Search results for: diagnostic challenge

Authors: Rajesh Kumar G

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A challenging aspect of any clinical trial is to carefully plan the study design to meet the study objective in optimum way and to validate the assumptions made during protocol designing. And when it is a pediatric study, there is the added challenge of stringent guidelines and difficulty in recruiting the necessary subjects. Unlike adult trials, there is not much historical data available for pediatrics, which is required to validate assumptions for planning pediatric trials. Typically, pediatric studies are initiated as soon as approval is obtained for a drug to be marketed for adults, so with the adult study historical information and with the available pediatric pilot study data or simulated pediatric data, the pediatric study can be well planned. Generalizing the historical adult study for new pediatric study is a tedious task; however, it is possible by integrating various statistical techniques and utilizing the advantage of hybrid study design, which will help to achieve the study objective in a smoother way even with the presence of many constraints. This research paper will explain how well the hybrid study design can be planned along with integrated technique (SEV) to plan the pediatric study; In brief the SEV technique (Simulation, Estimation (using borrowed adult data and applying Bayesian methods)) incorporates the use of simulating the planned study data and getting the desired estimates to Validate the assumptions.This method of validation can be used to improve the accuracy of data analysis, ensuring that results are as valid and reliable as possible, which allow us to make informed decisions well ahead of study initiation. With professional precision, this technique based on the collected data allows to gain insight into best practices when using data from historical study and simulated data alike.

Keywords: adaptive design, simulation, borrowing data, bayesian model

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Authors: Mandisi Matyana

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Although the South African local government is doing all the best in ensuring improved service delivery for the citizens, service delivery disparity still remains the real challenge for other municipalities. The unequal distribution of services within municipal wards is causing unequal happiness among the citizens; hence others do enjoy different provided municipal services, while others do not. It is acknowledged that less access to municipal services infringes one’s rights, such as the right to human dignity and the right to life. Some of the municipal services are basic services and they are the mainstay of human survival, such as water, housing, etc. It is quite evident that the service delivery disparity could be caused by the various factors within the local municipality affairs, including both administrative and political factors. Therefore, this study is undertaken to check and evaluate the main foundations of service delivery disparity in ensuring equal development of the state, particularly for local communities. The study used the qualitative method to collect the data from the citizens of Winnie Madikizela Mandela Local Municipality. An extensive literature was also conducted in understanding the causes of service delivery disparity. Study findings prove that the service delivery disparity could be caused by factors such as political interference in administration, corruption and fraud, elevated unemployment levels, inadequate institutional capacity, etc. Therefore, the study recommends strong community participation and constant external supervision in the local government so as to encourage openness in local government to ensure fair administration towards services to be provided.

Keywords: administration, development, municipal services, service delivery disparity, Winnie Madikizela Mandela local municipality

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Authors: Eugenia P. Ramirez, Kevin Matthe Caramancion, Mia Eleazar

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Getting the attention of students is a constant challenge to the instructors/lecturers. Although in the computer laboratories some networking and entertainment websites are blocked, yet, these websites have unlimited ways of attracting students to get into it. Thus, when an instructor gives a specific set of instructions, some students may not be able to follow sequentially the steps that are given. The instructor has to physically go to the specific remote terminal and show the student the details. Sometimes, during an examination in laboratory set-up, a proctor may prefer to give detailed and text-written instructions rather than verbal instructions. Even the mere calling of a specific student at any time will distract the whole class especially when activities are being performed. What is needed is : An application software that is able to lock the student's monitor and at the same time display the instructor’s screen; a software that is powerful enough to process in its side alone and manipulate a specific user’s terminal in terms of free configuration that is, without restrictions at the server level is a required functionality for a modern and optimal server structure; a software that is able to send text messages to students, per terminal or in group will be a solution. These features are found in LabSupport. This paper outlines the LabSupport application software framework to efficiently manage computer laboratory sessions and will include different modules: screen viewer, demonstration mode, monitor locking system, text messaging, and class management. This paper's ultimate aim is to provide a system that increases instructor productivity.

Keywords: application software, broadcast messaging, class management, locking system

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Authors: J. Szpor, K. Witczak, M. Storman, A. Orchel, D. Hodorowicz-Zaniewska, K. Okoń, A. Klimkowska

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Core needle biopsy (CNB) is well established as an important diagnostic tool in diagnosing breast cancer and it is now considered the initial method of choice for diagnosing breast disease. In comparison to fine needle aspiration (FNA), CNB provides more architectural information allowing for the evaluation of prognostic and predictive factors for breast cancer, including histological grade—one of three prognostic factors used to calculate the Nottingham Prognostic Index. Several studies have previously described the concordance rate between CNB and surgical excision specimen in determination of histological grade (HG). The concordance rate previously ascribed to overall grade varies widely across literature, ranging from 59-91%. The aim of this study is to see how the data looks like in material at authors’ institution and are the results as compared to those described in previous literature. The study population included 157 women with a breast tumor who underwent a core needle biopsy for breast carcinoma and a subsequent surgical excision of the tumor. Both materials were evaluated for the determination of histological grade (scale from 1 to 3). HG was assessed only in core needle biopsies containing at least 10 well preserved HPF with invasive tumor. The degree of concordance between CNB and surgical excision specimen for the determination of tumor grade was assessed by Cohen’s kappa coefficient. The level of agreement between core needle biopsy and surgical resection specimen for overall histologic grading was 73% (113 of 155 cases). CNB correctly predicted the grade of the surgical excision specimen in 21 cases for grade 1 tumors (Kappa coefficient κ = 0.525 95% CI (0.3634; 0.6818), 52 cases for grade 2 (Kappa coefficient κ = 0.5652 95% CI (0.458; 0.667) and 40 cases for stage 3 tumors (Kappa coefficient κ = 0.6154 95% CI (0.4862; 0.7309). The highest level of agreement was observed in grade 3 malignancies. In 9 of 42 (21%) discordant cases, the grade was higher in the CNB than in the surgical excision. This composed 6% of the overall discordance. These results correspond to the noted in the literature, showing that underestimation occurs more frequently than overestimation. This study shows that authors’ institution’s histologic grading of CNBs and surgical excisions shows a fairly good correlation and is consistent with findings in previous reports. Despite the inevitable limitations of CNB, CNB is an effective method for diagnosing breast cancer and managing treatment options. Assessment of tumour grade by CNB is useful for the planning of treatment, so in authors’ opinion it is worthy to implement it in daily practice.

Keywords: breast cancer, concordance, core needle biopsy, histological grade

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Authors: Adel Edwar Waheeb Louka

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Purpose AI-driven solutions are at the forefront of many pathology and medical imaging methods. Using algorithms designed to better the experience of medical professionals within their respective fields, the efficiency and accuracy of diagnosis can improve. In particular, X-rays are a fast and relatively inexpensive test that can diagnose diseases. In recent years, X-rays have not been widely used to detect and diagnose COVID-19. The under use of Xrays is mainly due to the low diagnostic accuracy and confounding with pneumonia, another respiratory disease. However, research in this field has expressed a possibility that artificial neural networks can successfully diagnose COVID-19 with high accuracy. Models and Data The dataset used is the COVID-19 Radiography Database. This dataset includes images and masks of chest X-rays under the labels of COVID-19, normal, and pneumonia. The classification model developed uses an autoencoder and a pre-trained convolutional neural network (DenseNet201) to provide transfer learning to the model. The model then uses a deep neural network to finalize the feature extraction and predict the diagnosis for the input image. This model was trained on 4035 images and validated on 807 separate images from the ones used for training. The images used to train the classification model include an important feature: the pictures are cropped beforehand to eliminate distractions when training the model. The image segmentation model uses an improved U-Net architecture. This model is used to extract the lung mask from the chest X-ray image. The model is trained on 8577 images and validated on a validation split of 20%. These models are calculated using the external dataset for validation. The models’ accuracy, precision, recall, f1-score, IOU, and loss are calculated. Results The classification model achieved an accuracy of 97.65% and a loss of 0.1234 when differentiating COVID19-infected, pneumonia-infected, and normal lung X-rays. The segmentation model achieved an accuracy of 97.31% and an IOU of 0.928. Conclusion The models proposed can detect COVID-19, pneumonia, and normal lungs with high accuracy and derive the lung mask from a chest X-ray with similarly high accuracy. The hope is for these models to elevate the experience of medical professionals and provide insight into the future of the methods used.

Keywords: artificial intelligence, convolutional neural networks, deeplearning, image processing, machine learningSarapin, intraarticular, chronic knee pain, osteoarthritisFNS, trauma, hip, neck femur fracture, minimally invasive surgery

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Authors: Najmeh Hamid, Vajiheh Hamedy , Zahra Rostamianasl

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Background: Cancer is one of the medical problems that have been associated with pain. Moreover, the pain is combined with negative emotions such as anxiety, depression and anger. Poor pain management causes negative effects on the quality of life, which results in negative effects that continue a long time after the painful experiences. Objectives: The aim of this research was to compare the effectiveness of Common Cognitive Behavioral Therapy for Pain and its computerized version on the reduction of pain intensity, depression, anger and anxiety in children with cancer. Methods: The research method of this “Randomized Controlled Clinical Trial” was a pre, post-test and follow-up with a control group. In this research, we have examined the effectiveness of Common Cognitive Behavioral Therapy for Pain and its computerized version on the reduction of pain intensity, anxiety, depression and anger in children with cancer in Ahvaz. Two psychological interventions (cognitive behavioral therapy for pain and the computerized version) were compared with the control group. The sample consisted of 60 children aged 8 to 12 years old with different types of cancer at Shafa hospital in Ahwaz. According to the including and excluding criteria such as age, socioeconomic status, clinical diagnostic interview and other criteria, 60 subjects were selected. Then, randomly, 45 subjects were selected. The subjects were randomly divided into three groups of 15 (two experimental and one control group). The research instruments included Spielberger Anxiety Inventory (STAY-2) and International Pain Measurement Scale. The first experimental group received 6 sessions of cognitive-behavioral therapy for 6 weeks, and the second group was subjected to a computerized version of cognitive-behavioral therapy for 6 weeks, but the control group did not receive any interventions. For ethical considerations, a version of computerized cognitive-behavioral therapy was provided to them. After 6 weeks, all three groups were evaluated as post-test and eventually after a one-month follow-up. Results: The findings of this study indicated that both interventions could reduce the negative emotions (pain, anger, anxiety, depression) associated with cancer in children in comparison with a control group (p<0.0001). In addition, there were no significant differences between the two interventions (p<0.01). It means both interventions are useful for reducing the negative effects of pain and enhancing adjustment. Conclusion: we can use CBT in situations in which there is no access to psychologists and psychological services. In addition, it can be a useful alternative to conventional psychological interventions.

Keywords: pain, children, psychological intervention, cancer, anger, anxiety, depression

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Authors: Recep Kesli, Huseyin Bilgin, Yasar Unlu, Gokhan Gungor

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Aim: The aim of this study, was to investigate the presence of Helicobacter pylori (H. pylori) infection by culture, histology, and RUT (Rapid Urease Test) in gastric antrum biopsy samples taken from patients presented with dyspeptic complaints and to determine resistance rates of amoxicillin, clarithromycin, levofloxacin and metronidazole against the H. pylori strains by E-test. Material and Methods: A total of 278 patients who admitted to Konya Education and Research Hospital Department of Gastroenterology with dyspeptic complaints, between January 2011-July 2013, were included in the study. Microbiological and histopathological examinations of biopsy specimens taken from antrum and corpus regions were performed. The presence of H. pylori in biopsy samples was investigated by culture (Portagerm pylori-PORT PYL, Pylori agar-PYL, GENbox microaer, bioMerieux, France), histology (Giemsa, Hematoxylin and Eosin staining), and RUT(CLOtest, Cimberly-Clark, USA). Antimicrobial resistance of isolates against amoxicillin, clarithromycin, levofloxacin, and metronidazole was determined by E-test method (bioMerieux, France). As a gold standard in the diagnosis of H. pylori; it was accepted that the culture method alone was positive or both histology and RUT were positive together. Sensitivity and specificity for histology and RUT were calculated by taking the culture as a gold standard. Sensitivity and specificity for culture were also calculated by taking the co-positivity of both histology and RUT as a gold standard. Results: H. pylori was detected in 140 of 278 of patients with culture and 174 of 278 of patients with histology in the study. H. pylori positivity was also found in 191 patients with RUT. According to the gold standard criteria, a false negative result was found in 39 cases by culture method, 17 cases by histology, and 8 cases by RUT. Sensitivity and specificity of the culture, histology, and RUT methods of the patients were 76.5 % and 88.3 %, 87.8 % and 63 %, 94.2 % and 57.2 %, respectively. Antibiotic resistance was investigated by E-test in 140 H. pylori strains isolated from culture. The resistance rates of H. pylori strains to the amoxicillin, clarithromycin, levofloxacin, and metronidazole was detected as 9 (6.4 %), 22 (15.7 %), 17 (12.1 %), 57 (40.7 %), respectively. Conclusion: In our study, RUT was found to be the most sensitive, culture was the most specific test between culture, histology, and RUT methods. Although we detected the specificity of the culture method as high, its sensitivity was found to be quite low compared to other methods. The low sensitivity of H. pylori culture may be caused by the factors affect the chances of direct isolation such as spoild bacterium, difficult-to-breed microorganism, clinical sample retrieval, and transport conditions.

Keywords: antimicrobial resistance, culture, histology, H. pylori, RUT

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Authors: Stanley Yap, Chong Wei Ying, Leow Hon Wei

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Purpose: In Malaysia, an effective financial planning is vital to accumulate wealth and financial independence. However, retirees are required to resume working due to insufficient pension fund. This study examines how the financial decision in retirement planning is being made based on the net worth from the household. Design/methodology/approach: This study uses financial data from a married working couple with children to evaluate their composition of financial position. Numerous financial methods are made pertaining to net worth analysis, insurance needs analysis, investment portfolio rebalancing, estate planning, education planning and retirement planning to enhance the financial decision. Findings: Our results show, firstly, financial planning is essential to achieve financial independence; secondly, insurance needs, education and retirement funding are the most significant for household. Thirdly, current resources are critical to maintain family lifestyle after retirement, emergency funds for critical illness, and the long term children education funding. Practical implications: Refer to the findings, sufficient net worth is priority in financial planning. Different suggestions for household include reduction of unnecessary expenses, re-allocate of cash flow, adequate insurance coverage and re-balancing of investment portfolios to accumulate wealth. It is a challenge to obtain financial independence, hence, there is a need to increase the literature on financial planning. Originality/value: To the best of our knowledge, this is the important paper that uses financial information from household to provide solutions to enhance the efficiency of financial planning industry.

Keywords: net worth, financial planning, wealth and financial independence, retirement planning

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Authors: O. Sunantha, S. Zhenfeng, S. Phattraporn, A. Zeeshan

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The decline of soil organic carbon (SOC) in global agriculture is a critical issue requiring rapid and accurate estimation for informed policymaking. While it is recognized that SOC predictors vary significantly when derived from remote sensing data and environmental variables, identifying the specific parameters most suitable for accurately estimating SOC in diverse agricultural areas remains a challenge. This study utilizes remote sensing data to precisely estimate SOC and identify influential factors in diverse agricultural areas, such as paddy, corn, sugarcane, cassava, and perennial crops. Extreme gradient boosting (XGBoost), random forest (RF), and support vector regression (SVR) models are employed to analyze these factors' impact on SOC estimation. The results show key factors influencing SOC estimation include slope, vegetation indices (EVI), spectral reflectance indices (red index, red edge2), temperature, land use, and surface soil moisture, as indicated by their averaged importance scores across XGBoost, RF, and SVR models. Therefore, using different machine learning algorithms for SOC estimation reveals varying influential factors from remote sensing data and environmental variables. This approach emphasizes feature selection, as different machine learning algorithms identify various key factors from remote sensing data and environmental variables for accurate SOC estimation.

Keywords: factors influencing SOC estimation, remote sensing data, environmental variables, machine learning

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Authors: Ncamisile T. Zulu, Nicholas Munro

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Black women academics in higher education institutions are predominantly portrayed by literature as individuals who usually lack a sense of belonging, progression, and workload management. The oversaturation of this literature can (overtime) perpetuate a stereotypical idea that Black women academics are incapable of coping and succeeding in higher education institutions. The current article explores the agency, motivated by critical consciousness that Black women professors have and utilise in higher education institutions. In order to provide an understanding of how Black women academics can progress, manage their workloads and succeed in higher education institutions, the article considers how these women can take responsibility for their self-development, adaptation, and self-renewal in academic endeavours. As a result, the article presents a line of thought which could help in challenging the stereotype about Black women academics. The study was conducted at two higher education institutions involving Black women professors from different disciplines. A combination of purposive and snowballing sampling was used to recruit nine women participants, while data were collected through interviews. A critical consciousness perspective was adopted to formulate an understanding of the agency of Black women professors in higher education institutions, while thematic analysis was used to analyse the data. The results challenge the widely disseminated view that portrays Black women academics as incapable of coping and succeeding in higher education institutions. The findings highlight Black women professors as proactive, flexible, and self-regulating in their academic endeavours. These findings contribute to the literature by adding a more constructive narrative of Black women academics in higher education.

Keywords: agency, Black women academics, critical consciousness, higher education institutions

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Authors: Mohamed Lotfy, Ghada Soliman

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Recognizing Arabic dot-matrix digits is a challenging problem due to the unique characteristics of dot-matrix fonts, such as irregular dot spacing and varying dot sizes. This paper presents an approach for recognizing Arabic digits printed in dot matrix format. The proposed model is based on Convolutional Neural Networks (CNN) that take the dot matrix as input and generate embeddings that are rounded to generate binary representations of the digits. The binary embeddings are then used to perform Optical Character Recognition (OCR) on the digit images. To overcome the challenge of the limited availability of dotted Arabic expiration date images, we developed a True Type Font (TTF) for generating synthetic images of Arabic dot-matrix characters. The model was trained on a synthetic dataset of 3287 images and 658 synthetic images for testing, representing realistic expiration dates from 2019 to 2027 in the format of yyyy/mm/dd. Our model achieved an accuracy of 98.94% on the expiry date recognition with Arabic dot matrix format using fewer parameters and less computational resources than traditional CNN-based models. By investigating and presenting our findings comprehensively, we aim to contribute substantially to the field of OCR and pave the way for advancements in Arabic dot-matrix character recognition. Our proposed approach is not limited to Arabic dot matrix digit recognition but can also be extended to text recognition tasks, such as text classification and sentiment analysis.

Keywords: computer vision, pattern recognition, optical character recognition, deep learning

Procedia PDF Downloads 92

Authors: Amna Beshir Medani Ahmed, Samia Mohammed Ali El Badwi, Ahmed El Amin Mohammed

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This work has been managed to yield toxicity information on water treatment agents in the Sudan namely polyDADMAC, using New Zealand rabbits at multiple daily oral doses for a period of 10 weeks. Thirty-three heads of New Zealand rabbits were divided into 11 groups, each of three. Group 1 animals were the undosed controls. Test groups of either species were given polyDADMAC at similar dose rates of 0.5, 2.5, 4.5, 10, 15, 20, 25, 50, 100 and 150 mg/kg body weight respectively for groups 2,3,4,5,6,7,8,9,10 and 11. Clinical signs were closely observed with postmortem and histopathological examinations. Chemical investigations included enzymatic concentrations of ALP, GOT, CK, GPT and LDH together with hematological changes in Hb, PCV, RBCs and WBCs. Mortalities occurred to variable degrees irrespective of the dose level. On polyDADMAC challenge, the test species showed clinical signs of dullness, loss of weight, anorexia, diarrhea, difficulty in respiration, hind limb paralysis and recumbency. Notably oral dosing with polyDADMAC caused lung emphysema, hepatic and renal dysfunctions, irregularity in enzymatic activities and serum metabolites, sloughing of intestinal epithelium, decreased electrolytes in serum, and splenic haemosiderosis. On evaluation of the above results, polyDADMAC was considered toxic to New Zealand rabbits at all dose rates tried. Practical implications of the results were highlighted and suggestions for future work were put forward.

Keywords: polydiallyldiethylaluminiumchloride (polyDADMAC), nubian goats, toxicity of drinking water, treatment of drinking water using chemicals

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Authors: Alexander A. Osmolovskiy, Anastasia V. Orekhova, Daria M. Bednenko, Yelyzaveta Boiko

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Micromycetes from Aspergillus genus can produce proteases capable of promoting proteolysis of hemostasis proteins or, along with hydrolytic activity, to show the ability to convert proenzymes of this system activating them into an active form. At the same time, practical medicine needs specific activators for quantitation of the level of some plasma enzymes, especially protein C and factor X, the lack of which leads to the development of thromboembolic diseases. Thus, some micromycetes of the genus Aspergillus were screened for the ability to synthesize extracellular proteases with promising activity for designing anti-thrombotic and diagnostic preparations. Such standard methods like salting out, electrophoresis, isoelectrofocusing were used for isolation, purification and study of physicochemical properties of proteases. Enzyme activity was measured spectrophotometrically fibrin as a substrate of the reaction and chromogenic peptide substrates of different proteases of the human hemostasis system. As a result of the screening, four active producers were selected: Aspergillus janus 301, A. flavus 1, A. terreus 2, and A. ochraceus L-1. The enzyme of A. janus 301 showed the greatest fibrinolytic activity (around 329.2 μmol Tyr/(ml × min)). The protease produced by A. terreus 2 had the highest plasmin-like activity (54.1 nmol pNA/(ml × min)), but fibrinolytic activity was lower than A. janus 301 demonstrated (25.2 μmol Tyr/(ml × min)). For extracellular protease of micromycete A. flavus a high plasmin-like activity was also shown (39.8 nmol pNA / (ml × min)). Moreover, according to our results proteases one of the fungi - A. terreus 2 were able to activate protein C of human plasma - the key factor of the human anticoagulant hemostasis system. This type of activity was 39.8 nmol pNA/(ml × min)). It was also shown that A. ochraceus L-1 could produce extracellular proteases with protein C and factor X activator activities (65.9 nmol pNA/(ml × min) and 34.6 nmol pNA/(ml × min) respectively). The maximum accumulation of the proteases falls on the 4th day of cultivation. Using isoelectrofocusing was demonstrated that the activation of both proenzymes might proceed via limited proteolysis induced by proteases of A. ochraceus L-1. The activatory activity of A. ochraceus L-1 proteases toward essential hemostatic proenzymes, protein C and X factor may be useful for practical needs. It is well known that similar enzymes, activators of protein C and X factor isolated from snake venom, South American copperhead Agkistrodon contortrix contortrix and Russell’s viper Daboia russelli russeli, respectively, are used for the in vitro diagnostics of the functional state of these proteins in blood plasma. Thus, the proteases of Aspergillus genus can be used as cheap components for enzyme thrombolytic preparations.

Keywords: anti-trombotic drugs, fibrinolysis, diagnostics, proteases, micromycetes

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Authors: Mustafa M. Donma, Orkide Donma

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Anthropometric measurements are essential for obesity studies. Waist circumference (WC) is the most frequently used measure, and along with hip circumference (HC), it is used in most equations derived for the evaluation of obese individuals. Morbid obesity is the most severe clinical form of obesity, and such individuals may also exhibit some clinical findings leading to metabolic syndrome (MetS). Then, it becomes a requirement to discriminate morbid obese children with (MOMetS+) and without (MOMetS-) MetS. Almost all obesity indices can differentiate obese (OB) children from children with normal body mass index (N-BMI). However, not all of them are capable of making this distinction. A recently introduced anthropometric obesity index, waist circumference + hip circumference/2 ((WC+HC)/2), was confirmed to differ OB children from those with N-BMI, however it has not been tested whether it will find clinical usage for the differential diagnosis of MOMetS+ and MOMetS-. This study was designed to find out the availability of (WC+HC)/2 for the purpose and to compare the possible preponderance of it over some other anthropometric or fat-based obesity indices. Forty-five MOMetS+ and forty-five MOMetS- children were included in the study. Participants have submitted informed consent forms. The study protocol was approved by the Non-interventional Ethics Committee of Tekirdag Namik Kemal University. Anthropometric measurements were performed. Body mass index (BMI), waist-to-hip circumference (W/H), (WC+HC)/2, trunk-to-leg fat ratio (TLFR), trunk-to-appendicular fat ratio (TAFR), trunk fat+leg fat/2 ((trunk+leg fat)/2), diagnostic obesity notation model assessment index-2 (D2I) and fat mass index (FMI) were calculated for both groups. Study data was analyzed statistically, and 0.05 for p value was accepted as the statistical significance degree. Statistically higher BMI, WC, (WC+HC)/2, (trunk+leg fat)/2 values were found in MOMetS+ children than MOMetS- children. No statistically significant difference was detected for W/H, TLFR, TAFR, D2I, and FMI between two groups. The lack of difference between the groups in terms of FMI and D2I pointed out the fact that the recently developed fat-based index; (trunk+leg fat)/2 gives much more valuable information during the evaluation of MOMetS+ and MOMetS- children. Upon evaluation of the correlations, (WC+HC)/2 was strongly correlated with D2I and FMI in both MOMetS+ and MOMetS- groups. Neither D2I nor FMI was correlated with W/H. Strong correlations were calculated between (WC+HC)/2 and (trunk+leg fat)/2 in both MOMetS- (r=0.961; p<0.001) and MOMetS+ (r=0.936; p<0.001) groups. Partial correlations between (WC+HC)/2 and (trunk+leg fat)/2 after controlling the effect of basal metabolic rate were r=0.726; p<0.001 in MOMetS- group and r=0.932; p<0.001 in MOMetS+ group. The correlation in the latter group was higher than the first group. In conclusion, recently developed anthropometric obesity index (WC+HC)/2 and fat-based obesity index (trunk+leg fat)/2 were of preponderance over the previously introduced classical obesity indices such as W/H, D2I and FMI during the differential diagnosis of MOMetS+ and MOMetS- children.

Keywords: children, hip circumference, metabolic syndrome, morbid obesity, waist circumference

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Authors: Shivaram P. Arunachalam, Mustafa Y. Sir, Andy Boggust, David M. Nestler, Thomas R. Hellmich, Kalyan S. Pasupathy

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Emergency departments (EDs) provide urgent care to patients throughout the day in a complex and chaotic environment. Real-time location systems (RTLS) are increasingly being utilized in healthcare settings, and have shown to improve safety, reduce cost, and increase patient satisfaction. Radio Frequency Identification Device (RFID) data in an ED has been shown to compute variables such as patient-provider contact time, which is associated with patient outcomes such as 30-day hospitalization. These variables can provide avenues for improving ED operational efficiency. A major challenge with ED financial operations is under-coding of critical care services due to physicians’ difficulty reporting accurate times for critical care provided under Current Procedural Terminology (CPT) codes 99291 and 99292. In this work, the authors propose a framework to optimize ED critical care billing using RFID data. RFID estimated physician-patient contact times could accurately quantify direct critical care services which will help model a data-driven approach for ED critical care billing. This paper will describe the framework and provide insights into opportunities to prevent under coding as well as over coding to avoid insurance audits. Future work will focus on data analytics to demonstrate the feasibility of the framework described.

Keywords: critical care billing, CPT codes, emergency department, RFID

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Authors: Abu Bakar Siddik

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The July Movement in Bangladesh marked a pivotal moment in the nation’s struggle for democratic freedom and the right to free speech. This movement, driven by citizens, intellectuals, and activists, opposed authoritarian governance and the violation of civil liberties. By encouraging support for democratic reforms, it significantly changed the political landscape and highlighted the importance of grassroots activism for human rights. This essay examines the sociopolitical dynamics of the July Movement and its roots in popular resistance to authoritarian rule. It explores the movement's beginnings, emphasizing how citizens, scholars, and activists united to challenge the regime that restricted freedom of speech. In order to show how the movement gathered support for democratic reforms and ultimately helped bring about the overthrow of the regime, the article examines significant demonstrations, speeches, and government acts. This book offers a thorough examination of how the July Movement changed Bangladesh's political landscape by acting as a revolution for free speech and a trigger for the overthrow of autocratic authority, using historical documents, media coverage, and firsthand recollections. This study provides insightful information about how grassroots activism advances human rights.

Keywords: July movement, Bangladesh, free speech, democracy, authoritarianism, civil liberties, political change, human rights, social movements, protests, political landscape, regime change, activism, socio-political dynamics

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Authors: Büşra Güven, Ebru Kerimoğlu

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Relevant departments of universities in creative fields are increasingly facing the challenge of developing curriculum for more employable creative workforce. In Turkey, as a developing country, the creative industries have not yet argued in the political axis and higher education also has not been addressed in this context. Istanbul has the highest creative and cultural industries share also provides both rooted and developing higher education institutes for these sectors in Turkey. With this in mind, the main purpose of the paper attempts to clarify that how does higher education in creative fields deal with the demands of creative industries in Istanbul? First, the paper elaborated creative class theory, second creative industries, employability and curriculum triangle is examined. The research methodology consisted of a qualitative model based on interview analysis. Data are collected by interviews with the head of the relevant departments and professional associations authorities in selected sectors. Four higher education institutes in Istanbul are selected according to the some clarified factors related to the literature. This also offered a comparing between public and private universities in terms of the adaptability of this changing concept of work. Industry expectations and content of educations were compared and found the blind spots in the education-industry relationships. As a consequence, produced inclusive policies for universities and industries to overcome these spots with collaboration, flexibility, adaptability, openness and feedback management and also for future policies in particular outcomes of university-industry collaborations.

Keywords: creative industries, curriculum, employability, high education, Istanbul

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Authors: Eze Chinwe Catherine, Orji Nkiru Marykate, Anyaegbunam L. C., Igbodika M.C.

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Uterine Leiomyomata (ULs) are the most frequently occurring pelvic and gynaecologic tumors in premenopausal women, occurring globally with a prevalence of 21.4%. UL represents a major public health problem in African women; therefore, this study aimed to reveal public health impact and risk factors associated with uterine leiomyomata among women in Imo state. A convenience sample of 2965 women was studied for gynaecological cases from October 2020 to March 2021 at the selected clinics of study. Eligible women were recruited to participate in a non interventional descriptive cross-sectional study. Data on socio demographic and gynaecological characteristics, BMI, parity, age, age at menarche, knowledge, attitudes, and perception were collected using a structured questionnaire, guided interviews, anthropometrics, and haematological tests. These were analyzed using SPSS Version 23. Associations between continuous variables were analysed appropriately and tested at 95% confidence level and standard error of 5%. A total of 652(22.0%) were diagnosed having uterine Leiomyomata (UL), and the overall prevalence of UF at clinics/Diagnostic centre in Imo State was 22%. A total of 652 women (46.1%) responded. More than half of the women had a parity of zero (1623: 54.8%), 664 (22.4%) had a parity of 1-2, and 491 (16.6%) had a parity of 3-4. Majority (68.6%) indicated that they experience an irregular menstrual cycle, and a similar proportion (67%) number experience pelvic pain. Age was found as a significant associating factor of uterine fibroids in this study (p=0.046, χ2= 6.158), lowest among the women between 16 to 25 years old and highest among the women between 36 – 45 years of age. The rate of UF was found to be 62.1% on the studied women menarche age of 11 years old or less while it was approximately 18% among the women whose age at menarche were at least 14 years old. Education ((p=0.003, χ²= 13.826), residency (p=0.066, χ²= 3.372). BMI (p= 0.000, χ²=102.36) were significantly associated with the risk of UL. Some of the Clinical presentation includes anaemia, abdominal pelvic mass, and infertility. The poor positive perception was obtained on the general perception (16.7%) as well as on treatment seeking behavior (28%). The study concluded that UL had a significant impact on health related quality of life on respondents due to its relatively high prevalence and their probable impact on patient’s quality of life.UL was especially prevalent in women aged between 36 to 45 years, nulliparous women, and women of higher BMI. Community enlightenment to enhance knowledge, attitude, and perception on fibroids and risk factors necessary to ensure early diagnosis and presentation, including patient centered treatment option.

Keywords: fibroids, prevalence, risk factors, body mass index, menarche, anaemia, KAP

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Authors: Isra Elfatih Salih Edrees, Mehmet Serdar Ufuk Türeli

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In this paper, an energy-aware method is presented, integrating energy-efficient relay-augmented techniques for correlated data routing with the goal of optimizing bottleneck throughput in wireless sensor networks. The system tackles the dual challenge of throughput optimization while considering sensor network energy consumption. A unique routing metric has been developed to enable throughput maximization while minimizing energy consumption by utilizing data correlation patterns. The paper introduces a game theoretic framework to address the NP-complete optimization problem inherent in throughput-maximizing correlation-aware routing with energy limitations. By creating an algorithm that blends energy-aware route selection strategies with the best reaction dynamics, this framework provides a local solution. The suggested technique considerably raises the bottleneck throughput for each source in the network while reducing energy consumption by choosing the best routes that strike a compromise between throughput enhancement and energy efficiency. Extensive numerical analyses verify the efficiency of the method. The outcomes demonstrate the significant decrease in energy consumption attained by the energy-efficient relay-augmented bottleneck throughput maximization technique, in addition to confirming the anticipated throughput benefits.

Keywords: correlated data aggregation, energy efficiency, game theory, relay-augmented routing, throughput maximization, wireless sensor networks

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Authors: Abdul Latheef O. Mavukkandy

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Islamization of knowledge (IOK) is an intellectual movement emerged in the middle of 1970s to address the threats by modern western civilizational onslaughts. This paper analyzes the discourse of Islamization of knowledge with special reference to the views of Kamal Hassan who prefers an alternative term called 'Islamicization'. First of all the theoretical and practical outlines of IOK movement were presented by Ismail Raji al-Faruqi in his book 'Islamization of Knowledge; General Principles and Work Plan' in 1982. He identified that the educational system in the Muslim world accounted for the decline of Muslim Ummah through de-Islamization and demoralization. So, the need for IOK was an academic challenge to reconstruct the Ummah. Kamal Hassan kept just different view from Ismail Raji al-Faruqi and Muhammed Naquib al-Attas that he coined the terms 'Relevantization and Contextualization'. So, he wanted the 'Islamization of Islamic Revealed Knowledge'. So, he used Islamization of Human Knowledge (IOHK) instead of IOK. As part of this movement, the IOK identified that the textbooks used in Muslim educational institutions systematically keep the students estranged from Islam and its heritage. Furthermore, the modern secular knowledge develops secular attitude devoid of Islamic moral philosophy and the sense of mission in life. Based upon the content analysis of some of the sources, this study found that Islamization of Knowledge is an important movement in Islamic world, but the IOK project is not practicable completely because of the lack of trained teachers and resources. Although, the project resulted in the foundation of some universities and publishing more works, journals and doctoral thesis on different dimensions of Islamization of Knowledge.

Keywords: Islamization, Islamicization, releventization, human knowledge

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Authors: Parker Murray, Marci Johnson, Tyson S. Burnham, Alina K. Fong, Mark D. Allen, Bruce McIff

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Purpose: Pathological dysregulation of Neurovascular Coupling (NVC) caused by mild traumatic brain injury (mTBI) is the predominant source of chronic post-concussion syndrome (PCS) symptomology. fNCI has the ability to localize dysregulation in NVC by measuring blood-oxygen-level-dependent (BOLD) signaling during the performance of fMRI-adapted neuropsychological evaluations. With fNCI, 57 brain areas consistently affected by concussion were identified as PCS neural markers, which were validated on large samples of concussion patients and healthy controls. These neuromarkers provide the basis for a computation of PCS severity which is referred to as the Severity Index Score (SIS). The SIS has proven valuable in making pre-treatment decisions, monitoring treatment efficiency, and assessing long-term stability of outcomes. Methods and Materials: After being scanned while performing various cognitive tasks, 476 concussed patients received an SIS score based on the neural dysregulation of the 57 previously identified brain regions. These scans provide an objective measurement of attentional, subcortical, visual processing, language processing, and executive functioning abilities, which were used as biomarkers for post-concussive neural dysregulation. Initial SIS scores were used to develop individualized therapy incorporating cognitive, occupational, and neuromuscular modalities. These scores were also used to establish pre-treatment benchmarks and measure post-treatment improvement. Results: Changes in SIS were calculated in percent change from pre- to post-treatment. Patients showed a mean improvement of 76.5 percent (σ= 23.3), and 75.7 percent of patients showed at least 60 percent improvement. Longitudinal reassessment of 24 of the patients, measured an average of 7.6 months post-treatment, shows that SIS improvement is maintained and improved, with an average of 90.6 percent improvement from their original scan. Conclusions: fNCI provides a reliable measurement of NVC allowing for identification of concussion pathology. Additionally, fNCI derived SIS scores direct tailored therapy to restore NVC, subsequently resolving chronic PCS resulting from mTBI.

Keywords: concussion, functional magnetic resonance imaging (fMRI), neurovascular coupling (NVC), post-concussion syndrome (PCS)

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Authors: Tianqi Yin

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The sharia had been the legislative basis in the Ottoman Empire since its emergence. The authority of sharia was superlative in the Islamic society compared to the power of the sulta, the nominal ruler of the nation, regulating essentially every aspect of people’s lives according to an ethical code. In modernity, however, as European sovereignty employed forces to re-engineer the Islamic world to make it more like their own, a society ruled by a state, the Ottoman legislation system encountered a great challenge of adopting codified laws to replace sharia with the formulation of the Mecelle being a prominent case. Interpretations of this transformation have been contentious, with the key debate revolving around whether these codified laws are authentic representations of sharia or alien legal formulations authorized by the modern nation-state under heavy European colonial influence. Because of the difference in methodology of the diverse theories, challenges toward having a universal conclusion on this issue remain. This paper argues that the formulation of the Mecelle and other codified laws is a discontinuity of sharia due to European modernity’s influence and that the emphasis on elements of Islamic laws is a tactic employed to promote this process. These codified laws signals a complete social transformation from the Islamic society ruled by the sharia to a replication of the European society that is ruled by a comprehensive ruling system of the modern state. In addition to advancing the discussion on the characterization of the codification movement in the Ottoman Empire in modernity, the research also promotes the determination of the nature of the modern codification movement globally.

Keywords: codification, mecelle, modernity, sharia, ottoman empire

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Authors: Nishant Rodrigues, Nicole Spanedda, Chilukuri K. Mohan, Arindam Chakraborty

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A crucial objective in quantum chemistry is the computation of the energy levels of chemical systems. This task requires electron-repulsion integrals as inputs, and the steep computational cost of evaluating these integrals poses a major numerical challenge in efficient implementation of quantum chemical software. This work presents a moment-based machine-learning approach for the efficient evaluation of electron-repulsion integrals. These integrals were approximated using linear combinations of a small number of moments. Machine learning algorithms were applied to estimate the coefficients in the linear combination. A random forest approach was used to identify promising features using a recursive feature elimination approach, which performed best for learning the sign of each coefficient but not the magnitude. A neural network with two hidden layers were then used to learn the coefficient magnitudes along with an iterative feature masking approach to perform input vector compression, identifying a small subset of orbitals whose coefficients are sufficient for the quantum state energy computation. Finally, a small ensemble of neural networks (with a median rule for decision fusion) was shown to improve results when compared to a single network.

Keywords: quantum energy calculations, atomic orbitals, electron-repulsion integrals, ensemble machine learning, random forests, neural networks, feature extraction

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Authors: Ryota Kuzuki, Mitsuhiro Kohara, Noboru Kizuki, Satoshi Yoshida, Hidetaka Hirai, Yuta Nezasa

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About fifty years have passed since Japan's gas supply industry became the first in the world to switch from coal and oil to LNG as a city gas feedstock. Since the Japanese government target of net-zero carbon emission in 2050 was announced in October 2020, it has now entered a new era of challenges to commit to the requirement for decarbonization. This paper describes the situation that synthetic methane, produced from renewable energy-derived hydrogen and recycled carbon, is a promising national policy of transition toward net-zero society. In November 2020, the Japan Gas Association announced the 'Carbon Neutral Challenge 2050' as a vision to contribute to the decarbonization of society by converting the city gas supply to carbon neutral. The key technologies is methanation. This paper shows that methanation is a realistic solution to contribute to the decarbonization of the whole country at a lower social cost, utilizing the supply chain that already exists, from LNG plants to burner chips. The challenges during the transition period (2030-2050), as CO2 captured from exhaust of thermal power plants and industrial factories are expected to be used, it is proposed that a system of guarantee of origin (GO) for H2 and CO2 should be established and harmonize international rules for calculating and allocating greenhouse gas emissions in the supply chain, a platform is also needed to manage tracking information on certified environmental values.

Keywords: synthetic methane, recycled carbon fuels, methanation, transition period, environmental value transfer platform

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Authors: Cecilia Moreira, Rita Paiva, Daniela Macedo, Leonor Ribeiro, Isabel Fernandes, Luis Costa

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Background: Head and neck paragangliomas are a rare group of tumors with a large spectrum of clinical manifestations. The approach to evaluate and treat these lesions has evolved over the last years. Surgery was the standard for the approach of these patients, but nowadays new techniques of imaging and radiation therapy changed that paradigm. Despite advances in treating, the growth potential and clinical outcome of individual cases remain largely unpredictable. Objectives: Characterization of our institutional experience with clinical management of these tumors. Methods: This was a cross-sectional study of patients followed in our institution between 01 January and 31 December 2017 with paragangliomas of the head and neck and cranial base. Data on tumor location, catecholamine levels, and specific imaging modalities employed in diagnostic workup, treatment modality, tumor control and recurrence, complications of treatment and hereditary status were collected and summarized. Results: A total of four female patients were followed between 01 January and 31 December 2017 in our institution. The mean age of our cohort was 53 (± 16.1) years. The primary locations were at the level of the tympanic jug (n=2, 50%) and carotid body (n=2, 50%), and only one of the tumors of the carotid body presented pulmonary metastasis at the time of diagnosis. None of the lesions were catecholamine-secreting. Two patients underwent genetic testing, with no mutations identified. The initial clinical presentation was variable highlighting the decrease of visual acuity and headache as symptoms present in all patients. In one of the cases, loss of all teeth of the lower jaw was the presenting symptomatology. Observation with serial imaging, surgical extirpation, radiation, and stereotactic radiosurgery were employed as treatment approaches according to anatomical location and resectability of lesions. As post-therapeutic sequels the persistence of tinnitus and disabling pain stands out, presenting one of the patients neuralgia of the glossopharyngeal. Currently, all patients are under regular surveillance with a median follow up of 10 months. Conclusion: Ultimately, clinical management of these tumors remains challenging owing to heterogeneity in clinical presentation, the existence of multiple treatment alternatives, and potential to cause serious detriment to critical functions and consequently interference with the quality of life of the patients.

Keywords: clinical outcomes, head and neck, management, paragangliomas

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Authors: Francis O. Iyoha, Daniel E. Gberevbie, Charles T. Iruonagbe, Matthew E. Egharevba

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Cost of governance in Nigeria has become a challenge to development and concern to practitioners and scholars alike in the field of business and social science research. It has been observed that it takes 70 percent of the nation’s revenue to maintain less than 20 percent of the Nigerian population that are public servants. Furthermore, it has been observed that on a consistent yearly basis, the recurrent expenditure of government from the national budget keeps rising, while capital expenditure meant for development keeps falling. The implication is that development is stagnated in the country. For instance, in the 2010 national budget of NGN4.60tn or USD28.75b, only NGN1.80tn or USD11.15b was set aside for capital expenditure. Also, in the 2013 national budget of NGN4.92tn or USD30.75b, only NGN1.50tn or USD9.38b was set aside for capital expenditure. Therefore, with the analysis of secondary data, this study examined the reasons for the high cost of governance in Nigeria. It observed that the high cost of governance in the country is in the interest of the ruling class, arising from their unethical behaviour – corrupt practices and the poor management of public resources. As a result, the study recommends the need to intensify the war against corruption and mismanagement of public resources by government officials as possible solution to overcome the high cost of governance in Nigeria. This could be achieved by strengthening the constitutional powers of the various anti-corruption agencies in the area of arrest, investigation and prosecution of offenders without the interference of the executive arm of government either at the local, state or federal level.

Keywords: cost of governance, capital expenditure, recurrent expenditure, unethical behavior, Nigeria

Procedia PDF Downloads 339

Authors: Moizza Tahir, Uzma Bashir, Aisha Akhtar, Zainab Ansari, Sameen Ansari, Muhammad Ali Tahir

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Cancer burden has globally increased. Among cutaneous cancers basal cell carcinoma constitute vast majority of skin cancer. There is need for appropriate diagnostic, therapeutic and prognostic significance evaluation for skin cancers Present study report intraoperative frozen section (FS) histopathological clearance for excision of BCC in a tertiary care center and find the frequency of involvement of surgical margin with reference to anatomical site, with size and surgical technique. It was prospective open label interventional study conducted at Dermatology department of tertiary care hospital Rawalpindi Pakistan in lais on with histopathology department from January 2023 to April 2024. Total of thirty-six (n = 36) patients between age 45-80 years with basal cell carcinoma of 10-20mm on face were included following inclusion exclusion criteria by purposive sampling technique. Informed consent was taken. Surgical excision was performed and intraoperative frozen section histopathology clearance of tumor margin was taken from histopathologist on telephone. Surgical reconstruction was done. Final Histopathology report was reexamined on day 10th for margin and depth clearance. Descriptive statistics were calculated for age, gender, sun exposure, reconstructive technique, anatomical site, and tumor free margin report on frozen section analysis. Chi square test was employed for statistical significance of involvement of surgical margin with reference to anatomical site, size and decision on reconstructive surgical technique, p value of <0.05 was considered significant. Total of 36 patients of BCC were enrolled, males 12 (33.3%) and females were 24 (66.6%). Age ranged from 45 year to 80 year mean of 58.36 ±SD7.8. Size of BCC ranged from 10mm to 35mm mean of 25mm ±SD 0.63. Morphology was nodular 18 (50%), superficial spreading 11(30.6%), morphoeic 1 (2.8%) and ulcerative in 6(16.7%) cases. Intraoperative frozen section for histopathological margin clearance with 2-3 mm safety margin and surgical technique has p-value0.51, for anatomical site p value 0.24 and size p-0.84. Intraoperative frozen section (FS) histopathological clearance for BCC face with 2-3mm safety margin with reference to reconstructive technique, anatomical site and size of BCC were insignificant.

Keywords: basal cell carcinoma, tumor free amrgin, basal cell carcinoma and frozen section, safety margin

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Authors: Nasser Mansour, Ziad Said, Abdullah Abu-Tineh

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STEM teachers face the challenge of possessing expertise not only in their subject disciplines but also in the pedagogical knowledge required for integrated STEM lessons. However, research reveals a lack of pedagogical competencies related to project-based learning (PBL) in the STEM context. To bridge this gap, the study examines teachers' competencies and self-efficacy in TPACK (Technological Pedagogical Content Knowledge) and its specific integration with PBL and STEM content. Data from 245 specialized science and math teachers were collected using a questionnaire. The study emphasizes the importance of addressing gender disparities, supporting formal teacher education, and recognizing the expertise and experiences of STEM teachers in effective technology integration. The findings indicate that gender plays a role in self-efficacy beliefs, with females exhibiting higher confidence in pedagogical knowledge and males demonstrating higher confidence in technological knowledge. Teaching experience and workload factors have a limited impact on teachers' Technological Pedagogical Content Knowledge (TPACK). These findings enhance our understanding of contextual factors impacting science and math teachers' self-efficacy in utilizing TPACK for STEM and PBL. They inform the development of targeted interventions, professional development programs, and support systems to enhance teachers' competencies and self-efficacy in TPACK for teaching science and Mathematics through STEM and PBL.

Keywords: technological pedagogical content knowledge, TPACK, STEM, project-based learning, PBL, self-efficacy, mathematics, science

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Authors: Tamphasana Wairokpam

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Inflammatory myopathies (IMs) have long been recognised as a heterogenous family of myopathies with acute, subacute, and sometimes chronic presentation and are potentially treatable. Necrotizing autoimmune myopathies (NAM) are a relatively new subset of myopathies. Patients generally present with subacute onset of proximal myopathy and significantly elevated creatinine kinase (CK) levels. It is being increasingly recognised that there are limitations to the independent diagnostic utility of muscle biopsy. Immunohistochemistry tests may reveal important information in these cases. The traditional classification of IMs failed to recognise NAM as a separate entity and did not adequately emphasize the diversity of IMs. This review and case report on NAM aims to highlight the heterogeneity of this entity and focus on the distinct clinical presentation, biopsy findings, specific auto-antibodies implicated, and available treatment options with prognosis. This article is a meta-analysis of literatures on NAM and a case report illustrating the clinical course, investigation and biopsy findings, antibodies implicated, and management of a patient with NAM. The main databases used for the search were Pubmed, Google Scholar, and Cochrane Library. Altogether, 67 publications have been taken as references. Two biomarkers, anti-signal recognition protein (SRP) and anti- hydroxyl methylglutaryl-coenzyme A reductase (HMGCR) Abs, have been found to have an association with NAM in about 2/3rd of cases. Interestingly, anti-SRP associated NAM appears to be more aggressive in its clinical course when compared to its anti-HMGCR associated counterpart. Biopsy shows muscle fibre necrosis without inflammation. There are reports of statin-induced NAM where progression of myopathy has been seen even after discontinuation of statins, pointing towards an underlying immune mechanism. Diagnosisng NAM is essential as it requires more aggressive immunotherapy than other types of IMs. Most cases are refractory to corticosteroid monotherapy. Immunosuppressive therapy with other immunotherapeutic agents such as IVIg, rituximab, mycophenolate mofetil, azathioprine has been explored and found to have a role in the treatment of NAM. In conclusion,given the heterogeneity of NAM, it appears that NAM is not just a single entity but consists of many different forms, despite the similarities in presentation and its classification remains an evolving field. A thorough understanding of underlying mechanism and the clinical correlation with antibodies associated with NAM is essential for efficacious management and disease prognostication.

Keywords: inflammatory myopathies, necrotising autoimmune myopathies, anti-SRP antibody, anti-HMGCR antibody, statin induced myopathy

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Authors: Mehrzad Soltani, Pegah Rezaei

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In the endeavor to construct cities that are not only thriving but also environmentally responsible, effective urban planning and architectural design assume paramount significance. The focal point of this pursuit is the harnessing of urban renewable energy. By embracing sustainable practices such as the integration of solar panels into the urban landscape and the establishment of smart grids, cities are poised to confront head-on the dual challenge of surging energy demands and pressing environmental concerns. Urban renewable energy solutions offer a multifaceted approach to these issues. Firstly, they usher in a clean and sustainable source of energy, reducing the cities' ecological footprint while ensuring a continuous power supply. This transition to eco-friendly energy is also intrinsically linked to enhanced spatial utilization, thereby streamlining the efficiency of urban areas. Moreover, it spurs the adoption of sustainable transportation alternatives, diminishing the reliance on fossil fuels and mitigating air pollution. However, the significance of integrating renewable energy solutions transcends the realm of urban sustainability. It embodies a holistic approach towards creating cities that harmoniously coexist with the natural environment while catering to the needs and aspirations of their inhabitants. In essence, prioritizing sustainability in urban planning and architectural design has evolved from a choice to a necessity, one that not only safeguards the cities' well-being but also fosters a better quality of life for their residents. Thus, it is imperative that we acknowledge the transformative potential of these innovations as we pave the way towards the cities of the future.

Keywords: sustainability, smart grids, solar panel, urban planning, environmental concerns

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