Search results for: institutional memory

Authors: G. Barański, P. Kacejko, M. Wendeker

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The impact of the ignition advance control algorithms of the ASz-62IR-16X aircraft piston engine on a combustion process has been presented in this paper. This aircraft engine is a nine-cylinder 1000 hp engine with a special electronic control ignition system. This engine has two spark plugs per cylinder with an ignition advance angle dependent on load and the rotational speed of the crankshaft. Accordingly, in most cases, these angles are not optimal for power generated. The scope of this paper is focused on developing algorithms to control the ignition advance angle in an electronic ignition control system of an engine. For this type of engine, i.e. radial engine, an ignition advance angle should be controlled independently for each cylinder because of the design of such an engine and its crankshaft system. The ignition advance angle is controlled in an open-loop way, which means that the control signal (i.e. ignition advance angle) is determined according to the previously developed maps, i.e. recorded tables of the correlation between the ignition advance angle and engine speed and load. Load can be measured by engine crankshaft speed or intake manifold pressure. Due to a limited memory of a controller, the impact of other independent variables (such as cylinder head temperature or knock) on the ignition advance angle is given as a series of one-dimensional arrays known as corrective characteristics. The value of the ignition advance angle specified combines the value calculated from the primary characteristics and several correction factors calculated from correction characteristics. Individual cylinder control can proceed in line with certain indicators determined from pressure registered in a combustion chamber. Control is assumed to be based on the following indicators: maximum pressure, maximum pressure angle, indicated mean effective pressure. Additionally, a knocking combustion indicator was defined. Individual control can be applied to a single set of spark plugs only, which results from two fundamental ideas behind designing a control system. Independent operation of two ignition control systems – if two control systems operate simultaneously. It is assumed that the entire individual control should be performed for a front spark plug only and a rear spark plug shall be controlled with a fixed (or specific) offset relative to the front one or from a reference map. The developed algorithms will be verified by simulation and engine test sand experiments. This work has been financed by the Polish National Centre for Research and Development, INNOLOT, under Grant Agreement No. INNOLOT/I/1/NCBR/2013.

Keywords: algorithm, combustion process, radial engine, spark plug

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Authors: Spencer Liu, William Chan, Marlena Komatz, Tommy Ramos, Mark Trentalange, Faye Rim, Dae Kim, Mary Kelly, Samuel Schuessler, Roberta Stack, Justas Lauzadis, Kathryn DelPizzo, Seth Waldman, Alexandra Sideris

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Background & Significance: The increasing prevalence of cannabis use in the United States has important safety considerations in the perioperative setting, as chronic or heavy preoperative cannabis use may increase the risk of intraoperative complications, postoperative nausea and vomiting (PONV), increased postoperative pain levels, and acute side effects associated with cannabis use cessation. In this retrospective chart review study, we sought to determine the prevalence of self-reported cannabis use in the past 5-years at a single institution in New York City. We hypothesized that there is an increasing prevalence of preoperative self-reported cannabis use among adult and adolescent patients undergoing orthopedic surgery. Methods: After IRB approval for this retrospective study, surgical cases performed on patients 12 years of age and older at the hospital’s main campus and two ambulatory surgery centers between January 1st, 2018, and December 31st, 2023, with preoperatively self-disclosed cannabis use entered in the social history intake form were identified using the tool SlicerDicer in Epic. Case and patient characteristics were extracted, and trends in utilization over time were assessed by the Cochran-Armitage trend test. Results: Overall, the prevalence of self-reported cannabis use increased from 6.6% in 2018 to 10.6% in 2023. By age group, the prevalence of self-reported cannabis use among adolescents remained consistently low (2018: 2.6%, 2023: 2.6%) but increased with significant evidence for a linear trend (p < 0.05) within every adult age group. Among adults, patients who were 18-24 years old (2018: 18%, 2023: 20.5%) and 25-34 years old (2018: 15.9%, 2023: 24.2%) had the highest prevalences of disclosure, whereas patients who were 75 years of age or older had the lowest prevalence of disclosure (2018: 1.9%, 2023: 4.6%). Patients who were 25-34 years old had the highest percent difference in disclosure rates of 8.3%, which corresponded to a 52.2% increase from 2018 to 2023. The adult age group with the highest percent change was patients who were 75 years of age or older, with a difference of 2.7%, which corresponded to a 142.1% increase from 2018 to 2023. Conclusions: These trends in preoperative self-reported cannabis use among patients undergoing orthopedic surgery have important implications for perioperative care and clinical outcomes. Efforts are underway to refine and standardize cannabis use data capture at our institution.

Keywords: orthopedic surgery, cannabis, postoperative pain, postoperative nausea

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Authors: Binaya Tamang, Buddhi R. Pokharel, Narayan Gautam, Puspa R. Dhakal, Yuresh Twayana

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Background and Objective: Microalbuminuria is often regarded as a sign of end-organ damage due to hypertension, with an increased risk for renal diseases. The present study was designed to find the prevalence of microalbuminuria in hypertensive patients by determining albumin creatinine ratio (ACR) and the association of ACR and microalbuminuria status with different stages and duration of hypertension (HTN). Also, to establish the correlation of systolic and diastolic blood pressure (SBP and DBP) with various parameters viz; ACR, urinary microalbumin (UMA), estimated glomerular filtration rate (eGFR), urinary creatinine (Ucreat), serum creatinine (Screat), and find out their significance among HTN and ACR status. Materials and Methods: A hospital-based cross-sectional study was conducted in the Department of Biochemistry in collaboration with the Department of Internal Medicine, UCMS, Bhairahawa, Nepal from April 2019 to September 2019 after obtaining ethical approval from institutional review committee (IRC), UCMS. A total of 120 hypertensive patients were enrolled whose blood, and spot urine samples were taken. eGFR was calculated by using Cockcroft-Gault formula after determining Screat while ACR was calculated after measuring Ucreat and UMA from the spot urine sample. Creatinine was estimated from modified jaffes’ reaction, whereas urinary micro albumin was done by Mispa i3 analyzer. Data were analyzed by using SPSS. 20 using p-value ≤ 0.05 as statistically significant. Results: In our study, the highest enrolled were grade II HTN (36.7%) followed by normal (33.3%), grade I (20.8%) and grade III (9.2%). Evaluating the ACR status, 19.2% were microalbuminuria, and the rest were normal. Though the ACR status (normal and microalbuminuria) was not statistically significant with HTN status (P=0.860) and the duration of HTN status (P=0.165), 5 (45.5%) out of 11 grade III HTN were microalbuminuria and the prevalence was also higher for longer duration .i.e., more than 10 years. In microalbuminuria, both the SBP (p=0.023, r=0.471) and DBP (P=0.034, r= 0.444) were strongly and positively correlated with Screat, in contrast to eGFR, which was negatively but weakly correlated. With the significant difference between the HTN group, the mean ACR (P=0.047) and UMA (P=0.02) were found to be highest among grade III patients, i.e., 84.3 ± 113.3 mg/gm. and 88.4 ± 83.9 mg/l respectively. The mean eGFR (64.2 ± 24.8 vs 77.2 ± 18.1 ml/min) was considerably lower in microalbuminuria ( p=0.026) than the normal in contrast to the SBP (160 ± 33.7 vs. 146.6 ± 19.5 mm of Hg) which was significantly higher (P=0.008). Among the different BMI category, the mean ACR was found to be significantly different (P= 0.01) with the highest value in underweight (115.2 ± 51.5 mg/gm.) and lowest in overweight (31.8 ± 4.3 mg/gm.). Conclusion: The study recommends that the microalbuminuria can be a very useful and imperative predictor of deranged kidney functions in hypertensive patients. The high value of ACR and UMA in hypertensive patients along with significant increased Screat, SBP whereas decreased eGFR in microalbuminuria patients explicitly supports the above statement.

Keywords: albumin creatinine ratio, hypertension, microalbuminuria, renal disease

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Authors: Harini Atturu, Divyani Byagari, Bindhu Rani Thumkunta, Sahitya Bammidi, Manasa Badveli

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Introduction: Biological, psychological and social domains influence the outcomes of pregnancy. The COVID19 pandemic had a significant effect on the psychological and social domains of pregnant women all over the world. Everyone has inherent coping mechanisms which ultimately determine the actual impact of such external stimulus on outcomes of pregnancy. This study aims to understand the coping strategies used by pregnant women to overcome the psychological impact of the first wave of the COVID 19 pandemic. Methods: Institutional ethics permission was sought. All pregnant women attending antenatal clinics in the institution during September 2020 were included in the study. Brief-COPE, a self-rated questionnaire, was provided to understand the coping strategies used by them. The Questionnaire consists of 28 questions that fall into 14 themes. These 14 themes were mapped into four domains consisting of Approaching coping (APC) styles, Avoidant Coping (AVC) styles, Humor and Religion. The results were analyzed using univariate and multivariate analysis. Factor analysis was performed to identify themes that are most frequently used. Results: 162 pregnant women were included in the study. The majority of the women were aged between 18 and 30 (90.1%). 60.9% of the respondents were having their first pregnancy and were in the 2nd trimester (59.6%). The majority of them were living in the city (74%), belonged to the middle class (77.6%) and were not working (70.1%). 56 respondents (34.6%) reported that they had contact with suspected or Covid positive patients. Many were worried that their pregnancy might be complicated (43%), their baby may contract COVID (45%) and their family members could get COVID during the hospital visits for antenatal check-ups. 33.6% of women admitted missing their regular antenatal check-ups because of the above concerns. All respondents used various coping strategies to overcome the psychological impact of COVID 19. Out of the 4 coping strategies, participants scored high on Religion with a mean of 5.471.45 followed by Approaching Coping (APC) styles (5.131.25), Humor (4.592.07) and Avoidant Coping (AVC) styles (4.130.88). Religion as a coping strategy scored high for all respondents irrespective of age, parity, trimester, social and employment status. Exploratory Factor analysis revealed two cluster groups that explained 68% of the variance, with Component 1 contributing to 58.9% and component 2 contributing 9.13% of the variance. Humor, Acceptance, Planning, and Religion were the top 4 factors that showed strong loadings. Conclusion: Most of the pregnant women were worried about the negative impact of COVID 19 on the outcomes of their pregnancy. Religion and Approaching coping styles seem to be the predominant coping strategies used by them. Interventionists and policymakers should consider these factors while providing support to such women.

Keywords: coping strategies, pregnancy, COVID-19, brief-COPE

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Authors: Mustafa Metin Donma, Orkide Donma

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Obesity in children particularly draws attention because it may threaten the individual’s future life due to many chronic diseases it may lead to. Most of these diseases, including obesity itself altogether are related to inflammation. For this reason, inflammation-related parameters gain importance. Within this context, complete blood cell counts, ratios or indices derived from these counts have recently found some platform to be used as inflammatory markers. So far, mostly adipokines were investigated within the field of obesity. The liver is at the center of the metabolic pathways network. Metabolic inflammation is closely associated with cellular dysfunction. In this study, hematologic inflammatory markers and two major hepatokines, cytokines produced predominantly by the liver, fibroblast growth factor-21 (FGF-21) and fetuin A were investigated in pediatric obesity. Two groups were constituted from seventy-six obese children based on World Health Organization criteria. Group 1 was composed of children whose age- and sex-adjusted body mass index (BMI) percentiles were between 95 and 99. Group 2 consists of children who are above the 99ᵗʰ percentile. The first and the latter groups were defined as obese (OB) and morbid obese (MO). Anthropometric measurements of the children were performed. Informed consent forms and the approval of the institutional ethics committee were obtained. Blood cell counts and ratios were determined by an automated hematology analyzer. The related ratios and indexes were calculated. Statistical evaluation of the data was performed by the SPSS program. There was no statistically significant difference in terms of neutrophil-to lymphocyte ratio, monocyte-to-high density lipoprotein cholesterol ratio and the platelet-to-lymphocyte ratio between the groups. Mean platelet volume and platelet distribution width values were decreased (p<0.05), total platelet count, red cell distribution width (RDW) and systemic immune inflammation index values were increased (p<0.01) in MO group. Both hepatokines were increased in the same group; however, increases were not statistically significant. In this group, also a strong correlation was calculated between FGF-21 and RDW when controlled by age, hematocrit, iron and ferritin (r=0.425; p<0.01). In conclusion, the association between RDW, a hematologic inflammatory marker, and FGF-21, an inflammation-related hepatokine, found in MO group is an important finding discriminating between OB and MO children. This association is even more powerful when controlled by age and iron-related parameters.

Keywords: childhood obesity, fetuin A , fibroblast growth factor-21, hematologic markers, red cell distribution width

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Authors: Kollie B. Dogba, Willis Oluoch-Kosura, Chepchumba Chumo

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In Liberia, many of the agricultural households cultivate cassava for either sustenance purposes, or to generate farm income. Many of the concentrated cassava farmers reside in Nimba, a north-eastern County that borders two other economies: the Republics of Cote D’Ivoire and Guinea. With a high demand for cassava output and products in emerging Asian markets coupled with an objective of the Liberia agriculture policies to increase the competitiveness of valued agriculture crops; there is a need to examine the level of resource-use efficiency for many agriculture crops. However, there is a scarcity of information on the efficiency of many agriculture crops, including cassava. Hence the study applying an output-oriented method seeks to assess the economic efficiency of cassava farmers in Nimba County, Liberia. A multi-stage sampling technique was employed to generate a sample for the study. From 216 cassava farmers, data related to on-farm attributes, socio-economic and institutional factors were collected. The stochastic frontier models, using the Translog functional forms, of production and revenue, were used to determine the level of revenue efficiency and its determinants. The result showed that most of the cassava farmers are male (60%). Many of the farmers are either married, engaged or living together with a spouse (83%), with a mean household size of nine persons. Farmland is prevalently obtained by inheritance (95%), average farm size is 1.34 hectares, and most cassava farmers did not access agriculture credits (76%) and extension services (91%). The mean cassava output per hectare is 1,506.02 kg, which estimates average revenue of L$23,551.16 (Liberian dollars). Empirical results showed that the revenue efficiency of cassava farmers varies from 0.1% to 73.5%; with the mean revenue efficiency of 12.9%. This indicates that on average, there is a vast potential of 87.1% to increase the economic efficiency of cassava farmers in Nimba by improving technical and allocative efficiencies. For the significant determinants of revenue efficiency, age and group membership had negative effects on revenue efficiency of cassava production; while farming experience, access to extension, formal education, and average wage rate have positive effects. The study recommends the setting-up and incentivizing of farmer field schools for cassava farmers to primarily share their farming experiences with others and to learn robust cultivation techniques of sustainable agriculture. Also, farm managers and farmers should consider a fix wage rate in labor contracts for all stages of cassava farming.

Keywords: economic efficiency, frontier production and revenue functions, Nimba County, Liberia, output-oriented approach, revenue efficiency, sustainable agriculture

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Authors: Felicia N. Obialo, Aliza Wingo, Thomas Wingo

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Psychosocial factors such as personality traits and social networks influence cognitive aging and dementia outcomes both positively and negatively. The inherent complexity of these factors makes defining the underlying mechanisms of their influence difficult; however, exploring their interactions affords promise in the field of cognitive aging. The objective of this study was to elucidate some of these interactions by determining the relationship between social network size and dementia outcomes and by determining whether personality traits mediate this relationship. The longitudinal Alzheimer’s Disease (AD) database provided by Rush University’s Religious Orders Study/Memory and Aging Project was utilized to perform retrospective regression and mediation analyses on 3,591 participants. Participants who were cognitively impaired at baseline were excluded, and analyses were adjusted for age, sex, common chronic diseases, and vascular risk factors. Dementia outcome measures included cognitive trajectory, clinical dementia diagnosis, and postmortem beta-amyloid plaque (AB), and neurofibrillary tangle (NT) accumulation. Personality traits included agreeableness (A), conscientiousness (C), extraversion (E), neuroticism (N), and openness (O). The results show a positive correlation between social network size and cognitive trajectory (p-value = 0.004) and a negative relationship between social network size and odds of dementia diagnosis (p = 0.024/ Odds Ratio (OR) = 0.974). Only neuroticism mediates the positive relationship between social network size and cognitive trajectory (p < 2e-16). Agreeableness, extraversion, and neuroticism all mediate the negative relationship between social network size and dementia diagnosis (p=0.098, p=0.054, and p < 2e-16, respectively). All personality traits are independently associated with dementia diagnosis (A: p = 0.016/ OR = 0.959; C: p = 0.000007/ OR = 0.945; E: p = 0.028/ OR = 0.961; N: p = 0.000019/ OR = 1.036; O: p = 0.027/ OR = 0.972). Only conscientiousness and neuroticism are associated with postmortem AD pathologies; specifically, conscientiousness is negatively associated (AB: p = 0.001, NT: p = 0.025) and neuroticism is positively associated with pathologies (AB: p = 0.002, NT: p = 0.002). These results support the study’s objectives, demonstrating that social network size and personality traits are strongly associated with dementia outcomes, particularly the odds of receiving a clinical diagnosis of dementia. Personality traits interact significantly and beneficially with social network size to influence the cognitive trajectory and future dementia diagnosis. These results reinforce previous literature linking social network size to dementia risk and provide novel insight into the differential roles of individual personality traits in cognitive protection.

Keywords: Alzheimer’s disease, cognitive trajectory, personality traits, social network size

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Authors: Shahzad A. Mughal, Ameer A. P. Ghaloo, Faisal Laghari, Mohsin A. Mirza

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Job satisfaction and level of job stressors among employees of a university are considered as essential factors responsible for institutional success. Job satisfaction is usually believed as a single baseline variable for the evaluation of a university human resource area. The objectives of this study were to assess the level of job satisfaction and influence of job stressors among university teachers and their association with long term physical health of the employees in government sector universities in Pakistan. A cross-sectional study was conducted on university employees including faculty members and administrative staff of three government sector universities in Sindh province of Pakistan who have completed at least ten years of their job. The study period was six months. All the employees were randomly selected. The job satisfaction scale Questionnaire with yes and no options, together with questions regarding demographic factors, job stress or other working factors and physical health issues were administered in questionnaires. These questionnaires were handed out to 100 faculty members of both genders with permanent job and 50 non faculty staff of grade 17 and above with permanent employment status. Students’ T test and one way ANOVA was applied to categorical variables and Pearson’s correlation analysis was performed to evaluate the correlations between study variables. 121 successful responses were obtained (effective respondent rate 80.6%). The average score of overall job satisfaction was 65.6%. Statistical analysis revealed that the job satisfaction and work related stressors had negative impact on overall health status of the employees with resultant less efficacy and mental stress. The positive relation was perceived by employees for organizational support and high income with job satisfaction. Demographic features such as age and female gender were also linked to the level of job satisfaction and health related issues. The total variation among all responses regarding correlation between job satisfaction job stressors and health related issues was 55%. A study was conducted on University employees of government sector Universities in Pakistan, regarding association of job satisfaction and job stressors with long term physical health of the employees. Study revealed a moderate level of job satisfaction among the employees of all universities included in this study. Attitude and personal relations with heads of the departments and institution along with salary packages were considered as biggest job stressors related correlated directly with physical health. Demographic features and gender were associated factors for job satisfaction. Organizational support was the strongest factor for job satisfaction and results pointed out that by improving support level from University may improve the quality of job satisfaction and overall health of employees.

Keywords: job satisfaction, organizational support, physical health, university employees

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Authors: Yuan-Hao Lee, Chia-Wei Lee, Ming-Fang Lin, Tzu-Huei Wu, Chih-Hsiang Ko, Wing P. Chan

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Computed tomography (CT) scan of the head is a good method for investigating cranial lesions. However, radiation-induced oxidative stress can be accumulated in the eyes and promote carcinogenesis and cataract. In this regard, we aimed to protect the eyes with barium sulfate shield(s) during CT scans and investigate the resultant image quality and radiation dose to the eye. Patients who underwent health examinations were selectively enrolled in this study in compliance with the protocol approved by the Ethics Committee of the Joint Institutional Review Board at Taipei Medical University. Participants’ brains were scanned with a water-based marker simultaneously by a multislice CT scanner (SOMATON Definition Flash) under a fixed tube current-time setting or automatic tube current modulation (TCM). The lens dose was measured by Gafchromic films, whose dose response curve was previously fitted using thermoluminescent dosimeters, with or without barium sulfate or bismuth-antimony shield laid above. For the assessment of image quality CT images at slice planes that exhibit the interested regions on the zygomatic, orbital and nasal bones of the head phantom as well as the water-based marker were used for calculating the signal-to-noise and contrast-to-noise ratios. The application of barium sulfate and bismuth-antimony shields decreased 24% and 47% of the lens dose on average, respectively. Under topogram-based TCM, the dose saving power of bismuth-antimony shield was mitigated whereas that of barium sulfate shield was enhanced. On the other hand, the signal-to-noise and contrast-to-noise ratios of DSCT images were decreased separately by barium sulfate and bismuth-antimony shield, resulting in an overall reduction of the CNR. In contrast, the integration of topogram-based TCM elevated signal difference between the ROIs on the zygomatic bones and eyeballs while preferentially decreasing the signal-to-noise ratios upon the use of barium sulfate shield. The results of this study indicate that the balance between eye exposure and image quality can be optimized by combining eye shields with topogram-based TCM on the multislice scanner. Eye shielding could change the photon attenuation characteristics of tissues that are close to the shield. The application of both shields on eye protection hence is not recommended for seeking intraorbital lesions.

Keywords: computed tomography, barium sulfate shield, dose saving, image quality

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Authors: Salamah Ansari

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In absence of a comprehensive international legal regime for sovereign debt restructuring, majority of the complications arising from sovereign debt restructuring are frequently left to the uncertain market forces. The resort to market forces for sovereign debt restructuring has led to a phenomenal increase in litigations targeting assets of defaulting sovereign nations, internationally across jurisdictions with the first major wave of lawsuits against sovereigns in the 1980s with the Latin American crisis. Recent experiences substantiate that majority of obstacles faced during sovereign debt restructuring process are caused by inefficient creditor coordination and collective action problems. Collective action problems manifest as grab race, rush to exits, holdouts, the free rider problem and the rush to the courthouse. On defaulting, for a nation to successfully restructure its debt, all the creditors involved must accept some reduction in the value of their claims. As a single holdout creditor has the potential to undermine the restructuring process, hold-out creditors are snowballing with the increasing probability of earning high returns through litigations. This necessitates a mechanism to avoid holdout litigations and reinforce collective action on the part of the creditor. This can be done either through a statutory reform or through market-based contractual approach. In absence of an international sovereign bankruptcy regime, the impetus is mostly on inclusion of collective action clauses in debt contracts. The preference to contractual mechanisms vis- a vis a statutory approach can be explained with numerous reasons, but that's only part of the puzzle in trying to understand the economics of the underlying system. The contractual approach proposals advocate the inclusion of certain clauses in the debt contract for an orderly debt restructuring. These include clauses such as majority voting clauses, sharing clauses, non- acceleration clauses, initiation clauses, aggregation clauses, temporary stay on litigation clauses, priority financing clauses, and complete revelation of relevant information. However, voluntary market based contractual approach to debt workouts has its own complexities. It is a herculean task to enshrine clauses in debt contracts that are detailed enough to create an orderly debt restructuring mechanism while remaining attractive enough for creditors. Introduction of collective action clauses into debt contracts can reduce the barriers in efficient debt restructuring and also have the potential to improve the terms on which sovereigns are able to borrow. However, it should be borne in mind that such clauses are not a panacea to the huge institutional inadequacy that persists and may lead to worse restructuring outcomes.

Keywords: sovereign debt restructuring, collective action clauses, hold out creditors, litigations

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Authors: R. Tariq, R. Lee

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Background: Additional demands placed on senior clinical teams with ongoing COVID-19 management has accelerated the need to harness the wider healthcare professional resources and upskill them to take on greater clinical responsibility safely. The UK NHS Long Term Plan (2019)¹ emphasises the importance of expanding Advanced Practitioners’ (APs) roles to take on more clinical diagnostic responsibilities to cope with increased demand. In acute settings, APs are often the first point of care for patients and require training to take on initial triage responsibilities efficiently and safely. Critically, their roles include determining which onward services the patients may require, and assessing whether they can be treated at home, avoiding unnecessary admissions to the hospital. Dem Dx is a Clinical Reasoning Platform (CRP) that claims to help frontline healthcare professionals independently assess and triage patients. It guides the clinician from presenting complaints through associated symptoms to a running list of differential diagnoses, media, national and institutional guidelines. The objective of this study was to compare the clinical referral rates and guidelines adherence registered by the HMR Urgent Community Care Team (UCCT)² and Dem Dx recommendations using retrospective cases. Methodology: 192 cases seen by the UCCT were anonymised and reassessed using Dem Dx clinical pathways. We compared the UCCT’s performance with Dem Dx regarding the appropriateness of onward referrals. We also compared the clinical assessment regarding adherence to NICE guidelines recorded on the clinical notes and the presence of suitable guidance in each case. The cases were audited by two medical doctors. Results: Dem Dx demonstrated appropriate referrals in 85% of cases, compared to 47% in the UCCT team (p<0.001). Of particular note, Dem Dx demonstrated an almost 65% (p<0.001) improvement in the efficacy and appropriateness of referrals in a highly experienced clinical team. The effectiveness of Dem Dx is in part attributable to the relevant NICE and local guidelines found within the platform's pathways and was found to be suitable in 86% of cases. Conclusion: This study highlights the potential of clinical decision support, as Dem Dx, to improve the quality of onward clinical referrals delivered by a multidisciplinary team in primary care. It demonstrated that it could support healthcare professionals in making appropriate referrals, especially those that may be overlooked by providing suitable clinical guidelines directly embedded into cases and clear referral pathways. Further evaluation in the clinical setting has been planned to confirm those assumptions in a prospective study.

Keywords: advanced practitioner, clinical reasoning, clinical decision-making, management, multidisciplinary team, referrals, triage

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Authors: Nivedhitha Venkatakrishnan

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Flooding in urban areas in India has become a usual ritual phenomenon and a nightmare to most cities, which is a consequence of man-made disruption resulting in disaster. The City planning in India falls short of withstanding hydro generated disasters. This has become a barrier and challenge in the process of development put forth by urbanization, high population density, expanding informal settlements, environment degradation from uncollected and untreated waste that flows into natural drains and water bodies, this has disrupted the natural mechanism of hazard protection such as drainage channels, wetlands and floodplains. The magnitude and the impact of the mishap was high because of the failure of development policies, strategies, plans that the city had adopted. In the current scenario, cities are becoming the home for future, with economic diversification bringing in more investment into cities especially in domains of Urban infrastructure, planning and design. The uncertainty of the Urban futures in these low elevated coastal zones faces an unprecedented risk and threat. The study on focuses on three major pillars of resilience such as Recover, Resist and Restore. This process of getting ready to handle the situation bridges the gap between disaster response management and risk reduction requires a shift in paradigm. The study involved a qualitative research and a system design approach (framework). The initial stages involved mapping out of the urban water morphology with respect to the spatial growth gave an insight of the water bodies that have gone missing over the years during the process of urbanization. The major finding of the study was missing links between traditional water harvesting network was a major reason resulting in a manmade disaster. The research conceptualized the ideology of a sponge city framework which would guide the growth through institutional frameworks at different levels. The next stage was on understanding the implementation process at various stage to ensure the shift in paradigm. Demonstration of the concepts at a neighborhood level where, how, what are the functions and benefits of each component. Quantifying the design decision with rainwater harvest, surface runoff and how much water is collected and how it could be collected, stored and reused. The study came with further recommendation for Water Mitigation Spaces that will revive the traditional harvesting network.

Keywords: flooding, man made disaster, resilient city, traditional harvesting network, waterbodies

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Authors: Erick C. Valverde, Wansu Lim

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Facial emotion recognition (FER) system has been recently developed for more advanced computer vision applications. The ability to identify human emotions would enable smart healthcare facility to diagnose mental health illnesses (e.g., depression and stress) as well as better human social interactions with smart technologies. The FER system involves two steps: 1) face detection task and 2) facial emotion recognition task. It classifies the human expression in various categories such as angry, disgust, fear, happy, sad, surprise, and neutral. This system requires intensive research to address issues with human diversity, various unique human expressions, and variety of human facial features due to age differences. These issues generally affect the ability of the FER system to detect human emotions with high accuracy. Early stage of FER systems used simple supervised classification task algorithms like K-nearest neighbors (KNN) and artificial neural networks (ANN). These conventional FER systems have issues with low accuracy due to its inefficiency to extract significant features of several human emotions. To increase the accuracy of FER systems, deep learning (DL)-based methods, like convolutional neural networks (CNN), are proposed. These methods can find more complex features in the human face by means of the deeper connections within its architectures. However, the inference speed and computational costs of a DL-based FER system is often disregarded in exchange for higher accuracy results. To cope with this drawback, an optimized DL-based FER system is proposed in this study.An extreme version of Inception V3, known as Xception model, is leveraged by applying different network optimization methods. Specifically, network pruning and quantization are used to enable lower computational costs and reduce memory usage, respectively. To support low resource requirements, a 68-landmark face detector from Dlib is used in the early step of the FER system.Furthermore, a DL compiler is utilized to incorporate advanced optimization techniques to the Xception model to improve the inference speed of the FER system. In comparison to VGG-Net and ResNet50, the proposed optimized DL-based FER system experimentally demonstrates the objectives of the network optimization methods used. As a result, the proposed approach can be used to create an efficient and real-time FER system.

Keywords: deep learning, face detection, facial emotion recognition, network optimization methods

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Authors: Jovana Vukcevic, Sanja Pekovic, Djurdjica Perovic, Tatjana Stanovcic

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This paper presents a critical inquiry into the role of uncomfortable heritage in nation branding with the particular focus on the specificities of the politics of memory, forgetting and revisionism in the post-communist post-Yugoslavia. It addresses legacies of unwanted, ambivalent or unacknowledged past and different strategies employed by the former-Yugoslav states and private actors in “rebranding” their heritage, ensuring its preservation, but re-contextualizing the narrative of the past through contemporary tourism practices. It questions the interplay between nostalgia, heritage and market, and the role of heritage in polishing the history of totalitarian and authoritarian regimes in the Balkans. It argues that in post-socialist Yugoslavia, the necessity to limit correlations with former ideology and the use of the commercial brush in shaping a marketable version of the past instigated the emergence of the profit-oriented heritage practices. Building on that argument, the paper addresses these issues as “commodification” and “disneyfication” of Balkans’ ambivalent heritage, contributing to the analysis of changing forms of memorialisation and heritagization practices in Europe. It questions the process of ‘coming to terms with the past’ through marketable forms of heritage tourism, fetching the boundary between market-driven nostalgia and state-imposed heritage policies. In order to analyse plurality of ways of dealing with controversial, ambivalent and unwanted heritage of dictatorships in the Balkans, the paper considers two prominent examples of heritage commodification in Serbia and Montenegro, and the re-appropriations of those narratives for the nation branding purposes. The first one is the story of the Tito’s Blue Train, the landmark of the socialist past and the symbol of Yugoslavia which has nowadays being used for birthday parties and marriage celebrations, while the second emphasises the unusual business arrangement turning the fortress Mamula, former concentration camp through the Second World War, into a luxurious Mediterranean resort. Questioning how the ‘uneasy’ past was acknowledged and embedded into the official heritage institutions and tourism practices, study examines the changing relation towards the legacies of dictatorships, inviting us to rethink the economic models of the things past. Analysis of these processes should contribute to better understanding of the new mnemonics strategies and (converging?) ways of ‘doing’ past in Europe.

Keywords: commodification, heritage tourism, totalitarianism, Serbia, Montenegro

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Authors: Grace C. Kuroki, Yixin Hu, Bailey Surtees, Rebecca Krimins, Nicholas J. Durr, Dara L. Kraitchman

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The purpose of this study was to perform a Phase I veterinary clinical trial with a low-cost, carbon-dioxide-based, passive thaw cryoablation device as proof-of-principle for application in pets and translation to third-world treatment of breast cancer. This study was approved by the institutional animal care and use committee. Client-owned dogs with subcutaneous masses, primarily lipomas or mammary cancers, were recruited for the study. Inclusion was based on clinical history, lesion location, preanesthetic blood work, and fine needle aspirate or biopsy confirmation of mass. Informed consent was obtained from the owners for dogs that met inclusion criteria. Ultrasound assessment of mass extent was performed immediately prior to mass cryoablation. Dogs were placed under general anesthesia and sterilely prepared. A stab incision was created to insert a custom 4.19 OD x 55.9 mm length cryoablation probe (Kubanda Cryotherapy) into the mass. Originally designed for treating breast cancer in low resource settings, this device has demonstrated potential in effectively necrosing subcutaneous masses. A dose escalation study of increasing freeze-thaw cycles (5/4/5, 7/5/7, and 10/7/10 min) was performed to assess the size of the iceball/necrotic extent of cryoablation. Each dog was allowed to recover for ~1-2 weeks before surgical removal of the mass. A single mass was treated in seven dogs (2 mammary masses, a sarcoma, 4 lipomas, and 1 adnexal mass) with most masses exceeding 2 cm in any dimension. Mass involution was most evident in the malignant mammary and adnexal mass. Lipomas showed minimal shrinkage prior to surgical removal, but an area of necrosis was evident along the cryoablation probe path. Gross assessment indicated a clear margin of cryoablation along the cryoprobe independent of tumor type. Detailed histopathology is pending, but complete involution of large lipomas appeared to be unlikely with a 10/7/10 protocol. The low-cost, carbon dioxide-based cryotherapy device permits a minimally invasive technique that may be useful for veterinary applications but is also informative of the unlikely resolution of benign adipose breast masses that may be encountered in third world countries.

Keywords: cryoablation, cryotherapy, interventional oncology, veterinary technology

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Authors: El Khaddam Safaa, Soulaymani Abdelmajid, Mokhtari Abdelghani, Ouammi Lahcen, Rachida Soulaymani-Beincheikh

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The poisonings represent a problem of health in the world and Morocco, The exact dimensions of this phenomenon are still poorly recorded that we see the lack of exhaustive statistical data. The objective of this retrospective study of a series of cases of the poisonings declared at the level of the region of Tadla-Azilal and collected by the Moroccan Poison Control and Pharmacovigilance Center. An epidemiological profile of the poisonings was to raise, to determine the risk factors influencing the vital preview of the poisoned And to follow the evolution of the incidence, the lethality, and the mortality. During the period of study, we collected and analyzed 9303 cases of poisonings by different incriminated toxic products with the exception of the scorpion poisonings. These poisonings drove to 99 deaths. The epidemiological profile which we raised, showed that the poisoned were of any age with an average of 24.62±16.61 years, The sex-ratio (woman/man) was 1.36 in favor of the women. The difference between both sexes is highly significant (χ2 = 210.5; p<0,001). Most of the poisoned which declared to be of urban origin (60.5 %) (χ2=210.5; p<0,001). Carbon monoxide was the most incriminated among the cases of poisonings (24.15 %), them putting in head, followed by some pesticides and farm produces (21.44 %) and food (19.95 %). The analysis of the risk factors showed that the grown-up patients whose age is between 20 and 74 years have twice more risk of evolving towards the death (RR=1,57; IC95 % = 1,03-2,38) than the other age brackets, so the male genital organ was the most exposed (explained) to the death that the female genital organ (RR=1,59; IC95 % = 1,07-2,38) The patients of rural origin had presented 5 times more risk (RR=4,713; IC95 % = 2,543-8,742). Poisoned by the mineral products had presented the maximum of risk on the vital preview death (RR=23,19, IC95 % = 2,39-224,1). The poisonings by pesticides produce a risk of 9 (RR=9,31; IC95 % = 6,10-14,18). The incidence was 3,3 cases of 10000 inhabitants, and the mortality was 0,004 cases of 1000 inhabitants (that is 4 cases by 1000 000 inhabitants). The rate of lethality registered annually was 10.6 %. The evolution of the indicators of health according to the years showed that the rate of statement measured by the incidence increased by a significant way. We also noted an improvement in the coverage which (who) ended up with a decrease in the rate of the lethality and the mortality during last years. The fight anti-toxic is a work of length time. He asks for a lot of work various levels. It is necessary to attack the delay accumulated by our country on the various legal, institutional and technical aspects. The ideal solution is to develop and to set up a national strategy.

Keywords: epidemiology, poisoning, risk factors, indicators of health, Tadla-Azilal grated by anti-toxic fight

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Authors: K. J. Keerthi, Vasundhara Kamineni, A. Ravi Shanker, T. Rammurthy, A. Vijaya Lakshmi, Q. Hasan

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Pancreatic β-cells are the predominant insulin-producing cell types within the Islets of Langerhans and insulin is the primary hormone which regulates carbohydrate and fat metabolism. Apoptosis of β-cells or insufficient insulin production leads to Diabetes Mellitus (DM). Current therapy for diabetes includes either medical management or insulin replacement and regular monitoring. Replacement of β- cells is an attractive treatment option for both Type-1 and Type-2 DM in view of the recent paper which indicates that β-cells apoptosis is the common underlying cause for both the Types of DM. With the development of Edmonton protocol, pancreatic β-cells allo-transplantation became possible, but this is still not considered as standard of care due to subsequent requirement of lifelong immunosuppression and the scarcity of suitable healthy organs to retrieve pancreatic β-cell. Fetal pancreatic cells from abortuses were developed as a possible therapeutic option for Diabetes, however, this posed several ethical issues. Hence, in the present study Mesenchymal stem cells (MSCs) were differentiated into insulin producing cells which were isolated from Human Umbilical cord (HUC) tissue. MSCs have already made their mark in the growing field of regenerative medicine, and their therapeutic worth has already been validated for a number of conditions. HUC samples were collected with prior informed consent as approved by the Institutional ethical committee. HUC (n=26) were processed using a combination of both mechanical and enzymatic (collagenase-II, 100 U/ml, Gibco ) methods to obtain MSCs which were cultured in-vitro in L-DMEM (Low glucose Dulbecco's Modified Eagle's Medium, Sigma, 4.5 mM glucose/L), 10% FBS in 5% CO2 incubator at 37°C. After reaching 80-90% confluency, MSCs were characterized with Flowcytometry and Immunocytochemistry for specific cell surface antigens. Cells expressed CD90+, CD73+, CD105+, CD34-, CD45-, HLA-DR-/Low and Vimentin+. These cells were differentiated to β-cells by using H-DMEM (High glucose Dulbecco's Modified Eagle's Medium,25 mM glucose/L, Gibco), β-Mercaptoethanol (0.1mM, Hi-Media), basic Fibroblast growth factor (10 µg /L,Gibco), and Nicotinamide (10 mmol/L, Hi-Media). Pancreatic β-cells were confirmed by positive Dithizone staining and were found to be functionally active as they released 8 IU/ml insulin on glucose stimulation. Isolating MSCs from usually discarded, abundantly available HUC tissue, expanding and differentiating to β-cells may be the most feasible cell therapy option for the millions of people suffering from DM globally.

Keywords: diabetes mellitus, human umbilical cord, mesenchymal stem cells, differentiation

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Authors: Alvin Uchenna Ugwu

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The United Nation’s 2030 agenda and Global Action Programme (GAP) for implementation of the Sustainable Development Goals (SDGs), has mandated all sectors in the societies, including education, to develop strategies towards actualizing sustainability in all facets of the society, by the year 2030. Education is no doubt a key tool for social change. However, educational institutions in most African nations need a paradigmatic shift to strike a balance between policies (curricular) and practices, with regards to Education for Sustainable Development (ESD). The paradigm shift in this regard is described as whole-institution/school approach. The whole institution approaches advocate action-focused ESD. In other words, ESD policy and curriculum makers, formal and non-formal education institutions, need to ‘practice what they preach’. This paper is developed from an ongoing study carried out by the author and guided by two research questions: -What are the views of intermediate phase science and technology preservice teachers on the ESD content included in the science and technology modules? -What challenges or enable intermediate phase science and technology pre-service teachers to learn about ESD in science and technology modules? The study drew from the views and experiences of preservice science teachers, learning about ESD in a university’s college of education in South Africa. Using qualitative case study research design, the research data were generated via questionnaires and focus group discussions. Analysis of generated data indicates that universities and institutions of higher learning need to demonstrate practical involvement while implementing ESD in societies, rather than just standing as knowledge media. Findings of the study further suggest that natural sciences and technology courses in teacher education programmes and other institutions of higher learning, should be perceived as key transformative tools in shaping the consciousness of students towards integrating and fostering ESD in developing countries such as South Africa. Thus, this paper seeks to promote ‘Whole Institution Involvement’ in teacher education colleges in South Africa, as a measure of improving ESD in higher education settings. The paper suggests that in order to achieve ESD in higher education settings and beyond, policies and practices should be reexamined beyond rhetoric and buzzwords. The paper further argues that implementation of ESD is largely influenced by context, hence two different contexts should be examined empirically.

Keywords: education for sustainable development, higher education institutions, pre-service science teachers, qualitative case study research, whole institution involvement

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Authors: Uyanga Jadamba

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Globalisation of the world economy has necessitated the development and implementation of a comparable and understandable reporting language suitable for use by all reporting entities. The International Accounting Standard Board (IASB) provides an international reporting language that lets all users understand the financial information of their business and potentially allows them to have access to finance at an international level. The study is based on logistic regression analysis to investigate the factors for the adoption of theInternational Financial Reporting Standard for Small and Medium sized Entities (IFRS for SMEs). The study started with a list of 217 countries from World Bank data. Due to the lack of availability of data, the final sample consisted of 136 countries, including 60 countries that have adopted the IFRS for SMEs and 76 countries that have not adopted it yet. As a result, the study included a period from 2010 to 2020 and obtained 1360 observations. The findings confirm that the adoption of the IFRS for SMEs is significantly related to the existence of national reporting standards, law enforcement quality, common law (legal system), and extent of disclosure. It means that the likelihood of adoption of the IFRS for SMEs decreases if the country already has a national reporting standard for SMEs, which suggests that implementation and transitional costs are relatively high in order to change the reporting standards. The result further suggests that the new standard adoption is easier in countries with constructive law enforcement and effective application of laws. The finding also shows that the adoption increases if countries have a common law system which suggests that efficient reportingregulations are more widespread in these countries. Countries with a high extent of disclosing their financial information are more likely to adopt the standard than others. The findings lastly show that the audit qualityand primary education levelhave no significant impact on the adoption.One possible explanation for this could be that accounting professionalsfrom in developing countries lacked complete knowledge of the international reporting standards even though there was a requirement to comply with them. The study contributes to the literature by providing factors that impact the adoption of the IFRS for SMEs. It helps policymakers to better understand and apply the standard to improve the transparency of financial statements. The benefit of adopting the IFRS for SMEs is significant due to the relaxed and tailored reporting requirements for SMEs, reduced burden on professionals to comply with the standard, and provided transparent financial information to gain access to finance.The results of the study are useful toemerging economies where SMEs are dominant in the economy in informing its evaluation of the adoption of the IFRS for SMEs.

Keywords: IFRS for SMEs, international financial reporting standard, adoption, institutional factors

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Authors: Sara Matsuzaka

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At the center of emerging policy debates on the rights of transgender individuals in public accommodations is the collision of gender binary views with transgender perspectives that challenge conventional gender norms. The results of such socio-political debates could have significant ramifications for the policies and infrastructures of public and private institutions nationwide, including within the addiction treatment field. Despite having disproportionately high rates of substance use disorder compared to the general population, transgender individuals experience significant barriers to engaging in addiction treatment programs. Inpatient addiction treatment centers were originally designed to treat heterosexual cisgender populations and, as such, feature gender segregated housing, bathrooms, and counseling sessions. Such heteronormative structural barriers, combined with exposures to stigmatic al attitudes, may dissuade transgender populations from benefiting from the addiction treatment they so direly need. A literature review is performed to explore the mechanisms by which gender segregation alienates transgender populations within inpatient addiction treatment. The constituent parts of the current debate on the rights of transgender individuals in public accommodations are situated the context of inpatient addiction treatment facilities. Minority Stress Theory is used as a theoretical framework for understanding substance abuse issues among transgender populations as a maladaptive behavioral response for coping with chronic stressors related to gender minority status and intersecting identities. The findings include that despite having disproportionately high rates of substance use disorder compared to the general population, transgender individuals experience significant barriers to engaging in and benefiting from addiction treatment. These barriers are present in the form of anticipated or real interpersonal stigma and discrimination by service providers and structural stigma in the form of policy and programmatic components in addiction treatment that marginalize transgender populations. Transphobic manifestations within addiction treatment may dissuade transgender individuals from seeking help, if not reinforce a lifetime of stigmatic experience, potentially exacerbating their substance use issues. Conclusive recommendations for social workers and addiction treatment professionals include: (1) dismantling institutional policies around gender segregation that alienate transgender individuals, (2) developing policies that provide full protections for transgender clients against discrimination based on their gender identity, and (3) implementing trans-affirmative cultural competency training requirements for all staff. Directions for future research are provided.

Keywords: addiction treatment, gender segregation, stigma, transgender

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Authors: Shangjun Zou, Zhiyuan Wang, Songhui You

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Introduction In recent years, the Chinese government has issued several policies to promote the institutional reform and innovation of the development of campus football, but many problems have been exposed in the process of policy implementation. Therefore, this paper attempts to conduct an empirical analysis of the campus football policy texts to reveal the dynamic development of the microsystem in the process of policy evolution. Methods The selected policy contents are coded by constructing a two-dimensional analysis framework of campus football policy tool-policy objective. Specifically, the X dimension consists of three oriented policy tools: environment, supply and demand, while the Y dimension is divided into six aspects of policy objectives, including institution, competition, player teaching, coach training, resource guarantee and popularization. And the distribution differences of textual analysis units on X and Y dimensions are tested by using SPSS22.0 so as to evaluate the characteristics and development trend of campus football policy on respective subjects. Results 1) In the policy evolution process of campus football stepping into the 2.0 Era, there were no significant differences in the frequency distribution of policy tools(p=0.582) and policy objectives(p=0.603). The collaborative governance of multiple participants has become the primary trend, and the guiding role of Chinese Football Association has gradually become prominent. 2) There were significant differences in the distribution of policy tools before the evolution at a 95% confidence level(p=0.041). With environmental tools always maintaining the dominant position, the overall synergy of policy tools increased slightly. 3) There were significant differences in the distribution of policy objectives after the evolution at a 90% confidence level(p=0.069). The competition system of policy objective has not received enough attention while the construction of institution and resource guarantee system has been strengthened. Conclusion The upgraded version of campus football should adhere to the education concept of health first, promote the coordinated development of youth cultural learning and football skills, and strive to achieve more solid popularization, more scientific institution, more comprehensive resource guarantee and adequate integration. At the same time, it is necessary to strengthen the collaborative allocation of policy tools and reasonable planning of policy objectives so as to promote the high quality and sustainable development of campus football in the New Era. Endnote The policy texts selected in this paper are “Implementation Opinions on Accelerating the Development of Youth Campus Football” and “Action Plans for the Construction of Eight Systems of National Youth Campus Football”, which were promulgated on August 13, 2015 and September 25, 2020 respectively.

Keywords: campus football, content analysis, evolution characteristics, policy objective, policy tool

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Authors: Kongmeng Ly

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The management of transboundary river basins across developing countries, such as the Lower Mekong River Basin (LMB), is frequently challenging given the development and conservation divergences of the basin countries. Driven by needs to sustain economic performance and reduce poverty, the LMB countries (Cambodia, Lao PDR, Thailand, Viet Nam) are embarking on significant land use changes in the form hydropower dam, to fulfill their energy requirements. This pathway could lead to irreversible changes to the ecosystem of the Mekong River, if not properly managed. Given the uncertain trade-offs of hydropower development and operation, the Lower Mekong River Basin Countries through the technical support of the Mekong River Commission (MRC) Secretariat embarked on decade long the development of Technical Guidelines for Transboundary Environmental Impact Assessment. Through a series of workshops, seminars, national and regional consultations, and pilot studies and further development following the recommendations generated through legal and institutional reviews undertaken over two decades period, the LMB Countries jointly adopted the MRC Technical Guidelines for Transboundary Environmental Impact Assessment (TbEIA Guidelines). These guidelines were developed with particular regard to the experience gained from MRC supported consultations and technical reviews of the Xayaburi Dam Project, Don Sahong Hydropower Project, Pak Beng Hydropower Project, and lessons learned from the Srepok River and Se San River case studies commissioned by the MRC under the generous supports of development partners around the globe. As adopted, the TbEIA Guidelines have been designed as a supporting mechanism to the national EIA legislation, processes and systems in each Member Country. In recognition of the already agreed mechanisms, the TbEIA Guidelines build on and supplement the agreements stipulated in the 1995 Agreement on the Cooperation for the Sustainable Development of the Mekong River Basin and its Procedural Rules, in addressing potential transboundary environmental impacts of development projects and ensuring mutual benefits from the Mekong River and its resources. Since its adoption in 2022, the TbEIA Guidelines have already been voluntary implemented by Lao PDR on its underdevelopment Sekong A Downstream Hydropower Project, located on the Sekong River – a major tributary of the Mekong River. While this implementation is ongoing with results expected in early 2024, the implementation thus far has strengthened cooperation among concerned Member Countries with multiple successful open dialogues organized at national and regional levels. It is hope that lessons learnt from this application would lead to a wider application of the TbEIA Guidelines for future water resources development projects in the LMB.

Keywords: transboundary, EIA, lower mekong river basin, mekong river

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Authors: Giuliana Scuderi, Patrick Teuffel

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The proven vulnerability of the existing social housing building heritage to natural or induced earthquakes requires the development of new design concepts and conceptual method to preserve materials and object, at the same time providing new performances. An integrate intervention between civil engineering, building physics and architecture can convert the social housing districts from a critical part of the city to a strategic resource of revitalization. Referring to bio-mimicry principles the present research proposes a taxonomy with the exoskeleton of the insect, an external, light and resistant armour whose role is to protect the internal organs from external potentially dangerous inputs. In the same way, a “building exoskeleton”, acting from the outside of the building as an enclosing cage, can restore, protect and support the existing building, assuming a complex set of roles, from the structural to the thermal, from the aesthetical to the functional. This study evaluates the structural efficiency of shape memory alloys devices (SMADs) connecting the “building exoskeleton” with the existing structure to rehabilitate, in order to prevent the out-of-plane collapse of walls and for the passive dissipation of the seismic energy, with a calibrated operability in relation to the intensity of the horizontal loads. The two case studies of a masonry structure and of a masonry structure with concrete frame are considered, and for each case, a theoretical social housing building is exposed to earthquake forces, to evaluate its structural response with or without SMADs. The two typologies are modelled with the finite element program SAP2000, and they are respectively defined through a “frame model” and a “diagonal strut model”. In the same software two types of SMADs, called the 00-10 SMAD and the 05-10 SMAD are defined, and non-linear static and dynamic analyses, namely push over analysis and time history analysis, are performed to evaluate the seismic response of the building. The effectiveness of the devices in limiting the control joint displacements resulted higher in one direction, leading to the consideration of a possible calibrated use of the devices in the different walls of the building. The results show also a higher efficiency of the 00-10 SMADs in controlling the interstory drift, but at the same time the necessity to improve the hysteretic behaviour, to maximise the passive dissipation of the seismic energy.

Keywords: adaptive structure, biomimetic design, building exoskeleton, social housing, structural envelope, structural retrofitting

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Authors: Genevieve Jorolan Quintero

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In Mindanao, the southern island of the Philippines, two provinces, Davao Oriental and Tboli of South Cotabato, respectively, are homes to indigenous communities known for their dream weavers. Davao Oriental is home to the Mandaya, while Lake Sebu is home to the Tboli. The dream weavers are mostly women who have continued the tradition of weaving, a spiritual practice of handicraft embodying the beliefs of the community. It is believed that a weaver is guided by the Tagamaling, or the nature spirit in Mandaya mythology, and Fu Dalu, or the spirit of the abaca among the Tboli. In the dream, the Tagamaling or Fu Dalu reveals to the weaver the design or the pattern of the dagmay as the abaca woven cloth is called among the Mandaya and the tnalak among the Tboli. The weaver then undertakes the production of this nature-spirit-inspired fabric based on her memory of the dream. This interaction between the spirit world and the human world inspired the theme of the short story with the title Loom of Dreams, published in 2015 by Kritika Kultura, an international peer-reviewed journal of language and literary/cultural studies of the Ateneo de Manila University in the Philippines. In Lake Sebu, a collection of the legendary tnalak with various designs is preserved by the cultural advocate and tnalak collector Reden S. Ulo. About a hundred tnalak designs are housed in a mini museum. The paper discusses how the dagmay and the tnalak of the two Philippine indigenous communities, the Mandaya and the Tboli, embody their folklore and cultural heritage. The specific objectives are: 1. To describe the role of the dreamweavers among the Mandaya and Tboli communities in the Philippines; 2. To analyse how folklore influences the designs on the woven fabric, the dagmay, and the tnalak, and 3. To discuss how dream-weaving helps preserve culture legacy. Ethnography was used in the conduct of this research. Specifically, the following data collection methods were done: 1. a series of visits to the Mandaya and Tboli communities; 2. face-to-face interviews with the respondents from the communities, and 3. the recording of the interviews with the knowledge-bearers and material culture keepers from both communities, the narratives of which were used as a basis for the data analysis. The influence of folklore in the culture and the arts of the indigenous communities is significantly evident in the designs of the dagmay and the tnalak. As the dream weavers continue to weave the dagmay and the tnalak, this cultural legacy will continue to prosper and be preserved for posterity.

Keywords: dreamweaver's, Mandaya, mindanao, Philippine folklore, Tboli

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Authors: Adel A. Ghoneim

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In most existing buildings in hot climate, cooling loads lead to high primary energy consumption and consequently high CO2 emissions. These can be substantially decreased with integrated renewable energy systems. Kuwait is characterized by its dry hot long summer and short warm winter. Kuwait receives annual total radiation more than 5280 MJ/m2 with approximately 3347 h of sunshine. Solar energy systems consist of PV modules and parabolic trough collectors are considered to satisfy electricity consumption, domestic water heating, and cooling loads of an existing building. This paper presents the results of an extensive program of energy conservation and energy generation using integrated photovoltaic (PV) modules and parabolic trough collectors (PTC). The program conducted on an existing institutional building intending to convert it into a Net-Zero Energy Building (NZEB) or near net Zero Energy Building (nNZEB). The program consists of two phases; the first phase is concerned with energy auditing and energy conservation measures at minimum cost and the second phase considers the installation of photovoltaic modules and parabolic trough collectors. The 2-storey building under consideration is the Applied Sciences Department at the College of Technological Studies, Kuwait. Single effect lithium bromide water absorption chillers are implemented to provide air conditioning load to the building. A numerical model is developed to evaluate the performance of parabolic trough collectors in Kuwait climate. Transient simulation program (TRNSYS) is adapted to simulate the performance of different solar system components. In addition, a numerical model is developed to assess the environmental impacts of building integrated renewable energy systems. Results indicate that efficient energy conservation can play an important role in converting the existing buildings into NZEBs as it saves a significant portion of annual energy consumption of the building. The first phase results in an energy conservation of about 28% of the building consumption. In the second phase, the integrated PV completely covers the lighting and equipment loads of the building. On the other hand, parabolic trough collectors of optimum area of 765 m2 can satisfy a significant portion of the cooling load, i.e about73% of the total building cooling load. The annual avoided CO2 emission is evaluated at the optimum conditions to assess the environmental impacts of renewable energy systems. The total annual avoided CO2 emission is about 680 metric ton/year which confirms the environmental impacts of these systems in Kuwait.

Keywords: building integrated renewable systems, Net-Zero energy building, solar fraction, avoided CO2 emission

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Authors: Malihe Aliasgari, Yousef Nejatbakhsh

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The era of Big Data and the immensity of real-life datasets compels computation tasks to be performed in a distributed fashion, where the data is dispersed among many servers that operate in parallel. However, massive parallelization leads to computational bottlenecks due to faulty servers and stragglers. Stragglers refer to a few slow or delay-prone processors that can bottleneck the entire computation because one has to wait for all the parallel nodes to finish. The problem of straggling processors, has been well studied in the context of distributed computing. Recently, it has been pointed out that, for the important case of linear functions, it is possible to improve over repetition strategies in terms of the tradeoff between performance and latency by carrying out linear precoding of the data prior to processing. The key idea is that, by employing suitable linear codes operating over fractions of the original data, a function may be completed as soon as enough number of processors, depending on the minimum distance of the code, have completed their operations. The problem of matrix-matrix multiplication in the presence of practically big sized of data sets faced with computational and memory related difficulties, which makes such operations are carried out using distributed computing platforms. In this work, we study the problem of distributed matrix-matrix multiplication W = XY under storage constraints, i.e., when each server is allowed to store a fixed fraction of each of the matrices X and Y, which is a fundamental building of many science and engineering fields such as machine learning, image and signal processing, wireless communication, optimization. Non-secure and secure matrix multiplication are studied. We want to study the setup, in which the identity of the matrix of interest should be kept private from the workers and then obtain the recovery threshold of the colluding model, that is, the number of workers that need to complete their task before the master server can recover the product W. The problem of secure and private distributed matrix multiplication W = XY which the matrix X is confidential, while matrix Y is selected in a private manner from a library of public matrices. We present the best currently known trade-off between communication load and recovery threshold. On the other words, we design an achievable PSGPD scheme for any arbitrary privacy level by trivially concatenating a robust PIR scheme for arbitrary colluding workers and private databases and the proposed SGPD code that provides a smaller computational complexity at the workers.

Keywords: coded distributed computation, private information retrieval, secret sharing, stragglers

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Authors: Charles Mazhazhate

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This study interrogates and analyses the intricate kin- and- kith network patterns of corruption and mismanagement of resources prevalent in public sector supply chains bedeviling the developing economies of Sub-Saharan Africa with particular reference to Zimbabwe. This is forcing governments to resort to harsh fiscal policies that see their citizens paying high taxes against a backdrop of incomes below the poverty datum line, and this negatively affects their quality of life. The corporate world is also affected by the various tax-regime instituted. Mismanagement of resources and corrupt practices are rampant in state-owned enterprises to the extent that institutional policies, procedures, and practices are often flouted for the benefit of a clique of individuals. This interwoven in kith and kin blood human relations in organizations where appointments to critical positions are based on ascribed status. People no longer place value in their systems to make them work thereby violating corporate governance principles. Greediness and ‘unholy friendship connections’ are instrumental in fueling the employment of people who know each other from their discrete backgrounds. Such employments or socio-metric unions are meant to protect those at the top by giving them intelligent information through spying on what other subordinates are doing inside and outside the organization. This practice has led to the underperforming of organizations as those employees with connections and their upper echelons favorites connive to abuse resources for their own benefit. Even if culprits are known, no draconian measures are employed as a deterrence measure. Public value along public sector supply chains is lost. The study used a descriptive case study research design on fifty organizations in Zimbabwe mainly state-owned enterprises. Both qualitative and quantitative instrumentations were used. Both Snowball and random sampling techniques were used. The study found out that in all the fifty SOEs, there were employees in key positions related to top management, with tentacles feeding into the law enforcement agents, judiciary, security systems, and the executive. Such employees in public seem not to know each other with but would be involved in dirty scams and then share the proceeds with top people behind the scenes. The study also established that the same employees do not have the necessary competencies, qualifications, abilities, and capabilities to be in those positions. This culture is now strong that it is difficult to bust. The study recommends recruitment of all employees through an independent employment bureau to ensure strategic fit.

Keywords: corruption, state owned enterprises, strategic fit, public sector supply chains, efficiency

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Authors: Păcurar Diana Istina

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The indissoluble link between aesthetics and semiotics, the harmonization and semiotic understanding of the interactions between the viewer and the object being looked at, are the basis of the practical demonstration of the importance of aesthetic perception within the theater performance. The design of a theater performance includes several structures, some considered from the beginning, art forms (i.e., the text), others being represented by simple, common objects (e.g., scenographic elements), which, if reunited, can trigger a certain aesthetic perception. The audience is delivered, by the team involved in the performance, a series of auditory and visual signs with which they interact. It is necessary to explain some notions about the physiological support of the transformation of different types of stimuli at the level of the cerebral hemispheres. The cortex considered the superior integration center of extransecal and entanged stimuli, permanently processes the information received, but even if it is delivered at a constant rate, the generated response is individualized and is conditioned by a number of factors. Each changing situation represents a new opportunity for the viewer to cope with, developing feelings of different intensities that influence the generation of meanings and, therefore, the management of interactions. In this sense, aesthetic perception depends on the detection of the “correctness” of signs, the forms of which are associated with an aesthetic property. Fairness and aesthetic properties can have positive or negative values. Evaluating the emotions that generate judgment and implicitly aesthetic perception, whether we refer to visual emotions or auditory emotions, involves the integration of three areas of interest: Valence, arousal and context control. In this context, superior human cognitive processes, memory, interpretation, learning, attribution of meanings, etc., help trigger the mechanism of anticipation and, no less important, the identification of error. This ability to locate a short circuit produced in a series of successive events is fundamental in the process of forming an aesthetic perception. Our main purpose in this research is to investigate the possible conditions under which aesthetic perception and its minimum content are generated by all these structures and, in particular, by interactions with forms that are not commonly considered aesthetic forms. In order to demonstrate the quantitative and qualitative importance of the categories of signs used to construct a code for reading a certain message, but also to emphasize the importance of the order of using these indices, we have structured a mathematical analysis that has at its core the analysis of the percentage of signs used in a theater performance.

Keywords: semiology, aesthetics, theatre semiotics, theatre performance, structure, aesthetic perception

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Authors: Zolani Metu

Abstract:

The death of more than 140 psychiatric patients who were unethically deinstitutionalized from the Life Esidimeni hospital Johannesburg, in 2016, shined a light on South Africa’s failing public mental healthcare system. Compounded by insufficient research evidence on African deinstitutionalization, this necessitates inquiries into deinstitutionalized mental healthcare, reintegration and community-based mental healthcare within the South African context. This study employed a quantitative research approach which utilized a cross-sectional research design, to investigate experiences with the reintegration of institutionalized forensic mental health service users into communities in the Western Cape, South Africa. A convenience sample of 100 mental health care workers from different occupational and organizational backgrounds in the Western Cape was purposively selected using the Western Cape Health Directorate as a sampling frame. A self-administered questionnaire (SAQ) was used as the data collection instrument. The results of the study indicate that criminogenic factors such as substance use, history of violent behaviour, criminal history and disruptive social behaviour complicate the reintegration of forensic mental health service users into communities. The current extent of reintegration of forensic mental health service users was found to be 'poor' (46%; n= 46); and financial difficulties, criminogenic factors and limited Community-Based Care (CBC) facilities were identified as key barriers to the reintegration process. 56% of all job applications for forensic mental health service users were unsuccessful, and 53% of all applications for their admission into CBC facilities were declined. Although social support (informal) was found to be essential for successful reintegration, institutional support (formal) through assertive community treatment (35%; n= 35) and CBC facilities (21%) and the disability grant (DG=50%) was found to be more important for family coping and reintegration. Moreover, 72% of respondents had positive perceptions about the process of reintegration; no statistically significant relationship was found between years of experience and perceptions about reintegration (P-value = 0.062); and perceptions were not found to be a barrier to reintegration. No statistically significant relationship was found between years of working experience and understanding the legislative framework of deinstitutionalization (P-Value =.0.061). However, using a Chi-square test, a significant relationship (P-value = 0.021) was found between sex and understanding the legal framework involved in the process of reintegration. The study recommends a post-2020 deinstitutionalization agenda that factors-in criminogenic realities associated with forensic mental health service users, and affirms the strengthening of PHC and community based care systems as precedents of successful deinstitutionalization and reintegration of mental health service users.

Keywords: forensic mental health, deinstitutionalization, reintegration, mental health service users

Procedia PDF Downloads 144

Authors: Roya Yumul, Ofelia Loani Elvir-Lazo, Sevan Komshian, Ruby Wang, Jun Tang

Abstract:

BACKGROUND: An objective means for monitoring the anti-nociceptive effects of perioperative medications has long been desired as a way to provide anesthesiologists information regarding a patient’s level of antinociception and preclude any untoward autonomic responses and reflexive muscular movements from painful stimuli intraoperatively. To this end, electroencephalogram (EEG) based tools including BIS and qCON were designed to provide information about the depth of sedation while qNOX was produced to inform on the degree of antinociception. The goal of this study was to compare the reliability of qCON/qNOX to BIS as specific indicators of response to nociceptive stimulation. METHODS: Sixty-two patients undergoing general anesthesia with LMA were included in this study. Institutional Review Board (IRB) approval was obtained, and informed consent was acquired prior to patient enrollment. Inclusion criteria included American Society of Anesthesiologists (ASA) class I-III, 18 to 80 years of age, and either gender. Exclusion criteria included the inability to consent. Withdrawal criteria included conversion to the endotracheal tube and EEG malfunction. BIS and qCON/qNOX electrodes were simultaneously placed on all patients prior to induction of anesthesia and were monitored throughout the case, along with other perioperative data, including patient response to noxious stimuli. All intraoperative decisions were made by the primary anesthesiologist without influence from qCON/qNOX. Student’s t-distribution, prediction probability (PK), and ANOVA were used to statistically compare the relative ability to detect nociceptive stimuli for each index. Twenty patients were included for the preliminary analysis. RESULTS: A comparison of overall intraoperative BIS, qCON and qNOX indices demonstrated no significant difference between the three measures (N=62, p> 0.05). Meanwhile, index values for qNOX (62±18) were significantly higher than those for BIS (46±14) and qCON (54±19) immediately preceding patient responses to nociceptive stimulation in a preliminary analysis (N=20, * p= 0.0408). Notably, certain hemodynamic measurements demonstrated a significant increase in response to painful stimuli (MAP increased from 74 ±13 mm Hg at baseline to 84 ± 18 mm Hg during noxious stimuli [p= 0.032] and HR from 76 ± 12 BPM at baseline to 80 ± 13 BPM during noxious stimuli [p=0.078] respectively). CONCLUSION: In this observational study, BIS and qCON/qNOX provided comparable information on patients’ level of sedation throughout the course of an anesthetic. Meanwhile, increases in qNOX values demonstrated a superior correlation to an imminent response to stimulation relative to all other indices

Keywords: antinociception, BIS, general anesthesia, LMA, qCON/qNOX

Procedia PDF Downloads 116