Search results for: database approach

Authors: Stephanie Ducrot, Marie Vernet, Eve Meiss, Yves Chaix

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Learning to read is a key topic of debate today, both in terms of its implications on school failure and illiteracy and regarding what are the best teaching methods to develop. It is estimated today that four to six percent of school-age children suffer from specific developmental disorders that impair learning. The findings from people with dyslexia and typically developing readers suggest that the problems children experience in learning to read are related to the preliteracy skills that they bring with them from kindergarten. Most tools available to professionals are designed for the evaluation of child language problems. In comparison, there are very few tools for assessing the relations between visual skills and the process of learning to read. Recent literature reports that visual-motor skills and visual-spatial attention in preschoolers are important predictors of reading development — the main goal of this study aimed at improving screening for future reading difficulties in preschool children. We used a prospective, longitudinal approach where oculomotor processes (assessed with the DiagLECT test) were measured in pre-readers, and the impact of these skills on future reading development was explored. The dialect test specifically measures the online time taken to name numbers arranged irregularly in horizontal rows (horizontal time, HT), and the time taken to name numbers arranged in vertical columns (vertical time, VT). A total of 131 preschoolers took part in this study. At Time 0 (kindergarten), the mean VT, HT, errors were recorded. One year later, at Time 1, the reading level of the same children was evaluated. Firstly, this study allowed us to provide normative data for a standardized evaluation of the oculomotor skills in 5- and 6-year-old children. The data also revealed that 25% of our sample of preschoolers showed oculomotor impairments (without any clinical complaints). Finally, the results of this study assessed the validity of the DiagLECT test for predicting reading outcomes; the better a child's oculomotor skills are, the better his/her reading abilities will be.

Keywords: vision, attention, oculomotor processes, reading, preschoolers

Procedia PDF Downloads 147

Authors: Bathmajaa Muralisankar

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As much as railway station infrastructure designs and ticket-booking norms have been changed to facilitate use by differently abled persons, the railway train compartments themselves have not been made user-friendly for differently abled persons. Owing to safety concerns, dependency on others for their travel, and fear of isolation, differently abled people do not prefer travelling by train. Rather than including a dedicated compartment open only to the differently abled, including the latter with others in the normal compartment (with the proposed modifications discussed here) will make them feel secure and make for an enhanced travel experience for them. This approach also represents the most practical way to include a particular category of people in the mainstream society. Lowering the height of the compartment doors and providing a wider entrance with a ramp will provide easy entry for those using wheelchairs. As well, removing the first two alternate rows and the first two side seats will not only widen the passage and increase seating space but also improve wheelchair turning radius. This will help them travel without having to depend on others. Seating arrangements may be done to accommodate their family members near them instead of isolating the differently abled in a separate compartment. According to present ticket-booking regulations of the Indian Railways, three to four disabled persons may travel without their family or one to two along with their family, and the numbers may be added or reduced. To help visually challenged and hearing-impaired persons, in addition to the provision of special instruments, railings, and textured footpaths and flooring, the seat numbers above the seats may be set in metal or plastic as an outward projection so the visually impaired can touch and feel the numbers. Braille boards may be included at the entrance to the compartment along with seat numbers in the aforementioned projected manner. These seat numbers may be designed as buttons, which when pressed results in an announcement of the seat number in the applicable local language as well as English. Emergency buttons, rather than emergency chains, within the easy reach of disabled passengers will also help them.

Keywords: dependency, differently abled, inclusion, mainstream society

Procedia PDF Downloads 254

Authors: Vinit Srivastava, Abhay Singh Thakur, Shivam Dubey, Rahul Vaish, Bharat Singh Rajpurohit

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This study examines the problem of students' poor comprehension of the thermal dependence of resistance by investigating this idea using an evidence-based inquiry approach. It suggests a practical exercise to improve secondary school students' comprehension of how materials' resistance to temperature changes. The suggested exercise uses an Arduino and Peltier device to test the resistance of aluminum and graphite at various temperatures. The study attempts to close the knowledge gap between the theoretical and practical facets of the subject, which students frequently find difficult to grasp. With the help of a variety of resistors made of various materials and pencils of varying grades, the Arduino experiment investigates the resistance of a metallic conductor (aluminum) and a semiconductor (graphite) at various temperatures. The purpose of the research is to clarify for students the relationship between temperature and resistance and to emphasize the importance of resistor material choice and measurement methods in obtaining precise and stable resistance values over dynamic temperature variations. The findings show that while the resistance of graphite decreases with temperature, the resistance of metallic conductors rises with temperature. The results also show that as softer lead pencils or pencils of a lower quality are used, the resistance values of the resistors drop. In addition, resistors showed greater stability at lower temperatures when their temperature coefficients of resistance (TCR) were smaller. Overall, the results of this article show that the suggested experiment is a useful and practical method for teaching students about resistance's relationship to temperature. It emphasizes how crucial it is to take into account the resistor material selection and the resistance measurement technique when designing and picking out resistors for various uses. The results of the study are anticipated to guide the creation of more efficient teaching methods to close the gap between science education's theoretical and practical components.

Keywords: electrical resistance, temperature dependence, science education, inquiry-based activity, resistor stability

Procedia PDF Downloads 76

Authors: Z. Kolacinski, L. Szymanski. G. Raniszewski, D. Koza, L. Pietrzak

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Magnetic Bio-Nano-Fluid (BNF) can be composed of a buffer fluid such as plasma and magnetic nanoparticles such as iron, nickel, cobalt and their oxides. However iron is one of the best elements for magnetization by electromagnetic radiation. It can be used as a tool for medical diagnosis and treatment. Radio frequency (RF) radiation is able to heat iron nanoparticles due to magnetic hysteresis. Electromagnetic heating of iron nanoparticles and ferro-fluids BNF can be successfully used for non-invasive thermal ablation of cancer cells. Moreover iron atoms can be carried by carbon nanotubes (CNTs) if iron is used as catalyst for CNTs synthesis. Then CNTs became the iron containers and they screen the iron content against oxidation. We will present a method of CNTs addressing to the required cells. For thermal ablation of cancer cells we use radio frequencies for which the interaction with human body should be limited to minimum. Generally, the application of RF energy fields for medical treatment is justified by deep tissue penetration. The highly iron doped CNTs as the carriers creating magnetic fluid will be presented. An excessive catalyst injection method using electrical furnace and microwave plasma reactor will be presented. This way it is possible to grow the Fe filled CNTs on a moving surface in continuous synthesis process. This also allows producing uniform carpet of the Fe filled CNTs carriers. For the experimental work targeted to cell ablation we used RF generator to measure the increase in temperature for some samples like: solution of Fe2O3 in BNF which can be plasma-like buffer, solutions of pure iron of different concentrations in plasma-like buffer and in buffer used for a cell culture, solutions of carbon nanotubes (MWCNTs) of different concentrations in plasma-like buffer and in buffer used for a cell culture. Then the targeted therapies which can be effective if the carriers are able to distinguish the difference between cancerous and healthy cell’s physiology are considered. We have developed an approach based on ligand-receptor or antibody-antigen interactions for the case of colon cancer.

Keywords: cancer treatment, carbon nano tubes, drag delivery, hyperthermia, iron

Procedia PDF Downloads 413

Authors: Naveed Mazhar

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Our cities are known to have significant modifying effects on the local climate. The nature of the modifications depends on a range of physical variables, usually assessed at a wide range of spatial scales. Physical spatial dimensions, such as measured parameters of microclimates and their significant influence on human sensations, are known to have far-reaching effects on human thermal comfort and by corollary a force that influences human perception. Less scholarship has thrown light on the subjective dimension and insufficiently demonstrates a relational approach between human behavior and how it is affected by the phenomenon of urban microclimates. Other than identifying gaps in the most recent scholarship and providing future research opportunities, the scope of this study will help improve urban design guidelines and raise framework standards of socially responsive urban design. This study will help equip future professionals to ameliorate the effects of urban microclimates on participant’s perceptions enabling more frequent usage of the outdoor urban spaces. However, it is informed that the physical parameters of an outdoor open space determine psychological human adaptations and is a measure of the degree to which people are willing to adapt to their surroundings. A large amount of research is available related to urban microclimates. However, very few studies are focused on the elucidation of the critical factors influencing human perceptions of the microclimates in urban spatial configurations. Based on the most recent scholarship, this study has evaluated the role urban microclimatic conditions have in the formation of human perceptions and, by extension, behavioral patterns formulating in outdoor open spaces. Furthermore, this study also defines, in the backdrop of the current scholarly literature, the socio-spatial interdependence of behavioral patterns with relationship to the built urban fabric and its resultant correlation with human perception. A comprehensive review and analysis of the recent research conducted within the scope of the study will help frame gaps, issues, current research methods and future research opportunities.

Keywords: urban design, urban microcliamate, human perception, human behavioral patterns

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Authors: Rodrigo Antunes, Olga Borisevich, David Demange

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In future nuclear fusion reactors, tritium self-sufficiency will be ensured by tritium (3H) production via reactions between the fusion neutrons and lithium. To favor tritium breeding, a neutron multiplier must also be used. Both tritium breeder and neutron multiplier will be placed in the so-called Breeding Blanket (BB). For the European Helium-Cooled Pebble Bed (HCPB) BB concept, the tritium production and neutron multiplication will be ensured by neutron bombardment of Li4SiO4 and Be pebbles, respectively. The produced tritium is extracted from the pebbles by purging them with large flows of He (~ 104 Nm3h-1), doped with small amounts of H2 (~ 0.1 vol%) to promote tritium extraction via isotopic exchange (producing HT). Due to the presence of oxygen in the pebbles, production of tritiated water is unavoidable. Therefore, the purging gas downstream of the BB will be composed by Q2/Q2O/He (Q = 1H, 2H, 3H), with Q2/Q2O down to ppm levels, which must be further processed for tritium recovery. A two-stage continuous approach, where zeolite membranes (ZMs) are followed by a catalytic membrane reactor (CMR), has been recently proposed to fulfil this task. The tritium recovery from Q2/Q2O/He is ensured by the CMR, that requires a reduction of the gas flow coming from the BB and a pre-concentration of Q2 and Q2O to be efficient. For this reason, and to keep this stage with reasonable dimensions, ZMs are required upfront to reduce as much as possible the He flows and concentrate the Q2/Q2O species. Therefore, experimental activities have been carried out at the Tritium Laboratory Karlsruhe (TLK) to test the separation performances of different zeolite membranes for H2/H2O/He. First experiments have been performed with binary mixtures of H2/He and H2O/He with commercial MFI-ZSM5 and NaA zeolite-type membranes. Only the MFI-ZSM5 demonstrated selectivity towards H2, with a separation factor around 1.5, and H2 permeances around 0.72 µmolm-2s-1Pa-1, rather independent for feed concentrations in the range 0.1 vol%-10 vol% H2/He. The experiments with H2O/He have demonstrated that the separation factor towards H2O is highly dependent on the feed concentration and temperature. For instance, at 0.2 vol% H2O/He the separation factor with NaA is below 2 and around 1000 at 5 vol% H2O/He, at 30°C. Overall, both membranes demonstrated complementary results at equivalent temperatures. In fact, at low feed concentrations ( ≤ 1 vol% H2O/He) MFI-ZSM5 separates better than NaA, whereas the latter has higher separation factors for higher inlet water content ( ≥ 5 vol% H2O/He). In this contribution, the results obtained with both MFI-ZSM5 and NaA membranes for H2/He and H2O/H2 mixtures at different concentrations and temperatures are compared and discussed.

Keywords: nuclear fusion, gas separation, tritium processes, zeolite membranes

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Authors: Charleen von Kolpinski, Karina Cagarman, Alina Blaute

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The circular economy concept is often framed by politicians, scientists and practitioners as being the solution to sustainability problems of our times. However, the focus of these discussions and publications is very often set on environmental and economic aspects. In contrast, the social dimension of sustainability has been neglected and only a few recent and mostly conceptual studies targeted the inclusion of social aspects and the SDGs into circular economy research. All stakeholders of this new circular system have to be included to represent a truly sustainable solution to all the environmental, economic and social challenges caused by the linear economic system. Hence, this empirical research aims to analyse, next to the environmental and economic dimension, also explicitly the social dimension of a sustainable circular business model. This inductive and explorative approach applies the single case study method. A multi-stakeholder view is adopted to shed light on social aspects of the circular business model. Different stakeholder views, tensions between stakeholders and conflicts of interest are detected. In semi-structured interviews with different stakeholders of the company, this study compares the different stakeholder views to profile the success factors of its business model in terms of sustainability implementation and to detect its shortcomings. These findings result in the development of propositions which cover different social aspects of sustainable circular business model implementation. This study is an answer to calls for future empirical research about the social dimension of the circular economy and contributes to sustainable business model thinking in entrepreneurial contexts of the circular economy. It helps identifying all relevant stakeholders and their needs to successfully and inclusively implement a sustainable circular business model. The method of a single case study has some limitations by nature as it only covers one enterprise with its special business model. Therefore, more empirical studies are needed to research sustainable circular business models from multiple stakeholder perspectives, in different countries and industries. Future research can build upon the developed propositions of this study and develop hypotheses to be tested.

Keywords: circular economy, single case study, social dimension, sustainable circular business model

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Authors: Francisco Fernandez de Castro

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The Conditional Cash Transfer (CCT) model gives monetary transfers to beneficiary families on the condition that they take specific education and health actions. According to the economic rationale of CCTs the poor need incentives to invest in their human capital because they are trapped by a lack of information and misleading beliefs. If left to their own decision, the poor will not be able to choose what is in their best interests. The basic assumption of the CCT model is that the poor need incentives to take care of their own education and health-nutrition. Due to the incentives (income cash transfers and conditionalities), beneficiary families are supposed to attend doctor visits and health talks. Children would stay in the school. These incentivized behaviors would produce outcomes such as better health and higher level of education, which in turn will reduce poverty. Based on a grounded theory approach to conduct a two-year period of qualitative data collection in northern Mexico, this study shows that this explanation is incomplete. In addition to the information failure and inadequate beliefs, there are structural barriers in everyday life of households that make health-nutrition and education investments difficult. In-depth interviews and observation work showed that the program takes for granted local conditions in which beneficiary families should fulfill their co-responsibilities. Data challenged the program’s assumptions and unveiled local obstacles not contemplated in the program’s design. These findings have policy and research implications for the CCT agenda. They bring elements for late programming due to the gap between the CCT strategy as envisioned by policy designers, and the program that beneficiary families experience on the ground. As for research consequences, these findings suggest new avenues for scholarly work regarding the causal mechanisms and social processes explaining CCT outcomes.

Keywords: conditional cash transfers, incentives, poverty, structural barriers

Procedia PDF Downloads 113

Authors: Amir Sina Fouladi, Arul Arulrajah, Jian Chu, Suksun Horpibulsuk

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Waste generation is a growing concern in many countries across the world, particularly in urban areas with high rates of population growth and industrialization. The increasing amount of waste generated from human activities has led to environmental, economic, and health issues. Improper disposal of waste can result in air and water pollution, land degradation, and the spread of diseases. Waste generation also consumes large amounts of natural resources and energy, leading to the depletion of valuable resources and contributing to greenhouse gas emissions. To address these concerns, there is a need for sustainable waste management practices that reduce waste generation and promote resource recovery and recycling. Amongst these, developing innovative technologies such as Microbially Induced Calcite Precipitation (MICP) in construction materials is an effective approach to transforming waste into valuable and sustainable applications. MICP is an environmentally friendly microbial-chemical technology that applies microorganisms and chemical reagents to biological processes to produce carbonate mineral. This substance can be an energy-efficient, cost-effective, sustainable solution to environmental and engineering challenges. Recent research has shown that waste streams can replace several MICP-chemical components in the cultivation media of microorganisms and cementation reagents (calcium sources and urea). In addition to its effectiveness in treating hazardous waste streams, MICP has been found to be cost-effective and sustainable solution applicable to various waste media. This comprehensive review paper aims to provide a thorough understanding of the environmental advantages and engineering applications of MICP technology, with a focus on the contribution of waste streams. It also provides researchers with guidance on how to identify and overcome the challenges that may arise applying the MICP technology using waste streams.

Keywords: waste stream, microbially induced calcite precipitation, construction materials, sustainability

Procedia PDF Downloads 79

Authors: Il Ho Park, Joong Seob Lee, Sung Hun Kang, Jae-Min Shin, Il Seok Park, Seok Min Hong, Seok Jin Hong

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Introduction: The human microbiota is the aggregate of microorganisms, and the bacterial microbiome of the human digestive tract contributes to both health and disease. In health, bacteria are key components in the development of mucosal barrier function and in innate and adaptive immune responses, and they also work to suppress the establishment of pathogens. In human upper airway, the sinonasal microbiota might play an important role in chronic rhinosinusitis (CRS). The purpose of this study is to investigate the human upper airway microbiome in CRS patients and to compare the sinonasal microbiome of adults with children. Materials and methods: A total of 19 samples from 19 patients (Group1; 9 CRS in children, aged 5 to 14 years versus Group 2; 10 CRS in adults aged 21 to 59 years) were examined. Swabs were collected from the middle meatus and/or anterior ethmoid region under general anesthesia during endoscopic sinus surgery or tonsillectomy. After DNA extraction from swab samples, we analysed bacterial microbiome consortia using 16s rRNA gene sequencing approach (the Illumina MiSeq platform). Results: In this study, relatively abundance of the six bacterial phyla and tremendous genus and species found in substantial amounts in the individual sinus swab samples, include Corynebacterium, Hemophilus, Moraxella, and Streptococcus species. Anaerobes like Fusobacterium and Bacteroides were abundantly present in the children group, Bacteroides and Propionibacterium were present in adults group. In genus, Haemophilus was the most common CRS microbiome in children and Corynebacterium was the most common CRS microbiome in adults. Conclusions: Our results show the diversity of human upper airway microbiome, and the findings will suggest that CRS is a polymicrobial infection. The Corynebacterium and Hemophilus may live as commensals on mucosal surfaces of sinus in the upper respiratory tract. The further study will be needed for analysis of microbiome-human interactions in upper airway and CRS.

Keywords: microbiome, upper airway, chronic rhinosinusitis, adult and children

Procedia PDF Downloads 126

Authors: Çisem Gündüz Arabacı

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Deliberation has been seen one of the most important components of democratic ideals especially since liberal democratic attributions have been under fire. Deliberative democracy advocates that people should participate in collective decision-making processes by other mechanisms rather than conventional ones in order to reach legitimate decisions. Deliberative democratic theory makes emphasis on deliberative communication between people and encourages them not to merely express their political opinions (through surveys and referendum) but to form those opinions through public debates. This paper focuses on deliberative democratic visions of Gezi Park Public Forums by taking deliberative democracy as theoretical basis and examining Gezi Park Public Forums in the light of core elements of deliberative democracy. Gezi Movement started on 28 May 2013 in İstanbul as a reaction to local government's revision plans for Taksim Gezi Park, spread throughout the country and created new zones in public sphere which are called Public Park Forums. During the summer of 2013, especially in İstanbul but also in other cities, people gathered in public parks, discussed and took collective decisions concerning actions which they will take. It is worth to mention that since 3 and half years some Public Park Forums are still continuing their meetings regularly in city of İzmir. This paper analyzes four 'Public Park Forums' in İzmir which are called Bornova Public Forum; Karşıyaka Public Forum, Foça Public Forum and Güzelyalı Public Forum. These Forums are under investigation in terms of their understanding of democracy and the values that support that understanding. Participant observation and in-depth interview methods are being used as research methods. Core element of deliberative democracy are being collected under three main category: common interest versus private interest, membership, rational argument and these values are being questioning within one of each Forum in order to draw an overall picture and also make comparison between them. Discourse analysis is being used in order to examine empirical data and paper aims to reveal how participants of public forums perceive deliberative democratic values and whether they give weight to these values.

Keywords: deliberative democracy, Gezi Park movement, public forums, social movement

Procedia PDF Downloads 319

Authors: Lidya Hailu, Ramesh Duraisamy, Masood Akhtar Khan, Belete Yilma

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Disposable food packaging is a single-use plastics that can include any disposable plastic item which could be designed and use only once. In this context, this study aimed to prepare and evaluate bioplastic food packaging material from avocado seed starch and sugarcane bagasse cellulose and to characterise avocado seed starch. Performed the physicomechanical, structural, thermal properties, and biodegradability of raw materials and readily prepared bioplastic using the universal tensile testing machine, FTIR, UV-Vis spectroscopy, TGA, XRD, and SEM. Results have shown that an increasing amount of glycerol (3-5 mL) resulted in increases in water absorption, density, water vapor permeability, and elongation at the break of prepared bioplastic. However, it causes decreases in % transmittance, thermal degradation, and the tensile strength of prepared bioplastic. Likewise, the addition of cellulose fiber (0-15 %) increases % transmittance ranged (91.34±0.12-63.03±0.05 %), density (0.93±0.04-1.27±0.02 g/cm3), thermal degradation (310.01-321.61°C), tensile strength (2.91±6.18-4.21±6.713 MPa) of prepared bioplastic. On the other hand, it causes decreases in water absorption (14.4±0.25-9.40±0.007 %), water vapor permeability (9.306x10-12±0.3-3.57x10-12±0.15 g•s−1•m−1•Pa−1) and elongation at break (34.46±3.37-27.63±5.67 %) of prepared bioplastic. All the readily prepared bioplastic films rapidly degraded in the soil in the first 6 days and decompose within 12 days with a diminutive leftover and completely degraded within 15 days under an open soil atmosphere. Studied results showed starch derived bioplastic reinforced with 15 % cellulose fiber that plasticized with 3 mL of glycerol had improved results than other combinations of glycerol and bagasse cellulose with avocado seed starch. Thus, biodegradable disposable food packaging cup has been successfully produced in the lab-scale level using the studied approach. Biodegradable disposable food packaging materials have been successfully produced by employing avocado seed starch and sugarcane bagasse cellulose. The future study should be done on nano scale production since this study was done at the micro level.

Keywords: avocado seed, food packaging, glycerol, sugarcane bagasse

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Authors: Alessandra Rossodivita, Alexei Tikhomirov, Andrey Trufanov, Nikolay Kinash, Olga Berestneva, Svetlana Nikitina, Fabio Casati, Alessandro Visconti, Tommaso Saporito

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It is well known that world and national societies are exposed to diverse threats: anthropogenic, technological, and natural. Anthropogenic ones are of greater risks and, thus, attract special interest to researchers within wide spectrum of disciplines in efforts to lower the pertinent risks. Some researchers showed by means of multilayered, complex network models how media promotes the prevention of disease spread. To go further, not only are mass-media sources included in scope the paper suggests but also personificated social bots (socbots) linked according to reflexive theory. The novel scope considers information spread over conscious and unconscious agents while counteracting both natural and man-made threats, i.e., infections and terrorist hazards. Contrary to numerous publications on misinformation disseminated by ‘bad’ bots within social networks, this study focuses on ‘good’ bots, which should be mobilized to counter the former ones. These social bots deployed mixture with real social actors that are engaged in concerted actions at spreading, receiving and analyzing information. All the contemporary complex network platforms (multiplexes, interdependent networks, combined stem networks et al.) are comprised to describe and test socbots activities within competing information sharing tools, namely mass-media hubs, social networks, messengers, and e-mail at all phases of disasters. The scope and concomitant techniques present evidence that embedding such socbots into information sharing process crucially change the network topology of actor interactions. The change might improve or impair robustness of social network environment: it depends on who and how controls the socbots. It is demonstrated that the topological approach elucidates techno-social processes within the field and outline the roadmap to a safer world.

Keywords: complex network platform, counterterrorism, information sharing topology, social bots

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Authors: Shammael Selorfia

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The Quality improvement project aimed to improve junior doctors and nurses’ knowledge and confidence in diagnosing and managing delirium on inpatient surgical wards in a tertiary hospital. The study aimed to develop a standardised assessment and management checklist for all staff working with patients who were presenting with signs of delirium. The aim of the study was to increase confidence of staff at dealing with delirium and improve the quality of referrals that were being sent to the Mental Health Liaison team over a 6-month period. A significant proportion of time was being spent by the Mental Health Liaison triage nurses on referrals for delirium. Data showed 28% of all delirium referrals from surgical teams were being closed at triage reflecting a poor standard of quality of those referrals. A qualitative survey of junior doctors in 6 surgical specialties in a UK tertiary hospital was conducted. These specialties include general surgery, vascular, plastic, urology, neurosurgery, and orthopaedics. The standardised checklist was distributed to all surgical wards. A comparison was made between the Mental health team caseload of delirium before intervention was compared and after. A Qualitative survey at end of 3-month cycle and compare overall caseload on Mental Health Liaison team to pre-QIP data with aim to improve quality of referrals and reduce workload on Mental Health Liaison team. At the end of the project cycle, we demonstrated an improvement in the quality of referrals with a decrease in the percentage of referrals being closed at triage by 8%. Our surveys also indicated an increase in the knowledge of official trust delirium guidelines and confidence at managing the patients. This project highlights that a new approach to delirium using multi-component interventions is needed, where the diagnosis of delirium is shared amongst medical and nursing staff, and everyone plays role in management. The key is improving awareness of delirium and encouraging the use of recognized diagnostic tools and official guidelines. Recommendations were made to the trust on how to implement a long-lasting change.

Keywords: delirium, surgery, quality, improvement

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Authors: Leonore Robieux, Franck Zenasni, Marc Pocard, Clarisse Eveno

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Empirical data in health psychology studies show the necessity to consider the doctor-patient communication and its positive impact on outcomes such as patients’ satisfaction, treatment adherence, physical and psychological wellbeing. In this line, the present research aims to define the role and determinants of an effective doctor–patient communication during the treatment of patients with serious illness (peritoneal carcinomatosis). We carried out a prospective longitudinal study including patients treated for peritoneal carcinomatosis of various origins. From November 2016, to date, data were collected using validated questionnaires at two times of evaluation: one month before the surgery (T0) and one month after (T1). Thus, patients reported their (a) anxiety and depression levels, (b) standardized and individualized quality of life and (c) how they perceived communication, attitude and empathy of the surgeon. 105 volunteer patients (Mean age = 58.18 years, SD = 10.24, 62.2% female) participated to the study. PC arose from rare diseases (14%), colorectal (38%), eso-gastric (24%) and ovarian (8%) cancer. Three groups are defined according to the severity of their pathology and the treatment offered to them: (1) important surgical treatment with the goal of healing (53%), (2) repeated palliative surgical treatment (17%), and (3) the patients recused for surgical treatment, only palliative approach (30%). Results are presented according to Baron and Kenny recommendations. The regressions analyses show that only depression and anxiety are sensitive to the communication and empathy of surgeon. The main results show that a good communication and high level of empathy at T0 and T1 limit depression and anxiety of the patients in T1. Results also indicate that the severity of the disease modulates this positive impact of communication: better is the communication the less are the level of depression and anxiety of the patients. This effect is higher for patients treated for the more severe disease. These results confirm that, even in the case severe disease a good communication between patient and physician remains a significant factor in promoting the well-being of patients. More specific training need to be developed to promote empathic care.

Keywords: clinical empathy, determinants, healthcare, psychological wellbeing

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Authors: Jeonghwan Jeon, Mintak Han, Youngjun Kim

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Due to the rapid development of information and communication technology (ICT), a substantial transformation is currently happening in the society. As the range of intelligent technologies and services is continuously expanding, ‘things’ are becoming capable of communicating one another and even with people. However, such “Internet of Things” has the technical weakness so that a great amount of such information transferred in real-time may be widely exposed to the threat of security. User’s personal data are a typical example which is faced with a serious security threat. The threats of security will be diversified and arose more frequently because next generation of unfamiliar technology develops. Moreover, as the society is becoming increasingly complex, security vulnerability will be increased as well. In the existing literature, a considerable number of private and public reports that forecast future society have been published as a precedent step of the selection of future technology and the establishment of strategies for competitiveness. Although there are previous studies that forecast security technology, they have focused only on technical issues and overlooked the interrelationships between security technology and social factors are. Therefore, investigations of security threats in the future and security technology that is able to protect people from various threats are required. In response, this study aims to derive potential security threats associated with the development of technology and to explore the security technology that can protect against them. To do this, first of all, private and public reports that forecast future and online documents from technology-related communities are collected. By analyzing the data, future issues are extracted and categorized in terms of STEEP (Society, Technology, Economy, Environment, and Politics), as well as security. Second, the components of potential security threats are developed based on classified future issues. Then, points that the security threats may occur –for example, mobile payment system based on a finger scan technology– are identified. Lastly, alternatives that prevent potential security threats are proposed by matching security threats with points and investigating related security technologies from patent data. Proposed approach can identify the ICT-related latent security menaces and provide the guidelines in the ‘problem – alternative’ form by linking the threat point with security technologies.

Keywords: future society, information and communication technology, security technology, technology forecasting

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Authors: Tajinder Pal Singh

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Teaching of mathematics to engineering students is an open ended problem in education. The main goal of mathematics learning for engineering students is the ability of applying a wide range of mathematical techniques and skills in their engineering classes and later in their professional work. Most of the undergraduate engineering students and faculties feels that no efforts and attempts are made to demonstrate the applicability of various topics of mathematics that are taught thus making mathematics unavoidable for some engineering faculty and their students. The lack of understanding of concepts in engineering mathematics may hinder the understanding of other concepts or even subjects. However, for most undergraduate engineering students, mathematics is one of the most difficult courses in their field of study. Most of the engineering students never understood mathematics or they never liked it because it was too abstract for them and they could never relate to it. A right balance of application and concept based teaching can only fulfill the objectives of teaching mathematics to engineering students. It will surely improve and enhance their problem solving and creative thinking skills. In this paper, some practical (informal) ways of making mathematics-teaching application based for the engineering students is discussed. An attempt is made to understand the present state of teaching mathematics in engineering colleges. The weaknesses and strengths of the current teaching approach are elaborated. Some of the causes of unpopularity of mathematics subject are analyzed and a few pragmatic suggestions have been made. Faculty in mathematics courses should spend more time discussing the applications as well as the conceptual underpinnings rather than focus solely on strategies and techniques to solve problems. They should also introduce more ‘word’ problems as these problems are commonly encountered in engineering courses. Overspecialization in engineering education should not occur at the expense of (or by diluting) mathematics and basic sciences. The role of engineering education is to provide the fundamental (basic) knowledge and to teach the students simple methodology of self-learning and self-development. All these issues would be better addressed if mathematics and engineering faculty join hands together to plan and design the learning experiences for the students who take their classes. When faculties stop competing against each other and start competing against the situation, they will perform better. Without creating any administrative hassles these suggestions can be used by any young inexperienced faculty of mathematics to inspire engineering students to learn engineering mathematics effectively.

Keywords: application based learning, conceptual learning, engineering mathematics, word problem

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Authors: Radin Siti Aishah Radin A Rahman, Norasmah Othman, Zaidatol Akmaliah Lope Pihie, Hariyaty Ab. Wahid

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The recent instability in economy was found to be influencing the situation in Malaysia whether directly or indirectly. Taking that into consideration, the government needs to find the best approach to balance its citizen’s socio-economic strata level urgently. Through education platform is among the efforts planned and acted upon for the purpose of balancing the effects of the influence, through the exposure of social entrepreneurial activity towards youth especially those in higher institution level. Armed with knowledge and skills that they gained, with the support by entrepreneurial culture and environment while in campus; indirectly, the students will lean more on making social entrepreneurship as a career option when they graduate. Following the issues of marketability and workability of current graduates that are becoming dire, research involving how far the willingness of student to create social innovation that contribute to the society without focusing solely on personal gain is relevant enough to be conducted. With that, this research is conducted with the purpose of identifying the level of entrepreneurial intention and social entrepreneurship among higher institution students in Malaysia. Stratified random sampling involves 355 undergraduate students from five public universities had been made as research respondents and data were collected through surveys. The data was then analyzed descriptively using min score and standard deviation. The study found that the entrepreneurial intention of higher education students are on moderate level, however it is the contrary for social entrepreneurship activities, where it was shown on a high level. This means that while the students only have moderate level of willingness to be a social entrepreneur, they are very committed to created social innovation through the social entrepreneurship activities conducted. The implication from this study can be contributed towards the higher institution authorities in prediction the tendency of student in becoming social entrepreneurs. Thus, the opportunities and facilities for realizing the courses related to social entrepreneurship must be created expansively so that the vision of creating as many social entrepreneurs as possible can be achieved.

Keywords: entrepreneurial intention, higher education institutions (HEIs), social entrepreneurship, social entrepreneurial activity, gender

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Authors: Moulay Driss Mellaoui, Khadija Zaki, Khalid Abbiche, Abdallah Imjjad, Rachid Boutiddar, Abdelouahid Sbai, Aaziz Jmiai, Souad El Issami, Al Mokhtar Lamsabhi, Hanane Zejli

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This study presents a comprehensive analysis of six isoxazolidine and isoxazoline derivatives, leveraging a multifaceted approach that combines Density Functional Theory (DFT), AdmetSAR analysis, and molecular docking simulations to explore their electronic, pharmacokinetic, and anticancer properties. Through DFT analysis, using the B3LYP-D3BJ functional and the 6-311++G(d,p) basis set, we optimized molecular geometries, analyzed vibrational frequencies, and mapped Molecular Electrostatic Potentials (MEP), identifying key sites for electrophilic attacks and hydrogen bonding. Frontier Molecular Orbital (FMO) analysis and Density of States (DOS) plots revealed varying stability levels among the compounds, with 1b, 2b, and 3b showing slightly higher stability. Chemical potential assessments indicated differences in binding affinities, suggesting stronger potential interactions for compounds 1b and 2b. AdmetSAR analysis predicted favorable human intestinal absorption (HIA) rates for all compounds, highlighting compound 3b superior oral effectiveness. Molecular docking and molecular dynamics simulations were conducted on isoxazolidine and 4-isoxazoline derivatives targeting the EGFR receptor (PDB: 1JU6). Molecular docking simulations confirmed the high affinity of these compounds towards the target protein 1JU6, particularly compound 3b, among the isoxazolidine derivatives, compound 3b exhibited the most favorable binding energy, with a g score of -8.50 kcal/mol. Molecular dynamics simulations over 100 nanoseconds demonstrated the stability and potential of compound 3b as a superior candidate for anticancer applications, further supported by structural analyses including RMSD, RMSF, Rg, and SASA values. This study underscores the promising role of compound 3b in anticancer treatments, providing a solid foundation for future drug development and optimization efforts.

Keywords: isoxazolines, DFT, molecular docking, molecular dynamic, ADMET, drugs.

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Authors: Ibragim Issabekov, Byron Crape, Lyazzat Toleubekova

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Background: Palliative care substantially improves the quality of life of terminally-ill patients. Symptom control is one of the keystones in the management of patients in palliative care settings, lowering distress as well as improving the quality of life of patients with end-stage diseases. The most common symptoms causing significant distress for patients are pain, nausea and vomiting, increased respiratory secretions and mental health issues like depression. Aims are: 1. to identify best practices in symptom management in palliative patients in accordance with internationally approved guidelines and compare aforementioned with actual practices in Kazakhstan; to evaluate the criteria for assessing symptoms in terminally-ill patients, 2. to review the availability and utilization of pharmaceutical agents for pain control, management of excessive respiratory secretions, nausea, and vomiting, and delirium and 3. to develop recommendations for the systematic approach to end-of-life symptom management in Kazakhstan. Methods: The use of qualitative research methods together with systematic literature review have been employed to provide a rigorous research process to evaluate current approaches for symptom management of palliative patients in Kazakhstan. Qualitative methods include in-depth semi-structured interviews of the healthcare professionals involved in palliative care provision. Results: Obstacles were found in appropriate provision of palliative care. Inadequate education and training to manage severe symptoms, poorly defined laws and regulations for palliative care provision, and a lack of algorithms and guidelines for care were major barriers in the effective provision of palliative care. Conclusion: Assessment of palliative care in this medium-income transitional-economy country is one of the first steps in the initiation of integration of palliative care into the existing health system. Achieving this requires identifying obstacles and resolving these issues.

Keywords: end-of-life care, middle income country, palliative care, symptom control

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Authors: Tess Howard, Lily Owens, Maneesha De Silva, Russell Hodgson

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Purpose: This study aims to evaluate the cost-effectiveness of laparoscopic common bile duct exploration (CBDE) compared to endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy for the emergency management of common bile duct (CBD) stones. Methodology: A retrospective case note review was conducted on consecutive patients undergoing emergency management of CBD stones using either CBDE, or ERCP and cholecystectomy at a single centre between January 2014-October 2014. Data on admission and procedural costs, length of hospital stay, postoperative complications and further stone related interventions were analysed. Results: A total of 350 patients were analysed. Among them, 299 patients underwent CBDE at the time of cholecystectomy, while the remaining 51 underwent ERCP either pre-, intra- or post cholecystectomy. CBDE was associated with lower overall costs compared to ERCP with an average hospital stay cost of $13,093 vs $22,930 respectively. This was largely attributed to shorter hospital stays (6.5 vs 10.3 days), decreased need for intensive care unit admission and fewer postoperative interventions within the CBDE group. Notably, single procedure laparoscopic cholecystectomy with CBDE demonstrated decreased operative costs compared to laparoscopic cholecystectomy combined with ERCP pre-/intra- or post-operatively ($3,747 vs. $4,641). Conclusion: Emergent CBDE is a cost-effective alternative to ERCP for managing CBD stones when combined with cholecystectomy. The upfront investment in equipment for CBDE and increased cholecystectomy procedural time is counterbalanced by reduced hospital stay, fewer procedures and subsequent cost savings. Economic considerations, in conjunction with clinical outcomes, should inform the selection of the optimal approach for CBD stone management in emergency settings.

Keywords: choledocolithiasis, management, cost-effectiveness, endoscopic retrograde cholangiopancreatography, ERCP, CBDE, common bile duct exploration

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Authors: Forouzan Salehi Fergeni

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Converting the movement intents of a person into commands for action employing brain signals like electroencephalogram signals is a brain-computer interface (BCI) system. When left or right-hand motions are imagined, different patterns of brain activity appear, which can be employed as BCI signals for control. To make better the brain-computer interface (BCI) structures, effective and accurate techniques for increasing the classifying precision of motor imagery (MI) based on electroencephalography (EEG) are greatly needed. Subject dependency and non-stationary are two features of EEG signals. So, EEG signals must be effectively processed before being used in BCI applications. In the present study, after applying an 8 to 30 band-pass filter, a car spatial filter is rendered for the purpose of denoising, and then, a method of analysis of variance is used to select more appropriate and informative channels from a category of a large number of different channels. After ordering channels based on their efficiencies, a sequential forward channel selection is employed to choose just a few reliable ones. Features from two domains of time and wavelet are extracted and shortlisted with the help of a statistical technique, namely the t-test. Finally, the selected features are classified with different machine learning and neural network classifiers being k-nearest neighbor, Probabilistic neural network, support-vector-machine, Extreme learning machine, decision tree, Multi-layer perceptron, and linear discriminant analysis with the purpose of comparing their performance in this application. Utilizing a ten-fold cross-validation approach, tests are performed on a motor imagery dataset found in the BCI competition III. Outcomes demonstrated that the SVM classifier got the greatest classification precision of 97% when compared to the other available approaches. The entire investigative findings confirm that the suggested framework is reliable and computationally effective for the construction of BCI systems and surpasses the existing methods.

Keywords: brain-computer interface, channel selection, motor imagery, support-vector-machine

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Authors: Seyran Naghdi

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Background: Orphan drug development is limited by very high costs attributed to the research and development and small size market. How health policymakers address this challenge to consider both supply and demand sides need to be explored for directing the policies and plans in the right way. The price is an important signal for pharmaceutical companies’ profitability and the patients’ accessibility as well. Objective: This study aims to find out the orphan drugs' price-setting patterns and approaches in health systems through a systematic review of the available evidence. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) approach was used. MedLine, Embase, and Web of Sciences were searched via appropriate search strategies. Through Medical Subject Headings (MeSH), the appropriate terms for pricing were 'cost and cost analysis', and it was 'orphan drug production', and 'orphan drug', for orphan drugs. The critical appraisal was performed by the Joanna-Briggs tool. A Cochrane data extraction form was used to obtain the data about the studies' characteristics, results, and conclusions. Results: Totally, 1,197 records were found. It included 640 hits from Embase, 327 from Web of Sciences, and 230 MedLine. After removing the duplicates, 1,056 studies remained. Of them, 924 studies were removed in the primary screening phase. Of them, 26 studies were included for data extraction. The majority of the studies (>75%) are from developed countries, among them, approximately 80% of the studies are from European countries. Approximately 85% of evidence has been produced in the recent decade. Conclusions: There is a huge variation of price-setting among countries, and this is related to the specific pharmacological market structure and the thresholds that governments want to intervene in the process of pricing. On the other hand, there is some evidence on the availability of spaces to reduce the very high costs of orphan drugs development through an early agreement between pharmacological firms and governments. Further studies need to focus on how the governments could incentivize the companies to agree on providing the drugs at lower prices.

Keywords: orphan drugs, orphan drug production, pricing, costs, cost analysis

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Authors: Li Yang, Yang Song, Martin Y. M. Chiang

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Objective: To experimentally substantiate the micromechanical compatibility between cell and scaffold, in the regenerative medicine approach for restoring bone volume, is essential for phenotypic transitions Methods: Through nanotechnology and electrospinning process, nanofibrous scaffolds were fabricated to host dental follicle stem cells (DFSCs). Blends (50:50) of polycaprolactone (PCL) and silk fibroin (SF), mixed with various content of cellulose nanocrystals (CNC, up to 5% in weight), were electrospun to prepare nanofibrous scaffolds with heterogeneous microstructure in terms of fiber size. Colloidal probe atomic force microscopy (AFM) and conventional uniaxial tensile tests measured the scaffold stiffness at the micro-and macro-scale, respectively. The cell elastic modulus and cell-scaffold adhesive interaction (i.e., a chemical function) were examined through single-cell force spectroscopy using AFM. The quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was used to determine if the mechanotransduction signal (i.e., Yap1, Wwr2, Rac1, MAPK8, Ptk2 and Wnt5a) is upregulated by the scaffold stiffness at the micro-scale (cellular scale). Results: The presence of CNC produces fibrous scaffolds with a bimodal distribution of fiber diameter. This structural heterogeneity, which is CNC-composition dependent, remarkably modulates the mechanical functionality of scaffolds at microscale and macroscale simultaneously, but not the chemical functionality (i.e., only a single material property is varied). In in vitro tests, the osteogenic differentiation and gene expression associated with mechano-sensitive cell markers correlate to the degree of micromechanical compatibility between DFSCs and the scaffold. Conclusion: Cells require compliant scaffolds to encourage energetically favorable interactions for mechanotransduction, which are converted into changes in cellular biochemistry to direct the phenotypic evolution. The micromechanical compatibility is indeed important to the efficacy of regenerative medicine.

Keywords: phenotype transition, scaffold stiffness, electrospinning, cellulose nanocrystals, single-cell force spectroscopy

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Authors: Cindy Davis

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Higher education is changing globally and there is increasing pressure from professional social work accreditation bodies for academic programs to demonstrate how students have successfully met mandatory graduate competencies. As professional accreditation organizations increase their demand for evidence of graduate competencies, strategies to document and recording learning outcomes becomes increasingly challenging for academics and students. Studies in higher education have found support for the pedagogical value of ePortfolios, a flexible personal learning space that is owned by the student and include opportunity for assessment, feedback and reflection as well as a virtual space to store evidence of demonstration of professional competencies and graduate attributes. Examples of institutional uses of ePortfolios include e-administration of a diverse student population, assessment of student learning, and the demonstration of graduate attributes attained and future student career preparation. The current paper presents a case study on the introduction of ePortfolios for social work graduates in Australia as part of an institutional approach to technology-enhanced learning and e-learning. Social work graduates were required to submit an ePortfolio hosted on PebblePad. The PebblePad platform was selected because it places the student at the center of their learning whilst providing powerful tools for staff to structure, guide and assess that learning. The ePortofolio included documentation and evidence of how the student met each graduate competency as set out by the social work accreditation body in Australia (AASW). This digital resource played a key role in the process of external professional accreditation by clearly documenting and evidencing how students met required graduate competencies. In addition, student feedback revealed a positive outcome on how this resource provided them with a consolidation of their learning experiences and assisted them in obtaining employment post-graduation. There were also significant institutional factors that were key to successful implementation such as investment in the digital technology, capacity building amongst academics, and technical support for staff and students.

Keywords: accreditation, social work, teaching, technology

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Authors: Fanny Guay

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Building resilience, sustainable buildings, urbanization, climate change, resilient cities, are just a few examples of where the focus of research has been in the last few years. It is obvious that there is a need to rethink how we are building our cities and how we are renovating our existing buildings. However, the question remaining is how can we assure that we are building sustainable yet resilient cities? There are many aspects one can touch upon when discussing resilience in cities, but after the event of Grenfell in June 2017, it has become clear that fire resilience must be a priority. We define resilience as a holistic approach including communities, society and systems, focusing not only on resisting the effects of a disaster, but also how it will cope and recover from it. Cities are an example of such a system, where components such as buildings have an important role to play. A building on fire will have an impact on the community, the economy, the environment, and so the entire system. Therefore, we believe that fire and resilience go hand in hand when we discuss building resilient cities. This article aims at discussing the current state of the concept of fire resilience and suggests actions to support the built of more fire resilient buildings. Using the case of Grenfell and the fire safety regulations in the UK, we will briefly compare the fire regulations in other European countries, more precisely France, Germany and Denmark, to underline the difference and make some suggestions to increase fire resilience via regulation. For this research, we will also include other types of resilience such as technological resilience, discussing the structure of buildings itself, as well as community resilience, considering the role of communities in building resilience. Our findings demonstrate that to increase fire resilience, amending existing regulations might be necessary, for example, how we performed reaction to fire tests and how we classify building products. However, as we are looking at national regulations, we are only able to make general suggestions for improvement. Another finding of this research is that the capacity of the community to recover and adapt after a fire is also an essential factor. Fundamentally, fire resilience, technological resilience and community resilience are closely connected. Building resilient cities is not only about sustainable buildings or energy efficiency; it is about assuring that all the aspects of resilience are included when building or renovating buildings. We must ask ourselves questions as: Who are the users of this building? Where is the building located? What are the components of the building, how was it designed and which construction products have been used? If we want to have resilient cities, we must answer these basic questions and assure that basic factors such as fire resilience are included in our assessment.

Keywords: buildings, cities, fire, resilience

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Authors: Vivek Anand, Rainer Naegele

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Industry 4.0 is a global mega-trend revolutionizing the world of advanced manufacturing, but also bringing up challenges for SMEs. In response, many regional, as well as digital Industry 4.0 Platforms, have been set up to boost the competencies of established enterprises as well as SMEs. The concept of 'Clusters' is a policy tool that aims to be a starting point to establish sustainable and self-supporting structures in industries of a region by identifying competencies and supporting cluster actors with services that match their growth needs. This paper is motivated by the idea that Clusters have the potential to enable firms, particularly SMEs, to accelerate the innovation process and transition to digital technologies. In this research, the efficacy of Industry 4.0 platforms as Cluster ecosystems is evaluated, especially for SMEs. Focusing on the Baden Wurttemberg region in Germany, an action research method is employed to study how SMEs leverage other actors on Industry 4.0 Platforms to further their Industry 4.0 journeys. The aim is to evaluate how such Industry 4.0 platforms stimulate innovation, cooperation and competitiveness. Additionally, the barriers to these platforms fulfilling their promise to serve as capacity building cluster ecosystems for SMEs in a region will also be identified. The findings will be helpful for academicians and policymakers alike, who can leverage a ‘cluster policy’ to enable Industry 4.0 ecosystems in their regions. Furthermore, relevant management and policy implications stem from the analysis. This will also be of interest to the various players in a cluster ecosystem - like SMEs and service providers - who benefit from the cooperation and competition. The paper will improve the understanding of how a dialogue orientation, a bottom-up approach and active integration of all involved cluster actors enhance the potential of Industry 4.0 Platforms. A strong collaborative culture is a key driver of digital transformation and technology adoption across sectors, value chains and supply chains; and will position Industry 4.0 Platforms at the forefront of the industrial renaissance. Motivated by this argument and based on the results of the qualitative research, a roadmap will be proposed to position Industry 4.0 Platforms as effective clusters ecosystems to support Industry 4.0 adoption in a region.

Keywords: cluster policy, digital transformation, industry 4.0, innovation clusters, innovation policy, SMEs and startups

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Authors: Elisa Menicucci, Guido Paolucci

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Purpose: The aim of this paper is to investigate the factors influencing profitability in the Italian hospitality industry during the period 2008-2016. Design/methodology/approach: This study examines the profitability and its determinants using a sample of 2366 Italian hotel firms. First, we use a multidimensional measure of profitability including attributes as return on equity, return on assets and occupancy rate. Second, we examine variables that are potentially related with performance and we sort these into five categories: market variables, business model, ownership structure, management education and control variables. Findings: The results show that financial crisis, business model and ownership structure influence profitability of hotel firms. Specific factors such as the internationalization, location, firm’s declaring accommodation as their primary activity and chain affiliation are associated positively with profitability. We also find that larger hotel firms have higher performance rankings, while hotels with higher operating cash flow volatility, greater sales volatility and a higher occurrence of losses have lower profitability. Research limitations/implications: Findings suggest the importance of considering firm specific factors to evaluate the profitability of a hotel firm. Results also provide evidence for academics to critically evaluate factors that would ensure profitability of hotels in developed countries such as Italy. Practical implications: This investigation offers valuable information and strategic implications for government, tourism policymakers, tourist hotel owners, hoteliers and tourism managers in their decision-making. Originality/value: This paper provides interesting insights into the characteristics and practices of profitable hotels in Italy. Few econometric studies empirically explored the determinants of performance in the European hospitality field so far. Therefore, this paper tries to close an important gap in the existing literature improving the understanding of profitability in the Italian hospitality industry.

Keywords: hotel firms, profitability, determinants, Italian hospitality industry

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Authors: Mohamed El Horri, Amine Mouden, Reda Messaoudi, Mohamed Chekkal, Driss Benlaldj, Malika Baghdadi, Lahcene Benmahdi, Fatima Seghier

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Background/aim: Recently, the Von Willebrand factor antigen (vWF-Ag)has been identified as a new marker of portal hypertension (PH) and its complications. Few studies talked about its role in the prediction of esophageal varices. VWF-Ag is considered a non-invasive approach, In order to avoid the endoscopic burden, cost, drawbacks, unpleasant and repeated examinations to the patients. In our study, we aimed to evaluate the ability of this marker in the prediction of another complication of portal hypertension, which is portal hypertensive gastropathy (PHG), the one that is diagnosed also by endoscopic tools. Patients and methods: It is about a prospective study, which include 124 cirrhotic patients with no history of bleeding who underwent screening endoscopy for PH-related complications like esophageal varices (EVs) and PHG. Routine biological tests were performed as well as the VWF-Ag testing by both ELFA and Immunoturbidimetric techniques. The diagnostic performance of our marker was assessed using sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and receiver operating characteristic curves. Results: 124 patients were enrolled in this study, with a mean age of 58 years [CI: 55 – 60 years] and a sex ratio of 1.17. Viral etiologies were found in 50% of patients. Screening endoscopy revealed the presence of PHG in 20.2% of cases, while for EVsthey were found in 83.1% of cases. VWF-Ag levels, were significantly increased in patients with PHG compared to those who have not: 441% [CI: 375 – 506], versus 279% [CI: 253 – 304], respectively (p <0.0001). Using the area under the receiver operating characteristic curve (AUC), vWF-Ag was a good predictor for the presence of PHG. With a value higher than 320% and an AUC of 0.824, VWF-Ag had an 84% sensitivity, 74% specificity, 44.7% positive predictive value, 94.8% negative predictive value, and 75.8% diagnostic accuracy. Conclusion: VWF-Ag is a good non-invasive low coast marker for excluding the presence of PHG in patients with liver cirrhosis. Using this marker as part of a selective screening strategy might reduce the need for endoscopic screening and the coast of the management of these kinds of patients.

Keywords: von willebrand factor, portal hypertensive gastropathy, prediction, liver cirrhosis

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Authors: Anamika Choudhary, Neha Qurrat Ain

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Background: Congenital agenesis of uterine cervix is a rare anomaly often associated with partial or complete agenesis of vagina. Here is a case report of a 14 year old girl who presented with primary amenorrhea and cyclical abdominal pain since last one year with suprapubic mass palpable. On examination complete absence of a vagina was found, and ultrasound along with magnetic resonance imaging (MRI) suggested cervicovaginal agenesis associated with cryptomenorrhea, which resulted in hematometra and b/l hematosalpinx with pelvic endometriosis. After proper counseling regarding anastomosis failure and the need for future laprotomy or hysterectomy, the patient planned for laparoscopic uterovaginal anastomosis with modified McIndoe vaginoplasty with split skin graft. Case Summary: Chief complaint: The 14 year old girl presented with primary amenorrhea and cyclical abdominal pain. Diagnosis:On history, examination and investigations we made differential diagnoses of cervicovaginal agenesis, cervicovaginal atresia. Post operatively, we concluded it’s a cervicovaginal agenesis. Intervention: Laparoscopic uterovaginal anastomosis was done, and neovagina was created using split skin graft from the thigh and silicone stent. The graft was kept patent, and restenosis was prevented using a dental mould as vaginal dilator. Outcome: Postoperatively 1 year follow-up has been done. We have observed successful uterovaginal anastomosis and good uptake of graft. We also observed the resumption of normal menstrual bleeding. Currently, there has been no restenosis, abnormal vaginal discharge and decreased dysmenorrhea. Conclusion: Laparoscopic-assisted uterovaginal anastomosis can be the treatment of choice in patients with cervical agenesis and atresia instead of hysterectomy, thereby preserving the reproductive function. This conservative approach has better outcomes, as stated in the procedure below. The procedure is successful insofar as the resumption of menstrual function. However, long-term reproductive outcomes, progression of endometriosis, functioning of fallopian tubes, and sexual life in these girls will require further follow-up.

Keywords: cervicovaginal agenesis, uterovaginal anastomosis, dental mould, silicon stent

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