Search results for: complex trauma

Authors: Bello Gonzalez, Setten Van M., Brouwer M.

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The chicken small intestine represents a dynamic and complex organ in which the enzymatic digestion and absorption of nutrients take place. The development of an in vitro fermentation chicken small intestinal model could be used as an alternative to explore the interaction between the microbiota and nutrient metabolism and to enhance the efficacy of targeting interventions to improve animal health. In the present study we have developed an in vitro fermentation chicken ileum microbiota model for unrevealing the complex interaction of ileum microbial community under physiological conditions. A two-vessel continuous fermentation process simulating in real-time the physiological conditions of the ileum content (pH, temperature, microaerophilic/anoxic conditions, and peristaltic movements) has been standardized as a proof of concept. As inoculum, we use a pool of ileum microbial community obtained from chicken broilers at the age of day 14. The development and validation of the model provide insight into the initial characterization of the ileum microbial community and its dynamics over time-related to nutrient assimilation and fermentation. Samples can be collected at different time points and can be used to determine the microbial compositional structure, dynamics, and diversity over time. The results of studies using this in vitro model will serve as the foundation for the development of a whole small intestine in vitro fermentation chicken gastrointestinal model to complement our already established in vitro fermentation chicken caeca model. The insight gained from this model could provide us with some information about the nutritional strategies to restore and maintain chicken gut homeostasis. Moreover, the in vitro fermentation model will also allow us to study relationships between gut microbiota composition and its dynamics over time associated with nutrients, antimicrobial compounds, and disease modelling.

Keywords: broilers, in vitro model, ileum microbiota, fermentation

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Authors: Anastasia Sorokina

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Graduate language loss or attrition has been well documented in individuals who migrate and become emersed in a different language environment. This phenomenon of first language (L1) attrition is an example of non-pathological (not due to trauma) and can manifest itself in frequent pauses, search for words, or grammatical errors. While the widely experienced loss of one’s first language might seem harmless, there is convincing evidence from the disciplines of Developmental Psychology, Bilingual Studies, and even Psychotherapy that language plays a crucial role in the memory of self. In fact, we remember, store, and share personal memories with the help of language. Dual-Coding Theory suggests that language memory code deterioration could lead to forgetting. Yet, no one has investigated a possible connection between language loss and memory. The present study aims to address this research gap by examining a corpus of 1,495 memories of Russian-English bilinguals who are on a continuum of L1 (first language) attrition. Since phenomenological properties capture how well a memory is remembered, the following descriptors were selected - vividness, ease of recall, emotional valence, personal significance, and confidence in the event. A series of linear regression statistical analyses were run to examine the possible negative effects of L1 attrition on autobiographical memory. The results revealed that L1 attrition might compromise perceived vividness and confidence in the event, which is indicative of memory deterioration. These findings suggest the importance of heritage language maintenance in immigrant communities who might be forced to assimilate as language loss might negatively affect the memory of self.

Keywords: L1 attrition, autobiographical memory, language loss, memory phenomenology, dual coding

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Authors: Benjamin J. Kuo, Silvia D. Vaca, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Lydia Nanjula, Christine Muhumuza, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

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Background: Traumatic Brain Injury (TBI) is disproportionally concentrated in low- and middle-income countries (LMICs), with the odds of dying from TBI in Uganda more than 4 times higher than in high income countries (HICs). The disparities in the injury incidence and outcome between LMICs and resource-rich settings have led to increased health outcomes research for TBIs and their associated risk factors in LMICs. While there have been increasing TBI studies in LMICs over the last decade, there is still a need for more robust prospective registries. In Uganda, a trauma registry implemented in 2004 at the Mulago National Referral Hospital (MNRH) showed that RTI is the major contributor (60%) of overall mortality in the casualty department. While the prior registry provides information on injury incidence and burden, it’s limited in scope and doesn’t follow patients longitudinally throughout their hospital stay nor does it focus specifically on TBIs. And although these retrospective analyses are helpful for benchmarking TBI outcomes, they make it hard to identify specific quality improvement initiatives. The relationship among epidemiology, patient risk factors, clinical care, and TBI outcomes are still relatively unknown at MNRH. Objective: The objectives of this study are to describe the processes of care and determine risk factors predictive of poor outcomes for TBI patients presenting to a single tertiary hospital in Uganda. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Research Electronic Data Capture (REDCap) was used to systematically collect variables spanning 8 categories. Univariate and multivariate analysis were conducted to determine significant predictors of mortality. Results: 563 TBI patients were enrolled from 1 June – 30 November 2016. 102 patients (18%) received surgery, 29 patients (5.1%) intended for surgery failed to receive it, and 251 patients (45%) received non-operative management. Overall mortality was 9.6%, which ranged from 4.7% for mild and moderate TBI to 55% for severe TBI patients with GCS 3-5. Within each TBI severity category, mortality differed by management pathway. Variables predictive of mortality were TBI severity, more than one intracranial bleed, failure to receive surgery, high dependency unit admission, ventilator support outside of surgery, and hospital arrival delayed by more than 4 hours. Conclusions: The overall mortality rate of 9.6% in Uganda for TBI is high, and likely underestimates the true TBI mortality. Furthermore, the wide-ranging mortality (3-82%), high ICU fatality, and negative impact of care delays suggest shortcomings with the current triaging practices. Lack of surgical intervention when needed was highly predictive of mortality in TBI patients. Further research into the determinants of surgical interventions, quality of step-up care, and prolonged care delays are needed to better understand the complex interplay of variables that affect patient outcome. These insights guide the development of future interventions and resource allocation to improve patient outcomes.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

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Authors: Siva K. Bathina, Sudheer Siddapureddy

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Pool fires are formed when the flammable liquid accidentally spills on the ground or water and ignites. Pool fire is a kind of buoyancy-driven and diffusion flame. There have been many pool fire accidents caused during processing, handling and storing of liquid fuels in chemical and oil industries. Such kind of accidents causes enormous damage to property as well as the loss of lives. Pool fires are complex in nature due to the strong interaction among the combustion, heat and mass transfers and pyrolysis at the fuel surface. Moreover, the experimental study of such large complex fires involves fire safety issues and difficulties in performing experiments. In the present work, large eddy simulations are performed to study such complex fire scenarios using fire dynamic simulator. A 1 m diesel pool fire is considered for the studied cases, and diesel is chosen as it is most commonly involved fuel in fire accidents. Fire simulations are performed by specifying two different boundary conditions: one the fuel is in liquid state and pyrolysis model is invoked, and the other by assuming the fuel is initially in a vapor state and thereby prescribing the mass loss rate. A domain of size 11.2 m × 11.2 m × 7.28 m with uniform structured grid is chosen for the numerical simulations. Grid sensitivity analysis is performed, and a non-dimensional grid size of 12 corresponding to 8 cm grid size is considered. Flame properties like mass burning rate, irradiance, and time-averaged axial flame temperature profile are predicted. The predicted steady-state mass burning rate is 40 g/s and is within the uncertainty limits of the previously reported experimental data (39.4 g/s). Though the profile of the irradiance at a distance from the fire along the height is somewhat in line with the experimental data and the location of the maximum value of irradiance is shifted to a higher location. This may be due to the lack of sophisticated models for the species transportation along with combustion and radiation in the continuous zone. Furthermore, the axial temperatures are not predicted well (for any of the boundary conditions) in any of the zones. The present study shows that the existing models are not sufficient enough for modeling blended fuels like diesel. The predictions are strongly dependent on the experimental values of the soot yield. Future experiments are necessary for generalizing the soot yield for different fires.

Keywords: burning rate, fire accidents, fire dynamic simulator, pyrolysis

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Authors: Emma Avoyan

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The safety standards for flood protection in the Netherlands have been revised recently. It is expected that all major flood-protection structures will have to be reinforced to meet the new standards. The Dutch Flood Protection Programme aims at accomplishing this task through innovative integrated projects such as construction of multi-functional flood defenses. In these projects, flood safety purposes will be combined with spatial planning, nature development, emergency management or other sectoral objectives. Therefore, implementation of dike reinforcement projects requires early involvement and collaboration between public and private sectors, different governmental actors and agencies. The development and implementation of such integrated projects has been an issue in Dutch flood risk management since long. Therefore, this article analyses how cross-sector collaboration within flood risk governance in the Netherlands has evolved over time, and how this development can be explained. The integrative framework for collaborative governance is applied as an analytical tool to map external factors framing possibilities as well as constraints for cross-sector collaboration in Dutch flood risk domain. Supported by an extensive document and literature analysis, the paper offers insights on how the system context and different drivers changing over time either promoted or hindered cross-sector collaboration between flood protection sector, urban development, nature conservation or any other sector involved in flood risk governance. The system context refers to the multi-layered and interrelated suite of conditions that influence the formation and performance of complex governance systems, such as collaborative governance regimes, whereas the drivers initiate and enable the overall process of collaboration. In addition, by applying a method of process tracing we identify a causal and chronological chain of events shaping cross-sectoral interaction in Dutch flood risk management. Our results indicate that in order to evaluate the performance of complex governance systems, it is important to firstly study the system context that shapes it. Clear understanding of the system conditions and drivers for collaboration gives insight into the possibilities of and constraints for effective performance of complex governance systems. The performance of the governance system is affected by the system conditions, while at the same time the governance system can also change the system conditions. Our results show that the sequence of changes within the system conditions and drivers over time affect how cross-sector interaction in Dutch flood risk governance system happens now. Moreover, we have traced the potential of this governance system to shape and change the system context.

Keywords: collaborative governance, cross-sector interaction, flood risk management, the Netherlands

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Authors: Yemane Hailu Fissuh, Zhongzhan Zhang

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An estimating equation technique is an alternative method of the widely used maximum likelihood methods, which enables us to ease some complexity due to the complex characteristics of time-varying covariates. In the situations, when both the time-varying covariates and left-truncation are considered in the model, the maximum likelihood estimation procedures become much more burdensome and complex. To ease the complexity, in this study, the modified estimating equations those have been given high attention and considerations in many researchers under semiparametric transformation model was proposed. The purpose of this article was to develop the modified estimating equation under flexible and general class of semiparametric transformation models for left-truncated and right censored survival data with time-varying covariates. Besides the commonly applied Cox proportional hazards model, such kind of problems can be also analyzed with a general class of semiparametric transformation models to estimate the effect of treatment given possibly time-varying covariates on the survival time. The consistency and asymptotic properties of the estimators were intuitively derived via the expectation-maximization (EM) algorithm. The characteristics of the estimators in the finite sample performance for the proposed model were illustrated via simulation studies and Stanford heart transplant real data examples. To sum up the study, the bias for covariates has been adjusted by estimating density function for the truncation time variable. Then the effect of possibly time-varying covariates was evaluated in some special semiparametric transformation models.

Keywords: EM algorithm, estimating equation, semiparametric transformation models, time-to-event outcomes, time varying covariate

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Authors: Hamish de Nett

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On 23rd June 2018, twelve young footballers from the Wild Boar Academy and their coach went to explore the Tham Luang cave in the Doi Nang Non mountain range in Chiang Rai Province, Northern Thailand. Whilst they were inside the cave, monsoon rains hit, and the complex became partially flooded. In the following days, Thai Navy SEALs and an international team of expert divers assembled at the cave complex in order to rescue the boys. Although it was only marginally reported in the Western press, Buddhism and ritual activities played a major role in the rescue and its aftermath. This paper utilises numerous news articles and books written by reporters who covered the cave rescue to uncover what the place of Buddhism was in the Tham Luang cave rescue. This paper initially sets out the development of Thai Buddhism and the Thai nation state, paying particular note to the tension in Thai Buddhism between Buddhism as it is popularly practised and normative, state-favoured Buddhism. Secondly, this paper demonstrates that, during the Tham Luang cave rescue, Buddhism helped people cope with the disaster, provided an explanation for its occurrence, and allowed bystanders some efficacy in the process. Thirdly, this paper discusses how Buddhism helped people to give thanks after the rescue, achieve reconciliation, and gain closure. Finally, this paper analyses how the government and the political sphere utilised Buddhism during the rescue. The conclusion reached is that the Buddhism practiced during the Tham Luang cave rescue and its aftermath is representative of the wider tension between popular Buddhism and normative state-favoured Buddhism that is currently present within Thai Buddhism and has been for centuries.

Keywords: cave rescue, contemporary Buddhism, lived religion, Thai Buddhism, Tham Luang cave rescue

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Authors: Bouayachi Ali, Alikouss Saida, Baroudi Zouhir, Zerhouni Youssef, Zouhair Mohammed, El Idrissi Assia, Essalhi Mourad

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The world-class Imiter silver deposit is located on the northern flank of the Precambrian Imiter buttonhole. This deposit is formed by epithermal veins hosted in the sandstone-pelite formations of the lower complex and in the basic conglomerates of the upper complex, these veins are controlled by a regional scale fault cluster, oriented N70°E to N90°E. The present work on the contribution of remote sensing on the geological mapping of the Imiter buttonhole and application to the mineralized structures of the Principal Corps B3. Mapping on satellite images is a very important tool in mineral prospecting. It allows the localization of the zones of interest in order to orientate the field missions by helping the localization of the major structures which facilitates the interpretation, the programming and the orientation of the mining works. The predictive map also allows for the correction of field mapping work, especially the direction and dimensions of structures such as dykes, corridors or scrapings. The use of a series of processing such as SAM, PCA, MNF and unsupervised and supervised classification on a Landsat 8 satellite image of the study area allowed us to highlight the main facies of the Imite area. To improve the exploration research, we used another processing that allows to realize a spatial distribution of the alteration mineral indices, and the application of several filters on the different bands to have lineament maps.

Keywords: principal corps B3, teledetection, Landsat 8, Imiter II, silver mineralization, lineaments

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Authors: Shivani Tiwari, Prathibha Karanth, B. Rajashekhar

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Impairments of syntactic morphology are often considered central in children with Specific Language Impairment (SLI). In English and related languages, deficits of tense-related grammatical morphology could serve as a clinical marker of SLI. Yet, cross-linguistic studies on SLI in the recent past suggest that the nature and severity of morphosyntactic deficits in children with SLI varies with the language being investigated. Therefore, in the present study we investigated the morphosyntactic deficits in a group of children with SLI who speak Kannada, a morphologically complex Dravidian language spoken in Indian subcontinent. A group of 15 children with SLI participated in this study. Two more groups of typical developing children (15 each) matched for language and age to children with SLI, were included as control participants. All participants were assessed for morphosyntactic comprehension and expression using standardized language test and a spontaneous speech task. Results of the study showed that children with SLI differed significantly from age-matched but not language-matched control group, on tasks of both comprehension and expression of morphosyntax. This finding is, however, in contrast with the reports of English-speaking children with SLI who are reported to be poorer than younger MLU-matched children on tasks of morphosyntax. The observed difference in impairments of morphosyntax in Kannada-speaking children with SLI from English-speaking children with SLI is explained based on the morphological richness theory. The theory predicts that children with SLI perform relatively better in morphologically rich language due to occurrence of their frequent and consistent features that mark the morphological markers. The authors, therefore, conclude that language-specific features do influence manifestation of the disorder in children with SLI.

Keywords: specific language impairment, morphosyntax, Kannada, manifestation

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Authors: Abdul Waris Jalili, Yanqing Wang, Som Suor

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This research paper explores the relationship between entrepreneurship education and students' entrepreneurial intentions. It aims to determine if entrepreneurship education reliably predicts students' intention to become entrepreneurs and how and when this relationship occurs. This study aims to investigate the predictive relationship between entrepreneurship education and student entrepreneurial intentions. The goal is to understand the factors that influence this relationship and to identify any mediating or moderating factors. A thorough and systematic search and review of empirical articles published between 2013 and 2023 were conducted. Three databases, Google Scholar, Science Direct, and PubMed, were explored to gather relevant studies. Criteria such as reporting empirical results, publication in English, and addressing the research questions were used to select 35 papers for analysis. The collective findings of the reviewed studies suggest a generally positive relationship between entrepreneurship education and student entrepreneurial intentions. However, recent findings indicate that this relationship may be more complex than previously thought. Mediators and moderators have been identified, highlighting instances where entrepreneurship education indirectly influences student entrepreneurial intentions. The review also emphasizes the need for more robust research designs to establish causality in this field. This research adds to the existing literature by providing a comprehensive review of the relationship between entrepreneurship education and student entrepreneurial intentions. It highlights the complexity of this relationship and the importance of considering mediators and moderators. The study also calls for future research to explore different facets of entrepreneurship education independently and examine complex relationships more comprehensively.

Keywords: entrepreneurship, entrepreneurship education, entrepreneurial intention, entrepreneurial self-efficacy

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Authors: A. Cerrato Casado, C. Guigou, P. Jean

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In this investigation, the particle swarm optimization (PSO) algorithm is used to perform the inversion of the dispersion curves in the spectral analysis of surface waves (SASW) method. This inverse problem usually presents complicated solution spaces with many local minima that make difficult the convergence to the correct solution. PSO is a metaheuristic method that was originally designed to simulate social behavior but has demonstrated powerful capabilities to solve inverse problems with complex space solution and a high number of variables. The dispersion curve of the synthetic soils is constructed by the vertical flexibility coefficient method, which is especially convenient for soils where the stiffness does not increase gradually with depth. The reason is that these types of soil profiles are not normally dispersive since the dominant mode of Rayleigh waves is usually not coincident with the fundamental mode. Multiple synthetic soil profiles have been tested to show the characteristics of the convergence process and assess the accuracy of the final soil profile. In addition, the inversion procedure is applied to multiple real soils and the final profile compared with the available information. The combination of the vertical flexibility coefficient method to obtain the dispersion curve and the PSO algorithm to carry out the inversion process proves to be a robust procedure that is able to provide good solutions for complex soil profiles even with scarce prior information.

Keywords: dispersion, inverse problem, particle swarm optimization, SASW, soil profile

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Authors: Aleburu Rufus Edeki

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The activities of Boko Haram terrorist group have become worrisome in Nigeria. Boko Haram killed innocent civilians, destroyed schools, churches, military barracks, police stations, and other government establishments. The federal government of Nigerian Military engaged in counter-insurgency to curtail the activities of Boko Haram militant. The engagement of the military led to mass killing across the Northeast region. The reported cases of mass-killing led to petition written to the International Criminal Court by the civil society organization as a result of denial by the military authorities of their involvement. The investigation carried out by the International Criminal Court awash by denial of military involvement in war crimes. As a result of this denial, the ICC called for further investigation of war crimes by the military. This study was carried out among fifty-eight participants. In-depth interviews were conducted among the following participants: civilians 41; human rights commission 5 and civil society 12. This study revealed that professional ethics is associated with denial of military involvement in mass killing in the region. This study also revealed that denial is associated with personality. It was also found that social attributes such as trauma, shame, ostracism, criticism, and punishment are found with denial. It is therefore concluded in this study that protection is needed for war actors, so that situation of denial is minimal in post-conflict truth findings.

Keywords: Boko Haram, crime, insurgence, war

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Authors: Jiangxia Han, Liang Xue, Keda Chen

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Despite the significant progress over the last decades in reservoir simulation using numerical discretization, meshing is complex. Moreover, the high degree of freedom of the space-time flow field makes the solution process very time-consuming. Therefore, we present Physics-Informed Convolutional Neural Networks(PICNN) as a hybrid scientific theory and data method for reservoir modeling. Besides labeled data, the model is driven by the scientific theories of the underlying problem, such as governing equations, boundary conditions, and initial conditions. PICNN integrates governing equations and boundary conditions into the network architecture in the form of a customized convolution kernel. The loss function is composed of data matching, initial conditions, and other measurable prior knowledge. By customizing the convolution kernel and minimizing the loss function, the neural network parameters not only fit the data but also honor the governing equation. The PICNN provides a methodology to model and history-match flow and transport problems in porous media. Numerical results demonstrate that the proposed PICNN can provide an accurate physical solution from a limited dataset. We show how this method can be applied in the context of a forward simulation for continuous problems. Furthermore, several complex scenarios are tested, including the existence of data noise, different work schedules, and different good patterns.

Keywords: convolutional neural networks, deep learning, flow and transport in porous media, physics-informed neural networks, reservoir simulation

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Authors: Gopinath Ganapathy, Chellammal Surianarayanan

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Services are growing rapidly and generally they are aggregated into a composite service to accomplish complex business processes. There may be several services that offer the same required function of a particular task in a composite service. Hence a choice has to be made for selecting suitable services from alternative functionally similar services. Quality of Service (QoS)plays as a discriminating factor in selecting which component services should be selected to satisfy the quality requirements of a user during service composition. There are two categories of approaches for QoS based service selection, namely global and local approaches. Global approaches are known to be Non-Polynomial (NP) hard in time and offer poor scalability in large scale composition. As an alternative to global methods, local selection methods which reduce the search space by breaking up the large/complex problem of selecting services for the workflow into independent sub problems of selecting services for individual tasks are coming up. In this paper, distributed architecture for selecting services based on QoS using local selection is presented with an overview of local selection methodology. The architecture describes the core components, namely, selection manager and QoS manager needed to implement the local approach and their functions. Selection manager consists of two components namely constraint decomposer which decomposes the given global or workflow level constraints in local or task level constraints and service selector which selects appropriate service for each task with maximum utility, satisfying the corresponding local constraints. QoS manager manages the QoS information at two levels namely, service class level and individual service level. The architecture serves as an implementation model for local selection.

Keywords: architecture of service selection, local method for service selection, QoS based service selection, approaches for QoS based service selection

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Authors: Meng Su

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High-dimensional data analysis often presents challenges in capturing the complex, nonlinear relationships and manifold structures inherent to the data. This article presents a novel approach that leverages the strengths of two powerful techniques, Diffusion Maps and Diffusion Probabilistic Models (DPMs), to address these challenges. By integrating the dimensionality reduction capability of Diffusion Maps with the data modeling ability of DPMs, the proposed method aims to provide a comprehensive solution for analyzing and generating high-dimensional data. The Diffusion Map technique preserves the nonlinear relationships and manifold structure of the data by mapping it to a lower-dimensional space using the eigenvectors of the graph Laplacian matrix. Meanwhile, DPMs capture the dependencies within the data, enabling effective modeling and generation of new data points in the low-dimensional space. The generated data points can then be mapped back to the original high-dimensional space, ensuring consistency with the underlying manifold structure. Through a detailed example implementation, the article demonstrates the potential of the proposed hybrid approach to achieve more accurate and effective modeling and generation of complex, high-dimensional data. Furthermore, it discusses possible applications in various domains, such as image synthesis, time-series forecasting, and anomaly detection, and outlines future research directions for enhancing the scalability, performance, and integration with other machine learning techniques. By combining the strengths of Diffusion Maps and DPMs, this work paves the way for more advanced and robust data analysis methods.

Keywords: diffusion maps, diffusion probabilistic models (DPMs), manifold learning, high-dimensional data analysis

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Authors: L. C. Prasanna, Antony Sylvan D’Souza, Kumar M. R. Bhat

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Although life as a conjoined twin would seem intolerable, there has recently been an increased interest in this subject because of the increasing number of cases where attempts have been made to separate them surgically. We have reviewed articles on cardiovascular anomalies in conjoined twins and presenting rarest anomaly in dicephalus parapagus fetus having two heads attached to one body from the neck or upper chest downwards, with a pair of limbs and a set of reproductive organs. Both the twins shared a common thoracic cavity with a single sternum. When the thoracic cavity was opened, a common anterior mediastinum was found. On opening the pericardium, two separate, closely apposed hearts were exposed. The two cardia are placed side by side. The left heart was slightly larger than the right and were joined at the atrial levels. Four atrial appendages were present, two for each twin. The atrial complex was a common chamber posterior to the ventricles. A single large tributary which could be taken as inferior vena cava drains into the common atrial chamber. In this case, the heart could not be assigned to either twin and therefore, it is referred to as the shared heart within a common pericardial sac. The right and left descending thoracic aorta have joined with each other just above the diaphragm to form a common descending thoracic aorta which has an opening in the diaphragm to be continued as common abdominal aorta which has a normal branching pattern. Upon an interior dissection, it is observed that the two atria have a wide communication which could be a wide patent foramen ovale and this common atrial cavity has a communication with a remnant of a possible common sinus venosus.

Keywords: atrium, congenital anomaly, conjoined twin, sinus venosus

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Authors: Anmol Patel

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Cardiopulmonary resuscitation is medical intervention which should be considered for all inpatients; with a patient centred approach, open communication and accurate documentation of clinical decisions. National enquiries have shown that in a significant number of cases CPR was attempted when it was considered inappropriate. In these circumstances attempting to prevent a natural death and subjecting a patient to trauma at the end of life would deprive them of a dignified death. Anticipatory “do not attempt CPR (DNACPR)” decisions aim to prevent this for those considered appropriate. As a legal document, these forms are required to be completed accurately and thoroughly. The aim of this study was to evaluate the difference in quality of DNACPR forms completed using electronic versus paper formats. A retrospective review of DNACPR forms and related documentation was completed in two District General Hospitals in South-East England, one of which uses electronic forms, while the other uses paper red forms. 50 completed forms from each hospital were analysed to assess for legibility, and quality of completion of all subsections of the form, including communications with family, relatives and the Multidisciplinary team. The hospital using paper forms showed a 40-44% rate of completion of sections relating to communication with patients and family, compared to 70% with the hospital using electronic forms. Similar trends were observed with other sections of the form. Conclusion: This study suggests that the implementation of electronic DNACPR forms significantly improves clinical practice and promotes better open communication with patients, family and the MDT.

Keywords: DNACPR, resuscitation, DNAR, patient communication

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Authors: Hossein Hassani, Ali Rezaei

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In recent years, the study of soil contamination problems surrounding mines and smelting plants has attracted some serious attention of the environmental experts. These elements due to the non- chemical disintegration and nature are counted as environmental stable and durable contaminants. Variability of these contaminants in the soil and the time and financial limitation for the favorable environmental application, in order to reduce the risk of their irreparable negative consequences on environment, caused to apply the favorable grading of these contaminant for the further success of the risk management processes. In this study, we use the contaminants factor risk indices, average concentration, enrichment factor and geoaccumulation indices for evaluating the metal contaminant of including Pb, Ni, Se, Mo and Zn in the soil of Sarcheshmeh copper mine area. For this purpose, 120 surface soil samples up to the depth of 30 cm have been provided from the study area. And the metals have been analyzed using ICP-MS method. Comparison of the heavy and potentially toxic elements concentration in the soil samples with the world average value of the uncontaminated soil and shale average indicates that the value of Zn, Pb, Ni, Se and Mo is higher than the world average value and only the Ni element shows the lower value than the shale average. Expert opinions on the relative importance of each indicators were used to assign a final weighting of the metals and the heavy metals were ranked using the TOPSIS approach. This allows us to carry out efficient environmental proceedings, leading to the reduction of environmental ricks form the contaminants. According to the results, Ni, Pb, Mo, Zn, and Se have the highest rate of risk contamination in the soil samples of the study area.

Keywords: contamination coefficient, geoaccumulation factor, TOPSIS techniques, Sarcheshmeh copper complex

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Authors: Min Jindong, Wang Mingxia

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With the widespread use of artificial intelligence in life, computer vision, especially deep convolutional neural network models, has developed rapidly. With the increase of the complexity of the real visual target detection task and the improvement of the recognition accuracy, the target detection network model is also very large. The huge deep neural network model is not conducive to deployment on edge devices with limited resources, and the timeliness of network model inference is poor. In this paper, knowledge distillation is used to compress the huge and complex deep neural network model, and the knowledge contained in the complex network model is comprehensively transferred to another lightweight network model. Different from traditional knowledge distillation methods, we propose a novel knowledge distillation that incorporates multi-faceted features, called M-KD. In this paper, when training and optimizing the deep neural network model for target detection, the knowledge of the soft target output of the teacher network in knowledge distillation, the relationship between the layers of the teacher network and the feature attention map of the hidden layer of the teacher network are transferred to the student network as all knowledge. in the model. At the same time, we also introduce an intermediate transition layer, that is, an intermediate guidance layer, between the teacher network and the student network to make up for the huge difference between the teacher network and the student network. Finally, this paper adds an exploration module to the traditional knowledge distillation teacher-student network model. The student network model not only inherits the knowledge of the teacher network but also explores some new knowledge and characteristics. Comprehensive experiments in this paper using different distillation parameter configurations across multiple datasets and convolutional neural network models demonstrate that our proposed new network model achieves substantial improvements in speed and accuracy performance.

Keywords: object detection, knowledge distillation, convolutional network, model compression

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Authors: Vivian Correa

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Hypothesis There are typical patterns - phenotypes - of sleep behaviors by age and biological sex groups of parasomnia patients where wearable devices could avoid injuries. Materials and methods We analyzed public video records on sleep-related behaviors likely representing parasomnias, looking for phenotypes in different groups. We searched public internet databases using the keywords “sleepwalking”, “sleep eating,” “sleep sex”, and “aggression in sleep” in six languages. Poor-quality vide-records and those showing apparently faked sleep behaviors were excluded. We classified the videos into estimated sex and age (children, adults, elderly) groups; scored the activity types by a self-made scoring scale; and applied binary logistic regression for analyzing the association between sleep behaviors versus the groups by STATA package providing 95% confidence interval and the probability of statistical significance. Results 224 videos (102 women) were analyzed. The odds of sleepwalking and related dangerous behaviors were lower in the elderly than in adults (P<0.025). Females performed complex risky behaviors during sleepwalking more often than males (P<0.012). Elderly people presented emotional behaviors less frequently than adults (P<0.004), and females showed them twice often as males. Elderly males had 40-fold odds compared to adults and children to perform aggressive movements and 70-fold odds of complex movements in the bed compared to adults. Conclusion Unlike other groups, the high chances of adults being sleepwalkers and elderly males performing intense and violent movements in bed showed us the importance of developing wearable parasomnia devices to prevent injuries.

Keywords: parasomnia, wearable devices, sleepwalking, RBD

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Authors: Siqi Fang, Man Cheung Chung

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This study examined the inter-relationship between childhood maltreatment, cognitive distortion, alexithymia, eudemonic well-being, and psychological distress. One hundred and eighty-two university students participated in the study and completed an online survey comprising the Childhood Trauma Questionnaire, Cognitive Distortion Scale, Toronto Alexithymia Scale, Psychological Well-Being Scale, and General Health Questionnaire-28. Hierarchical multiple regression analysis showed that child maltreatment, perceptions of hopelessness and helplessness, preoccupation with danger, personal growth, and purpose in life predicted psychological distress. However, alexithymia was not a significant predictor. Further analysis using the regression models with bootstrapping procedure showed that feeling hopeless, helpless and preoccupation with danger mediated the path between child maltreatment and psychological distress. Meanwhile, coping with beliefs in personal growth and life purpose moderated the mediation effects of distorted cognition on psychological distress. To conclude, childhood maltreatment is associated with psychological distress. This relationship is influenced by people’s perceptions of life being hopeless, helpless or dangerous. At the same time, the effect of hopelessness, helplessness, and feelings of danger also depends on the degree of using coping strategies of positive psychological functioning.

Keywords: alexithymia, childhood maltreatment, cognitive distortion, eudemonic well-being, psychological distress

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Authors: Brody R. Clark, Chaminda Gallage, John Yeaman

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Multigrade bitumen asphalt is a quality asphalt product that is not utilised in many places globally. Multigrade bitumen is believed to be less sensitive to temperature, which gives it an advantage over conventional binders. Previous testing has shown that asphalt temperature changes greatly with depth, but currently the industry standard is to nominate a single temperature for design. For detailed design of asphalt roads, perhaps asphalt layers should be divided into nominal layer depths and different modulus and fatigue equations/values should be used to reflect the temperatures of each respective layer. A collaboration of previous laboratory testing conducted on multigrade bitumen asphalt beams under a range of temperatures and loading conditions was analysed. The samples tested included 0% or 15% recycled asphalt pavement (RAP) to determine what impact the recycled material has on the fatigue life and stiffness of the pavement. This paper investigated the temperature susceptibility of multigrade bitumen asphalt pavements compared to conventional binders by combining previous testing that included conducting a sweep of fatigue tests, developing complex modulus master curves for each mix and a study on how pavement temperature changes through pavement depth. This investigation found that the final design of the pavement is greatly affected by the nominated pavement temperature and respective material properties. This paper has outlined a potential revision to the current design approach for asphalt pavements and proposes that further investigation is needed into pavement temperature and its incorporation into design.

Keywords: asphalt, complex modulus, fatigue life, flexural stiffness, four point bending, multigrade bitumen, recycled asphalt pavement

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Authors: Emad A. Mohammed

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The concept of hydraulic flow units (HFU) has been used for decades in the petroleum industry to improve the prediction of permeability. This concept is strongly related to the flow zone indicator (FZI) which is a function of the reservoir rock quality index (RQI). Both indices are based on reservoir porosity and permeability of core samples. It is assumed that core samples with similar FZI values belong to the same HFU. Thus, after dividing the porosity-permeability data based on the HFU, transformations can be done in order to estimate the permeability from the porosity. The conventional practice is to use the power law transformation using conventional HFU where percentage of error is considerably high. In this paper, neural network technique is employed as a soft computing transformation method to predict permeability instead of power law method to avoid higher percentage of error. This technique is based on HFU identification where Amaefule et al. (1993) method is utilized. In this regard, Kozeny and Carman (K–C) model, and modified K–C model by Hasan and Hossain (2011) are employed. A comparison is made between the two transformation techniques for the two porosity-permeability models. Results show that the modified K-C model helps in getting better results with lower percentage of error in predicting permeability. The results also show that the use of artificial intelligence techniques give more accurate prediction than power law method. This study was conducted on a heterogeneous complex carbonate reservoir in Oman. Data were collected from seven wells to obtain the permeability correlations for the whole field. The findings of this study will help in getting better estimation of permeability of a complex reservoir.

Keywords: permeability, hydraulic flow units, artificial intelligence, correlation

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Authors: Mrinal Kanti Bhowmik, Kakali Das Jr., Barin Kumar De, Debotosh Bhattacharjee

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Breast cancer is the most common cancer and a leading cause of death for women in the 35 to 55 age group. Early detection of breast cancer can decrease the mortality rate of breast cancer. Mammography is considered as a ‘Gold Standard’ for breast cancer detection and a very popular modality, presently used for breast cancer screening and detection. The screening of digital mammograms often leads to over diagnosis and a consequence to unnecessary traumatic & painful biopsies. For that reason recent studies involving the use of thermal imaging as a screening technique have generated a growing interest especially in cases where the mammography is limited, as in young patients who have dense breast tissue. Tumor is a significant sign of breast cancer in both mammography and thermography. The tumors are complex in structure and they also exhibit a different statistical and textural features compared to the breast background tissue. Fractal geometry is a geometry which is used to describe this type of complex structure as per their main characteristic, where traditional Euclidean geometry fails. Over the last few years, fractal geometrics have been applied mostly in many medical image (1D, 2D, or 3D) analysis applications. In breast cancer detection using digital mammogram images, also it plays a significant role. Fractal is also used in thermography for early detection of the masses using the thermal texture. This paper presents an overview of the recent aspects and initiatives of fractals in breast cancer detection in both mammography and thermography. The scope of fractal geometry in automatic breast cancer detection using digital mammogram and thermogram images are analysed, which forms a foundation for further study on application of fractal geometry in medical imaging for improving the efficiency of automatic detection.

Keywords: fractal, tumor, thermography, mammography

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Authors: Mohammad R. Kavian Nezhad, Carlos F. Lange, Brian A. Fleck

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This research presents the validation study of a computational fluid dynamics (CFD) model developed to simulate the scalar dispersion emitted from rooftop sources around the buildings at the University of Alberta North Campus. The ANSYS CFX code was used to perform the numerical simulation of the wind regime and pollutant dispersion by solving the 3D steady Reynolds-averaged Navier-Stokes (RANS) equations on a building-scale high-resolution grid. The validation study was performed in two steps. First, the CFD model performance in 24 cases (eight wind directions and three wind speeds) was evaluated by comparing the predicted flow fields with the available data from the previous measurement campaign designed at the North Campus, using the standard deviation method (SDM), while the estimated results of the numerical model showed maximum average percent errors of approximately 53% and 37% for wind incidents from the North and Northwest, respectively. Good agreement with the measurements was observed for the other six directions, with an average error of less than 30%. In the second step, the reliability of the implemented turbulence model, numerical algorithm, modeling techniques, and the grid generation scheme was further evaluated using the Mock Urban Setting Test (MUST) dispersion dataset. Different statistical measures, including the fractional bias (FB), the geometric mean bias (MG), and the normalized mean square error (NMSE), were used to assess the accuracy of the predicted dispersion field. Our CFD results are in very good agreement with the field measurements.

Keywords: CFD, plume dispersion, complex urban geometry, validation study, wind flow

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Authors: Suk Kyoon Song, Myung-Rae Cho

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Purpose: Paralytic ileus occurs in up to 18% of patients with pelvic bone fractures. The aim of this study is to determine if massive bleeding requiring arterial angioembolization is related to the duration of ileus in patients with traumatic pelvic ring injuries. Methods: This retrospective study included 25 patients who underwent arterial angioembolization for traumatic pelvic ring injuries. Data were collected from prospectively maintained databases of two independent hospitals. Results: Demographic characteristics (such as age, sex, body mass index, and Charlson Comorbidity Index), cause of trauma, and severity of pelvic injuries were similar in the non-prolonged and prolonged ileus groups. As expected, the prolonged ileus group had a significantly longer duration of ileus than the non-prolonged ileus group (8.0 ± 4.2 days vs. 1.2 ± 0.4 days, respectively, P < 0.001). The mortality rate was higher in the prolonged ileus group (20% vs. 0%), but it was not significantly different (P = 0.13). Interestingly, the prolonged ileus group received significantly higher amounts of packed red blood cell (PRBC) transfusions (6.1 ± 2.1 units vs. 3.8 ± 2.5 units; P = 0.02). The amount of PRBC transfusions was associated with a greater risk of prolonged ileus development (P = 0.03, OR = 2.04, 95% CI = 1.08-3.88). Conclusion: This study supports the idea that the duration of the ileus is related to the amount of bleeding caused by the traumatic pelvic ring injury. In order to prevent further complications, conservative treatments of the ileus should be considered.

Keywords: pelvic ring injury, bleeding, ileus, arterial angioembolization

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Authors: Otuu O. Obasi, Jude C. Ajaraogu, Happiness C. Anthony-Ikpe

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Women in Igbo land generally experience culture-related mistreatment in the event of the death of their husbands. The mistreatment ranges from scraping of widows’ hair to denial of the right to see their husbands’ corpses. The objectives of the study were to determine the forms and prevalence of widowhood practice in the studied communities, the effects of the socio-cultural attributes of the people on the practice, and the perceived effect of the practice on the victims. Data for the study were collected from 64 randomly selected communities out of 640 communities in Imo State, Nigeria. 450 copies of the researcher-made-questionnaire were distributed across the three senatorial zones of the State. A total of 418 or 92.8% were completely filled and returned. The result of the study showed, among other things, that the majority of males and females recognized widowhood practice as dehumanizing, but opined that it cannot be stopped because it is rooted in culture. However, 30.2% of the female population did not agree that the practice is dehumanizing to women since it was their cultural practice. The study also revealed that scrapping of widows’ hair was the commonest practice while sleeping alone with the husband’s corpse was the least practice. Regarding the effect which this practice has on widows, emotional trauma topped the list; and was followed by economic hardship and health deterioration. Also shown by the study was that the level of education and religion did not have a notable effect on widowhood practice. With regard to possible stoppage measures, greater number of the respondents (38%) indicated that a synergy of efforts was needed to curb the social scourge.

Keywords: widowhood practice, socio-cultural attributes, violence, impact

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Authors: Shivam Adhikary

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Sports stadiums are not merely public amenities for entertainment and recreation for a city. They are buildings with extremely high construction investment and running costs which holds the supreme responsibility of social integration, nation building and financial upliftment of the community apart from its primary motive of conducting and promotion of the sports. But the present scenario of sports performances at international events and growing physical inactivity among the youth in India show that the sports facilities are far behind in achieving these goals. A pilot study of Indira Gandhi Sports complex in Vijayawada, Andhra Pradesh gave an indication of underutilization of sports stadia in India. This probed a crying need for the assessment of the present usage and functioning of the major sports (non-cricketing) facilities within the country. This paper assesses the sustainability of stadiums built for national and international sporting (non-cricket) events in terms of sporting, socio-cultural and financial sustainability by mainly focusing on their usage in non-event days. The criteria for the assessment and comparison of the stadiums within the nation is done using World Stadium Index and GDI (Gross Domestic Income) while with international counterparts using WSI and GNI (Gross National Income). The pilot case of India Gandhi Sports complex in Vijayawada is further investigated for a deeper understanding of the present usage, the existing issues for its underutilization and the way-forward (at least a few) to reach its sustainable potential. The paper finally concludes with the discussion on whether sports stadiums are being utilized to its financial potential and if it is at par with its international counterparts.

Keywords: economic sustainability, social sustainability, sports infrastructure, stadium efficiency

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Authors: Angelis P. Barlampas

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PURPOSE: The purpose of this paper is to demonstrate the important role of taking an appropriate and detailed history, in order to reach the best possible diagnostic conclusion. MATERIAL: A patient presented to the emergency department due to the sudden onset of continuous abdominal pain, during the last hour and with the clinical symptoms of an acute abdomen. During the clinical examination, signs of peritoneal irritation and diffuse abdominal tenderness were found. The rest of the clinical and laboratory tests did not reveal anything important. From the reported medical history, nothing of note was found, except for the report of a large liver cyst, for which he was advised not to take any further action, except from regular ultrasound examination . METHOD: A computed tomography examination was performed after per os administration of gastrografin, which revealed a hyperdense ascitic effusion, similar in density to that of gastrografin within the intestinal tract. The presence of a large cyst of the left hepatic lobe was confirmed, contacting and pushing against the stomach. In the area of the contact between the liver cyst and the pylorus, there were extraluminal air bubbles and local opacity of the peritoneal fat, with a small hyperdense effusion. Result : The above, as well as the absence of a history of stomach ulcer or recent trauma, or other pathology, argue in favor of acute pyloric perforation, due to mural necrosis, in response to chronic external pressure from the pre-existing large liver cyst.

Keywords: perforation, stomach, large liver cyst, CT abdomen, acute abdominal pain, intraperitoneal leakage, constrast leakage

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Authors: Helena Baffoe

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The US has developed numerous programs over the past 50 years to enhance the lives of those who suffer from mental health illnesses and substance abuse, as well as the effectiveness of their treatments. Despite these advances over the past 50 years, there hasn't been a corresponding improvement in American public attitudes and beliefs about mental health disorders and substance abuse. Highly publicized acts of violence frequently elicit comments that blame the perpetrator's perceived mental health disorder since such people are thought to be substance abusers. Despite these strong public beliefs and perception about mental disorder and substance abuse, concreate empirical evidence that entail this perception is lacking, and evidence of their effectiveness has not been integrated. A rich data was collected from Substance Abuse and Mental Health Services Administration (SAMHSA) with a hypothesis that people who are diagnosed with a mental health disorder are likely to be diagnosed with substance abuse using logit regression analysis and Instrumental Variable. It was found that depressive, anxiety, and trauma/stressor mental disorders constitute the most common mental disorder in the United States, and the study could not find statistically significant evidence that being diagnosed with these leading mental health disorders in the United States does necessarily imply that such a patient is diagnosed with substances abuse. Thus, the public has a misconception of mental health and substance abuse issues, and social workers' responsibilities are outlined in order to assist ameliorate this attitude and perception.

Keywords: mental health disorder, substance use, empirical evidence, logistic regression

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