Search results for: diagnostic challenge

Authors: E. Younsi, H. Andriamboavonjy, A. David, S. Dokou, B. Lemrabet

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Software and time optimization are very important factors in financial markets, which are competitive fields, and emergence of new computer tools further stresses the challenge. In this context, any improvement of technical indicators which generate a buy or sell signal is a major issue. Thus, many tools have been created to make them more effective. This worry about efficiency has been leading in present paper to seek best (and most innovative) way giving largest improvement in these indicators. The approach consists in attaching a signature to frequent market configurations by application of frequent patterns extraction method which is here most appropriate to optimize investment strategies. The goal of proposed trading algorithm is to find most accurate signatures using back testing procedure applied to technical indicators for improving their performance. The problem is then to determine the signatures which, combined with an indicator, outperform this indicator alone. To do this, the FP-Tree algorithm has been preferred, as it appears to be the most efficient algorithm to perform this task.

Keywords: quantitative analysis, back-testing, computational models, apriori algorithm, pattern recognition, data mining, FP-tree

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Authors: Pechpailin Kortnoi, Tanitnun Paprad

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Background: Myasthenia gravis (MG) is an autoimmune disorder characterized by impaired neuromuscular transmission due to antibodies against nicotinic receptors, leading to muscle weakness, ptosis, and respiratory issues. The incidence of MG has risen globally, emphasizing the need for effective diagnostics. Objective: This study evaluates the validity of a combined bedside test (the ice pack test and fatigability test) for diagnosing juvenile myasthenia gravis (JMG) in pediatric patients with ptosis. Methods: This cross-sectional study, conducted from January 2012 to May 2024 at King Chulalongkorn Memorial Hospital, Thailand, included pediatric patients (1 month to 18 years) with ptosis undergoing ice pack and fatigability tests. Data included demographics, clinical findings, and test results. Diagnostic efficacy was assessed using sensitivity, specificity, accuracy, PPV, NPV, Fagan Nomogram, Kappa Statistics, and McNemar’s Chi-Square. Results: Of 43 identified patients, 32 were included, with 47% male and a mean age of 7 years. The combined bedside test had high sensitivity (92.8%) and accuracy (87.5%) but moderate specificity (50%). It significantly outperformed the ice pack test (P = 0.0005), which showed low sensitivity (42.8%) and accuracy (43.8%). The fatigability test had 82% sensitivity and 92% PPV. Confirmatory tests (AChR-Ab, MuSK-Ab, neostigmine, repetitive nerve stimulation) supported most diagnoses. Conclusions: The combined bedside test, with high sensitivity (92.8%) and accuracy (87.5%), is an effective screening tool for juvenile myasthenia gravis, outperforming the ice pack test. Integrating it into clinical practice may improve diagnosis and enable timely treatment. The fatigability test (82% sensitivity) is also useful as an adjunct screening tool.

Keywords: myasthenia gravis, the fatigability test, the ice pack test, the combined bedside test

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Authors: Amine Ben Slama, Aymen Mouelhi, Sondes Manoubi, Chiraz Mbarek, Hedi Trabelsi, Mounir Sayadi, Farhat Fnaiech

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Vertigo is a sensation of feeling off balance; the cause of this symptom is very difficult to interpret and needs a complementary exam. Generally, vertigo is caused by an ear problem. Some of the most common causes include: benign paroxysmal positional vertigo (BPPV), Meniere's disease and vestibular neuritis (VN). In clinical practice, different tests of videonystagmographic (VNG) technique are used to detect the presence of vestibular neuritis (VN). The topographical diagnosis of this disease presents a large diversity in its characteristics that confirm a mixture of problems for usual etiological analysis methods. In this study, a vestibular neuritis analysis method is proposed with videonystagmography (VNG) applications using an estimation of pupil movements in the case of an uncontrolled motion to obtain an efficient and reliable diagnosis results. First, an estimation of the pupil displacement vectors using with Hough Transform (HT) is performed to approximate the location of pupil region. Then, temporal and frequency features are computed from the rotation angle variation of the pupil motion. Finally, optimized features are selected using Fisher criterion evaluation for discrimination and classification of the VN disease.Experimental results are analyzed using two categories: normal and pathologic. By classifying the reduced features using the Support Vector Machine (SVM), 94% is achieved as classification accuracy. Compared to recent studies, the proposed expert system is extremely helpful and highly effective to resolve the problem of VNG analysis and provide an accurate diagnostic for medical devices.

Keywords: nystagmus, vestibular neuritis, videonystagmographic system, VNG, Fisher criterion, support vector machine, SVM

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Authors: Caridad Maylin-Aguilar, Beatriz Duarte-Monedero

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Problem-based learning (PBL) is a useful tool for adult and practice oriented audiences, as University students. As a consequence of the huge disruption caused by the COVID pandemic in the hospitality industry, hotels of all categories closed down in Spain from March 2020. Since that moment, the luxury segment was blooming with optimistic prospects for new openings. Hence, Hospitality students were expecting a positive situation in terms of employment and career development. By the beginning of the 2020-21 academic year, these expectations were seriously harmed. By October 2020, only 9 of the 32 hotels in the luxury segment were opened with an occupation rate of 9%. Shortly after, the evidence of a second wave affecting especially Spain and the homelands of incoming visitors bitterly smashed all forecasts. In accordance with the situation, a team of four professors and practitioners, from four different subject areas, developed a real case, inspired in one of these hotels, the 5-stars Emperatriz by Barceló. Students in their 2nd course were provided with real information as marketing plans, profit and losses and operational accounts, employees profiles and employment costs. The challenge for them was to act as consultants, identifying potential courses of action, related to best, base and worst case. In order to do that, they were organized in teams and supported by 4th course students. Each professor deployed the problem in their subject; thus, research on the customers behavior and feelings were necessary to review, as part of the marketing plan, if the current offering of the hotel was clear enough to guarantee and to communicate a safe environment, as well as the ranking of other basic, supporting and facilitating services. Also, continuous monitoring of competitors’ activity was necessary to understand what was the behavior of the open outlets. The actions designed after the diagnose were ranked in accordance with their impact and feasibility in terms of time and resources. Also they must be actionable by the current staff of the hotel and their managers and a vision of internal marketing was appreciated. After a process of refinement, seven teams presented their conclusions to Emperatriz general manager and the rest of professors. Four main ideas were chosen, and all the teams, irrespectively of authorship, were asked to develop them to the state of a minimum viable product, with estimations of impacts and costs. As the process continues, students are nowadays accompanying the hotel and their staff in the prudent reopening of facilities, almost one year after the closure. From a professor’s point of view, key learnings were 1.- When facing a real problem, a holistic view is needed. Therefore, the vision of subjects as silos collapses, 2- When educating new professionals, providing them with the resilience and resistance necessaries to deal with a problem is always mandatory, but now seems more relevant and 3.- collaborative work and contact with real practitioners in such an uncertain and changing environment is a challenge, but it is worth when considering the learning result and its potential.

Keywords: problem-based learning, hospitality recovery, collaborative learning, resilience

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Authors: Ahmad H. Abdelgwad, Galal E. Nadim, Tarek M. Said, Amr M. Gody

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The prime objective of this manuscript is to provide intensive review of the techniques used for permittivity measurements. The measurement techniques, relevant for any desired application, rely on the nature of the measured dielectric material, both electrically and physically, the degree of accuracy required, and the frequency of interest. Regardless of the way that distinctive sorts of instruments can be utilized, measuring devices that provide reliable determinations of the required electrical properties including the obscure material in the frequency range of interest can be considered. The challenge in making precise dielectric property or permittivity measurements is in designing of the material specimen holder for those measurements (RF and MW frequency ranges) and adequately modeling the circuit for reliable computation of the permittivity from the electrical measurements. If the RF circuit parameters such as the impedance or admittance are estimated appropriately at a certain frequency, the material’s permittivity at this frequency can be estimated by the equations which relate the way in which the dielectric properties of the material affect on the parameters of the circuit.

Keywords: dielectric permittivity, free space measurement, waveguide techniques, coaxial probe, cavity resonator

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Authors: Saidu I. Rambo, Emmanuel O. Ibam, Sunday O. Adewale

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The configuration of routers for effective communication in the Nigerian Navy (NN) enables the navy to improve on the current communication systems. The current system is faced with challenges that make the systems partially effective. The major implementation of the system is to configure routers using hierarchical model and obtaining a VSAT option on C-band platform. These routers will act as a link between Naval Headquarters and the Commands under it. The routers main responsibilities are to forward packets from source location to destination using a Link State Routing Protocol (LSRP). Also using the Point to Point Protocol (PPP), creates a strong encrypted password using Challenge Handshake Authentication Protocol (CHAP) which uses one-way hash function of Message Digest 5 (MD5) to provide complete protection against hackers/intruders. Routers can be configured using a Linux operating system or internet work operating system in the Microsoft platform. With this, system packets can be forwarded to various locations more effectively than the present system being used.

Keywords: C-band, communication, router, VSAT

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Authors: Ahmad Bilal

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Digital and convergent media can be helpful in terms of acquiring film production skills and knowledge, and it has also reduced the cost of production. Thus, allowing filmmakers greater opportunities and access to the medium of film. Both these dimensions of new and convergent media have been challenging the established cinema of Pakistan, as traditionally, it has been controlled by the authorities through censorship policies. The use of the smartphone as a movie camera, editing machine, and a transmitter can further challenge the control in a postcolonial society. To explore the impact of new and convergent media on the art of filmmaking, a film 'Sohni Dharti: An untrue story' is produced. It is shot both on a smartphone and a Digital Single Lens Reflex Camera (DSLR), with almost zero budgets. It is distributed through Vimeo from Pakistan. This process reveals how the technologies that are available today, and the increased knowledge of film production that they bring, allow a more inclusive experience of the film production and distribution. At the same time, however, it also discloses the limitations that accompany new technologies within the context of a postcolonial society. This paper will investigate the role of technology to bring filmmaking at a level of pencil and paper.

Keywords: convergent media, filmmaking, smartphone, Pakistan

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Authors: Selim A., Albasher N., Bakrmom G., Alanzi S.

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Irritable bowel syndrome (IBS) is a chronic functional bowel disorder characterized by abdominal discomfort or pain and associated with alteration in frequency and/or form of bowel habit among other symptoms. This diagnosis is associated with increased levels of psychological distress, maladaptive coping, genetic risk factors, abnormal small and colonic intestine transit, change in stool frequency or form and abdominal discomfort or pain. Aim: The aim of the study was to assess psychological alarm among individuals suffering from Irritable Bowel Syndrome (IBS). Methods: A cross-sectional correlational research design was used to conduct the current study. A convenience sample of 504 participants was included in the present study. Data were collected using a self-report questionnaire. The questionnaire included socio-demographic data, ROME III to identify Irritable Bowel Syndrome (IBS) and Psychological Alarm Questionnaire. Results: Out of 504 participants who reported abdominal discomfort, 297 (58.9 %) participants met the diagnostic criteria of IBS. The mean age of the IBS participants was 30.16 years, females composed 75.1% of the IBS participants, and 55.2% did not seek medical help. Psychological alarms such as feeling anxious, feeling depressed, having suicidal ideations, bodily pain, having impaired functioning due to pain and feeling unable to cope with pain were significantly high among IBS individuals when compared to individuals not suffering from IBS. Psychological alarms such as feeling anxious, feeling depressed, having suicidal ideations, bodily pain, having impaired functioning due to pain and feeling unable to cope with pain were significantly high among IBS individuals compared to individuals not suffering from IBS. Conclusion: IBS is highly associated with significant psychological alarms including depression, anxiety and suicidal ideas.

Keywords: abdominal pain , irritable bowel syndrome, distress, psychological alarms

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Authors: S. Nasri, H. Bouziri

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Disasters are quite experienced in our days. They are caused by floods, landslides, and building fires that is the main objective of this study. To cope with these unexpected events, precautions must be taken to protect human lives. The emphasis on disposal work focuses on the resolution of the evacuation problem in case of no-notice disaster. The problem of evacuation is listed as a dynamic network flow problem. Particularly, we model the evacuation problem as an earliest arrival flow problem with load dependent transit time. This problem is classified as NP-Hard. Our challenge here is to propose a metaheuristic solution for solving the evacuation problem. We define our objective as the maximization of evacuees during earliest periods of a time horizon T. The objective provides the evacuation of persons as soon as possible. We performed an experimental study on emergency evacuation from the tunisian children’s hospital. This work prompts us to look for evacuation plans corresponding to several situations where the network dynamically changes.

Keywords: dynamic network flow, load dependent transit time, evacuation strategy, earliest arrival flow problem, tabu search metaheuristic

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Authors: Patricia Amorim Da Silva

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This paper explores the ongoing process of decolonialism, focusing on addressing the lasting consequences of colonialism. Centred on identity within marginalized communities, the study challenges Eurocentric frameworks and advocates for diverse perspectives. Emphasizing critical self-awareness among researchers regarding biases in their work, decolonialism influences feminist theory and global counter-publics. At its core is the concept of epistemicide, the intentional suppression of knowledge in unequal cultural interactions. Colonial imposition has devalued local knowledge, contributing to cultural loss and undermining autonomy. The paper underscores the importance of reclaiming indigenous knowledge to revitalize local cultures and languages, particularly pertinent to the Brazilian context. This contribution to the discourse on decolonialism underscores the imperative to challenge prevailing narratives and empower historically subordinated communities. The study aspires to advance feminist theory and decolonial studies, fostering a more equitable and inclusive global society.

Keywords: decolonialism, colonial legacies, identity, Eurocentrism, epistemicide

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Authors: Mona Vijayaran, Gurleen Oberoi, Sanjay Mishra

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Introduction: p190 BCR‐ABL1 in CML is often associated with monocytosis. In the case described here, monocytosis is associated with coexisting p210 BCR‐ABL and CMML clones. Mutation analysis using next‐generation sequence (NGS) in our case showed TET2 and SRSF2 mutations. Aims & Objectives: A 75-year male was evaluated for monocytosis and thrombocytopenia. CBC showed Hb-11.8g/dl, TLC-12,060/cmm, Monocytes-35%, Platelets-39,000/cmm. Materials & Methods: Bone marrow examination showed a hypercellular marrow with myeloid series showing sequential maturation up to neutrophils with 30% monocytes. Immunophenotyping by flow cytometry from bone marrow had 3% blasts. Making chronic myelomonocytic leukemia as the likely diagnosis. NGS for myeloid mutation panel had TET2 (48.9%) and SRSF2 (32.5%) mutations. This report further supported the diagnosis of CMML. To fulfil the WHO diagnostic criteria for CMML, a BCR ABL1 by RQ-PCR was sent. The report came positive for p210 (B3A2, B2A2) Major Transcript (M-BCR) % IS of 38.418. Result: The patient was counselled regarding the unique presentation of the presence of 2 clones- P210 CML and CMML. After discussion with an international faculty with vast experience in CMML. It was decided to start this elderly gentleman on Imatinib 200mg and not on azacytidine, as ASXL1 was not present; hence, his chances of progressing to AML would be less and on the other end, if CML is left untreated then chances of progression to blast phase would always be a possibility. After 3 months on Imatinib his platelet count improved to 80,000 to 90,000/cmm, but his monocytosis persists. His 3rd month BCR-ABL1 IS% is 0.004%. Conclusion: After searching the literature, there were no case reports of a coexisting CML p210 with CMML. This case might be the first case report. p190 BCR ABL1 is often associated with monocytosis. There are few case reports of p210 BCR ABL1 positivity in patients with monocytosis but none with coexisting CMML. This case highlights the need for extensively evaluating patients with monocytosis with next-generation sequencing for myeloid mutation panel and BCR-ABL1 by RT-PCR to correctly diagnose and treat them.

Keywords: CMML, NGS, p190 CML, Imatinib

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Authors: Latif Duran, Erdem Aydin, Ahmet Baydin, Ali Kemal Erenler, Iskender Aksoy

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Aim: In this retrospective study, we aim to contribute to the literature by presenting the proposals for taking measures to reduce the mortality by examining the demographic characteristics of the pediatric age group patients presenting with trauma and the factors that may cause mortality Material and Method: This study has been performed by retrospectively investigating the data obtained from the patient files and the hospital automation registration system of the pediatric trauma patients who applied to the Adult Emergency Department of the Ondokuz Mayıs University Medical Faculty between January 1, 2016, and December 31, 2016. Results: 289 of 415 patients involved in our study, were males. The median age was 11.3 years. The most common trauma mechanism was falling from the high. A significant statistical difference was found on the association between trauma mechanisms and gender. An increase in the number of trauma cases was found especially in the summer months. The study showed that thoracic and abdominal trauma was relevant to the increased mortality. Computerized tomography was the most common diagnostic imaging modality. The presence of subarachnoid hemorrhage has increased the risk of mortality by 62.3 fold. Eight of the patients (1.9%) died. Scoring systems were statistically significant to predict mortality. Conclusion: Children are vulnerable to trauma because of their unique anatomical and physiological differences compared to adult patient groups. It will be more successful in the mortality rate and in the post-traumatic healing process by administering the patient triage fast and most appropriate trauma centers in the prehospital period, management of the critical patients with the scoring systems and management with standard treatment protocols

Keywords: emergency service, pediatric patients, scoring systems, trauma, age groups

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Authors: A. Sherif, A. El Zafarany, R. Arafa

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Hospitals, everywhere, are considered heavy energy consumers. Hospital Intensive Care Unit spaces pose a special challenge, where design guidelines requires the provision of external windows for day-lighting and external view. Window protection strategies could be employed to reduce energy loads without detriment effect on comfort or health care. This paper addresses the effectiveness of using various window strategies on the annual cooling, heating and lighting energy use of a typical Hospital Intensive Unit space. Series of experiments were performed using the EnergyPlus simulation software for a typical Intensive Care Unit (ICU) space in Cairo, located in the Egyptian desert. This study concluded that the use of shading systems is more effective in conserving energy in comparison with glazing of different types, in the Cairo ICUs. The highest energy savings in the West and South orientations were accomplished by external perforated solar screens, followed by overhangs positioned at a protection angle of 45°.

Keywords: energy, hospital, intensive care units, shading

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Authors: K. Tejasri, K. Suvarna Vani, S. Prathyusha, S. Ramya

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Proteins are chained sequences of amino acids which are brought together by the peptide bonds. Many varying formations of the chains are possible due to multiple combinations of amino acids and rotation in numerous positions along the chain. Protein structure prediction is one of the crucial goals worked towards by the members of bioinformatics and theoretical chemistry backgrounds. Among the four different structure levels in proteins, we emphasize mainly the secondary level structure. Generally, the secondary protein basically comprises alpha-helix and beta-sheets. Multi-class classification problem of data with disparity is truly a challenge to overcome and has to be addressed for the beta strands. Imbalanced data distribution constitutes a couple of the classes of data having very limited training samples collated with other classes. The secondary structure data is extracted from the protein primary sequence, and the beta-strands are predicted using suitable machine learning algorithms.

Keywords: proteins, secondary structure elements, beta-sheets, beta-strands, alpha-helices, machine learning algorithms

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Authors: Pierce Radecki, Pulkit Malik, Bharath Ramaswamy, Ben Shapiro

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The ability to effectively design and test magnetic nanoparticles for controlled movement has been an elusive goal in the design of these particles. Magnetic nanoparticles of various characteristics have been created for use towards therapeutic effects, however the challenge of designing for controlled movement remains unmet. A step towards design in this aspect is a first principles model that captures and predicts the behaviors of particles in a magnetic field. The model is governed by four forces acting on the particles, the magnetic gradient, the dipole-dipole forces, the steric forces, and the viscous drag force. The particles are multi-core or single core, and incorporate a preferred magnetization axis. Particles exhibit behaviors, such as chaining, in simulations that are similar to those witnessed through experimentation. Currently, experimental results are being compared to the modeling results for verification of the model, through the analysis of chaining behaviors. This modeling system will be used in designing magnetic nanoparticles for specific chaining and movement behaviors.

Keywords: controlled movement, modeling, magnetic nanoparticles, nanoparticle design

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Authors: Ji Hoon Kim, Jong Man Kim, Hyung Woo Lee, Soo Hyung Kim

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The applications of nanoenergetic materials (nEMs) could be extended by developing more convenient and reliable ignition methods. However, the underwater ignition of nEMs is a significant challenge because water perturbs the reactants prior to ignition and also quenches the subsequent combustion reaction of nEMs upon ignition. In this study, we developed flash and laser-ignitable nEMs for underwater explosion. This was achieved by adding various carbon nanotubes (CNTs) as the optical igniter into an nEM matrix, composed of Al/CuO nanoparticles. The CNTs absorb the irradiated optical energy and rapidly convert it into thermal energy, and then the thermal energy is concentrated to ignite the core catalysts and neighboring nEMs. The maximum burn rate was achieved by adding 1 wt% CNTs into the nEM matrix. The burn rate significantly decreased with increasing amount of CNTs (≥ 2 wt%), indicating that the optical ignition and controlled-explosion reactivity of nEMs are possible by incorporating an appropriate amount of CNTs.

Keywords: nanoenergetic materials, carbon nanotubes, optical ignition, tunable explosion

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Authors: Melissa Beck Wells

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This study examines the complex factors affecting teacher retention across states, focusing on the roles of salaries, educational policies, and professional development. Despite efforts to reduce teacher turnover, it remains a significant challenge, impacting the quality of education and student outcomes. Analysis of data from the National Education Association, the ‘Raise the Bar’ initiative, and the Education Commission of the States reveals a minimal negative correlation between teacher salaries and retention, indicating that salary alone does not determine retention. Additionally, thematic analysis of educational policies and development programs highlights effective strategies for addressing retention challenges. The research emphasizes the need for holistic support systems, including mentorship and professional growth opportunities, to improve retention. These findings urge policymakers and educational leaders to develop comprehensive strategies to maintain a qualified teaching workforce and enhance educational quality and equity nationwide.

Keywords: teacher retention, salary levels, educational policies, professional development, teacher turnover

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Authors: Willy Mbenza, Sho Kenjiro

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Increasing efforts are directed towards a better understanding and foreknowledge of extreme precipitation likelihood, given the adverse effects associated with their occurrence. This knowledge plays a crucial role in long-term planning and the formulation of effective emergency response. However, predicting extreme events reliably presents a challenge to conventional empirical/statistics due to the involvement of numerous variables spanning different time and space scales. In the recent time, Machine Learning has emerged as a promising tool for predicting the dynamics of extreme precipitation. ML techniques enables the consideration of both local and regional physical variables that have a strong influence on the likelihood of extreme precipitation. These variables encompasses factors such as air temperature, soil moisture, specific humidity, aerosol concentration, among others. In this study, we develop an ML model that incorporates both local and regional variables while establishing a robust relationship between physical variables and precipitation during the downscaling process. Furthermore, the model provides valuable information on the frequency and duration of a given intensity of precipitation.

Keywords: machine learning (ML), predictions, rainfall events, regional variables

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Authors: E. Kissi, V. K. Acheamfour, J. J. Gyimah, T. Adjei-Kumi

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Factoring accounts receivable is widely accepted as an alternative financing source and utilized in almost every industry that sells business-to-business or business-to-government. However, its patronage in the construction industry is very limited as some barriers hinder its application in the construction industry. This study aims at assessing the barriers to the use of factoring accounts receivables in the Ghanaian construction industry. The study adopted the sequential exploratory research method where structured and unstructured questionnaires were conveniently distributed to D1K1 and D2K2 construction firms in Ghana. Using the one-sample t-test and Kendall’s Coefficient of concordance data was analyzed. The most severe challenge concluded is the high cost of factoring patronage. Other critical challenges identified were low knowledge on factoring processes, inadequate access to information on factoring, and high risks involved in factoring. Hence, it is recommended that contractors should be made aware of the prospects of factoring of accounts receivables in the construction industry. This study serves as basis for further rigorous research into factoring of accounts receivables in the industry.

Keywords: barriers, contractors, factoring accounts receivables, Ghanaian, perception

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Authors: G. Tamanza, A. Bossoni

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84 deaf students (from primary school to college) and their families participated in this inclusion project in cooperation with numerous institutions in northern Italy (Brescia-Lombardy). Participants were either congenitally deaf or their deafness was related to other pathologies. This research promoted the integration of deaf students as they pass from primary school to high school to college. Learning methods and processes were studied that focused on encour­aging individual autonomy and socialization. The research team and its collaborators included school teachers, speech ther­apists, psychologists and home tutors, as well as teaching assistants, child neuropsychiatrists and other external authorities involved with deaf persons social inclusion programs. Deaf children and their families were supported, in terms of inclusion, and were made aware of the research team that focused on the Bisogni Educativi Speciali (BES or Special Educational Needs) (L.170/2010 - DM 5669/2011). This project included a diagnostic and evaluative phase as well as an operational one. Results demonstrated that deaf children were highly satisfied and confident; academic performance improved and collaboration in school increased. Deaf children felt that they had access to high school and college. Empowerment for the families of deaf children in terms of networking among local services that deal with the deaf also improved while family satisfaction also improved. We found that teachers and those who gave support to deaf children increased their professional skills. Achieving autonomy, instrumental, communicative and relational abilities were also found to be crucial. Project success was determined by temporal continuity, clear theoretical methodology, strong alliance for the project direction and a resilient team response.

Keywords: autonomy, inclusion, skills, well-being

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Authors: A. A. Akharayi, B. E. Anjola

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The economic development of a country depends greatly on internally built revenue. Small and Medium-scale Enterprise (SMEs) contributes to the economic buoyancy as it provides employment for the teeming population, encourages job creation by youths who believes in themselves and also by others who have gathered finance enough to invest in growable investment. SMEs is faced with several challenges. The study investigates the role and challenges of SMEs Somolu Local Government Area. Simple random sampling techniques were used to select entrepreneurs (SMEs owners and managers). One hundred and fifty (150) registered SMEs were selected across the LGA data collection with the use of well-structured questionnaire. The data collected were analysed using Statistical Package for Social Science (SPSS) version 21. The result of the analysis indicated that marketing, finance, social facilities and indiscriminate taxes among other high level of fund available significantly (p <0 .05) increase firm capacity while marketing showed a significant (p < 0.05) relationship with profit level.

Keywords: challenge, development, economic, small and medium scale enterprise

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Authors: Hasan Al Bashar Abul Ulayee, AKM Saifun Nabi, MD Mesbah-Ul-Awal

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Alert system for disaster management is common now a day and can play a vital role reducing devastation and saves lives and costs. An alert in right time can save thousands of human life, help to take shelter, manage other assets including live stocks and above all, a right time alert will help to take preparation to face and early recovery of the situation. In a country like Bangladesh where populations is more than 170 million and always facing different types of natural calamities and disasters, an early right time alert is very effective and implementation of alert system is challenging. The challenge comes from the time constraint of alerting the huge number of population. The other method of existing disaster management pre alert is traditional, sequential and non-selective so efficiency is not good enough. This paper describes a way by which alert can be provided to maximum number of people within the short time bound using parallel processing as well as random selection of selective target audience.

Keywords: alert system, Bangladesh, disaster management, parallel processing, SMS

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Authors: Munu Fritz-Austin Ndam

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Although the Cameroonian system of farming is considered as the first generation, the primary actors here involved have not yet understood the meaning of adding value to the product or produce they produce. The challenge here is for everyone who practices agriculture as an income generating activity in Cameroon to be able to understand the concept of value-added products and to know how to go about it. Recent studies have shown that these farmers who depend on agriculture as their main income generation activity make a great loss out of it because they don’t have the means to either transport their produce to the appropriate market, they don’t the knowledge on how to transform it, or they don’t have a means of conserving the product for a longer duration. It is important to note that after a thorough evaluation of the activity carried out, the final added value product sold is of great benefit not only to the producer but the buyer and the population at large. In my proposed prestation, I will discuss how the transformation activity will have a positive impact on the lives of farmers and the buyers and, most importantly, describe the methodology and procedure which is followed before the tubers (banana, Plantain, potato)is transformed into the finished or semi-finished product.

Keywords: transformation, sustainability, development, consumption

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Authors: Sally A. Brown

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Over the last 30 years, researchers have developed models or frameworks to provide a more structured understanding of the reading comprehension process. Cognitive information processing models and social cognitive theories both provide frameworks to inform reading comprehension instruction. The purpose of this paper is to (a) provide an overview of the historical development of reading comprehension theory, (b) review the literature framed by cognitive information processing, social cognitive, and integrated reading comprehension theories, and (c) demonstrate how these frameworks inform instruction. As integrated models of reading can guide the interpretation of various factors related to student learning, an integrated framework designed by the researcher will be presented. Results indicated that features of cognitive processing and social cognitivism theory—represented in the integrated framework—highlight the importance of the role of the teacher. This model can aid teachers in not only improving reading comprehension instruction but in identifying areas of challenge for students.

Keywords: explicit instruction, integrated models of reading comprehension, reading comprehension, teacher’s role

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Authors: Victoria Wolf, Renata Dobrucka, Robert Prezkop, Stephan Haubold

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The COVID-19 causes a worldwide crisis and has an impact in every dimension of the economy. Organizations with the ability to adapt to new developments and which innovate solutions for the disrupted world during and after the Corona crises have the opportunity to not only survive the crisis but rather to use new trends to implement new business models and gain advantage. In this context, startups seem to have better opportunities to manage the Corona crisis through their innovation-based nature. The main result of this paper is the understanding that by applying a startup orientated innovation (SOCI) strategy, established companies can be motivated to meet the challenge of COVID-19 in a similar way like startups. This result can be achieved by describing the role of innovation and a SOCI strategy as helpful methods for organizations to meet the coming challenges during and after the COVID-19 epidemics. In addition to this, this paper presents a practical application of SOCI through the PANDA approach of the Fresenius University of Applied Sciences in Germany and discuss it in the context of COVID-19 as an exemplary successful real-world implementation of SOCI strategy.

Keywords: Covid-19, innovation, open innovation, startup, soci framework

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Authors: T. Ganesan, M. S. Aris, I. Elamvazuthi, Momen Kamal Tageldeen

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Terms set in power purchase agreements (PPA) challenge power utility companies in balancing between the returns (from maximizing power production) and securing long term supply contracts at capped production. The production limitation set in the PPA has driven efforts to maximize profits through efficient and economic power production. In this paper, a combined industrial-scale gas turbine (GT) - absorption chiller (AC) system is considered to cool the GT air intake for reducing the plant’s heat rate (HR). This GT-AC system is optimized while considering power output limitations imposed by the PPA. In addition, the proposed formulation accounts for uncertainties in the ambient temperature using Type-2 fuzzy programming. Using the enhanced chaotic differential evolution (CEDE), the Pareto frontier was constructed and the optimization results are analyzed in detail.

Keywords: absorption chillers (AC), turbine inlet air cooling (TIC), power purchase agreement (PPA), multiobjective optimization, type-2 fuzzy programming, chaotic differential evolution (CDDE)

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Authors: Rachel Shukrun, Szilvia Baron, Victoria Fidel, Anna Shusterman, Osnat Sher, Netanya Kollender, Dror Levin, Yair Peled, Yair Gortzak, Yoav Ben-Shahar, Revital Caspi, Sagi Gordon, Michal Manisterski, Ronit Elhasid

Abstract:

Ewing sarcoma (EWS) is a highly aggressive cancer with a survival rate of 70–80% for patients with localized disease and under 30% for those with metastatic disease. Tumor-infiltrating neutrophils (TIN) can generate extracellular net-like DNA structures known as neutrophil extracellular traps (NETs). However, little is known about the presence and prognostic significance of tumor-infiltrating NETs in EWS. Herein, we investigated 46 patients diagnosed with EWS and treated in the Tel Aviv Medical Center between 2010 and 2021. TINs and NETs were identified in diagnostic biopsies of EWS by immunofluorescent. In addition, NETs were investigated in neutrophils isolated from peripheral blood samples of EWS patients at diagnosis and following neoadjuvant chemotherapy. The relationships between the presence of TINs and NETs, pathological and clinical features, and outcomes were analyzed. Our results demonstrate that TIN and NETs at diagnosis were higher in EWS patients with metastatic disease compared to those with local disease. High NETs formation at diagnosis predicted poor response to neo-adjuvant chemotherapy, relapse, and death from disease (P < .05). NETs formation in peripheral blood samples at diagnosis was significantly elevated among patients with EWS compared to pediatric controls and decreased significantly following neoadjuvant chemotherapy. In conclusion, NETs formation seems to have a role in the EWS immune microenvironment. Their presence can refine risk stratification, predict chemotherapy resistance and survival, and serve as a therapeutic target in patients with EWS.

Keywords: Ewing sarcoma, tumor microenvironment, neutrophil, neutrophil extracellular traps (NETs), prognosis

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Authors: Valentine Ayo Mebu

Abstract:

The study examined the efficacy of a brief intervention programme in the treatment of post-traumatic stress disorder (PTSD) symptoms exhibited by secondary school students exposed to conflict in Kano metropolis. The study tested three hypotheses that there is no significant difference between post-test re-experiencing, hyper-arousal, and avoidance mean scores of students exposed to the intervention and those who were not exposed to the intervention. The design of the study was an experimental design, specifically the pre-test and post-test control group design. The purposive sampling technique was used to select 60 research participants (male=30, female=30, Mean Age=15.50) for the study. These participants met the Diagnostic Statistical Manual of Mental Disorders (DSM-5) criteria of PTSD symptoms and were randomly assigned to experimental and control groups, respectively. Instrument for data collection was the University of California Post-Traumatic Stress Disorder Reaction Index (UCLA PTSD Index). Findings from the study indicated that there was a significant effect of the intervention on post re-experiencing symptoms scores [ F (1, 57) = 85.97, p=.00, partial eta squared η²=.60], hyper-arousal symptoms scores[ F (1, 57) = 27.81, p=.00, partial eta squared η² =.33], and avoidance symptoms scores [ F (1, 57) = 59.56, p=.00, partial eta squared η² =.51]. The efficacy of this brief psycho-educational intervention as an effective treatment in reducing PTSD symptoms among secondary school students exposed to conflict is supported by the results of this study and this will also add to the existing literature on the effectiveness of psycho-educational intervention in treating PTSD symptoms among students exposed to conflict.

Keywords: avoidance symptoms, hyper-arousal symptoms, re-experiencing symptoms, post-traumatic stress disorder, psycho-education

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Authors: Shang-Yu Chiang, Yu-Shan Tsai, Shih-Hsien Sung, Chung-Ming Lo

Abstract:

Mitral regurgitation (MR) is a heart disorder which the mitral valve does not close properly when the heart pumps out blood. MR is the most common form of valvular heart disease in the adult population. The diagnostic echocardiographic finding of MR is straightforward due to the well-known clinical evidence. In the determination of MR severity, quantification of sonographic findings would be useful for clinical decision making. Clinically, the vena contracta is a standard for MR evaluation. Vena contracta is the point in a blood stream where the diameter of the stream is the least, and the velocity is the maximum. The quantification of vena contracta, i.e. the vena contracta width (VCW) at mitral valve, can be a numeric measurement for severity assessment. However, manually delineating the VCW may not accurate enough. The result highly depends on the operator experience. Therefore, this study proposed an automatic method to quantify VCW to evaluate MR severity. Based on color Doppler ultrasound, VCW can be observed from the blood flows to the probe as the appearance of red or yellow area. The corresponding brightness represents the value of the flow rate. In the experiment, colors were firstly transformed into HSV (hue, saturation and value) to be closely align with the way human vision perceives red and yellow. Using ellipse to fit the high flow rate area in left atrium, the angle between the mitral valve and the ultrasound probe was calculated to get the vertical shortest diameter as the VCW. Taking the manual measurement as the standard, the method achieved only 0.02 (0.38 vs. 0.36) to 0.03 (0.42 vs. 0.45) cm differences. The result showed that the proposed automatic VCW extraction can be efficient and accurate for clinical use. The process also has the potential to reduce intra- or inter-observer variability at measuring subtle distances.

Keywords: mitral regurgitation, vena contracta, color doppler, image processing

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Authors: Eric Lai, Sarah Lorger, David Eisinger, Richard Waugh

Abstract:

Introduction: Percutaneous embolization of varicoceles has shown similar outcomes to surgery. However, there are advantages of radiological intervention as patients are not exposed to general anaesthesia, experience a quicker recovery and face a lower risk of major complications. Radiological interventions are also preferable after a failed surgical approach. We evaluate clinical outcomes of percutaneous embolization at a tertiary hospital in Sydney, Australia. Methods: Retrospective case series without a control group from a single site (Royal Prince Alfred Hospital, Sydney, Australia). A data search was performed on the interventional radiology database with the word “varicocele” between February 2017 and March 2022. 62 patients were identified. Each patient file was reviewed and included in the study if they met the inclusion criteria. Results: A total of 56 patients were included. 6 patients were excluded as they did not receive intervention after the initial diagnostic venography. Technical success was 100%. Complications were seen in 3 patients (5.3%). The complications included post-procedural pain and fever, venous perforation with no clinical adverse outcome, and a mild allergic reaction to contrast. Recurrence occurred in 3 patients (5.6%), all of whom received a successful second procedure. DISCUSSION: This study demonstrates comparable rates of technical success, complication rate and recurrence to other studies in the literature. When compared to surgical outcomes, the results were also similar. The main limitation is multiple patients lack long-term follow-up beyond 1 year, resulting in potential underestimation of the recurrence rate. Conclusion: Percutaneous embolization of varicocele is a safe alternative to surgical intervention.

Keywords: varicocele, interventional radiology, urology, radiology

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