Search results for: case example

Authors: Amir Feily, Hazhir Shahmoradi Akram, Mojtaba Ghaedi, Farshid Javdani, Naser Hatami, Navid Kalani, Mohammad Zarenezhad

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Background: Filler-induced facial skin ischemia is a potential complication of dermal filler injections that can result in tissue damage and necrosis. Nitroglycerin has been suggested as a treatment option due to its vasodilatory effects, but its efficacy in this context is unclear. Methods: A narrative review was conducted to examine the available evidence on the efficacy of nitroglycerin in filler-induced facial skin ischemia. Relevant studies were identified through a search of electronic databases and manual searching of reference lists. Results: The review found limited evidence supporting the efficacy of nitroglycerin in this context. While there were case reports where the combination of nitroglycerin and hyaluronidase was successful in treating filler-induced facial skin ischemia, there was only one case report where nitroglycerin alone was successful. Furthermore, a rat model did not demonstrate any benefits of nitroglycerin and showed harmful results. Conclusion: The evidence regarding the efficacy of nitroglycerin in filler-induced facial skin ischemia is inconclusive and seems to be against its application. Further research is needed to determine the effectiveness of nitroglycerin alone and in combination with other treatments for this condition. Clinicians should consider limited evidence bases when deciding on treatment options for patients with filler-induced facial skin ischemia.

Keywords: nitroglycerin, facial, skin ischemia, fillers, efficacy, narrative review

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Authors: Atitallah Sofien, Bouyahia Olfa, Krifi farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Subcutaneous fat necrosis of the newborn (SCFN) is a rare acute hypodermatitis characterized by skin lesions in the form of infiltrated, hard plaques and subcutaneous nodules, with a purplish-red color, occurring between the first and sixth week of life. SCFN is generally a benign condition that spontaneously regresses without sequelae, but it can be complicated by severe hypercalcemia. Methodology: This is a retrospective case report of neonatal subcutaneous fat necrosis complicated with severe hypercalcemia and nephrocalcinosis. Results: This is a case of a female newborn with a family history of a hypothyroid mother on Levothyrox, born to non-consanguineous parents and from a well-monitored pregnancy. The newborn was delivered by cesarean section at 39 weeks gestation due to severe preeclampsia. She was admitted to the Neonatal Intensive Care Unit at 1 hour of life for the management of grade 1 perinatal asphyxia and immediate neonatal respiratory distress related to transient respiratory distress. Hospitalization was complicated by a healthcare-associated infection, requiring intravenous antibiotics for ten days, with a good clinical and biological response. On the 20th day of life, she developed skin lesions in the form of indurated purplish-red nodules on the back and on both arms. A SCFN was suspected. A calcium level test was conducted, which returned a result of 3 mmol/L. The rest of the phosphocalcic assessment was normal, with early signs of nephrocalcinosis observed on renal ultrasound. The diagnosis of SCFN complicated by nephrocalcinosis associated with severe hypercalcemia was made, and the condition improved with intravenous hydration and corticosteroid therapy. Conclusion: SCFN is a rare and generally benign hypodermatitis in newborns with an etiology that is still poorly understood. Despite its benign nature, SCFN can be complicated by hypercalcemia, which can sometimes be life-threatening. Therefore, it is important to conduct a thorough skin examination of newborns, especially those with risk factors, to detect and correct any potential hypercalcemia.

Keywords: subcutaneous fat necrosis, newborn, hypercalcemia, nephrocalcinosis

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Authors: Jennifer Sturgeon

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Stable relationships provide a predictable and trusting environment and are essential for early development, but high teacher turnover rates in childcare settings make it challenging for infants and toddlers to form stable relationships with their teachers. This can have an adverse effect on development and learning. The qualitative study discussed in this article draws from the experiences of early Head Start teachers and administrators to describe both the impact of teacher turnover and the motivational factors that contribute to teacher retention. A case study approach was used and included classroom observations, a review of exit interviews, and perceptions from focus groups of early Head Start staff in an urban early Head Start childcare center. Emerging from the case study was the discovery that teacher turnover has an impact on the social-emotional development of toddlers, particularly in self-regulation. Additional key findings that emerged include teacher turnover leading to negative effects on learning, a decrease in preschool preparation, and increased chaos in the classroom and center. Motivational factors that contributed to teacher retention included positive leadership, the mission to make a difference, and fair compensation.

Keywords: early childhood, teacher turnover, continuity of care, early head start

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Authors: Mawloud Mosbah, Bachir Boucheham

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We present here the results for a comparative study of some techniques, available in the literature, related to the relevance feedback mechanism in the case of a short-term learning. Only one method among those considered here is belonging to the data mining field which is the K-Nearest Neighbours Algorithm (KNN) while the rest of the methods is related purely to the information retrieval field and they fall under the purview of the following three major axes: Shifting query, Feature Weighting and the optimization of the parameters of similarity metric. As a contribution, and in addition to the comparative purpose, we propose a new version of the KNN algorithm referred to as an incremental KNN which is distinct from the original version in the sense that besides the influence of the seeds, the rate of the actual target image is influenced also by the images already rated. The results presented here have been obtained after experiments conducted on the Wang database for one iteration and utilizing colour moments on the RGB space. This compact descriptor, Colour Moments, is adequate for the efficiency purposes needed in the case of interactive systems. The results obtained allow us to claim that the proposed algorithm proves good results; it even outperforms a wide range of techniques available in the literature.

Keywords: CBIR, category search, relevance feedback, query point movement, standard Rocchio’s formula, adaptive shifting query, feature weighting, original KNN, incremental KNN

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Authors: Muhammad Waqar Aziz, Syed Abdul Baqi Shah

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The execution time analysis is fundamental to the successful design and execution of real-time embedded software. In such analysis, the Worst-Case Execution Time (WCET) of a program is a key measure, on the basis of which system tasks are scheduled. The WCET analysis of embedded software is also needed for system understanding and to guarantee its behavior. WCET analysis can be performed statically (without executing the program) or dynamically (through measurement). Traditionally, research on the WCET analysis assumes sequential code running on single-core platforms. However, as computation is steadily moving towards using a combination of parallel programs and multi-core hardware, new challenges in WCET analysis need to be addressed. In this article, we report our experiences of performing the WCET analysis of Parallel Embedded Software (PES) running on multi-core platform. The primary purpose was to investigate how WCET estimates of PES can be computed statically, and how they can be derived dynamically. Our experiences, as reported in this article, include the challenges we faced, possible suggestions to these challenges and the workarounds that were developed. This article also provides observations on the benefits and drawbacks of deriving the WCET estimates using the said methods and provides useful recommendations for further research in this area.

Keywords: embedded software, worst-case execution-time analysis, static flow analysis, measurement-based analysis, parallel computing

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Authors: Emily Awuor, Helga Huszar, Zoltan Bozoki

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Isotope analysis has found numerous applications in the environmental science discipline, most common being the tracing of environmental contaminants on both regional and global scales. Many environmental contaminants contain ammonia (NH₃) since it is the most abundant gas in the atmosphere and its largest sources are from agricultural and industrial activities. NH₃ isotopes (¹⁴NH₃ and ¹⁵NH₃) are therefore important and can be used in the traceability studies of these atmospheric pollutants. The goal of the project is the construction of a photoacoustic spectroscopy system that is capable of measuring ¹⁵NH₃ isotope selectively in terms of its concentration. A further objective is for the system to be robust, easy-to-use, and automated. This is provided by using two telecommunication type near-infrared distributed feedback (DFB) diode lasers and a laser coupler as the light source in the photoacoustic measurement system. The central wavelength of the lasers in use was 1532 nm, with the tuning range of ± 1 nm. In this range, strong absorption lines can be found for both ¹⁴NH₃ and ¹⁵NH₃. For the selective measurement of ¹⁵NH₃, wavelengths were chosen where the cross effect of ¹⁴NH₃ and water vapor is negligible. We completed the calibration of the photoacoustic system, and as a result, the lowest detectable concentration was 3.32 ppm (3Ϭ) in the case of ¹⁵NH₃ and 0.44 ppm (3Ϭ) in the case of ¹⁴NH₃. The results are most useful in the environmental pollution measurement and analysis.

Keywords: ammonia isotope, near-infrared DFB diode laser, photoacoustic spectroscopy, environmental monitoring

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Authors: Karissa A. Graham

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Pyoderma gangrenosum (PG) is a prototypic autoinflammatory neutrophilic dermatosis that is a rare disorder. It presents a diagnostic challenge owing to its variable presentation, clinical overlap with other conditions, it is often associated with other systemic conditions, and there is no definitive histological or laboratory characteristic. The Delphai consensus for PG includes the presence of at least one ulcer on the anterior lower limb. Systemic corticosteroids and immunosuppressive therapies are the mainstay treatment for PG. We describe a case report of delayed diagnosis of ulcerative pyoderma gangrenosum in a 44-year-old male on his forearm. The patient presented with an infected ulcer on his right forearm that had been present for over three years. The patient was a Type 2 Diabetic with no personal or family history of inflammatory bowel disease or other autoimmune diseases. The patient was initially investigated for malignancy, but biopsies returned as chronic inflammatory tissue with neutrophilic infiltrate and no malignancy. The patient was commenced on systemic prednisone for the treatment of pyoderma gangrenosum. The diagnosis of ulcerative PG poses a challenge given the vast differential diagnosis for a cutaneous ulcer (i.e., malignant, vascular, autoimmune, trauma, infective, etc.). Diagnostic accuracy is important given that the treatment for PG with steroids does not go without risks and indeed may be contraindicated in other potential causes of the ulcer. Indeed, more common and more sinister causes of ulcers should be investigated first, as death from PG is quite rare.

Keywords: dermatological diagnosis, dermatosis, pyoderma gangrenosum, rare presentation

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Authors: Chan Hui-Ya, Ding Shin-Tan

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Background and Aim: The discharge planning is considered helpful to reduce the hospital length of stay and readmission rate, and then increased satisfaction with healthcare for patients and professionals. In order to decrease the waiting time of long-term care and boost the care quality of patients after discharge from the hospital, the Ministry of Health and Welfare department in Taiwan initiates a program “discharge planning connects with long-term care 2.0 services” in 2017. The purpose of this study is to investigate the outcome of the pilot of this program in a medical center. Methods: By purpose sampling, the study chose five wards in a medical center as pilot units. The researchers compared the beds of service, the numbers of cases which were transferred to the long-term care center and transferred rates per month between the pilot units and the other units, and analyze the basic data, the long-term care service needs and the approval service items of cases transfer to the long-term care center in pilot units. Results: From June to September 2017, a total of 92 referrals were made, and 51 patients were enrolled into the pilot program. There is a significant difference of transferring rate between the pilot units and the other units (χ = 702.6683, p < 0.001). Only 20 cases (39.2% success rate) were approved to accept the parts of service items of long-term care in the pilot units. The most approval item was respite care service (n = 13; 65%), while it was third at needs ranking of service lists during linking services process. Among the reasons of patients who cancelled the request, 38.71% reasons were related to the services which could not match the patients’ needs and expectation. Conclusion: The results indicate there is a requirement to modify the long-term care services to fit the needs of cases. The researchers suggest estimating the potential cases by screening data from hospital informatics systems and to hire more case manager according the service time of potential cases. Meanwhile, the strategies shortened the assessment scale and authorized hospital case managers to approve some items of long-term care should be considered.

Keywords: discharge planning, long-term care, case manager, patient care

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Authors: E. Tugba Topcu

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The emergency services are usually the first places to encounter forensic cases. Hence, it is important to consider forensics from the perspective of the emergency services staff and the physiological and psychological consequences that may arise as a result of behaviour by itself or another person. Accurate and detailed documentation of the situation in which the patient first arrives at the emergency service and preservation of the forensic findings is pivotal for the subsequent forensic investigation. The first step in determining whether or not a forensic case exists is to perform a medical examination of the patient. For each individual suspected to be part of a forensic case, police officers should be informed at the same time as the medical examination is being conducted. Violent events are increasing every year and with an increase in the number of forensic cases, emergency service workers have increasing responsibility and consequently play a key role in protecting, collecting and arranging the forensic evidence. In addition, because the emergency service workers involved in forensic events typically have information about the accused and/or victim, as well as evidence related to the events and the cause of injuries, police officers often require their testimony. However, both nurses and other health care personnel do not typically have adequate expertise in forensic medicine. Emergency nurses should take an active role for determining that whether any patient admitted to the emergency services is a clinical forensic patient the emergency service with injury and requiring possible punishment and knowing of their roles and responsibilities in this area provides legal protection as well as the protection of the judicial affair. Particularly, in emergency services, where rapid patient turnover and high workload exists, patient registration and case reporting may not exist. In such instances, the witnesses, typically the nurses, are often consulted for information. Knowledge of forensic medical matters plays a vital role in achieving justice. According to the Criminal Procedure Law, Article 75, Paragraph 3, ‘an internal body examination or the taking of blood or other biological samples from the body can be performed only by a doctor or other health professional member’. In favour of this item, the clinic nurse and doctor are mainly responsible for evaluating forensic cases in emergency departments, performing the examination, collecting evidence, and storing and reporting data. The courts place considerable importance on determining whether a suspect is the victim or accused and, thus, in terms of illuminating events, it is crucial that any evidence is gathered carefully and appropriately. All the evidence related to the forensic case including the forensic report should be handed over to the police officers. In instances where forensic evidence cannot be collected and the only way to obtain the evidence is the hospital environment, health care personnel in emergency services need to have knowledge about the diagnosis of forensic evidence, the collection of evidence, hiding evidence and provision of the evidence delivery chain.

Keywords: emergency department, emergency nursing, forensic cases, forensic nursing

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Authors: Tatenda Manomano

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The chronic challenges presented by HIV/AIDS globally have come with extreme negative effects on individuals, families and communities as well as governments. Sub-Saharan Africa remains strongly challenged with South Africa bearing a huge brunt of these. The paper examines the extent to which the effects of HIV/AIDS are addressed in low cost housing projects in South Africa with a case of the RDP Golf Course Housing Project in Alice Town. The study used a triangulation of both qualitative and quantitative methods with the qualitative as the dominant method while the quantitative was less dominant. Findings revealed that infection rate was high; prostitution was high; alcohol abuse was also high; and rape and sexual abuse was also high and there was also lack of hospitals and social workers around the location. These findings prompted this researcher to recommend for proactive policy making that can bolster the challenges faced by these low cost housing projects in accessing health and social services as well as massive campaigns that can promote behavior modification among other things. It is hoped that this paper will be a platform to ring a bell to both government and non-government to augment the campaign against HIV/AIDS in South Africa.

Keywords: HIV/AIDS, RDP houses, low cost housing projects, campaigns

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Authors: Samar F. Elkasrawy

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Museums play a significant role in their communities with respect to culture, history, environment, and social development. They are considered as important sites for families, tourists, school groups, cultural visitors and individuals, looking to enjoy, learn and expand their horizons. Aim of audience development programs is to support individuals and organizations to work together to deliver messages that will raise museums' profile for both existing and potential visitors. They recognize the particular role that museums play for communities, the audiences they seek to reach, the experience they seek to offer and the extent and nature of their collections. This study aims at using both the qualitative and quantitative approach to explore the important role that audience development programs in museums can play in raising awareness in their communities concerning cultural heritage preservation and tourism. The Alexandria National Museum is considered as a valuable case study. In depth interviews with museum managers and staff was conducted as well as an online questionnaire. The study also includes suggestions and guidelines for applying audience development programs in Egyptian museums.

Keywords: Alexandria National Museum, audience development programs, cultural heritage, tourism and preservation awareness

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Authors: Jitka Molnarova

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Based on De Soto’s idea that a formal land title can provide a secure home and access to credit to poor urban families, a large number of developing countries accepted the formalization of informal settlements as the ultimate solution for their housing crises and struggles with poverty. After two decades of implementation, very little is known about the effects this policy has on the quality of the neighborhoods it produces and on the development of cities in general. Using the capital of Peru -where the solution originated- as a case study, this paper illustrates the negative outcomes this policy has on urban development arguing that land titling encourages 1) expansion of the city often to areas of high physical risk, 2) production of precarious housing on unserviced land, and 3) practices of illegal land trafficking. The evidence is based on interviews with community leaders and officials working at the Cooperation for Formalization of Informal Property (COFOPRI), comparison of satellite images documenting the expansion of Lima in the past twenty years, and a technical evaluation of dozens of houses that have been or are in the process of being granted a land title.

Keywords: COFOPRI, De Soto, housing policies, land titling, land trafficking, Lima, Peru, precarious housing, urban expansion

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Authors: Rosa Sobreira, Paula Arriscado

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Marketers are aware that media relations is an important touch point, which is also cheaper, to bring their products and their brands to the consumer. They recognize the role of journalists as moderators and transformers of public opinion, and they realize their influence on brand image. And also, they know that readers, listeners, viewers and internet users "believe" more what they read, hear and see in the news than in an advertisement. The study is focused on the automotive industry and analyses the news published about three brands that share industrial facilities and components. We wanted to understand the role of the information created by the brand`s media team in the journalists’ work, and the impact on management, activation and differentiation of brands and their products` attributes and benefits. Based on a qualitative methodology, the analysis focused on press news, making comparison between media coverage and their “narratives” about the three cars from different brands. The results point to the fact that journalists easily integrate speech from the marks on their products. In the case of this study, we found that apart from the description of the many similarities between the three cars, the average speech also "struggled" for revealing the attributes that differentiate them. This interpretation of the results helps us to understand the "marriage" between branding and media. We believe also this paper let us to understand how journalists, through news, join the speech of the brands.

Keywords: brand management, media relations, differentiation, positioning

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Authors: Edward Pol

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All companies are confronted with the need to innovate in order to meet market demands. In so doing they are challenged with the dilemma of whether to aim to be first into the market with a new innovative product or to deliberately wait and learn from a pioneers’ mistakes; potentially avoiding higher risks. It is therefore important to critically understand from a first-mover advantage and disadvantage perspective the decision-making implications of defence industry transformation onset by an innovative paradigm shift. This paper will argue that the type of industry characteristics matter, especially when considering what role the clients play in the innovation process and what is their level of influence. Through investigation of qualitative case study research, this inquiry will focus on first mover advantages and first mover disadvantages with a view to establish practical and value-added academic findings by focusing on specific industries where the clients play an active role in cooperation with the supplier innovation. The resulting findings will help managers to mitigate risk in innovative technology introduction. A selection from several defense industry innovations is specifically chosen because of the client-supplier relationship typically differing from traditional first-mover research. In this instance, case studies will be used referencing vertical-takeoff-and-landing defence equipment innovations.

Keywords: innovation, pioneer, first-mover advantage, first-mover disadvantage, risk

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Authors: Alya Al Ghufli, Kelaithim Al Tunaiji, Sara Al Ali, Khalid Samara

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It is well known that health care systems encompass a variety of key knowledge sources that need to be integrated and shared amongst all types of users to attain higher-levels of motivation and productivity. The development of Health Integrated Systems (HIS) is often seen as a crucial step in strengthening the integration of knowledge to help serve the information needs of health care users. As an emergent economy, the United Arab Emirates (UAE) is regarded as a new arrival in the area of health information systems. As a new nation, there may be several challenges in terms of organisational climate and the sufficient skills and knowledge activities for effective use of HIS. In this regard, the lack of coordination, attitudes and practice of health-related systems can eventually result in unnecessary data and generally poor use of the system. This paper includes results from a qualitative preliminary study carried out from a case study investigation in a single large primary health care organisation in the United Arab Emirates (UAE) comprising various health care users. The study explored health care user’s perceptions about health integration and the impact it has on their practice. The main sources of information were semi-structured interviews and non-obtrusive observations. The authors conclude by presenting various recommendations for the development of HIS and knowledge activities and areas for further study.

Keywords: health integrated systems, knowledge sharing, knowledge activities, health information systems

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Authors: Nirit Raichel, Dorit Alt

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Although university teaching is claimed to have a special task to support students in adopting ways of thinking and producing new knowledge anchored in scientific inquiry practices, it is argued that students' habits of learning are still overwhelmingly skewed toward passive acquisition of knowledge from authority sources rather than from collaborative inquiry activities. In order to overcome this critical inadequacy between current educational goals and instructional methods, the LLAF consortium is aimed at developing updated instructional practices that put a premium on adaptability to the emerging requirements of present society. LLAF has created a practical guide for teachers containing updated pedagogical strategies based on the constructivist approach for learning, arranged along Delors’ four theoretical ‘pillars’ of education: Learning to know, learning to do, learning to live together, and learning to be. This presentation will be limited to problem-based learning (PBL), as a strategy introduced in the second pillar. PBL leads not only to the acquisition of technical skills, but also allows the development of skills like problem analysis and solving, critical thinking, cooperation and teamwork, decision- making and self-regulation that can be transferred to other contexts. This educational strategy will be exemplified by a case study conducted in the pre-piloting stage of the project. The case describes a three-fold process implemented in a postgraduate course for in-service teachers, including: (1) learning about PBL (2) implementing PBL in the participants' classes, and (3) qualitatively assessing the contributions of PBL to students' outcomes. An example will be given regarding the ways by which PBL was applied and assessed in civic education for high-school students. Two 9th-grade classes have participated the study; both included several students with learning disability. PBL was applied only in one class whereas traditional instruction was used in the other. Results showed a robust contribution of PBL to students' affective and cognitive outcomes as reflected in their motivation to engage in learning activities, and to further explore the subject. However, students with learning disability were less favorable with this "active" and "annoying" environment. Implications of these findings for the LLAF project will be discussed.

Keywords: problem-based learning, higher education, pedagogical strategies

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Authors: Rogerio Vieira Dos Reis

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Countries like Brazil that despite fighting hard against corruption are not improving their corruption perception, especially due to systemic political corruption, should review their corruption prevention strategies. This thesis brings a case study based on an alternative way of preventing corruption: addressing the corruption drivers in public policies that lead to poor economic performance. After discussing the Brazilian industrial policies adopted recently, especially the measures towards the automotive sector, two corruption issues in this sector are analyzed: facilitating payment for fiscal benefits and buying the extension of fiscal benefits. In-depth interviews conducted with a policymaker and an executive of the automobile sector provide insights for identifying three main corruption drivers: excessive and unnecessary bureaucracy, a complex tax system and the existence of a closed market without setting performance requirements to be achieved by the benefited firms. Both the identification of the drivers of successful industrial policies and the proposal of anti-corruption strategies to ensure developmental outcomes are based on the economic perspective of industrial policy advocated by developmental authors and on the successful South Korean economic development experience. Structural anti-corruption measures include tax reform, the regulation of lobbying and legislation to allow corporate political contribution. Besides improving policymakers’ technical capabilities, measures at the ministry level include redesigning the automotive regimes as long-term policies focused on national investment with simple and clear rules and making fiscal benefits conditional upon performance targets focused on suppliers. This case study is of broader interest because it recommends the importance of adapting performance audits conducted by anti-corruption agencies, to focus not only on the delivery of public services, but also on the identification of potentially highly damaging corruption drivers in public policies that grant fiscal benefits to achieve developmental outcomes.

Keywords: Brazilian automotive sector, corruption, economic development, industrial policy, Inovar-Auto

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Authors: Yagnik Patel

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This paper will analyze and explain two main objectives. First, it will examine the emergence of the insurgency in the state of Tripura. The State of Tripura was facing the full blow of insurgency problem since 1978 after the formation of Tripura National Volunteers (TNV). But, the roots of this insurgency were found even before 1978. This study will analyze the roots and trajectory of insurgency in the Tripura. Second, it will examine the role played by the police in counterinsurgency in the State of Tripura. Even though state police are mandated for the maintenance of the law and order and public order (like every police), the state police of Tripura have played a significant role in curbing the insurgency by enhancing their counterinsurgency (COIN) capabilities and re-structuring the new comprehensive COIN doctrine. And by the end of May 2015, the State Government has lifted The Armed Forces (Special Powers) Act (AFSPA) from the State of Tripura, as declaiming of the violence. The fight against the insurgency, usually done by the military or para-military, but nowadays the police organization is also becoming a vital state apparatus. After Punjab police and Andhra Pradesh police, Tripura police have also successfully curbed the insurgency from the state. This was the third time when successful counterinsurgency did by the state police in India. This has shown the importance of the police in the fight against the insurgency. In this regard, this paper will use both quantitative and qualitative research methods for an explanatory case study to analyze and explain the roots, causes and the trajectory of insurgency in the state of Tripura and the role played by the police in COIN in Tripura. Along with this, the paper will also examine the successful ‘Police Model of Tripura’.

Keywords: counterinsurgency, insurgency, police, Tripura state rifles

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Authors: Khemakhem Nahed, Hammami Fatma, Trabelsi Houaida, Neji Sourour, Sellami Hayet, Makni Fattouma, Turki Hamida, Ayadi Ali

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Dermatophytoses are considered a public health problem and represent 10% of dermatological consultations in our region. Their epidemiology is influenced by various factors, such as lifestyle, human migration patterns, changes in the environment and the host relationship. The understanding of epidemiology has a major impact on their prevention and treatment. The aim of the study is to determine the prevalence pattern of aetiological agents and to describe the clinical characteristics of dermatophytoses between 1999 and 2019. Out of 65 059 subjects suspected to have superficial mycoses, 36 220 (55.67%) were affected with dermatophytoses. The mean age was 40.1 years (range: 10 days to 99 years). The sex ratio was 0.8. Our patients were from urban regions in 80.9% of cases. The most common type of infection was onychomycosis (42.64%), followed by tinea pedis (20.8%), intertrigo (18.3%), tinea corporis (8.48%) and tinea capitis (7.87%). The most isolated dermatophyte was Trichophyton rubrum (76.5%), followed by T. mentagrophytes complex (6.3%), Microsporum canis (5.8%), T. violaceum (5.3%), T. verrucosum (0.83%) and Epidermophyton floccosum (0.3%). Zoophilic agents have become more prevalent and their frequency has been increased from 6.46% in 1999 to 13% in 2019. It is interesting to note that M. canis has been on the rise since 2010 and it was the first etiological agent of tinea capitis (48%), while infections caused by T. violaceum continued to decrease from 1999 (16.2%) to 2019 (4.7%). Other dermatophytes have been rarely isolated: T. tonsurans (9 cases), T. schoenleinii (3 cases), T. soudanense (2 cases), M. fulvum (1 case), M. audouinii (1 case) and M. ferrugineum (2 cases).T. mentagrophytes var. quinckeanum was isolated from an inflammatory tinea capitis lesion in an a-3-year-old girl. T. mentagrophytes var. erinacei was isolated from the first case of tinea manuum, in-a-10-year-old girl. The same fungus was isolated from the hair and scales of the hedgehog. Our study showed significant changes in the dermatophytes spectrum in our region. The prevalence of zoophilic species increased in recent years due to people's behavioral changes with the adoption of pets and animal husbandry in urban settings. Molecular methods are often crucial that help us to refine the identification strains of dermatophytes and to identify their origin of the contamination.

Keywords: dermatophytoses, PCR-sequencing, spectrum, Sfax, Tunisia

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Authors: Meenakshi Dahal

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Generally, children start verbal communication by the age of eighteen months. Though they have difficulties in constructing complete sentences, they try to make their thought s understandable to the audience. By the age of 36 months, when they enroll in preschool, their Language and communication skills are enhanced. Children need plenty of classroom experiences that will help them to develop their oral language skills. Oral language is the primary means through which each individual child is enabled to structure, evaluate, describe and to express his/her experiences. In the context of multi lingual and multi-cultural country like Nepal, the languages used in preschool and the communities vary. In such a case, the language of instruction in the preschool is different from the language used by the children to communicate at home. Using qualitative research method the socio-cultural aspect of the language learning has been analyzed. This has been done by analyzing and exploring preschool activities as well as the language of instruction and communication in the preschools in rural Nepal. It is found that the language of instruction is different from the language of communications primarily used by the children. Teachers seldom use local language resulting in difficulties for the children to understand. Instead of recognizing their linguistic, social and cultural capitals teachers conform to using the Nepali language which the children are not familiar with. Children have to adapt to new language structures and patterns of usage resulting them to be slow in oral language and communication in the preschool. The paper concludes that teachers have to recognize the linguistic capitals of the children and schools need to be responsible to facilitate this process for all children, whatever their language background.

Keywords: children, language, preschool, socio-culture

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Authors: Ahmad Almajid

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The idea of unifying quantum mechanics with general relativity is still a dream for many researchers, as physics has only two paths, no more. Einstein's path, which is mainly based on particle mechanics, and the path of Paul Dirac and others, which is based on wave mechanics, the incompatibility of the two approaches is due to the radical difference in the initial assumptions and the mathematical nature of each approach. Logical thinking in modern physics leads us to two problems: - In quantum mechanics, despite its success, the problem of measurement and the problem of wave function interpretation is still obscure. - In special relativity, despite the success of the equivalence of rest-mass and energy, but at the speed of light, the fact that the energy becomes infinite is contrary to logic because the speed of light is not infinite, and the mass of the particle is not infinite too. These contradictions arise from the overlap of relativistic and quantum mechanics in the neighborhood of the speed of light, and in order to solve these problems, one must understand well how to move from relativistic mechanics to quantum mechanics, or rather, to unify them in a way different from Dirac's method, in order to go along with God or Nature, since, as Einstein said, "God doesn't play dice." From De Broglie's hypothesis about wave-particle duality, Léon Brillouin's definition of the new proper time was deduced, and thus the quantum Lorentz factor was obtained. Finally, using the Euler-Lagrange equation, we come up with new equations in quantum mechanics. In this paper, the two problems in modern physics mentioned above are solved; it can be said that this new approach to quantum mechanics will enable us to unify it with general relativity quite simply. If the experiments prove the validity of the results of this research, we will be able in the future to transport the matter at speed close to the speed of light. Finally, this research yielded three important results: 1- Lorentz quantum factor. 2- Planck energy is a limited case of Einstein energy. 3- Real quantum mechanics, in which new equations for quantum mechanics match and exceed Dirac's equations, these equations have been reached in a completely different way from Dirac's method. These equations show that quantum mechanics is a limited case of relativistic mechanics. At the Solvay Conference in 1927, the debate about quantum mechanics between Bohr, Einstein, and others reached its climax, while Bohr suggested that if particles are not observed, they are in a probabilistic state, then Einstein said his famous claim ("God does not play dice"). Thus, Einstein was right, especially when he didn't accept the principle of indeterminacy in quantum theory, although experiments support quantum mechanics. However, the results of our research indicate that God really does not play dice; when the electron disappears, it turns into amicable particles or an elastic medium, according to the above obvious equations. Likewise, Bohr was right also, when he indicated that there must be a science like quantum mechanics to monitor and study the motion of subatomic particles, but the picture in front of him was blurry and not clear, so he resorted to the probabilistic interpretation.

Keywords: lorentz quantum factor, new, planck’s energy as a limiting case of einstein’s energy, real quantum mechanics, new equations for quantum mechanics

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Authors: Nima Dastanboo, Xiao-Qing Li, Hamed Gharibdoost

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The purpose of this study is to investigate about the geological properties ahead of a tunnel face with using Electrical Resistivity Tomography ERT and Tunnel Seismic Prediction TSP303 methods. In deep tunnels with hydro-geological conditions, it is important to study the geological structures of the region before excavating tunnels. Otherwise, it would lead to unexpected accidents that impose serious damage to the project. For constructing Nosoud tunnel in west of Iran, the ERT and TSP303 methods are employed to predict the geological conditions dynamically during the excavation. In this paper, based on the engineering background of Nosoud tunnel, the important results of applying these methods are discussed. This work demonstrates seismic method and electrical tomography as two geophysical techniques that are able to detect a tunnel. The results of these two methods were being in agreement with each other but the results of TSP303 are more accurate and quality. In this case, the TSP 303 method was a useful tool for predicting unstable geological structures ahead of the tunnel face during excavation. Thus, using another geophysical method together with TSP303 could be helpful as a decision support in excavating, especially in complicated geological conditions.

Keywords: tunnel seismic prediction (TSP303), electrical resistivity tomography (ERT), seismic wave, velocity analysis, low-velocity zones

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Authors: Omar Sorour, Michael Leahy, Thomas Irvine, Vladimir Koren

Abstract:

Introduction: Covid encephalitis is a rare yet dangerous complication, particularly affecting the older and immunocompromised. Symptoms range from confusion to delirium, coma, and seizures. Although neurological manifestations have become more well-characterized in COVID patients, little is known about whether priorneurological abnormalities may predispose patients to COVID encephalopathy. Case Description: A 73 y.o. male with a CT and MRI-confirmed stable, prior 9 mm cavernoma in the right frontal lobe and no past history of seizures was hospitalized with generalized weakness, abdominal pain, nausea, and shortness of breath with subsequent COVID pneumonia. Three days after the initial presentation, the patient developed a spontaneous generalized tonic-clonic seizure consistent with presumed COVID encephalitis, along with somnolence and confusion. A day later, the patient had two other seizure episodes. Follow-up EEG suggested an inter-ictal epileptic focus with sharp waves corresponding to roughly the same location as the patient’s pre-existing cavernoma. The patient’s seizures stopped shortly thereafter, while his encephalopathy continued for days. Conclusion: We illustrate that a pre-existing anatomic cortical abnormality may act as a potential nidus for new-onset seizure activity in the context of suggested COVID encephalopathy. Future studies may further demonstrate that manifestations of COVIDencephalopathy in certain patients may be more predictable than initially assumed.

Keywords: cavernoma, covid, encephalopathy, seizures

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Authors: N. Bakradze, T. Dumbadze, N. Gagelidze, L. Amiranashvili, A. D. L. Batako

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Cereals are considered as a strategic product in human life and it demand is increasing with the growth of world population. There is always shortage of cereals in various areas of the globe. For example, Georgia own production meets only 15-20% of the demand for grain, despite the fact that the country is considered one of the main centers of wheat origin. In Georgia, there are 14 types of wheat and more than 150 subspecies, and 40 subspecies of common wheat. Increasing wheat production is important for the country. One of the ways to solve the problem is to develop and implement new, environmentally and economically acceptable technologies. Such technologies include pre-sowing treatment of seed with a laser and associative nitrogen-fixing of the Azospirillum brasilensse bacteria. In the region there are Dika and Lomtagora which are among the most common in Georgia. Dika is a frost-resistant wheat, with a high ability to adapt to the environment, resistant to falling and it is sown in highlands. Dicka excellent properties are due to its strong immunity to fungal diseases; Dicka grains are rich in protein and lysine. Lomtagora 126 differs with its winter and drought resistance, and, it has a great ability to germinate. Lomtagora is characterized by a strong root system and a high budding capacity. It is an early variety, fall-resistant, easy to thresh and suitable for mechanized harvesting with large and red grains. The plant is moderately resistant to fungal diseases. This paper presents some preliminary experimental results where, a continuous CO2 laser at a power of 25-40 W/cm2 was used to radiate grains at a flow rate of 10-15 cm/sec. The treatment was carried out on grains of the Triticum aestivum L. var. of Lutescens (local variety name - Lomtagora 126), and Triticum carthlicum Nevski (local variety name - Dika). Here the grains were treated with Azospirillum brasilensse isolate (108-109 CFU / ml), which was isolated from the rhizosphere of wheat. It was observed that the germination of the wheat was not significantly influenced by either laser or bacteria treatment. In the case of the variety Lomtagora 126, when irradiated at an angle of 90°, it slightly improved the growth within 38 days of sawing, and in the case of irradiation at an angle of 90°+1, by 23%. The treatment of seeds with Azospirillum brazilense in both irradiated and non-irradiated variants led to an improvement in the growth of ssprouts. However, in the case of treatment with azospiril alone - by 22%, and with joint treatment of seeds with azospiril and irradiation - by 29%. In the case of the Dika wheat, the irradiation only led to an increase in growth by 8-9%, and the combine treatment of seeds with azospiril and irradiation - by 10-15%, in comparison with the control. Thus, the combine treatment of wheat of different varieties provided the best effect on the growth. Acknowledgment: This work was supported by Shota Rustaveli National Science Foundation of Georgia (SRNSFG) (Grant number CARYS 19-573)

Keywords: laser treatment, Azospirillum brasilensse, seeds, wheat varieties, Lomtagora, Dika

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Authors: Jerry D. Johnson, Jason A. LaFrance, Matthew A. Ohlson, Shane C. Shope

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The public school system is the largest employer and most impactful factor in the local economy for many rural communities in the United States. The relationship between the school system and the community is symbiotic—they thrive together or decline together. Understanding the perceptions of rural school superintendents (the titular head of the local school district) with regard to rural development is foundational to understanding how the school and community interact and collaborate in key areas like economic development, community development, and workforce development. To investigate those perceptions as they manifest among superintendents in thriving rural communities, a collective case study was designed and conducted to disclose and characterize superintendent perceptions about rural development in three diverse rural settings in the U.S.: Florida, Kansas, and Ohio. Appreciative Inquiry (AI) served as the conceptual framework and supported a focus on identifying and describing assets and strategies/activities that helped explain the positive results in the communities of interest. Implementation of a criterion-based purposive sampling process (using extant data and a nomination process to identify rural superintendents in communities with vibrant economies and recognized the contribution by the schools in rural development) resulted in two superintendents from each of these state settings who participated in semi-structured interviews. Interview transcripts and relevant extant documents were coded and analyzed to produce individual cases with representative themes, after which a cross-case analysis was conducted to generate overarching themes. The overarching themes were then scrutinized and tested through the application of appropriate credibility techniques to promote the trustworthiness of the results. Findings include the importance of building and maintaining relationships that extend beyond the immediate collaboration activity, the importance of collaboration skills, intentionality of practice, and organizational systems/structures as facilitators/affordances. The results offer potential guidance for leveraging the potential for public schools to contribute to their rural development in the communities they serve.

Keywords: collaboration, leadership, rural development, rural schools

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Authors: Shameka Stanford

Abstract:

This presentation will discuss how cognitive and communication disorders in the areas of executive functioning, receptive and expressive language can impact the problem-solving and decision making of individuals with such impairments. More specifically, this presentation will discuss approaches the legal defense team of capital case lawyers can add to their experience when servicing individuals who have a history of educational decline, special education, and limited intervention and treatment. The objective of the research is to explore and identify the correlations between impaired executive function skills and decision making and competency for individuals facing death penalty charges. To conduct this research, experimental design, randomized sampling, qualitative analysis was employed. This research contributes to the legal and criminal justice system related to how they view, defend, and characterize, and judge individuals with documented cognitive and communication disorders who are eligible for capital case charges. More importantly, this research contributes to the increased ability of death penalty lawyers to successfully defend clients with a history of academic difficulty, special education, and documented disorders that impact educational progress and academic success.

Keywords: cognitive impairments, communication disorders, death penalty, executive function

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Authors: Aisya Zaharin

Abstract:

The reporting of Islam in the Malaysian government-controlled press is complicated and occurs almost daily. This is due to the Islamisation process that has been heavily politicized in recent years. This article analyses media representations of Islam in the Malaysian media through the social responsibility theory. A provocative case study of media reporting on the “I want to touch a dog” event was analysed since dog’s saliva is ritually considered unhygienic by Muslims. This paper will not question the Islamic ruling on the dog’s issue. Instead, it calls for discussions in relation to openness and maturity in religious discourse with respect to the dog’s saliva dialogue in 1937. It applies Hage’s “minor and major reality” to explain the increasing percentage of Muslim who define their own understandings of Islam vs the government’s dogmatic versions. This paper employs Alatas’s method of “sociological investigation in Southeast Asia” by using ethnographic examination on selected mass media. Through Asiacentricity approach, this paper revisited the local framework of Alatas’s New Man encouraging Muslims to engage in knowledge and to appreciate diversities in Islamic jurisprudences. Despite government’s control, findings showed that non-Malay languages and online media are more comprehensive in reporting the news about Islam. Clearly, there has to be a re-conceptualization of Islamic discourses in the Malay-language media.

Keywords: dog, Fiqh, Islamic jurisprudence, Malaysian media, New Man, social responsibility

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Authors: Zuhrotun Ulya, Muchammad Syamsulhadi, Debree Septiawan

Abstract:

Patients with bipolar disorder are three times more likely to suffer cardiovascular disorders than the general population, which will influence their level of morbidity and rate of mortality. Bipolar disorder also affects the pulmonary system. The choice of long term-monotherapy and other combinative therapies have clinical impacts on patients. This study investigates the case of a woman who has been suffering from bipolar disorder for 16 years, and who has a history of Steven Johnson Syndrome. At present she is suffering also from cardiovascular and pulmonary disorder. An analysis of the results of this study suggests that there is a relationship between cardiovascular disorder, drug therapies, Steven Johnson Syndrome and mood stabilizer obtained from the PubMed, Cochrane, Medline, and ProQuest (publications between 2005 and 2015). Combination therapy with mood stabilizer is recommended for patients who do not have side effect histories from these drugs. The replacement drugs and combinations may be applied, especially for those with bipolar disorders, and the combination between atypical antipsychotic groups and mood stabilizers is often made. Clinicians, however, should be careful with the patients’ physical and metabolic changes, especially those who have experienced long-term therapy and who showed a history of Steven Johnson Syndrome (for which clinicians probably prescribed one type of medicine).

Keywords: cardiopulmonary disease, bipolar disorder, SJS, therapy

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Authors: T. L. Granzyk, S. Scarborough, J. DeCosmo

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The use of health-related or medical narratives has gained increasing anecdotal and research-based support as a successful device for changing health behavior and outcomes. These narratives, in the form of oral storytelling, short films, and educational documentaries, for example, are most effective when including empathetic characters that transport viewers into the story and command both their attention and emotional response. This case study outlines how and why one large health system created a short narrative film for their internal Sepsis Awareness campaign, which told the dramatic story of a patient recovering from a missed sepsis diagnosis, leaving her a quad-amputee. Results include positive global anecdotal response to the film from healthcare professionals and patients, as well as use of the film to support legislation, ultimately passed in favor of the formation of Sepsis Awareness Workgroups in Maryland. Authors conclude that narrative films can be used successfully to initiate healthcare legislation and to increase internal and external awareness of health-related areas in need of greater improvement and support. As such, healthcare leaders and stakeholders would benefit from learning how to intentionally create, cultivate, and curate narratives from within their own health systems that elicit an empathetic response.

Keywords: healthcare policy, healthcare narratives, sepsis awareness, short films

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Authors: Saad Mohamed Elsaid Abdelrahman

Abstract:

The adsorption method is one of the best modern techniques used in removing pollutants, especially organic hydrocarbon compounds, from polluted water. Through this research, bentonite clay can be used to remove organic hydrocarbon compounds, such as heptane and octane, resulting from oil spills in seawater. Bentonite clay can be obtained from the Kholayaz area, located north of Jeddah, at a distance of 80 km. Chemical analysis shows that bentonite clay consists of a mixture of silica, alumina and oxides of some elements. Bentonite clay can be activated in order to raise its adsorption efficiency and to make it suitable for removing pollutants using an ionic organic solvent. It is necessary to study some of the factors that could be in the efficiency of bentonite clay in removing oily organic compounds, such as the time of contact of the clay with heptane and octane solutions, pH and temperature, in order to reach the highest adsorption capacity of bentonite clay. The temperature can be a few degrees Celsius higher. The adsorption capacity of the clay decreases when the temperature is raised more than 4°C to reach its lowest value at the temperature of 50°C. The results show that the friction time of 30 minutes and the pH of 6.8 is the best conditions to obtain the highest adsorption capacity of the clay, 467 mg in the case of heptane and 385 mg in the case of octane compound. Experiments conducted on bentonite clay were encouraging to select it to remove heavy molecular weight pollutants such as petroleum compounds under study.

Keywords: adsorbent, bentonite clay, oil spills, removal

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