Search results for: multiple rare variants

Authors: Linyue Jia, Wenbo Du, Zhaohui Wang, Ke Liu, Shubo Li

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Due to the great potential for weight reduction in aerospace and automotive industries, magnesium-rare earth (Mg-RE) based alloys with outstanding mechanical performance have been widely investigated for decades. However, magnesium alloys are still restricted in engineering applications because of their lower strength and ductility. Hence, there are large spaces and challenges in achieving high-performance Mg alloys. This work reports an Mg-Gd-Er-Zn-Zr alloy with ultrahigh strength and good ductility developed via hot extrusion, pre-deformation, and two-stage aging. The extruded alloy comprises fine dynamically recrystallized (DRXed) grains and coarse worked grains with a large aspect ratio. Pre-deformation has little effect on the microstructure and macro-texture and serves primarily to introduce a large number of dislocations, resulting in strain hardening and higher precipitation strengthening during subsequent aging due to more nucleation sites. As a result, the alloy exhibits a yield strength (YS) of 506 MPa, an ultimate tensile strength (UTS) of 549 MPa, and elongation (EL) of 8.2% at room temperature, showing superior strength-ductility balance than the other wrought Mg-RE alloys previously reported. The current study proposes a combination of pre-deformation and two-stage aging to further improve the mechanical properties of wrought Mg alloys for engineering applications.

Keywords: magnesium alloys, mechanical properties, microstructure, pre-deformation, two-stage aging

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Authors: Nousheen Hashmi, Shoab Ahmad Khan

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Active collaboration among the green energy sources and the load demand leads to serious issues related to power quality and stability. The growing number of green energy resources and Distributed-Generators need newer strategies to be incorporated for their operations to keep the power energy stability among green energy resources and micro-grid/Utility Grid. This paper presents a novel technique for energy power management in Grid-Connected Photovoltaic with energy storage system under set of constraints including weather conditions, Load Shedding Hours, Peak pricing Hours by using rule-based fuzzy smart grid controller to schedule power coming from multiple Power sources (photovoltaic, grid, battery) under the above set of constraints. The technique fuzzifies all the inputs and establishes fuzzify rule set from fuzzy outputs before defuzzification. Simulations are run for 24 hours period and rule base power scheduler is developed. The proposed fuzzy controller control strategy is able to sense the continuous fluctuations in Photovoltaic power generation, Load Demands, Grid (load Shedding patterns) and Battery State of Charge in order to make correct and quick decisions.The suggested Fuzzy Rule-based scheduler can operate well with vague inputs thus doesn’t not require any exact numerical model and can handle nonlinearity. This technique provides a framework for the extension to handle multiple special cases for optimized working of the system.

Keywords: photovoltaic, power, fuzzy logic, distributed generators, state of charge, load shedding, membership functions

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Authors: Tamar Lin, Nufar Buchshtab, Yifat Elharar, Julian Nicenboim, Rotem Edgar, Iddo Weiner, Lior Zelcbuch, Ariel Cohen, Sharon Kredo-Russo, Inbar Gahali-Sass, Naomi Zak, Sailaja Puttagunta, Merav Bassan

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Background: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disorder that is characterized by dry skin and flares of eczematous lesions and intense pruritus. Multiple lines of evidence suggest that AD is associated with increased colonization by Staphylococcus aureus, which contributes to disease pathogenesis through the release of virulence factors that affect both keratinocytes and immune cells, leading to disruption of the skin barrier and immune cell dysfunction. The aim of the current study is to develop a bacteriophage-based product that specifically targets S. aureus. Methods: For the discovery of phage, environmental samples were screened on 118 S. aureus strains isolated from skin samples, followed by multiple enrichment steps. Natural phages were isolated, subjected to Next-generation Sequencing (NGS), and analyzed using proprietary bioinformatics tools for undesirable genes (toxins, antibiotic resistance genes, lysogeny potential), taxonomic classification, and purity. Phage host range was determined by an efficiency of plating (EOP) value above 0.1 and the ability of the cocktail to completely lyse liquid bacterial culture under different growth conditions (e.g., temperature, bacterial stage). Results: Sequencing analysis demonstrated that the 118 S. aureus clinical strains were distributed across the phylogenetic tree of all available Refseq S. aureus (~10,750 strains). Screening environmental samples on the S. aureus isolates resulted in the isolation of 50 lytic phages from different genera, including Silviavirus, Kayvirus, Podoviridae, and a novel unidentified phage. NGS sequencing confirmed the absence of toxic elements in the phages’ genomes. The host range of the individual phages, as measured by the efficiency of plating (EOP), ranged between 41% (48/118) to 79% (93/118). Host range studies in liquid culture revealed that a subset of the phages can infect a broad range of S. aureus strains in different metabolic states, including stationary state. Combining the single-phage EOP results of selected phages resulted in a broad host range cocktail which infected 92% (109/118) of the strains. When tested in vitro in a liquid infection assay, clearance was achieved in 87% (103/118) of the strains, with no evidence of phage resistance throughout the study (24 hours). A S. aureus host was identified that can be used for the production of all the phages in the cocktail at high titers suitable for large-scale manufacturing. This host was validated for the absence of contaminating prophages using advanced NGS methods combined with multiple production cycles. The phages are produced under optimized scale-up conditions and are being used for the development of a topical formulation (BX005) that may be administered to subjects with atopic dermatitis. Conclusions: A cocktail of natural phages targeting S. aureus was effective in reducing bacterial burden across multiple assays. Phage products may offer safe and effective steroid-sparing options for atopic dermatitis.

Keywords: atopic dermatitis, bacteriophage cocktail, host range, Staphylococcus aureus

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Authors: Kwabena Asare, Ezekiel N. N. Nortey, Felix O. Mettle

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Modelling of extreme events has always been of interest in fields such as hydrology and meteorology. However, after the recent global financial crises, appropriate models for modelling of such rare events leading to these crises have become quite essential in the finance and risk management fields. This paper models the extreme values of the Ghana Stock Exchange All-Shares indices (2000-2010) by applying the Extreme Value Theory to fit a model to the tails of the daily stock returns data. A conditional approach of the EVT was preferred and hence an ARMA-GARCH model was fitted to the data to correct for the effects of autocorrelation and conditional heteroscedastic terms present in the returns series, before EVT method was applied. The Peak Over Threshold (POT) approach of the EVT, which fits a Generalized Pareto Distribution (GPD) model to excesses above a certain selected threshold, was employed. Maximum likelihood estimates of the model parameters were obtained and the model’s goodness of fit was assessed graphically using Q-Q, P-P and density plots. The findings indicate that the GPD provides an adequate fit to the data of excesses. The size of the extreme daily Ghanaian stock market movements were then computed using the Value at Risk (VaR) and Expected Shortfall (ES) risk measures at some high quantiles, based on the fitted GPD model.

Keywords: extreme value theory, expected shortfall, generalized pareto distribution, peak over threshold, value at risk

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Authors: Weaam Aldeeban, Majd Aljamali, Lama A. Youssef

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Background & Objective: Warfarin is considered a problematic drug due to its narrow therapeutic window and wide inter-individual response variations, which are attributed to demographic, environmental, and genetic factors, particularly single nucleotide polymorphism (SNPs) in the genes encoding VKORC1 and CYP2C9 involved in warfarin's mechanism of action and metabolism, respectively. CYP2C9*2rs1799853 and CYP2C9*3rs1057910 alleles are linked to reduced enzyme activity, as carriers of either or both alleles are classified as moderate or slow metabolizers, and therefore exhibit higher sensitivity of warfarin compared with wild type (CYP2C9*1*1). Our study aimed to assess the frequency of *1, *2, and *3 alleles in the CYP2C9 gene in a cohort of Syrian patients receiving a maintenance dose of warfarin for different indications, the impact of genotypes on warfarin dosing, and the frequency of adverse effects (i.e., bleedings). Subjects & Methods: This retrospective cohort study encompassed 94 patients treated with warfarin. Patients’ genotypes were identified by sequencing the polymerase chain reaction (PCR) specific products of the gene encoding CYP2C9, and the effects on warfarin therapeutic outcomes were investigated. Results: Sequencing revealed that 43.6% of the study population has the *2 and/or *3 SNPs. The mean weekly maintenance dose of warfarin was 37.42 ± 15.5 mg for patients with the wild-type allele (CYP2C9*1*1), whereas patients with one or both variants (*2 and/or *3) demanded a significantly lower dose (28.59 ±11.58 mg) of warfarin, (P= 0.015). A higher percentage (40.7%) of patients with allele *2 and/or *3 experienced hemorrhagic accidents compared with only 17.9% of patients with the wild type *1*1, (P = 0.04). Conclusions: Our study proves an association between *2 and *3 genotypes and higher sensitivity to warfarin and a tendency to bleed, which necessitates lowering the dose. These findings emphasize the significance of CYP2C9 genotyping prior to commencing warfarin therapy in order to achieve optimal and faster dose control and to ensure effectiveness and safety.

Keywords: warfarin, CYP2C9, polymorphisms, Syrian, hemorrhage

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Authors: Richard Vuijk, Arnoud Arntz

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Rationale: To our knowledge treatment of personality disorder comorbidity in adults with autism spectrum disorder (ASD) is understudied and is still in its infancy: We do not know if treatment of personality disorders may be applicable to adults with ASD. In particular, it is unknown whether patients with ASD benefit from experiential techniques that are part of schema therapy developed for the treatment of personality disorders. Objective: The aim of the study is to investigate the efficacy of a schema mode focused treatment with adult clients with ASD and comorbid personality pathology (i.e. at least one personality disorder). Specifically, we investigate if they can benefit from both cognitive-behavioral, and experiential interventions. Study design: A multiple baseline case series study. Study population: Adult individuals (age > 21 years) with ASD and at least one personality disorder. Participants will be recruited from Sarr expertise center for autism in Rotterdam. The study requires 12 participants. Intervention: The treatment protocol consists of 35 weekly offered sessions, followed by 10 monthly booster sessions. A multiple baseline design will be used with baseline varying from 5 to 10 weeks, with weekly supportive sessions. After baseline, a 5-week exploration phase follows with weekly sessions during which current and past functioning, psychological symptoms, schema modes are explored, and information about the treatment will be given. Then 15 weekly sessions with cognitive-behavioral interventions and 15 weekly sessions with experiential interventions will be given. Finally, there will be a 10-month follow-up phase with monthly booster sessions. Participants are randomly assigned to baseline length, and respond weekly during treatment and monthly at follow-up on Belief Strength of negative core beliefs (by VAS), and fill out SMI, SCL-90 and SRS-A 7 times during screening procedure (i.e. before baseline), after baseline, after exploration, after cognitive and behavioral interventions, after experiential interventions, and after 5- and 10- month follow-up. The SCID-II will be administered during screening procedure (i.e. before baseline), at 5- and at 10-month follow-up. Main study parameters: The primary study parameter is negative core beliefs. Secondary study parameters include schema modes, personality disorder manifestations, psychological symptoms, and social interaction and communication. Discussion: To the best of author’s knowledge so far no study has been published on the application of schema mode focused interventions in adult patients with ASD and comorbid PD(s). This study offers the first systematic test of application of schema therapy for adults with ASD. The results of this study will provide initial evidence for the effectiveness of schema therapy in treating adults with both ASD and PD(s). The study intends to provide valuable information for future development and implementation of therapeutic interventions for adults with both ASD and PD(s).

Keywords: adults, autism spectrum disorder, personality disorder, schema therapy

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Authors: Suphaphon Udomluck, Pannathorn Chachvarat

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Information Communication Technology (ICT) using management is essential for effective decision making in organization. The Concerns Based Adoption Model (CBAM) was employed as the conceptual framework. The purposes of the study were to assess the situation of Information Communication Technology (ICT) using management in College of Nursing under the Praboromarajchanok Institute. The samples were multi – stage sampling of 10 colleges of nursing that participated include directors, vice directors, head of learning groups, teachers, system administrator and responsible for ICT. The total participants were 280; the instrument used were questionnaires that include 4 parts, general information, Information Communication Technology (ICT) using management, the Stage of concern Questionnaires (SoC), and the Levels of Use (LoU) ICT Questionnaires respectively. Reliability coefficients were tested; alpha coefficients were 0.967for Information Communication Technology (ICT) using management, 0.884 for SoC and 0.945 for LoU. The data were analyzed by frequency, percentage, mean, standard deviation, Pearson Product Moment Correlation and Multiple Regression. They were founded as follows: The high level overall score of Information Communication Technology (ICT) using management and issue were administration, hardware, software, and people. The overall score of the Stage of concern (SoC)ICTis at high level and the overall score of the Levels of Use (LoU) ICTis at moderate. The Information Communication Technology (ICT) using management had the positive relationship with the Stage of concern (SoC)ICTand the Levels of Use (LoU) ICT(p < .01). The results of Multiple Regression revealed that administration hardwear, software and people ware could predict SoC of ICT (18.5%) and LoU of ICT (20.8%).The factors that were significantly influenced by SoCs were people ware. The factors that were significantly influenced by LoU of ICT were administration hardware and people ware.

Keywords: information communication technology (ICT), management, the concerns-based adoption model (CBAM), stage of concern(SoC), the levels of use(LoU)

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Authors: Amir Abbas Fatemi, Zahra Tabrizian, Kabir Sadeghi

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To find the location and severity of damage that occurs in a structure, characteristics changes in dynamic and static can be used. The non-destructive techniques are more common, economic, and reliable to detect the global or local damages in structures. This paper presents a non-destructive method in structural damage detection and assessment using GA and static data. Thus, a set of static forces is applied to some of degrees of freedom and the static responses (displacements) are measured at another set of DOFs. An analytical model of the truss structure is developed based on the available specification and the properties derived from static data. The damages in structure produce changes to its stiffness so this method used to determine damage based on change in the structural stiffness parameter. Changes in the static response which structural damage caused choose to produce some simultaneous equations. Genetic Algorithms are powerful tools for solving large optimization problems. Optimization is considered to minimize objective function involve difference between the static load vector of damaged and healthy structure. Several scenarios defined for damage detection (single scenario and multiple scenarios). The static damage identification methods have many advantages, but some difficulties still exist. So it is important to achieve the best damage identification and if the best result is obtained it means that the method is Reliable. This strategy is applied to a plane truss. This method is used for a plane truss. Numerical results demonstrate the ability of this method in detecting damage in given structures. Also figures show damage detections in multiple damage scenarios have really efficient answer. Even existence of noise in the measurements doesn’t reduce the accuracy of damage detections method in these structures.

Keywords: damage detection, finite element method, static data, non-destructive, genetic algorithm

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Authors: Moyosooore A. Babalola, Ayodeji S. Ogunleye

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The main focus of the study was to determine the profitability of investment in the Oil Palm value chain of Osun State, Nigeria in 2015. The specific objectives were to describe the socio-economic characteristics of Oil Palm investors (producers, processors and marketers), to determine the profitability of the investment to investors in the Oil Palm value chain, and to determine the factors affecting the profitability of the investment of the oil palm investors in Osun state. A sample of 100 respondents was selected in this cross-sectional survey. Multiple stage sampling procedure was used for data collection of producers and processors while purposive sampling was used for marketers. Data collected was analyzed using the following analytical tools: descriptive statistics, budgetary analysis and regression analysis. The results of the gross margin showed that the producers and processors were more profitable than the marketers in the oil palm value chain with their benefit-cost ratios as 1.93, 1.82 and 1.11 respectively. The multiple regression analysis showed that education and years of experience were significant among marketers and producers while age and years of experience had significant influence on the gross margin of processors. Based on these findings, improvement on the level of education of oil palm investors is recommended in order to address the relatively low access to post-primary education among the oil palm investors in Osun State. In addition to this, it is important that training be made available to oil palm investors. This will improve the quality of their years of experience, ensuring that it has a positive influence on their gross margin. Low access to credit among processors and producer could be corrected by making extension services available to them. Marketers would also greatly benefit from subsidized prices on oil palm products to increase their gross margin, as the huge percentage of their total cost comes from acquiring palm oil.

Keywords: oil palm, profitability analysis, regression analysis, value chain

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Authors: Hannah Yael Ephraim

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During reproductive age (between 15 and 44), women are particularly susceptible to psychiatric illness. Depression and anxiety disorders are especially common for women during reproductive age. Women of reproductive age are also at greater risk for multiple physical conditions during this time. Existing literature focuses on the impact of mental health on physical health, showing that people with anxiety and depression repeatedly show greater physical health risk among those with developing chronic medical illness. However, there is limited research on the impact physical health has on mental health in women of reproductive age, a large and vulnerable population. For this reason, the current study seeks to ask the following questions: are women of reproductive age with a diagnosis of a chronic physical condition more likely to experience symptoms of mental illness than women without a diagnosis of a chronic physical condition? Does the type of physical illness relate to signs and symptoms of depression and anxiety? A quasi-experimental research design was implemented to compare the mental health outcomes of women with the diagnosis of chronic medical conditions and women without the diagnosis of a chronic medical condition. Quantitative data was collected through an anonymous ten-minute Qualtrics survey. The survey was sent out through multiple online platforms. The sample includes two groups of women: one group with the diagnosis of a chronic medical illness, and one group without a diagnosis and/or symptoms (N = 541). Participants identify as a woman and are between the ages of 15 and 44. A comparison of women with a diagnosis of a chronic physical condition and those without a diagnosis will be conducted to explore differences in depression and anxiety symptoms between women with and without a chronic medical diagnosis. The impact race, SES, and occupation will also be addressed in relation to anxiety and/or depression in women of reproductive age. This study will further the understanding of the relationship between mental illness in women of reproductive age with chronic medical conditions. The results of this study will have implications for the integration of mental health care in women’s health centers and perhaps training of clinicians and physicians providing psychological and medical care to women of reproductive age.

Keywords: mental health, physical health, reproductive age, women

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Authors: Vishnu A., Ashesh Saha

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The operation of high-speed rotating machinery in industries is accompanied by rotor vibrations due to many factors. One of the primary instability mechanisms in a rotor system is the centrifugal force induced due to the eccentricity of the center of mass away from the center of rotation. These unwanted vibrations may lead to catastrophic fatigue failure. So, there is a need to control these rotor vibrations. In this work, control of rotor vibrations by using a 4-pole Radial Active Magnetic Bearing (RAMB) as an actuator is analysed. A continuous rotor system model is considered for the analysis. Several important factors, like the gyroscopic effect and rotary inertia of the shaft and disc, are incorporated into this model. The large deflection of the shaft and the restriction to axial motion of the shaft at the bearings result in nonlinearities in the system governing equation. The rotor system is modeled in such a way that the system dynamics can be related to the geometric and material properties of the shaft and disc. The mathematical model of the rotor system is developed by incorporating the control forces generated by the RAMB. A simple PD controller is used for the attenuation of system vibrations. An analytical expression for the amplitude and phase equations is derived using the Method of Multiple Scales (MMS). Analytical results are verified with the numerical results obtained using an ‘ode’ solver in-built into MATLAB Software. The control force is found to be effective in attenuating the system vibrations. The multi-valued solutions leading to the jump phenomenon are also eliminated with a proper choice of control gains. Most interestingly, the shape of the backbone curves can also be altered for certain values of control parameters.

Keywords: rotor dynamics, continuous rotor system model, active magnetic bearing, PD controller, method of multiple scales, backbone curve

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Authors: Ebtissem Sassi, Abdellatif Benabdelhafid, Sami Hammami

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Congestion, pollution and space misuse are the major risks in the hinterland. Management of these risks is a major issue for all the actors intervening in territory management. A good mastery of these risks is based on the consideration of environmental and physical constraints since the implementation of a policy integrates simultaneously an efficient use, territorial resources, and financial resources which become increasingly rare. Yet, this balance can be difficult to establish simultaneously by all the actors. Indeed, every actor has often the tendency to favor these objectives in detriment to others. In this framework, we have fixed the objective of designing and achieving a model which will centralize multidisciplinary data and serve the analysis tool as well as a decision support tool. In this article, we will elaborate some methodological axes allowing the good management of the territory system through (i) determination of the structural factors of the decision support system, (ii) integration of methods tools favoring the territorial decisional process. Logistics territory geographic information system is a model dealing with this issue. The objective of this model is to facilitate the exchanges between the actors around a common question which was the research subject of human sciences researchers (geography, economy), nature sciences (ecology) as well as finding an optimal solution for simultaneous responses to all these objectives.

Keywords: complexity, territory, logistics, territory planning, conceptual model, GIS, MCA

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Authors: Ruth Leitch, Joanne Hughes

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This paper presents the findings of a three-year government-funded study (ILiAD) that aimed to understand the reasons for differential educational achievement within and between socially and economically deprived areas in Northern Ireland. Previous international studies have concluded that there is a positive correlation between deprivation and underachievement. Our preliminary secondary data analysis suggested that the factors involved in educational achievement within multiple deprived areas may be more complex than this, with some areas of high multiple deprivation having high levels of student attainment, whereas other less deprived areas demonstrated much lower levels of student attainment, as measured by outcomes on high stakes national tests. The study proposed that no single explanation or disparate set of explanations could easily account for the linkage between levels of deprivation and patterns of educational achievement. Using a social capital perspective that centralizes the connections within and between individuals and social networks in a community as a valuable resource for educational achievement, the ILiAD study involved a multi-level case study analysis of seven community sites in Northern Ireland, selected on the basis of religious composition (housing areas are largely segregated by religious affiliation), measures of multiple deprivation and differentials in educational achievement. The case study approach involved three (interconnecting) levels of qualitative data collection and analysis - what we have termed Micro (or community/grassroots level) understandings, Meso (or school level) explanations and Macro (or policy/structural) factors. The analysis combines a statistical mapping of factors with qualitative, in-depth data interpretation which, together, allow for deeper understandings of the dynamics and contributory factors within and between the case study sites. Thematic analysis of the qualitative data reveals both cross-cutting factors (e.g. demographic shifts and loss of community, place of the school in the community, parental capacity) and analytic case studies of explanatory factors associated with each of the community sites also permit a comparative element. Issues arising from the qualitative analysis are classified either as drivers or inhibitors of educational achievement within and between communities. Key issues that are emerging as inhibitors/drivers to attainment include: the legacy of the community conflict in Northern Ireland, not least in terms of inter-generational stress, related with substance abuse and mental health issues; differing discourses on notions of ‘community’ and ‘achievement’ within/between community sites; inter-agency and intra-agency levels of collaboration and joined-up working; relationship between the home/school/community triad and; school leadership and school ethos. At this stage, the balance of these factors can be conceptualized in terms of bonding social capital (or lack of it) within families, within schools, within each community, within agencies and also bridging social capital between the home/school/community, between different communities and between key statutory and voluntary organisations. The presentation will outline the study rationale, its methodology, present some cross-cutting findings and use an illustrative case study of the findings from a community site to underscore the importance of attending to community differences when trying to engage in research to understand and improve educational attainment for all.

Keywords: educational achievement, multiple deprivation, community case studies, social capital

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Authors: Amit Das

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Background and significance of the study: Generally investors and market forecasters use financial statement for investigation while it awakens contribute to investing. The main vicinity of financial accounting and reporting practices recommends a few basic financial performance indicators, namely, return on capital employed, return on assets and earnings per share, which is associated considerably with share prices. It is principally true in case of Indian pharmaceutical companies also. Share investing is intriguing a financial risk in addition to investors look for those financial evaluations which have noteworthy shock on share price. A crucial intention of financial statement analysis and reporting is to offer information which is helpful predominantly to exterior clients in creating credit as well as investment choices. Sound financial performance attracts the investors automatically and it will increase the share price of the respective companies. Keeping in view of this, this research work investigates the impact of financial performance indicators on share price of pharmaceutical companies in India which is listed in the Bombay Stock Exchange. Methodology: This research work is based on secondary data collected from moneycontrol database on September 28, 2015 of top 101 pharmaceutical companies in India. Since this study selects four financial performance indicators purposively and availability in the database, that is, earnings per share, return on capital employed, return on assets and net profits as independent variables and one dependent variable, share price of 101 pharmaceutical companies. While analysing the data, correlation statistics, multiple regression technique and appropriate test of significance have been used. Major findings: Correlation statistics show that four financial performance indicators of 101 pharmaceutical companies are associated positively and negatively with its share price and it is very much significant that more than 80 companies’ financial performances are related positively. Multiple correlation test results indicate that financial performance indicators are highly related with share prices of the selected pharmaceutical companies. Furthermore, multiple regression test results illustrate that when financial performances are good, share prices have been increased steadily in the Bombay stock exchange and all results are statistically significant. It is more important to note that sensitivity indices were changed slightly through financial performance indicators of selected pharmaceutical companies in India. Concluding statements: The share prices of pharmaceutical companies depend on the sound financial performances. It is very clear that share prices are changed with the movement of two important financial performance indicators, that is, earnings per share and return on assets. Since 101 pharmaceutical companies are listed in the Bombay stock exchange and Sensex are changed with this, it is obvious that Government of India has to take important decisions regarding production and exports of pharmaceutical products so that financial performance of all the pharmaceutical companies are improved and its share price are increased positively.

Keywords: financial performance indicators, share prices, pharmaceutical companies, India

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Authors: Mohand Yaghi, O. Kehinde

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Background: For the diagnosis of prostate cancer Trans-rectal prostate biopsy (TRPB) is used commonly, the procedure is associated with infective complications. There is evidence that antibiotics (ABx) decrease infective events after TRPB, but different regimens are used. Aim: To systematically review different regimens of prophylactic oral antibiotics in TRPB. Design: Medline, Embase, Clinical trials site, and Cochrane library were searched, experts were consulted about relevant studies. Randomized clinical trials (RCT) conducted in the last twenty years, which investigated different oral antibiotic regimens in TRPB, and compared their efficacy to reduce infectious complications were analyzed. Measurements: Primary outcomes were bacteriuria, urinary tract infection (UTI), fever, bacteremia, sepsis. Secondary outcomes were hospitalization rate, and the prevalence of ABx-resistant bacteria. Results: Nine trials were eligible with 3012 patients. Antibiotics prevented bacteriuria (3.5% vs. 9.88%), UTI (4.46% vs. 9.75%), and hospitalization (0.21% vs. 2.13%) significantly in comparison with placebo or no treatment. No significant difference was found in all outcomes of the review between the single dose regimen and the 3 days. The single dose regimen was as effective as the multiple dose except in Bacteriuria (6.75% vs. 3.25%), and the prevalence of ABx-resistant bacteria (1.57% vs. 0.27%). Quinolones reduced only UTI significantly in comparison with other antibiotics. Lastly, Ciprofloxacin is the best Quinolone to prevent UTI, and hospitalization. Conclusion: it is essential to prescribe prophylactic Antibiotics in TRPB. No conclusive evidence could be claimed about the superiority of the multiple or the 3 days regimens to the single dose regimen. Unexpectedly, ABx-resistant bacteria was identified more often in the single dose cohorts.

Keywords: infection, prostate cancer, sepsis, TRPB

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Authors: Athulya Jayakumar, M. Manjula

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Though there has been a shift in the understanding of homosexuality from being a sin, crime or pathology in the medical and legal perspectives, the acceptance of homosexuality still remains very scanty in the Indian subcontinent. The present case study is a 24-year-old female who has completed a diploma in polytechnic engineering and residing in the state of Kerala. She initially presented with her husband with complaints of lack of sexual desire and non-cooperation from the index client. After an initial few sessions, the client revealed, in an individual session, about her homosexual orientation which was unknown to her family. She has had multiple short-term relations with females and never had any heterosexual orientation/interest. During her adolescence, she was wondering if she could change herself into a male. However, currently, she accepts her gender. She never wanted a heterosexual marriage; but, had to succumb to the pressure of mother, as a result of a series of unexpected incidents at home and had to agree for the marriage, also with a hope that she may change herself into a bi-sexual. The client was able to bond with the husband emotionally but the multiple attempts at sexual intercourse, at the insistence of the husband, had always been non-pleasurable and induced a sense of disgust. Currently, for several months, there has not been any sexual activity. Also, she actively avoids any chance to have a warm communication with him so that she can avoid chances of him approaching her in a sexual manner. The case study is an attempt to highlight the culture and the struggles of a homosexual individual who comes to therapy for wanting to be a ‘normal wife’ despite having knowledge of legal rights and scenario. There is a scarcity of Indian literature that has systematically investigated issues related to homosexuality. Data on prevalence, emotional problems faced and clinical services available are sparse though it is crucial for increasing understanding of sexual behaviour, orientation and difficulties faced in India.

Keywords: case study, culture, cognitive behavior therapy, female homosexuality

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Authors: Lauren M. Cook, Tove A. Larsen

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Due to their potential to provide numerous ecosystem services, green roofs have been proposed as a solution to mitigate a growing list of environmental challenges, like urban flooding and urban heat island effect. Because of their cooling effect, green roofs placed below rooftop photovoltaic (PV) panels also have the potential to increase PV panel efficiency. Sedums, a type of succulent plant, are commonly used on green roofs because they are drought and heat tolerant. However, other plant species, such as grasses or plants with reflective properties, have been shown to reduce more runoff and cool the rooftop more than succulent species due to high evapotranspiration (ET) and reflectivity, respectively. The goal of this study is to evaluate whether vegetation with high ET or reflectivity can influence multiple co-benefits of the green roof. Four small scale green roofs in Zurich are used as an experiment to evaluate differences in (1) the timing and amount of runoff discharged from the roof, (2) the air temperature above the green roof, and (3) the temperature and efficiency of solar panels placed above the green roof. One grass species, Silene vulgaris, and one silvery species, Stachys byzantia, are compared to a baseline of Sedum album and black roof. Initial results from August to November 2019 show that the grass species has retained more cumulative runoff and led to a lower canopy temperature than the other species. Although the results are not yet statistically significant, they may suggest that plants with higher ET will have a greater effect on canopy temperature than plants with high reflectivity. Future work will confirm this hypothesis and evaluate whether it holds true for solar panel temperature and efficiency.

Keywords: co-benefit estimation, green cities, green roofs, solar panels

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Authors: In-Tsang Lin, Chiching Wei

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Reading order is an important task in many digitization scenarios involving the preservation of the logical structure of a document. From the paper survey, it finds that the state-of-the-art algorithm could not fulfill to get the accurate reading order in the portable document format (PDF) files with rich formats, diverse layout arrangement. In recent years, most of the studies on the analysis of reading order have targeted the specific problem of associating layout components with logical labels, while less attention has been paid to the problem of extracting relationships the problem of detecting the reading order relationship between logical components, such as cross-references. Over 3 years of development, the company Foxit has demonstrated the layout recognition (LR) engine in revision 20601 to eager for the accuracy of the reading order. The bounding box of each paragraph can be obtained correctly by the Foxit LR engine, but the result of reading-order is not always correct for single-column, and two-column layout format due to the table issue, formula issue, and multiple mini separated bounding box and footer issue. Thus, the algorithm is developed to improve the accuracy of the reading order based on the Foxit LR structure. In this paper, a creative observation method (Here called the MESH method) is provided here to open a new chance in the research of the reading-order field. Here two important parameters are introduced, one parameter is the number of the bounding box on the right side of the present bounding box (NRight), and another parameter is the number of the bounding box under the present bounding box (Nunder). And the normalized x-value (x/the whole width), the normalized y-value (y/the whole height) of each bounding box, the x-, and y- position of each bounding box were also put into consideration. Initial experimental results of single column layout format demonstrate a 19.33% absolute improvement in accuracy of the reading-order over 7 PDF files (total 150 pages) using our proposed method based on the LR structure over the baseline method using the LR structure in 20601 revision, which its accuracy of the reading-order is 72%. And for two-column layout format, the preliminary results demonstrate a 44.44% absolute improvement in accuracy of the reading-order over 2 PDF files (total 18 pages) using our proposed method based on the LR structure over the baseline method using the LR structure in 20601 revision, which its accuracy of the reading-order is 0%. Until now, the footer issue and a part of multiple mini separated bounding box issue can be solved by using the MESH method. However, there are still three issues that cannot be solved, such as the table issue, formula issue, and the random multiple mini separated bounding boxes. But the detection of the table position and the recognition of the table structure are out of the scope in this paper, and there is needed another research. In the future, the tasks are chosen- how to detect the table position in the page and to extract the content of the table.

Keywords: document processing, reading order, observation method, layout recognition

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Authors: Ahmet Emre Yonder

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The concept of present time is inevitably and rapidly changing. That provokes unbalanced, uncertain and elusive platform in the world order. Keeping up with this fluctuation requires a willingness to step beyond the comfort zones and to take a step through unknown. That is the perspectives of organizations in which the shareholders persistently create and then they share their creation. Moreover they are adapted to the unpredictable shifts and they establish vision. These are the meaning of innovation which is a process that converts new ideas to invaluable outcomes and that process can be ensured via innovative leaders. Leaders’ creativity is needed when challenging against countless complicated and unsteady situations in the battlefield. However, little attention has been paid to the importance of being innovative leader apart from innovating new technologies so far. Additionally, in most situation militarist organizations are hesitant to welcome different attitudes and that may discourage new ideas. Furthermore military leaders may complain about the lack of sources in today's world where the sources are very rare. In that point military leaders should change the strategies they apply from conventional views to the innovation of different point of views. But the constant occupation in Air Forces can be counted as a huge obstacle for innovative thinking. An organizational structure is needed to be developed for solutions of the problems which the creative leaders will encounter.This article focuses on how to raise innovative military leaders with innovative thinking skills and the need for a change from conventional to the innovative leadership in Air Forces. It also gives important suggestions to encourage raising innovative military leaders.

Keywords: air force, creativity, leadership, military, innovation

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Authors: Maryam Ghavam Sadri, Maryam Shahrooz

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Background: Nowadays the prevalence of metabolic syndrome (Mets) has taken on a growing trend. Studies have shown the relationship between vitamin D deficiency (VDD) status and Mets in children. Also studies have recorded that exerting strategies for vitamin D status improvement can help prevent Mets in children. This study investigated multiple strategies of prevention of Mets resulting from VDD in children. Methods: This review study has been done by using keywords related to the topic and 54 articles were found (2000-2015) that 25 were selected according to the indicators of Mets, supplementation and fortification of foods with vitamin D and attention to children environment and life style. Results: Studies have suggested the correlation between serum levels of vitamin D with waist circumference (p < 0.0001), systolic blood pressure (p=0.01), HOMA-IR (p=0.001) and HDL cholesterol (p < 0.0001). An inverse correlation between serum 25 (OH) D and HOMA-IR (p = 0.006) and insulin (P = 0.002) has been proved in overweight group. Higher HOMASDS and triglycerides found in vitamin D deficient obese children compared to control group without VDD (p=0.04). After supplementation with vitamin D, serum TG concentration decreases significantly (p=0.04), and improves insulin resistance (p=0.02). The prevalence of VDD is associated with time of watching TV (P < 0.01), hours of physical activity per week (P = 0.01), skipping breakfast (P < 0.001) soda intake (P < 0.001), and milk intake per day (P < 0.01). Conclusion: According to the beneficial role of vitamin D in prevention of Mets and proven relationship between serum levels of vitamin D and Mets indicators, we can prevent childhood Mets through the application of appropriate strategies such as supplementation and food fortification with vitamin D and positive changes in children life style with especial attention to physical activity in exposure of sunlight and their environment condition.

Keywords: children, metabolic syndrome, prevention strategies, vitamin D

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Authors: Abdulrahman Alajlan

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While the sun serves as a robust energy source, the frigid conditions of outer space present promising prospects for nocturnal power generation due to its continuous accessibility during nighttime hours. This investigation illustrates a proficient methodology facilitating uninterrupted energy capture throughout the day. This method involves the utilization of water-based heat storage systems and radiative thermal emitters implemented across thermometric devices. Remarkably, this approach permits an enhancement of nighttime power generation that exceeds the level of 1 Wm-2, which is unattainable by alternative methodologies. Outdoor experiments conducted at the King Abdulaziz City for Science and Technology (KACST) have demonstrated unparalleled performance, surpassing prior experimental benchmarks by nearly an order of magnitude. Furthermore, the developed device exhibits the capacity to concurrently supply power to multiple light-emitting diodes, thereby showcasing practical applications for nighttime power generation. This research unveils opportunities for the creation of scalable and efficient 24-hour power generation systems based on thermoelectric devices. Central findings from this study encompass the realization of continuous 24-hour power generation from clean and sustainable energy sources. Theoretical analyses indicate the potential for nighttime power generation reaching up to 1 Wm-2, while experimental results have reached nighttime power generation at a density of 0.5 Wm-2. Additionally, the efficiency of multiple light-emitting diodes (LEDs) has been evaluated when powered by the nighttime output of the integrated thermoelectric generator (TEG). Therefore, this methodology exhibits promise for practical applications, particularly in lighting, marking a pivotal advancement in the utilization of renewable energy for both on-grid and off-grid scenarios.

Keywords: nighttime power generation, thermoelectric devices, radiative cooling, thermal management

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Authors: Diane Ghanem, Whitney Kagabo, Rebecca Engels, Uma Srikumaran, Babar Shafiq

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Hospitalist co-management of orthopaedic surgery patients is a growing trend across the country. It was created as a collaborative effort to provide overarching care to patients with the goal of improving their postoperative care and decreasing in-hospital medical complications. The aim of this project is to provide a guide for implementing and optimizing a hospitalist co-management service in orthopaedic surgery. Key leaders from the hospitalist team, orthopaedic team and quality, safety and service team were identified. Multiple meetings were convened to discuss the comanagement service and determine the necessary building blocks behind an efficient and well-designed co-management framework. After meticulous deliberation, a consensus was reached on the final service agreement and a written guide was drafted. Fundamental features of the service include the identification of service stakeholders and leaders, frequent consensus meetings, a well-defined framework, with goals, program metrics and unified commands, and a regular satisfaction assessment to update and improve the program. Identified pearls for co-managing orthopaedic surgery patients are standardization, timing, adequate patient selection, and two-way feedback between hospitalists and orthopaedic surgeons to optimize the protocols. Developing a service agreement is a constant work in progress, with meetings, discussions, revisions, and multiple piloting attempts before implementation. It is a partnership created to provide hospitals with a streamlined admission process where at-risk patients are identified early, and patient care is optimized regardless of the number or nature of medical comorbidities. A wellestablished hospitalist co-management service can increase patient care quality and safety, as well as health care value.

Keywords: co-management, hospitalist co-management, implementation, orthopaedic surgery, quality improvement

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Authors: Randy M. Fitratullah, Afriwardi, Nurhayati

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Overweight-obesity caused by exercise. The objective of this research is to analyze the relation between exercise with the incidence of overweight-obesity of medical students of medical faculty of Andalas Univesity batch 2013. This is an analytical observational research with case-control method. This research conducted in FK Unand on September-October 2015. The population of this research is medical students batch 2013. 26 samples (13 samples were case, 13 samples were control) were taken by purposive sampling technique and analysed using statistical univariate and bivariate analysis. Exercise questionnaire was used as research instruments. Based on the interview with questionnaire, anaerobic exercise was majority in case group and aerobic exercise was majority in control group. The case and control group have a rare category in exercise. Less category was majority in exercise duration of case and enough category was majority in control group. Bivariate analysis is using chi-square test with cell combining to 2x2 table, obtained p-value=0.097 in sort of exercise, p-value=1,000 in the frequency of exercise, and p-value=0,112 in duration of exercise, which means statistically unsignificant. There is no relation between exercise with the incidence of overweight-obesity of medical students of FK Unand batch 2013. For medical students suffers overweight-obesity is suggested for increase the frequency of exercise.

Keywords: overweight-obesity, exercise, aerobic, anaerobic, frequency, duration

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Authors: Ahmed Tafraoui, Gilles Escadeillas, Thierry Vidal

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The southern Algeria is known for its huge sand dunes that cover part of its territory (Sahara). This sand has features that allow a glimpse of a recovery in the construction field in the form of Ultra High Performance Concrete (UHPC). This type of concrete using a large amount of silica fume, ultra fine addition that gives very high performance but is also relatively rare and expensive. Replacing it with another addition to equivalent properties, such as metakaolin, can also be considered. The objective of this study is to both enhance the sand dunes of Erg south west western Algeria but also reduce manufacturing costs of Ultra High Performance Concrete to incorporating metakaolin to instead of silica fume. Performances to determine mechanical performance are instantaneous, compression and bending. Initially, we characterized the Algerian sand dune. Then, we have to find a formulation of UHPC, adequate in terms of implementation and to replace silica fume by metakaolin. Finally, we studied the actual value of the sand dune. Concrete obtained have very high mechanical performance, up to a compressive strength of 250 MPa, a tensile strength of 45 MPa by bending with the method of heat treatment. This study shows that the enhancement of dune sand studied is quite possible in UHPC, and in particular UHPC bundles and the replacement of silica fume by metakaolin do not alter the properties of these concretes.

Keywords: Ultra High Performance Concrete, sand dune, formulations, silica fume, metakaolin, strength

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Authors: Saleh Abdullah Dabil

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The research aims to survey the dates factories in Al-Kharj Province, and then identify the nature of a series of different production processes and the using of raw materials, as well as their finished products, and the extent of their impact on the environment or consumers satisfaction. Twenty dates factories were selected according to their willingness to participate. The participants of dates factories consist of approximately 40 % of all dates factories in Al-Kharj province. All of the dates factories which were visited were observed. The research team also administered number of questionnaires to the public to know their satisfaction levels of the dates products as well as their suggestions. It is accounted to 237 participants who gave their opinion about the dates products and their suggestions. This study is one of rare studies about green marketing in dates factories. What is new about this study is that it depends upon both of the managers and consumers as well as the researchers to look into the factories’ production line and to observe the level of satisfaction. The study resulted in a very good ending because that the green marketing of dates is in its highest level. This indicates that the factories in general using natural materials and no bad materials or subsides used in the production, the levels of satisfaction by consumers are very good, preferring mostly lose product of dates. The preference of lose dates means the tendency to use the dates in their natural product. The recommendations of this study suggest solving marketing problems in transforming raw dates into manufacturing products. This includes biscuits and other types of sweet products.

Keywords: green marketing, dates factories, environment impact, consumer satisfaction

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Authors: Tracy Smith-Carrier

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Burgeoning research extols the benefits of innovative experiential learning activities to increase participants’ engagement, enhance their individual learning, and bridge the gap between theory and practice. This presentation discusses findings from a multiple case study on poverty simulation events conducted with two samples: undergraduate students and community participants. After exploring the nascent research on the benefits and limitations of poverty simulation activities, the study explores whether participating in a poverty simulation resulted in changes to participants’ beliefs about the causes and effects of poverty, as well as shifts in their attitudes and actions toward people experiencing poverty. For the purposes of triangulation, quantitative and qualitative data from a variety of sources were analyzed: participant feedback surveys, qualitative responses, and pre, post, and follow-up questionnaires. Findings show statistically significant results (p<.05) from both samples on cumulative scores of the modified Attitudes Toward Poverty Scale, indicating an improvement in participants’ attitudes toward poverty. Although generally positive about their experiences, participating in the simulation did not appear to have prompted participants to take specific actions to reduce poverty. Conclusions drawn from the research study suggest that poverty simulation planners should be wary of adopting scenarios that emphasize, or fail to adequately contextualize, behaviours or responses that might perpetuate individual explanations of poverty. Moreover, organizers must carefully consider how to ensure participants in their audience currently experiencing low-income do not become emotionally distressed, triggered or further marginalized in the process. While overall participants were positive about their experiences in the simulation, the events did not appear to have prompted them to action. Moving beyond the goal of increasing participants’ understandings of poverty, interventions that foster greater engagement in poverty issues over the long-term are necessary.

Keywords: empathy, experiential learning, poverty awareness, poverty simulation

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Authors: S. J. Yune, S. Y. Lee, S. J. Im, B. S. Kam, S. Y. Baek

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This study explored whether academic emotion, major satisfaction, and learning flow are associated with academic achievement in medical school. We know that emotion and affective factors are important factors in students' learning and performance. Emotion has taken the stage in much of contemporary educational psychology literature, no longer relegated to secondary status behind traditionally studied cognitive constructs. Medical school students (n=164) completed academic emotion, major satisfaction, and learning flow online survey. Academic performance was operationalized as students' average grade on two semester exams. For data analysis, correlation analysis, multiple regression analysis, hierarchical multiple regression analyses and ANOVA were conducted. The results largely confirmed the hypothesized relations among academic emotion, major satisfaction, learning flow and academic achievement. Positive academic emotion had a correlation with academic achievement (β=.191). Positive emotion had 8.5% explanatory power for academic achievement. Especially, sense of accomplishment had a significant impact on learning performance (β=.265). On the other hand, negative emotion, major satisfaction, and learning flow did not affect academic performance. Also, there were differences in sense of great (F=5.446, p=.001) and interest (F=2.78, p=.043) among positive emotion, boredom (F=3.55, p=.016), anger (F=4.346, p=.006), and petulance (F=3.779, p=.012) among negative emotion by grade. This study suggested that medical students' positive emotion was an important contributor to their academic achievement. At the same time, it is important to consider that some negative emotions can act to increase one’s motivation. Of particular importance is the notion that instructors can and should create learning environment that foster positive emotion for students. In doing so, instructors improve their chances of positively impacting students’ achievement emotions, as well as their subsequent motivation, learning, and performance. This result had an implication for medical educators striving to understand the personal emotional factors that influence learning and performance in medical training.

Keywords: academic achievement, learning emotion, learning flow, major satisfaction

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Authors: Indhie Febrianti Herlina, Riri Akadafi, Alna Hanana

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This research describes the constructivism of the Halal beauty of Wardah commercials that present hijab women as the advertising models and shows the sign of Halal in each promotion. There are differences of the concept of beauty between wardah and other beauty ads. When today’s ads describe that beautiful women are who have bright skin, sharp nose and long hair, wardah describes that beautiful women are the hijab women and wear Halal beauty product. This research is interesting because it is so rare when the beauty is presented by hijab women. By using the constructivism paradigm and combining it with reception theory, the author wants to reveal whether women are constructed by these commercials. Reception theory is about how public accept the content of a media. The informants are the women who wear hijab, wear Wardah products and join ‘Wardah Goes to Campus’, a roadshow event conducted by Wardah in Universities all around Indonesia. By interviewing the informants, a statement can be inferred that informants A, B, C, and D assumed that beauty is a physical beauty. However, after they have learned about the true meaning of beauty and watched Wardah commercials, those informants understand that beauty is reflected by the women who wear hijab and wear Halal Cosmetics. Meanwhile, the informant E assumes that beauty is relative, inner, and good-looking. The conclusion of this research is that the informants are constructed by the halal beauty described by Wardah commercials. By presenting the models wearing hijab and wear natural-looking cosmetics, Wardah successfully influences the informants to be more confident to look good by wearing hijab.

Keywords: ad, commercial, construction, halal beauty, wardah

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Authors: Monjur E-Khoda Tarafdar

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Institutional autonomy and academic freedom corresponding to accountability are seen as a core concept of university governance. Universities are crucial factors in search of truth for knowledge production and dissemination. Academic leaders are the pivots to progressively influence the university governance. Therefore, in a continuum of debate about autonomy and accountability in the aspect of perception, academic leadership has been studied. Having longstanding acquaintance in the field the researcher has been instrumental to gain lived experiences of the informants in this qualitative study. Case studies are useful to gain an understanding of the complexities of a particular site to preserve a sense of wholeness of the site being investigated. Thus, multiple case study approach has been employed with a sample size of seventy-one. Such large size of informants was interviewed in order to capture a wider range of views that exist in Bangladesh. This qualitative multiple case study has engaged in-depth interviewing method of academic leaders and policy makers of three case universities. Open-ended semi-structured questionnaires are used to have a comprehensive understanding of how the perception of autonomy and accountability of academic leaders has impacted university governance in the context of Bangladesh. The paper has interpreted the voices of the informants and distinguished both the transformational and transactional style of academic leaderships in local university settings against the globally changed higher education demography. The study finds contextual dissimilarity in the perspectives of autonomy and accountability of academic leadership towards university governance. Unaccountability results in losing autonomous power and collapsing academic excellence. Since accountability grows competitiveness and competence, the paper also focuses on how academic leaders abuse the premise of academic loyalty to universities.

Keywords: academic loyalty, accountability, autonomy, leadership, perception, university governance

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Authors: Thomas P. Jones

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Overview: Drowning is an important cause of accidental death, particularly in children and young people. Although many survive drowning incidents, it is a relatively rare presenting complaint in Emergency Departments. When cases do present, they can be complex and unpredictable. For patients to receive the best care, it is important that their management is standardized and evidence based, however this can be difficult in a topic area with limited studies and inconsistencies in case reporting. Objectives: To review recent cases to assess the performance of Manchester Royal Infirmary Emergency Department in the management of near drowning. To produce evidence based guideline on the management of drowning victims in the ED. Methods: Emergency department records were searched for patients with the diagnosis of ‘fatal drowning’ or ‘nearly drowning’ and two relevant case notes reviewed. To produce the guideline a literature review was conducted and a series of structured short cut systematic reviews known as Best BETs carried out. This information was used to produce a clear treatment pathway. Results: The case studies emphasized the variety in presentation of drowning victims whilst highlighting inconsistencies in management and documentation. An evidence-based guideline is presented as a flowchart, which illustrates the relevant investigations and treatment that victims of a drowning incident should receive, based on the best available evidence. Conclusion: It is hoped that when put into practice, the guideline will improve and standardize patient care in cases of near drowning. An audit is recommended to assess its effectiveness.

Keywords: drowning, near drowning, non fatal drowning, fatal drowning

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