaging

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Authors: Yu-Tzu Hsu, Alice Wu, Hsiang-Kuang Tseng

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Introduction: Hepatitis A virus causes acute hepatitis and is usually transmitted by a fecal-oral route of food contamination, which is more prevalent in areas with poor hygienic practices. However, we described a hepatitis A outbreak associated with a fecal-oral route of sexual behavior in men who has sex with men (MSM) in Northern Taiwan. Methods: We retrospectively collected patients with acute HAV infection in MacKay Memorial Hospital, Taipei, Taiwan between July 2015 and November 2016. Demographic data (age, gender, onset time and infection risk), laboratory data (GOT, GPT, bilirubin, HIV status, HBsAg, HCV antibody and syphilis), clinical symptoms and travel history with a foreign tour were analyzed. We compared variables between HIV and non-HIV group. Unless otherwise stated, continuous variables were expressed as mean ± SD, and categorical variables were expressed as number (percentage) for each item. The t test for continuous variables was applied for the comparison between two groups and chi-square for categorical variables were applied for measures of association. Results: We collected 80 cases during the study period. Among them, 54 (67.5%) cases were MSM and 43 (53.8%) cases were HIV positive. The average age was 32.6±7.59 years-old. The average value of initial liver function was 1324 IU/L for AST (GOT), 2100 IU/L for ALT (GPT), and 5.82 mg/dL for bilirubin. We found seven (8.6%) cases were in the status of HBV carrier, five (6.3%) cases were positive for HCV antibody, and 15 (18.6%) cases were co-infected with syphilis. With regards to associated symptoms, 32 (40%) had fever, 46 (57.5%) had nausea, 34 (42.5%) had abdominal discomfort and 46 (57.5%) had general malaise. To compare the non-HIV patients with HIV patients, HIV patients were more likely to be male (p=0.008), MSM (p=0.000), co-infected syphilis (p=0.000) and slowly improving liver function of transaminases (p=0.033, 0.027). Conclusion: The HAV outbreak in Northern Taiwan was mainly occurred in MSM population. Hereafter, our cohort data support a policy in Taiwan to provide one dose of free HAV vaccine shot in this population. Hopefully, the outbreak could be stop by the free vaccine policy and public education.

Keywords: acute hepatitis A, men who has sex with men, human immunodeficiency virus, vaccine

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