Search results for: diagnostic challenge

Authors: Ching-Yuan Chen, Lung-Kwang Pan

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Objective: Back pain is a major health problem costing billions of health budgets annually in Taiwan. Thousands of back pain surgeries are performed annually with up to 40% of patients complaining of back pain at time of post-surgery causing failed back surgery syndrome (FBSS), although diagnosis in these patients may be complex. The aim of study is to assess the feasibility of using bone SPECT-CT imaging to localize the active lesions causing persistent, recurrent or new backache after spine surgery. Materials and Methods: Bone SPECT-CT imaging was performed after the intravenous injection of 20 mCi of 99mTc-MDP for all the patients with diagnosis of FBSS. Patients were evaluated using status of subjectively pain relief, functional improvement and degree of satisfaction by reviewing the medical records and questionnaires in a 2 more years’ follow-up. Results: We enrolled a total of 16 patients were surveyed in our hospital from Jan. 2015 to Dec. 2016. Four people on SPEC/CT imaging ensured significant lesions were undergone a revised surgery (surgical treatment group). The mean visual analogue scale (VAS) decreased 5.3 points and mean Oswestry disability index (ODI) improved 38 points in the surgical group. The remaining 12 on SPECT/CT imaging were diagnosed as no significant lesions then received drug treatment (medical treatment group). The mean VAS only decreased 2 .1 point and mean ODI improved 12.6 points in the medical treatment group. In the posttherapeutic evaluation, the pain of the surgical treatment group showed a satisfactory improvement. In the medical treatment group, 10 of the 12 were also satisfied with the symptom relief while the other 2 did not improve significantly. Conclusions: Findings on SPECT-CT imaging appears to be easily explained the patients' pain. We recommended that SPECT/CT imaging was a feasible and useful clinical tool to improve diagnostic confidence or specificity when evaluating patients with FBSS.

Keywords: failed back surgery syndrome, oswestry disability index, SPECT-CT imaging, 99mTc-MDP, visual analogue scale

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Authors: Jakub Zágora, Daniela Plachá, Karla Čech Barabaszová, Sylva Holešová, Roman Gábor, Alexandra Muñoz Bonilla, Marta Fernández García

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The development of new antimicrobial materials that are not toxic to higher living organisms is a major challenge today. Newly developed materials can have high application potential in biomedicine, coatings, packaging, etc. A combination of commonly used biopolymer polylactide with cationic polymers seems to be very successful in the fight against antimicrobial resistance [1].PLA will play a key role in fulfilling the intention set out in the New Deal announced by the EU commission, as it is a bioplastic that is easily degradable, recyclable, and mass-produced. Also, the development of 3D printing in the context of this initiative, and the actual use of PLA as one of the main materials used for this printing, make the technology around the preparation and modification of PLA quite logical. Moreover, theenvironmentally friendly and energy saving technology like supercritical fluid process (SFP) will be used for their preparation. In a first approach, polylactide nano- and microparticles and structures were prepared by supercritical fluid extraction. The RESS (rapid expansion supercritical fluid solution) method is easier to optimize and shows better particle size control. On the contrary, a highly porous structure was obtained using the SAS (supercritical antisolvent) method. In a second part, the antimicrobial biobased polymer was introduced by SFP.

Keywords: polylactide, antimicrobial polymers, supercritical fluid technology, micronization

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Authors: Nadia Nisha Musa, Nur Atirah Hasmi, Hasnun Nita Ismail, Zulfadli Mahfodz

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In Malaysian Education System, subject related to biodiversity has started in the curriculum from Foundation Study until tertiary education. Biodiversity become the focus of attention due to awareness on global warming which potentially leads to a loss of biodiversity. A loss in biodiversity means a loss in medicinal discoveries and reduces food supply. It is of great important to ensure that young generations become aware of biodiversity conservation. The more interactive approaches are needed to build society with a high awareness for biodiversity conservation. To address this challenge, the goal of this study is to enhance intrinsic motivation of biological students via ARCS model of instruction. Self-access learning materials such as tutorial, module and fieldwork were designed with ARCS elements to a sample size of 70 university students from the beginning of the semester. Both paper and online surveys were used to collect data from the respondents. The results showed that elements of attention, relevance, confidence and satisfaction have a positive impact on intrinsic motivation of students and their academic performance.

Keywords: intrinsic motivation, ARCS model of instruction, biodiversity, self-access learning

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Authors: Anes Enakoa, Yawei Liang

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Question Answering (QA) system is one of the most important and demanding tasks in the field of Natural Language Processing (NLP). In QA systems, the answer generation task generates a list of candidate answers to the user's question, in which only one answer is correct. Answer selection is one of the main components of the QA, which is concerned with selecting the best answer choice from the candidate answers suggested by the system. However, the selection process can be very challenging especially in Arabic due to its particularities. To address this challenge, an approach is proposed to answer questions with multiple answer choices for Arabic QA systems based on Textual Entailment (TE) recognition. The developed approach employs a Support Vector Machine that considers lexical, semantic and syntactic features in order to recognize the entailment between the generated hypotheses (H) and the text (T). A set of experiments has been conducted for performance evaluation and the overall performance of the proposed method reached an accuracy of 67.5% with C@1 score of 80.46%. The obtained results are promising and demonstrate that the proposed method is effective for TE recognition task.

Keywords: information retrieval, machine learning, natural language processing, question answering, textual entailment

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Authors: Aelina Franz

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In recent years, the scientific community has witnessed a paradigm shift in the exploration of unconventional levitation methods, particularly in the domain of spherical combat platforms. This paper explores aerodynamics and levitational dynamics inherent in these spheres by examining interactions at the quantum level. Our research unravels the nuanced aerodynamic phenomena governing the levitation of spherical combat platforms. Through an analysis of the quantum fluid dynamics surrounding these spheres, we reveal the crucial interactions between air resistance, surface irregularities, and the quantum fluctuations that influence their levitational behavior. Our findings challenge conventional understanding, providing a perspective on the aerodynamic forces at play during the levitation of spherical combat platforms. Furthermore, we propose design modifications and control strategies informed by both classical aerodynamics and quantum information processing principles. These advancements not only enhance the stability and maneuverability of the combat platforms but also open new avenues for exploration in the interdisciplinary realm of engineering and quantum information sciences. This paper aims to contribute to levitation technologies and their applications in the field of spherical combat platforms. We anticipate that our work will stimulate further research to create a deeper understanding of aerodynamics and quantum phenomena in unconventional levitation systems.

Keywords: spherical combat platforms, levitation technologies, aerodynamics, maneuverable platforms

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Authors: Gabriela Tutuanu

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The economic, social and environmental undesirable impact of the existing development pattern pushes to the adoption and use of a new development paradigm that of sustainable development. This paper intends to substantiate how the marketing can help the sustainable development. It begins with the subjects of sustainable development and sustainable marketing as they are discussed in literature. The sustainable development is a three dimensional concept which embeds the economic dimension, the social dimension and the environmental dimension that ask to have in view the simultaneous pursuit of economic prosperity, social equity and environmental quality. A major challenge to achieve these goals at business level and to integrate all three dimensions of sustainability is the sustainable marketing. The sustainable marketing is a relationship marketing that aims at building lasting relationships with the social and natural environment on a long-term thinking and futurity and this philosophy allows helping all three dimensions of sustainability. As marketing solutions that could contribute to the sustainable development. We advance the stimulation of sustainable demand, the constant innovation and improvement of sustainable products, the design and use of customized communication, a multichannel distribution network and the sale of sustainable products and services at fair prices. Their implementation will increase the economic, social and environmental sustainability at a large extent in the future if they are supported by political, governmental and legal authorities.

Keywords: sustainable development, sustainable marketing, sustainable demand, sustainable product, credible communication, multi-channel distribution network, fair price

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Authors: Dina H. Gabr, Mona A. El Bannan

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With growing worldwide concern for global warming, green finance has become the fuel that pushes the world to act in combating and mitigating climate change. Coupled with adopting the Paris Agreement and the United Nations Sustainable Development Goals, Green finance became a vital tool in creating a pathway to sustainable development, as it connects the financial world with environmental and societal benefits. This paper provides a comprehensive review of the concepts and definitions of green finance and the importance of 'green' impact investments today. The core challenge in combating climate change is reducing and controlling Greenhouse gas emissions; therefore, this study explores the solutions green finance provides putting emphasis on the use of renewable energy, which is necessary for enhancing the transition to the green economy. With increasing attention to the concept of green finance, multiple forms of green investments and financial tools have come to fruition; the most prominent are green bonds. The rise of green bonds, a debt market to finance climate solutions, provide a promising mechanism for sustainable finance. Following the review, this paper compiles a comprehensive green bond dataset, presenting a statistical study of the evolution of the green bonds market from its first appearance in 2006 until 2021.

Keywords: climate change, GHG emissions, green bonds, green finance, sustainable finance

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Authors: Godwin Dennison, C. E. Boulind, O. Gould, B. de Lacy Costello, J. Allison, P. White, P. Ewings, A. Wicaksono, N. J. Curtis, A. Pullyblank, D. Jayne, J. A. Covington, N. Ratcliffe, N. K. Francis

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Background: Colorectal symptoms are common but only infrequently represent serious pathology, including colorectal cancer (CRC). A large number of invasive tests are presently performed for reassurance. We investigated the feasibility of urinary volatile organic compound (VOC) testing as a potential triage tool in patients fast-tracked for assessment for possible CRC. Methods: A prospective, multi-centre, observational feasibility study was performed across three sites. Patients referred on NHS fast-track pathways for potential CRC provided a urine sample which underwent Gas Chromatography Mass Spectrometry (GC-MS), Field Asymmetric Ion Mobility Spectrometry (FAIMS) and Selected Ion Flow Tube Mass Spectrometry (SIFT-MS) analysis. Patients underwent colonoscopy and/or CT colonography and were grouped as either CRC, adenomatous polyp(s), or controls to explore the diagnostic accuracy of VOC output data supported by an artificial neural network (ANN) model. Results: 558 patients participated with 23 (4.1%) CRC diagnosed. 59% of colonoscopies and 86% of CT colonographies showed no abnormalities. Urinary VOC testing was feasible, acceptable to patients, and applicable within the clinical fast track pathway. GC-MS showed the highest clinical utility for CRC and polyp detection vs. controls (sensitivity=0.878, specificity=0.882, AUROC=0.884). Conclusion: Urinary VOC testing and analysis are feasible within NHS fast-track CRC pathways. Clinically meaningful differences between patients with cancer, polyps, or no pathology were identified therefore suggesting VOC analysis may have future utility as a triage tool. Acknowledgment: Funding: NIHR Research for Patient Benefit grant (ref: PB-PG-0416-20022).

Keywords: colorectal cancer, volatile organic compound, gas chromatography mass spectrometry, field asymmetric ion mobility spectrometry, selected ion flow tube mass spectrometry

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Authors: Y. Long, L. Liu, K. V. Branin

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One challenge faced by procurement decision-maker during the acquisition process is how to compare similar products from different suppliers and allocate orders among different products or services. This work focuses on allocating orders among multiple suppliers considering rebate. The objective function is to minimize the total acquisition cost including purchasing cost and rebate benefit. Rebate benefit is complex and difficult to estimate at the ordering step. Rebate rules vary for different suppliers and usually change over time. In this work, we developed a system to collect the rebate policies, standardized the rebate policies and developed two-stage optimization models for ordering allocation. Rebate policy with multi-tiers is considered in modeling. The discontinuous cost function of rebate benefit is formulated for different scenarios. A piecewise linear function is used to approximate the discontinuous cost function of rebate benefit. And a Mixed Integer Programing (MIP) model is built for order allocation problem with multi-tier rebate. A case study is presented and it shows that our optimization model can reduce the total acquisition cost by considering rebate rules.

Keywords: discontinuous cost function, mixed integer programming, optimization, procurement, rebate

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Authors: Hubert Pun

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When a manufacturer outsources the production of a product, it distributes its intellectual property (IP) into a supply chain that it may not be able to fully control. An IP agreement between a manufacturer and its suppliers is a popular solution to address the challenge of supplier-copycatting. The goal of this paper is to examine the impact of copycatting, from both the supplier and third-party firms, and the effectiveness of an IP agreement. Specifically, we use a game-theoretic approach to examine a system where a manufacturer outsources to a supplier. The supplier and a third-party firm decide whether or not to enter the market with copycat products while the manufacturer selects the level of marketing investment. The manufacturer can reduce the threat of supplier-copycatting by signing an IP agreement. We find that the manufacturer can be worse off from signing an IP agreement with its supplier, even if the IP agreement is costless and perfectly enforceable. We show that a manufacturer can deter copycat products through vertical integration and IP agreements and we outline the instances where each method is preferred. Furthermore, we find that the manufacturer may choose not to invest in quality improvements as a copycat deterrence strategy. We show that the supplier can benefit from the manufacturer’s decision to sign an IP agreement and that the supplier and the consumers can benefit from government regulations against copycat products. Our paper demonstrates the strengths and limitations of various copycat deterrence strategies when a supplier and third-party may produce copycat products.

Keywords: coopetitive supply chain, copycat, government regulation, intellectual property

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Authors: Stanley Fore

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The case study company is one of the leading newsprint companies in South Africa. The company has achieved this status through operational expansion, diversification and investing in cutting-edge technology. They have a reputation for the highest quality and personalised service that transcends borders and industries. The company offers a wide variety of small and large scales printing services. The company is faced with the challenge of significant waste production during normal operations. The company generates 1200 kg of plastic waste and 60 – 70 tonnes of paper waste per month. The company operates a waste management process currently, whereby waste paper is sold, at low cost, to recycling firms for further processing. Having considered the quantity of waste being generated, the company has embarked on a venture to find a more profitable solution to its current waste production. As waste management and recycling is not the company’s core business, the aim of the venture is to implement a secondary profitable waste process business. The venture will be expedited as a strategic project. This research aims to estimate the financial feasibility of a selected solution as well as the impact of non-financial considerations thereof. The financial feasibility is analysed using metrics such as Payback period; internal rate of return and net present value.

Keywords: waste, printing industry, up-cycling, management

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Authors: Bahare Askarian, Suchithra Rajendran

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Maintaining the freshness and quality of perishable goods during distribution is a critical challenge for logistics companies. This study presents a comprehensive framework aimed at optimizing the distribution of perishable goods through a mathematical model of the Transportation Inventory Location Routing Problem (TILRP). The model incorporates the impact of product age on customer demand, addressing the complexities associated with inventory management and routing. To tackle this problem, we develop both simple and hybrid metaheuristic algorithms designed for small- and medium-scale scenarios. The hybrid algorithm combines Biogeographical Based Optimization (BBO) algorithms with local search techniques to enhance performance in small- and medium-scale scenarios, extending our approach to larger-scale challenges. Through extensive numerical simulations and sensitivity analyses across various scenarios, the performance of the proposed algorithms is evaluated, assessing their effectiveness in achieving optimal solutions. The results demonstrate that our algorithms significantly enhance distribution efficiency, offering valuable insights for logistics companies striving to improve their perishable goods supply chains.

Keywords: perishable goods, meta-heuristic algorithm, vehicle problem, inventory models

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Authors: Amir Amiri, Naghmeh Morakabati

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During the recent years the six-fold growth of cancer in Iran has led the production of healthy products to become a challenge in the food industry. Due to the young population in the country, the consumption of fast foods is growing. The chemical cancer-causing preservatives are used to produce these products more than the standard; so using an appropriate alternative seems to be important. On the one hand, the plant essential oils show the high antimicrobial potential against pathogenic and spoilage microorganisms and on the other hand they are highly volatile and decomposed under the processing conditions. The study aims to produce the loaded chitosan nanoparticles with different concentrations of savory essential oil to improve the anti-microbial property and increase the resistance of essential oil to oxygen and heat. The encapsulation efficiency was obtained in the range of 32.07% to 39.93% and the particle size distribution of the samples was observed in the range of 159 to 210 nm. The range of Zeta potential was obtained between -11.9 to -23.1 mV. The essential oil loaded in chitosan showed stronger antifungal activity against Rhizopus stolonifer. The results showed that the antioxidant property is directly related to the concentration of loaded essential oil so that the antioxidant property increases by increasing the concentration of essential oil. In general, it seems that the savory essential oil loaded in chitosan particles can be used as a food processor.

Keywords: chitosan, encapsulation, essential oil, nanogel

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Authors: Gehan Hussein, Hala Agha, Rasha Abdelraof, Marina George, Antoine Fakhri

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Background: β-Thalassemia major (TM) and sickle cell disease (SCD) are inherited hemoglobin disorders resulting in chronic hemolytic anemia. Cardiovascular involvement is an important cause of morbidity and mortality in these groups of patients. The narrow border is between overt myocardial dysfunction and clinically silent left ventricular (LV) and / or right ventricular (RV) dysfunction in those patients. 3 D Speckle tracking echocardiography (3D STE) is a novel method for the detection of subclinical myocardial involvement. We aimed to study myocardial affection in SCD and TM using 3D STE, comparing it with conventional echocardiography, correlate it with serum ferritin level and lactate dehydrogenase (LDH). Methodology: Thirty SCD and thirty β TM patients, age range 4-18 years, were compared to 30 healthy age and sex matched control group. Cases were subjected to clinical examination, laboratory measurement of hemoglobin level, serum ferritin, and LDH. Transthoracic color Doppler echocardiography, 3D STE, tissue Doppler echocardiography, and aortic speckle tracking were performed. Results: significant reduction in global longitudinal strain (GLS), global circumferential strain (GCS), and global area strain (GAS) in SCD and TM than control (P value <0.001) there was significantly lower aortic speckle tracking in patients with TM and SCD than control (P value< 0.001). LDH was significantly higher in SCD than both TM and control and it correlated significantly positive mitral inflow E, (p value:0.022 and 0.072. r: 0.416 and -0.333 respectively) lateral E/E’ (p value.<0.001and 0.818. r. 0.618 and -0. 044.respectively) and septal E/E’ (p value 0.007 and 0.753& r value 0.485 and -0.060 respectively) in SCD but not TM and significant negative correlation between LDH and aortic root speckle tracking (value 0.681& r. -0.078.). The potential diagnostic accuracy of LDH in predicting vascular dysfunction as represented by aortic root GCS with a sensitivity 74% and aortic root GCS was predictive of LV dysfunction in SCD patients with sensitivity 100% Conclusion: 3D STE LV and RV systolic dysfunction in spite of their normal values by conventional echocardiography. SCD showed significantly lower right ventricular dysfunction and aortic root GCS than TM and control. LDH can be used to screen patients for cardiac dysfunction in SCD, not in TM

Keywords: thalassemia major, sickle cell disease, 3d speckle tracking echocardiography, LDH

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Authors: Laura Zizka, Gaby Probst

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The Covid-19 pandemic has affected the way Higher Education Institutions (HEIs) have given their courses. From emergency remote where all students and faculty were immediately confined to home teaching and learning, the continuing evolving sanitary situation obliged HEIs to adopt other methods of teaching and learning from blended courses that included both synchronous and asynchronous courses and activities to hy-flex models where some students were on campus while others followed the course simultaneously online. Each semester brought new challenges for HEIs and, subsequently, additional emotional reactions. This paper investigates the affective side of teaching and learning in various online modalities and its toll on students and faculty members over the past three semesters. The findings confirm that students and faculty who have more self-efficacy, flexibility, and resilience reported positive emotions and embraced the opportunities that these past semesters have offered. While HEIs have begun a new semester in an attempt to return to ‘normal’ face-to-face courses, this paper posits that there are lessons to be learned from these past three semesters. The opportunities that arose from the challenge of the pandemic should be considered when moving forward by focusing on a greater emphasis on the affective aspect of teaching and learning in HEIs worldwide.

Keywords: effective teaching and learning, higher education, engagement, interaction, motivation

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Authors: Shammael Selorfia

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

Keywords: delirium, surgery, quality, improvement

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Authors: Jonathan Palatz Cedeño

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The paper will seek to examine the scope and limitations of the process of construction of ordinary and extraordinary migration regulatory tools of the countries of Latin America, due to the Venezuelan diaspora in Ibero-America (2015-2018). The analysis methodology will be based on a systematic presentation of the existing advances in the subject under a qualitative approach, in which the results are detailed. We hold that an important part of the Latin American countries that used to be the emitters of migrants have had to generate, with greater or lesser success both nationally and regionally, ordinary and extraordinary migration regulatory tools to respond to the rapid intensification of the current Venezuelan migratory flows. This fact beyond implementing policies for the reception and integration of this population marks a new moment that represents a huge challenge both for the receiving States and for the young Ibero-American institutional migration system. Therefore, we can say that measures to adopt reception and solidarity policies, despite being supported by organs of the multilateral system such as UNHCR and IOM, are not found as guidelines for national and regional action, at the expense of the reactions of the respective public opinions and the influence of what to do of the neighboring countries in the face of the problem.

Keywords: Venezuela, migration, migration policies and governance, Venezuelan diaspora

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Authors: Nitai Biswas, Prasenjit Kapas, Arumay Jana, Asish Paul

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Introduction: Motivation is basic drive for all kinds of action. It has direct influence on academic achievement and sports performance that builds urge to incentive values of success. In other words, it can be defined as the need for success to attain excellence. Anxiety in pre competition especially in sports formulates positive inward settings in mind to overcome the challenge. There is a tendency to perceive competitive situations as some threatening issues and to respond them with feelings of apprehension and tension. Aim: Aim of the study was to compare the achievement motivation and competition anxiety among three different classes of students. Methods and Materials: To conduct the study the researcher has taken 131 male subjects from three different classes as Extra Department, Bachelor of Physical Education-I and Master of Physical EducationII, aged 19-28 years. Achievement motivation and sports competition anxiety were measured by the questionnaire. To analyze the data mean, standard deviation for each parameter as descriptive statistics and one way analysis of variance as inferential statistics were employed. Results: From the result of the study in achievement motivation (p ≥ 0.05) and competition anxiety (p ≥ 0.05) no significant differences were found among the said three groups. Conclusion: The study concluded that all three groups had almost the same state of achievement motivation and sports competition anxiety.

Keywords: anxiety, sports psychology, sports competition anxiety, achievement motivation, academic hierarchy, E.D., B.P.Ed., M.P.Ed

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Authors: Abbas Nesayan

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Background: In recent years, autism has been under consideration in public and research area. Autistic children have dysfunction in communication, socialization, repetitive and stereotyped behaviors. In addition, they clinically suffer from difficulty in attention, challenge with familiar behaviors and sensory processing problems. Several variables are linked to sensory processing problems in autism, one of these variables is working memory. Working memory is part of the executive function which provides the necessary ability to completing multiple stages tasks. Method: This study has categorized in correlational research methods. After determining of entry criteria, according to purposive sampling method, 50 children were selected. Dunn’s sensory profile school companion was used for assessment of sensory processing patterns; behavioral rating inventory of executive functions was used (BRIEF) for assessment of working memory. Pearson correlation coefficient and linear regression were used for data analyzing. Results: The results showed the significant relationship between sensory processing patterns (low registration, sensory seeking, sensory sensitivity and sensory avoiding) with working memory in autistic children. Conclusion: According to the findings, there is the significant relationship between the patterns of sensory processing and working memory. So, in order to improve the working memory could be used some interventions based on the sensory processing.

Keywords: sensory processing patterns, working memory, autism, autistic children

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Authors: Shazmeen Maroof

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The study is motivated by a desire to investigate whether there is substance to claims that, relative to traditional donors, China disregards human rights considerations when allocating overseas aid. While the stated policy of the U.S. is that consideration of potential aid recipients’ respect for human rights is mandatory, some quantitative studies have cast doubt on whether this is reflected in actual allocations. There is a lack of academic literature that formally assesses the extent to which the two countries' aid allocations differ; which is essential to test whether the criticisms of China's aid policy in comparison to that of the U.S. are justified. Using data on two standard human rights measures, 'Political Terror Scale' and 'Civil Liberties', the study analyse the two donors’ aid allocations among 125 countries over the period 2000 to 2014. The bivariate analysis demonstrated that a significant share of China’s aid flow to countries with poor human rights record. At the same time, the U.S. seems little different in providing aid to these countries. The empirical results obtained from the Fractional Logit model also provided some support to the general pessimism regarding China’s provision of aid to countries with poor human rights record, yet challenge the optimists expecting better targeted aid from the U.S. These findings are consistent with the split between humanitarian and non-humanitarian aid and in the sample of countries whose human rights record is below some threshold level.

Keywords: China's aid policy, foreign aid allocation, human rights, United States Foreign Assistance Act

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Authors: Olufemi Adedamola Oyedele

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Infrastructure provision in Nigeria is now at its lowest ebb in spite of its being critical to the socio-economic and political development of any nation. This is partly because the policy that will ensure its adequate provisioning is missing and partly because politics is affecting its provision. Policy is the basic principles by which a government is guided. Infrastructural development is the basis for measuring the performance of governments and it is the foundation of good governance. Demand for infrastructural development is higher and resources used in its provision are limited. Ethnic-interest agitation and lobbying for infrastructure provision are common things in multi-ethnic state like Nigeria. Most infrastructures are now decayed and need repair or replacement. Government is the system that organizes, control and sensitizes the people in a society in other for all to have an acceptable level of living. Governments have the power to put in place all measures that they deem fit will make an environment conducive for living for everybody. Infrastructure development in any environment requires needs assessment, feasibility and viability studies and carrying out physical development of the project. The challenge in Nigeria is largely carrying out development where they are not needed but where the people are loyal. There are numerous abandoned projects because they were started due to politics and not because they are feasible. Policies and politics greatly affect infrastructure provisioning in Nigeria and this is the premise of this paper.

Keywords: infrastructure challenges, infrastructure development, policy making, politics, project finance

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Authors: Cherif Y., Ghariani R., Derbal S., Farhati S., Ben Dahmen F., Abdallah M.

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Introduction: Tuberculosis (TBC) is a frequent infection and is still a major public health problem in Tunisia. The aim of this work is to focus on diagnostic and therapeutic characteristics of TBC in patients referred to our internal medicine department. Patients and Methods: The study was retrospective and descriptive of a cohort of consecutive cases treated from January 2016 to December 2019, collecting patients with latent or patent TBC. Twenty-eight medical records of adults diagnosed with TBC were reviewed. Results: Twenty-eight patients, including 18 women and 10 men, were diagnosed with TBC. Their mean age is 48 years (range: 22-78 years). Five patients have a medical history of diabetes mellitus, 1 patient was followed for systemic lupus erythematosus treated with corticosteroids and immunosuppressant drugs, and another was treated with corticosteroids for Mac Duffy syndrome. The TBC is latent in 12 cases and patent in 16 cases. The most common symptoms were fever and weight loss and were found in 10 cases, a cough in 2 cases, sputum in 3 cases, lymph nodes in 4 cases, erythema nodosum in 2 cases, and neurological signs in 3 cases. Lymphopenia is noticed in 3 cases and a biological inflammatory syndrome in 18 of the cases. The purified protein derivate reaction was positive in 17 cases, anergic in 3 cases, negative in 5 cases, and not done in 3 cases. The acid-fast bacilli stain culture was strongly positive in one patient. The histopathological study was conclusive in 11 patients and showed granulomatosis with caseous necrosis. TBC was pulmonary in 7 patients, lymph node in 7 cases, peritoneal in 7 cases, digestive in 1 case, neuromeningeal in 3 cases, and thyroïd in 1 case. Seven patients had multifocal TBC. All the patients received anti-tuberculosis treatment with a mean duration of 8 months with no failure or relapse with an average follow-up time of 10.58 months. Conclusion: Diagnosis and management of TBC remain essential to avoid serious complications. The survey is necessary to ensure timely detection and treatment of infected adults to decrease its incidence. The best treatment remains preventive through vaccination and improving social and economic conditions.

Keywords: tuberculosis, infection, autoimmune disease, granulomatosis

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Authors: Irfan Abdulrahman Sheth, Sohil Pothiawala

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Dermatomyositis is an idiopathic inflammatory myopathy, traditionally characterized by a progressive, symmetrical proximal muscle weakness and pathognomonic or characteristic cutaneous manifestations. We report a case of a 60-year old Chinese female who was referred from polyclinic for allergic rash over the body after applying hair dye 3 weeks ago. It was associated with puffiness of face, shortness of breath and hoarse voice since last 2 weeks with decrease effort tolerance. She also complained of dysphagia/ myalgia with progressive weakness of proximal muscles and palpitations. She denied chest pain, loss of appetite, weight loss, orthopnea or fever. She had stable vital signs and appeared cushingoid. She was noted to have rash over the scalp/ face and ecchymosis over the right arm with puffiness of face and periorbital oedema. There was symmetrical muscle weakness and other neurological examination was normal. Initial impression was of allergic reaction and underlying nephrotic syndrome and Cushing’s syndrome from TCM use. Diagnostic tests showed high Creatinine kinase (CK) of 1463 u/l, CK–MB of 18.7 ug/l and Troponin –T of 0.09 ug/l. The Full blood count and renal panel was normal. EMG showed inflammatory myositis. Patient was managed by rheumatologist and discharged on oral prednisolone with methotrexate/ ergocalciferol capsule and calcium carb, vitamin D tablets and outpatient follow up. In some patients, cutaneous disease exists in the absence of objective evidence of muscle inflammation. Management of dermatomyositis begins with careful investigation for the presence of muscle disease or of additional systemic involvement, particularly of the pulmonary, cardiac or gastrointestinal systems, and for the possibility of an accompanying malignancy. Muscle disease and systemic involvement can be refractory and may require multiple sequential therapeutic interventions or, at times, combinations of therapies. Thus, we want to highlight to the physicians that the cutaneous disease of dermatomyositis should not be confused with allergic reaction. It can be particularly challenging to diagnose. Early recognition aids appropriate management of this group of patients.

Keywords: dermatomyositis, myopathy, allergy, cutaneous disease

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Authors: Lorico D. S. Lapitan Jr., Yihan Xu, Yuan Guo, Dejian Zhou

Abstract:

The ability of ultrasensitive detection of specific genes and discrimination of single nucleotide polymorphisms is important for clinical diagnosis and biomedical research. Herein, we report the development of a new ultrasensitive approach for label-free DNA detection using magnetic nanoparticle (MNP) assisted rapid target capture/separation in combination with signal amplification using poly-enzyme tagged polymer nanobead. The sensor uses an MNP linked capture DNA and a biotin modified signal DNA to sandwich bind the target followed by ligation to provide high single-nucleotide polymorphism discrimination. Only the presence of a perfect match target DNA yields a covalent linkage between the capture and signal DNAs for subsequent conjugation of a neutravidin-modified horseradish peroxidase (HRP) enzyme through the strong biotin-nuetravidin interaction. This converts each captured DNA target into an HRP which can convert millions of copies of a non-fluorescent substrate (amplex red) to a highly fluorescent product (resorufin), for great signal amplification. The use of polymer nanobead each tagged with thousands of copies of HRPs as the signal amplifier greatly improves the signal amplification power, leading to greatly improved sensitivity. We show our biosensing approach can specifically detect an unlabeled DNA target down to 10 aM with a wide dynamic range of 5 orders of magnitude (from 0.001 fM to 100.0 fM). Furthermore, our approach has a high discrimination between a perfectly matched gene and its cancer-related single-base mismatch targets (SNPs): It can positively detect the perfect match DNA target even in the presence of 100 fold excess of co-existing SNPs. This sensing approach also works robustly in clinical relevant media (e.g. 10% human serum) and gives almost the same SNP discrimination ratio as that in clean buffers. Therefore, this ultrasensitive SNP biosensor appears to be well-suited for potential diagnostic applications of genetic diseases.

Keywords: DNA detection, polymer beads, signal amplification, single nucleotide polymorphisms

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Authors: Yan Yu, Wang Yu, Chen Xintong, Liu Yi, Zhang Yanzhong, Wang Yanji, Chen Xingyu, Zhang Miaocheng, Tong Yi

Abstract:

Neuromorphic computing based on spiking neural networks (SNNs) has emerged as a promising avenue for building the next generation of intelligent computing systems. Owing to its high-density integration, low power, and outstanding nonlinearity, memristors have attracted emerging attention on achieving SNNs. However, fabricating a low-power and robust memristor-based spiking neuron without extra electrical components is still a challenge for brain-inspired systems. In this work, we demonstrate a TiO₂-based threshold switching (TS) memristor to emulate a leaky integrate-and-fire (LIF) neuron without auxiliary circuits, used to realize single layer fully connected (FC) SNNs. Moreover, our TiO₂-based resistive switching (RS) memristors realize spiking-time-dependent-plasticity (STDP), originating from the Ag diffusion-based filamentary mechanism. This work demonstrates that TiO2-based memristors may provide an efficient method to construct hardware neuromorphic computing systems.

Keywords: leaky integrate-and-fire, memristor, spiking neural networks, spiking-time-dependent-plasticity

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Authors: Teklay Gebrecherkos

Abstract:

Background: Serological testing for SARS-CoV-2 plays an important role in epidemiological studies, in aiding the diagnosis of COVID-19 and assess vaccine responses. Little is known about the dynamics of SARS-CoV-2 serology in African settings. Here, we aimed to characterize the longitudinal antibody response profile to SARS-CoV-2 in Ethiopia. Methods: In this prospective study, a total of 102 PCR-confirmed COVID-19 patients were enrolled. We obtained 802 plasma samples collected serially. SARS-CoV-2 antibodies were determined using four lateral flow immune assays (LFIAs) and an electrochemiluminescent immunoassay. We determined longitudinal antibody response to SARS-CoV-2 as well as seroconversion dynamics. Results: Serological positivity rate ranged between 12%-91%, depending on timing after symptom onset. There was no difference in the positivity rate between severe and non-severe COVID-19 cases. The specificity ranged between 90%-97%. Agreement between different assays ranged between 84%-92%. The estimated positive predictive value (PPV) for IgM or IgG in a scenario with seroprevalence at 5% varies from 33% to 58%. Nonetheless, when the population seroprevalence increases to 25% and 50%, there is a corresponding increase in the estimated PPVs. The estimated negative-predictive value (NPV) in a low seroprevalence scenario (5%) is high (>99%). However, the estimated NPV in a high seroprevalence scenario (50%) for IgM or IgG is reduced significantly from 80% to 85%. Overall, 28/102 (27.5%) seroconverted by one or more assays tested within a median time of 11 (IQR: 9–15) days post symptom onset. The median seroconversion time among symptomatic cases tended to be shorter when compared to asymptomatic patients [9 (IQR: 6–11) vs. 15 (IQR: 13–21) days; p = 0.002]. Overall, seroconversion reached 100% 5.5 weeks after the onset of symptoms. Notably, of the remaining 74 COVID-19 patients included in the cohort, 64 (62.8%) were positive for antibodies at the time of enrollment, and 10 (9.8%) patients failed to mount a detectable antibody response by any of the assays tested during follow-up. Conclusions: Longitudinal assessment of antibody response in African COVID-19 patients revealed heterogeneous responses. This underscores the need for a comprehensive evaluation of serum assays before implementation. Factors associated with failure to seroconvert need further research.

Keywords: COVID-19, antibody, rapid diagnostic tests, ethiopia

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Authors: Mohd Moiz Khan, S. M. Mahajani, G. N. Jadhav

Abstract:

Waste foundry sand (total clay content 15%) contains toxic heavy metals and particulate matter which make dumping of waste sand an environmental and health hazard. Disposal of waste foundry sand (WFS) remains one of the substantial challenges faced by Indian foundries nowadays. To cope up with this issue, the chemical method was used to reclaim WFS. A stirrer tank reactor was used for chemical reclamation. Experiments were performed to reduce the total clay content from 15% to as low as 0.9% in chemical reclamation. This method, although found to be effective for WFS reclamation, it may face a challenge due to the possibly high operating cost. Reclaimed sand was found to be satisfactory in terms of sand qualities such as total clay (0.9%), active clay (0.3%), acid demand value (ADV) (2.6%), loss on igniting (LOI) (3 %), grain fineness number (GFN) (56), and compressive strength (60 kPa). The experimental data generated on chemical reactor under different conditions is further used to optimize the design and operating parameters (rotation speed, sand to acidic solution ratio, acid concentration, temperature and time) for the best performance. The use of reclaimed sand within the foundry would improve the economics and efficiency of the process and reduce environmental concerns.

Keywords: chemical reclamation, clay content, environmental concerns, recycle, waste foundry sand

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Authors: Mona K. Fehling, Jakob Unger, Dietmar J. Hecker, Bernhard Schick, Joerg Lohscheller

Abstract:

Voice disorders origin from disturbances of the vibration patterns of the two vocal folds located within the human larynx. Consequently, the visual examination of vocal fold vibrations is an integral part within the clinical diagnostic process. For an objective analysis of the vocal fold vibration patterns, the two-dimensional vocal fold dynamics are captured during sustained phonation using an endoscopic high-speed camera. In this work, we present an approach allowing a fully automatic analysis of the high-speed video data including a computerized classification of healthy and pathological voices. The approach bases on a wavelet-based analysis of so-called phonovibrograms (PVG), which are extracted from the high-speed videos and comprise the entire two-dimensional vibration pattern of each vocal fold individually. Using a principal component analysis (PCA) strategy a low-dimensional feature set is computed from each phonovibrogram. From the PCA-space clinically relevant measures can be derived that quantify objectively vibration abnormalities. In the first part of the work it will be shown that, using a machine learning approach, the derived measures are suitable to distinguish automatically between healthy and pathological voices. Within the approach the formation of the PCA-space and consequently the extracted quantitative measures depend on the clinical data, which were used to compute the principle components. Therefore, in the second part of the work we proposed a strategy to achieve a normalization of the PCA-space by registering the PCA-space to a coordinate system using a set of synthetically generated vibration patterns. The results show that owing to the normalization step potential ambiguousness of the parameter space can be eliminated. The normalization further allows a direct comparison of research results, which bases on PCA-spaces obtained from different clinical subjects.

Keywords: Wavelet-based analysis, Multiscale product, normalization, computer assisted classification, high-speed laryngoscopy, vocal fold analysis, phonovibrogram

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Authors: Harley Bray, Helen Pymar, Michelle Liu, Chau Pham, Tomislav Jelic, Fran Mulhall

Abstract:

Background: Our study assesses the impact of the COVID-19 pandemic on early pregnancy assessment clinic (EPAC) referrals and the use of virtual consultation in Winnipeg, Manitoba. Our clinic expanded to accept referrals from all Winnipeg Emergency Department (ED)/Urgent Care (UC) sites beginning November 2019 to April 2020. By May 2020, the COVID-19 pandemic reached Manitoba and EPAC virtual care was expanded by performing hCG remotely and reviewing blood and ED/UC ultrasound results by phone. Methods: Emergency Department Information Systems (EDIS) and EPAC data reviewed ED/UC visits for pregnancy <20 weeks and vaginal bleeding 1-year pre-COVID (March 12, 2019, to March 11, 2020) and during COVID (March 12, 2020 (first case in Manitoba) to March 11, 2021). Results: There were fewer patient visits for vaginal bleeding or pregnancy of <20 weeks (4264 vs. 5180), diagnoses of threatened abortion (1895 vs. 2283), and ectopic pregnancy (78 vs. 97) during COVID compared with pre-COVID, respectively. ICD 10 codes were missing in 849 (20%) and 1183 (23%) of patients during COVID and pre-COVID, respectively. Wait times for all patient visits improved during COVID-19 compared to pre-COVID (5.1 ± 4.4 hours vs. 5.5 ± 3.8 hours), more patients received obstetrical ultrasounds, 761 (18%) vs. 787 (15%), and fewer patients returned within 30 days (1360 (32%) vs. 1848 (36%); p<0.01). EPAC saw 708 patients (218; 31% new ED/UC) during COVID-19 compared to 552 (37; 7% new ED/UC) pre-COVID. Fewer operative interventions for pregnancy loss (346 vs. 456) and retained products (236 vs. 272) were noted. Surgeries to treat ectopic pregnancy (106 vs 113) remained stable during the study time interval. Conclusion: Accurate identification of pregnancy complications was difficult, with over 20% missing ICD-10 diagnostic codes. There were fewer ED/UC visits and surgical management for threatened abortion during COVID-19, but ectopic pregnancy operative management remained unchanged.

Keywords: early pregnancy, ultrasound, COVID-19, obstetrics

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Authors: Henok Metaferia Gebremariam

Abstract:

Worldwide, considerable resources are spent implementing public health interventions that are interrupted soon after the initial funding ends. However, ambiguity remains as to how health programs can be effectively sustained over time because of the diversity of perspectives, definitions, study methods, outcomes measures and timeframes. From all the above-mentioned research challenges, standardized measures of sustainability should ultimately become a key research issue. To resolve this key challenge, the objective of the study was to adapt a tool for measuring the program’s capacity for sustainability and evaluating its reliability and validity. To adapt and validate the tool, a cross-sectional and cohort study design was conducted at 26 programs in Addis Ababa between September 2014 and May 2015. An adapted version of the tool after the pilot test was administered to 220 staff. The tool was analyzed for reliability and validity. Results show that a 40-item PSAT tool had been adapted into the Amharic version with good internal consistency (Cronbach’s alpha= 0.80), test-retest reliability(r=0.916) and construct validity. Factor analysis resulted in 7 components explaining 56.67 % of the variance. In conclusion, it was found that the Amharic version of PAST was a reliable and valid tool for measuring the program’s capacity for sustainability.

Keywords: program sustainability, public health interventions, reliability, validity

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