Search results for: difficulty in hospital acceptance

Authors: Ahmad Alshammari

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This study focused on exploring the students’ views about the science education in intermediate stage in State of Kuwait. This study used Social-Culture Theory (SCT) as a theoretical framework to understand the science curriculum reform process through the socio-cultural context and to discuss and explain the study findings. This study used a multi-method design, with both quantitative and qualitative methods to collect the data: students’ questionnaires and interviews. The study sample was selected randomly. First, the questionnaire was conducted with 647 students. Then 30 students (5 in each of 6 focus groups) were chosen to conduct the in-depth interviews. The findings of this study indicated the generally negative views of most of the students about the new science curriculum. The findings showed that most of the students have a negative attitude toward science, they have difficulty understanding most of the lessons, and they do not enjoy studying the science subject. This study recommends reviewing the new science curriculum (now currently in use) and taking into account the perspectives of the students about this curriculum. Developing and adapting the new science curriculum took place without taking into consideration the socio-culture and Islamic religion of Kuwaiti students. The MoE should deal with the relationship between science and culture and between science and religion, integrating more relevant science into the curriculum.

Keywords: science education, students views, science curriculum, curriculum development

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Authors: Miramar Damanhouri

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This study examines the relationship between language use in computer-mediated communication and the social identity of the user. The data were collected by surveying 298 Saudi bilingual speakers who are familiar with Arabizi, a blend of Latin characters and Arabic numerals to transliterate Arabic sounds, and then analyzed quantitatively by running tests for statistical confidence in order to determine differences in perceptions between young adults (ages 15-25 years) and middle-aged adults (ages 26-50 years). According to the findings of this study, English is the dominant language among most of the young adults surveyed, and when they do use Arabic, they use Arabizi because of its flexibility, compatibility with modern technology, and its acceptance among people of their age and sociocultural backgrounds. On the other hand, most middle-aged adults surveyed here tend to use Arabic, as they believe that they should show their loyalty to their origin. The results of the study demonstrate a mutual relationship between language use in computer-mediated communication and the user’s social identity, as language is used both to reflect and construct that identity.

Keywords: Arabizi, computer mediated communication, digital communication, language use

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Authors: Gamze Atay, Altay Colak

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It is a fact that today's technology shapes the change and development of architectural forms by creating different perspectives. The research is an experimental study that explores the integration of architectural forms in this process of change/development into design education through traditional design tools. An examination of the practices in the studio environment shows that the students who just started architectural education have difficulty accessing the form. The main objective of this study has been to enable students to use and interpret different disciplines in the design process to improve their perception of form. In this sense, the origami, which is defined as "the art of paper folding", and isomorphous (equally formed) approaches have been used with design studio students at the beginning stage as methods in the process of 3-dimensional thinking and creating the form. These two methods were examined with students in three stages: analysis, creation, and outcome. As a result of the study, it was seen that the use of different disciplines as a method during form creation gave the designs of the student originality, freedom, and dynamism.

Keywords: architectural form, design education, isomorphic approach, origamic approach

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Authors: Sonia Wahengbam, Natasha Elangbam

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Female impersonation has existed through the length of human civilization and the breadth of its cultures. Transvestism and drag queen cultures have created multi-sited spaces where in the shadow of art, one can cross the gender barrier and express one’s hidden identity. This paper will explore a dynamic cultural space that exists in Manipur, a state in the northeastern region of India, where the female impersonators (nupi shabis) of a folk theater (Shumang Leela) are using this traditional and popular art form to claim social acceptance of their homosexual identities through the medium of entertainment. It will highlight how by crossing the gender boundary, this third gender group has carved out a unique socio-economic niche where they have exploited their sexual identities to their advantage. The paper will trace the expanding cultural ‘’borderland’’ of Manipur where there is an increasing sense of ‘becoming’, belonging and sharing” of identities through the interweaving of old and new media. The research will be based on interviews with the nupi shabis, cultural critics and other experts.

Keywords: transvestism, Manipur, female impersonators (nupi shabis), Shumang Leela, gender

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Authors: Khalid A. Al-Afandy, El-Sayyed El-Rabaie, Osama Salah, Ahmed El-Mhalaway

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This paper presents a high secure data hiding technique using image cropping and Least Significant Bit (LSB) steganography. The predefined certain secret coordinate crops will be extracted from the cover image. The secret text message will be divided into sections. These sections quantity is equal the image crops quantity. Each section from the secret text message will embed into an image crop with a secret sequence using LSB technique. The embedding is done using the cover image color channels. Stego image is given by reassembling the image and the stego crops. The results of the technique will be compared to the other state of art techniques. Evaluation is based on visualization to detect any degradation of stego image, the difficulty of extracting the embedded data by any unauthorized viewer, Peak Signal-to-Noise Ratio of stego image (PSNR), and the embedding algorithm CPU time. Experimental results ensure that the proposed technique is more secure compared with the other traditional techniques.

Keywords: steganography, stego, LSB, crop

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Authors: Guilherme Oliveira

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The assimilation of images and their potential symbolism into lived experiences is inherent. It is through this exercise of recognition via imagistic records that the questioning of the origins of a constant narrative stimulated by the media arises. The construction of the "Man" archetype and the reflections of active masculine imagery in the 21st century, when conveyed through media channels, could potentially have detrimental effects. Addressing this systematic behavioral chronology of virile cisgender, permeated imagistically through these means, involves exploring potential resolutions. Thus, an investigation process is initiated into the potential representation of the 'hero' in this media emulation through idols contextualized in the political sphere, with the purpose of elucidating the processes of simulation and emulation of narratives based on mythical, historical, and sacred accounts. In this process of sharing, the narratives contained in the imagistic structuring offered by information dissemination channels seek validation through a process of public acceptance. To achieve this consensus, a visual set adorned with mythological and sacred symbolisms adapted to the intended environment is promoted, thus utilizing sociocultural characteristics in favor of political marketing. Visual recognition, therefore, becomes a direct reflection of a cultural heritage acquired through lived human experience, stimulated by continuous representations throughout history. Echoes of imagery and narratives undergo a constant process of resignification of their concepts, sharpened by their premises, and adapted to the environment in which they seek to establish themselves. Political figures analyzed in this article employ the practice of taking possession of symbolisms, mythological stories, and heroisms and adapt their visual construction through a continuous praxis of emulation. Thus, they utilize iconic mythological narratives to gain credibility through belief. Utilizing iconic mythological narratives for credibility through belief, the idol becomes the very act of release of trauma, offering believers liberation from preconceived concepts and allowing for the attribution of new meanings. To dissolve this issue and highlight the subjectivities within the intention of the image, a linguistic, semiotic, and anthropological methodology is created. Linguistics uses expressions like 'Blaming the Image' to create a mechanism of expressive action in questioning why to blame a construction or visual composition and thus seek answers in the first act. Semiotics and anthropology develop an imagistic atlas of graphic analysis, seeking to make connections, comparisons, and relations between modern and sacred/mystical narratives, emphasizing the different subjective layers of embedded symbolism. Thus, it constitutes a performative act of disarming the image. It creates a disenchantment of the superficial gaze under the constant reproduction of visual content stimulated by virtual networks, enabling a discussion about the acceptance of caricatures characterized by past fables.

Keywords: image, heroic narrative, media heroism, virile politics, political, myth, sacred performance, visual mythmaking, characterization dynamics

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Authors: Vishwesh Kulkarni, Nikhil Bellarykar

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Cellular complexity stems from the interactions among thousands of different molecular species. Thanks to the emerging fields of systems and synthetic biology, scientists are beginning to unravel these regulatory, signaling, and metabolic interactions and to understand their coordinated action. Reverse engineering of biological networks has has several benefits but a poor quality of data combined with the difficulty in reproducing it limits the applicability of these methods. A few years back, many of the commonly used predictive algorithms were tested on a network constructed in the yeast Saccharomyces cerevisiae (S. cerevisiae) to resolve this issue. The network was a synthetic network of five genes regulating each other for the so-called in vivo reverse-engineering and modeling assessment (IRMA). The network was constructed in S. cereviase since it is a simple and well characterized organism. The synthetic network included a variety of regulatory interactions, thus capturing the behaviour of larger eukaryotic gene networks on a smaller scale. We derive a new set of algorithms by solving a nonlinear optimization problem and show how these algorithms outperform other algorithms on these datasets.

Keywords: synthetic gene network, network identification, optimization, nonlinear modeling

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Authors: Hestiasari Rante, Leonardo De Araújo, Heidi Schelhowe

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Usability testing with children is similar in many aspects to usability testing with adults. However, there are a few differences that one needs to be aware of in order to get the most out of the sessions, and to ensure that children are comfortable and enjoying the process. This paper presents the need to acquire methodological knowledge for involving children as test users in usability testing, with consideration on Piaget’s theory of cognitive growth. As a case study, we use BatiKids, an application developed to evoke children’s enthusiasm to be involved in culture heritage preservation. The usability test was applied to 24 children from 9 to 10 years old. The children were divided into two groups; one interacted with the application through a graphic tablet with pen, and the other through touch screen. Both of the groups had to accomplish the same amount of tasks. In the end, children were asked to give feedback. The results suggested that children who interacted using the graphic tablet with pen had more difficulties rather than children who interacted through touch screen. However, the difficulty brought by the graphic tablet with pen is an important learning objective in order to understand the difficulties of using canting, which is an important part of batik.

Keywords: batikids, children, child-computer interaction, usability test

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Authors: Ratchaneewan Salao, Steven W. Edwards, Kiatichai Faksri, Kanin Salao

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Background: A two-dose regimen of COVID-19 vaccination (inactivated whole virion SARS-CoV-2 and adenoviral vector) has been widely used. Side effects are very low, but several adverse effects have been reported. Methods: A 40-year-old female patient, with a previous history of thyroid goitre, developed severe neck pain, headache, nausea and fatigue 7-days after receiving second vaccination with Vaxzevria® (Oxford-AstraZeneca). Clinical and laboratory findings, including thyroid function tests and ultrasound of thyroid glands, were performed. Results: Her left thyroid gland was multinodular enlarged, and severely tender on palpation. She had difficulty in swallowing and had tachycardia but no signs of hyperthyroidism. Laboratory results supported a diagnosis of subacute thyroiditis. She was prescribed NSAID (Ibuprofen 400 mg) and dexamethasone for 3-days and her symptoms resolved. Conclusions: Although this is an extremely rare event, physicians may encounter more cases of this condition due to the extensive vaccination program using this combination of vaccines.

Keywords: SARS-CoV-2, adenoviral vector vaccines, vaccination, subacute thyroiditis

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Authors: Sidi Mohamed Mesli, Mohamed Habchi, Arslane Boudghene Stambouli, Rafik Benallal

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The BaMnMF7 (M=Fe,V, transition metal fluoride glass, assuming isomorphous replacement) have been structurally studied through the simultaneous simulation of their neutron diffraction patterns by reverse Monte Carlo (RMC) and by the Hybrid Reverse Monte Carlo (HRMC) analysis. This last is applied to remedy the problem of the artificial satellite peaks that appear in the partial pair distribution functions (PDFs) by the RMC simulation. The HRMC simulation is an extension of the RMC algorithm, which introduces an energy penalty term (potential) in acceptance criteria. The idea of this work is to apply the Buckingham potential at the title glass by ignoring the van der Waals terms, in order to make a fit of the partial pair distribution functions and give the most possible realistic features. When displaying the partial PDFs, we suggest that the Buckingham potential is useful to describe average correlations especially in similar interactions.

Keywords: fluoride glasses, RMC simulation, hybrid RMC simulation, Buckingham potential, partial pair distribution functions

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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Diabetes Mellitus (DM) is commonly encountered metabolic disorder in clinical practice. An estimated 25 percent of DM patients develop foot problems. Foot ulceration and infection are one of the major causes of morbidity, hospitalization or even amputation. Objective: To isolate and identify bacterial pathogens in Diabetic Foot Ulcer (DFU) and to observe its antimicrobial sensitivity pattern. Methodology: A prospective study was conducted for a period of 9 months at the Department of Microbiology, GD Hospital & Diabetes Institute, Kolkata. 75 DFU patients were recruited in the study. Specimens for microbiological studies obtained from ulcer base were examined as gram stained smear and was cultured aerobically on Nutrient agar, Blood agar and MacConkey agar plates. Antimicrobial sensitivity test was performed by disc diffusion techniques according to CLSI guidelines. Result: In this study out of 75cases, 73% (55/75) were male and 27% (20/75) were females with mean (SD) age of 51.11(±10) years. Out of 75 pus cultures, 63(84%) showed growth of microorganism making total of 81 bacterial isolates with 71.42% of monomicrobial infection and 28.57% of polymicrobial infection. Out of 81 isolates 53(65.43%) were gram negative and 21(25.92%) were gram positive. E.coli was relatively common isolate 21(26%) followed by Staphylococcus aureus 15(18.5%), Klebsiella pneumonia 14(17.28%), Pseudomonas aeruginosa 12 (14.81%), Proteus spp. 3 (3.70%), and Enterococcus faecalis 6 (7.40%). 75% of Gram-negative microorganism were extended Beta-lactamase enzyme (ESBL) producer and around 20 % of Klebsiella and Proteus spp. were carbapenemase enzyme producer. Among Gram positive, around 50% of S.aureus was MRSA, sensitive only to Vancomycin, Teicoplanin & Linezolid. Conclusion: More prevalence of monomicrobial gram-negative bacteria than gram-positive bacteria in DFU was observed. This study emphasizes that Beta-Lactam group of antibiotics should not be the empirical treatment of choice for Gram-negative isolates; instead alternatives like Carbapenems, Amikacin could be a better option. On the other hand, Vancomycin and Linezolid are preferred for most of the infection with gram-positive aerobes. Continuous surveillance of resistant bacteria is required for empiric therapy.

Keywords: antibiotic resistant, antimicrobial susceptibility, diabetic foot ulcer, surveillance

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Authors: E. Marušić-Paloka, I. Pažanin, M. Prša

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Subject of this study is the stationary heat conduction problem through a pipe filled with incompressible viscous fluid. In previous work, we observed the existence and uniqueness theorems for the corresponding boundary-value problem and within we have taken into account the effects of the pipe's dilatation due to the temperature of the fluid inside of the pipe. The main difficulty comes from the fact that flow domain changes depending on the solution of the observed heat equation leading to a non-standard coupled governing problem. The goal of this work is to find solution estimate since the exact solution of the studied problem is not possible to determine. We use an asymptotic expansion in order of a small parameter which is presented as a heat expansion coefficient of the pipe's material. Furthermore, an error estimate is provided for the mentioned asymptotic approximation of the solution for inner area of the pipe. Close to the boundary, problem becomes more complex so different approaches are observed, mainly Theory of Perturbations and Separations of Variables. In view of that, error estimate for the whole approximation will be provided with additional software simulations of gotten situation.

Keywords: asymptotic analysis, dilated pipe, error estimate, heat conduction

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Authors: Jiya Mohammed, Tsadu Shuaib, Yusuf Abdulhakeem

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The research work focuses on the cases of MHD boundary layer flow past a stretching plate with heat transfer and viscous dissipation. The non-linear of momentum and energy equation are transform into ordinary differential equation by using similarity transformation, the resulting equation are solved using Adomian Decomposition Method (ADM). An attempt has been made to show the potentials and wide range application of the Adomian decomposition method in the comparison with the previous one in solving heat transfer problems. The Pade approximates value (η= 11[11, 11]) is use on the difficulty at infinity. The results are compared by numerical technique method. A vivid conclusion can be drawn from the results that ADM provides highly precise numerical solution for non-linear differential equations. The result where accurate especially for η ≤ 4, a general equating terms of Eckert number (Ec), Prandtl number (Pr) and magnetic parameter ( ) is derived which was used to investigate velocity and temperature profiles in boundary layer.

Keywords: MHD, Adomian decomposition, boundary layer, viscous dissipation

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Authors: K. Rhea Devaiah, B. S. Premalatha

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Background: Tonsillar Lingual sulcus is the area between the tonsils and the base of the tongue. The surgical resection of the lesions in the head and neck results in changes in speech and swallowing functions. The severity of the speech and swallowing problem depends upon the site and extent of the lesion, types and extent of surgery and also the flexibility of the remaining structures. Need of the study: This paper focuses on the importance of speech and swallowing rehabilitation in an individual with the lesion in the Tonsillar Lingual Sulcus and post-operative functions. Aim: Evaluating the speech and swallow functions post-intensive speech and swallowing rehabilitation. The objectives are to evaluate the speech intelligibility and swallowing functions after intensive therapy and assess the quality of life. Method: The present study describes a report of an individual aged 47years male, with the diagnosis of basaloid squamous cell carcinoma, left tonsillar lingual sulcus (pT2n2M0) and underwent wide local excision with left radical neck dissection with PMMC flap reconstruction. Post-surgery the patient came with a complaint of reduced speech intelligibility, and difficulty in opening the mouth and swallowing. Detailed evaluation of the speech and swallowing functions were carried out such as OPME, articulation test, speech intelligibility, different phases of swallowing and trismus evaluation. Self-reported questionnaires such as SHI-E(Speech handicap Index- Indian English), DHI (Dysphagia handicap Index) and SESEQ -K (Self Evaluation of Swallowing Efficiency in Kannada) were also administered to know what the patient feels about his problem. Based on the evaluation, the patient was diagnosed with pharyngeal phase dysphagia associated with trismus and reduced speech intelligibility. Intensive speech and swallowing therapy was advised weekly twice for the duration of 1 hour. Results: Totally the patient attended 10 intensive speech and swallowing therapy sessions. Results indicated misarticulation of speech sounds such as lingua-palatal sounds. Mouth opening was restricted to one finger width with difficulty chewing, masticating, and swallowing the bolus. Intervention strategies included Oro motor exercise, Indirect swallowing therapy, usage of a trismus device to facilitate mouth opening, and change in the food consistency to help to swallow. A practice session was held with articulation drills to improve the production of speech sounds and also improve speech intelligibility. Significant changes in articulatory production and speech intelligibility and swallowing abilities were observed. The self-rated quality of life measures such as DHI, SHI and SESE Q-K revealed no speech handicap and near-normal swallowing ability indicating the improved QOL after the intensive speech and swallowing therapy. Conclusion: Speech and swallowing therapy post carcinoma in the tonsillar lingual sulcus is crucial as the tongue plays an important role in both speech and swallowing. The role of Speech-language and swallowing therapists in oral cancer should be highlighted in treating these patients and improving the overall quality of life. With intensive speech-language and swallowing therapy post-surgery for oral cancer, there can be a significant change in the speech outcome and swallowing functions depending on the site and extent of lesions which will thereby improve the individual’s QOL.

Keywords: oral cancer, speech and swallowing therapy, speech intelligibility, trismus, quality of life

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Authors: Nwauzoma Ohale Rowland, Bright Ugochukwu Umunna

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The world has been referred to as a global village for decades, adapting various technological and digital innovations to progress along the lines of development. Different continents have fully automated processes and procedures in the various sectors of their economies. This paper attempts to ascertain why the West African sub-continent while displaying a slow progression, has also joined the race toward having a fully automated process, albeit only in certain areas of its economy. Different reasons for this have been posited and will be discussed in this work. These reasons include high illiteracy rates and poor acceptance of new technologies. Studies were carried out that involved interactions with different business sectors and also a secondary-level investigation of experiments to ascertain the impact of automation in supply chain management on the West African market. Our reports show remarkable growth in businesses and sectors that have automated their processes. While this is the case, other results have also confirmed as due to the high illiteracy rates; the labour force has also been affected.

Keywords: Africa, automation, business, innovation, supply chain management, technology

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Authors: C. Scurr, J. Jeans, S. Srivastava

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Introduction: Acute type two respiratory failure (T2RF) has become a common presentation over the last two decades primarily due to an increase in the prevalence of chronic lung disease. Acute exacerbations can be managed either medically or in combination with non-invasive ventilation (NIV) which should be monitored with regular arterial blood gas samples (ABG). Arterial lines allow more frequent arterial blood sampling with less patient discomfort. We present the experience from a teaching hospital emergency department (ED) and level 2 medical high-dependency unit (HDU) that together form the pathway for management of acute type 2 respiratory failure. Methods: Patients acutely presenting to Charing Cross Hospital, London, with T2RF requiring non-invasive ventilation (NIV) over 14 months (2011 to 2012) were identified from clinical coding. Retrospective data collection included: demographics, co-morbidities, blood gas numbers and timing, if arterial lines were used and who performed this. Analysis was undertaken using Microsoft Excel. Results: Coding identified 107 possible patients. 69 notes were available, of which 41 required NIV for type 2 respiratory failure. 53.6% of patients had an arterial line inserted. Patients with arterial lines had 22.4 ABG in total on average compared to 8.2 for those without. These patients had a similar average time to normalizing pH of (23.7 with arterial line vs 25.6 hours without), and no statistically significant difference in mortality. Arterial lines were inserted by Foundation year doctors, Core trainees, Medical registrars as well as the ICU registrar. 63% of these were performed by the medical registrar rather than ICU, ED or a junior doctor. This is reflected in that the average time until an arterial line was inserted was 462 minutes. The average number of ABGs taken before an arterial line was 2 with a range of 0 – 6. The average number of gases taken if no arterial line was ever used was 7.79 (range of 2-34) – on average 4 times as many arterial punctures for each patient. Discussion: Arterial line use was associated with more frequent arterial blood sampling during each inpatient admission. Additionally, patients with an arterial line have less individual arterial punctures in total and this is likely more comfortable for the patient. Arterial lines are normally sited by medical registrars, however this is normally after some delay. ED clinicians could improve patient comfort and monitoring thus allowing faster titration of NIV if arteral lines were regularly inserted in the ED. We recommend that ED doctors insert arterial lines when indicated in order improve the patient experience and facilitate medical management.

Keywords: non invasive ventilation, arterial blood gas, acute type, arterial line

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Authors: S. Yeo, M. Mathur

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Introduction: Obesity, defined as a Body Mass Index (BMI) of more than or equal to 30kg/m, is associated with an increased risk of complications during pregnancy and delivery. During labour, obese mothers often require greater intervention and have higher rates of caesarean section. Despite a low overall rate of serious complications following caesarean section, a high BMI predisposes to a higher risk of postoperative complications. Our study, therefore, aimed to investigate the impact of antenatal obesity on adverse outcomes following caesarean section, particularly wound-related infections. Materials and Methods: A retrospective cohort study of all caesarean deliveries during the first quarter of a chosen year was undertaken in our hospital, which is a tertiary referral centre with > 12,000 deliveries per year. Patients’ health records and data from our hospital’s electronic labour and delivery database were reviewed. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS), and odds ratios plus adjusted odd ratios were calculated with 95% confidence intervals (CI). Results: A total of 1829 deliveries were reviewed during our study period. Of these, 180 (9.8%) patients were obese. The rate of caesarean delivery was 48.9% in obese patients versus 28.1% in non-obese patients. Post-operatively, 17% of obese patients experienced wound infection versus 0.2% of non-obese patients. Obese patients were also more likely to experience major postpartum haemorrhage (4.6% vs. 0.2%) and postpartum pyrexia (18.2% vs. 5.0%) in comparison to non-obese patients. Conclusions: Obesity is a significant risk factor in the development of postoperative complications following caesarean section. Wound infection remains a major concern for obese patients undergoing major surgery and results in extensive morbidity during the postnatal period. Postpartum infection can prolong recovery and affect maternal mental health, leading to reduced perinatal bonding with long-term implications on breastfeeding and parenting confidence. This study supports the need for the development of standardized protocols specifically for obese patients undergoing caesarean section. Multidisciplinary team care, in conjunction with anaesthesia, family physicians, and plastic surgery counterparts, early on in the antenatal journey, may be beneficial where wound complications are anticipated and to minimize the burden of postoperative infection in obese mothers.

Keywords: pregnancy, obesity, caesarean, infection

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Authors: Victor E. Lopez, L. Dale Thomas

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As engineered systems become more complex, the difficulty associated with predicting, developing, and operating engineered systems also increases, resulting in increased costs, failure rates, and unexpected consequences. Successfully managing the complexity of the system should reduce these negative consequences. The study of complexity in the context of engineering development has suffered due to the ambiguity of the nature of complexity, what makes a system complex and how complexity translates to real world engineering attributes and consequences. This paper argues that the use of an ontology of engineering design complexity would i) improve the clarity of the research being performed by allowing researchers to use a common conceptualization of complexity, with more precise terminology, and ii) elucidate the connections between certain types of complexity and their consequences for system development. The ontology comprises concepts of complexity found in the literature and the different relations that exists between them. The ontology maps different complexity concepts such as structural complexity, creation complexity, and information entropy, and then relates the to system aspects such as interfaces, development effort, and modularity. The ontology is represented using the Web Ontology Language (OWL). This paper presents the current status of the ontology of engineering design complexity, the main challenges encountered, and the future plans for the ontology.

Keywords: design complexity, ontology, design effort, complexity ontology

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Authors: Ana Luísa Mouro

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When the financial crisis exploded in 2008 in the United States, unleashed by the collapse of Lehman Brothers, and contaminated the economies of the European periphery, Germany appeared as the anchor of the stability of all European institutions and countries in difficulty. The solutions provided by the German government have triggered a deep political debate about the key position Germany has conquered at the heart of Europe - a new “German question” has been created. Some say Germany has achieved by peaceful means what was not able to get through military conquest - the domination of Europe – and many fear Germany’s economic power. This debate about the new role of Germany in Europe has received special attention in the European media and Portugal has not been the exception. The present study has been based on the survey, selection and critical analysis of news reporting, opinion articles, interviews and editorials, published in the weekly Expresso and in the daily Público, between 2008 and 2015 (year of the 25th anniversary of Germany’s unification). The findings of this study will show the paradox of German power and its relevance for Europe’s future.

Keywords: Euro crises, German Europe, intercultural hermeneutics, Portuguese quality press

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Authors: Budi Annisa Sidi

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Present-day Indonesia maintains a narrative of a culturally plural but unified nation. At the same time, multicultural policies extend different degrees of recognition, accommodation, toleration and even discrimination towards different socio-cultural groups. In conjunction with different ethnographic landscapes across regions in Indonesia, this approach leads to a varied experience and understanding of national identity and multiculturalism among people. As a result, governments seeking to maintain national unity while practicing multiculturalism have to juggle different expectations. This situation is examined through the microcosms of university students using questionnaires followed up by focus group discussions and personal interviews. A comparison between university students across four different provinces in Indonesia (Aceh, Jakarta, West Java and the Moluccas) highlights the influence of one’s surroundings on their perception of multiculturalism. Students in the more heterogeneous areas generally show more acceptance towards diversity compared to students in primarily homogenous areas who have little actual experience in dealing with diversity. Regardless of their environment, students claim to have positive feelings and a strong sense of attachment to Indonesia but hold different ideas of what constitutes an ideal Indonesian national identity.

Keywords: Indonesia, multiculturalism, national identity, nationalism

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Authors: Mohamad Sharif bin Mustaffa, Maizatul Akmam binti Abu Bakar, Mohd Harriszamani bin Abu Bakar

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Most teens who gave birth to an illegitimate child will suffer from depression. This depression issues arising from the incident itself which contains the teen will feel ashamed because labeled as immoral, apart from that most teenagers go through this episode without support from their spouse or family. Teens also face the possibility of a large part with the will be born babies because the issue of too young and needs to go back to school. Teens also can not make a decision on the future of the baby later because they are too immature and no baby care skills other than financial issues, where young people themselves are still dependent on their family. This paper will look at how to apply neurofeedback can be used to see the level of depression experienced by teenagers who get pregnant out of wedlock. Play therapy that will help improve adolescent focus will be used for this purpose. Each level experienced by teenagers going through the phase of easy-to-high difficulty level. Apart from that a recovery module will also be developed as a whole to reduce the level of depression to enable the youth to perform routine healthy activities and can go back to school with cheerful feeling, motivated and active.

Keywords: neurofeedback, depression, pregnant, adolescent, illegitimate

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Authors: Eman Mohamed Abdelwahab, Badreyya Alkhanbooli

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This study focuses on exploring the challenges encountered by English language teachers in same-ability English language classrooms in the United Arab Emirates public schools. This qualitative study uses open-ended questions for data collection from teacher participants. The study sample includes the participation of 60 English language teachers from 8 public schools across 4 emirates/cities in the United Arab Emirates. The study results highlight a number of challenges that are mostly encountered by English language teachers in their classrooms while teaching in same-ability classrooms, including lack of diversity in abilities, class-time limitation, difficulty in engaging all students (especially lower-achieving students), limited opportunities for peer learning and limited linguistic diversity. A set of suggestions is to be provided by participating teachers and researchers to improve the same-ability teaching and learning experience in English language classrooms.

Keywords: English language teaching, same ability grouping, ESL, English language learners

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Authors: Michal Krčál

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Since their introduction in 1990’s, Enterprise Information Portals (EIPs) were investigated from different perspectives (e.g. project management, technology acceptance, IS success). However, no systematic literature review was produced to systematize both the research efforts and the technology itself. This paper reports first results of an extent systematic literature review study focused on research of EIPs and its categorization, specifically it reports a conceptual model of EIP features. The previous attempt to categorize EIP features was published in 2002. For the purpose of the literature review, content of 89 articles was analyzed in order to identify and categorize features of EIPs. The methodology of the literature review was as follows. Firstly, search queries in major indexing databases (Web of Science and SCOPUS) were used. The results of queries were analyzed according to their usability for the goal of the study. Then, full-texts were coded in Atlas.ti according to previously established coding scheme. The codes were categorized and the conceptual model of EIP features was created.

Keywords: enterprise information portal, content analysis, features, systematic literature review

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Authors: Khosro Barkhordari, Fateme Sadr, Mina Pashang

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Back ground: Blood transfusion is one of the major issues in cardiac surgery patients. Transfusing patients based on fixed cut-off points of hemoglobin is the current protocol in most institutions. The hemoglobin level of 7- 10 has been suggested for blood transfusion in cardiac surgery patients. We aimed to evaluate if blood transfusion based on change in percentage of hematocrit has different outcomes. Methods: In this retrospective cohort study, we investigated the early postoperative outcome of cardiac surgery patients who received blood transfusions at Tehran Heart Center Hospital, IRAN. We reviewed and analyzed the basic characteristics and clinical data of 700 patients who met our exclusion and inclusion criteria. The two groups of blood transfused patients were compared, those who have 30-50 percent decrease in basal hematocrit versus those with 10 -29 percent decrease. Results: This is ongoing study, and the results would be completed in two weeks after analysis of the date. Conclusion: Early analysis has shown no difference in early post-operative outcomes between the two groups, but final analysis will be completed in two weeks. 1-Department of Anesthesiology and Critical Care, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IRAN 2- Department of Research, Tehran Heart Center, Tehran, IRAN Quantitative variables were compared using the Student t-test or the Mann‐Whitney U test, as appropriate, while categorical variables were compared using the χ2 or the Fisher exact test, as required. Our intention was to compare the early postoperative outcomes between the two groups, which include 30 days mortality, Length of ICU stay, Length of hospital stay, Intubation time, Infection rate, acute kidney injury, and respiratory complications. The main goal was to find if transfusing blood based on changes in hematocrit from a basal level was better than to fixed cut-off point regarding early post-operative outcomes. This has not been studied enough and may need randomized control trials.

Keywords: post-operative, cardiac surgery, outcomes, blood transfusion

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Authors: Murat Iskender Aktaş, Sadi Ergin, Rasime Acar Aktaş

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In the light of fast-paced changes and developments in the health sector, the Ministry of Health started a new structuring with decree law numbered 663 within the scope of the Project of Transformation in Health. Accordingly, hospitals should ensure patient satisfaction through more efficient, more effective use of resources and sustainable finance by placing patients in the centre and should operate to increase efficiency to its maximum level while doing these. Within this study, in order to find out how efficient the hospitals were in terms of medical waste management between the years 2011-2014, the data from six hospitals of Amasya Public Hospitals Union were evaluated separately through Data Envelopment Analysis (DEA) method. First of all, input variables were determined. Input variables were the number of patients admitted to polyclinics, the number of inpatients in clinics, the number of patients who were operated and the number of patients who applied to the laboratory. Output variable was the cost of medical wastes in Turkish liras. Each hospital’s total medical waste level before and after public hospitals union; the amounts of average medical waste per patient admitted to polyclinics, per inpatient in clinics, per patient admitted to laboratory and per operated patient were compared within each group. In addition, average medical waste levels and costs were compared for Turkey in general and Europe in general. Paired samples t-test was used to find out whether the changes (increase-decrease) after public hospitals union were statistically significant. The health facilities that were unsuccessful in terms of medical waste management before and after public hospital union and the factors that caused this failure were determined. Based on the results, for each health facility that was ineffective in terms of medical waste management, the level of improvement required for each input was determined. The results of the study showed that there was an improvement in medical waste management applications after the health facilities became a member of public hospitals union; their medical waste levels were lower than the average of Turkey and Europe while the averages of cost of disposal were the highest.

Keywords: medical waste management, cost of medical waste, public hospitals, data envelopment analysis

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Authors: Ashish Kumar Singh, Mehak Gulati, Neelam Verma

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Arginine majorly acts as a substrate for the enzyme nitric oxide synthase (NOS) for the production of nitric oxide, a strong vasodilator. Current study demonstrated a novel amperometric approach for estimation of arginine using nitric oxide synthase. The enzyme was co-immobilized in carbon paste electrode with NADP+, FAD and BH4 as cofactors. The detection principle of the biosensor is enzyme NOS catalyzes the conversion of arginine into nitric oxide. The developed biosensor could able to detect up to 10-9M of arginine. The oxidation peak of NO was observed at 0.65V. The developed arginine biosensor was used to monitor arginine content in fruit juices.

Keywords: arginine, biosensor, carbon paste elctrode, nitric oxide

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Authors: Philip Friedlander, John Rutledge, Jason Suh

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Inhibition of programmed death-1 (PD-1) or its ligand PD-L1 confers therapeutic efficacy in a wide range of solid tumor malignancies. Primary or acquired resistance can develop through activation of immunosuppressive immune cells such as tumor-associated macrophages. The renin angiotensin system (RAS) systemically regulates fluid and sodium hemodynamics, but components are expressed on and regulate the activity of immune cells, particularly of myeloid lineage. We hypothesized that inhibition of RAS would improve the efficacy of PD-1/PD-L-1 treatment. A retrospective analysis was performed through a chart review of patients with solid metastatic malignancies treated with a PD-1/PD-L1 inhibitor between 1/2013 and 6/2019 at Valley Hospital, a community hospital in New Jersey, USA. Efficacy was determined by medical oncologist documentation of clinical benefit in visit notes and by the duration of time on immunotherapy treatment. The primary endpoint was the determination of efficacy differences in patients treated with an inhibitor of RAS ( ace inhibitor, ACEi, or angiotensin blocker, ARB) compared to patients not treated with these inhibitors. To control for broader antihypertensive effects, efficacy as a function of treatment with beta blockers was assessed. 173 patients treated with PD-1/PD-L-1 inhibitors were identified of whom 52 were also treated with an ACEi or ARB. Chi-square testing revealed a statistically significant relationship between being on an ACEi or ARB and efficacy to PD-1/PD-L-1 therapy (p=0.001). No statistically significant relationship was seen between patients taking or not taking beta blocker antihypertensives (p= 0.33). Kaplan-Meier analysis showed statistically significant improvement in the duration of therapy favoring patients concomitantly treated with ACEi or ARB compared to patients not exposed to antihypertensives and to those treated with beta blockers. Logistic regression analysis revealed that age, gender, and cancer type did not have significant effects on the odds of experiencing clinical benefit (p=0.74, p=0.75, and p=0.81, respectively). We conclude that retrospective analysis of the treatment of patients with solid metastatic tumors with anti-PD-1/PD-L1 in a community setting demonstrates greater clinical benefit in the context of concomitant ACEi or ARB inhibition, irrespective of gender or age. This data supports the development of prospective assessment through randomized clinical trials.

Keywords: angiotensin, cancer, immunotherapy, PD-1, efficacy

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Authors: Zainuddin Zakaria, Sun Woh Lye

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Despite the continuous advancements in automated conflict resolution tools, there is still a low rate of adoption of automation from Air Traffic Control Officers (ATCOs). Trust or acceptance in these tools and conformance to the individual ATCO preferences in strategy execution for conflict resolution are two key factors that impact their use. This paper proposes a methodology to unearth and classify ATCO conflict resolution strategies from simulator data of trained and qualified ATCOs. The methodology involves the extraction of ATCO executive control actions and the establishment of a system of strategy resolution classification based on ATCO radar commands and prevailing flight parameters in deconflicting a pair of aircraft. Six main strategies used to handle various categories of conflict were identified and discussed. It was found that ATCOs were about twice more likely to choose only vertical maneuvers in conflict resolution compared to horizontal maneuvers or a combination of both vertical and horizontal maneuvers.

Keywords: air traffic control strategies, conflict resolution, simulator data, strategy classification system

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Authors: Ihuarulam A. Ikenna

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In the past few decades, the field of chemistry education has grown tremendously and researches indicated that after traditional chemistry instruction students often lacked deep conceptual understanding and failed to integrate their ideas into coherent conceptual framework. For several concepts in chemistry, students at all levels have demonstrated difficulty in changing their initial perceptions. Their perceptions are most often wrong and do not agree with correct scientific concepts. This study explored the effectiveness of intervention discussion sections for a college general chemistry course designed to apply research on students preconceptions, knowledge integration and student explanation. Three interventions discussions lasting three hours on bond energy and spontaneity were done tested and intervention (treatment) students’ performances were compared with that of control group which did not use the experimental pedagogy. Results indicated that this instruction which was capable of identifying students' misconceptions, initial conceptions and integrating those ideas into class discussion led to enhanced conceptual understanding and better achievement for the experimental group.

Keywords: remedying, students’ misconceptions, learning, intervention discussion, learning model

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Authors: Diego Diaz H., Cristian Larroulet

Abstract:

Although a large earthquake has clear and immediate consequences such as deaths, destruction of infrastructure and displacement (at least temporary) of part of the population, scientific research about the impact of a geological disaster in economic activity is inconclusive, especially when looking beyond the very short term. Estimating the economic impact years after a disaster strike is non-trivial since there is an unavoidable difficulty in attributing the observed effect to the disaster and not to other economic shocks. Case studies are performed that determine the impact of earthquakes in Chile, Japan, and New Zealand at a regional level by applying the synthetic control method, using the natural disaster as treatment. This consisted in constructing a counterfactual from every region in the same country that is not affected (or is slightly affected) by the earthquake. The results show that the economies of Canterbury and Tohoku achieved greater levels of GDP per capita in the years after the disaster than they would have in the absence of the disaster. For the case of Chile, however, the region of Maule experiences a decline in GDP per capita because of the earthquake. All the results are robust according to the placebo tests. Also, the results suggest that national institutional quality improve the growth process after the disaster.

Keywords: earthquake, economic growth, institutional quality, synthetic control

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