Search results for: critical diagnostic distinctions
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6187

Search results for: critical diagnostic distinctions

3697 Psychosocial Experiences of Black Male Students in Public and Social Spaces on and around a Historically White South African Campus

Authors: Claudia P. Saunderson

Abstract:

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

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

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3696 Exploring the Impact of Mobility-Related Treatments (Drug and Non-Pharmacological) on Independence and Wellbeing in Parkinson’s Disease - A Qualitative Synthesis

Authors: Cameron Wilson, Megan Hanrahan, Katie Brittain, Riona McArdle, Alison Keogh, Lynn Rochester

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Background: The loss of mobility and functional dependence is a significant marker in the progression of neurodegenerative diseases such as Parkinson’s Disease (PD). Pharmacological, surgical, and therapeutic treatments are available that can help in the management and amelioration of PD symptoms; however, these only prolong more severe symptoms. Accordingly, ensuring people with PD can maintain independence and a healthy wellbeing are essential in establishing an effective treatment option for those afflicted. Existing literature reviews have examined experiences in engaging with PD treatment options and the impact of PD on independence and wellbeing. Although, the literature fails to explore the influence of treatment options on independence and wellbeing and therefore misses what people value in their treatment. This review is the first that synthesises the impact of mobility-related treatments on independence and wellbeing in people with PD and their carers, offering recommendations to clinical practice and provides a conceptual framework (in development) for future research and practice. Objectives: To explore the impact of mobility-related treatment (both pharmacological and non-pharmacological) on the independence and wellbeing of people with PD and their carers. To propose a conceptual framework to patients, carers and clinicians which captures the qualities people with PD value as part of their treatment. Methods: We performed a critical interpretive synthesis of qualitative evidence, searching six databases for reports that explored the impact of mobility-related treatments (both drug and non-pharmacological) on independence and wellbeing in Parkinson’s Disease. The types of treatments included medication (Levodopa and Amantadine), dance classes, Deep-Brain Stimulation, aquatic therapies, physical rehabilitation, balance training and foetal transplantation. Data was extracted, and quality was assessed using an adapted version of the NICE Quality Appraisal Tool Appendix H before being synthesised according to the critical interpretive synthesis framework and meta-ethnography process. Results: From 2301 records, 28 were eligible. Experiences and impact of treatment pathway on independence and wellbeing was similar across all types of treatments and are described by five inter-related themes: (i) desire to maintain independence, (ii) treatment as a social experience during and after, (iii) medication to strengthen emotional health, (iv) recognising physical capacity and (v) emphasising the personal journey of Parkinson’s treatments. Conclusion: There is a complex and inter-related experience and effect of PD treatments common across all types of treatment. The proposed conceptual framework (in development) provides patients, carers, and clinicians recommendations to personalise the delivery of PD treatment, thereby potentially improving adherence and effectiveness. This work is vital to disseminate as PD treatment transitions from subjective and clinically captured assessments to a more personalised process supplemented using wearable technology.

Keywords: parkinson's disease, medication, treatment, dance, review, healthcare, delivery, levodopa, social, emotional, psychological, personalised healthcare

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3695 The Use of Venous Glucose, Serum Lactate and Base Deficit as Biochemical Predictors of Mortality in Polytraumatized Patients: Acomparative with Trauma and Injury Severity Score and Acute Physiology and Chronic Health Evalution IV

Authors: Osama Moustafa Zayed

Abstract:

Aim of the work: To evaluate the effectiveness of venous glucose, levels of serum lactate and base deficit in polytraumatized patients as simple parameters to predict the mortality in these patients. Compared to the predictive value of Trauma and injury severity (TRISS) and Acute Physiology And Chronic Health Evaluation IV (APACHE IV). Introduction: Trauma is a serious global health problem, accounting for approximately one in 10 deaths worldwide. Trauma accounts for 5 million deaths per year. Prediction of mortality in trauma patients is an important part of trauma care. Several trauma scores have been devised to predict injury severity and risk of mortality. The trauma and injury severity score (TRISS) was most common used. Regardless of the accuracy of trauma scores, is based on an anatomical description of every injury and cannot be assigned to the patients until a full diagnostic procedure has been performed. So we hypothesized that alterations in admission glucose, lactate levels and base deficit would be an early and easy rapid predictor of mortality. Patient and Method: a comparative cross-sectional study. 282 Polytraumatized patients attended to the Emergency Department(ED) of the Suez Canal university Hospital constituted. The period from 1/1/2012 to 1/4/2013 was included. Results: We found that the best cut off value of TRISS probability of survival score for prediction of mortality among poly-traumatized patients is = 90, with 77% sensitivity and 89% specificity using area under the ROC curve (0.89) at (95%CI). APACHE IV demonstrated 67% sensitivity and 95% specificity at 95% CI at cut off point 99. The best cutoff value of Random Blood Sugar (RBS) for prediction of mortality was>140 mg/dl, with 89%, sensitivity, 49% specificity. The best cut off value of base deficit for prediction of mortality was less than -5.6 with 64% sensitivity, 93% specificity. The best cutoff point of lactate for prediction of mortality was > 2.6 mmol/L with 92%, sensitivity, 42% specificity. Conclusion: According to our results from all evaluated predictors of mortality (laboratory and scores) and mortality based on the estimated cutoff values using ROC curves analysis, the highest risk of mortality was found using a cutoff value of 90 in TRISS score while with laboratory parameters the highest risk of mortality was with serum lactate > 2.6 . Although that all of the three parameter are accurate in predicting mortality in poly-traumatized patients and near with each other, as in serum lactate the area under the curve 0.82, in BD 0.79 and 0.77 in RBS.

Keywords: APACHE IV, emergency department, polytraumatized patients, serum lactate

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3694 Influence of Pretreatment Magnetic Resonance Imaging on Local Therapy Decisions in Intermediate-Risk Prostate Cancer Patients

Authors: Christian Skowronski, Andrew Shanholtzer, Brent Yelton, Muayad Almahariq, Daniel J. Krauss

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Prostate cancer has the third highest incidence rate and is the second leading cause of cancer death for men in the United States. Of the diagnostic tools available for intermediate-risk prostate cancer, magnetic resonance imaging (MRI) provides superior soft tissue delineation serving as a valuable tool for both diagnosis and treatment planning. Currently, there is minimal data regarding the practical utility of MRI for evaluation of intermediate-risk prostate cancer. As such, the National Comprehensive Cancer Network’s guidelines indicate MRI as optional in intermediate-risk prostate cancer evaluation. This project aims to elucidate whether MRI affects radiation treatment decisions for intermediate-risk prostate cancer. This was a retrospective study evaluating 210 patients with intermediate-risk prostate cancer, treated with definitive radiotherapy at our institution between 2019-2020. NCCN risk stratification criteria were used to define intermediate-risk prostate cancer. Patients were divided into two groups: those with pretreatment prostate MRI, and those without pretreatment prostate MRI. We compared the use of external beam radiotherapy, brachytherapy alone, brachytherapy boost, and androgen depravation therapy between the two groups. Inverse probability of treatment weighting was used to match the two groups for age, comorbidity index, American Urologic Association symptoms index, pretreatment PSA, grade group, and percent core involvement on prostate biopsy. Wilcoxon Rank Sum and Chi-squared tests were used to compare continuous and categorical variables. Of the patients who met the study’s eligibility criteria, 133 had a prostate MRI and 77 did not. Following propensity matching, there were no differences between baseline characteristics between the two groups. There were no statistically significant differences in treatments pursued between the two groups: 42% vs 47% were treated with brachytherapy alone, 40% vs 42% were treated with external beam radiotherapy alone, 18% vs 12% were treated with external beam radiotherapy with a brachytherapy boost, and 24% vs 17% received androgen deprivation therapy in the non-MRI and MRI groups, respectively. This analysis suggests that pretreatment MRI does not significantly impact radiation therapy or androgen deprivation therapy decisions in patients with intermediate-risk prostate cancer. Obtaining a pretreatment prostate MRI should be used judiciously and pursued only to answer a specific question, for which the answer is likely to impact treatment decision. Further follow up is needed to correlate MRI findings with their impacts on specific oncologic outcomes.

Keywords: magnetic resonance imaging, prostate cancer, definitive radiotherapy, gleason score 7

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3693 Integrated Model for Enhancing Data Security Processing Time in Cloud Computing

Authors: Amani A. Saad, Ahmed A. El-Farag, El-Sayed A. Helali

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Cloud computing is an important and promising field in the recent decade. Cloud computing allows sharing resources, services and information among the people of the whole world. Although the advantages of using clouds are great, but there are many risks in a cloud. The data security is the most important and critical problem of cloud computing. In this research a new security model for cloud computing is proposed for ensuring secure communication system, hiding information from other users and saving the user's times. In this proposed model Blowfish encryption algorithm is used for exchanging information or data, and SHA-2 cryptographic hash algorithm is used for data integrity. For user authentication process a simple user-name and password is used, the password uses SHA-2 for one way encryption. The proposed system shows an improvement of the processing time of uploading and downloading files on the cloud in secure form.

Keywords: cloud computing, data security, SAAS, PAAS, IAAS, Blowfish

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3692 Impact of Transportation on the Economic Growth of Nigeria

Authors: E. O. E. Nnadi

Abstract:

Transportation is a critical factor in the economic growth and development of any nation, region or state. Good transportation network supports every sector of the economy like the manufacturing, transportation and encourages investors thereby affect the overall economic prosperity. The paper evaluates the impact of transportation on the economic growth of Nigeria using south eastern states as a case study. The choice of the case study is its importance as the commercial and industrial nerve of the country. About 200 respondents who are of different professions such as dealers in goods, transporters, contractors, consultants, bankers were selected and a set of questionnaire were administered to using the systematic sampling technique in the five states of the region. Descriptive statistics and relative importance index (RII) technique was employed for the analysis of the data gathered. The findings of the analysis reveal that Nigeria has the least effective ratio per population in Africa of 949.91 km/Person. Conclusion was drawn to improve road network in the area and the country as a whole to enhance the economic activities of the people.

Keywords: economic growth, south-east, transportation, transportation cost, Nigeria

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3691 Seismic Perimeter Surveillance System (Virtual Fence) for Threat Detection and Characterization Using Multiple ML Based Trained Models in Weighted Ensemble Voting

Authors: Vivek Mahadev, Manoj Kumar, Neelu Mathur, Brahm Dutt Pandey

Abstract:

Perimeter guarding and protection of critical installations require prompt intrusion detection and assessment to take effective countermeasures. Currently, visual and electronic surveillance are the primary methods used for perimeter guarding. These methods can be costly and complicated, requiring careful planning according to the location and terrain. Moreover, these methods often struggle to detect stealthy and camouflaged insurgents. The object of the present work is to devise a surveillance technique using seismic sensors that overcomes the limitations of existing systems. The aim is to improve intrusion detection, assessment, and characterization by utilizing seismic sensors. Most of the similar systems have only two types of intrusion detection capability viz., human or vehicle. In our work we could even categorize further to identify types of intrusion activity such as walking, running, group walking, fence jumping, tunnel digging and vehicular movements. A virtual fence of 60 meters at GCNEP, Bahadurgarh, Haryana, India, was created by installing four underground geophones at a distance of 15 meters each. The signals received from these geophones are then processed to find unique seismic signatures called features. Various feature optimization and selection methodologies, such as LightGBM, Boruta, Random Forest, Logistics, Recursive Feature Elimination, Chi-2 and Pearson Ratio were used to identify the best features for training the machine learning models. The trained models were developed using algorithms such as supervised support vector machine (SVM) classifier, kNN, Decision Tree, Logistic Regression, Naïve Bayes, and Artificial Neural Networks. These models were then used to predict the category of events, employing weighted ensemble voting to analyze and combine their results. The models were trained with 1940 training events and results were evaluated with 831 test events. It was observed that using the weighted ensemble voting increased the efficiency of predictions. In this study we successfully developed and deployed the virtual fence using geophones. Since these sensors are passive, do not radiate any energy and are installed underground, it is impossible for intruders to locate and nullify them. Their flexibility, quick and easy installation, low costs, hidden deployment and unattended surveillance make such systems especially suitable for critical installations and remote facilities with difficult terrain. This work demonstrates the potential of utilizing seismic sensors for creating better perimeter guarding and protection systems using multiple machine learning models in weighted ensemble voting. In this study the virtual fence achieved an intruder detection efficiency of over 97%.

Keywords: geophone, seismic perimeter surveillance, machine learning, weighted ensemble method

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3690 Translation Quality Assessment: Proposing a Linguistic-Based Model for Translation Criticism with Considering Ideology and Power Relations

Authors: Mehrnoosh Pirhayati

Abstract:

In this study, the researcher tried to propose a model of Translation Criticism (TC) regarding the phenomenon of Translation Quality Assessment (TQA). With changing the general view on re/writing as an illegal act, the researcher defined a scale for the act of translation and determined the redline of translation with other products. This research attempts to show TC as a related phenomenon to TQA. This study shows that TQA with using the rules and factors of TC as depicted in both product-oriented analysis and process-oriented analysis, determines the orientation or the level of the quality of translation. This study also depicts that TC, regarding TQA’s perspective, reveals the aim of the translation of original text and the root of ideological manipulation and re/writing. On the other hand, this study stresses the existence of a direct relationship between the linguistic materials and semiotic codes of a text or book. This study can be fruitful for translators, scholars, translation criticizers, and translation quality assessors, and also it is applicable in the area of pedagogy.

Keywords: a model of translation criticism, a model of translation quality assessment, critical discourse analysis (CDA), re/writing, translation criticism (TC), translation quality assessment (TQA)

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3689 Preparation of Essential Oil Capsule (Carum Copticum) In Chitosan Nanoparticles and Investigation of Its Biological Properties

Authors: Akbar Esmaeili, Azadeh Asgari

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Essential oils’ unique and practical properties have been widely reported in recent years. Still, the sensitivity of critical oils to environmental factors and their poor solubility in aqueous solutions have limited their use in industries. Therefore, we encapsulated C. copticum essential oil in chitosan nanoparticles by emulsion-ionic gelation with sodium tripolyphosphate and sodium hexametaphosphate cross-linkers. The nanoparticles showed a round shape with an average size of 30-80 nm and a regular distribution. The release profile in the laboratory environment showed a burst in the initial release and then a stable release of C. copticum essential oil from chitosan nanoparticles at different pH. Antioxidant and antibacterial properties of C. copticum essential oil before and after the encapsulation process were evaluated by 2,2-diphenyl-1-picrylhydrazyl radical and disc diffusion methods, respectively. The results showed that the encapsulation of C. copticum essential oil in chitosan nanoparticles could protect its quality and bioactive compounds and improve the properties of the crucial oil.

Keywords: essential oils, Carum copticum, biological activities, nanotechnology

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3688 Presenting a Job Scheduling Algorithm Based on Learning Automata in Computational Grid

Authors: Roshanak Khodabakhsh Jolfaei, Javad Akbari Torkestani

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As a cooperative environment for problem-solving, it is necessary that grids develop efficient job scheduling patterns with regard to their goals, domains and structure. Since the Grid environments facilitate distributed calculations, job scheduling appears in the form of a critical problem for the management of Grid sources that influences severely on the efficiency for the whole Grid environment. Due to the existence of some specifications such as sources dynamicity and conditions of the network in Grid, some algorithm should be presented to be adjustable and scalable with increasing the network growth. For this purpose, in this paper a job scheduling algorithm has been presented on the basis of learning automata in computational Grid which the performance of its results were compared with FPSO algorithm (Fuzzy Particle Swarm Optimization algorithm) and GJS algorithm (Grid Job Scheduling algorithm). The obtained numerical results indicated the superiority of suggested algorithm in comparison with FPSO and GJS. In addition, the obtained results classified FPSO and GJS in the second and third position respectively after the mentioned algorithm.

Keywords: computational grid, job scheduling, learning automata, dynamic scheduling

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3687 The Need for the Inclusion of Museum Studies at All Levels of Education in Nigeria

Authors: Stephany Inalegwu

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Museums play a very critical role in understanding the cultural values and the history of any given society in Nigeria and the world at large. The role of Museums as an avenue through which artefacts are collected, preserved and exhibited cannot be over emphasized as they are now seen as not only with the above stated aims but also as a creator of employment and revenue generation if properly harnessed. Interestingly, despite its importance, museum studies have been limited to University curriculum alone causing a dearth of information for the younger generation up until they attain the University age. It is against this background that this paper carefully analyses the definitions of museums, the state of museums and museum studies in Nigeria today and the need to include its studies at all the levels of Education in Nigeria from the primary, to secondary and tertiary levels. It should reflect a study of all ages, as this is vital in the development of individuals. It concludes by harping on the need for a better appreciation of the Nigerian culture ranging from the famous Nok Terracotta, Benin Bronze works etc and its importance of museums as an avenue to display the rich Nigerian cultural heritage.

Keywords: culture, curriculum, education, museum

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3686 Analysis of Risk-Based Disaster Planning in Local Communities

Authors: R. A. Temah, L. A. Nkengla-Asi

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Planning for future disasters sets the stage for a variety of activities that may trigger multiple recurring operations and expose the community to opportunities to minimize risks. Local communities are increasingly embracing the necessity for planning based on local risks, but are also significantly challenged to effectively plan and response to disasters. This research examines basic risk-based disaster planning model and compares it with advanced risk-based planning that introduces the identification and alignment of varieties of local capabilities within and out of the local community that can be pivotal to facilitate the management of local risks and cascading effects prior to a disaster. A critical review shows that the identification and alignment of capabilities can potentially enhance risk-based disaster planning. A tailored holistic approach to risk based disaster planning is pivotal to enhance collective action and a reduction in disaster collective cost.

Keywords: capabilities, disaster planning, hazards, local community, risk-based

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3685 Representing a Methodology for Refinement of Strategic Objectives in Strategy Map Establishment: Combining Quality Function Deployment and Fuzzy Screening

Authors: Bijan Nahavandi, Navid Jafarinejad, Somayeh Mehrafzad

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Strategy maps represent the way of value creation in in each organization. Nowadays, implementation of strategy is the main concern for all organizations. Strategy map establishment is the start-up point of strategy implementation and this shows the critical importance of this concept. After some years past since emergence of strategy map, there are some shortcomings in its methodology that frequently quoted by many of researchers. One of these shortcomings is the shortage of a mechanism for refinement of objectives candidate for entrance to map. Organizations in practice have obsession and avidity to determine more number of objectives in strategy map. This study wants to represent a step by step approach to help obviate this problem using quality function deployment (QFD) as a helpful tool and fuzzy screening method. Finally, represented approach applies in a practical case and conclusions have been explained.

Keywords: balanced scorecard, fuzzy screening, house of strategic objectives (HoSO), quality function deployment, strategy map

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3684 Cargo Securement Standards and Braking Maneuvers

Authors: Jose A. Romero, Frank Otremba, Alejandro A. Lozano-Guzman

Abstract:

Road safety is affected by many factors, involving the vehicle, the infrastructure, and the environment. Many efforts have been thus made to improve road safety through rational standards for the different systems involved in freight transportation. Cargo shifting and falling have been recognized as critical and contributive effects for road crashes. To avoid such situations, regional and international standards have been implemented, aiming to prevent such types of cargo-related accidents. In particular, there are specific compulsory standard requirements to maintain the cargo on the vehicle without shifting, when the vehicle performs an emergency braking maneuver. In this paper, a simulation is presented to analyze the effect of the vibration of the cargo on the braking distance of the vehicle. Such vibration can lead to a poor cargo restraining, and higher braking efficiency, as a result of the decoupling of the cargo mass from the vehicle mass. Such higher braking efficiency, on the order of 4.4%, further suggests a greater demand for the current braking standards.

Keywords: road safety, cargo securement, shifting cargo, vehicle dynamics, ABS

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3683 Factors Influencing the Housing Price: Developers’ Perspective

Authors: Ernawati Mustafa Kamal, Hasnanywati Hassan, Atasya Osmadi

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The housing industry is crucial for sustainable development of every country. Housing is a basic need that can enhance the quality of life. Owning a house is therefore the main aim of individuals. However, affordability has become a critical issue towards homeownership. In recent years, housing price in the main cities has increased tremendously to unaffordable level. This paper investigates factors influencing the housing price from developer’s perspective and provides recommendation on strategies to tackle this issue. Online and face-to-face survey was conducted on housing developers operating in Penang, Malaysia. The results indicate that (1) location; (2) macroeconomics factor; (3) demographic factors; (4) land/zoning and; (5) industry factors are the main factors influencing the housing price. This paper contributes towards better understanding on developers’ view on how the housing price is determined and form a basis for government to help tackle the housing affordability issue.

Keywords: factors influence, house price, housing developers, Malaysia

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3682 Whale Optimization Algorithm for Optimal Reactive Power Dispatch Solution Under Various Contingency Conditions

Authors: Medani Khaled Ben Oualid

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Most of researchers solved and analyzed the ORPD problem in the normal conditions. However, network collapses appear in contingency conditions. In this paper, ORPD under several contingencies is presented using the proposed method WOA. To ensure viability of the power system in contingency conditions, several critical cases are simulated in order to prevent and prepare the power system to face such situations. The results obtained are carried out in IEEE 30 bus test system for the solution of ORPD problem in which control of bus voltages, tap position of transformers and reactive power sources are involved. Moreover, another method, namely, Particle Swarm Optimization with Time Varying Acceleration Coefficient (PSO-TVAC) has been compared with the proposed technique. Simulation results indicate that the proposed WOA gives remarkable solution in terms of effectiveness in case of outages.

Keywords: optimal reactive power dispatch, metaheuristic techniques, whale optimization algorithm, real power loss minimization, contingency conditions

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3681 Emancipation through the Inclusion of Civil Society in Contemporary Peacebuilding: A Case Study of Peacebuilding Efforts in Colombia

Authors: D. Romero Espitia

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Research on peacebuilding has taken a critical turn into examining the neoliberal and hegemonic conception of peace operations. Alternative peacebuilding models have been analyzed, but the scholarly discussion fails to bring them together or form connections between them. The objective of this paper is to rethink peacebuilding by extracting the positive aspects of the various peacebuilding models, connecting them with the local context, and therefore promote emancipation in contemporary peacebuilding efforts. Moreover, local ownership has been widely labelled as one, if not the core principle necessary for a successful peacebuilding project. Yet, definitions of what constitutes the 'local' remain debated. Through a qualitative review of literature, this paper unpacks the contemporary conception of peacebuilding in nexus with 'local ownership' as manifested through civil society. Using Colombia as a case study, this paper argues that a new peacebuilding framework, one that reconsiders the terms of engagement between international and national actors, is needed in order to foster effective peacebuilding efforts in contested transitional states.

Keywords: civil society, Colombia, emancipation, peacebuilding

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3680 Utilization of Standard Paediatric Observation Chart to Evaluate Infants under Six Months Presenting with Non-Specific Complaints

Authors: Michael Zhang, Nicholas Marriage, Valerie Astle, Marie-Louise Ratican, Jonathan Ash, Haddijatou Hughes

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Objective: Young infants are often brought to the Emergency Department (ED) with a variety of complaints, some of them are non-specific and present as a diagnostic challenge to the attending clinician. Whilst invasive investigations such as blood tests and lumbar puncture are necessary in some cases to exclude serious infections, some basic clinical tools in additional to thorough clinical history can be useful to assess the risks of serious conditions in these young infants. This study aimed to examine the utilization of one of clinical tools in this regard. Methods: This retrospective observational study examined the medical records of infants under 6 months presenting to a mixed urban ED between January 2013 and December 2014. The infants deemed to have non-specific complaints or diagnoses by the emergency clinicians were selected for analysis. The ones with clear systemic diagnoses were excluded. Among all relevant clinical information and investigation results, utilization of Standard Paediatric Observation Chart (SPOC) was particularly scrutinized in these medical records. This specific chart was developed by the expert clinicians in local health department. It categorizes important clinical signs into some color-coded zones as a visual cue for serious implication of some abnormalities. An infant is regarded as SPOC positive when fulfills 1 red zone or 2 yellow zones criteria, and the attending clinician would be prompted to investigate and treat for potential serious conditions accordingly. Results: Eight hundred and thirty-five infants met the inclusion criteria for this project. The ones admitted to the hospital for further management were more likely to have SPOC positive criteria than the discharged infants (Odds ratio: 12.26, 95% CI: 8.04 – 18.69). Similarly, Sepsis alert criteria on SPOC were positive in a higher percentage of patients with serious infections (56.52%) in comparison to those with mild conditions (15.89%) (p < 0.001). The SPOC sepsis criteria had a sensitivity of 56.5% (95% CI: 47.0% - 65.7%) and a moderate specificity of 84.1% (95% CI: 80.8% - 87.0%) to identify serious infections. Applying to this infant population, with a 17.4% prevalence of serious infection, the positive predictive value was only 42.8% (95% CI: 36.9% - 49.0%). However, the negative predictive value was high at 90.2% (95% CI: 88.1% - 91.9%). Conclusions: Standard Paediatric Observation Chart has been applied as a useful clinical tool in the clinical practice to help identify and manage young sick infants in ED effectively.

Keywords: clinical tool, infants, non-specific complaints, Standard Paediatric Observation Chart

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3679 Geographic Variation in the Baseline Susceptibility of Helicoverpa armigera (Hubner) (Noctuidae: Lepidoptera) Field Populations to Bacillus thuringiensis Cry Toxins for Resistance Monitoring

Authors: Muhammad Arshad, M. Sufian, Muhammad D. Gogi, A. Aslam

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The transgenic cotton expressing Bacillus thuringiensis (Bt) provides an effective control of Helicoverpa armigera, a most damaging pest of the cotton crop. However, Bt cotton may not be the optimal solution owing to the selection pressure of Cry toxins. As Bt cotton express the insecticidal proteins throughout the growing seasons, there are the chances of resistance development in the target pests. A regular monitoring and surveillance of target pest’s baseline susceptibility to Bt Cry toxins is crucial for early detection of any resistance development. The present study was conducted to monitor the changes in the baseline susceptibility of the field population of H. armigera to Bt Cry1Ac toxin. The field-collected larval populations were maintained in the laboratory on artificial diet and F1 generation larvae were used for diet incorporated diagnostic studies. The LC₅₀ and MIC₅₀ were calculated to measure the level of resistance of population as a ratio over susceptible population. The monitoring results indicated a significant difference in the susceptibility (LC₅₀) of H. armigera for first, second, third and fourth instar larval populations sampled from different cotton growing areas over the study period 2016-17. The variations in susceptibility among the tested insects depended on the age of the insect and susceptibility decreased with the age of larvae. The overall results show that the average resistant ratio (RR) of all field-collected populations (FSD, SWL, MLT, BWP and DGK) exposed to Bt toxin Cry1Ac ranged from 3.381-fold to 7.381-fold for 1st instar, 2.370-fold to 3.739-fold for 2nd instar, 1.115-fold to 1.762-fold for 3rd instar and 1.141-fold to 2.504-fold for 4th instar, depicting maximum RR from MLT population, whereas minimum RR for FSD and SWL population. The results regarding moult inhibitory concentration of H. armigera larvae (1-4th instars) exposed to different concentrations of Bt Cry1Ac toxin indicated that among all field populations, overall Multan (MLT) and Bahawalpur (BWP) populations showed higher MIC₅₀ values as compared to Faisalabad (FSD) and Sahiwal (SWL), whereas DG Khan (DGK) population showed an intermediate moult inhibitory concentrations. This information is important for the development of more effective resistance monitoring programs. The development of Bt Cry toxins baseline susceptibility data before the widespread commercial release of transgenic Bt cotton cultivars in Pakistan is important for the development of more effective resistance monitoring programs to identify the resistant H. armigera populations.

Keywords: Bt cotton, baseline, Cry1Ac toxins, H. armigera

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3678 Patterns of Eosinophilia in Cardiac Patients and its Association with Endomyocardial Disease Presenting to Tertiary Care Hospital in Peshawar

Authors: Rashid Azeem

Abstract:

Introduction: Eosinophilia, which can be categorized as mild, moderate, and severe form on the basis of increasing eosinophil counts, might be responsible for a wide range of cardiac manifestations, varying from a simple myocarditis to a severe state like endomyocardial fibrosis. Eosinophils are involved in the pathogenesis of a variety of cardiovascular disorder like Loffler endocarditis, eosinophilic granulomatosis with polyangitis (EGPH), and hyper eosinophilic (HES). Among them HES carries and incidence rate b/w 48% and 75% and is the main causes of cardiac motility and mobility due to eosinophilia involvement. Aims and objectives: The aim of this study is to determine the frequency of eosinophilia in cardiac patients and to ascertain the evidence of endomyocardial diseases in eosinophilic patients in a cardiology institution Material and Methods: This cross sectional analytical study was conducted in hematology Department of Peshawar institute of Cardiology after approval from hospital ethical and research committee. All 70 patients were subjected to detailed history and clinical examination. Investigation like CBC, Chest X-ray, ECG, Echo, Angiography findings were used to monitor patient’s clinical status. Data is analyzed using SPSS version 25 and MS Excel. Results: Out of 70 patients in our study, a total of 66 patients(94 %) shows evidence of cardiac manifestations. In our study, we have observed a number of abnormal ECG patterns in cardiac patients presenting with eosinophilia, like T wave changes, loss of R wave, sinus bradycardia with LVH strain, and ST wave abnormality. abnormal echocardiographic findings were observed in our patients, like valvular abnormalities (in 45.7%), RWMA abnormalities (in 2.8%), isolated ventricular dysfunction (in 21.4%), and in 10% patients, normal echocardiography. We further noted abnormal coronary angiography findings in cardiac patients with eosinophilia ranging from single vessel to multi vessel occlusions. Conclusions: Eosinophils are involved in the pathogenesis of a variety of cardiovascular disorders which can be detected by various diagnostic means, and the severity of the disease increases with time and with increasing eosinophil count ranging from simple myocarditis to a fatal condition like endomyocardial fibrosis. Thus, increased eosinophilic count as a laboratory parameter in cardiac patients may be a sign of endomyocardial damage which will further help cardiologist to intervene more aggressively then routine approach to a cardiac patient.

Keywords: eosinophilia, endomyocardial fibrosis, cardiac, hypereosinophilic syndrome

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3677 Small Entrepreneurs as Creators of Chaos: Increasing Returns Requires Scaling

Authors: M. B. Neace, Xin GAo

Abstract:

Small entrepreneurs are ubiquitous. Regardless of location their success depends on several behavioral characteristics and several market conditions. In this concept paper, we extend this paradigm to include elements from the science of chaos. Our observations, research findings, literature search and intuition lead us to the proposition that all entrepreneurs seek increasing returns, as did the many small entrepreneurs we have interviewed over the years. There will be a few whose initial perturbations may create tsunami-like waves of increasing returns over time resulting in very large market consequences–the butterfly impact. When small entrepreneurs perturb the market-place and their initial efforts take root a series of phase-space transitions begin to occur. They sustain the stream of increasing returns by scaling up. Chaos theory contributes to our understanding of this phenomenon. Sustaining and nourishing increasing returns of small entrepreneurs as complex adaptive systems requires scaling. In this paper we focus on the most critical element of the small entrepreneur scaling process–the mindset of the owner-operator.

Keywords: entrepreneur, increasing returns, scaling, chaos

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3676 Effect of Asymmetric Amphiphilic Dicationic Ionic Liquids as Oil Spill Dispersants in Red Sea

Authors: Raghda El-Nagara, Maher I. Nessim, Carmen E. Elshafee, Renee I. Abdallah, Yasser M. Moustafa

Abstract:

Three asymmetric dicationic ionic liquids (ADILs), 1-(2-(1-dodecyl-2-methyl-1H-imidazolium-3-yl)ethyl)-3-methyl pyridinium bromide (IL₁), 1-(6-(1-dodecyl-2-methyl-1H-imidazolium-3-yl)hexyl)-3-methyl pyridinium bromide (IL₂) and 1-(10-(1-dodecyl-2-methyl-1H-imidazolium-3-yl)decyl)-3-methyl pyridinium bromide (IL₃) were synthesized with yield of 83.54, 84.12 & 83.05% respectively. They were elucidated via conventional tools of analysis (elemental analysis, FT-IR, and 1H-NMR). The thermogravimetric analysis confirmed that the three ADILs possessed high thermal stability (up to 500ᵒC). Their critical micelle concentration (CMC) was investigated and exhibited values of 5.5-1*10⁻³ Mol./L. They were evaluated as oil spill dispersants were at different temperatures (10, 30 & 50ᵒC) with different concentrations (750, 1500, 2000, 3000 ppm). Data reveals that the efficiency is ranked as follows: IL₂ > IL₁ > IL₃, which showed high dispersion efficiency reached to 63% with the concentration of 1500 ppm.

Keywords: ionic liquids, amphiphilic, oil spill dispersants, dicationic, efficiency test

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3675 Bit Error Rate Monitoring for Automatic Bias Control of Quadrature Amplitude Modulators

Authors: Naji Ali Albakay, Abdulrahman Alothaim, Isa Barshushi

Abstract:

The most common quadrature amplitude modulator (QAM) applies two Mach-Zehnder Modulators (MZM) and one phase shifter to generate high order modulation format. The bias of MZM changes over time due to temperature, vibration, and aging factors. The change in the biasing causes distortion to the generated QAM signal which leads to deterioration of bit error rate (BER) performance. Therefore, it is critical to be able to lock MZM’s Q point to the required operating point for good performance. We propose a technique for automatic bias control (ABC) of QAM transmitter using BER measurements and gradient descent optimization algorithm. The proposed technique is attractive because it uses the pertinent metric, BER, which compensates for bias drifting independently from other system variations such as laser source output power. The proposed scheme performance and its operating principles are simulated using OptiSystem simulation software for 4-QAM and 16-QAM transmitters.

Keywords: automatic bias control, optical fiber communication, optical modulation, optical devices

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3674 Development of a New Method for T-Joint Specimens Testing under Shear Loading

Authors: Radek Doubrava, Roman Ruzek

Abstract:

Nonstandard tests are necessary for analyses and verification of new developed structural and technological solutions with application of composite materials. One of the most critical primary structural parts of a typical aerospace structure is T-joint. This structural element is loaded mainly in shear, bending, peel and tension. The paper is focused on the shear loading simulations. The aim of the work is to obtain a representative uniform distribution of shear loads along T-joint during the mechanical testing is. A new design of T-joint test procedure, numerical simulation and optimization of representative boundary conditions are presented. The different conditions and inaccuracies both in simulations and experiments are discussed. The influence of different parameters on stress and strain distributions is demonstrated on T-joint made of CFRP (carbon fiber reinforced plastic). A special test rig designed by VZLU (Aerospace Research and Test Establishment) for T-shear test procedure is presented.

Keywords: T-joint, shear, composite, mechanical testing, finite element analysis, methodology

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3673 Demographic Determinants of Spatial Patterns of Urban Crime

Authors: Natalia Sypion-Dutkowska

Abstract:

Abstract — The main research objective of the paper is to discover the relationship between the age groups of residents and crime in particular districts of a large city. The basic analytical tool is specific crime rates, calculated not in relation to the total population, but for age groups in a different social situation - property, housing, work, and representing different generations with different behavior patterns. They are the communities from which criminals and victims of crimes come. The analysis of literature and national police reports gives rise to hypotheses about the ability of a given age group to generate crime as a source of offenders and as a group of victims. These specific indicators are spatially differentiated, which makes it possible to detect socio-demographic determinants of spatial patterns of urban crime. A multi-feature classification of districts was also carried out, in which specific crime rates are the diagnostic features. In this way, areas with a similar structure of socio-demographic determinants of spatial patterns on urban crime were designated. The case study is the city of Szczecin in Poland. It has about 400,000 inhabitants and its area is about 300 sq km. Szczecin is located in the immediate vicinity of Germany and is the economic, academic and cultural capital of the region. It also has a seaport and an airport. Moreover, according to ESPON 2007, Szczecin is the Transnational and National Functional Urban Area. Szczecin is divided into 37 districts - auxiliary administrative units of the municipal government. The population of each of them in 2015-17 was divided into 8 age groups: babes (0-2 yrs.), children (3-11 yrs.), teens (12-17 yrs.), younger adults (18-30 yrs.), middle-age adults (31-45 yrs.), older adults (46-65 yrs.), early older (66-80) and late older (from 81 yrs.). The crimes reported in 2015-17 in each of the districts were divided into 10 groups: fights and beatings, other theft, car theft, robbery offenses, burglary into an apartment, break-in into a commercial facility, car break-in, break-in into other facilities, drug offenses, property damage. In total, 80 specific crime rates have been calculated for each of the districts. The analysis was carried out on an intra-city scale, this is a novel approach as this type of analysis is usually carried out at the national or regional level. Another innovative research approach is the use of specific crime rates in relation to age groups instead of standard crime rates. Acknowledgments: This research was funded by the National Science Centre, Poland, registration number 2019/35/D/HS4/02942.

Keywords: age groups, determinants of crime, spatial crime pattern, urban crime

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3672 Dealing with Neighbors: River Water Sharing between India, Pakistan and Bangladesh

Authors: Ashutosh Pujari

Abstract:

The sharing of natural resources is one of the most important aspects of relations between two neighboring countries, especially when it is a resource that has a presence in both the countries in question. River water is an important resource that is shared between India and its neighbors, namely Pakistan and Bangladesh. India shares Indus, Chenab, and Jhelum rivers with Pakistan, while with Bangladesh, it shares Ganges and Brahmaputra. However, it is interesting to note how does India deals with her sharing of water with these two countries. Although water sharing with both the countries has been dotted by irritants over the years, relations with Bangladesh is undoubtedly better in this respect. Given the common history of the region, this paper analyses the reasons behind this difference in the relationship between India and her neighbors and its implications for the present times. Through critical analysis of literature and the official policy of all the governments involved and the narratives present, this paper tries to present understand how India’s relations with its neighbors are a function of geopolitics, culture, and perceptions on both sides.

Keywords: geopolitics, river water sharing, India-Pakistan relations, India-Bangladesh relations

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3671 Coalescence of Insulin and Triglyceride/High Density Lipoprotein Cholesterol Ratio for the Derivation of a Laboratory Index to Predict Metabolic Syndrome in Morbid Obese Children

Authors: Orkide Donma, Mustafa M. Donma

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Morbid obesity is a health threatening condition particularly in children. Generally, it leads to the development of metabolic syndrome (MetS) characterized by central obesity, elevated fasting blood glucose (FBG), triglyceride (TRG), blood pressure values and suppressed high density lipoprotein cholesterol (HDL-C) levels. However, some ambiguities exist during the diagnosis of MetS in children below 10 years of age. Therefore, clinicians are in the need of some surrogate markers for the laboratory assessment of pediatric MetS. In this study, the aim is to develop an index, which will be more helpful during the evaluation of further risks detected in morbid obese (MO) children. A total of 235 children with normal body mass index (N-BMI), with varying degrees of obesity; overweight (OW), obese (OB), MO as well as MetS participated in this study. The study was approved by the Institutional Ethical Committee. Informed consent forms were obtained from the parents of the children. Obesity states of the children were classified using BMI percentiles adjusted for age and sex. For the purpose, tabulated data prepared by WHO were used. MetS criteria were defined. Systolic and diastolic blood pressure values were measured. Parameters related to glucose and lipid metabolisms were determined. FBG, insulin (INS), HDL-C, TRG concentrations were determined. Diagnostic Obesity Notation Model Assessment Laboratory (DONMALAB) Index [ln TRG/HDL-C*INS] was introduced. Commonly used insulin resistance (IR) indices such as Homeostatic Model Assessment for IR (HOMA-IR) as well as ratios such as TRG/HDL-C, TRG/HDL-C*INS, HDL-C/TRG*INS, TRG/HDL-C*INS/FBG, log, and ln versions of these ratios were calculated. Results were interpreted using statistical package program (SPSS Version 16.0) for Windows. The data were evaluated using appropriate statistical tests. The degree for statistical significance was defined as 0.05. 35 N, 20 OW, 47 OB, 97 MO children and 36 with MetS were investigated. Mean ± SD values of TRG/HDL-C were 1.27 ± 0.69, 1.86 ± 1.08, 2.15 ± 1.22, 2.48 ± 2.35 and 4.61 ± 3.92 for N, OW, OB, MO and MetS children, respectively. Corresponding values for the DONMALAB index were 2.17 ± 1.07, 3.01 ± 0.94, 3.41 ± 0.93, 3.43 ± 1.08 and 4.32 ± 1.00. TRG/HDL-C ratio significantly differed between N and MetS groups. On the other hand, DONMALAB index exhibited statistically significant differences between N and all the other groups except the OW group. This index was capable of discriminating MO children from those with MetS. Statistically significant elevations were detected in MO children with MetS (p < 0.05). Multiple parameters are commonly used during the assessment of MetS. Upon evaluation of the values obtained for N, OW, OB, MO groups and for MO children with MetS, the [ln TRG/HDL-C*INS] value was unique in discriminating children with MetS.

Keywords: children, index, laboratory, metabolic syndrome, obesity

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3670 A Performance Comparison between Conventional and Flexible Box Erecting Machines Using Dispatching Rules

Authors: Min Kyu Kim, Eun Young Lee, Dong Woo Son, Yoon Seok Chang

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In this paper, we introduce a flexible box erecting machine (BEM) that swiftly and automatically transforms cardboard into a three dimensional box. Recently, the parcel service and home-shopping industries have grown rapidly, and there is an increasing need for various box types to ship various products. However, workers cannot fold thousands of boxes manually in a day. As such, automatic BEMs are garnering greater attention. This study takes equipment operation into consideration as well as mechanical improvements in order to design a BEM that is able to outperform its conventional counterparts. We analyzed six dispatching rules – First In First Out (FIFO), Shortest Processing Time (SPT), Earliest Due Date (EDD), Setup Avoidance, EDD + SPT, and EDD + Setup Avoidance – to determine which one was most suitable for BEM operation. Consequently, SPT and Setup Avoidance were found to be the most critical rules, followed by EDD + Setup Avoidance, EDD + SPT, EDD, and FIFO. This hierarchy was valid for both our conventional BEM and our new flexible BEM from the viewpoint of processing time. We believe that this research can contribute to flexible BEM management, which has the potential to increase productivity and convenience.

Keywords: automation, box erecting machine, dispatching rule, setup time

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3669 Using Lean Six-Sigma in the Improvement of Service Quality at Aviation Industry: Case Study at the Departure Area in KKIA

Authors: Tareq Al Muhareb, Jasper Graham-Jones

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The service quality is a significant element in aviation industry especially in the international airports. Through this paper, the researchers built a model based on Lean six sigma methodologies and applied it in the departure area at KKIA (King Khalid International Airport) in order to assess it. This model characterized with many special features that can become over the cultural differences in aviation industry since it is considered the most critical circumstance in this field. Applying the model of this study is depending on following the DMAIC procedure systemized in lean thinking aspects. This model of Lean-six-sigma as a managerial procedure is mostly focused on the change management culture that requires high level of planning, organizing, modifying, and controlling in order to benefit from strengths as well as revoke weaknesses.

Keywords: lean-six-sigma, service quality, aviation industry, KKIA (King Khalid International Airport), SERVQUAL

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3668 Impact of Transportation on Access to Reproductive and Maternal Health Services in Northeast Cambodia: A Policy Brief

Authors: Zaman Jawahar, Anne Rouve-Khiev, Elizabeth Hoban, Joanne Williams

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Ensuring access to timely obstetric care is essential to prevent maternal deaths. Geographical barriers pose significant challenges for women accessing quality reproductive and maternal health services in rural Cambodia. This policy brief affirms the need to address the issue of transportation and cost (direct and indirect) as critical barriers to accessing reproductive and maternal health (RMH) services in four provinces in Northeast Cambodia (Kratie, Ratanak Kiri, Mondul Kiri, Stung Treng). A systemic search of the literature identified 1,116 articles, and only ten articles from low-and-middle-income countries met the inclusion criteria. The ten articles reported on transportation and cost related to accessing RMH services. In addition, research findings from Partnering to Save Lives (PSL) studies in the four provinces were included in the analysis. Thematic data analysis using the information in the ten articles and PSL research findings was conducted, and the findings are presented in this paper. The key findings are the critical barriers to accessing RMH services in the four provinces because women experience: 1) difficulties finding affordable transportation; 2) lack of available and accessible transportation; 3) greater distance and traveling time to services; 4) poor geographical terrain and; 5) higher opportunity costs. Distance and poverty pose a double burden for the women accessing RMH services making a facility-based delivery less feasible compared to home delivery. Furthermore, indirect and hidden costs associated with institutional delivery may have an impact on women’s decision to seek RMH care. Existing health financing schemes in Cambodia such as the Health Equity Fund (HEF) and the Voucher Scheme contributed to the solution but have also shown some limitations. These schemes contribute to improving access to RMH services for the poorest group, but the barrier of transportation costs remains. In conclusion, initiatives that are proven to be effective in the Cambodian context should continue or be expanded in conjunction with the HEF, and special consideration should be given to communities living in geographically remote regions and difficult to access areas. The following strategies are recommended: 1) maintain and further strengthen transportation support in the HEF scheme; 2) expand community-based initiatives such as Community Managed Health Equity Funds and Village Saving Loans Associations; 3) establish maternity waiting homes; and 4) include antenatal and postnatal care in the provision of integrated outreach services. This policy brief can be used to inform key policymakers and provide evidence that can assist them to develop strategies to increase poor women’s access to RMH services in low-income settings, taking into consideration the geographic distance and other indirect costs associated with a facility-based delivery.

Keywords: access, barriers, northeast Cambodia, reproductive and maternal health service, transportation and cost

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