Search results for: investments criteria

Authors: Nur Atiqah Adam, Mor Jack Ng, Bernard Chern, Kok Hian Tan

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Introduction: Gestational diabetes (GDM) is a common pregnancy complication with short and long-term health consequences for both mother and fetus. Factors such as family history of diabetes mellitus, maternal obesity, maternal age, ethnicity and parity have been reported to influence the risk of GDM. In a multi-racial country like Singapore, it is worthwhile to study the GDM prevalences of different ethnicities. We aim to investigate the influence of ethnicity on the racial prevalences of GDM in Singapore. This is important as it may help us to improve guidelines on GDM healthcare services according to significant risk factors unique to Singapore. Materials and Methods: Obstetric cohort data of 926 singleton deliveries in KK Women’s and Children’s Hospital (KKH) from 2011 to 2013 was obtained. Only patients aged 18 and above and without complicated pregnancies or chronic illnesses were targeted. Factors such as ethnicity, maternal age, parity and maternal body mass index (BMI) at booking visit were studied. A multivariable logistic regression model, adjusted for confounders, was used to determine which of these factors are significantly associated with an increased risk of GDM. Results: The overall GDM prevalence rate based on WHO 1999 criteria & at risk screening (race alone not a risk factor) was 8.86%. GDM rates were higher among women above 35 years old (15.96%), obese (15.15%) and multiparous women (10.12%). Indians had a higher GDM rate (13.0 %) compared to the Chinese (9.57%) and Malays (5.20%). However, using multiple logistic regression model, variables that are significantly related to GDM rates were maternal age (p < 0.001) and maternal BMI at booking visit (p = 0.006). Conclusion: Maternal age (p < 0.001) and maternal booking BMI (p = 0.006) are the strongest risk factors for GDM. Ethnicity per se does not seem to have a significant influence on the prevalence of GDM in Singapore (p = 0.064). Hence we should tailor guidelines on GDM healthcare services according to maternal age and booking BMI rather than ethnicity.

Keywords: ethnicity, gestational diabetes, healthcare, pregnancy

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Authors: Caroline F. Moeser

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The skin-gut axis defines the relationship between the intestinal microbiota and the development of pathological skin diseases. Low diversity within the gut can predispose to the development of allergic skin conditions, and a greater diversity of the gastrointestinal microflora has been associated with a reduction of skin flares in people with atopic dermatitis. Manipulation of the gut microflora has been used as a treatment option for several conditions in people, but there is limited data available on the use of faecal transplantation as a preventative measure in either people or dogs. Six, 4-month-old pups from a litter of ten were presented for diarrhea and/or signs of skin disease (chronic scratching, otitis externa). Of these pups, two were given probiotics with a resultant resolution of diarrhea. The other four pups were given faecal transplantation, either as a sole treatment or in combination with other treatments. Follow-up on the litter of ten pups was performed at 18 months of age. At this stage, the four pups that had received faecal transplantation had resolved all clinical signs and had no recurrence of either skin or gastrointestinal symptoms. Of the remaining six pups from the litter, all had developed at least one episode of Malassezia otitis externa within the period of 5 months to 18 months of age. Two pups had developed two Malassezia otitis infections, and one had developed three Malassezia otitis infections during this period. Favrot’s criteria for the diagnosis of canine atopic dermatitis include chronic or recurrent Malassezia infections by the age of three years. Early results from this litter predict a reduction in the development of canine atopic disease in dogs given faecal microbial transplantation. Follow-up studies at three years of age and within a larger population of dogs can enhance understanding of the impact of early faecal transplantation in the prevention of canine atopic dermatitis.

Keywords: canine atopic dermatitis, faecal microbial transplant, skin-gut axis, otitis

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Authors: Amel Osman, Stewart McKenna

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Aim: Fever may present as the sole sign of a serious underlying infection in young infants. Febrile Infants aged less than 90 days are at an elevated susceptibility to invasive bacterial infections, thus presenting a challenge in ensuring the appropriate management of these cases. This study aims to ensure strict adherence to NICE guidelines for the management of fever in infants between 0 and 90 days presenting to Tallaght Hospital ED. A comprehensive audit, followed by a re-audit, was conducted to enhance the quality of care delivered to these patients. In accordance with NICE guidelines, all febrile infants should undergo blood tests. Additionally, LP should be performed in all neonates under 28 days, infants displaying signs of illness, and those with WCC below 5 or above 15. Method: A retrospective case review was performed, encompassing all patients aged between 0 to 90 days who presented with fever at Tallaght ED. Data retrieval was conducted from electronic records on two separate occasions, six months apart. The evaluation encompassed the assessment of body temperature as well as both partial and full septic workups. Results: Over the study period, 150 infants presented to the ED with fever in the initial audit, and 120 in the re-audit. In the first study, 81 patients warranted a full septic workup as per NICE, but only 48 received it. Conversely, 40 patients met criteria for a partial septic workup, with 12 undergoing blood tests. In the second study, 73 patients qualified for a full septic workup, of which 52 were completed. Additionally, 27 patients were indicated for a partial workup, with 20 undergoing blood tests. Conclusion: Managing febrile infants under three months of age presenting to Tallaght ED remains a persistent challenge, underscoring the need for continuous educational initiatives to guarantee that these patients receive the requisite assessments and treatments.

Keywords: infants, fever, septic workup, tallaght

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Authors: K. M. Pratap Shankar, Dattatreya Rao, Sai Prasad

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Background: Skin diseases are among the most common health problems worldwide and are associated with a considerable burden. Eczema is such a skin ailment which cause psychological, social and financial burden on the patient and their families. Management of eczema with antibiotics, antihistamines, steroids etc., are available but even after their use relapses, recurrences and other complications are very common. Aim: The aim of this study was to assess the efficacy of leech application in the management of vicarcikā (Eczema) with Histopathological study. Methods: For the present study 10 patients having the classical symptoms of Vicarcikā, were randomly selected as per the inclusion and exclusion criteria from O.P.D. & I.P.D. sections of Śalya department, S.V. Āyurvedic Hospital, Tirupati. Minimum 4 sittings of Leech application was carried out with seven days interval. Total duration of treatment was 6 weeks. Biopsy samples were collected from the lesion site before and after treatment. Histopathological examination was done by the pathologist. Results: In eczema (dermatitis) the leech application therapy gives excellent response by reducing the inflammatory component, hyperkeratosis, spongiosis, irregular acanthosis and by evoking a granulation tissue response in the dermis and in most of the cases with complete recovery from the lesion. Most of the cases in the study were chronic dermatitis and sebhoric keratosis, almost all local/focal pigmented lesions is totally relieved by leech therapy especially in cases of sebhoric keratosis. Conclusion: In the present study it was found that, leech application evokes significant changes at histological level specifically in reduction of inflammatory component, hyperkeratosis, spongiosis and irregular acanthosis. It was also found that there was a considerable formation of granulation tissue, which helps in formation of healthy new tissues.

Keywords: acanthosis, eczema, hyperkeratosis, leech application, spongiosis

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Authors: Charles Amoo, Joshua New, Bill Eckman

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Buildings in the United States account for a significant proportion of energy consumption and greenhouse gas (GHG) emissions, and this trend is expected to continue as well as rise in the near future. Low-income households, in particular, bear a disproportionate burden of high building energy consumption and spending due to high energy costs. Energy efficiency improvements need to reach an average of 4% per year in this decade in order to meet global net zero emissions target by 2050, but less than 1 % of U.S. buildings are improved each year. The government has recognized the importance of technology in addressing this issue, and energy efficiency programs have been developed to tackle the problem. The Weatherization Assistance Program (WAP), the largest residential whole-house energy efficiency program in the U.S., is specifically designed to reduce energy costs for low-income households. Under the WAP, energy auditors must follow specific audit procedures and use Department of Energy (DOE) approved energy audit tools or software. This article proposes an expanded framework of factors that should be considered in energy audit software that is approved for use in energy efficiency programs, particularly for low-income households. The framework includes more than 50 factors organized under 14 assessment criteria and can be used to qualitatively and quantitatively score different energy audit software to determine their suitability for specific energy efficiency programs. While the tool can be useful for developers to build new tools and improve existing software, as well as for energy efficiency program administrators to approve or certify tools for use, there are limitations to the model, such as the lack of flexibility that allows continuous scoring to accommodate variability and subjectivity. These limitations can be addressed by using aggregate scores of each criterion as weights that could be combined with value function and direct rating scores in a multicriteria decision analysis for a more flexible scoring.

Keywords: buildings, energy efficiency, energy audit, software

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Authors: Maxwell Ladogo Abilla

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As evidence from the 2007–2008 and 2010 global food and financial crises revealed that food systems were under stress, the idea of sustainable food systems rose to prominence in the discussion of food security. The idea suggests moving away from a conception of food security that emphasizes production in favor of one that is more socially and environmentally conscious and interested in tackling a wide range of issues that have rendered the food system dysfunctional. This study evaluates the efforts made by international development organizations to increase food security in the area, taking into account the persistence of poverty and food insecurity in northern Ghana, utilizing the idea of sustainable food systems as the evaluation criterion. The study used triangulation to address the research questions by combining qualitative interview data with documentary analysis. To better comprehend the concept of sustainability, a variety of discourses and concepts are used, which results in the development of eight doable objectives for attaining sustainable food systems. The study finds that the food system in northern Ghana is unsustainable because of three kinds of barriers, with the practical objectives of developing sustainable food systems serving as the assessment criteria (natural, cultural and economic, and institutional). According to an evaluation of the World Food Programme's development support in northern Ghana, regional challenges to attaining sustainable food systems continue to be unaddressed by global development initiatives. Due to institutional constraints, WFP's interventions fell short of their promise. By demonstrating the need for development partners to enhance institutional efficiency and coordination, enable marginalized communities to access their rights, and prioritize agricultural irrigation in the area, the study makes a contribution to development policy and practice in northern Ghana.

Keywords: sustainable, food security, development, institutional

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Authors: Mercy D. Chirwa, Juliet Nyasulu, Lebisti Modiba, Makombo Ganga-Limando

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Maternal death review is an initiative that provides a deeper understanding of the causes and circumstances sorounding of maternal deaths in Malawi and globally. Midwives are frontline members of the healthcare team and have stories about what pregnant women go through as such they are better placed to contribute to these reviews. Despite midwives’ participation as members of the facility-based maternal death review team, maternal deaths continues to occur. A lot has been documented around processes involved in maternal review, however, not much has been written around challenges experienced by midwives in maternal death review. This study explored the challenges faced by midwives in the implementation of maternal death reviews in the context of the healthcare system in Malawi. Methodology: This was a qualitative exploratory study design. Focus group discussions and individual face-to-face interviews were used to collect data in the study. A total of 40 midwives, who met the inclusion criteria, participated in the study. Data was analysed manually using a thematic content procedure. Findings: The four major challenges identified were: knowledge and skill gaps; lack of leadership and accountability; lack of institutional political will and inconsistency in conducting FBMDR, impeding midwives’ effective contribution to the implementation of maternal death review. The practical solutions and recommendations that emerged were: need-based knowledge and skills updates, supportive leadership, effective and efficient interdisciplinary work ethics, and sustained availability of material and human resources. Conclusion: Midwives have the highest potential to contribute to the reduction of maternal deaths. Practice development strategies are required to improve their practice in all the areas they are challenged with.

Keywords: facility-based maternal death review, maternal deaths, midwife, midwife challenges

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Authors: H. Nikzad, S. Yoshitomi

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In this paper, the optimal seismic design of reinforced concrete shear wall-frame building structures was done using structural optimization. The optimal section sizes were generated through structural optimization based on linear static analysis conforming to American Concrete Institute building design code (ACI 318-14). An analytical procedure was followed to validate the accuracy of the proposed method by comparing stresses on structural members through output files of MATLAB and ETABS. In order to consider the difference of stresses in structural elements by ETABS and MATLAB, and to avoid over-stress members by ETABS, a stress constraint ratio of MATLAB to ETABS was modified and introduced for the most critical load combinations and structural members. Moreover, seismic design of the structure was done following the International Building Code (IBC 2012), American Concrete Institute Building Code (ACI 318-14) and American Society of Civil Engineering (ASCE 7-10) standards. Typical reinforcement requirements for the structural wall, beam and column were discussed and presented using ETABS structural analysis software. The placement and detailing of reinforcement of structural members were also explained and discussed. The outcomes of this study show that the modification of section sizes play a vital role in finding an optimal combination of practical section sizes. In contrast, the optimization problem with size constraints has a higher cost than that of without size constraints. Moreover, the comparison of optimization problem with that of ETABS program shown to be satisfactory and governed ACI 318-14 building design code criteria.

Keywords: structural optimization, seismic design, linear static analysis, etabs, matlab, rc shear wall-frame structures

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Authors: Pia Moschall, Kathrin Sackmann

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Considering a purchasing volume of around two trillion Euros per year, which equals about 14% of the European Union’s gross domestic product, European public authorities have significant market power. Making use of this market power by prioritizing the procurement of green products and services offers a great potential to contribute to the Green New Deal. The market demand that is created by Green Public Procurement (GPP) sets incentives for European producers to design and develop Green Products and Eco-Innovations. However, most procurement still does not consider environmental criteria. The goal of the work is to encourage the adaptation of GPP in the European Union. To this end, the drivers for the adaptation were investigated over different case studies. The paper analyzes good-practice cases from European authorities from 2010 to 2020 that were provided by the European Commission. This analysis was guided by Philipp Mayring’s method of qualitative content analysis, whereby the inductively formed categories led to the identification of nine major drivers. The most important ones are ‘use of official guidelines and standards, ‘political support and requirements as well as ‘market research and involvement.’ Further, the paper discusses mutual dependencies between several drivers and how to exploit them. A supporting infrastructure was identified as a crucial factor for the successful adaption of green public procurement. In the next step, the work aims to examine on which administrative level the single drivers can be implemented most effectively. Practical implications of this research are recommendations on how to create a supporting structure on a municipal, federal and national level, including training for the responsible staff, support tools, as well as guidelines and standards for involved stakeholders.

Keywords: content analysis, green public procurement, public authorities, sustainable procurement

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Authors: M. Mulumpwa, W. W. L. Jere, M. Lazaro, A. H. N. Mtethiwa

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The study considered Seasonal Autoregressive Integrated Moving Average (SARIMA) processes to select an appropriate stochastic model to forecast the monthly data from the Lake Malawi water levels for the period 1986 through 2015. The appropriate model was chosen based on SARIMA (p, d, q) (P, D, Q)S. The Autocorrelation function (ACF), Partial autocorrelation (PACF), Akaike Information Criteria (AIC), Bayesian Information Criterion (BIC), Box–Ljung statistics, correlogram and distribution of residual errors were estimated. The SARIMA (1, 1, 0) (1, 1, 1)12 was selected to forecast the monthly data of the Lake Malawi water levels from August, 2015 to December, 2021. The plotted time series showed that the Lake Malawi water levels are decreasing since 2010 to date but not as much as was the case in 1995 through 1997. The future forecast of the Lake Malawi water levels until 2021 showed a mean of 474.47 m ranging from 473.93 to 475.02 meters with a confidence interval of 80% and 90% against registered mean of 473.398 m in 1997 and 475.475 m in 1989 which was the lowest and highest water levels in the lake respectively since 1986. The forecast also showed that the water levels of Lake Malawi will drop by 0.57 meters as compared to the mean water levels recorded in the previous years. These results suggest that the Lake Malawi water level may not likely go lower than that recorded in 1997. Therefore, utilisation and management of water-related activities and programs among others on the lake should provide room for such scenarios. The findings suggest a need to manage the Lake Malawi jointly and prudently with other stakeholders starting from the catchment area. This will reduce impacts of anthropogenic activities on the lake’s water quality, water level, aquatic and adjacent terrestrial ecosystems thereby ensuring its resilience to climate change impacts.

Keywords: forecasting, Lake Malawi, water levels, water level fluctuation, climate change, anthropogenic activities

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Authors: Ademilade J. Aboginije, Clinton O. Aigbavboa

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South Africa is among the emerging economy, which has a policy and suitable environment that dynamically stimulates waste management practices of diverting waste away from landfill through prevention, reuse, recycling, and recovery known as the 4R-approaches. The focus of this paper is to investigate the existing structures and processes that are environmentally responsible, then determine the resource-efficiency of the waste management practices in the South Africa construction industry. This paper indicates the results of an investigation carried out by using a systematic review of several related literatures to assess the sustainability of waste management scenarios with secondary material recovery to pinpoint all influential criteria and consequently, highlights a step by step approach to adequately analyze the process by using the indicators that can clearly and fully value the waste management practices in South Africa. Furthermore, a life cycle Analytical tool is used to support the development of a framework which can be applied in measuring the sustainability of existing waste management practices in South Africa. Finding shows that sustainable C&D waste management practices stance a great prospect far more noticeable in terms of job creation and opportunities, saving cost and conserving natural resources when incorporated, especially in the process of recycling and reusing of C&D waste materials in several construction projects in South Africa. However, there are problems such as; inadequacy of waste to energy plants, low compliances to policies and sustainable principles, lack of enough technical capacities confronting the effectiveness of the current waste management practices. Thus, with the increase in the pursuit of sustainable development in most developing countries, this paper determines how sustainability can be measured and used in top-level decision-making policy within construction and demolition waste management for a sustainable built environment.

Keywords: construction industry, green-star rating, life-cycle analysis, sustainability, zero-waste hierarchy

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Authors: Chang-Jen Lan

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Current Level of Service (LOS) index adopted in Highway Capacity Manual (HCM) for signalized intersections on surface streets is based on the intersection average delay. The delay thresholds for defining LOS grades are subjective and is unrelated to critical traffic condition. For example, an intersection delay of 80 sec per vehicle for failing LOS grade F does not necessarily correspond to the intersection capacity. Also, a specific measure of average delay may result from delay minimization, delay equality, or other meaningful optimization criteria. To that end, a reliability version of the intersection critical degree of saturation (v/c) as the LOS index is introduced. Traditionally, the level of saturation at a signalized intersection is defined as the ratio of critical volume sum (per lane) to the average saturation flow (per lane) during all available effective green time within a cycle. The critical sum is the sum of the maximal conflicting movement-pair volumes in northbound-southbound and eastbound/westbound right of ways. In this study, both movement volume and saturation flow are assumed log-normal distributions. Because, when the conditions of central limit theorem obtain, multiplication of the independent, positive random variables tends to result in a log-normal distributed outcome in the limit, the critical degree of saturation is expected to be a log-normal distribution as well. Derivation of the risk index predictive limits is complex due to the maximum and absolute value operators, as well as the ratio of random variables. A fairly accurate functional form for the predictive limit at a user-specified significant level is yielded. The predictive limit is then compared with the designated LOS thresholds for the intersection critical degree of saturation (denoted as X

Keywords: reliability analysis, level of service, intersection critical degree of saturation, risk based index

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Authors: Laid Fekih

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Background: It is difficult to detect lying, deception, and misrepresentation just by looking at verbal or non-verbal expression during the criminal investigation process, as there is a common belief that it is possible to tell whether a person is lying or telling the truth just by looking at the way they act or behave. The process of detecting lies and deception during the criminal investigation process needs more studies and research to overcome the difficulties facing the investigators. Method: The present study aimed to identify the effectiveness of cognitive methods and techniques in detecting deception during the criminal investigation. It adopted the quasi-experimental method and covered a sample of (20) defendants distributed randomly into two homogeneous groups, an experimental group of (10) defendants be subject to criminal investigation by applying cognitive techniques to detect deception and a second experimental group of (10) defendants be subject to the direct investigation method. The tool that used is a guided interview based on models of investigative questions according to the cognitive deception detection approach, which consists of three techniques of Vrij: imposing the cognitive burden, encouragement to provide more information, and ask unexpected questions, and the Direct Investigation Method. Results: Results revealed a significant difference between the two groups in term of lie detection accuracy in favour of defendants be subject to criminal investigation by applying cognitive techniques, the cognitive deception detection approach produced superior total accuracy rates both with human observers and through an analysis of objective criteria. The cognitive deception detection approach produced superior accuracy results in truth detection: 71%, deception detection: 70% compared to a direct investigation method truth detection: 52%; deception detection: 49%. Conclusion: The study recommended if practitioners use a cognitive deception detection technique, they will correctly classify more individuals than when they use a direct investigation method.

Keywords: the cognitive lie detection approach, deception, criminal investigation, mental health

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Authors: Mahtab Baghaei, Seyed Mahmoud Tabatabaei

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Aim & Background: Electrical stimulation of transcranial direct current is considered one of the treatment methods for mental disorders. The aim of this study was to evaluate the effectiveness of transcranial electrical stimulation on the delta, theta, alpha, beta and systolic and diastolic blood pressure in patients with generalized anxiety disorder. Materials and Methods: The present study was a double-blind intervention with a pre-test and post-test design on people with generalized anxiety disorder in Tabriz in 1400. In this study, 30 patients with generalized anxiety disorder were selected by purposive sampling method based on the criteria specified in DSM-5 and randomly divided into an experimental group (n = 15) and a control group (n = 15). The experimental group received two sessions of 30 minutes of electrical stimulation of transcranial direct current with an intensity of 2 mA in the area of the lateral dorsal prefrontal cortex, and the control group also received artificial stimulation. Results: The results showed that transcranial electrical stimulation reduces delta and theta waves and increases beta and alpha brain waves in the experimental group. On the other hand, this method also showed a significant decrease in systolic and diastolic blood pressure in these patients (p <0.01). Conclusion: The results show that transcranial electrical stimulation has a statistically significant effect on brain waves and blood pressure, and this non-invasive method can be used as one of the treatment methods in people with generalized anxiety disorder.

Keywords: transcranial direct current electrical stimulation, brain waves, systolic blood pressure, diastolic blood pressure

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Authors: Dario Barsi, Marina Ubaldi, Pietro Zunino, Robert Fink

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A design and optimization procedure is proposed and developed to provide the geometry of a high efficiency compact hydraulic propeller turbine for low head. For the preliminary design of the machine, classic design criteria, based on the use of statistical correlations for the definition of the fundamental geometric parameters and the blade shapes are used. These relationships are based on the fundamental design parameters (i.e., specific speed, flow coefficient, work coefficient) in order to provide a simple yet reliable procedure. Particular attention is paid, since from the initial steps, on the correct conformation of the meridional channel and on the correct arrangement of the blade rows. The preliminary geometry thus obtained is used as a starting point for the hydrodynamic optimization procedure, carried out using a CFD calculation software coupled with a genetic algorithm that generates and updates a large database of turbine geometries. The optimization process is performed using a commercial approach that solves the turbulent Navier Stokes equations (RANS) by exploiting the axial-symmetric geometry of the machine. The geometries generated within the database are therefore calculated in order to determine the corresponding overall performance. In order to speed up the optimization calculation, an artificial neural network (ANN) based on the use of an objective function is employed. The procedure was applied for the specific case of a propeller turbine with an innovative design of a modular type, specific for applications characterized by very low heads. The procedure is tested in order to verify its validity and the ability to automatically obtain the targeted net head and the maximum for the total to total internal efficiency.

Keywords: renewable energy conversion, hydraulic turbines, low head hydraulic energy, optimization design

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Authors: Noof Eid Al Shammari

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Background: Living with haemodialysis (HD) can impose several physical and social restrictions on the lives of individuals. Usually, the patient has three dialysis sessions per week that each run for three to four hours. This limits the social life of patients and causes a lower quality of life, in conjunction with the fact that people with chronic kidney disease must follow strict fluid and food regimens and use multiple medications. Given these factors, patients undergoing HD generally need psychological support. Objective: This scoping review study aims to evaluate the effectiveness of physical and breathing exercises on quality of life (QOL) and psychophysical status in patients undergoing HD. Methodology: Searches for relevant studies were performed in four databases (MEDLINE, CINAHL, Google Scholar, and PubMed) for articles published between 2011 and 2021. Out of all the searched literature, ten studies met the inclusion criteria (8 randomised controlled trials, one quasi-experimental study, and one pilot study), with a total of 588 patients. Different types of physical and breathing exercises were used (breathing, cardiopulmonary, and physical exercises). Results: All included studies in this scoping review revealed that most of the aerobic or anaerobic exercises, as well as breathing exercises, had a positive effect and significantly improved patients’ QOL, physical functioning, and psychological status. Conclusions: In this review, most of the articles demonstrated a positive effect of physical and breathing exercises on the QOL and psychophysical status of HD patients. Based on the findings of these studies, physical and breathing exercises were shown to improve muscle strength and other health-related aspects of QOL, including sexual, social, cognitive, and physical functions. However, more studies will need to be conducted with a larger sample to determine the best intervention that could be implemented and standardised in nursing care for patients undergoing HD.

Keywords: physical exercise, breathing exercises, quality of life, depression, hemodialysis

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Authors: Anood Al-Shibli

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Designing a learner corpus is not an easy task to accomplish because dealing with learners’ language has many variables which might affect the results of any study based on learners’ language production (spoken and written). Also, it is very essential to systematically design a learner corpus especially when it is aimed to be a reference to language research. Therefore, designing the Omani Learner Corpus (OLEC) has undergone many explicit and systematic considerations. These criteria can be regarded as the foundation to design any learner corpus to be exploited effectively in language use and language learning studies. Added to that, OLEC is manually error-annotated corpus. Error-annotation in learner corpora is very essential; however, it is time-consuming and prone to errors. Consequently, a navigating tool is designed to help the annotators to insert errors’ codes in order to make the error-annotation process more efficient and consistent. To assure accuracy, error annotation procedure is followed to annotate OLEC and some preliminary findings are noted. One of the main results of this procedure is creating an error-annotation system based on the Omani learners of English language production. Because OLEC is still in the first stages, the primary findings are related to only one level of proficiency and one error type which is verb related errors. It is found that Omani learners in OLEC has the tendency to have more errors in forming the verb and followed by problems in agreement of verb. Comparing the results to other error-based studies indicate that the Omani learners tend to have basic verb errors which can found in lower-level of proficiency. To this end, it is essential to admit that examining learners’ errors can give insights to language acquisition and language learning and most errors do not happen randomly but they occur systematically among language learners.

Keywords: error-annotation system, error-annotation manual, learner corpora, verbs related errors

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Authors: Lusia Ndahafa Nghitotelwa

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India is a home to many languages, cultures, traditions, castes and religions. This diversity, when observed in education, appears to be challenging and difficult to manage with respect to including everyone in the educational system. But in order to achieve this, attempts to understand the complexity of the issue and find some solutions for including everyone in education has been made in India since independence, regardless of the students’ background. Despite that, the challenge is still topical. Plenty of students are left out of the system due to the lack of awareness and appropriate management of these diversities. Therefore, the present paper makes an attempt to study the awareness and management of diversity in Indian schools. Existing studies on diversity in Indian schools, along with how measures and which measures have been taken to accommodate and retain everyone in school, have been looked at, and a thorough critical analysis of findings has been narrated. It was found that a lot of efforts have been conjugated to include and educate children of all castes, religions, and linguistic backgrounds. Furthermore, the awareness of inclusive education among teachers and society members is moderate, but teachers lack the necessary skills and knowledge on how to deal with students with special educational needs in regular classes. Also, the management is aware of inclusive education, but the management does not include teachers in decision-making. Moreover, it was found that the poor management of inclusion services and retention of special needs students in Indian schools results in their poor effective integration into the workforce. Finally, the management was found to have stringent admission criteria, which has the effect of hindering some students from entering the educational system. Based on the results of the study, it is clear that the implementation of inclusive education is still a challenge in India. However, there are promising results in tackling the issue. All children should be given an opportunity to learn together with other children in order to broaden their interest and challenge their potential.

Keywords: awareness, management, inclusive education, students

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Authors: Madhur Verma, Meena Rajput, Kamal Kishore

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Background: The general view that obesity is a problem of prosperous Western countries has been repealed with substantial evidence showing that middle-income countries like India are now at the heart of a fat explosion. Neck circumference has evolved as a promising index to measure obesity, because of the convenience of its use, even in culture sensitive population. Objectives: To determine whether neck circumference (NC) was associated with overweight and obesity and contributed to the prediction like other classical anthropometric indices. Methodology: Cross-sectional study consisting of 1080 adults (> 19 years) selected through Multi-stage random sampling between August 2013 and September 2014 using the pretested semi-structured questionnaire. After recruitment, the demographic and anthropometric parameters [BMI, Waist & Hip Circumference (WC, HC), Waist to hip ratio (WHR), waist to height ratio (WHtR), body fat percentage (BF %), neck circumference (NC)] were recorded & calculated as per standard procedures. Analysis was done using appropriate statistical tests. (SPSS, version 21.) Results: Mean age of study participants was 44.55+15.65 years. Overall prevalence of overweight & obesity as per modified criteria for Asian Indians (BMI ≥ 23 kg/m2) was 49.62% (Females-51.48%; Males-47.77%). Also, number of participants having high WHR, WHtR, BF%, WC & NC was 827(76.57%), 530(49.07%), 513(47.5%), 537(49.72%) & 376(34.81%) respectively. Variation of NC, BMI & BF% with age was non- significant. In both the genders, as per the Pearson’s correlational analysis, neck circumference was positively correlated with BMI (men, r=0.670 {p < 0.05}; women, r=0.564 {p < 0.05}), BF% (men, r=0.407 {p < 0.05}; women, r= 0.283 {p < 0.05}), WC (men, r=0.598{p < 0.05}; women, r=0.615 {p < 0.05}), HC (men, r=0.512{p < 0.05}; women, r=0.523{p < 0.05}), WHR (men, r= 0.380{p > 0.05}; women, r=0.022{p > 0.05}) & WHtR (men, r=0.318 {p < 0.05}; women, r=0.396{p < 0.05}). On ROC analysis, NC showed good discriminatory power to identify obesity with AUC (AUC for males: 0.822 & females: 0.873; p- value < 0.001) with maximum sensitivity and specificity at a cut-off value of 36.55 cms for males & 34.05cms for females. Conclusion: NC has fair validity as a community-based screener for overweight and obese individuals in the study context and has also correlated well with other classical indices.

Keywords: neck circumference, obesity, anthropometric indices, body fat percentage

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Authors: Alireza Monzavi Chaleshtari, Mahnaz Aliakbari Dehkordi, Nazila Esmaeili, Ahmad Alipour, Amin Asadi Hieh

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Headache disorders are one of the most common disorders of the nervous system and are associated with suffering, disability, and financial costs for patients. Mindfulness as a lifestyle, in line with human nature, has the ability to affect the emotional system, i.e. thoughts, body sensations, raw emotions and action impulses of people. The aim of this study was to test the fit of structural model of mindfulness and severity of headache mediated by resilience and perfectionism in patients with migraine. Methods: The statistical population of this study included all patients with migraine referred to neurologists in Tehran in the spring and summer of 1401. The inclusion criteria were diagnosis of migraine by a neurologist, not having mental disorders or other physical diseases, and having at least a diploma. According to the number of research variables, 180 people were selected by convenience sampling method, which online answered the Ahvaz perfectionism questionnaire (AMQ), Connor and Davidson resilience questionnaire (CD-RISC), Ahvaz migraine headache questionnaire (APS) and 5-factor mindfulness questionnaire ((MAAS). Data were analyzed using structural equation modeling and Amos software. Results: The results showed that the direct pathways of mindfulness were not significant for severe headache (P <0.05), but other direct pathways - mindfulness to resilience, mindfulness to perfectionism, resilience to severe headache and perfectionism to severe headache), Was significant (P <0.01). After modifying and removing the non-significant paths, the final model fitted. Mediating variables Resilience and perfectionism mediated all paths of predictor variables to the criterion. Conclusion: According to the findings of the present study, mindfulness in migraine patients reduces the severity of headache by promoting resilience and reducing perfectionism.

Keywords: migraine, headache severity, mindfulness, resilience, perfectionism

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Authors: Catarina Ramos Pereira, Jorge Rodrigues, Natália Oliveira, Jorge Machado, Maria Begoña Criado, Jorge Machado, Henri J. Greten

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Background: Parkinson's disease is a multi-system neurodegenerative disorder characterized by motor and non-motor symptoms. To slow disorder progression, different treatment options are now available, but in most cases, these therapeutic strategies also involve the presence of important side effects. This has led many patients to pursue complementary therapies, such as acupuncture, to alleviate PD symptoms. Therefore, an update on the efficacy of this treatment for patients of PD is of great value. This work presents a systematic review of the efficacy of acupuncture treatments in relieving PD symptoms. Methods: EMBASE, Medline, Pubmed, Science Direct, The Cochrane Library, Cochrane Central Register of Controlled Trials (Central), and Scielo databases were systematically searched from January 2011 through July 2021. Randomized controlled trials (RCTs) published in English with all types of acupuncture treatment were included. The selection and analysis of the articles were conducted by two blinding authors through the Rayyan application. Results: 720 potentially relevant articles were identified; 52 RCTs met our inclusion criteria. After the exclusion of 35, we found 17 eligible. The included RCTs reported positive effects for acupuncture plus conventional treatment compared with conventional treatment alone in the UPDRS score. Conclusions: Additional evidence should be supported by rigorous methodological strategies. Although firm conclusions cannot be drawn, acupuncture treatment, in the framework of an interdisciplinary care team, appears to have positive effects on PD symptoms.

Keywords: systematic review, Parkinson disease, acupuncture, traditional Chinese medicine

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Authors: Laid Fekih

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Background: Depression affects people in all communities across the world and in all aspects of their lives. Its spread varies from one country to another, can happen at any age and get rid of it is not easy. There is no clear policy in Algeria's higher education institutions to detect and treat these disorders or pay particular attention to those at risk. Identifying the prevalence of depression among Algerian students, its correlation with different variables, and studying gender differences in the light of a range of variables is necessary to develop an appropriate plan to raise the level of hope and love of life among students. Method: Random samples of 1500 University of Tlemcen students (967 girls and 533 boys), aged 19 to 24 years completed a self-administered questionnaire that included Beck's Depression Inventory ®-II (BDI®-II), (School Health Promotion: The Mood part), Other questions included in this survey focused on demographic characteristics including gender, age and year of study, academic performance (Annual Average Score (0-20) AAS), were examined. Results: The rate of depression (moderate, severe and extreme) varied from 03% to 13% among university students in Tlemcen University. There was no difference in the rates of depression in male and female students, which means that male and female students do have similar rates of depression. The rate of depression in the first-year of the study shows a higher score relative to students of other years. Depression has a negative relationship with academic performance, which means that depressed students have many difficulties in academic tasks at university. Conclusion: Depression among university students is an important center of interest in the world, not only because of the ease with which they can be followed, or the difficulties encountered during their studies and their technical courses but for the link between the level of depression and the quality of care of mental health services, especially if many students with mood and emotional problems don't meet the criteria for psychotherapy.

Keywords: depression, epidemiology, university students, academic performance

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Authors: Fabiane Alves Farias Guimarães, Rodrigo Otávio Moretti-Pires, Ana Lúcia Schaefer Ferreira de Mello

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Introduction: Considering the last changes in Brazilian Health and Higher Educational Systems, the production of scientific knowledge regarding dental education and training has been increasing. The National Curriculum Guidelines for undergraduate courses in Dentistry established in 2002 the principles and procedures to perform a more generalist dental professional profile. Objectives: To perform a systematic review of the Brazilian scientific literature about dental education and training. Methods: The systematic review was conducted considering the Lilacs - Latin American Literature in Health Sciences and SciELO - Scientific Electronic Library Online data bases, using the combination of key words dentistry, education, teaching or training. It was select original research articles, published between 2010 and 2013, in Portuguese. Results: Based on the selection criteria, it was found 23 articles. In order to organize the outcomes, the analysis was separated in three themes: Ethical aspects of education (3 articles), integrating dental service with training (10 articles) and Dental education and the Brazilian curriculum guidelines (10 articles). Most of the studies were published between 2011 and 2012 (35% each) and were held in public universities. The studied populations included dental students, teachers, universities directors, health managers and dentists. The qualitative methodological approach was predominant. Conclusion: It was possible to identify a transience time in Brazilian undergraduate courses in Dentistry after curricular changes. The produced literature shows some advances, as the incorporation of ethical values on dental education and the inclusion of new practices environments for students by integrating education and training in diversified dental services scenarios.

Keywords: Teaching, Dental Students, Human resources in dentistry

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Authors: Daniel M. Muntean, Viorel Ungureanu

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More than half of the urban population in Romania lives today in residential buildings made out of large prefabricated reinforced concrete panels. Since their initial design was made in the 1960’s, these housing units are now being technically and morally outdated, consuming large amounts of energy for heating, cooling, ventilation and lighting, while failing to meet the needs of the contemporary life-style. Due to their widespread use, the design of a system that improves their energy efficiency would have a real impact, not only on the energy consumption of the residential sector, but also on the quality of life that it offers. Furthermore, with the transition of today’s existing power grid to a “smart grid”, buildings could become an active element for future electricity networks by contributing in micro-generation and energy storage. One of the most addressed issues today is to find locally adapted strategies that can be applied considering the 20-20-20 EU policy criteria and to offer sustainable and innovative solutions for the cost-optimal energy performance of buildings adapted on the existing local market. This paper presents a possible adaptive design scenario towards sustainable retrofitting of these housing units. The apartments are transformed in order to meet the current living requirements and additional extensions are placed on top of the building, replacing the unused roof space, acting not only as housing units, but as active solar energy collection systems. An adaptive building envelope is ensured in order to achieve overall air-tightness and an elevator system is introduced to facilitate access to the upper levels.

Keywords: adaptive building, energy efficiency, retrofitting, residential buildings, smart grid

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Authors: Nitesh Kumar, Eoin Twohig, jasparl cheema, Sadiq mawji, Yousif al najjar

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Basal cell carcinoma (BCC) is the commonest cutaneous malignancy affecting humans. Despite this, distant spread is exceptionally rare. Metastatic BCC (mBCC) is estimated to occur in 0.0028 - 0.5%. it aim to illustrate with the aid of histological slides, a case of mBCC occurring in a fit and well 67-year-old. Initial diagnosis of desmoplastic BCC was made in 2006 from a scalp biopsy with the lesion then being excised. Re-excision of local recurrence was undertaken the following year. In 2014 the patient presented with an ipsilateral level 2a mass. Fine Needle Aspiration raised the suspicion of metastatic carcinoma. The patient had excision of two nodes from the left neck alongside pharyngeal tonsillectomy and tongue base biopsies. Histologically, the nodes closely resembled the immunophenotype of the initial scalp lesion. The patient subsequently had a modified radical neck dissection, and residual mBCC was excised from the left Sternocleidomastoid muscle. In 2023 the patient developed haematuria. On further investigation bilateral lung lesions on CT were noted with subsequent biopsy confirming mBCC. Spinal and renal lesions have also been found. Histopathology showed clear resemblance of the lung metastases to both those in the neck and the primary (scalp BCC) – with no squamous differentiation seen. The time span from primary to occurrence of lung metastasis (18 years) affirms the indolent and slow growing nature of BCC.  This case fulfils Lattes and Kessler diagnostic criteria. High risk cases are described as those with advanced local presentation, primary tumour on the Head and Neck and locally recurrent lesions.

Keywords: BCC, metastasis, rare, skin cancer

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Authors: A. Mollafilabi, A. Koocheki, P. Rezvani Moghaddam, M. Nassiri Mahalati

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In order to study the effects of corm weights and times of corm lifting saffron in different planting beds, an experiment was conducted as Factorial layout based on a Randomized Complete Block Design with three replications at the Fadak Research Center of Agricultural Research in Food Science during 2010. Treatments were two corm weights (8-10, 10 < g), two planting beds (stone wool and peat moss) and five levels of lifting time (mi-June, early July, mid-July, early August and mid-August). No. of corms were 457 corms.m-2 and for 40 days and were stored for 90 days in incubation, 85% relative humidity and 25°C temperature in the darkness. Then, saffron corms were transferred to growth chamber with 17 °C in 8 hours light and 16 hours darkness. Characteristics were number of flower, fresh weight of flower, dry weight of flower, fresh and dry weight of stigma, fresh and dry weight of style, fresh and dry weight of stigma+style and Picrocrocin, Safronal and Crocin contents of saffron were measured. Results showed that the corm weight, bed type and time of corm lifting had significant effects on economical yield of saffron such as picked flowers, dry weight of stigma and fresh weight of flowers. The highest saffron economical yield was obtained in interaction of corm weight, 10 g, peat moss and lifting time in mid-June as much as 5.2 g.m-2. This yield is 11 fold of average yield of Iranian farms. Picrocrocin, Safranal and Crocin contents was graded as excellent thread in peat moss under controlled conditions compared with ISO Standard of 203.

Keywords: corm density, dry stigma, safranal-flowering, yield saffron

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Authors: Haythem A. Nakkas, Philip J. Scott, Jim S. Briggs

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This paper reports a structured literature review of the application of Health Information Technology in developing countries, defined as the World Bank categories Low-income countries, Lower-middle-income, and Upper-middle-income countries. The aim was to identify and classify the various applications of health information technology to assess its current state in developing countries and explore potential areas of research. We offer specific analysis and application of HIT in Libya as one of the developing countries. Method: A structured literature review was conducted using the following online databases: IEEE, Science Direct, PubMed, and Google Scholar. Publication dates were set for 2000-2013. For the PubMed search, publications in English, French, and Arabic were specified. Using a content analysis approach, 159 papers were analyzed and a total number of 26 factors were identified that affect the adoption of health information technology. Results: Of the 2681 retrieved articles, 159 met the inclusion criteria which were carefully analyzed and classified. Conclusion: The implementation of health information technology across developing countries is varied. Whilst it was initially expected financial constraints would have severely limited health information technology implementation, some developing countries like India have nevertheless dominated the literature and taken the lead in conducting scientific research. Comparing the number of studies to the number of countries in each category, we found that Low-income countries and Lower-middle-income had more studies carried out than Upper-middle-income countries. However, whilst IT has been used in various sectors of the economy, the healthcare sector in developing countries is still failing to benefit fully from the potential advantages that IT can offer.

Keywords: developing countries, developed countries, factors, failure, health information technology, implementation, libya, success

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Authors: Yuekun Chen, Yousef Sardahi, Salam Hajjar, Christopher Greer

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This paper presents a multi-objective optimal design of a cascade control system for an underactuated mechanical system. Cascade control structures usually include two control algorithms (inner and outer). To design such a control system properly, the following conflicting objectives should be considered at the same time: 1) the inner closed-loop control must be faster than the outer one, 2) the inner loop should fast reject any disturbance and prevent it from propagating to the outer loop, 3) the controlled system should be insensitive to measurement noise, and 4) the controlled system should be driven by optimal energy. Such a control problem can be formulated as a multi-objective optimization problem such that the optimal trade-offs among these design goals are found. To authors best knowledge, such a problem has not been studied in multi-objective settings so far. In this work, an underactuated mechanical system consisting of a rotary servo motor and a ball and beam is used for the computer simulations, the setup parameters of the inner and outer control systems are tuned by NSGA-II (Non-dominated Sorting Genetic Algorithm), and the dominancy concept is used to find the optimal design points. The solution of this problem is not a single optimal cascade control, but rather a set of optimal cascade controllers (called Pareto set) which represent the optimal trade-offs among the selected design criteria. The function evaluation of the Pareto set is called the Pareto front. The solution set is introduced to the decision-maker who can choose any point to implement. The simulation results in terms of Pareto front and time responses to external signals show the competing nature among the design objectives. The presented study may become the basis for multi-objective optimal design of multi-loop control systems.

Keywords: cascade control, multi-Loop control systems, multiobjective optimization, optimal control

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Authors: Olivia Rachel Hwang, Yu-Hsuan Joni Shao

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Androgen Deprivation Therapy (ADT) has been a primary treatment for patients with advanced prostate cancer. However, it is associated with numerous adverse effects related to Metabolic Syndrome (MetS), including hypertension, diabetes, hyperlipidaemia, heart diseases and ischemic strokes. However, complications associated with ADT for prostate cancer in Taiwan is not well documented. The purpose of this study is to utilize the data from NHIRD (National Health Insurance Research Database) to examine the trajectory changes of MetS-related complications in men receiving ADT. The risks of developing complications after the treatment were analyzed with multivariate Cox regression model. Covariates including in the model were the complications before the diagnosis of prostate cancer, the age, and the year at cancer diagnosis. A total number of 17268 patients from 1997-2013 were included in this study. The exclusion criteria were patients with any other types of cancer or with the existing MetS-related complications. Changes in MetS-related complications were observed among two treatment groups: 1) ADT (n=9042), and 2) non-ADT (n=8226). The ADT group appeared to have an increased risk in hypertension (hazard ratio 1.08, 95% confidence interval 1.03-1.13, P = 0.001) and hyperlipidemia (hazard ratio 1.09, 95% confidence interval 1.01-1.17, P = 0.02) when compared with non-ADT group in the multivariate Cox regression analyses. In the risk of diabetes, heart diseases, and ischemic strokes, ADT group appeared to have an increased but not significant hazard ratio. In conclusion, ADT was associated with an increased risk in hypertension and hyperlipidemia in prostate cancer patients in Taiwan. The risk of hypertension and hyperlipidemia should be considered while deciding on ADT, especially those with the known history of hypertension and hyperlipidemia.

Keywords: androgen deprivation therapy, ADT, complications, metabolic syndrome, MetS, prostate cancer

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Authors: João Coutinho-Rodrigues, Nuno Sousa, Luís Alçada-Almeida

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Transportation infrastructure systems are fundamental in modern society and economy. However, they need modernizing, maintaining, and reinforcing interventions which require large investments. In many countries, accumulated intervention delays arise from aging and intense use, being magnified by financial constraints of the past. The decision problem of managing the renewal of large backlogs is common to several types of important transportation infrastructures (e.g., railways, roads). This problem requires considering financial aspects as well as operational constraints under a multidimensional framework. The present research introduces a linear programming multiobjective model for managing railway infrastructure asset renewal. The model aims at minimizing three objectives: (i) yearly investment peak, by evenly spreading investment throughout multiple years; (ii) total cost, which includes extra maintenance costs incurred from renewal backlogs; (iii) priority delays related to work start postponements on the higher priority railway sections. Operational constraints ensure that passenger and freight services are not excessively delayed from having railway line sections under intervention. Achieving a balanced annual investment plan, without compromising the total financial effort or excessively postponing the execution of the priority works, was the motivation for pursuing the research which is now presented. The methodology, inspired by a real case study and tested with real data, reflects aspects of the practice of an infrastructure management company and is generalizable to different types of infrastructure (e.g., railways, highways). It was conceived for treating renewal interventions in infrastructure assets, which is a railway network may be rails, ballasts, sleepers, etc.; while a section is under intervention, trains must run at reduced speed, causing delays in services. The model cannot, therefore, allow for an accumulation of works on the same line, which may cause excessively large delays. Similarly, the lines do not all have the same socio-economic importance or service intensity, making it is necessary to prioritize the sections to be renewed. The model takes these issues into account, and its output is an optimized works schedule for the renewal project translatable in Gantt charts The infrastructure management company provided all the data for the first test case study and validated the parameterization. This case consists of several sections to be renewed, over 5 years and belonging to 17 lines. A large instance was also generated, reflecting a problem of a size similar to the USA railway network (considered the largest one in the world), so it is not expected that considerably larger problems appear in real life; an average of 25 years backlog and ten years of project horizon was considered. Despite the very large increase in the number of decision variables (200 times as large), the computational time cost did not increase very significantly. It is thus expectable that just about any real-life problem can be treated in a modern computer, regardless of size. The trade-off analysis shows that if the decision maker allows some increase in max yearly investment (i.e., degradation of objective ii), solutions improve considerably in the remaining two objectives.

Keywords: transport infrastructure, asset renewal, railway maintenance, multiobjective modeling

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