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Authors: Samson Munn, Virginia H. Kim, Huija Chen, Sean Maldonado, Michelle Kim, Paul Koscheski, Babak N. Kalantari, Gregory Eckel, Albert Lee

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In terms of screening mammography quality, neither the portion of reports that advise call-back imaging that should be bilateral versus unilateral nor how much the unilateral call-backs may appropriately diverge from 50–50 (left versus right) is known. Many factors may affect detection laterality: display arrangement, reflections preferentially striking one display location, hanging protocols, seating positions with respect to others and displays, visual field cuts, health, etc. The call-back bilateral fraction may reflect radiologist experience (not in our data) or confidence level. Thus, laterality and bilaterality of call-backs advised in screening mammography reports could be worthy quality metrics. Here, laterality data did not reveal a concern until drilling down to individuals. Bilateral screening mammogram report recommendations by five breast imaging, attending radiologists at Harbor-UCLA Medical Center (Torrance, California) 9/1/15--8/31/16 and 9/1/16--8/31/17 were retrospectively reviewed. Recommended call-backs for bilateral versus unilateral, and for left versus right, findings were counted. Chi-square (χ²) statistic was applied. Year 1: of 2,665 bilateral screening mammograms, reports of 556 (20.9%) recommended call-back, of which 99 (17.8% of the 556) were for bilateral findings. Of the 457 unilateral recommendations, 222 (48.6%) regarded the left breast. Year 2: of 2,106 bilateral screening mammograms, reports of 439 (20.8%) recommended call-back, of which 65 (14.8% of the 439) were for bilateral findings. Of the 374 unilateral recommendations, 182 (48.7%) regarded the left breast. Individual ranges of call-backs that were bilateral were 13.2–23.3%, 10.2–22.5%, and 13.6–17.9%, by year(s) 1, 2, and 1+2, respectively; these ranges were unrelated to experience level; the two-year mean was 15.8% (SD=1.9%). The lowest χ² p value of the group's sidedness disparities years 1, 2, and 1+2 was > 0.4. Regarding four individual radiologists, the lowest p value was 0.42. However, the fifth radiologist disfavored the left, with p values of 0.21, 0.19, and 0.07, respectively; that radiologist had the greatest number of years of experience. There was a concerning, 93% likelihood that bias against left breast findings evidenced by one of our radiologists was not random. Notably, very soon after the period under review, he retired, presented with leukemia, and died. We call for research to be done, particularly by large departments with many radiologists, of two possible, new, quality metrics in screening mammography: laterality and bilaterality. (Images, patient outcomes, report validity, and radiologist psychological confidence levels were not assessed. No intervention nor subsequent data collection was conducted. This uncomplicated collection of data and simple appraisal were not designed, nor had there been any intention to develop or contribute, to generalizable knowledge (per U.S. DHHS 45 CFR, part 46)).

Keywords: mammography, screening mammography, quality, quality metrics, laterality

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Authors: Jayashree And Gajjam

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Intellectual humility (IH) is defined as a virtuous mean between intellectual arrogance and intellectual self-diffidence by the ‘Doxastic Account of IH’ studied, researched and developed by western scholars not earlier than 2015 at the University of Edinburgh. Ancient Indian philosophical texts or the Upanisads written in the Sanskrit language during the later Vedic period (circa 600-300 BCE) have long addressed the virtue of being humble in several stories and narratives. The current research paper questions and revisits these character traits in an Indian context following an experimental method. Based on the subjective reports of more than 400 Indian teenagers and adults, it argues that while a few traits of IH (such as trustworthiness, respectfulness, intelligence, politeness, etc.) are panhuman and pancultural, a few are not. Some attributes of IH (such as proper pride, open-mindedness, awareness of own strength, etc.) may be taken for arrogance by the Indian population, while other qualities of Intellectual Diffidence such as agreeableness, surrendering can be regarded as the characteristic of IH. The paper then gives the reasoning for this discrepancy that can be traced back to the ancient Indian (Upaniṣadic) teachings that are still prevalent in many Indian families and still anchor their views on IH. The name Upanisad itself means ‘sitting down near’ (to the Guru to gain the Supreme knowledge of the Self and the Universe and setting to rest ignorance) which is equivalent to the three traits among the BIG SEVEN characterized as IH by the western scholars viz. ‘being a good listener’, ‘curious to learn’, and ‘respect to other’s opinion’. The story of Satyakama Jabala (Chandogya Upanisad 4.4-8) who seeks the truth for several years even from the bull, the fire, the swan and waterfowl, suggests nothing but the ‘need for cognition’ or ‘desire for knowledge’. Nachiketa (Katha Upanisad), a boy with a pure mind and heart, follows his father’s words and offers himself to Yama (the God of Death) where after waiting for Yama for three days and nights, he seeks the knowledge of the mysteries of life and death. Although the main aim of these Upaniṣadic stories is to give the knowledge of life and death, the Supreme reality which can be identical with traits such as ‘curious to learn’, one cannot deny that they have a lot more to offer than mere information about true knowledge e.g., ‘politeness’, ‘good listener’, ‘awareness of own limitations’, etc. The possible future scope of this research includes (1) finding other socio-cultural factors that affect the ideas on IH such as age, gender, caste, type of education, highest qualification, place of residence and source of income, etc. which may be predominant in current Indian society despite our great teachings of the Upaniṣads, and (2) to devise different measures to impart IH in Indian children, teenagers, and younger adults for the harmonious future. The current experimental research can be considered as the first step towards these goals.

Keywords: ethics and virtue epistemology, Indian philosophy, intellectual humility, upaniṣadic texts in ancient India

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Authors: Woolfrey K., Woolfrey M., Bolton C. L., Warchuk D.

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Objectives: Osteoarthritis is the most common joint disease of adults worldwide. Despite total knee arthroplasty (TKA) demonstrating high levels of success, 20% of patients report dissatisfaction with their result. VOXX Wellness Stasis Socks are embedded with a proprietary pattern of neuro-receptor activation points that have been proven to activate a precise neuro-response, according to the pattern theory of haptic perception, which stimulates improvements in pain and function. The use of this technology in TKA patients may prove beneficial as an adjunct to recovery as many patients suffer from deficits to their proprioceptive system caused by ligamentous damage and alterations to mechanoreceptors during the procedure. We hypothesized that VOXX Wellness Stasis Socks are a safe, cost-effective, and easily scalable strategy to support TKA patients through their recovery. Design: Double-blinded, placebo-controlled randomized trial. Participants: Patients scheduled to receive TKA were considered eligible for inclusion in the trial. Interventions: Intervention group (I): VOXX Wellness Stasis socks containing receptor point-activation technology. Control group (C): VOXX Wellness Stasis socks without receptor point-activation technology. Sock use during the waking hours x 6 weeks. Main Outcome Measures: Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) questionnaire completed at baseline, 2 weeks, and 6 weeks to assess pain, stiffness, and physical function. Results: Data analysis using SPSS software. P-values, effect sizes, and confidence intervals are reported to assess clinical relevance of the finding. Physical status classifications were compared using t-test. Within-subject and between-subject differences in the mean WOMAC were analyzed by ANOVA. Effect size was analyzed using Cramer’s V. Consistent improvement in WOMAC scores for pain and stiffness at 2 weeks post op in the I over the C group. The womac scores assessing physical function showed a consistent improvement at both 2 and 6 weeks post op in the I group compared to C group. Conclusions: VOXX proved to be a low cost, safe intervention in TKA to help patients improve with regard to pain, stiffness, and physical function. Disclosures: None

Keywords: osteoarthritis, RCT, pain management, total knee arthroplasty

Procedia PDF Downloads 515

Authors: S. Cheng, C. Catallo

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Introduction: Canada's healthcare and social services systems are failing high risk, vulnerable older adults. Care for vulnerable older Canadians (65 and older) is not optimal in Canada. It does not address the care needs of vulnerable, high risk adults using a holistic approach. Given the growing aging population, and the care needs for seniors with complex conditions is one of the highest in Canada's health care system, there is a sense of urgency to optimize care. Integration of health and social services is an emerging trend in Canada when compared to European countries. There is no common and universal understanding of healthcare and social services integration within the country. Consequently, a clear understanding and definition of integrated health and social services are absent in Canada. Objectives: A study was undertaken to develop a case definition for integrated health and social care initiatives that serve older adults, which was then tested against three Canadian integrated initiatives. Methodology: A limited literature review was undertaken to identify common characteristics of integrated health and social care initiatives that serve older adults, and comprised both scientific and grey literature, in order to develop a case definition. Three Canadian integrated initiatives that are located in the province of Ontario, were identified using an online search and a screening process. They were surveyed to determine if the literature-based integration definition applied to them. Results: The literature showed that there were 24 common healthcare and social services integration characteristics that could be categorized into ten themes: 1) patient-care approach; 2) program goals; 3) measurement; 4) service and care quality; 5) accountability and responsibility; 6) information sharing; 7) Decision-making and problem-solving; 8) culture; 9) leadership; and 10) staff and professional interaction. The three initiatives showed agreement on all the integration characteristics except for those characteristics associated with healthcare and social care professional interaction, collaborative leadership and shared culture. This disagreement may be due to several reasons, including the existing governance divide between the healthcare and social services sectors within the province of Ontario that has created a ripple effect in how professions in the two different sectors interact. In addition, the three initiatives may be at maturing levels of integration, which may explain disagreement on the characteristics associated with leadership and culture. Conclusions: The development of a case definition for healthcare and social services integration that incorporates common integration characteristics can act as a useful instrument in identifying integrated healthcare and social services, particularly given the emerging and evolutionary state of this phenomenon within Canada.

Keywords: Canada, case definition, healthcare and social services integration, integration, seniors health, services delivery

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Authors: Min Koo Choi

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The paper will examine Im Sun-dŭk’s two short stories, 'Iryoil' (Sunday, 1937) and 'Nazuoya' (A Godmother, 1942), which illuminate the subjects of Korean intellectuals going through the later period of a harsh and oppressive Japanese colonial rule. When Japan went to war against China in 1937, Korea, a colony of Japan since 1910, became an outpost for Japanese expansionism into China, and the Korean people were mobilized into the war effort. Nationalist movements and radical ideas that posed a threat and opposition to Japanese colonial rule in Korea and its colonial expansionism were ruthlessly suppressed, and Koreans were forcibly assimilated into becoming Japanese citizens without political rights. Racial discrimination between Koreans and Japanese was prevalent. Im Sun-dŭk, who participated in the Socialist movement in the 1930s, had his debut as a literary writer and a critic in the late 1930s, when Korean literary society was reincorporated in order to collaborate with the Japanese war effort through writing and public speech. Sun-duk's writing illuminates the unique internal landscape of a female subject who strives to live on while preserving her commitment and dignity under the circumstances that force Korean intellectuals either to collaborate with or acquiesce to Japanese colonial rule. 'Iryoil' (Sunday, 1937) foregrounds an educated intellectual, Hyeyŏng, who supplies her fiancé in prison for political involvement in resistance against Japan. On Sundays, she turns down her friends’ suggestion for enjoying holidays outside, due to her indebtedness to her fiancé. Her fiancé's imprisonment indicates the social conscience that still remains, and she seeks to share the commitment and suffering with her fiancé. The short story 'Nazuoya' (A Godmother, 1942), written in Japanese due to the suppression of Korean language publications at the time, also problematizes Japanese policy that forces Koreans to change their names into Japanese. Through the narrator I, who struggles to find a meaningful name for her cousin brother’s baby, she highlights how meaningful one’s name is for one’s life and identity. What makes her two stories unique is that her writing draws other people’s confessions into its own narrative through fragmentary forms, such as part of letter or reflection. The voices of others are intersected with the main character in 'Iryoil' (Sunday, 1937) and a narrator in 'Nazuoya' (A Godmother, 1942). In many ways, the narrator and main character provide the confessional voices who display the characters' gloomy interiorities. Even though these confessional voices do not share the commitment and values, both the main character and I in the stories reveal a more open set of viewpoints to them. In this way, they seek to form bonds and encouragement and acquire a more resilient sensibility that embraces those who strive to survive and endure in the gloomy days of the later period of Japanese colonial rule.

Keywords: Im Sun-dŭk, Japanese colonial rule, Korean literature, socialist movement

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Authors: Susanna Graziano, Lydia Krstic Ward

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The purpose of this presentation is to demonstrate the steps of using multimedia and collaborative platforms in project-based learning. The presentation will demonstrate the stages of the learning project with various components of independent and collaborative learning, where students research the topic, share information, prepare a survey, use social media (Facebook, Instagram, WhasApp) and collaborative platforms (wikispaces.com and Google docs) to collect, analyze and process data, then produce reports and logos to be displayed as a final product. At the beginning of the presentation participants will answer a questionnaire about project based learning and share their experience on using social media, real–world project work and collaborative learning. Using a PPP, the presentation will walk participants through the steps of a completed project where tertiary education students are involved in putting together a multimedia campaign for safe driving in Kuwait. The research component of the project entails taking a holistic view on the problem of the high death rate in traffic accidents. The final goal of the project is to lead students to raise public awareness about the importance of safe driving. The project steps involve using the social media and collaborative platforms for collecting data and sharing the required materials to be used in the final product – a display of written reports, slogans and videos, as well as oral presentations. The same structure can be used to organize a multimedia campaign focusing on other issues, whilst scaffolding on students’ ability to brainstorm, retrieve information, organize it and engage in collaborative/ cooperative learning whilst being immersed in content-based learning as well as in authentic tasks. More specifically, the project we carried out at Box Hill College was a real-world one and involved a multimedia Campaign for Safe Driving since reckless driving is one of the major problems in the country. The idea for the whole project started by a presentation given by a board member of the Kuwaiti Society for Traffic Safety who was invited to college and spoke about: • Driving laws in the country, • What causes car accidents, • Driving safety tips. The principal goal of this project was to let students consider problems of traffic in Kuwait from different points of view. They also had to address the number and causes of accidents, evaluate the effectiveness of the local traffic law in order to send a warning about the importance of safe driving and, finally, suggest ways of its improvement. Benefits included: • Engagement, • Autonomy, • Motivation, • Content knowledge, • Language mastery, • Enhanced critical thinking, • Increased metacognitive awareness, • Improved social skills, • Authentic experience.

Keywords: social media, online learning platforms, collaborative platforms, project based learning

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Authors: Ana L. Gonzalez-Celis, Edgardo Ruiz-Carrillo, Karina Reyes-Jarquin, Margarita Chavez-Becerra

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Since recent decades, the aging has been viewed from a more positive perspective, where is not only about losses and damage, but also about being on a stage where you can enjoy life and live with well-being and quality of life. The challenge to feel better is to find those resources that seniors have. For that reason, psychological well-being has shown interest in the study of the affect and life satisfaction (hedonic well-being), while from a more recent tradition, focus on the development of capabilities and the personal growth, considering both as the main indicators of the quality of life. A resource that can be used in the later age is generativity, which refers to the ability of older people to develop and grow through activities that contribute with the improvement of the context in which they live and participate. In this way the generative interest is understood as a favourable attitude that contribute to the common benefit while strengthening and enriching the social institutions, to ensure continuity between generations and social development. On the other hand, generative behavior, differentiating from generative interest, is the expression of that attitude reflected in activities that make a social contribution and a benefit for generations to come. Hence the purpose of the research was to test if there is an association between the generative behaviour type and the psychological well-being with their dimensions. For this reason 188 Mexican adults from 60 to 94 years old (M = 69.78), 67% women, 33% men, completed two instruments: The Ryff’s Well-Being Scales to measure psychological well-being with 39 items with two dimensions (Hedonic and Eudaimonic well-being), and the Loyola’s Generative Behaviors Scale, grouped in five categories: Knowledge transmitted to the next generation, things to be remember, creativity, be productive, contribution to the community, and responsibility of other people. In addition, the socio-demographic data sheet was tested, and self-reported health status. The results indicated that the psychological well-being and its dimensions were significantly associated with the presence of generative behavior, where the level of well-being was higher when the frequency of some generative behaviour excelled; finding that the behavior with greater psychological well-being (M = 81.04, SD = 8.18) was "things to be remembered"; while with greater hedonic well-being (M = 73.39, SD = 12.19) was the behavior "responsibility of other people"; and with greater Eudaimonic well-being (M = 84.61, SD = 6.63), was the behavior "things to be remembered”. The most important findings highlight the importance of generative behaviors in adulthood, finding empirical evidence that the generativity in the last stage of life is associated with well-being. However, by finding differences in the types of generative behaviors at the level of well-being, is proposed the idea that generativity is not situated as an isolated construct, but needs other contextualized and related constructs that can simultaneously operate at different levels, taking into account the relationship between the environment and the individual, encompassing both the social and psychological dimension.

Keywords: eudaimonic well-being, generativity, hedonic well-being, Mexican elders, psychological well-being

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Authors: Mequanent Wale Mekonen, Edoardo Otranto, Angela Alibrandi

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Diabetic kidney disease is one of the main microvascular complications caused by diabetes. Several clinical and biochemical variables are reported to be associated with diabetic kidney disease in people with type 2 diabetes. However, their interrelations could distort the effect estimation of these variables for the disease's progression. The objective of the study is to determine how the biochemical and clinical variables in people with type 2 diabetes are interrelated with each other and their effects on kidney disease progression through advanced statistical methods. First, principal component analysis was used to explore how the biochemical and clinical variables intercorrelate with each other, which helped us reduce a set of correlated biochemical variables to a smaller number of uncorrelated variables. Then, ordered logit regression models (cumulative, stage, and adjacent) were employed to assess the effect of biochemical and clinical variables on the order-level response variable (progression of kidney function) by considering the proportionality assumption for more robust effect estimation. This retrospective cross-sectional study retrieved data from a type 2 diabetic cohort in a polyclinic hospital at the University of Messina, Italy. The principal component analysis yielded three uncorrelated components. These are principal component 1, with negative loading of glycosylated haemoglobin, glycemia, and creatinine; principal component 2, with negative loading of total cholesterol and low-density lipoprotein; and principal component 3, with negative loading of high-density lipoprotein and a positive load of triglycerides. The ordered logit models (cumulative, stage, and adjacent) showed that the first component (glycosylated haemoglobin, glycemia, and creatinine) had a significant effect on the progression of kidney disease. For instance, the cumulative odds model indicated that the first principal component (linear combination of glycosylated haemoglobin, glycemia, and creatinine) had a strong and significant effect on the progression of kidney disease, with an effect or odds ratio of 0.423 (P value = 0.000). However, this effect was inconsistent across levels of kidney disease because the first principal component did not meet the proportionality assumption. To address the proportionality problem and provide robust effect estimates, alternative ordered logit models, such as the partial cumulative odds model, the partial adjacent category model, and the partial continuation ratio model, were used. These models suggested that clinical variables such as age, sex, body mass index, medication (metformin), and biochemical variables such as glycosylated haemoglobin, glycemia, and creatinine have a significant effect on the progression of kidney disease.

Keywords: diabetic kidney disease, ordered logit model, principal component analysis, type 2 diabetes

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Authors: Susanne Ferschl, Peter Holzmüller, Elisabeth Wacker

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Ageing populations, advances in medical sciences and digitalization, diversity and social disparities, as well as the increasing need for skilled healthcare professionals, are challenging healthcare systems around the globe. To address these challenges, future healthcare systems need to center on human needs taking into account the living environments that shape individuals’ knowledge of and opportunities to access healthcare. Moreover, health should be considered as a common good and an integral part of securing livelihoods for all people. Therefore, the adoption of a systems approach, as well as inter-disciplinary and inter-sectoral cooperation among healthcare providers, are essential. Additionally, the active engagement of target groups in the planning and design of healthcare structures is indispensable to understand and respect individuals’ health and livelihood needs. We will present the research project b4 – identifying needs | building bridges | developing health care in the social space, which is situated within this reasoning and accompanies the cross-sectoral cooperation project Brückenschlag (building bridges) in a Bavarian district. Brückenschlag seeks to explore effective ways of health care linking university medicine (Maximalversorgung | maximum care) with regional inpatient, outpatient, rehabilitative, and preventive care structures (Regionalversorgung | regional care). To create advantages for both (potential) patients and the involved cooperation partners, project b4 qualitatively assesses needs and motivations among professionals, population groups, and political stakeholders at individual and collective levels. Besides providing an overview of the project structure as well as of regional population and healthcare characteristics, the first results of qualitative interviews conducted with different health experts will be presented. Interviewed experts include managers of participating hospitals, nurses, medical specialists working in the hospital and registered doctors operating in practices in rural areas. At the end of the project life and based on the identified factors relevant to the success -and also for failure- of participatory cooperation in health care, the project aims at informing other districts embarking on similar systems-oriented and human-centered healthcare projects. Individuals’ health care needs in dependence on the social space in which they live will guide the development of recommendations.

Keywords: cross-sectoral collaboration in health care, human-centered health care, regional health care, individual and structural health conditions

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Authors: Ye Sun, Han-Youl Lee, Kathy Musa-Veloso, Nabil Bosco

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Japan has been experiencing global ageing of population with the World’s leading life expectancy (80.8 y for men and 86.9 y for women) and among the lowest birth rate. Preventive nutrition-based approaches have been identified by the health authorities as one of the strategies to increase the healthy life expectancy and reduce the healthcare costs. However, the nutritional needs and status of the senior population have not been well characterized to provide targeted solutions. This study aims to describe the age- and gender-specific prevalence of inadequacy of macro- and micronutrients intake based on the latest Japan National Health and Nutrition Survey (JNHNS) 2014. JNHNS collected data on the consumption of foods and beverages using 1-day semi-weight household dietary record. Nutrient intake levels were then calculated using the Japanese standard tables of food composition. Where applicable, Japanese population-specific estimated average requirements (EAR) were used as a benchmark to determine the prevalence of potential nutrient intake inadequacy, and adequate intake (AI) were used for nutrients with no available EARs. In all, 3403 senior adults aged 60 y and above and 3324 young adults aged 19 to 59 y were included in the 2014 JNHNS. Age- and gender-specific differences were observed in the mean nutrient intakes as well as the prevalence of inadequacy. Among the 22 nutrients examined, the prevalence of inadequacy for iron, vitamin C, magnesium, potassium, and folic acid in the senior adults was significantly lower than young adults, suggesting potentially healthier dietary choices by the seniors. However, there was still a considerable proportion of seniors who did not meet the requirement for key nutrients like vitamin B1 (67%), calcium (57%), vitamin A (48%), magnesium (47%), vitamin E (44%), and vitamin B6 (41%). Inadequate nutrient intake is generally more prevalent among elderly males than females for many nutrients, with the exception of iron (prevalence of inadequacy: 21% versus 42%) which could partly be explained by the higher intake recommendations for the females. In conclusion, high prevalence of nutrient inadequacy exists in older adults, with a potentially worsened picture for men. Such inadequacies could have multiple health implications including physical frailty and mental health. Further study is warranted to investigate the food consumption patterns that could explain the observed nutrient inadequacies, and to eventually develop nutrition-based solutions tailored to the needs of specific subgroups of the population.

Keywords: ageing, national health and nutrition survey, nutrients, nutrition

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Authors: Ernest Nweke

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Mongolia has made giant strides in the development of its auditing and accounting system from Soviet-style to a market-oriented system. High levels of domestic and foreign investment desired by the Mongolian government require that better and improved quality of corporate information and disclosure consistent with international standards be made available to investors. However, the Mongolian Certified Public Accountants (CPA) profession is still developing, and the quality of services provided by accounting firms in most cases do not comply with International Financial Reporting Standards (IFRS) framework approved by the government for use in financial reporting. Against this backdrop, Accounting and audit reforms, liberalization and deregulation, establishment of an efficient and effective professional monitoring and supervision regime are policy necessities. These will further enhance the Mongolian business environment, eliminate incompetence in the system, make the economy more attractive to investors and ultimately lift reporting standards and bring about improved accounting, auditing and disclosure practices among Mongolian firms. This paper examines the fundamental issues in the accounting and auditing environment in Mongolia and investigates the relationship between selected characteristics of Mongolian Stock Exchange (MSE) listed firms (profitability, leverage, firm size, firm auditor size, firm listing age, board size and proportion of independent directors) and voluntary accounting disclosures in their annual reports and accounts. The selected sample of firms for the research purpose consists of the top 20 indexes of the MSE, representing over 95% of the market capitalization. An empirical analysis of the hypothesized relationship was carried out using multiple regression in EViews analytical software. Research results lend credence to the fact that only a few of the company attributes positively impact voluntary accounting disclosures in Mongolian Stock Exchange-listed firms. The research is motivated by the absence of empirical evidence on the correlation between the quality of voluntary accounting disclosures made by listed companies in Mongolia and company characteristics and the findings thereof significantly useful to both firms and regulatory authorities. The concluding part of the paper precisely consists of useful research-based recommendations for listed firms and regulatory agencies on measures to put in place in order to enhance the quality of corporate financial reporting and disclosures in Mongolia.

Keywords: accounting, auditing, corporate disclosure, listed firms

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Authors: Klaus Peter Scherer, Daniel Knöll, Constantin Rieder

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Problem and Purpose: Intelligent systems are available and helpful to support the human being decision process, especially when complex surgical eye interventions are necessary and must be performed. Normally, such a decision support system consists of a knowledge-based module, which is responsible for the real assistance power, given by an explanation and logical reasoning processes. The interview based acquisition and generation of the complex knowledge itself is very crucial, because there are different correlations between the complex parameters. So, in this project (semi)automated self-learning methods are researched and developed for an enhancement of the quality of such a decision support system. Methods: For ophthalmic data sets of real patients in a hospital, advanced data mining procedures seem to be very helpful. Especially subgroup analysis methods are developed, extended and used to analyze and find out the correlations and conditional dependencies between the structured patient data. After finding causal dependencies, a ranking must be performed for the generation of rule-based representations. For this, anonymous patient data are transformed into a special machine language format. The imported data are used as input for algorithms of conditioned probability methods to calculate the parameter distributions concerning a special given goal parameter. Results: In the field of knowledge discovery advanced methods and applications could be performed to produce operation and patient related correlations. So, new knowledge was generated by finding causal relations between the operational equipment, the medical instances and patient specific history by a dependency ranking process. After transformation in association rules logically based representations were available for the clinical experts to evaluate the new knowledge. The structured data sets take account of about 80 parameters as special characteristic features per patient. For different extended patient groups (100, 300, 500), as well one target value as well multi-target values were set for the subgroup analysis. So the newly generated hypotheses could be interpreted regarding the dependency or independency of patient number. Conclusions: The aim and the advantage of such a semi-automatically self-learning process are the extensions of the knowledge base by finding new parameter correlations. The discovered knowledge is transformed into association rules and serves as rule-based representation of the knowledge in the knowledge base. Even more, than one goal parameter of interest can be considered by the semi-automated learning process. With ranking procedures, the most strong premises and also conjunctive associated conditions can be found to conclude the interested goal parameter. So the knowledge, hidden in structured tables or lists can be extracted as rule-based representation. This is a real assistance power for the communication with the clinical experts.

Keywords: an expert system, knowledge-based support, ophthalmic decision support, self-learning methods

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Authors: Hemant Upadhyay, Tarun Kumar Kundu

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It is utmost important for a blast furnace operator to understand the mechanisms governing the liquid flow, accumulation, drainage and heat transfer between various phases in blast furnace hearth for a stable and efficient blast furnace operation. Abnormal drainage behavior may lead to high liquid build up in the hearth. Operational problems such as pressurization, low wind intake, and lower material descent rates, normally be encountered if the liquid levels in the hearth exceed a critical limit when Hearth coke and Deadman start to float. Similarly, hot metal temperature is an important parameter to be controlled in the BF operation; it should be kept at an optimal level to obtain desired product quality and a stable BF performance. It is not possible to carry out any direct measurement of above due to the hostile conditions in the hearth with chemically aggressive hot liquids. The objective here is to develop a mathematical model to simulate the variation in hot metal / slag accumulation and temperature during the tapping of the blast furnace based on the computed drainage rate, production rate, mass balance, heat transfer between metal and slag, metal and solids, slag and solids as well as among the various zones of metal and slag itself. For modeling purpose, the BF hearth is considered as a pressurized vessel, filled with solid coke particles. Liquids trickle down in hearth from top and accumulate in voids between the coke particles which are assumed thermally saturated. A set of generic mass balance equations gives the amount of metal and slag intake in hearth. A small drainage (tap hole) is situated at the bottom of the hearth and flow rate of liquids from tap hole is computed taking in account the amount of both the phases accumulated their level in hearth, pressure from gases in the furnace and erosion behaviors of tap hole itself. Heat transfer equations provide the exchange of heat between various layers of liquid metal and slag, and heat loss to cooling system through refractories. Based on all that information a dynamic simulation is carried out which provides real time information of liquids accumulation in hearth before and during tapping, drainage rate and its variation, predicts critical event timings during tapping and expected tapping temperature of metal and slag on preset time intervals. The model is in use at JSPL, India BF-II and its output is regularly cross-checked with actual tapping data, which are in good agreement.

Keywords: blast furnace, hearth, deadman, hotmetal

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Authors: Elene Zhuravliova, Tamar Barbakadze, Irina Kalandadze, Elnari Zaalishvili, Lali Shanshiashvili, David Mikeladze

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Background: Multiple sclerosis (MS) is an inflammatory, neurodegenerative disease, which is accompanied by demyelination and autoimmune response to myelin proteins. Among post-translational modifications, which mediate the modulation of inflammatory pathways during MS, methylation is the main one. The methylation of DNA, also amino acids lysine and arginine, occurs in the cell. It was found that decreased trans-methylation is associated with neuroinflammatory diseases. Therefore, abnormal regulation of the methyl cycle could induce demyelination through the action on PAD (peptidyl-arginine-deiminase) gene promoter. PAD takes part in protein citrullination and targets myelin basic protein (MBP), which is affected during demyelination. To determine whether MBP charge isomers are changing the methyl cycle, we have estimated the concentrations of methyl cycle metabolites in MBP-activated primary astrocytes and oligodendrocytes. For this purpose, the action of the citrullinated MBP- C8 and the most cationic MBP-C1 isomers on the primary cells were investigated. Methods: Primary oligodendrocyte and astrocyte cell cultures were prepared from whole brains of 2-day-old Wistar rats. The methyl cycle metabolites, including homocysteine, S-adenosylmethionine (SAM), and S-adenosylhomocysteine (SAH), were estimated by HPLC analysis using fluorescence detection and prior derivatization. Results: We found that the action of MBP-C8 and MBP-C1 induces a decrease in the concentration of both methyl cycle metabolites, S-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH), in astrocytes compared to the control cells. As for oligodendrocytes, the concentration of SAM was increased by the addition of MBP-C1, while MBP-C8 has no significant effect. As for SAH, its concentration was increased compared to the control cells by the action of both MBP-C1 and MBP-C8. A significant increase in homocysteine concentration was observed by the action of the MBP-C8 isomer in both oligodendrocytes and astrocytes. Conclusion: These data suggest that MBP charge isomers change the concentration of methyl cycle metabolites. MBP-C8 citrullinated isomer causes elevation of homocysteine in astrocytes and oligodendrocytes, which may be the reason for decreased astrocyte proliferation and increased oligodendrocyte cell death which takes place in neurodegenerative processes. Elevated homocysteine levels and subsequent abnormal regulation of methyl cycles in oligodendrocytes possibly change the methylation of DNA that activates PAD gene promoter and induces the synthesis of PAD, which in turn provokes the process of citrullination, which is the accompanying process of demyelination. Acknowledgment: This research was supported by the SRNSF Georgia RF17_534 grant.

Keywords: myelin basic protein, astrocytes, methyl cycle metabolites, homocysteine, oligodendrocytes

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Authors: El Khaddam Safaa, Soulaymani Abdelmajid, Mokhtari Abdelghani, Ouammi Lahcen, Rachida Soulaymani-Beincheikh

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The poisonings represent a problem of health in the world and Morocco, The exact dimensions of this phenomenon are still poorly recorded that we see the lack of exhaustive statistical data. The objective of this retrospective study of a series of cases of the poisonings declared at the level of the region of Tadla-Azilal and collected by the Moroccan Poison Control and Pharmacovigilance Center. An epidemiological profile of the poisonings was to raise, to determine the risk factors influencing the vital preview of the poisoned And to follow the evolution of the incidence, the lethality, and the mortality. During the period of study, we collected and analyzed 9303 cases of poisonings by different incriminated toxic products with the exception of the scorpion poisonings. These poisonings drove to 99 deaths. The epidemiological profile which we raised, showed that the poisoned were of any age with an average of 24.62±16.61 years, The sex-ratio (woman/man) was 1.36 in favor of the women. The difference between both sexes is highly significant (χ2 = 210.5; p<0,001). Most of the poisoned which declared to be of urban origin (60.5 %) (χ2=210.5; p<0,001). Carbon monoxide was the most incriminated among the cases of poisonings (24.15 %), them putting in head, followed by some pesticides and farm produces (21.44 %) and food (19.95 %). The analysis of the risk factors showed that the grown-up patients whose age is between 20 and 74 years have twice more risk of evolving towards the death (RR=1,57; IC95 % = 1,03-2,38) than the other age brackets, so the male genital organ was the most exposed (explained) to the death that the female genital organ (RR=1,59; IC95 % = 1,07-2,38) The patients of rural origin had presented 5 times more risk (RR=4,713; IC95 % = 2,543-8,742). Poisoned by the mineral products had presented the maximum of risk on the vital preview death (RR=23,19, IC95 % = 2,39-224,1). The poisonings by pesticides produce a risk of 9 (RR=9,31; IC95 % = 6,10-14,18). The incidence was 3,3 cases of 10000 inhabitants, and the mortality was 0,004 cases of 1000 inhabitants (that is 4 cases by 1000 000 inhabitants). The rate of lethality registered annually was 10.6 %. The evolution of the indicators of health according to the years showed that the rate of statement measured by the incidence increased by a significant way. We also noted an improvement in the coverage which (who) ended up with a decrease in the rate of the lethality and the mortality during last years. The fight anti-toxic is a work of length time. He asks for a lot of work various levels. It is necessary to attack the delay accumulated by our country on the various legal, institutional and technical aspects. The ideal solution is to develop and to set up a national strategy.

Keywords: epidemiology, poisoning, risk factors, indicators of health, Tadla-Azilal grated by anti-toxic fight

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Authors: E. G. Karvelas, C. Liosis, A. Theodorakakos, T. E. Karakasidis

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Magnetic navigation of the drug inside the human vessels is a very important concept since the drug is delivered to the desired area. Consequently, the quantity of the drug required to reach therapeutic levels is being reduced while the drug concentration at targeted sites is increased. Magnetic navigation of drug agents can be achieved with the use of magnetic nanoparticles where anti-tumor agents are loaded on the surface of the nanoparticles. The magnetic field that is required to navigate the particles inside the human arteries is produced by a magnetic resonance imaging (MRI) device. The main factors which influence the efficiency of the usage of magnetic nanoparticles for biomedical applications in magnetic driving are the size and the magnetization of the biocompatible nanoparticles. In this study, a computational platform for the simulation of the optimal gradient magnetic fields for the navigation of magnetic nanoparticles inside a carotid artery is presented. For the propulsion model of the particles, seven major forces are considered, i.e., the magnetic force from MRIs main magnet static field as well as the magnetic field gradient force from the special propulsion gradient coils. The static field is responsible for the aggregation of nanoparticles, while the magnetic gradient contributes to the navigation of the agglomerates that are formed. Moreover, the contact forces among the aggregated nanoparticles and the wall and the Stokes drag force for each particle are considered, while only spherical particles are used in this study. In addition, gravitational forces due to gravity and the force due to buoyancy are included. Finally, Van der Walls force and Brownian motion are taken into account in the simulation. The OpenFoam platform is used for the calculation of the flow field and the uncoupled equations of particles' motion. To verify the optimal gradient magnetic fields, a covariance matrix adaptation evolution strategy (CMAES) is used in order to navigate the particles into the desired area. A desired trajectory is inserted into the computational geometry, which the particles are going to be navigated in. Initially, the CMAES optimization strategy provides the OpenFOAM program with random values of the gradient magnetic field. At the end of each simulation, the computational platform evaluates the distance between the particles and the desired trajectory. The present model can simulate the motion of particles when they are navigated by the magnetic field that is produced by the MRI device. Under the influence of fluid flow, the model investigates the effect of different gradient magnetic fields in order to minimize the distance of particles from the desired trajectory. In addition, the platform can navigate the particles into the desired trajectory with an efficiency between 80-90%. On the other hand, a small number of particles are stuck to the walls and remains there for the rest of the simulation.

Keywords: artery, drug, nanoparticles, navigation

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Authors: Vittorio Linfante

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Utopìa is a term that, since its first appearance in 1516, in Tommaso Moro’s work, has taken on different meanings and forms in various fields: social studies, politics, art, creativity, and design. The utopias, although of short duration and in their apparent impossibility, have been able to give a shape to the future, laying the foundations for our present and the future of the next generations. The Twentieth century was the historical period crossed by many changes, and it saw the most significant number of utopias not only social, political, and scientific but also artistic, architectural, in design, communication, and, last but not least, in fashion. Over the years, fashion has been able to interpret various utopistic impulses giving form to the most futuristic visions. From the Manifesto del Vestito by Giacomo Balla, through the functional experiments that led to the Tuta by Thayath and the Varst by Aleksandr Rodčenko and Varvara Stepanova, through the Space Age visions of Rudi Gernreich, Paco Rabanne and Pierre Cardin, and the Archizoom’s political actions and their fashion project Vestirsi è facile. Experiments that have continued to the present days through the (sometimes) excessive visions of Hussein Chalayan, Alexander McQueen, and Gareth Pugh or those that are more anchored to the market (but no fewer innovative and visionaries) by Prada, Chanel, and Raf Simmons. If, as Bauman states, it is true that we have entered in a phase of Retrotopia characterized by the inability to think about new forms of the future; it is necessary, more than ever, to redefine the role of history, of its narration and its mise en scène, within the contemporary creative process. A process that increasingly requires an in-depth knowledge of the past for the definition of a renewed discourse about design processes. A discourse in which words like archive, exhibition, curating, revival, vintage, and costume take on new meanings. The paper aims to investigate–through case studies, research, and professional projects–the renewed role of curating and preserving fashion artefacts. A renewed role that–in an era of Retrotopia–museums, exhibitions, and archives can (and must) assume, to contribute to the definition of new design paradigms, capable of overcoming the traditional categories of revival or costume in favour of a more contemporary “mash-up” approach. Mash-up in which past and present, craftsmanship and new technologies, revival and experimentation merge seamlessly. In this perspective, dresses (as well as fashion accessories) should be considered not only as finished products but as artefacts capable of talking about the past and of producing unpublished new stories at the same time. Archives, exhibitions (academic and not), and museums thus become powerful sources of inspiration for fashion: places and projects capable of generating innovation, becoming active protagonists of the contemporary fashion design processes.

Keywords: heritage, history, costume and fashion interface, performance, language, design research

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Authors: Rati Sandeep Choudhari

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Mobility flows are considered one of the most important elements of urbanisation, with transport infrastructure serving as a backbone of urban fabrics. Although rapid urbanisation and changing land use patterns have led to an increase in urban mobility levels around the globe, mobility, in general, has become an unpleasant experience for city dwellers, making locations around the city inconvenient to access. With public transport featured in almost every sustainable mobility plan in developing countries, the intermodality and integration with appropriate non–motorised transport infrastructure is often neglected. As a result, people choose to use private cars and two-wheelers to travel, rendering public transit systems underutilised, and encroaching onto pedestrian space on streets, thus making urban mobility unsafe and inconvenient for a major section of society. On the other hand, cities in the West, especially in Europe, depend heavily on inter–modal transit systems, allowing people to shift between metros, buses, trams, walking, and cycling to access even the remote locations of the city. Keeping accessibility as the focal point while designing urban mobility plans and policies, these cities have appropriately refined their urban form, optimised urban densities, developed a multimodal transit system, and adopted place-making strategies to foster a sense of place, thus, improving the quality of urban mobility experience in cities. Using a qualitative research approach, the research looks in detail into the existing literature on what kind of strategies can be applied to improve the urban mobility experience for city dwellers. It further studies and draws out a comparative analysis of cities in both developed and developing parts of the world where these strategies have been used to create people-centric mobility systems, fostering a sense of place with respect to urban mobility and how these strategies affected their social, economic, and environmental dynamics. The examples reflect on how different strategies like redefining land use patterns to form close knit neighbourhoods, development of non – motorise transit systems, and their integration with public transport infrastructure and place-making approach has helped in enhancing the quality and experience of mobility infrastructure in cities. The research finally concludes by laying out strategies that can be adopted by cities of the Global South to develop future mobility systems in a people-centric and sustainable way.

Keywords: urban mobility, sustainable transport, strategic planning, people-centric approach

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Authors: Auzair Mehmood, Mohammad Arif

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The LCT (Li, Cs and Ta rich)-type pegmatites, genetically related to peraluminous S-type granites, are being mined for strategic metals (SMs) and rare earth elements (REEs) around the world. This study investigates the SMs and REEs potentials of pegmatites that are spatially associated with an S-type granitic suite of the Himalayan sequence, specifically Mansehra Granitic Complex (MGC), northwest Pakistan. Geochemical signatures of the pegmatites and some of their mineral extracts were analyzed using Inductive Coupled Plasma Mass Spectroscopy (ICP-MS) technique to explore and generate potential prospects (if any) for SMs and REEs. In general, the REE patterns of the studied whole-rock pegmatite samples show tetrad effect and possess low total REE abundances, strong positive Europium (Eu) anomalies, weak negative Cesium (Cs) anomalies and relative enrichment in heavy REE. Similar features have been observed on the REE patterns of the feldspar extracts. However, the REE patterns of the muscovite extracts reflect preferential enrichment and possess negative Eu anomalies. The trace element evaluation further suggests that the MGC pegmatites have undergone low levels of fractionation. Various trace elements concentrations (and their ratios) including Ta versus Cs, K/Rb (Potassium/Rubidium) versus Rb and Th/U (Thorium/Uranium) versus K/Cs, were used to analyze the economically viable mineral potential of the studied rocks. On most of the plots, concentrations fall below the dividing line and confer either barren or low-level mineralization potential of the studied rocks for both SMs and REEs. The results demonstrate paucity of the MGC pegmatites with respect to Ta-Nb (Tantalum-Niobium) mineralization, which is in sharp contrast to many Pan-African S-type granites around the world. The MGC pegmatites are classified as muscovite pegmatites based on their K/Rb versus Cs relationship. This classification is consistent with the occurrence of rare accessory minerals like garnet, biotite, tourmaline, and beryl. Furthermore, the classification corroborates with an earlier sorting of the MCG pegmatites into muscovite-bearing, biotite-bearing, and subordinate muscovite-biotite types. These types of pegmatites lack any significant SMs and REEs mineralization potentials. Field relations, such as close spatial association with parent granitic rocks and absence of internal zonation structure, also reflect the barren character and hence lack of any potential prospects of the MGC pegmatites.

Keywords: exploration, fractionation, Himalayas, pegmatites, rare earth elements

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Authors: Bingqing Chen

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The Opium War unlocked the gate of China. Since then, modern western culture has been imported strongly and spread throughout this Asian country. The monologue of traditional Chinese culture in the past has been replaced by the hustle and bustle of multiculturalism. In the field of music, starting from school music, China, a country without the concept of composition, was deeply influenced by western culture and professional music composition, and entered the era of professional music composition. Recognizing the importance of national culture, a group of insightful artists began to try to add ‘China’ to musical composition. However, due to the special historical origin of Chinese professional musical composition and the three times of cultural nihilism in China, professional musical composition at this time failed to interpret the deep language structure of local culture within Chinese traditional culture, but only regarded Chinese traditional music as a ‘melody material library.’ At this time, the cross-cultural composition still takes Western music as its ‘norm,’ while our own music culture only exists as the sound of the contrast of Western music. However, after reading scores extensively, watching video performances, and interviewing several active composers, we found that at least in the past 30 years, China has created some works that can be called intercultural music. In these kinds of music, composers put Chinese and Western, traditional and modern in an almost equal position to have a dialogue based on their deep understanding and respect for the two cultures. This kind of music connects two music worlds, and links the two cultural and ideological worlds behind it, and communicates and grows together. This paper chose the works of three composers with different educational backgrounds, and pay attention to how composers can make a dialogue at the organizational structure level of their works. Based on the strategies adopted by composers in structuring their works, this paper expounds on how the composer's music procedure shows intercultural in terms of whole sound effects and cultural symbols. By actively participating in this intercultural practice, composers resorting to various musical and extra-musical procedures to arrive at the so-called ‘innovation within tradition.’ Through the dialogue, we can activate the space of creative thinking and explore the potential contained in culture. This interdisciplinary research promotes the rethinking of the possibility of innovation in contemporary Chinese intercultural music composition, spanning the fields of sound studies, dialogue theory, cultural research, music theory, and so on. Recently, China is calling for actively promoting 'the construction of Chinese music canonization,’ expecting to form a particular music style to show national-cultural identity. In the era of globalization, it is possible to form a brand-new Chinese music style through intercultural composition, but it is a question about talents, and the key lies in how composers do it. There is no recipe for the formation of the Chinese music style, only the composers constantly trying and tries to solve problems in their works.

Keywords: dialogism, intercultural music, national-cultural identity, organization/structure, sound

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Authors: Khalid Alshaikh

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In recent years, leadership, Corporate Governance (CG) and Corporate Social Responsibility (CSR) have been under scrutiny in the Libyan society. Scholars and institutions have commenced investigating the possible resolutions they can arrange to alleviate the economic, social and environmental problems the war has produced. Thus far, these constructs requisite an in-depth reinvestigation, reconceptualization, and analysis to clearly reconstruct their rules and regulations. With the demise of Qaddafi’s regime, levels, degrees, and efforts to apply CG regulations have varied in public and private commercial banks. CSR is a new organizational culture that still designs its route within these financial institutions. Detaching itself from any notion of dictatorship and autocratic traits, leadership counts on transformational and transactional styles. Therefore, this paper investigates the extent to which the Board of Directors and Chief Executive Officers (CEOs) redefine these concepts and how they entrench CSR within the framework of CG. The research methodology used both public and private banks as a case study and qualitative research to interview ten Board of Directors (BoDs) and eleven Chief executive managers to explore how leadership, CG, and CSR are defined and how leadership integrates CSR into CG structures. The findings suggest that the CG framework in Libya still requires great efforts to be developed. Full CG code implementation appears daunting. Also, the CSR is still influenced by the power of religion. Nevertheless, the Islamic perspective is more consistent with the social contract concept of the CSR. The Libyan commercial banks do not solely focus on the economic side of maximizing profits, but also concentrate on its morality. The issue is that CSR activities are not enough to achieve good charity publicly and needs strategies to address major social issues. Moreover, leadership is more transformational and transactional and endeavors to make economic, social and environmental changes, but these changes are curtailed by tradition and traditional values dominating the Libyan social life where religious and tribal practices establish the relationship between leaders and their subordinates. Finally, the findings reveal that transformational and transactional leadership styles encourage the incorporation of CSR into the CG regulations. The boardroom and executive management have such a particular role in flagging up how embedded corporate Social responsibility is in organizational culture across the commercial banks, yet it is still important that the BoDs and CEOs need to do much more to embed corporate social responsibility through their core functions. They need to boost their standing to be more influential and make sure that the right discussions about CSR happen with the right stakeholders involved.

Keywords: board of directors, chief executive officers, corporate governance, corporate social responsibility

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Authors: Lakmini Wijesooriya, Vicki Chalker, Jessica Day, Priyantha Perera, N. P. Sunil-Chandra

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M. pneumoniae has been identified as an etiology for exacerbation of asthma (EQA), although viruses play a major role in EOA. M. pneumoniae infection is treated empirically with macrolides, and its antibiotic sensitivity is not detected routinely. Characterization of the organism by genotyping and determination of macrolide resistance is important epidemiologically as it guides the empiric antibiotic treatment. To date, there is no such characterization of M. pneumoniae performed in Sri Lanka. The present study describes the characterization of M. pneumoniae detected from a child with EOA following a screening of 100 children with EOA. Of the hundred children with EOA, M. pneumoniae was identified only in one child by Real-Time polymerase chain reaction (PCR) test for identifying the community-acquired respiratory distress syndrome (CARDS) toxin nucleotide sequences. The M. pneumoniae identified from this patient underwent detection of macrolide resistance via conventional PCR, amplifying and sequencing the region of the 23S rDNA gene that contains single nucleotide polymorphisms that confer resistance. Genotyping of the isolate was performed via nested Multilocus Sequence Typing (MLST) in which eight (8) housekeeping genes (ppa, pgm, gyrB, gmk, glyA, atpA, arcC, and adk) were amplified via nested PCR followed by gene sequencing and analysis. As per MLST analysis, the M. pneumoniae was identified as sequence type 14 (ST14), and no mutations that confer resistance were detected. Resistance to macrolides in M. pneumoniae is an increasing problem globally. Establishing surveillance systems is the key to informing local prescriptions. In the absence of local surveillance data, antibiotics are started empirically. If the relevant microbiological samples are not obtained before antibiotic therapy, as in most occasions in children, the course of antibiotic is completed without a microbiological diagnosis. This happens more frequently in therapy for M. pneumoniae which is treated with a macrolide in most patients. Hence, it is important to understand the macrolide sensitivity of M. pneumoniae in the setting. The M. pneumoniae detected in the present study was macrolide sensitive. Further studies are needed to examine a larger dataset in Sri Lanka to determine macrolide resistance levels to inform the use of macrolides in children with EOA. The MLST type varies in different geographical settings, and it also provides a clue to the existence of macrolide resistance. The present study enhances the database of the global distribution of different genotypes of M. pneumoniae as this is the first such characterization performed with the increased number of samples to determine macrolide resistance level in Sri Lanka. M. pneumoniae detected from a child with exacerbation of asthma in Sri Lanka was characterized as ST14 by MLST and no mutations that confer resistance were detected.

Keywords: mycoplasma pneumoniae, Sri Lanka, characterization, macrolide resistance

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Authors: Andrea Giacomelli, Luciano Massetti, Elena Maggi, Antonio Raschi

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The presentation will report the activities managed during the Summer of 2017 by a team composed by staff from a University Department, a National Research Council Institute, and an outreach NGO, collecting measurements of night sky brightness and other information on artificial lighting, in order to characterize light pollution issues on portions of the Tuscan coast, in Central Italy. These activities combine measurements collected by the principal scientists, citizen science observations led by students, and outreach events targeting a broad audience. This campaign aggregates the efforts of three actors: the BuioMetria Partecipativa project, which started collecting light pollution data on a national scale in 2008 with an environmental engineering and free/open source GIS core team; the Institute of Biometeorology from the National Research Council, with ongoing studies on light and urban vegetation and a consolidated track record in environmental education and citizen science; the Department of Biology from the University of Pisa, which started experiments to assess the impact of light pollution in coastal environments in 2015. While the core of the activities concerns in situ data, the campaign will account also for remote sensing data, thus considering heterogeneous data sources. The aim of the campaign is twofold: (1) To test actions of citizen and student engagement in monitoring sky brightness (2) To collect night sky brightness data and test a protocol for applications to studies on the ecological impact of light pollution, with a special focus on marine coastal ecosystems. The collaboration of an interdisciplinary team in the study of artificial lighting issues is not a common case in Italy, and the possibility of undertaking the campaign in Tuscany has the added value of operating in one of the territories where it is possible to observe both sites with extremely high lighting levels, and areas with extremely low light pollution, especially in the Southern part of the region. Combining environmental monitoring and communication actions in the context of the campaign, this effort will contribute to the promotion of night skies with a good quality as an important asset for the sustainability of coastal ecosystems, as well as to increase citizen awareness through star gazing, night photography and actively participating in field campaign measurements.

Keywords: citizen science, light pollution, marine coastal biodiversity, environmental education

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Authors: Ambeck Celyne Tebid, Harry S. Rampa

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The South African Education system recognises the need for all learners including those experiencing learning difficulties, to have access to a single unified system of education. For teachers to be pedagogically responsive to an increasingly diverse learner population without appropriate support has been proven to be unrealistic. As such, this has considerably hampered interest amongst teachers, especially those at the foundation phase to work within an Inclusive Education (IE) and training system. This qualitative study aimed at investigating foundation phase teachers’ experiences of school-based support teams (SBSTs) in two Full-Service (inclusive schools) and one Mainstream public primary school in the Gauteng province of South Africa; with particular emphasis on finding ways to supporting them, since teachers claimed they were not empowered in their initial training to teach learners experiencing learning difficulties. Hence, SBSTs were created at school levels to fill this gap thereby, supporting teaching and learning by identifying and addressing learners’, teachers’ and schools’ needs. With the notion that IE may be failing because of systemic reasons, this study uses Bronfenbrenner’s (1979) ecosystemic as well as Piaget’s (1980) maturational theory to examine the nature of support and experiences amongst teachers taking individual and systemic factors into consideration. Data was collected using in-depth, face-to-face interviews, document analysis and observation with 6 foundation phase teachers drawn from 3 different schools, 3 SBST coordinators, and 3 school principals. Data was analysed using the phenomenological data analysis method. Amongst the findings of the study is that South African full- service and mainstream schools have functional SBSTs which render formal and informal support to the teachers; this support varies in quality depending on the socio-economic status of the relevant community where the schools are situated. This paper, however, argues that what foundation phase teachers settled for as ‘support’ is flawed; as well as how they perceive the SBST and its role is problematic. The paper conclude by recommending that, the SBST should consider other approaches at foundation phase teacher support such as, empowering teachers with continuous practical experiences on how to deal with real classroom scenarios, as well as ensuring that all support, be it on academic or non-academic issues should be provided within a learning community framework where the teacher, family, SBST and where necessary, community organisations should harness their skills towards a common goal.

Keywords: foundation phase, full- service schools, inclusive education, learning difficulties, school-based support teams, teacher support

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Authors: Anthony R. Townsend, Robyn L. Fasser

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This research project provides an interpretative phenomenological analysis of a proposed conceptual model of parenting ability that has been designed to offer recommendations to guide intervention in child custody evaluations in South Africa. A recent review of the literature on child custody evaluations reveals that while there have been significant and valuable shifts in the capacity of the legal system aided by mental health professionals in understanding children and family dynamics, there remains a conceptual gap regarding the nature of parenting ability. With a view to addressing this paucity of a theoretical basis for considering parenting ability, this research project reviews a dimensional model for the assessment of parenting ability by conceiving parenting ability as a combination of good parenting and parental fitness. This model serves as a conceptual framework to guide child-custody evaluation and refine intervention in such cases to better meet the best interests of the child in a manner that bridges the professional gap between parties, legal entities, and mental health professionals. Using a model of good parenting as a point of theoretical departure, this model incorporates both intra-psychic and interpersonal attributes and behaviours of parents to form an impression of parenting ability and identify areas for potential enhancement. This research, therefore, hopes to achieve the following: (1) to provide nuanced descriptions of parents’ parenting ability; (2) to describe parents’ parenting potential; (3) to provide a parenting assessment tool for investigators in forensic family matters that will enable more useful recommendations and interventions; (4) to develop a language of consensus for investigators, attorneys, judges and parents, in forensic family matters, as to what comprises parenting ability and how this can be assessed; and (5) that all of the aforementioned will serve to advance the best interests of the children involved in such litigious matters. The evaluative promise and post-assessment prospects of this model are illustrated through three interlinking data sets: (1) the results of interviews with South African psychologists about the model, (2) retrospective analysis of care and contact evaluation reports using the model to determine if different conclusions or more specific recommendations are generated with its use and (3) the results of an interview with a psychologist who piloted this model by using it in care and contact evaluation.

Keywords: alienation, attachment, best interests of the child, care and contact evaluation, children’s act (38 of 2005), child custody evaluation, civil forensics, gatekeeping, good parenting, good-enough parenting, health professions council of South Africa, family law, forensic mental healthcare practitioners, parental fitness, parenting ability, parent management training, parenting plan, problem-determined system, psychotherapy, support of other child-parent relationship, voice of the child

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Authors: Ashima Sharma, Tapan K. Chaudhuri

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Human Serum Albumin (HSA) is one of the most demanded therapeutic protein with immense biotechnological applications. The current source of HSA is human blood plasma. Blood is a limited and an unsafe source as it possesses the risk of contamination by various blood derived pathogens. This issue led to exploitation of various hosts with the aim to obtain an alternative source for the production of the rHSA. But, till now no host has been proven to be effective commercially for rHSA production because of their respective limitations. Thus, there exists an indispensable need to promote non-animal derived rHSA production. Of all the host systems, Escherichia coli is one of the most convenient hosts which has contributed in the production of more than 30% of the FDA approved recombinant pharmaceuticals. E. coli grows rapidly and its culture reaches high cell density using inexpensive and simple substrates. The fermentation batch turnaround number for E. coli culture is 300 per year, which is far greater than any of the host systems available. Therefore, E. coli derived recombinant products have more economical potential as fermentation processes are cheaper compared to the other expression hosts available. Despite of all the mentioned advantages, E. coli had not been successfully adopted as a host for rHSA production. The major bottleneck in exploiting E. coli as a host for rHSA production was aggregation i.e. majority of the expressed recombinant protein was forming inclusion bodies (more than 90% of the total expressed rHSA) in the E. coli cytosol. Recovery of functional rHSA form inclusion body is not preferred because it is tedious, time consuming, laborious and expensive. Because of this limitation, E. coli host system was neglected for rHSA production for last few decades. Considering the advantages of E. coli as a host, the present work has targeted E. coli as an alternate host for rHSA production through resolving the major issue of inclusion body formation associated with it. In the present study, we have developed a novel and innovative method for enhanced soluble and functional production of rHSA in E.coli (~60% of the total expressed rHSA in the soluble fraction) through modulation of the cellular growth, folding and environmental parameters, thereby leading to significantly improved and enhanced -expression levels as well as the functional and soluble proportion of the total expressed rHSA in the cytosolic fraction of the host. Therefore, in the present case we have filled in the gap in the literature, by exploiting the most well studied host system Escherichia coli which is of low cost, fast growing, scalable and ‘yet neglected’, for the enhancement of functional production of HSA- one of the most crucial biomolecule for clinical and biotechnological applications.

Keywords: enhanced functional production of rHSA in E. coli, recombinant human serum albumin, recombinant protein expression, recombinant protein processing

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Authors: M. Bonello, D. Micallef, S. P. Borg

Abstract:

Driven by increased comfort standards, but at the same time high energy consciousness, energy-efficient space cooling has become an essential aspect of building design. Its aims are simple, aiming at providing satisfactory thermal comfort for individuals in an interior space using low energy consumption cooling systems. In this context, evaporative cooling is both an energy-efficient and an eco-friendly cooling process. In the past two decades, several academic studies have been performed to determine the resulting thermal comfort produced by an evaporative cooling system, including studies on temperature profiles, air speed profiles, effect of clothing and personnel activity. To the best knowledge of the authors, no studies have yet considered the analysis of relative humidity (RH) profiles in a space cooled using evaporative cooling. Such a study will determine the effect of different humidity levels on a person's thermal comfort and aid in the consequent improvement designs of such future systems. Under this premise, the research objective is to characterise the resulting different RH profiles in a chamber micro-climate using the evaporative cooling system in which the inlet air speed, temperature and humidity content are varied. The chamber shall be modelled using Computational Fluid Dynamics (CFD) in ANSYS Fluent. Relative humidity shall be modelled using a species transport model while the k-ε RNG formulation is the proposed turbulence model that is to be used. The model shall be validated with measurements taken using an identical test chamber in which tests are to be conducted under the different inlet conditions mentioned above, followed by the verification of the model's mesh and time step. The verified and validated model will then be used to simulate other inlet conditions which would be impractical to conduct in the actual chamber. More details of the modelling and experimental approach will be provided in the full paper The main conclusions from this work are two-fold: the micro-climatic relative humidity spatial distribution within the room is important to consider in the context of investigating comfort at occupant level; and the investigation of a human being's thermal comfort (based on Predicted Mean Vote – Predicted Percentage Dissatisfied [PMV-PPD] values) and its variation with different locations of relative humidity values. The study provides the necessary groundwork for investigating the micro-climatic RH conditions of environments cooled using evaporative cooling. Future work may also target the analysis of ways in which evaporative cooling systems may be improved to better the thermal comfort of human beings, specifically relating to the humidity content around a sedentary person.

Keywords: chamber micro-climate, evaporative cooling, relative humidity, thermal comfort

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Authors: Kongmeng Ly

Abstract:

The management of transboundary river basins across developing countries, such as the Lower Mekong River Basin (LMB), is frequently challenging given the development and conservation divergences of the basin countries. Driven by needs to sustain economic performance and reduce poverty, the LMB countries (Cambodia, Lao PDR, Thailand, Viet Nam) are embarking on significant land use changes in the form hydropower dam, to fulfill their energy requirements. This pathway could lead to irreversible changes to the ecosystem of the Mekong River, if not properly managed. Given the uncertain trade-offs of hydropower development and operation, the Lower Mekong River Basin Countries through the technical support of the Mekong River Commission (MRC) Secretariat embarked on decade long the development of Technical Guidelines for Transboundary Environmental Impact Assessment. Through a series of workshops, seminars, national and regional consultations, and pilot studies and further development following the recommendations generated through legal and institutional reviews undertaken over two decades period, the LMB Countries jointly adopted the MRC Technical Guidelines for Transboundary Environmental Impact Assessment (TbEIA Guidelines). These guidelines were developed with particular regard to the experience gained from MRC supported consultations and technical reviews of the Xayaburi Dam Project, Don Sahong Hydropower Project, Pak Beng Hydropower Project, and lessons learned from the Srepok River and Se San River case studies commissioned by the MRC under the generous supports of development partners around the globe. As adopted, the TbEIA Guidelines have been designed as a supporting mechanism to the national EIA legislation, processes and systems in each Member Country. In recognition of the already agreed mechanisms, the TbEIA Guidelines build on and supplement the agreements stipulated in the 1995 Agreement on the Cooperation for the Sustainable Development of the Mekong River Basin and its Procedural Rules, in addressing potential transboundary environmental impacts of development projects and ensuring mutual benefits from the Mekong River and its resources. Since its adoption in 2022, the TbEIA Guidelines have already been voluntary implemented by Lao PDR on its underdevelopment Sekong A Downstream Hydropower Project, located on the Sekong River – a major tributary of the Mekong River. While this implementation is ongoing with results expected in early 2024, the implementation thus far has strengthened cooperation among concerned Member Countries with multiple successful open dialogues organized at national and regional levels. It is hope that lessons learnt from this application would lead to a wider application of the TbEIA Guidelines for future water resources development projects in the LMB.

Keywords: transboundary, EIA, lower mekong river basin, mekong river

Procedia PDF Downloads 19

Authors: Dennis Kreutzer, Sarah Müller-Abdelrazeq, Ingrid Isenhardt

Abstract:

Resource scarcity, energy transition and the planned climate neutrality pose enormous challenges for manufacturing companies. In order to achieve these goals and a holistic sustainable development, the European Union has listed the circular economy as part of the Circular Economy Action Plan. In addition to a reduction in resource consumption, reduced emissions of greenhouse gases and a reduced volume of waste, the principles of the circular economy also offer enormous economic potential for companies, such as the generation of new circular business models. However, many manufacturing companies, especially small and medium-sized enterprises, do not have the necessary capacity to plan their transformation. They need support and strategies on the path to circular transformation, because this change affects not only production but also the entire company. Maturity models offer an approach, as they enable companies to determine the current status of their transformation processes. In addition, companies can use the models to identify transformation strategies and thus promote the transformation process. While maturity models are established in other areas, e.g. IT or project management, only a few circular economy maturity models can be found in the scientific literature. The aim of this paper is to analyse the identified maturity models of the circular economy through a systematic literature review (SLR) and, besides other aspects, to check their completeness as well as their quality. Since the terms "maturity model" and "readiness model" are often used to assess the transformation process, this paper considers both types of models to provide a more comprehensive result. For this purpose, circular economy maturity models at the company (micro) level were identified from the literature, compared, and analysed with regard to their theoretical and methodological structure. A specific focus was placed, on the one hand, on the analysis of the business units considered in the respective models and, on the other hand, on the underlying metrics and indicators in order to determine the individual maturity level of the entire company. The results of the literature review show, for instance, a significant difference in the holism of their assessment framework. Only a few models include the entire company with supporting areas outside the value-creating core process, e.g. strategy and vision. Additionally, there are large differences in the number and type of indicators as well as their metrics. For example, most models often use subjective indicators and very few objective indicators in their surveys. It was also found that there are rarely well-founded thresholds between the levels. Based on the generated results, concrete ideas and proposals for a research agenda in the field of circular economy maturity models are made.

Keywords: maturity model, circular economy, transformation, metric, assessment

Procedia PDF Downloads 92

Authors: Ahmed Mantawy, James C. Anderson

Abstract:

Numerous cases of earthquakes (main-shocks) that were followed by aftershocks have been recorded in California. In 1992 a pair of strong earthquakes occurred within three hours of each other in Southern California. The first shock occurred near the community of Landers and was assigned a magnitude of 7.3 then the second shock occurred near the city of Big Bear about 20 miles west of the initial shock and was assigned a magnitude of 6.2. In the same year, a series of three earthquakes occurred over two days in the Cape-Mendocino area of Northern California. The main-shock was assigned a magnitude of 7.0 while the second and the third shocks were both assigned a value of 6.6. This paper investigates the effect of a main-shock accompanied with aftershocks of significant intensity on reinforced concrete (RC) frame buildings to indicate nonlinear behavior using PERFORM-3D software. A 6-story building in San Bruno and a 20-story building in North Hollywood were selected for the study as both of them have RC moment resisting frame systems. The buildings are also instrumented at multiple floor levels as a part of the California Strong Motion Instrumentation Program (CSMIP). Both buildings have recorded responses during past events such as Loma-Prieta and Northridge earthquakes which were used in verifying the response parameters of the numerical models in PERFORM-3D. The verification of the numerical models shows good agreement between the calculated and the recorded response values. Then, different scenarios of a main-shock followed by a series of aftershocks from real cases in California were applied to the building models in order to investigate the structural behavior of the moment-resisting frame system. The behavior was evaluated in terms of the lateral floor displacements, the ductility demands, and the inelastic behavior at critical locations. The analysis results showed that permanent displacements may have happened due to the plastic deformation during the main-shock that can lead to higher displacements during after-shocks. Also, the inelastic response at plastic hinges during the main-shock can change the hysteretic behavior during the aftershocks. Higher ductility demands can also occur when buildings are subjected to trains of ground motions compared to the case of individual ground motions. A general conclusion is that the occurrence of aftershocks following an earthquake can lead to increased damage within the elements of an RC frame buildings. Current code provisions for seismic design do not consider the probability of significant aftershocks when designing a new building in zones of high seismic activity.

Keywords: reinforced concrete, existing buildings, aftershocks, damage accumulation

Procedia PDF Downloads 269