Search results for: management of people in the public sector

Authors: Sue S. Feldman

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As clinical and nursing informatics mature, an area that has gotten a lot of attention is the value capstone projects. Capstones are meant to address authentic and complex domain-specific problems. While capstone projects have not always been essential in graduate clinical and nursing informatics education, employers are wanting to see evidence of the prospective employee's knowledge and skills as an indication of employability. Capstones can be organized in many ways: a single course over a single semester, multiple courses over multiple semesters, as a targeted demonstration of skills, as a synthesis of prior knowledge and skills, mentored by one single person or mentored by various people, submitted as an assignment or presented in front of a panel. Because of the potential for capstones to enhance the educational experience, and as a mechanism for application of knowledge and demonstration of skills, a rigorous capstone can accelerate a graduate's potential in the workforce. In 2016, the capstone at the University of Alabama at Birmingham (UAB) could feel the external forces of a maturing Clinical and Nursing Informatics discipline. While the program had a capstone course for many years, it was lacking the depth of knowledge and demonstration of skills being asked for by those hiring in a maturing Informatics field. Since the program is online, all capstones were always in the online environment. While this modality did not change, other contributors to instruction modality changed. Pre-2016, the instruction modality was self-guided. Students checked in with a single instructor, and that instructor monitored progress across all capstones toward a PowerPoint and written paper deliverable. At the time, the enrollment was few, and the maturity had not yet pushed hard enough. By 2017, doubling enrollment and the increased demand of a more rigorously trained workforce led to restructuring the capstone so that graduates would have and retain the skills learned in the capstone process. There were three major changes: the capstone was broken up into a 3-course sequence (meaning it lasted about 10 months instead of 14 weeks), there were many chunks of deliverables, and each faculty had a cadre of about 5 students to advise through the capstone process. Literature suggests that the chunking, breaking up complex projects (i.e., the capstone in one summer) into smaller, more manageable chunks (i.e., chunks of the capstone across 3 semesters), can increase and sustain learning while allowing for increased rigor. By doing this, the teaching responsibility was shared across faculty with each semester course being taught by a different faculty member. This change facilitated delving much deeper in instruction and produced a significantly more rigorous final deliverable. Having students advised across the faculty seemed like the right thing to do. It not only shared the load, but also shared the success of students. Furthermore, it meant that students could be placed with an academic advisor who had expertise in their capstone area, further increasing the rigor of the entire capstone process and project and increasing student knowledge and skills.

Keywords: capstones, clinical informatics, health informatics, informatics

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Authors: Elaheh Ghasempour

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India has always been an all-encompassing center of attention in the theological and cultural studies since it beholds a very diverse nation within its borders. Among the uncountable faiths and traditions of this massive land, this article shall negotiate Islam in a Hindu dominated society. Practicing Caste and the views on it are the most controversial topics in modern-day India. Some blame it on the teachings of Hinduism; some call it a colonial outcome; and yet many believe that it is, in fact, a social construct. Islam was the souvenir coming from the Arabian Peninsula into the Indian Subcontinent in the hands of Arab, Persian, and Turk religious missionaries and Sufi saints. The aim of bringing the faith to this region was to enlighten the people of East and the Far East with the ideas of peace, justice, brotherhood as well as a proper way of living. Due to many reasons, the concept of the Islamic Nation or ‘Ummah’ has been touched by the native teachings of Hinduism which negates and questions the actual Islamic principles and laws. The Islamic Nation in India has been parted to different classes and each class nowadays beholds one level of a hierarchy. The superiors do not hesitate to keep the inferiors oppressed as much as they can since their own high position in this hierarchy depends on such oppressions. Their rules and laws to keep the lower castes out of the political and economical scene found ways into the religious traditions so much that it has become hard to question it by the masses; the masses who are too uneducated to question their own heretical faith and traditions. But now that the world is rapidly evolving, the access to knowledge has evoked an awareness of many lower caste or ‘Dalit’ Muslims. They no longer wish to be oppressed for their ethnicity or rootless principles of the old generations to guarantee the survival of the higher caste Muslims or ‘Ashrafs’. In recent years, many have stood against the rules of the caste system. As the oppressed no longer wishes to be oppressed, they also show acts of violence against the rulers who destined them the life they currently have. Considering they are usually poor and uneducated, and they might do violent actions, this can threaten not only Indians but the whole world; especially because the ISIS can easily fund a troop of hungry men who are looking forward to revenge their masters and others for all the unjust discriminations. Therefore for the sake of social security and stopping the disrepute for followers of Islam, the entire Islamic nation must consider taking actions against practicing Caste, regardless of where they come from. Since the teachings of the Quran and the Sunnah of the Prophet (PBUH) invite all Muslims to practice equality and brotherhood in the Ummah, this article would find the practical ways to abolish the caste-system through the Islamic liturgical texts and traditions.

Keywords: Dalit Muslims, Islam in India, caste system, justice in Islam, violence

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Authors: Marc Dietrich

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Youth cultures like Punk as much as media relevant to the specific scenes associated with them offer ample opportunity for young people or juvenile adults to construct their personal identities. However, developmental psychology has largely neglected such identity construction processes during the last decades. Such was not always the case: Early developmental psychologists intensely studied youth cultures and their meaningful objects and media in the early 20th century but lost interest when cultural studies and the social sciences occupied the field after World War II. Our project Constructions of Juvenility and Generation(ality), funded by the German Federal Ministry for Education and Research, reintegrates the study of youth cultures and their meaningful objects and media in a developmental psychology perspective. We present an empirical study of the ways in which youth, juvenility, and generation (ality) are constructed and negotiated in underground media like punk fanzines (a portmanteau of fan and magazine), including both semantic and aesthetic aspects of these construction processes within punk culture. The fanzine sample was accessed by the theoretical sampling strategy typical for GTM studies. Acknowledging fanzines as artful self-produced media by scene members for scene members, we conceptualize them as authentic documents of scene norms and values. Drawing on an analysis of both text and (cover) images in Punk fanzines published in Germany (and within a sample dating from 1981 until 2015) using a novel Visual Grounded Theory approach, we found that: a) Juvenility is a highly contested concept in punk culture. Its semantic quality and valuation varies with the perspectives present within the culture (e.g. embryo punks versus older punks); b) Juvenility is constructed as having energy and being socio-critical that does not depend on biological age; c) Juvenility is regarded not an ideal per se in German Punk culture; Punk culture constructs old age in a largely positive way (e.g., as marker of being real and a historical innovator); d) Juvenility is constructed as a habit that should be kept for life as it is constantly adapted to individual biographical trajectories like specific job situations or having a family. Consequently, identity negotiation as documented in the zines attempts to balance subculturally driven perspectives on life and society with the pragmatic requirements of a bourgeois life. The proposed paper will present the main results of this large-scale study of punk fanzines and show how developmental psychology perspectives as represented in the novel methodology applied in it can advance the study of youth cultures.

Keywords: construction of juvenility, developmental psychology, visual GTM, youth culture, fanzines

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Authors: John Narh

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There is high rate of deforestation in Ghana due to agricultural expansion, illegal mining and illegal logging. While it is attempting to address the illegalities, Ghana has also initiated a reforestation program known as the Modified Taungya System (MTS). Within the MTS framework, farmers are allocated degraded forestland and provided with tree seedlings to practice agroforestry until the trees form canopy. Yet, the political, ecological and economic models that inform the selection of tree species, the motivations of participating farmers as well as the factors that accounts for differential access to the land and performance of farmers engaged in the program lie underexplored. Using a sequential explanatory mixed methods approach in five forest-fringe communities in the Eastern Region of Ghana, the study reveals that economic factors and Ghana’s commitment to international conventions on the environment underpin the selection of tree species for the MTS program. Social network and access to remittances play critical roles in having access to, and enhances poor farmers’ chances in the program respectively. Farmers are more motivated by the access to degraded forestland to cultivate food crops than having a share in the trees that they plant. As such, in communities where participating farmers are not informed about their benefit in the tree that they plant, the program is largely unsuccessful.

Keywords: translocality, deforestation, forest management, social network

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Authors: Mehmet Sinan Erguven

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A number of authorities argue that radio is an outdated medium for advertising and does not have the same impact on consumers as it did in the past. This grim outlook on the future of radio has its basis in the audio-visual world that consumers now live in and the popularity of Internet-based marketing tools among advertising professionals. Nonetheless, consumers still appear to overwhelmingly prefer radio as an entertainment tool. Today, in Canada, 90% of all adults (18+) tune into the radio on a weekly basis, and they listen for 17 hours. Teens are the most challenging group for radio to capture as an audience, but still, almost 75% tune in weekly. One online radio station reaches more than 250 million registered listeners worldwide, and revenues from radio advertising in Australia are expected to grow at an annual rate of 3% for the foreseeable future. Radio is also starting to become popular again in Turkey, with a 5% increase in the listening rates compared to 2014. A major matter of concern always affecting radio advertising is creativity. As radio generally serves as a background medium for listeners, the creativity of the radio commercials is important in terms of attracting the attention of the listener and directing their focus on the advertising message. This cannot simply be done by using audio tools like sound effects and jingles. This study aims to identify the creative elements (execution formats appeals and approaches) and creativity factors of radio commercials in Turkey. As part of the study, all of the award winning radio commercials produced throughout the history of the Kristal Elma Advertising Festival were analyzed using the content analysis technique. Two judges (an advertising agency copywriter and an academic) coded the commercials. The reliability was measured according to the proportional agreement. The results showed that sound effects, jingles, testimonials, slices of life and announcements were the most common execution formats in creative Turkish radio ads. Humor and excitement were the most commonly used creative appeals while award-winning ads featured various approaches, such as surprise musical performances, audio wallpaper, product voice, and theater of the mind. Some ads, however, were found to not contain any creativity factors. In order to be accepted as creative, an ad must have at least one divergence factor, such as originality, flexibility, unusual/empathic perspective, and provocative questions. These findings, as well as others from the study, hold great value for the history of creative radio advertising in Turkey. Today, the nature of radio and its listeners is changing. As more and more people are tuning into online radio channels, brands will need to focus more on this relatively cheap advertising medium in the very near future. This new development will require that advertising agencies focus their attention on creativity in order to produce radio commercials for their customers that will differentiate them from their competitors.

Keywords: advertising, creativity, radio, Turkey

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Authors: Dina Helmy El-Ghonemy, Thanaa Hamed Ali

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The aim of this study was to purify and characterize a keratinolytic enzyme produced by Aspergillus sp. DHE7 cultured in basal medium containing chicken feather as substrate. The enzyme was purified through ammonium sulfate saturation of 60%, followed by gel filtration chromatography in Sephadex G-100, with a 16.4-purification fold and recovery yield of 52.2%. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed that the purified enzyme is a monomeric enzyme with an apparent molecular mass of 30 kDa — the purified keratinase of Aspergillus sp. DHE7 exhibited activity in a broad range of pH (7- 9) and temperature (40℃-60℃) profiles with an optimal activity at pH eight and 50℃. The keratinolytic activity was inhibited by protease inhibitors such as phenylmethylsulfonyl fluoride and ethylenediaminetetraacetate, while no reduction of activity was detected by the addition of dimethyl sulfoxide (DMSO). Bivalent cations, Ca²⁺ and Mn²⁺, were able to greatly enhance the activity of keratinase by 125.7% and 194.8%, respectively, when used at one mM final concentration. On the other hand, Cu²⁺ and Hg²⁺ inhibited the enzyme activity, which might be indicative of essential vicinal sulfhydryl groups of the enzyme for productive catalysis. Furthermore, the purified keratinase showed significant stability and compatibility against the tested commercial detergents at 37ºC. Therefore, these results suggested that the purified keratinase from Aspergillus sp. DHE7 may have potential use in the detergent industry and should be of interest in the processing of poultry feather waste.

Keywords: Aspergillus sp. DHE7, biochemical characterization, keratinase, purification, waste management

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Authors: Shayla He

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Background and Purpose: According to Chamie (2017), it’s estimated that no less than 150 million people, or about 2 percent of the world’s population, are homeless. The homeless population in the United States has grown rapidly in the past four decades. In New York City, the sheltered homeless population has increased from 12,830 in 1983 to 62,679 in 2020. Knowing the trend on the homeless population is crucial at helping the states and the cities make affordable housing plans, and other community service plans ahead of time to better prepare for the situation. This study utilized the data from New York City, examined the key factors associated with the homelessness, and developed systematic modeling to predict homeless populations of the future. Using the best model developed, named HP-RNN, an analysis on the homeless population change during the months of 2020 and 2021, which were impacted by the COVID-19 pandemic, was conducted. Moreover, HP-RNN was tested on the data from Seattle. Methods: The methodology involves four phases in developing robust prediction methods. Phase 1 gathered and analyzed raw data of homeless population and demographic conditions from five urban centers. Phase 2 identified the key factors that contribute to the rate of homelessness. In Phase 3, three models were built using Linear Regression, Random Forest, and Recurrent Neural Network (RNN), respectively, to predict the future trend of society's homeless population. Each model was trained and tuned based on the dataset from New York City for its accuracy measured by Mean Squared Error (MSE). In Phase 4, the final phase, the best model from Phase 3 was evaluated using the data from Seattle that was not part of the model training and tuning process in Phase 3. Results: Compared to the Linear Regression based model used by HUD et al (2019), HP-RNN significantly improved the prediction metrics of Coefficient of Determination (R2) from -11.73 to 0.88 and MSE by 99%. HP-RNN was then validated on the data from Seattle, WA, which showed a peak %error of 14.5% between the actual and the predicted count. Finally, the modeling results were collected to predict the trend during the COVID-19 pandemic. It shows a good correlation between the actual and the predicted homeless population, with the peak %error less than 8.6%. Conclusions and Implications: This work is the first work to apply RNN to model the time series of the homeless related data. The Model shows a close correlation between the actual and the predicted homeless population. There are two major implications of this result. First, the model can be used to predict the homeless population for the next several years, and the prediction can help the states and the cities plan ahead on affordable housing allocation and other community service to better prepare for the future. Moreover, this prediction can serve as a reference to policy makers and legislators as they seek to make changes that may impact the factors closely associated with the future homeless population trend.

Keywords: homeless, prediction, model, RNN

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Authors: Lucy Novianti

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The purpose of this study is to determine the effect of corporate governance, ownership structure, and cash holdings on firm value, either direct or indirect through profitability as an intervening variable for non-financial companies listed on the Indonesia Stock Exchange during 2006 to 2014. Samples of 176 firms are chosen based on purposive sampling method. The results of this study conclude that profitability, the size of Audit Committee, audit quality, and cash flow have positive effects on firm value. This study also shows that the meeting frequency of the Board of Directors and free cash flow have negative effects on firm value. In addition, this study finds that the size of the Board of Directors, Independent Commissioner, and ownership structure do not have significant effects on firm value. In this study, the function of profitability as an intervening variable can only be done on the impact of the meeting frequency of the Board of Directors and cash flow on firm value. This study provides a reference for management in decision making concerning the application of corporate governance, cash holdings, and financial performance. Moreover, it can be used as additional information for investors in assessing the feasibility of an investment. Finally, it provides a suggestion for the government regarding the regulation of corporate governance.

Keywords: cash holdings, corporate governance, firm value, ownership structure, profitability

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Authors: Haythem H. Abdullah, Hesham Elkady

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With the fast increase in radio frequency identification (RFID) applications such as medical recording, library management, etc., the limitation of active tags stems from its need to external batteries as well as passive or active chips. The chipless RFID tag reduces the cost to a large extent but at the expense of utilizing the spectrum. The reduction of the cost of chipless RFID is due to the absence of the chip itself. The identification is done by utilizing the spectrum in such a way that the frequency response of the tags consists of some resonance frequencies that represent the bits. The system capacity is decided by the number of resonators within the pre-specified band. It is important to find a solution to enhance the spectrum utilization when using chipless RFID. Target identification is a process that results in a decision that a specific target is present or not. Several target identification schemes are present, but one of the most successful techniques in radar target identification in the oscillatory region is the extinction pulse technique (E-Pulse). The E-Pulse technique is used to identify targets via its characteristics (natural) modes. By introducing an innovative solution for chipless RFID reader and tag designs, the spectrum utilization goes to the optimum case. In this paper, a novel capacity enhancement scheme based on the E-pulse technique is introduced to improve the performance of the chipless RFID system.

Keywords: chipless RFID, E-pulse, natural modes, resonators

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Authors: Jennifer E. Lynette

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The purpose of this study is to develop a nation-wide assessment tool to gauge the quality and efficiency of response activities by emergency personnel to fires in Denmark. Current fire incident reports lack detailed information that can lead to breakthroughs in research and improve emergency response efforts. Information generated from the report database is analyzed and assessed for efficiency and quality. By utilizing information collection gaps in the incident reports, an improved, indepth, and streamlined quality gauging system is developed for use by fire brigades. This study pinpoints previously unrecorded factors involved in the response phases of a fire. Variables are recorded and ranked based on their influence to event outcome. By assessing and measuring these data points, quality standards are developed. These quality standards include details of the response phase previously overlooked which individually and cumulatively impact the overall success of a fire response effort. Through the application of this tool and implementation of associated quality standards at Denmark’s fire brigades, there is potential to increase efficiency and quality in the preparedness and response phases, thereby saving additional lives, property, and resources.

Keywords: emergency management, fire, preparedness, quality standards, response

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Authors: Claudia P. Saunderson

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Widening of participation in higher education globally has increased diversity of student populations. However, widening participation is more than mere access. Central to the debate about widening participation are social justice issues of authentic inclusion and appropriate support for success for all students in higher education (HE). Given the recent global campaign for 'Black Lives Matter' as well as the worldwide advocacy for justice in the George Floyd case, the importance of the experiences of Black men, were again poignantly foregrounded. The literature abounds with the negative experiences of Black male students in higher education. Much of this literature emanates from the Global North, with little systematic research on black male students' university experiences originating from the Global South. This research, therefore, explores the psychosocial experiences of Black male students at a historically white South African university. Not only are these students' educational or academic adjustment important, but so is their psychosocial adjustment to the institution. The psychosocial adjustment might include emotional well-being, motivation, as well as the student’s perception of how well he fits in or is made to feel welcome at the institution. The study draws on strands of critical race theory (CRT), co-cultural theory (CCT) as well as defining properties of micro-aggression theory (MAT). In the study, CRT, therefore, served as an overarching theory at the macro level, and it comments on the structural dynamics while MAT and CCT rather focussed on the impact of structural arrangements like racialization, at an individual and micro-level. These theories furthermore provided a coherent analytic framework for this study. Using a case study design, this qualitative study, employing focus groups and individual interviews, drew on the psychosocial experiences of twenty Black male students to explore how they navigate this specific historically white campus. The data were analyzed using thematic analysis that provided a systematic procedure for generating codes and themes from the qualitative data. The study found that the combination of race and gender-based micro-aggressions experienced by students included negative stereotyping, criminalization as well as racial profiling and that these experiences impede participants' ability to thrive at the institution. However, participants also shared positive perspectives about the institution. Some of the positive traits of the institution that the participants mentioned were well-aligned administration, good quality of education, as well as various funding opportunities. This study implies that if any HE institution values transformation, it necessitates the exploration and interrogation of potential aspects that are subtly hidden in the institutional culture and environment that might serve as barriers to the transformation process. This positioning is based on a social justice stance and believes that all students are equal and have the right to racially and culturally equitable and appropriate education and support.

Keywords: critical race theory, higher education transformation, micro-aggression, student experience

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Authors: Malihe Motiei, Nor Hidayati Zakaria, Davide Aloini

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This study aims to present a method to develop the failure measurement model for ERP post-implementation. To achieve this outcome, the study firstly evaluates the suitability of Technology-Organization-Environment framework for the proposed conceptual model. This study explains how to discover the constructs and subsequently to design and evaluate the constructs as formative or reflective. Constructs are used including reflective and purely formative. Then, the risk dimensions are investigated to determine the instruments to examine the impact of risk on ERP failure after implementation. Two construct as formative constructs consist inadequate implementation and poor organizational decision making. Subsequently six construct as reflective construct include technical risks, operational risks, managerial risks, top management risks, lack of external risks, and user’s inefficiency risks. A survey was conducted among Iranian industries to collect data. 69 data were collected from manufacturing sectors and the data were analyzed by Smart PLS software. The results indicated that all measurements included 39 critical risk factors were acceptable for the ERP post-implementation failure model.

Keywords: critical risk factors (CRFs), ERP projects, ERP post-implementation, measurement instruments, ERP system failure measurement model

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Authors: Mustafa Var, Yasin Kültiğin Yaman, Elif Berna Var, Müberra Pulatkan

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This study deals with real application of an urban transformation project in Trabzon, Turkey. It aims to highlight the significance of using native species in terms of planting design of transformation projects which will also promote sustainability of urban identity. Urban identity is a phenomenon shaped not only by physical, but also by natural, spatial, social, historical and cultural factors. Urban areas face with continuous change which can be whether positive or negative way. If it occurs in a negative way that may have some destructive effects on urban identity. To solve this problematic issue, urban renewal movements initally started after 1840s around the world especially in the cities with ports. This process later followed by the places where people suffered a lot from fires and has expanded to all over the world. In Turkey, those processes have been experienced mostly after 1980s as country experienced the worst effects of unplanned urbanization especially in 1950-1990 period. Also old squares, streets, meeting points, green areas, Ottoman bazaars have changed slowly. This change was resulted in alienation of inhabitants to their environments. As a solution, several actions were taken like Mass Housing Laws which was enacted in 1981 and 1984 or urban transformation projects. Although projects between 1990-2000 were tried to satisfy the expectations of local inhabitants by the help of several design solutions to promote cultural identity; unfortunately those modern projects has also been resulted in alienation of urban environments to the inhabitants. Those projects were initially done by TOKI (Housing Development Administration of Turkey) and later followed by the Ministry of Environment and Urbanization after 2011. Although they had significant potentials to create healthy urban environments, they could not use this opportunity in an effective way. The reason for their failure is that their architectural styles and planting designs are unrespectful to local identity and environments. Generally, it can be said that the most of the urban transformation projects implementing in Turkey nearly have no concerns about the locality. However, those projects can be used as a positive tool for enhanching the urban identity of cities by means of local planting material. For instance, Kyoto can be identified by Japanese Maple trees or Seattle can be specified by Dahlia. In the same way, in Turkey, Istanbul city can be identified by Judas and Stone Pine trees or Giresun city can be identified by Cherry trees. Thus, in this paper, the importance of conserving urban identity is discussed specificly with the help of using local planting elements. After revealing the mistakes that are made during urban transformation projects, the techniques and design criterias for preserving and promoting urban identity are examined. In the end, it is emphasized that every city should have their own original, local character and specific planting design which can be used for highlighting its identity as well as architectural elements.

Keywords: urban identity, urban transformation, planting design, landscape architecture

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Authors: Richele P. Severino, Maria M. F. Alchaar, Lorena R. F. De Sousa, Patrik S. Vital, Ana G. Silva, Rosy I. M. A. Ribeiro

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Recognized as a global biodiversity hotspot, the Cerrado (Brazil) presents an extreme abundance of endemic species and it is considered to be one of the biologically richest tropical savanna regions in the world. Erythroxylum genus is found in Cerrado and chemically is characterized by the presence of tropane alkaloids, among them cocaine, a natural alkaloid produced by Erythroxylum coca Lam., which was used as a local anesthetic in small surgeries. However, cocaine gained notoriety due to its psychoactive activity in the Central Nervous System (CNS), becoming one of the major problems of public health today. Some species of Erythroxylum are referred to in the literature as having pharmacological potential, which provide alkaloids, terpenoids, and flavonoids. E. vacciniifolium Mart., commonly known as 'catuaba', is used as a central nervous system stimulant and has aphrodisiac properties and E. pelleterianum A. St.-Hil. in the treatment of stomach pains. Already E. myrsinites Mart. and E. suberosum A. St.-Hil. are used in the tannery industry. Species of Erythroxylum are also used in folk medicine for various diseases, against diabetes, antiviral, fungicidal, cytotoxicity, among others. The Cerrado is recognized as the richer savannah in the world in biodiversity but little explored from the chemical view. In our on-going study of the chemistry of Erythroxylum genus, we have investigated four specimens collected in central Cerrado of Brazil: E. campestre (EC), E. deciduum (ED), E. suberosum (ES) and E. tortuosum (ET). The cytotoxic activity of extracts was evaluated using HeLa cells, in vitro assays. The chemical investigation was performed preparing the extracts using n-hexane (H), dichloromethane (D), ethyl acetate (E) and methanol (M). The cells were treated with increasing concentrations of extracts (50, 75 and 100 μg/mL) diluted in DMSO (1%) and DMEM (0.5% FBS and 1% P/S). The IC₅₀ values were determined measured spectrophotometrically at 570 nm, after incubation of HeLa cell line for 48 hours using the MTT (SIGMA M5655), and calculated by nonlinear regression analysis using GraphPad Prism software. All the assays were done in triplicate and repeated at least two times. The cytotoxic assays showed some promising results with IC₅₀ values less than 100 μg/mL (ETD = 38.5 μg/mL; ETM = 92.3 μg/mL; ESM = 67.8 μg/mL; ECD = 24.0 μg/mL; ECM = 32.9; EDA = 44.2 μg/mL). The chemical profile study of ethyl acetate (E) and methanolic (M) extracts of E. tortuosum leaves was performed by LC-MS, and the structures of the compounds were determined by analysis of ¹H, HSQC and HMBC spectra, and confirmed by comparison with the literature data. The investigation led to six substances: α-amyrin, β-amyrin, campesterol, stigmastan-3,5-diene, β-sitosterol and 7,4’-di-O-methylquercetin-3-O-β-rutinoside, with flavonoid the major compound of extracts. By alkaline extraction of the methanolic extract, it was possible to identify three alkaloids: tropacocaine, cocaine and 6-methoxy-8-methyl-8-azabicyclo[3.2.1]octan-3-ol. The results obtained are important for the chemical knowledge of the Cerrado biodiversity and brought a contribution to the chemistry of Erythroxylum genus.

Keywords: cytotoxicity, Erythroxylum, chemical profile, secondary metabolites

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Authors: Arjun Goutham, Chaitanya Sridhar, Sunita Maheshwari, Robin Uthappa, Prasanna Gopinath

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In alignment with the growth in the sporting industry, a number of people playing and competing in sports are growing exponentially across the globe. However, the number of sports psychology experts are not growing at a similar rate, especially in the Asian and more so, Indian context. Hence, the access to actionable mental training solutions specific to individual athletes is limited. Also, the time constraint an athlete faces due to their intense training schedule makes one-on-one sessions difficult. One of the means to bridge that gap is through technology. Technology makes individualization possible. It allows for easy access to specific-qualitative content/information and provides a medium to place individualized assessments, analysis, solutions directly into an athlete's hands. This enables mental training awareness, education, and real-time actionable solutions possible for athletes in-spite of the limitation of available sports psychology experts in their region. Furthermore, many athletes are hesitant to seek support due to the stigma of appearing weak. Such individuals would prefer a more discreet way. Athletes who have strong mental performance tend to produce better results. The mobile application helps to equip athletes with assessing and developing their mental strategies directed towards improving performance on an ongoing basis. When an athlete understands their strengths and limitations in their mental application, they can focus specifically on applying the strategies that work and improve on zones of limitation. With reports, coaches get to understand the unique inner workings of an athlete and can utilize the data & analysis to coach them with better precision and use coaching styles & communication that suits better. Systematically capturing data and supporting athletes(with individual-specific solutions) or teams with assessment, planning, instructional content, actionable tools & strategies, reviewing mental performance and the achievement of objectives & goals facilitate for a consistent mental skills development at all levels of sporting stages of an athlete's career. The mobile application will help athletes recognize and align with their stable attributes such as their personalities, learning & execution modalities, challenges & requirements of their sport, etc and help develop dynamic attributes like states, beliefs, motivation levels, focus etc. with practice and training. It will provide measurable analysis on a regular basis and help them stay aligned to their objectives & goals. The solutions are based on researched areas of influence on sporting performance individually or in teams.

Keywords: athletes, mental training, mobile application, performance, sports

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Authors: Vaida Zemlickiene

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Scientists around the world and practitioners are working to identify the factors that influence the results of technology commercialization and to propose the ideal model for the technology commercialization process. In other words, all stakeholders of technology commercialization seek to find a formula or set of rules to succeed in commercializing technologies in order to avoid unproductive investments. In this article, the process of commercialization technology is understood as the process of transforming inventions into marketable products, services, and processes, or the path from the idea of using an invention to a product that incorporates process from 1 to 9 technology readiness level (TRL). There are many publications in the field of management literature, which are aimed at managing the commercialization process. However, there is an apparent lack of research for communication in decision-making in the process of technology commercialization. Works were done in the past, and the last decade's global research analysis led to the unambiguous conclusion that the methodological framework is not mature enough to be of practical use in business. The process of technology commercialization and the decisions made in the process should be explored in-depth. An archival analysis is performed to find insights into decision-making communication in the process of technologies commercialization, to find out the content of technology commercialization process: decision-making stages and participants, to analyze the internal factors of technology commercialization, to perform their critical analysis, to analyze the concept of successful/unsuccessful technology commercialization.

Keywords: the process of technology commercialization, communication in decision-making process, the content of technology commercialization process, successful/unsuccessful technology commercialization

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Authors: Pascal Alberti, Mustapha Mouloua

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In today’s global market economy, various companies are often confronted with the dynamic and complex nature of current competitive markets. The dynamics of these markets are becoming more and more fluid, often requiring companies to provide competitive, definite advantages, and technological responses within increasingly shorte time frames. To meet these demands, companies must rely on the cognitive abilities of actors of creativity to provide tangible answers to the current contextual problems. Thus, it is important to provide a variety of instruments and design tools to support this particular stage of innovation, and to meet their demand expectations. For a number of years now, we have been extensively conducting experiments on the use of mind maps in the context of innovative projects with collaborative research teams from various nationalities. Our research findings reported a significant difference between a “Word” Mind Map and “Photographic” Mind Map, a correlation between the different uses of iconic tools and certain types of innovation, and a relationship between the different cognitive logics. In this paper, we will present our new results related to the effect of symmetrical presentation of a Photographic Mind Map" on the production of design solutions. Finally, we will conclude by highlighting the importance of our experimental method, and discussing both the theoretical and practical implications of our research.

Keywords: creativity, innovation, management, mind mapping, design product

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Authors: Hiba Dakroub, Danilo Russo, Luca Cistrone, Francesco Serra, Giovanna Fusco, Esterina De Carlo, Maria Grazia Amoroso

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The question of the origin of SARS-CoV-2 and the cycle of transmission between humans and animals is still unanswered. One serious concern associated with the SARS-CoV-2 pandemic is that the virus might spill back from humans to wildlife, which would render some animal species reservoirs of the human virus. The aim of the present study is to monitor the potential risk of SARS-CoV-2 reverse infection from humans to bats, by performing bat surveillance from different sites in Central-Southern Italy. We collected 240 droppings or saliva from 129 bats and tested them using specific and general primers of SARS-COV-2 and coronaviruses respectively. All samples, including 127 nasal swabs and 113 fecal droppings resulted negative for SARS-COV-2, and these results were confirmed by testing the samples with the Droplet Digital PCR. Also, an end-point RT-PCR was performed and no sample showed specific bands. The absence of SARS-CoV-2 in the bats we surveyed is a first step towards a better understanding of reverse transmission to bats of this virus. We hope our first contribution will encourage the establishment of systematic surveillance of wildlife, and specifically bats, to help prevent reverse zoonotic episodes that would jeopardize human health as well as biodiversity conservation and management.

Keywords: coronaviruses, bats, zoonotic viruses, spillback, SARS-CoV-2

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Authors: Elena Pucci, Margherita Tufarelli, Leonardo Giliberti

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As central for human and social development of the future, sustainability is becoming a recurring theme also in the fashion industry, where the need to explore new possible directions aimed at achieving sustainability goals and their communication is rising. Scholars have been devoted to the overall environmental impact of the textile and fashion industry, which, emerging as one of the world’s most polluting, today concretely assumes the need to take the path of sustainability in both products and production processes. Every day we witness the impact of our consumption, showing that the sustainability concept is as vast as complex: with a sometimes ambiguous definition, sustainability can concern projects, products, companies, sales, packagings, supply chains in relation to the actors proximity as well as traceability, raw materials procurement, and disposal. However, in its primary meaning, sustainability is the ability to maintain specific values and resources for future generations. The contribution aims to address sustainability in the fashion system as a layered problem that requires substantial changes at different levels: in the fashion product (materials, production processes, timing, distribution, and disposal), in the functioning of the system (life cycle, impact, needs, communication) and last but not least in the practice of fashion design which should conceive durable, low obsolescence and possibly demountable products. Moreover, consumers play a central role for the growing awareness, together with an increasingly strong sensitivity towards the environment and sustainable clothing. Since it is also a market demand, undertaking significant efforts to achieve total transparency and sustainability in all production and distribution processes is becoming fundamental for the fashion system. Sustainability is not to be understood as purely environmental but as the pursuit of collective well-being in relation to conscious production, human rights, and social dignity with the aim to achieve intelligent, resource, and environmentally friendly production and consumption patterns. Assuming sustainability as a layered problem makes the role of communication crucial to convey scientific or production specific content so that people can obtain and interpret information to make related decisions. Hence, if it is true that “what designers make becomes the future we inhabit'', design is facing great and challenging responsibility. The fashion industry needs a system of rules able to assess the sustainability of products, which is transparent and easily interpreted by consumers, identifying and enhancing virtuous practices. There are still complex and fragmented value chains that make it extremely difficult for brands and manufacturers to know the history of their products, to identify exactly where the risks lie, and to respond to the growing demand from consumers and civil society for responsible and sustainable production practices in the fashion industry.

Keywords: fashion design, fashion system, sustainability, communication, complexity

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Authors: Turkyh Alotibi, Ghadah Obeid Alrasheed, Afaf Saad Alshaibani, Moneerah Obeid Alrasheed

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This study explores factors that influence MBA enrolment and investigates strategic prerequisites for developing a viable online MBA program at Alfaisal University in the Kingdom of Saudi Arabia. It compares students’ perspectives about online MBA against the face-to-face on-site MBA program. With the self-administered online survey tool, we collected data from 52 first- and second-year MBA students enrolled at Alfaisal University for the 2021 Fall Semester. The data from the survey questionnaire, distributed at the university’s College of Business, reports that approximately 60% of MBA students prefer face-to-face, in-person courses. Their preference for considering an online MBA, primarily rests on two factors, the university’s ranking (68% would enroll for an online MBA program offered by Harvard Business School) and 34.07% for the program timing (timetable). Alfaisal University’s outstanding ranking makes it viable to offer an online MBA either independently or in collaboration with other internationally reputed business schools. The paper contains useful insights to set “the strategic agenda for Online MBA program” in no accredited University but with a good reputation. The information from the case study could be useful for supporting the strategic intent to start an Online MBA program in Saudi Arabia.

Keywords: online MBA, online education demand, university management, course evaluation, blended learning

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Authors: Anupama Purohit

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The paper is a study on the inevitable cross-linguistic effect found in the early multilingual learners. The cross-linguistic behaviour like code-mixing, code-switching, foreign accent, literal translation, redundancy and syntactic manipulation effected due to other languages on the English language output of a non-native pre-school child are discussed here. A case study method is adopted in this paper to support the claim of the title. A simultaneously tetra lingual pre-school child’s (within 1;3 to 4;0) language behaviour is analysed here. The sample output data of the child is gathered from the diary entries maintained by her family, regular observations and video recordings done since her birth. She is getting the input of her mother tongue, Sambalpuri, from her grandparents only; Hindi, the local language from her play-school and the neighbourhood; English only from her mother and occasional visit of other family friends; Odia only during the reading of the Odia story book. The child is exposed to code-mixing of all the languages throughout her childhood. But code-mixing, literal translation, redundancy and duplication were absent in her initial stage of multilingual acquisition. As the child was more proficient in English in comparison to her other first languages and had never heard code-mixing in English language; it was expected from her input pattern of English (one parent, English language) that she would maintain purity in her use of English while talking to the English language interlocutor. But with gradual increase in the language proficiency in each of the languages of the child, her handling of the multiple codes becomes deft cross-linguistically. It can be deduced from the case study that after attaining certain milestone proficiency in each language, the child’s linguistic faculty can operate at a metalinguistic level. The functional use of each morpheme, their arrangement in words and in the sentences, the supra segmental features, lexical-semantic mapping, culture specific use of a language and the pragmatic skills converge to give a typical childlike multilingual output in an intelligible manner to the multilingual people (with the same set of languages in combination). The result is appealing because for expressing the same ideas which the child used to speak (may be with grammatically wrong expressions) in one language, gradually, she starts showing cross-linguistic effect in her expressions. So the paper pleads for the separatist view from the very beginning of the holophrastic phase (as the child expresses in addressee-specific language); but development of a metalinguistic ability that helps the child in communicating in a sophisticated way according to the linguistic status of the addressee is unique to the multilingual child. This metalinguistic ability is independent of the mode if input of a multilingual child.

Keywords: code-mixing, cross-linguistic effect, early multilingualism, literal translation

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Authors: Mohammadreza Heydariazad

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Productivity growth of wind energy as a clean source needed to achieve improved strategy in production and transmission and management of wind resources in order to increase quality of power and reduce costs. New technologies based on power converters that cause changing turbine speed to suit the wind speed blowing turbine improve extraction efficiency power from wind. This article introduces variable speed wind turbines and optimization of power, and presented methods to use superconducting inductor in the composition of power converter and is proposed the dc measurement for the wind farm and especially is considered techniques available to them. In fact, this article reviews mechanisms and function, changes of wind speed turbine according to speed control strategies of various types of wind turbines and examines power possible transmission and ac from producing location to suitable location for a strong connection integrating wind farm generators, without additional cost or equipment. It also covers main objectives of the dynamic control of wind turbines, and the methods of exploitation and the ways of using it that includes the unique process of these components. Effective algorithm is presented for power control in order to extract maximum active power and maintains power factor at the desired value.

Keywords: wind energy, generator, superconducting inductor, wind turbine power

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Authors: Muhammad Qamar Masood, Syed Abbas Raza, Umar Yousaf Raja, Imran Hassan, Bilal Afzal, Muhammad Aleem Zahir, Atika Shaheer

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Background: Cardiovascular disease (CVD) is a major burden among people with type 2 diabetes (T2D) with 1 in 3 reported to have CVD. Therefore, understanding real-world clinical characteristics and prescribing patterns could help in better care. Objective: The CONVERGE (Cardiovascular Outcomes and Value in the Real world with GLP-1RAs) study characterized demographics and medication usage patterns in T2D intensified (add-on to metformin) overall population. The data were further divided into subgroups {dipeptidyl peptidase-4 inhibitors (DPP-4is), sulfonylureas (SUs), insulins, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2is)}, according to the latest prescribed antidiabetic agent (ADA) in India/Pakistan/Thailand. Here, we report findings from Pakistan. Methods: A multi-center retrospective study utilized data from medical records between 13-Sep-2008 (post-market approval of GLP-1RAs) and 31-Dec-2017 in adults (≥18-year-old). The data for this study were collected from 05 centers / institutes located in major cities of Pakistan, including Karachi, Lahore, Islamabad, and Multan. These centers included National Hospital, Aga Khan University Hospital, Diabetes Endocrine Clinic Lahore, Shifa International Hospital, Mukhtar A Sheikh Hospital Multan. Data were collected at start of medical record and at 6 or 12-months prior to baseline based on variable type; analyzed descriptively. Results: Overall, 1,010 patients were eligible. At baseline, overall mean age (SD) was 51.6 (11.3) years, T2D duration was 2.4 (2.6) years, HbA1c was 8.3% (1.9) and 35% received ≥1CVD medications in the past 1-year (before baseline). Most frequently prescribed ADAs post-metformin were DPP-4is and SUs (~63%). Only 6.5% received GLP-1RAs and SGLT-2is were not available in Pakistan during the study period. Overall, it took a mean of 4.4 years and 5 years to initiate GLP-1RAs and SGLT-2is, respectively. In comparison to other subgroups, more patients from GLP-1RAs received ≥3 types of ADA (58%), ≥1 CVD medication (64%) and had higher body mass index (37kg/m2). Conclusions: Utilization of GLP-1RAs and SGLT-2is was low, took longer time to initiate and not before trying multiple ADAs. This may be due to lack of evidence for CV benefits for these agents during the study period. The planned phase 2 of the CONVERGE study can provide more insights into utilization and barriers to prescribe GLP-1RAs and SGLT-2is post 2018 in Pakistan.

Keywords: type 2 diabetes, GLP-1RA, treatment intensification, cardiovascular disease

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Authors: Georgios Samaras

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New media such as Facebook, YouTube and Twitter introduced the world to a new era of instant communication. An era where online interactions could replace a lot of offline actions. Technology can create a mediated environment in which participants can communicate (one-to-one, one-to-many, and many-to-many) both synchronously and asynchronously and participate in reciprocal message exchanges. Currently, social networks are attracting similar academic attention to that of the internet after its mainstream implementation into public life. Websites and platforms are seen as the forefront of a new political change. There is a significant backdrop of previous methodologies employed to research the effects of social networks. New approaches are being developed to be able to adapt to the growth of social networks and the invention of new platforms. Golden Dawn was the first openly neo-Nazi party post World War II to win seats in the parliament of a European country. Its racist rhetoric and violent tactics on social networks were rewarded by their supporters, who in the face of Golden Dawn’s leaders saw a ‘new dawn’ in Greek politics. Mainstream media banned its leaders and members of the party indefinitely after Ilias Kasidiaris attacked Liana Kanelli, a member of the Greek Communist Party, on live television. This media ban was seen as a treasonous move by a significant percentage of voters, who believed that the system was desperately trying to censor Golden Dawn to favor mainstream parties. The shocking attack on live television received international coverage and while European countries were condemning this newly emerged neo-Nazi rhetoric, almost 7 percent of the Greek population rewarded Golden Dawn with 18 seats in the Greek parliament. Many seem to think that Golden Dawn mobilised its voters online and this approach played a significant role in spreading their message and appealing to wider audiences. No strict online censorship existed back in 2012 and although Golden Dawn was openly used neo-Nazi symbolism, it was allowed to use social networks without serious restrictions until 2017. This paper used qualitative methods to investigate Golden Dawn’s rise in social networks from 2012 to 2019. The focus of the content analysis was set on three social networking platforms: Facebook, Twitter and YouTube, while the existence of Golden Dawn’s website, which was used as a news sharing hub, was also taken into account. The content analysis included text and visual analyses that sampled content from their social networking pages to translate their political messaging through an ideological lens focused on extreme-right populism. The absence of hate speech regulations on social network platforms in 2012 allowed the free expression of those heavily ultranationalist and populist views, as they were employed by Golden Dawn in the Greek political scene. On YouTube, Facebook and Twitter, the influence of their rhetoric was particularly strong. Official channels and MPs profiles were investigated to explore the messaging in-depth and understand its ideological elements.

Keywords: populism, far-right, social media, Greece, golden dawn

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Authors: Nipon Sasithornsaowapa

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This research aims to study the impact of personality and family status on women executives’ career success of the primary education department of Thailand. The independent variable includes three factors, namely family status, personality, and knowledge-skill-experience, while the dependent variable is the career success. The population of this study includes 2,179 female management officials in the department of primary education. A total of 400 female managers is interviewed and utilized as a sample group. A questionnaire is developed and used as a research tool for data collection. Content analysis is performed to get the quantitative data. Descriptive statistics in this research is conducted by SPSS program. The findings revealed that personality and family status of samples have an influence on the overall career success of women executives in terms of their objective career success. However, in terms of specific factors of personality or family status, it is found that there is no relevance of each factor on the women executives’ career success. It can be concluded that the factor affecting the women executives’ career success is subjective career success including the happiness and enjoyment with the job not factor concerning materials. Their success is the result of each individual working experience. However, their personal characteristics do not affect their success.

Keywords: career success, women executives, primary education, knowledge-skill-experience

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Authors: Hesham Osman

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The challenges facing aging urban infrastructure systems require a more holistic and comprehensive approach to their management. The large number of urban infrastructure renewal activities occurring in cities throughout the world leads to social, economic and environmental impacts on the communities in its vicinity. As such, a coordinated effort is required to streamline these activities. This paper presents a framework to enable temporal (time-based) coordination of water, sewer and road intervention activities. Intervention activities include routine maintenance, renewal, and replacement of physical assets. The coordination framework considers 1) Life-cycle costs, 2) Infrastructure level-of-service, and 3) Risk exposure to system operators. The model enables infrastructure asset managers to trade-off options of delaying versus bringing forward intervention activities of one system in order to be executed in conjunction with another co-located system in the right-of-way. The framework relies on a combination of meta-heuristics and goal-based optimization. In order to demonstrate the applicability of the framework, a case study for a major infrastructure corridor in Cairo, Egypt is taken as an example. Results show that the framework can be scaled-up to include other infrastructure systems located in the right-of-way like electricity, gas and telecom, provided that information can be shared among these entities.

Keywords: infrastructure, rehabilitation, construction, optimization

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Authors: Tatyana Savchuk, Yelena Grinvald, Mohamed Ali, Ramune Sepetiene, Dinara Sadvakassova, Saniya Saussakova, Kuralay Zhangazieva, Dulat Imashpayev

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Introduction. The problem of viral hepatitis B (HBV) takes a vital place in the global health system. The existing risk of HBV transmission through blood transfusions is associated with transfusion of blood taken from infected individuals during the “serological window” period or from patients with latent HBV infection, the marker of which is anti-HBcore. In the absence of information about other markers of hepatitis B, the presence of anti-HBcore suggests that a person may be actively infected or has suffered hepatitis B in the past and has immunity. Aim. To study the risk factors influencing the positive anti-HBcore indicators among the donor population. Materials and Methods. The study was conducted in 2021 in the Scientific and Production Center of Transfusiology of the Ministry of Healthcare in Kazakhstan. The samples taken from blood donors were tested for anti-HBcore, by CLIA on the Architect i2000SR (ABBOTT). A special questionnaire was developed for the blood donors’ socio-demographic characteristics. Statistical analysis was conducted by the R software (version 4.1.1, USA, 2021). Results.5709 people aged 18 to 66 years were included in the study, the proportion of men and women was 68.17% and 31.83%, respectively. The average age of the participants was 35.7 years. A weighted multivariable mixed effects logistic regression analysis showed that age (p<0.001), ethnicity (p<0.05), and marital status (p<0.05) were statistically associated with anti-HBcore positivity. In particular, analysis adjusting for gender, nationality, education, marital status, family history of hepatitis, blood transfusion, injections, and surgical interventions, with a one-year increase in age (adjOR=1.06, 95%CI:1.05-1.07), showed an 6% growth in odds of having anti-HBcore positive results. Those who were russian ethnicity (adjOR=0.65, 95%CI:0.46-0.93) and representatives of other nationality groups (adjOR=0.56, 95%CI:0.37-0.85) had lower odds of having anti-HBcore when compared to Kazakhs when controlling for other covariant variables. Among singles, the odds of having a positive anti-HBcore were lower by 29% (adjOR = 0.71, 95%CI:0.57-0.89) compared to married participants when adjusting for other variables. Conclusions.Kazakhstan is one of the countries with medium endemicity of HBV prevalence (2%-7%). Results of the study demonstrated the possibility to form a profile of risk factors (age, nationality, marital status). Taking into account the data, it is recommended to increase attention to donor questionnaires by adding leading questions and to improve preventive measures to prevent HBV. Funding. This research was supported by a grant from Abbott Laboratories.

Keywords: anti-HBcore, blood donor, donation, hepatitis B virus, occult hepatitis

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Authors: Mercy Chepkirui, Paul Orina, Robin Abell, Leonard Akwany, Tonny Orina, Mercy Matuma, Rasowo Joseph

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Lake jipe, a shared water resource between Kenya and Tanzania located at the East African Coast, is under multiple pressures. The lake has receded from 30Km2 to 27.32Km2 due to prolonged dry spells and intensified water abstraction for irrigation and re-route to Mungu ya Nyumba Dam in Tanzania. Agricultural activities have significantly (90%) contributed to the lake levels decline and further affected the lakes’ aquatic biodiversity. Among the most affected are the commercially important endemic fish species of the lake, of which Oreochromis jipe has experienced the greatest decline. Overfishing, use of illegal unreported and unregulated fishing gears, intensified fishing along protected fish breeding areas as well as poor management and uncoordinated conservation efforts have significantly contributed to the decline of fish catches from 348 kg of O. jipe in 2016 to 90 kg daily catches in 2022. Therefore, the lake is on the verge of extinction if no action is taken. This calls for awareness of the significance of the L. Jipe ecosystems and its immediate and long-term benefits. Further, there is a need to revive alternative economic activities, including aquaculture and sustainable agriculture, to offer alternative livelihood to local communities.

Keywords: biodiversity, ecosystem, conservation, fisheries

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Authors: Benjamin J. Kuo, Silvia D. Vaca, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Lydia Nanjula, Christine Muhumuza, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

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Background: Traumatic Brain Injury (TBI) is disproportionally concentrated in low- and middle-income countries (LMICs), with the odds of dying from TBI in Uganda more than 4 times higher than in high income countries (HICs). The disparities in the injury incidence and outcome between LMICs and resource-rich settings have led to increased health outcomes research for TBIs and their associated risk factors in LMICs. While there have been increasing TBI studies in LMICs over the last decade, there is still a need for more robust prospective registries. In Uganda, a trauma registry implemented in 2004 at the Mulago National Referral Hospital (MNRH) showed that RTI is the major contributor (60%) of overall mortality in the casualty department. While the prior registry provides information on injury incidence and burden, it’s limited in scope and doesn’t follow patients longitudinally throughout their hospital stay nor does it focus specifically on TBIs. And although these retrospective analyses are helpful for benchmarking TBI outcomes, they make it hard to identify specific quality improvement initiatives. The relationship among epidemiology, patient risk factors, clinical care, and TBI outcomes are still relatively unknown at MNRH. Objective: The objectives of this study are to describe the processes of care and determine risk factors predictive of poor outcomes for TBI patients presenting to a single tertiary hospital in Uganda. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Research Electronic Data Capture (REDCap) was used to systematically collect variables spanning 8 categories. Univariate and multivariate analysis were conducted to determine significant predictors of mortality. Results: 563 TBI patients were enrolled from 1 June – 30 November 2016. 102 patients (18%) received surgery, 29 patients (5.1%) intended for surgery failed to receive it, and 251 patients (45%) received non-operative management. Overall mortality was 9.6%, which ranged from 4.7% for mild and moderate TBI to 55% for severe TBI patients with GCS 3-5. Within each TBI severity category, mortality differed by management pathway. Variables predictive of mortality were TBI severity, more than one intracranial bleed, failure to receive surgery, high dependency unit admission, ventilator support outside of surgery, and hospital arrival delayed by more than 4 hours. Conclusions: The overall mortality rate of 9.6% in Uganda for TBI is high, and likely underestimates the true TBI mortality. Furthermore, the wide-ranging mortality (3-82%), high ICU fatality, and negative impact of care delays suggest shortcomings with the current triaging practices. Lack of surgical intervention when needed was highly predictive of mortality in TBI patients. Further research into the determinants of surgical interventions, quality of step-up care, and prolonged care delays are needed to better understand the complex interplay of variables that affect patient outcome. These insights guide the development of future interventions and resource allocation to improve patient outcomes.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

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Authors: Arya S. S.

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India is one of the powerful country in the world .India and Maldives having common interests in regional security and economic growth, this relationship has seen substantial change in recent years. This paper examines the complex dynamics of this bilateral relationship, emphasizing the careful balancing act that both countries perform in order to advance regional prosperity. It looks at historical connections, geopolitical factors, and current issues like economic cooperation, climate change, and marine security. The study highlights how India's involvement in the Maldives contributes to both bilateral ties and regional stability by examining important initiatives including trade agreements and infrastructure projects. It also discusses the effects of outside factors and the necessity for both nations to strategically manage their interests. In order to contribute to a more affluent and stable Indian Ocean area, this study ultimately seeks to shed light on how India and the Maldives may cooperate to promote sustainable development while tackling security issues. The India Maldives relation is very crucial in the regional stability of Indian ocean region. The initiatives like building infrastructure, giving financial support, and establishing the India-Maldives Friendship Bridge demonstrate India's dedication to Maldivian prosperity. In addition to boosting the Maldives' economy, these investments strengthen India's clout in the area, which is essential for preserving its maritime security interests in the face of growing Chinese dominance. Both India and China involved in a strategic tug of war in order to enhance their dominance in Maldives. There are difficulties with this collaboration including, political unrest in the Maldives has occasionally resulted in changes to foreign policy, particularly under regimes that support stronger ties with China. India has expressed concern about losing strategic footholds in the Indian Ocean as a result of China's extension of influence through debt diplomacy and infrastructure projects. India must therefore strike a balance between advancing its objectives and upholding Maldivian sovereignty as well as the goals of its people and government. In summary, the partnership between India and the Maldives is a complex balancing act that is marked by cultural links, security cooperation, and economic dependency. Both countries must negotiate the complexity of international relations as they work for regional prosperity, especially in light of both internal and external factors. India and the Maldives can strengthen their positions as key actors in the changing dynamics of the Indian Ocean by promoting cooperation and communication. This would not only protect their particular interests but also help create a stable and prosperous South Asian region.

Keywords: regional security, balancing act, debt trap diplomacy, strategic tug of war

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