Search results for: cases

Authors: Yexin Qu

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Izafe is a construction typically found in Iranian languages, which is attested already in Old Avestan and Old Persian. The narrow sense of izafe can be described as the linear structure of [NP pt Modifier] with pt as an uninflectable particle or clitic. The history of the Iranian izafe has the following stages: Stage I: Verbless nominal relative clauses, Stage II: Verbless nominal relative clauses with Case Attraction; and Stage III: Narrow sense izafe. Previous works suggest that embedded relative clauses and correlatives in other Indo-European languages might be relevant for the source of the izafe-construction. Stage I, as the precursor of narrow sense izafe, or so-called “prezafe” is not found in branches other than Iranian. Comparable cases have been demonstrated in Vedic, Greek, and some rare cases in Latin. This suggests “prezafe” may date back very early in Indo-European. Izafe-like structures are not attested in branches such as Balto-Slavic and Germanic, but Balto-Slavic definite adjectives and Germanic weak adjectives can be compared to the verbless nominal relative clauses and analyzed as developments of verbless relative clauses parallel to izafe in Indo-Iranian, as are called “parizafe” in this paper. In this paper, the verbless RC is compared with Germanic weak adjectives. The Germanic languages used n-stem derivation to form determined derivatives, which are semantically equivalent to the appositive RC and eventually became weak adjectives. To be more precise, starting from an adjective “X”, the Germanic weak adjective structure is formed as [det X-n], literally “the X”, with the meaning “the X one”, which can be shown to be semantically equivalent to “the one which is X”. In this paper, Stage I suggest that, syntactically, the Germanic verbless relative clauses went through CP to DP relabeling like Iranian, based on the following observations: (1) Germanic relative pronouns (e.g., Gothic saei, Old English se) and determiners (e.g., Gothic sa, Old English se) are both from the *so/to pronominal roots; (2) the semantic equivalence of Germanic weak adjectives and the izafe structure. This may suggest that Germanic may also have had “Prezafe” Stages I and II. In conclusion: “Prezafe” in Stage I may have been a phenomenon of the proto-language, Stage II was the result of independent parallel developments and then each branch had its own strategy.

Keywords: izafe, relative clause, Germanic, Indo-European

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Authors: Teklay Gebrecherkos

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Background: Serological testing for SARS-CoV-2 plays an important role in epidemiological studies, in aiding the diagnosis of COVID-19 and assess vaccine responses. Little is known about the dynamics of SARS-CoV-2 serology in African settings. Here, we aimed to characterize the longitudinal antibody response profile to SARS-CoV-2 in Ethiopia. Methods: In this prospective study, a total of 102 PCR-confirmed COVID-19 patients were enrolled. We obtained 802 plasma samples collected serially. SARS-CoV-2 antibodies were determined using four lateral flow immune assays (LFIAs) and an electrochemiluminescent immunoassay. We determined longitudinal antibody response to SARS-CoV-2 as well as seroconversion dynamics. Results: Serological positivity rate ranged between 12%-91%, depending on timing after symptom onset. There was no difference in the positivity rate between severe and non-severe COVID-19 cases. The specificity ranged between 90%-97%. Agreement between different assays ranged between 84%-92%. The estimated positive predictive value (PPV) for IgM or IgG in a scenario with seroprevalence at 5% varies from 33% to 58%. Nonetheless, when the population seroprevalence increases to 25% and 50%, there is a corresponding increase in the estimated PPVs. The estimated negative-predictive value (NPV) in a low seroprevalence scenario (5%) is high (>99%). However, the estimated NPV in a high seroprevalence scenario (50%) for IgM or IgG is reduced significantly from 80% to 85%. Overall, 28/102 (27.5%) seroconverted by one or more assays tested within a median time of 11 (IQR: 9–15) days post symptom onset. The median seroconversion time among symptomatic cases tended to be shorter when compared to asymptomatic patients [9 (IQR: 6–11) vs. 15 (IQR: 13–21) days; p = 0.002]. Overall, seroconversion reached 100% 5.5 weeks after the onset of symptoms. Notably, of the remaining 74 COVID-19 patients included in the cohort, 64 (62.8%) were positive for antibodies at the time of enrollment, and 10 (9.8%) patients failed to mount a detectable antibody response by any of the assays tested during follow-up. Conclusions: Longitudinal assessment of antibody response in African COVID-19 patients revealed heterogeneous responses. This underscores the need for a comprehensive evaluation of serum assays before implementation. Factors associated with failure to seroconvert need further research.

Keywords: COVID-19, antibody, rapid diagnostic tests, ethiopia

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Authors: Behzad Moeini Sam, Sara Mohammadi Avandi

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One of the reasons for the success of the Achaemenids was the innovation and precise organization used in the administrative and military fields. Of course, these organizations had their roots in the previous governments that had changed in these borrowings. The units of the Achaemenid army are also among the cases that have their origins in the ancient East. In this article, the attempt is to find the sources of the Immortal Army based on the writings of old and current authors and archaeological documents, and the name mentioned by Herodotus and rejected by some authors. Of course, linguistic sources have also been used for better conclusions than the indicated sources. It emphasizes linguistic data to lead to a better deduction. Thus, it was included that ‘anauša’ is more probable than anušiya.

Keywords: army, immortal, ten thousand, Anauša, Anušiya

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Authors: Antoifi Abdoulhalik, Ashraf Ahmed

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Saltwater intrusion (SWI) in coastal aquifers has become a growing threat for many countries around the world. While various control measures have been suggested to mitigate SWI, the construction of subsurface physical barriers remains one of the most effective solutions for this problem. In this work, we used laboratory experiments and numerical simulations to investigate the effectiveness of subsurface dams in heterogeneous layered coastal aquifer with different layering patterns. Four different cases were investigated, including a homogeneous (case H), and three heterogeneous cases in which a low permeability (K) layer was set in the top part of the system (case LH), in the middle part of the system (case HLH) and the bottom part of the system (case HL). Automated image analysis technique was implemented to quantify the main SWI parameters under high spatial and temporal resolution. The method also provides transient salt concentration maps, allowing for the first time clear visualization of the spillage of saline water over the dam (advancing wedge condition) as well as the flushing of residual saline water from the freshwater area (receding wedge condition). The SEAWAT code was adopted for the numerical simulations. The results show that the presence of an overlying layer of low permeability enhanced the ability of the dam to retain the saline water. In such conditions, the rate of saline water spillage and inland extension may considerably be reduced. Conversely, the presence of an underlying low K layer led to a faster increase of saltwater volume on the seaward side of the wall, therefore considerably facilitating the spillage. The results showed that a complete removal of the residual saline water eventually occurred in all the investigated scenarios, with a rate of removal strongly affected by the hydraulic conductivity of the lower part of the aquifer. The data showed that the addition of the underlying low K layer in case HL caused the complete flushing to be almost twice longer than in the homogeneous scenario.

Keywords: heterogeneous coastal aquifers, laboratory experiments, physical barriers, seawater intrusion control

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Authors: Pia Ulvenblad, Henrik Barth, Jennie Cederholm BjöRklund, Maya Hoveskog, Per-Ola Ulvenblad

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The importance of business model innovation (BMI) is widely recognized. This is also valid for firms in the agri-food industry, closely connected to global challenges. Worldwide food production will have to increase 70% by 2050 and the United Nations’ sustainable development goals prioritize research and innovation on food security and sustainable agriculture. The firms of the agri-food industry have opportunities to increase their competitive advantage through BMI. However, the process of BMI is complex and the implementation of new business models is associated with high degree of risk and failure. Thus, managers from all industries and scholars need to better understand how to address this complexity. Therefore, the research presented in this paper (i) explores different categories of barriers in research literature on business models in the agri-food industry, and (ii) illustrates categories of barriers with empirical cases. This study is addressing the rather limited understanding on barriers for BMI in the agri-food industry, through a systematic literature review (SLR) of 570 peer-reviewed journal articles that contained a combination of ‘BM’ or ‘BMI’ with agriculture-related and food-related terms (e.g. ‘agri-food sector’) published in the period 1990-2014. The study classifies the barriers in several categories and illustrates the identified barriers with ten empirical cases. Findings from the literature review show that barriers are mainly identified as outcomes. It can be assumed that a perceived barrier to growth can often be initially exaggerated or underestimated before being challenged by appropriate measures or courses of action. What may be considered by the public mind to be a barrier could in reality be very different from an actual barrier that needs to be challenged. One way of addressing barriers to growth is to define barriers according to their origin (internal/external) and nature (tangible/intangible). The framework encompasses barriers related to the firm (internal addressing in-house conditions) or to the industrial or national levels (external addressing environmental conditions). Tangible barriers can include asset shortages in the area of equipment or facilities, while human resources deficiencies or negative willingness towards growth are examples of intangible barriers. Our findings are consistent with previous research on barriers for BMI that has identified human factors barriers (individuals’ attitudes, histories, etc.); contextual barriers related to company and industry settings; and more abstract barriers (government regulations, value chain position, and weather). However, human factor barriers – and opportunities - related to family-owned businesses with idealistic values and attitudes and owning the real estate where the business is situated, are more frequent in the agri-food industry than other industries. This paper contributes by generating a classification of the barriers for BMI as well as illustrating them with empirical cases. We argue that internal barriers such as human factors barriers; values and attitudes are crucial to overcome in order to develop BMI. However, they can be as hard to overcome as for example institutional barriers such as governments’ regulations. Implications for research and practice are to focus on cognitive barriers and to develop the BMI capability of the owners and managers of agri-industry firms.

Keywords: agri-food, barriers, business model, innovation

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Authors: Zubdahe Noor, Haseeb Athar

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In this article, first a relation for conditional expectation is developed and then is used to characterize a general class of distributions F(x) = 1-e^(-ah(x)) through conditional expectation of difference of pair of generalized order statistics. Some results are reduced for particular cases. In the end, a list of distributions is presented in the form of table that are compatible with the given general class.

Keywords: generalized order statistics, order statistics, record values, conditional expectation, characterization

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Authors: Abdullah E. Al-Mazrooei

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In this paper, we present a new kind of the bilinear systems in the form of state space model. The evolution of this system depends on the product of state vector by its self. The well known Lotak Volterra and Lorenz models are special cases of this new model. We also present here a generalization of Kalman filter which is suitable to work with the new bilinear model. An application to real measurements is introduced to illustrate the efficiency of the proposed algorithm.

Keywords: bilinear systems, state space model, Kalman filter, application, models

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Authors: Dativa Maria Aliddeki, Fred Monje, Godfrey Nsereko, Benon Kwesiga, Daniel Kadobera, Alex Riolexus Ario

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Background: Cholera is a severe gastrointestinal disease caused by Vibrio cholera. It has caused several pandemics. On 26 February 2018, a suspected cholera outbreak, with one death, occurred in School X in Hoima Municipality, western Uganda. We investigated to identify the scope and mode of transmission of the outbreak, and recommend evidence-based control measures. Methods: We defined a suspected case as onset of diarrhea, vomiting, or abdominal pain in a student or staff of School X or their family members during 14 February–10 March. A confirmed case was a suspected case with V. cholerae cultured from stool. We reviewed medical records at Hoima Hospital and searched for cases at School X. We conducted descriptive epidemiologic analysis and hypothesis-generating interviews of 15 case-patients. In a retrospective cohort study, we compared attack rates between exposed and unexposed persons. Results: We identified 15 cases among 75 students and staff of School X and their family members (attack rate=20%), with onset from 25-28 February. One patient died (case-fatality rate=6.6%). The epidemic curve indicated a point-source exposure. On 24 February, a student brought fried fish from her home in a fishing village, where a cholera outbreak was ongoing. Of the 21 persons who ate the fish, 57% developed cholera, compared with 5.6% of 54 persons who did not eat (RR=10; 95% CI=3.2-33). None of 4 persons who recooked the fish before eating, compared with 71% of 17 who did not recook it, developed cholera (RR=0.0, 95%CIFisher exact=0.0-0.95). Of 12 stool specimens cultured, 6 yielded V. cholerae. Conclusion: This cholera outbreak was caused by eating fried fish, which might have been contaminated with V. cholerae in a village with an ongoing outbreak. Lack of thorough cooking of the fish might have facilitated the outbreak. We recommended thoroughly cooking fish before consumption.

Keywords: cholera, disease outbreak, foodborne, global health security, Uganda

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Authors: Panas Gerasimos, Kotidou Varvara, Halkiopoulos Constantinos, Gkintoni Evgenia

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As a result of growing technology and briefing by the internet, users resort to the internet and subsequently to the opinion of an expert. In many cases, they take control of their health in their hand and make a decision without the contribution of a doctor. According to that, this essay intends to analyze the confidence of searching health issues on the internet. For the fulfillment of this study, there has been a survey among doctors in order to find out the reasons a patient uses the internet about their health problems and the consequences that health information could lead by searching on the internet, as well. Specifically, the results regarding the research of the users demonstrate: a) the majority of users make use of the internet about health issues once or twice a month, b) individuals that possess chronic disease make health search on the internet more frequently, c) the most important topics that the majority of users usually search are pathological, dietary issues and the search of issues that are associated with doctors and hospitals. However, it observed that topic search varies depending on the users’ age, d) the most common sources of information concern the direct contact with doctors, as there is a huge preference from the majority of users over the use of the electronic form for their briefing and e) it has been observed that there is large lack of knowledge about e-health services. From the doctor's point of view, the following conclusions occur: a) almost all doctors use the internet as their main source of information, b) the internet has great influence over doctors’ relationship with the patients, c) in many cases a patient first makes a visit to the internet and then to the doctor, d) the internet significantly has a psychological impact on patients in order to for them to reach a decision, e) the most important reason users choose the internet instead of the health professional is economic, f) the negative consequence that emerges is inaccurate information, g) and the positive consequences are about the possibility of online contact with the doctor and contributes to the easy comprehension of the doctor, as well. Generally, it’s observed from both sides that the use of the internet in health issues is intense, which declares that the new means the doctors have at their disposal, produce the conditions for radical changes in the way of providing services and in the doctor-patient relationship.

Keywords: cognitive models, health marketing, e-health, psychological factors, digital marketing, e-health services

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Authors: Maria M. Calheiros, Carla Silva, Eunice Magalhães

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Professionals working in child protection services (CPS) need to have common and clear criteria to identify cases of maltreatment and to differentiate levels of severity in order to determine when CPS intervention is required, its nature and urgency, and, in most countries, the service that will be in charge of the case (community or specialized CPS). Actually, decision-making process is complex in CPS, and, for that reason, such criteria are particularly important for who significantly contribute to that decision-making in child maltreatment cases. The main objective of this presentation is to describe the Maltreatment Severity Assessment Questionnaire (MSQ), specifically designed to be used by professionals in the CPS, which adopts a multidimensional approach and uses a scale of severity within subtypes. Specifically, we aim to provide evidence of validity and reliability of this tool, in order to improve the quality and validity of assessment processes and, consequently, the decision making in CPS. The total sample was composed of 1000 children and/or adolescents (51.1% boys), aged between 0 and 18 years old (M = 9.47; DP = 4.51). All the participants were referred to official institutions of the children and youth protective system. Children and adolescents maltreatment (abuse, neglect experiences and sexual abuse) were assessed with 21 items of the Maltreatment Severity Questionnaire (MSQ), by professionals of CPS. Each item (sub-type) was composed of four descriptors of increasing severity. Professionals rated the level of severity, using a 4-point scale (1= minimally severe; 2= moderately severe; 3= highly severe; 4= extremely severe). The construct validity of the Maltreatment Severity Questionnaire was assessed with a holdout method, performing an Exploratory Factor Analysis (EFA) followed by a Confirmatory Factor Analysis (CFA). The final solution comprised 18 items organized in three factors 47.3% of variance explained. ‘Physical neglect’ (eight items) was defined by parental omissions concerning the insurance and monitoring of the child’s physical well-being and health, namely in terms of clothing, hygiene, housing conditions and contextual environmental security. ‘Physical and Psychological Abuse’ (four items) described abusive physical and psychological actions, namely, coercive/punitive disciplinary methods, physically violent methods or verbal interactions that offend and denigrate the child, with the potential to disrupt psychological attributes (e.g., self-esteem). ‘Psychological neglect’ (six items) involved omissions related to children emotional development, mental health monitoring, school attendance, development needs, as well as inappropriate relationship patterns with attachment figures. Results indicated a good reliability of all the factors. The assessment of child maltreatment cases with MSQ could have a set of practical and research implications: a) It is a valid and reliable multidimensional instrument to measure child maltreatment, b) It is an instrument integrating the co-occurrence of various types of maltreatment and a within-subtypes scale of severity; c) Specifically designed for professionals, it may assist them in decision-making processes; d) More than using case file reports to evaluate maltreatment experiences, researchers could guide more appropriately their research about determinants and consequences of maltreatment.

Keywords: assessment, maltreatment, children and youth, decision-making

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Authors: Riccardo Cacciotti, Jiri Frankl, Benjamin Wolf, Michael Machacek

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Moisture fluctuations govern the occurrence of fungi-related problems in buildings, which may impose significant health risks for users and even lead to structural failures. Several numerical engineering models attempt to capture the complexity of mold growth on building materials. From real life observations, in cases with suppressed daily variations of boundary conditions, e.g. in crawlspaces, mold growth model predictions well correspond with the observed mold growth. On the other hand, in cases with substantial diurnal variations of boundary conditions, e.g. in the ventilated cavity of a cold flat roof, mold growth predicted by the models is significantly overestimated. This study, founded by the Grant Agency of the Czech Republic (GAČR 20-12941S), aims at gaining a better understanding of mold growth behavior on solid wood, under varying boundary conditions. In particular, the experimental investigation focuses on the response of mold to changing conditions in the boundary layer and its influence on heat and moisture transfer across the surface. The main results include the design and construction at the facilities of ITAM (Prague, Czech Republic) of an innovative device allowing for the simulation of changing environmental conditions in buildings. It consists of a square section closed circuit with rough dimensions 200 × 180 cm and cross section roughly 30 × 30 cm. The circuit is thermally insulated and equipped with an electric fan to control air flow inside the tunnel, a heat and humidity exchange unit to control the internal RH and variations in temperature. Several measuring points, including an anemometer, temperature and humidity sensor, a loading cell in the test section for recording mass changes, are provided to monitor the variations of parameters during the experiments. The research is ongoing and it is expected to provide the final results of the experimental investigation at the end of 2022.

Keywords: moisture, mold growth, testing, wood

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Authors: D. S. Palimkar

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The FRIGDI (functional random integrodifferential inclusion) seems to be new and includes several known random differential inclusions already studied in the literature as special cases have been discussed in the literature for various aspects of the solutions. In this paper, we prove the existence result for FIGDI under the non-convex case of multi-valued function involved in it.Using random fixed point theorem of B. C. Dhage and caratheodory condition. This result is new to the theory of differential inclusion.

Keywords: caratheodory condition, random differential inclusion, random solution, integro-differential inclusion

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Authors: Vaisnavy Govindasamy, Saba Ishrat

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Introduction: The Dexamethasone Intravitreal Implant 0.7 mg (OzurdexTM, Allergan®) is a biodegradable corticosteroid implant approved by the FDA for managing diabetic macular edema (DMO), macular edema following branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO), and posterior segment non-infectious uveitis. This implant can release dexamethasone over a six-month period, exhibiting peak effectiveness between 60 and 90 days post-administration. The intravitreal injection should be performed under sterile conditions. At James Cook University Hospital (JCUH), Ozurdex injections are currently administered in the Vitreo-Retinal (VR) theatre. This study aimed to evaluate the feasibility and potential advantages of establishing a dedicated clinic for Ozurdex administration separate from the VR theatre setting. Method: Retrospectively, data of all Ozurdex injections administered between October 2021 to October 2022 was collected from operating theatre registers at JCUH. Data pertaining to the indications for Ozurdex; waiting times from referral date to date of injection; duration of theatre time consumed; and post-injection complications were collected from electronic notes. The resources needed to establish a dedicated Ozurdex clinic were evaluated. Over a six-month period from October 2023 to March 2024, we gathered data on utilization of theatre 28. Results: A total of 135 Ozurdex injections were administered. Among the indications, uveitis represented 47.3% of cases, DMO with 23.6% and RVO with 22.9%. Remaining cases lacked sufficient data. Each Ozurdex injection procedure consumed 15 minutes in the VR theatre list. Complications arose in 5% of injections, totaling 7 cases. These included glaucoma, ocular hypertension, subconjunctival haemorrhage and implant migration. Waiting times averaged 6 weeks from date for referral to procedure date. We also found that, on an average theatre 28 was offered but remained unused for 4 days, totalling eight sessions in a month. Analysis: Establishing a sperate Ozurdex clinic would improve the quality of patient care in following ways: 1.Decrease injection waiting times (currently averaging 6 weeks), leading to better visual outcomes. 2.Free up approximately three hours of theatre time in Vitreo-Retina theatres each month, allowing for 3-4 additional surgeries. Reduce waiting times for critical retinal surgeries and enhance visual outcomes. 3.Provide additional training opportunities for trainees and retina fellows, improving their skills. 4.Optimize the use of empty theatre slots (theatre 28) currently experiencing underutilization of resources. Conclusion: These findings support the implementation of a separate clinic for administering Ozurdex injections at JCUH. It is evident that introducing a dedicated clinic will enhance operational efficiency, optimise resource utilsation, and improve overall quality of care for patients undergoing this treatment.

Keywords: opthalmology, ozurdex, efficiency, complication

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Authors: Yousef Barahmeh

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This paper is a linguistic and pragmatic analysis of the use of the diminutive in Colloquial Jordanian Arabic (CJA). It demonstrates a peculiar form of the diminutive in CJA inflected by means of feminine plural ends with -aat suffix. The analysis shows that the pragmatic function(s) of the diminutive in CJA refers primarily to ‘littleness’ while the morphological inflection conveys the message of ‘the plethora’. Examples of this linguistic phenomenon are intelligible and often include a large number of words that are culture-specific to the rural dialect in the north of Jordan. In both cases, the diminutive in CJA is an adaptive strategy relative to its pragmatic and social contexts.

Keywords: Colloquial Jordanian Arabic, diminutive, morphology, pragmatics

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Authors: E. Al Daoud

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In many cases, theoretical treatments are available for models for which there is no perfect physical realization. In this situation, the only possible test for an approximate theoretical solution is to compare with data generated from a computer simulation. In this paper, Monte Carlo tools are used to study and compare the elementary particles models. All the experiments are implemented using 10000 events, and the simulated energy is 13 TeV. The mean and the curves of several variables are calculated for each model using MadAnalysis 5. Anomalies in the results can be seen in the muons masses of the minimal supersymmetric standard model and the two Higgs doublet model.

Keywords: Feynman rules, hadrons, Lagrangian, Monte Carlo, simulation

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Authors: Hugo Rodríguez

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Migrations of researchers, scientists, and inventors are a widespread phenomenon in modern times. In some cases, migrants stay linked to research groups in their countries of origin, either out of their own conviction or because of government policies. We examine different linear models of technological development (using the Ordinary Least Squares (OLS) technique) in eight selected countries and find that the collaborations between resident and nonresident patent applicants correlate with different levels of performance of the technological policies in three different scenarios. Therefore, the reinforcement of that link must be considered a powerful tool for technological development.

Keywords: development, collaboration, patents, technology

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Authors: Iris W. A. Boot, Anke Wesselius, Maurice P. Zeegers

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Diet may play an essential role in the aetiology of bladder cancer (BC). Vitamin D is involved in various biological functions which have the potential to prevent BC development. Besides, vitamin D also influences the uptake of calcium and phosphorus , thereby possibly indirectly influencing the risk of BC. The aim of the present study was to investigate the relation between vitamin D intake and BC risk. Individual dietary data were pooled from three cohort studies. Food item intake was converted to daily intakes of vitamin D, calcium and phosphorus. Pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs) were obtained using Cox-regression models. Analyses were adjusted for gender, age and smoking status (Model 1), and additionally for the food groups fruit, vegetables and meat (Model 2). Dose–response relationships (Model 1) were examined using a nonparametric test for trend. In total, 2,871 cases and 522,364 non-cases were included in the analyses. The present study showed an overall increased BC risk for high dietary vitamin D intake (HR: 1.14, 95% CI: 1.03-1.26). A similar increase BC risk with high vitamin D intake was observed among women and for the non-muscle invasive BC subtype, (HR: 1.41, 95% CI: 1.15-1.72, HR: 1.13, 95% CI: 1.01-1.27, respectively). High calcium intake decreased the BC risk among women (HR: 0.81, 95% CI: 0.67-0.97). A combined inverse effect on BC risk was observed for low vitamin D intake and high calcium intake (HR: 0.67, 95% CI: 0.48-0.93), while a positive effect was observed for high vitamin D intake in combination with low, moderate and high phosphorus (HR: 1.31, 95% CI: 1.09-1.59, HR: 1.17, 95% CI: 1.01-1.36, HR: 1.16, 95% CI: 1.03-1.31, respectively). Combining all nutrients showed a decreased BC risk for low vitamin D intake, high calcium and moderate phosphor intake (HR: 0.37, 95% CI: 0.18-0.75), and an increased BC risk for moderate intake of all the nutrients (HR: 1.18, 95% CI: 1.02-1.38), for high vitamin D and low calcium and phosphor intake (HR: 1.28, 95% CI: 1.01-1.62), and for moderate vitamin D and calcium and high phosphorus intake (HR: 1.27, 95% CI: 1.01-1.59). No significant dose-response analyses were observed. The findings of this study show an increased BC risk for high dietary vitamin D intake and a decreased risk for high calcium intake. Besides, the study highlights the importance of examining the effect of a nutrient in combination with complementary nutrients for risk assessment. Future research should focus on nutrients in a wider context and in nutritional patterns.

Keywords: bladder cancer, nutritional oncology, pooled cohort analysis, vitamin D

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Authors: Kai Pai Huang

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Background: There are several types of plasma cell neoplasms including multiple myeloma, plasmacytoma, lymphoplasmacytic lymphoma, and monoclonal gammopathy of undetermined significance (MGUS) are found in our lab. Today, we want to compare with two cases using the method of capillary electrophoresis. Method: Serum is prepared and electrophoresis is performed at alkaline PH in a capillary using the Sebia® Capillary 2. Albumin and globulins are detected by the detector which is located in the cathode of the capillary and the signals are transformed to peaks. Serum was treated with beta-mercaptoethanol which reducing the polymerized immunoglobulin to monomer immunoglobulin to clarify two M-protein are secreted from the same plasma cell clone in bone marrow. Result: Case 1: A 78-year-old female presenting dysuria, oliguria and leg edema for several months. Laboratory data showed proteinuria, leukocytosis, results of high serum IgA and lambda light chain. A renal biopsy found amyloid fibrils in the glomerular mesangial area. Serum protein electrophoresis shows a major monoclonal peak in the β region and minor small peak in gamma region, and the immunotyping studies for serum showed two IgA/λ type. Case 2: A 55-year-old male presenting abdominal distension and low back pain for more than one month. Laboratory data showed T12 T8 compression fracture, results of high serum IgM and kappa light chain. Bone marrow aspiration showed the cells from the bone marrow are B cells with monotypic kappa chain expression. Bone marrow biopsy found this is lymphoplasmacytic lymphoma (Waldenstrom macroglobulin). Serum protein electrophoresis shows a monoclonal peak in the β region and the immunotyping studies for serum showed IgM/κ type. Conclusion: Plasma cell neoplasm can be diagnosed by many examinations. Among them, using capillary electrophoresis by a lab can separate several types of gammopathy and the quantification of a monoclonal peak can be used to evaluate the patients’ prognosis or treatment.

Keywords: plasma cell neoplasm, capillary electrophoresis, serum protein electrophoresis, immunotyping

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Authors: Syed Afrozuddin Ahmed, Junaid Saghir Siddiqi, Sabah Quaiser

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Various studies have reported that global warming causes unstable climate and many serious impact to physical environment and public health. The increasing incidence of dengue incidence is now a priority health issue and become a health burden of Pakistan. In this study it has been investigated that spatial pattern of environment causes the emergence or increasing rate of dengue fever incidence that effects the population and its health. The climatic or environmental structure data and the Dengue Fever (DF) data was processed by coding, editing, tabulating, recoding, restructuring in terms of re-tabulating was carried out, and finally applying different statistical methods, techniques, and procedures for the evaluation. Five climatic variables which we have studied are precipitation (P), Maximum temperature (Mx), Minimum temperature (Mn), Humidity (H) and Wind speed (W) collected from 1980-2012. The dengue cases in Karachi from 2010 to 2012 are reported on weekly basis. Principal component analysis is applied to explore the climatic variables and/or the climatic (structure) which may influence in the increase or decrease in the number of dengue fever cases in Karachi. PC1 for all the period is General atmospheric condition. PC2 for dengue period is contrast between precipitation and wind speed. PC3 is the weighted difference between maximum temperature and wind speed. PC4 for dengue period contrast between maximum and wind speed. Negative binomial and Poisson regression model are used to correlate the dengue fever incidence to climatic variable and principal component score. Relative humidity is estimated to positively influence on the chances of dengue occurrence by 1.71% times. Maximum temperature positively influence on the chances dengue occurrence by 19.48% times. Minimum temperature affects positively on the chances of dengue occurrence by 11.51% times. Wind speed is effecting negatively on the weekly occurrence of dengue fever by 7.41% times.

Keywords: principal component analysis, dengue fever, negative binomial regression model, poisson regression model

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Authors: Sopit Tubtimhin, Chaliya Wamaloon, Anchalee Supattagorn

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Background and Significance: Breast cancer is the most frequently diagnosed and leading cause of cancer death among women. This study aims to determine factors potentially predicting recurrence and long-term survival after the first recurrence in surgically treated patients between postmenopausal and younger women. Methods and Analysis: A retrospective cohort study was performed on 498 Thai women with invasive breast cancer, who had undergone mastectomy and been followed-up at Ubon Ratchathani Cancer Hospital, Thailand. We collected based on a systematic chart audit from medical records and pathology reports between January 1, 2002, and December 31, 2011. The last follow-up time point for surviving patients was December 31, 2016. A Cox regression model was used to calculate hazard ratios of recurrence and death. Findings: The median age was 49 (SD ± 9.66) at the time of diagnosis, 47% was post-menopausal women ( ≥ 51years and not experienced any menstrual flow for a minimum of 12 months), and 53 % was younger women ( ˂ 51 years and have menstrual period). Median time from the diagnosis to the last follow-up or death was 10.81 [95% CI = 9.53-12.07] years in younger cases and 8.20 [95% CI = 6.57-9.82] years in postmenopausal cases. The recurrence-free survival (RFS) for younger estimates at 1, 5 and 10 years of 95.0 %, 64.0% and 58.93% respectively, appeared slightly better than the 92.7%, 58.1% and 53.1% for postmenopausal women [HRadj = 1.25, 95% CI = 0.95-1.64]. Regarding overall survival (OS) for younger at 1, 5 and 10 years were 97.7%, 72.7 % and 52.7% respectively, for postmenopausal patients, OS at 1, 5 and 10 years were 95.7%, 70.0% and 44.5 respectively, there were no significant differences in survival [HRadj = 1.23, 95% CI = 0.94 -1.64]. Multivariate analysis identified five risk factors for negatively impacting on survival were triple negative [HR= 2.76, 95% CI = 1.47-5.19], Her2-enriched [HR = 2.59, 95% CI = 1.37-4.91], luminal B [HR = 2.29, 95 % CI=1.35-3.89], not free margin [HR = 1.98, 95%CI=1.00-3.96] and patients who received only adjuvant chemotherapy [HR= 3.75, 95% CI = 2.00-7.04]. Statistically significant risks of overall cancer recurrence were Her2-enriched [HR = 5.20, 95% CI = 2.75-9.80], triple negative [HR = 3.87, 95% CI = 1.98-7.59], luminal B [HR= 2.59, 95% CI = 1.48-4.54,] and patients who received only adjuvant chemotherapy [HR= 2.59, 95% CI = 1.48-5.66]. Discussion and Implications: Outcomes from this studies have shown that postmenopausal women have been associated with increased risk of recurrence and mortality. As the results, it provides useful information for planning the screening and treatment of early-stage breast cancer in the future.

Keywords: breast cancer, menopause status, recurrence-free survival, overall survival

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Authors: Teresita Lopez Joy, Jose A. Acevedo Suarez, Martha I. Gomez Acosta, Ana Julia Acevedo Urquiaga

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Current trends in business competitiveness indicate the need to manage businesses as supply chains and not in isolation. The use of strategies aimed at maximum satisfaction of customers in a network and based on inter-company cooperation; contribute to obtaining successful joint results. In the Cuban economic context, the development of productive linkages to achieve integrated management of supply chains is considering a key aspect. In order to achieve this jump, it is necessary to develop acting capabilities in the entities that make up the chains through a systematic procedure that allows arriving at a management model in consonance with the environment. The objective of the research focuses on: designing a model and procedure for the development of integrated management of supply chains in economic entities. The results obtained are: the Model and the Procedure for the Development of the Supply Chains Integrated Management (MP-SCIM). The Model is based on the development of logistics in the network actors, the joint work between companies, collaborative planning and the monitoring of a main indicator according to the end customers. The application Procedure starts from the well-founded need for development in a supply chain and focuses on training entrepreneurs as doers. The characterization and diagnosis is done to later define the design of the network and the relationships between the companies. It takes into account the feedback as a method of updating the conditions and way to focus the objectives according to the final customers. The MP-SCIM is the result of systematic work with a supply chain approach in companies that have consolidated as coordinators of their network. The cases of the edible oil chain and explosives for construction sector reflect results of more remarkable advances since they have applied this approach for more than 5 years and maintain it as a general strategy of successful development. The edible oil trading company experienced a jump in sales. In 2006, the company started the analysis in order to define the supply chain, apply diagnosis techniques, define problems and implement solutions. The involvement of the management and the progressive formation of performance capacities in the personnel allowed the application of tools according to the context. The company that coordinates the explosives chain for construction sector shows adequate training with independence and opportunity in the face of different situations and variations of their business environment. The appropriation of tools and techniques for the analysis and implementation of proposals is a characteristic feature of this case. The coordinating entity applies integrated supply chain management to its decisions based on the timely training of the necessary action capabilities for each situation. Other cases of study and application that validate these tools are also detailed in this paper, and they highlight the results of generalization in the quantitative and qualitative improvement according to the final clients. These cases are: teaching literature in universities, agricultural products of local scope and medicine supply chains.

Keywords: integrated management, logistic system, supply chain management, tactical-operative planning

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Authors: Chun-Liang Wu, Kai-Ping Shaw, Cheng-Ping Yu, Wu-Chien Chien, Hsiao-Ting Chen, Shao-Huang Wu

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Objective: This study analyzed three criminal judicial cases. We applied the damage analysis of the two vehicles to verify other evidence, such as dashboard camera records of each accident, reconstruct the scenes, and pursue the truth. Methods: Evidence analysis, the method is to collect evidence and the reason for the results in judicial procedures, then analyze the involved damage evidence to verify other evidence. The collision damage analysis method is to inspect the damage to the vehicles and utilize the principles of tool mark analysis, Newtonian physics, and vehicle structure to understand the relevant factors when the vehicles collide. Results: Case 1: Sedan A turned right at the T junction and collided with Scooter B, which was going straight on the left road. The dashboard camera records showed that the left side of Sedan A’s front bumper collided with the body of Scooter B and rider B. After the analysis of the study, the truth was that the front of the left side of Sedan A impacted the right pedal of Scooter B and the right lower limb of rider B. Case 2: Sedan C collided with Scooter D on the left road at the crossroads. The dashboard camera record showed that the left side of the Sedan C’s front bumper collided with the body of Scooter D and rider D. After the analysis of the study, the truth was that the left side of the Sedan C impacted the left side of the car body and the front wheel of Scooter D and rider D. Case 3: Sedan E collided with Scooter F on the right road at the crossroads. The dashboard camera record showed that the right side of the Sedan E’s front bumper collided with the body of Scooter F and rider F. After the analysis of the study, the truth was that the right side of the front bumper and the right side of the Sedan F impacted the Scooter. Conclusion: The application of collision damage analysis in the reconstruction of a sedan-scooter collision could discover the truth and provide the basis for judicial justice. The cases and methods could be the reference for the road safety policy.

Keywords: evidence analysis, collision damage analysis, accident reconstruction, sedan-scooter collision, dashboard camera records

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Authors: Girma Y. Iyassu Menelik

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The international community has gone through indescribable atrocities resulting from acts of war. These atrocities turned Europe and Africa into a wilderness of bloodshed and crime. In the period 1960- 1970s Africa witnessed unprecedented and well-documented assaults on life and property. This necessitated the adoption, signing and ratification of the International Criminal Court, establishment of the International Court of Justice which is a great achievement for the protection and fulfilling of human rights in the context of international political instability. The ICC came as an important opportunity to advance justice for serious crimes committed in violation of international law. Thus the Rome statute has become a formidable contribution to peace and security. There are concerns that the ICC is targeting African states. However, the ICC cannot preside over cases that are not parties to the Rome statute unless the UN Security council refers the situation or the relevant state asks the court to become involved. The instable international political situation thus deals with criminal prosecutions where amnesty is not permissible or is strongly repudiated. The court has become important justice instruments for states that are unable or unwilling to fulfill their obligation to address legacies of massive human rights violations. The ICJ as a court has a twofold role; to settle legal disputes submitted to it by states, and to give advisory opinions on legal questions referred to it by duly authorized United Nations organs and specialized agencies. All members of the UN are ipso facto parties to the statute of the ICJ. The court gives advisory opinion on any legal question. These courts are the most appropriate fora to pronounce on international crimes and are in a better position to know and apply international law. Cases that have been brought to the courts include Rwanda’s genocide, Liberia’s Charles Taylor etc. The receptiveness and cooperation of the local populations are important to the courts and if the ICC and ICJ can provide appropriate protections for the physical and economic safety of victims then peace and human rights observance can be attained. This paper will look into the effectiveness and impediments of these courts in handling criminal and injustices in international politics as while as what needs to be done to strengthen the capacity of these courts.

Keywords: ICC, international politics, justice, UN security council, violence, protection, fulfilling

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Authors: David Mafullul, Jiang Lei, Edward Goacher, Jibin Francis

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PURPOSE: Timely decompressive surgery for cauda equina syndrome (CES) is dependent on efficient referral pathways for patients presenting at local primary or secondary centres to tertiary spinal centres in the United Kingdom (UK). Identifying modifiable points of delay within this process is important as minimising time between presentation and surgery may improve patient outcomes. This study aims to analyse whether adequacy of referral impacts on time to surgery in CES. MATERIALS AND METHODS: Data from all cases of confirmed CES referred to a single tertiary UK hospital between August 2017 to December 2019, via a suspected CES e-referral pathway, were obtained retrospectively. Referral adequacy was defined by the inclusion of sufficient information to determine the presence or absence of several NICE ‘red flags’. Correlation between referral adequacy and delay from referral-to-surgery was then analysed. RESULTS: In total, 118 confirmed CES cases were included. Adequate documentation for saddle anaesthesia was associated with reduced delays of more than 48 hours from referral-to-surgery [X2(1, N=116)=7.12, p=.024], an effect partly attributable to these referrals being accepted sooner [U=16.5; n1=27, n2=4, p=.029, r=.39]. Other red flags had poor association with delay. Referral adequacy was better for somatic red flags [bilateral sciatica (97.5%); severe or progressive bilateral neurological deficit of the legs (95.8%); saddle anaesthesia (91.5%)] compared to autonomic red flags [loss of anal tone (80.5%); urinary retention (79.7%); faecal incontinence or lost sensation of rectal fullness (57.6%)]. Although referral adequacy for urinary retention was 79.7%, only 47.5% of referrals documented a post-void residual numerical value. CONCLUSIONS: Adequate documentation of saddle anaesthesia in e-referrals is associated with reduced delay-to-surgery for confirmed CES, partly attributable to these referrals being accepted sooner. Other red flags had poor association with delay to surgery. Referral adequacy for autonomic red flags, including documentation for post-void residuals, has significant room for improvement.

Keywords: cauda equina, cauda equina syndrome, neurosurgery, spinal surgery, decompression, delay, referral, referral adequacy

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Authors: Angelo I. Aquino, Luis Ma. T. Bo-ot

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We use the Homotopy Analysis Method (HAM) to solve the system of equations modeling the two-level system and extract results which will pinpoint to turbulent behavior. We look at multi-valued solutions as indicative of turbulence or turbulent-like behavior. We take dierent specic cases which result in multi-valued velocities. The solutions are in series form and application of HAM ensures convergence in some region.

Keywords: multivalued solutions, homotopy analysis method, two-level system, equation

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Authors: Mahmoudi Noureddine, Kaou Abdellah

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Energy absorption is a major requirement for automotive structures. Although crashworthy structures of composite based glass fiber have exhibited energy absorption greater than similar at other composites structures, the crush process in many cases is accompanied by fracture, rather than by plastic deformation. The crash experiments show that the tubes are crushed in progressive manner start from one end of the tubes and delamination takes place between the layers. To better understand details of the crash process, ABAQUS finite element code is used.

Keywords: Energy absorption, crash, PEHD

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Authors: Krunal Thakar

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Wire ropes combine high tensile strength and flexibility as compared to other general steel products. They are used in various application areas such as cranes, mining, elevators, bridges, cable cars, etc. The earliest reported use of wire ropes was for mining hoist application in 1830s. Over the period, there have been substantial advancement in the design of wire ropes for various application areas. Under operational conditions, wire ropes are subjected to varying tensile loads and bending loads resulting in material wear and eventual structural failure due to fretting fatigue. The conventional inspection methods to determine wire failure is only limited to outer wires of rope. However, till date, there is no effective mathematical model to examine the inter wire contact forces and wear characteristics. The scope of this paper is to present a computational simulation technique to evaluate inter wire contact forces and wear, which are in many cases responsible for rope failure. Two different type of ropes, IWRC-6xFi(29) and U3xSeS(48) were taken for structural strength evaluation and wear prediction. Both ropes have a double helix twisted wire profile as per JIS standards and are mainly used in cranes. CAD models of both ropes were developed in general purpose design software using in house developed formulation to generate double helix profile. Numerical simulation was done under two different load cases (a) Axial Tension and (b) Bending over Sheave. Different parameters such as stresses, contact forces, wear depth, load-elongation, etc., were investigated and compared between both ropes. Numerical simulation method facilitates the detailed investigation of inter wire contact and wear characteristics. In addition, various selection parameters like sheave diameter, rope diameter, helix angle, swaging, maximum load carrying capacity, etc., can be quickly analyzed.

Keywords: steel wire ropes, numerical simulation, material wear, structural strength, axial tension, bending over sheave

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Authors: Avani Jain, S. Shelley, M. Indirani, Shilpa Kalal, Jaykanth Amalachandran

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Aim: To evaluate the prevalence of gall bladder dysfunction in patients with dyspepsia using In-House fatty meal cholescintigraphy. Materials & Methods: This study is a prospective cohort study. 59 healthy volunteers with no dyspeptic complaints and negative ultrasound and endoscopy were recruited in study. 61 patients having complaint of dyspepsia for duration of more than 6 months were included. All of them underwent 99mTc-Mebrofenin fatty meal cholescintigraphy following a standard protocol. Dynamic acquisitions were acquired for 120 minutes with an In-House fatty meal being given at 45th minute. Gall bladder emptying kinetics was determined with gall bladder ejection fractions (GBEF) calculated at 30minutes, 45minutes and at 60 minutes (30min, 45min & 60 min). Standardization of fatty meal was done for volunteers. Receiver operating characteristic (ROC) analysis was used assess the diagnostic accuracy of 3 time points (30min, 45min & 60 min) used for measuring gall bladder emptying. On the basis of cut off derived from volunteers, the patients were assessed for gall bladder dysfunction. Results: In volunteers, the GBEF at 30 min was 74.42±8.26 % (mean ±SD), at 45 min was 82.61 ± 6.5 % and at 60 min was 89.37±4.48%, compared to patients where at 30min it was 33.73±22.87%, at 45 min it was 43.03±26.97% and at 60 min it was 51.85±29.60%. The lower limit of GBEF in volunteers at 30 min was 60%, 45 min was 69% and at 60 min was 81%. ROC analysis showed that area under curve was largest for 30 min GBEF (0.952; 95% CI = 0.914-0.989) and that all the 3 measures were statistically significant (p < 0.005). Majority of the volunteers had 74% of gall bladder emptying by 30 minutes; hence it was taken as an optimum cutoff time to assess gall bladder contraction. > 60% GBEF at 30 min post fatty meal was considered as normal and < 60% GBEF as indicative of gall bladder dysfunction. In patients, various causes for dyspepsia were identified: GB dysfunction (63.93%), Peptic ulcer (8.19 %), Gastroesophageal reflux disease (8.19%), Gastritis (4.91%). In 18.03% of cases GB dysfunction coexisted with other gastrointestinal conditions. The diagnosis of functional dyspepsia was made in 14.75% of cases. Conclusions: Gall bladder dysfunction contributes significantly to the causation of dyspepsia. It could coexist with various other gastrointestinal diseases. Fatty meal was well tolerated and devoid of any side effects. Many patients who are labeled as functional dyspeptics could actually have gall bladder dysfunction. Hence as an adjunct to ultrasound and endoscopy, fatty meal cholescintigraphy can also be used as a screening modality in characterization of dyspepsia.

Keywords: in-house fatty meal, choescintigraphy, dyspepsia, gall bladder ejection fraction, functional dyspepsia

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Authors: Hilly Moodrick-Even Khen

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This study analyzes the legal regulation of the use of force in international law in the context of three emerging Palestinian forms of struggle against Israeli occupation: the Knife Intifada, Gaza border disturbances, and the launching of incendiary kites. It discusses what legal paradigms or concepts should regulate the type and level of force used in each situation—a question that is complicated by various dilemmas—and appraises the Israel Defence Forces policies tailored in response. Methodologically, the study is based on analysis of scholarship on the conceptual legal issues as well as dicta of the courts. It evaluates the applicability of two legal paradigms regulating the use of force in military operations—(i) the conduct of hostilities and (ii) law enforcement—as well as the concept of self-defense in international law and the escalation of force procedure. While the “Knife Intifada” clearly falls under the law enforcement paradigm, the disturbances at the border and the launching of incendiary kites raise more difficult questions, as applying law enforcement, especially in the latter case, can have undesirable ramifications for safeguarding humanitarian interests. The use of force in the cases of the border disturbances and the incendiary kites should thus be regulated, mutatis mutandis, by the concept of self-defense and escalation of force procedures; and in the latter case, the hostilities paradigm can also be applied. The study provides a factual description and analysis of the background and nature of the forms of struggle in Gaza and the West Bank—in each case surveying the geo-political developments since operation Protective Edge, contextualizing how the organized and unorganized violent activities evolved, and analyzing them in terms of level of organization and intensity. It then presents the two paradigms of the use of force—law enforcement and conduct of hostilities—and the concept of self-defense. Lastly, it uses the factual findings as the basis for legally analyzing which paradigm or concept regulating the use of force applies for each form of struggle. The study concludes that in most cases, the concept of self-defense is preferable to the hostilities or the law enforcement paradigms, as it best safeguards humanitarian interests and ensures the least loss of civilian lives.

Keywords: Israeli-Palestinian conflict, self defense, terrorism, use of force

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Authors: Ashenafi Ayele, Shewit Haftu, Tesfalem Araya

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Background: “Post-psychotic depression”, “post schizophrenic depression”, and “secondary depression” have been used to describe the occurrence of depressive symptoms during the chronic phase of schizophrenia. Post-psychotic depression is the most common cause of death due to suicide in schizophrenia patients. Overall lifetime risk for patients with schizophrenia is 50% for suicide attempts and 9-13% lifetime risk for completed suicide and also it is associated with poor prognosis and poor quality of life. Objective: To assess determinant of post psychotic depression in schizophrenia patients ACSH and Mekelle General Hospital, Tigray Ethiopia 2019. Methods: An institutional based unmatched case control study was conducted among 69 cases and 138 controls with the ratio of case to control 1 ratio 2. The sample is calculated using epi-info 3.1 to assess the determinant factors of post-psychotic depression in schizophrenia patients. The cases were schizophrenia patients who have been diagnosed at least for more than one-year stable for two months, and the controls are any patients who are diagnosed as schizophrenia patients. Study subjects were selected using a consecutive sampling technique. The Calgary depression scale for schizophrenia self-administered questionnaire was used. Before the interview, it was assessed the client’s capacity to give intended information using a scale called the University of California, San Diego Brief Assessment of Capacity to Consent (UBACC). Bivariant and multiple Logistic regression analysis was performed to determine between the independent and dependent variables. The significant independent predictor was declared at 95% confidence interval and P-value of less than 0.05. Result: Females were affected by post psychotic depression with the (AOR=2.01, 95%CI: 1.003- 4.012, P= 0.49).Patients who have mild form of positive symptom of schizophrenia affected by post psychotic depression with (AOR =4.05, 95%CI: 1.888- 8.7.8, P=0001).Patients who have minimal form of negative symptom of schizophrenia are affected by post psychotic depression with (AOR =4.23, 95%CI: 1.081-17.092, P=.038). Conclusion: In this study, sex (female) and presence of positive and negative symptoms of schizophrenia were significantly associated. It is recommended that the post psychotic depression should be assessed in every schizophrenia patient to decrease the severity of illness, and to improve patient’s quality of life.

Keywords: determinants, post-psychotic depression, Mekelle city

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