Search results for: risk sharing

Authors: Abrar Al-Enzi

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Despite being frequently used everyday in the Arab World, Wasta, which is seen as a type of social capital, has received little attention from previous scholars, even in the Middle East. In simple words, Wasta basically means granting deserved or undeserved privileges to others through personal contacts. This paper suggests that Wasta is an important determinant of how some employees get recruited and turn to Wasta for privileges and favors in organizations. It is said, that Wasta accelerates career advancement and other work practices for employees, whether they deserve it or even are suitable for it or not. The overall goal of this paper is to see how Wasta influences human resource management practices by viewing the history of Wasta, the importance of using it, and how it affects employees as well as organizations in terms of recruitment and work practices. Accordingly, the question that will be addressed is: Does Wasta influence human resource management, knowledge sharing and innovation in Kuwait, which in turn affects employees’ commitment within organizations? Therefore, a mixed method sequential exploratory research design will be used to explore the research topic through initial exploratory interviews, paper-based and online surveys (Quantitative method) and semi-structured interviews (Qualitative method). The reason behind such a choice is because both qualitative and quantitative methods complement each other when combined by providing a clearer picture of the topic.

Keywords: human resource management practices, Kuwait, social capital, Wasta

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Authors: Lingxia Li, Frédéric Schnell, Shuzhe Ding, Solène Le Douairon Lahaye

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Background: The risk of sudden cardiac arret/death (SCA/D) in athletes is controversial. There is a lack of meta-analyses assessing the sex differences in the risk of SCA/D in competitive athletes. Purpose: The aim of the present study was to evaluate sex differences in the incidence of SCA/D in competitive athletes using meta-analyses. Methods: The systematic review was registered in the PROSPERO database (registration ID: CRD42023432022) and was conducted according to the PRISMA guidelines. PubMed, Embase, Scopus, SPORT Discus and Cochrane Library were searched up to July 2023. To avoid systematic bias in data pooling, only studies with data for both sexes were included. Results: From the 18 included studies, 2028 cases of SCA/D were observed (males 1821 (89.79%), females 207 (10.21%)). The age ranges from the adolescents (<26 years) to the elderly (>45 years). The incidence in male athletes was 1.32/100,000 AY (95% CI: [0.90, 1.93]) and in females was 0.26/100,000 AY (95% CI: [0.16, 0.43]), the incidence rate ratio (IRR) was 6.43 (95% CI: [4.22, 9.79]). The subgroup synthesis showed a higher incidence in males than in females in both age groups <25 years and ≤35 years, the IRR was 5.86 (95% CI: [4.69, 7.32]) and 5.79 (95% CI: [4.73, 7.09]), respectively. When considering the events, the IRR was 6.73 (95%CI: [3.06, 14.78]) among studies involving both SCA/D events and 7.16 (95% CI: [4.93, 10.40]) among studies including only cases of SCD. The available clinical evidence showed that cardiac events were most frequently seen in long-distance running races (26, 35.1%), marathon (16, 21.6%) and soccer (10, 13.5%). Coronary artery disease (14, 18.9%), hypertrophic cardiomyopathy (8, 10.8%), and arrhythmogenic right ventricular cardiomyopathy (7, 9.5%) are the most common causes of SCA/D in competitive athletes. Conclusion: The meta-analysis provides evidence of sex differences in the incidence of SCA/D in competitive athletes. The incidence of SCA/D in male athletes was 6 to 7 times higher than in females. Identifying the reasons for this difference may have implications for targeted the prevention of fatal evets in athletes.

Keywords: incidence, sudden cardiac arrest, sudden cardiac death, sex difference, athletes

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Authors: Hamid Abbasi, Neda Jourabchi, Ranasadat Abedi, Kiarash Tajernarenj, Mehdi Farhoudi, Sarvin Sanaie

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Background: Alpha lipoic acid (ALA), fat- and water-soluble, coenzyme with sulfuret content, has received considerable attention for its potential therapeutic role in diabetes, cardiovascular diseases, cancers, and central nervous disease. This investigation aims to evaluate the probable protective effects of ALA in stroke patients. Methods: Based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, This meta-analysis was performed. The PICO criteria for this meta-analysis were as follows: Population/Patients (P: stroke patients); Intervention (I: ALA); Comparison (C: control); Outcome (O: blood glucose, lipid profile, oxidative stress, inflammatory factors).In addition, Studies that were excluded from the analysis consisted of in vitro, in vivo, and ex vivo studies, case reports, quasi-experimental studies. Scopus, PubMed, Web of Science, EMBASE databases were searched until August 2023. Results: Of 496 records that were screened in the title/abstract stage, 9 studies were included in this meta-analysis. The sample sizes in the included studies vary between 28 and 90. The result of risk of bias was performed via risk of bias (RoB) in randomized-controlled trials (RCTs) based on the second version of the Cochrane RoB assessment tool. 8 studies had a definitely high risk of bias. Discussion: To the best of our knowledge, The present meta-analysis is the first study addressing the effectiveness of ALA supplementation in enhancing post-stroke metabolic markers, including lipid profile, oxidative stress, and inflammatory indices. It is imperative to acknowledge certain potential limitations inherent in this study. First of all, type of treatment (oral or intravenous infusion) could alter the bioavailability of ALA. Our study had restricted evidence regarding the impact of ALA supplementation on included outcomes. Therefore, further research is warranted to develop into the effects of ALA specifically on inflammation and oxidative stress. Funding: The research protocol was approved and supported by the Student Research Committee, Tabriz University of Medical Sciences (grant number: 72825). Registration: This study was registered in the International prospective register of systematic reviews (PROSPERO ID: CR42023461612).

Keywords: alpha-lipoic acid, lipid profile, blood glucose, inflammatory factors, oxidative stress, meta-analysis, post-stroke

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Authors: Almutazballlah Bassam Qablan, Jihan M. Muhaidat, bana Abu Rajab

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Background: Acne vulgaris is considered one of the most common skin conditions encountered by dermatologists. It is a chronic inflammation affecting the pilosebaceous unit. Although acne vulgaris is not fatal, it leads to permanent scarring and disfigurement, and even without scarring, it has a huge effect on patients, causing negative health outcomes. Acne vulgaris patients experience psychological, and emotional ramifications as those with chronic health problems; they feel depressed, angry, anxious, and confused. Although acne is a popular disease, many thoughts and myths are still discussed about its origins and triggering factors. These myths can make you feel guilt as if you were somehow responsible for your acne. In this case control study, we want to define the relationship between two modifiable risk factors ;BMI and smoking, with acne vulgaris. Methods: A case-control study was conducted at King Abdullah University Hospital in Ramtha, Jordan in 2019/2020. A total number of 325 participants between 14 and 33 years of age were interviewed by the authors; including 163 acne vulgaris cases and 162 controls without acne vulgaris. Anthropometric measures and smoking for Acne patients and control participants were the independent variables used to assess acne. Univariate and multivariate analysis were used to compare the characteristics of people who reported acne with those with no acne. The collected data analyzed by using the Statistical Package for Social Sciences (SPSS). Results: Cigarette smoking was highly associated with controls; odds ratio 0.4 (95% CI: 0.2–0.9) , P-value = 0.018. BMI and waterpipe smoking were statistically insignificant with acne in the multivariate analysis. Conclusion: We found that cigarette smoking was protective against Acne. There was a statistically insignificant relation between BMI, waterpipe smoking and the development of Acne Vulgaris.

Keywords: acne, adolescents, BMI, smoking, case-control, risk factors

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Authors: Thitima Plejai

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The practice in the operating room has been continually performed according to standards of services; however, undesirable incidents from surgical services are found such as surgical complications in the operating room. This participation action research aimed to develop practice guidelines for surgical safety management to reduce undesirable incidents from surgical services in the operating room of Songkhla Hospital. The target population was all 84 members of the multidisciplinary team who were involved in surgical services in the operating room consisting of 28 surgeons from five branches of surgery, 27 anesthetists and nurse anesthetists, and 29 surgical nurses. The data were collected through in-depth interviews, and non-participatory observations. The research instrument was tested by three experts, and the steps of the development consisted of four cycles, each consisting of assessment, planning, practice, practice reflection, and improvement until every step is practicable. The data were validated through triangulation research method, analyzed through content analysis and statistical analysis with number and percentage. The results of the development of practice guidelines surgical safety management to reduce undesirable incidents from surgical services could be concluded as follows. 1) The multidisciplinary team in surgery participated in the needs assessment for development of practice guidelines for surgical patient safety, and agreed on adapting the WHO Surgical Safety Checklists for use. 2) The WHO Surgical Safety Checklists was implemented, and meetings were held for the multidisciplinary team in surgery and the organizational risk committee to improve the practice guidelines to make them more practicable. 3) The multidisciplinary team consisting of surgeons from five branches of surgery, anesthetists, nurse anesthetists, surgical nurses, and the organizational risk committee announced policy on safety for surgical patients; the organizational risk committee designated the Surgical Safety Checklist as an instrument for surgical patient safety. The results of the safety management found that the surgical team members who could follow 100 percent of the guidelines were: professional nurses who checked patient identity and information before taking the patient to the operating room and kept complete records of data on the patients; surgical nurses who checked readiness of the patient before surgery; nurse anesthetists who assessed readiness before administering anesthetic drugs, and confirmed correctness of the patient; and circulating perioperative nurses who gave confirmation to the surgical team after completion of the surgery. The rates of undesirable incidents (surgical complications rates) before and after the implementation of the surgical safety management were 1.60 percent and 0.66 percent, respectively. The satisfaction of the surgery-related teams towards the use of the guidelines was 89 percent. The practice guidelines for surgical safety management to reduce undesirable incidents were taken as guidelines for surgical safety that the multidisciplinary team involved in the surgical process implemented correctly and in the same direction and clearly reduced undesirable incidents in surgical patients.

Keywords: practice guidelines, surgical safety management, reduce undesirable incidents, operating Room

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Authors: Maryam Nazari, Atefeh Ghanbari, Saghar Noorinia

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Obesity, as an abnormal or excessive accumulation of fat, is caused by genetic, behavioral and environmental factors. Recently, obesity surgeries, such as bariatric surgery, as the last measure to control obesity, have attracted experts and society, especially women, attention, so knowing the possible complications of this major surgery and their control in reproductive age is of particular importance due to its effects on pregnancy outcomes. Bariatric surgery reduces the risk of diabetes and high blood pressure associated with pregnancy, premature birth, macrosomia, stillbirth and dumping syndrome. Although in the first months after surgery, nausea and vomiting caused by changes in intra-abdominal pressure are associated with an increased risk of malabsorption of micronutrients such as folic acid, iron, vitamin B1, D, calcium, selenium and phosphorus and finally, fetal growth disorder. Moreover, serum levels of micronutrients such as vitamin D, calcium, and iron in mothers who used to have bariatric surgery and their babies have been shown to be lower than in mothers without a history of bariatric surgery. Moreover, vitamin A deficiency is shown to be more widespread in pregnancies after bariatric surgery, which leads to visual problems in newborns and premature delivery. However, complications such as the duration of hospitalization of newborns in the NICU, disease rate in the first 28 days of life and congenital anomalies are not significantly different in babies born to mothers undergoing bariatric surgery compared to the control group. In spite of the vast advantages following obesity surgeries, due to the catabolic conditions and severe weight loss followed by such major intervention and the probability of nutrients malnutrition in a pregnant woman and her baby, after having surgery, at least 12 to 18 months should be considered to get pregnant as a recovery period. In addition, taking essential supplements before and at least 6 months after this approach is recommended.

Keywords: bariatric surgery, pregnancy, malnutrition, vitamin and mineral deficiency

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Authors: Shima Nikanjam, Badiossadat Hassanpour, Adi Irfan Che Ani

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The design process in architecture education is based upon the Learning-by-Doing method, which leads students to understand how to design by practicing rather than studying. First-year design studios, as starting educational stage, provide integrated knowledge and skills of design for newly jointed architecture students. Within the basic design studio environment, students are guided to transfer their abstract thoughts into visual concrete decisions under the supervision of design educators for the first time. Therefore, introductory design studios have predominant impacts on students’ operational thinking and designing. Architectural design thinking is quite different from students’ educational backgrounds and learning habits. This educational challenge at basic design studios creates a severe need to study the reality of design education at foundation year and define appropriate educational methods with convenient project types with the intention of enhancing architecture education quality. Material for this study has been gathered through long-term direct observation at a first year second semester design studio at the faculty of architecture at EMU (known as FARC 102), fall and spring academic semester 2014-15. Distribution of a questionnaire among case study students and interviews with third and fourth design studio students who passed through the same methods of education in the past 2 years and conducting interviews with instructors are other methodologies used in this research. The results of this study reveal a risk of a mismatch between the implemented teaching method, project type and scale in this particular level and students’ learning styles. Although the existence of such risk due to varieties in students’ profiles could be expected to some extent, recommendations can support educators to reach maximum compatibility.

Keywords: architecture education, basic design studio, educational method, forms creation skill

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Authors: Ali Alavi, Owen Nguyen, Jiangang Fei, Jafar Sayareh

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The main purpose of this research is to propose a conceptual framework to analyze port logistics integration in general and for the Iranian port sector in particular, including consideration of the challenges, outcomes, and opportunities in implementing port logistics integration. First, a literature review of studies on logistics integration in seaports and terminals is conducted. Second, a new conceptual framework for port logistics integration is proposed to incorporate the role of the new variables emerging from the recent developments in the global business environment. The literature review has found the logistics process and operations, information integration, value-added services, and logistics practices, organizational activities, resource sharing and institutional support being influential to logistics integration. The study used survey method to test the proposed conceptual framework. Both online and self-administrative survey have been used to collect data from ‎port official staffs in Iranian seaports and their associations (internal port ‎stakeholders) as well ‎as other experts in various actors. In the study, the questionnaire was first validated using exploratory factor analysis (EFA) and then by confirmatory factor analysis (CFA). The results of the EFA and CFA confirmed the finding from the literature review. Research results and conceptual framework shed the lights on port logistics integration concept and suggest guidelines and procedures improve port logistics integration.

Keywords: maritime logistics, logistics integration, port management, EFA, CFA

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Authors: Abeer K. Jameel, Harry Evdorides

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Iraq is a middle income country where the road safety issue is considered one of the leading causes of deaths. To control the road risk issue, the Iraqi Ministry of Planning, General Statistical Organization started to organise a collection system of traffic accidents data with details related to their causes and severity. These data are published as an annual report. In this paper, a review of the available crash data in Iraq will be presented. The available data represent the rate of accidents in aggregated level and classified according to their types, road users’ details, and crash severity, type of vehicles, causes and number of causalities. The review is according to the types of models used in road safety studies and research, and according to the required road safety data in the road constructions tasks. The available data are also compared with the road safety dataset published in the United Kingdom as an example of developed country. It is concluded that the data in Iraq are suitable for descriptive and exploratory models, aggregated level comparison analysis, and evaluation and monitoring the progress of the overall traffic safety performance. However, important traffic safety studies require disaggregated level of data and details related to the factors of the likelihood of traffic crashes. Some studies require spatial geographic details such as the location of the accidents which is essential in ranking the roads according to their level of safety, and name the most dangerous roads in Iraq which requires tactic plan to control this issue. Global Road safety agencies interested in solve this problem in low and middle-income countries have designed road safety assessment methodologies which are basing on the road attributes data only. Therefore, in this research it is recommended to use one of these methodologies.

Keywords: road safety, Iraq, crash data, road risk assessment, The International Road Assessment Program (iRAP)

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Authors: Prakash Singh

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Being a collegial leader would require such a person to promote an organizational passion that identifies and acknowledges the contribution of every employee. Collegiality is about sharing responsibilities and being accountable for one’s actions. Leaders must therefore be equipped with the knowledge, skills, abilities, beliefs, and dispositions that will allow them to succeed in their organizations. These abilities should not only dwell on cognition alone, but also, equally, on the development of their emotional intelligence (EQ). It is therefore a myth that leaders are entrusted with absolute power to manage all the resources of their organizations. Workers feel confident with leaders who are adaptable, flexible and supportive when it comes to shared decision-making and the devolution of power within the organization. Research strongly supports the notion that a leader requires a high level of EQ in addition to IQ (cognitive intelligence) to achieve the goals of the organization. On the other hand, traditional managers require cognitive abilities and technical skills to get the work done by their employees. This does not imply that management is not important in organizations. However, the approach of managers becomes highly critical when the focus is purely task orientated. Enabling or empowering employees, therefore, is an important aspect in establishing emotionally intelligent collaboration, as the willing and satisfied participation of the employees can be the result of leaders’ commitment to establishing a collegial working environment as demonstrated by their behaviours. This paper therefore analyses why it matters for ideal leaders to be imbued with the traits of EQ and collegiality.

Keywords: collegiality, emotional intelligence, empowering employees, traditional managers

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Authors: Sundaresan Soundararajan, Chor Ngee Tan

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Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.

Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF

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Authors: Tadesse Melaku Abegaz, Akshaya Srikanth Bahagavathula, Abdulla Shehab Sheab, Asim Hassen

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Objectives: Non-adherence and discontinuation of anticoagulant therapy lead to increased ischemic stroke risk and contributes to suboptimal outcomes of the anticoagulant treatment. This systematic review and meta-analysis were aimed to investigate the adherence to NOACs and adverse events in patients with AF. Methods: Original research articles conducted on patients with AF and using any NOACs (dabigatran, rivoraxaban and apixaban) reporting adherence for at least 35 days were included. Scientific databases including PubMed, Web of Science, and Google Scholar were searched using MeSH keywords to obtaining literature researched between 2008 to till June, 2016. Study characteristics, patient’s sociodemographic and clinical characteristics, medication adherence levels and bleeding events reported were recorded. Results: The overall sample size of the six studies is 1,640,157, with CHADS2 scores < 2 in 551 patients, CHADS2-VASc ≥ 2 in 62,232 AF patients. Three-forth [75.6% (95%CI= 66.5-84.8), p < 0.001] are adherent to NOACs. However, a higher rate [72.7% (62.5-82.9), p < 0.001] of adherence was observed with Dabigatran than Apixaban [59.9% (3.2-123.1), p=0.063] and Rivaroxaban [59.3% (38.7-80.0), p<0.001]. Sub-group analysis revealed that nearly 57% of the AF patients on NOACs have CHADS2 scores < 2 and 20% of these patients were non-adherent to NOACs. Overall bleeding events rate associated with NOACs non-adherent AF patients was found to be 7.5% (0.2-14.8), p=0.045. However, nearly 11.2% of AF patients experienced bleeding events were non-adherent to NOAC medications. A higher proportion of bleeding events were noticed with Dabigatran (14.7%). Conclusions: Adherence rates, while uniformly suboptimal, nevertheless varied considerably, lowest at 59.3% for rivaroxaban and 59.9% for apixaban, followed by dabigatran (75.6%). Overall bleeding events associated with NOACs rates were 7.5%. However, lower adherence to NOACs was associated with worse outcomes among patients with greater stroke risk.

Keywords: atrial fibrillation, bleeding events, meta-analysis, novel oral anticoagulants

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Authors: Farhana Alam Bhuiyan, Saad Khan, Tanveer Hassan, Jhalok Ranjon Talukder, Syeda Farjana Ahmed, Rahil Roodsaz, Els Rommes, Sabina Faiz Rashid

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Breaking the shame’ is a 3 year (2015-2018) qualitative implementation research project which investigates several aspects of sexual and reproductive health and rights (SRHR) issues for adolescents living in Bangladesh. Scope of learning SRHR issues for adolescents is limited here due to cultural and religious taboos. This study adds to the ongoing discussions around adolescent’s SRHR needs and aims to, 1) understand the overall SRHR needs of urban and rural unmarried female and male adolescents and the challenges they face, 2) explore existing gaps in the content of SRHR curriculum and 3) finally, addresses some critical knowledge gaps by developing and implementing innovative SRHR educational materials. 18 in-depth interviews (IDIs) and 10 focus-group discussions (FGDs) with boys and 21 IDIs and 14 FGDs with girls of ages 13-19, from both urban and rural setting took place. Curriculum materials from two leading organizations, Unite for Body Rights (UBR) Alliance Bangladesh and BRAC Adolescent Development Program (ADP) were also reviewed, with discussions with 12 key program staff. This paper critically analyses the relevance of some of the SRHR topics that are covered, the challenges with existing pedagogic approaches and key sexuality issues that are not covered in the content, but are important for adolescents. Adolescents asked for content and guidance on a number of topics which remain missing from the core curriculum, such as emotional coping mechanisms particularly in relationships, bullying, impact of exposure to porn, and sexual performance anxiety. Other core areas of concern were effects of masturbation, condom use, sexual desire and orientation, which are mentioned in the content, but never discussed properly, resulting in confusion. Due to lack of open discussion around sexuality, porn becomes a source of information for the adolescents. For these reasons, several myths and misconceptions regarding SRHR issues like body, sexuality, agency, and gender roles still persist. The pedagogical approach is very didactic, and teachers felt uncomfortable to have discussions on certain SRHR topics due to cultural taboos or shame and stigma. Certain topics are favored- such as family planning, menstruation- and presented with an emphasis on biology and risk. Rigid formal teaching style, hierarchical power relations between students and most teachers discourage questions and frank conversations. Pedagogy approaches within classrooms play a critical role in the sharing of knowledge. The paper also describes the pilot approaches to implementing new content in SRHR curriculum. After a review of findings, three areas were selected as critically important, 1) myths and misconceptions 2) emotional management challenges, and 3) how to use condom, that have come up from adolescents. Technology centric educational materials such as web page based information platform and you tube videos are opted for which allow adolescents to bypass gatekeepers and learn facts and information from a legitimate educational site. In the era of social media, when information is always a click away, adolescents need sources that are reliable and not overwhelming. The research aims to ensure that adolescents learn and apply knowledge effectively, through creating the new materials and making it accessible to adolescents.

Keywords: adolescents, Bangladesh, media, sexuality education, unmet needs

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Authors: Bipasha Sen, Aditya Agarwal

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Multilingual automatic speech recognition (ASR) system is a single entity capable of transcribing multiple languages sharing a common phone space. Performance of such a system is highly dependent on the compatibility of the languages. State of the art speech recognition systems are built using sequential architectures based on recurrent neural networks (RNN) limiting the computational parallelization in training. This poses a significant challenge in terms of time taken to bootstrap and validate the compatibility of multiple languages for building a robust multilingual system. Complex architectural choices based on self-attention networks are made to improve the parallelization thereby reducing the training time. In this work, we propose Reed, a simple system based on 1D convolutions which uses very short context to improve the training time. To improve the performance of our system, we use raw time-domain speech signals directly as input. This enables the convolutional layers to learn feature representations rather than relying on handcrafted features such as MFCC. We report improvement on training and inference times by atleast a factor of 4x and 7.4x respectively with comparable WERs against standard RNN based baseline systems on SpeechOcean's multilingual low resource dataset.

Keywords: convolutional neural networks, language compatibility, low resource languages, multilingual automatic speech recognition

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Authors: Luedech Girdwichai, Witthaya Mekhum

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This research analyses the factors affecting the success and develops a guideline for self- reliance planning of the entrepreneurs for effective implementation. Samples in this study included 42 awarded winners from the 2nd Sufficiency Economics Philosophy (SEP) National Contest arranged by Office of the Royal Development Projects Board. The results revealed 4 main factors affecting the success as follows: 1) there is a need to encourage unity and cooperation in the enterprise in conducting development plan. 2) The entrepreneur must be a knowledge seeker and lead by example on SEP life. 3) The entrepreneur must be able to apply traditional local wisdom with his present experience and knowledge in defining product identity. 4) The entrepreneur should provide career training for the staffs to develop their competencies. The guideline for self-reliance planning consisted of 4 aspects: 1) Human resource development: the enterprise should develop its staffs especially on integrity, honesty, and public minded. 2) Local community development: there should be a clear target for the local community development. 3) Local community economic development: by encouraging additional incomes through experience sharing. 4) Enterprise development planning: by arranging monthly meeting to conduct the development plan including analysing problems and synthesizing data.

Keywords: potential development, SME entrepreneurs, sufficiency economics philosophy, finance, management

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Authors: Wei-Chih Huang, Pei-Lung Chung, Ching-Heng Lin, Hsuan-Chia Yang, Der-Ming Liou

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Background: In-Hospital Cardiac Arrest (IHCA) threaten life of the inpatients, cause serious effect to patient safety, quality of inpatients care and hospital service. Health providers must identify the signs of IHCA early to avoid the occurrence of IHCA. This study will consider the potential association between early signs of IHCA and the essence of patient care provided by nurses and other professionals before an IHCA occurs. The aim of this study is to identify significant associations between nursing interventions and abnormal early evaluation results of IHCA that can assist health care providers in monitoring inpatients at risk of IHCA to increase opportunities of IHCA early detection and prevention. Materials and Methods: This study used one of the data mining techniques called association rules mining to compute associations between nursing interventions and abnormal early evaluation results of IHCA. The nursing interventions and abnormal early evaluation results of IHCA were considered to be co-occurring if nursing interventions were provided within 24 hours of last being observed in abnormal early evaluation results of IHCA. The rule based methods were utilized 23.6 million electronic medical records (EMR) from a medical center in Taipei, Taiwan. This dataset includes 733 concepts of nursing interventions that coded by clinical care classification (CCC) codes and 13 early evaluation results of IHCA with binary codes. The values of interestingness and lift were computed as Q values to measure the co-occurrence and associations’ strength between all in-hospital patient care measures and abnormal early evaluation results of IHCA. The associations were evaluated by comparing the results of Q values and verified by medical experts. Results and Conclusions: The results show that there are 4195 pairs of associations between nursing interventions and abnormal early evaluation results of IHCA with their Q values. The indication of positive association is 203 pairs with Q values greater than 5. Inpatients with high blood sugar level (hyperglycemia) have positive association with having heart rate lower than 50 beats per minute or higher than 120 beats per minute, Q value is 6.636. Inpatients with temporary pacemaker (TPM) have significant association with high risk of IHCA, Q value is 47.403. There is significant positive correlation between inpatients with hypovolemia and happened abnormal heart rhythms (arrhythmias), Q value is 127.49. The results of this study can help to prevent IHCA from occurring by making health care providers early recognition of inpatients at risk of IHCA, assist with monitoring patients for providing quality of care to patients, improve IHCA surveillance and quality of in-hospital care.

Keywords: in-hospital cardiac arrest, patient safety, nursing intervention, association rule mining

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Authors: Fernanda M. Assef, Maria Teresinha A. Steiner

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The aim of this paper is to compare and discuss better classifier algorithm options for credit risk assessment by applying different Machine Learning techniques. Using records from a Brazilian financial institution, this study uses a database of 5,432 companies that are clients of the bank, where 2,600 clients are classified as non-defaulters, 1,551 are classified as defaulters and 1,281 are temporarily defaulters, meaning that the clients are overdue on their payments for up 180 days. For each case, a total of 15 attributes was considered for a one-against-all assessment using four different techniques: Artificial Neural Networks Multilayer Perceptron (ANN-MLP), Artificial Neural Networks Radial Basis Functions (ANN-RBF), Logistic Regression (LR) and finally Support Vector Machines (SVM). For each method, different parameters were analyzed in order to obtain different results when the best of each technique was compared. Initially the data were coded in thermometer code (numerical attributes) or dummy coding (for nominal attributes). The methods were then evaluated for each parameter and the best result of each technique was compared in terms of accuracy, false positives, false negatives, true positives and true negatives. This comparison showed that the best method, in terms of accuracy, was ANN-RBF (79.20% for non-defaulter classification, 97.74% for defaulters and 75.37% for the temporarily defaulter classification). However, the best accuracy does not always represent the best technique. For instance, on the classification of temporarily defaulters, this technique, in terms of false positives, was surpassed by SVM, which had the lowest rate (0.07%) of false positive classifications. All these intrinsic details are discussed considering the results found, and an overview of what was presented is shown in the conclusion of this study.

Keywords: artificial neural networks (ANNs), classifier algorithms, credit risk assessment, logistic regression, machine Learning, support vector machines

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Authors: Fasil Wagnew, Kerri Viney, Kefyalew Addis Alene, Matthew Kelly, Darren Gray

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Background: Undernutrition is a risk factor for tuberculosis (TB), including poor treatment outcomes. However, evidence regarding the effect of undernutrition on TB treatment outcomes is not well understood. We aimed to evaluate the effect of undernutrition on sputum culture conversion and treatment outcomes among people with multi-drug resistance (MDR)-TB. Methods: We searched for publications in the Medline, Embase, Scopus, and Web of Science databases without restrictions on geography or year of publication. We conducted a random-effect meta-analysis to estimate the effects of undernutrition on sputum culture conversion and treatment outcomes. Two reviewers independently assessed the study eligibility, extracted the necessary information, and assessed the risk of bias. Depending on the nature of the data, odds ratio (OR) and hazard ratio (HR) with 95% confidence intervals (CIs) were used to summarize the effect estimates. Potential publication bias was checked using funnel plots and Egger’s tests. Results: Of 2358 records screened, 59 studies comprising a total of 31,254 people with MDR-TB were included. Undernutrition was significantly associated with a lower sputum culture conversion rate (HR 0·7, 95% CI 0·6–0·9, I2=67·1%) and a higher rate of mortality (OR 2·9, 95%CI 2·1–3·8, I2=23·7%) and unfavourable treatment outcomes (OR 1·8, 95%CI 1·5–2·0, I2=72·7%). There was no statistically significant publication bias in the included studies. Three studies were low, forty-two studies were moderate, and fourteen studies were high quality. Interpretations: Undernutrition was significantly associated with unfavourable treatment outcomes, including mortality and lower sputum culture conversion among people with MDR-TB. These findings have implications for supporting targeted nutritional interventions alongside standardised second-line TB drugs.

Keywords: undernutrition, MDR-TB, sputum culture conversion, treatment outcomes, meta-analysis

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Authors: Robin Becker, Nane Roetmann, Manfred Helmus

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The construction industry faces a significant challenge due to a shortage of skilled work-ers, especially in construction management, despite an increase in graduates. This is main-ly because the job is associated with high stress, long hours, and poor work-life balance. A survey revealed that the profession is unattractive to students, who prioritize personal growth, flexibility, and digitalization in their careers. To address this issue, companies can consider implementing various work modules like "working time documentation," "home office," "job sharing," and "time off." These modules can improve control, work-life bal-ance, and efficiency if tailored to the company's framework. They offer a way to make the field more appealing to future employees while benefiting existing staff, provided that both employers and employees are flexible and considerate of project-specific conditions and teams. The feasibility of these models depends on the company's overall framework, with potential for cost-neutral implementation and positive effects on efficiency and men-tal health. However, their success also relies on the specific context of the company, and more data is needed to assess their full impact.

Keywords: modern construction management, construction industry, work modules, shortage of junior staff, sustainable personnel management, making construction management more attractive, working time model

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Authors: Alya Al Ghufli, Kelaithim Al Tunaiji, Sara Al Ali, Khalid Samara

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It is well known that health care systems encompass a variety of key knowledge sources that need to be integrated and shared amongst all types of users to attain higher-levels of motivation and productivity. The development of Health Integrated Systems (HIS) is often seen as a crucial step in strengthening the integration of knowledge to help serve the information needs of health care users. As an emergent economy, the United Arab Emirates (UAE) is regarded as a new arrival in the area of health information systems. As a new nation, there may be several challenges in terms of organisational climate and the sufficient skills and knowledge activities for effective use of HIS. In this regard, the lack of coordination, attitudes and practice of health-related systems can eventually result in unnecessary data and generally poor use of the system. This paper includes results from a qualitative preliminary study carried out from a case study investigation in a single large primary health care organisation in the United Arab Emirates (UAE) comprising various health care users. The study explored health care user’s perceptions about health integration and the impact it has on their practice. The main sources of information were semi-structured interviews and non-obtrusive observations. The authors conclude by presenting various recommendations for the development of HIS and knowledge activities and areas for further study.

Keywords: health integrated systems, knowledge sharing, knowledge activities, health information systems

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Authors: R. Maher, D. Marchant, F. Fazel

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The initial aim of the study was to capitalize on the depth of athletes’ and coaches’ knowledge pertaining to the phenomenon of choking in basketball, free-throw shooting in particular, from an ‘insiders’ perspective. The findings of this study have developed a deeper understanding of how basketball players and coaches deal with choking and potentially contribute new knowledge relevant to designing useful interventions for alleviating choking. A key element was thus, knowledge, transfer, and exchange (KTE). KTE is the process of acquiring, developing, sharing and applying knowledge. Semi-structured interviews were conducted employing a composed sample of eight elite basketball players and four elite coaches who have been experiencing the choking episode previously. All interviews have been digitally recorded and later transcribed verbatim. Then the interviews have been content analyzed. Participants of the present study have provided useful information regarding the underlying mechanisms and antecedents of choking and also suggested applicable antidotes to conquer the phenomenon of choking. According to the results of the present study, self-confidence, mental and physical preparation, and coping styles should be considered as influential factors in athletes’ performance under pressure. Moreover, using all noteworthy information and preventative strategies suggested by participants of the present study, an effective multi-modal intervention has been introduced that should be taken into account by sports psychologists, coaches and athletes.

Keywords: anxiety, basketball, choking, free-throw shooting, psychological intervention

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Authors: Sumaya Iqbal, Aijaz Ahmad Reshi

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The advances in sensor and embedded technologies have led to rapid developments in Wireless Sensor Networks (WSNs). Presently researchers focus on the integration of WSNs to Internet for their pervasive availability to access these network resources as the interoperable subsystems. The recent computing technologies like cloud computing has made the resource sharing as a converged infrastructure with required service interfaces for the shared resources over the Internet. This paper presents application architecture for wireless Sensor and Actuator Networks (WSANS) following web of things, which allows easy integration of each node to the Internet in order to provide them web accessibility. The architecture enables the sensors and actuator nodes accessed and controlled using cloud interface on WWW. The application architecture was implemented using existing web and its emerging technologies. In particular Representational State Transfer protocol (REST) was extended for the specific requirements of the application. Cloud computing environment has been used as a development platform for the application to assess the possibility of integrating the WSAN nodes to Cloud services. The mushroom farm environment monitoring and control using WSANs has been taken as a research use case.

Keywords: WSAN, REST, web of things, ZigBee, cloud interface, PaaS, sensor gateway

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Authors: Preston Nabors, Nasseh Tabrizi

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Portable Document Format (PDF) files have gained significant popularity for sharing and distributing documents due to their universal compatibility. However, the widespread use of PDF files has made them attractive targets for cybercriminals, who exploit vulnerabilities to deliver malware and compromise the security of end-user systems. This paper reviews notable contributions in PDF malware detection, including static, dynamic, signature-based, and hybrid analysis. It presents a comprehensive examination of PDF malware detection techniques, focusing on the emerging threat of adversarial sampling and the need for robust defense mechanisms. The paper highlights the vulnerability of machine learning classifiers to evasion attacks. It explores adversarial sampling techniques in PDF malware detection to produce mimicry and reverse mimicry evasion attacks, which aim to bypass detection systems. Improvements for future research are identified, including accessible methods, applying adversarial sampling techniques to malicious payloads, evaluating other models, evaluating the importance of features to malware, implementing adversarial defense techniques, and conducting comprehensive examination across various scenarios. By addressing these opportunities, researchers can enhance PDF malware detection and develop more resilient defense mechanisms against adversarial attacks.

Keywords: adversarial attacks, adversarial defense, adversarial machine learning, intrusion detection, PDF malware, malware detection, malware detection evasion

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Authors: Amir Farouk Ahmed Ali Hussin

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Social media, such as Facebook, LinkedIn and Ex-Twitter have experienced exponential growth and a remarkable adoption rate in recent years. They give fantastic means of online social interactions and communications with family, friends, and colleagues from around the corner or across the globe, and they have become an important part of daily digital interactions for more than one and a half billion users around the world. The personal information sharing practices that social network providers encourage have led to their success as innovative social interaction platforms. Moreover, these practices have outcome in concerns with respect to privacy and security from different stakeholders. Guiding these privacy and security concerns in social networks is a must for these networks to be sustainable. Real security and privacy tools may not be enough to address existing concerns. Some points should be followed to protect users from the existing risks. In this research, we have checked the various privacy and security issues and concerns pertaining to social media. However, we have classified these privacy and security issues and presented a thorough discussion of the effects of these issues and concerns on the future of the social networks. In addition, we have presented a set of points as precaution measures that users can consider to address these issues.

Keywords: international legal, consultation mix, legal research, small and medium-sized enterprises, strategic International law, strategy alignment, house of laws, deployment, production strategy, legal strategy, business strategy

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Authors: Aanh Eduardo Dimate-Garcia, Diana Carolina Rodriguez-Romero, Edna Yuliana Gonzalez Rincon, Diana Marcela Pardo Lopez, Yessica Garibello Cubillos

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Musculoskeletal disorders (MD) are the new epidemic of chronic diseases, are multifactorial and affect the different productive sectors. Although there are multiple instruments to evaluate the static and dynamic load, the method of repetitive occupational action (OCRA) seems to be an attractive option. Objective: It is aimed to analyze the use of the OCRA method and the prevalence of MD in workers of various productive sectors according to the literature (2007-2018). Materials and Methods: A literature review (following the PRISMA statement) of studies aimed at assessing the level of biomechanical risk (OCRA) and the prevalence of MD in the databases Scielo, Science Direct, Scopus, ProQuest, Gale, PubMed, Lilacs and Ebsco was realized; 7 studies met the selection criteria; the majority are quantitative (cross section). Results: it was evidenced (gardening and flower-growers) in this review that 79% of the conditions related to the task require physical requirements and involve repetitive movements. In addition, of the high appearance of DM in the high-low back, upper and lower extremities that are produced by the frequency of the activities carried out (footwear production). Likewise, there was evidence of 'very high risks' of developing MD (salmon industry) and a medium index (OCRA) for repetitive movements that require special care (U-Assembly line). Conclusions: the review showed the limited use of the OCRA method for the detection of MD in workers from different sectors, and this method can be used for the detection of biomechanical risk and the appearance of MD.

Keywords: checklist, cumulative trauma disorders, musculoskeletal diseases, repetitive movements

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Authors: Sandrieli Afornali, Adriano Keijiro Maeda, Renato Fedatto Beraldo, Carlos Alberto Mattozo, Ricardo Nascimento Brito

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BACKGROUND: The most used variety in hydrocephalus treatment is the ventriculoperitoneal shunt (VPS). However, it may fails in 20 to 70% of cases. It makes necessary to have alternative cavities for the implantation of the distal catheter. Ventriculo-atrial shunting (VAS) is described as the second option. To our knowledge, there are 121 reported cases of VGB shunt in children until 2020 and a highly variable success rate, from 25 to 100%, with an average of 63% of patients presenting good long-term results. Our goal is to evaluate the epidemiological profile of patients submitted to ventriculo-gallbladder (VGB) shunt and, through a review of literature, to compare our results with others series. METHODS: a retrospective cross-sectional observational study of a case series of nine patients. The medical records of all patients were reviewed, who underwent VGB shunt at the Hospital Pequeno Príncipe from Curitiba, Paraná, Brazil, from January 2014 to October 2022. The inclusion criteria were: patients under 17 years of age with hydrocephalus of any etiology, currently using or prior to VGB shunt. RESULTS: There were 6 (66,7%) male and 3 (33,3%) female. The average age of 73.6 months or 6.1 years at the time of surgery. They were submitted on average 5.1 VPS reviews previous to VGB shunt. Five (55,5%) had complications of VGB shunt: infection (11.1%), atony (11.1%), hypodrainage due to kinking the distal catheter in the solution (11.1%) and ventriculoenteric fistula (22.2%); all these patients were cured at surgical reapproach, and in 2 of them the VGB shunt was reimplanted. Two patients died (22.2%), and five (55,5%) patients maintained the use of VGB shunt in the follow-up period; and in 4 (44.4%) there was never need for review. CONCLUSION: VGB shunt tends to be underestimated because it is still unconventional and little publicized in literature. Our article shows a lower risk of death and similar risk of complications when compared to others altenatives shunts. We emphasize VGB shunt as a safe procedure to be the second option when VPS fails or has contraindications.

Keywords: hydrocephalus, ventricular-gallbladder shunt, VGB shunt, VPS, ventriculoperitoneal shunt, ventriculoatrial shunt

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Authors: Vasiliki Vlachou, Christos Kontzinos, Ourania Markaki, Panagiotis Kokkinakos, Vagelis Karakolis, John Psarras

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Higher Education is resisting the pull of technology, especially as this concerns the issuance and verification of degrees and certificates. It is widely known that education certificates are largely produced in paper form making them vulnerable to damage while holders of such certificates are dependent on the universities and other issuing organisations. QualiChain is an EU Horizon 2020 (H2020) research project aiming to transform and revolutionise the domain of public education and its ties with the job market by leveraging blockchain, analytics and decision support to develop a platform for the verification and sharing of education certificates. Blockchain plays an integral part in the QualiChain solution in providing a trustworthy environment to store, share and manage such accreditations. Under the context of this paper, three prominent blockchain platforms (Ethereum, Hyperledger Fabric, Hyperledger Iroha) were considered as a means of experimentation for creating a system with the basic functionalities that will be needed for trustworthy degree verification. The methodology and respective system developed and presented in this paper used Hyperledger Iroha and proved that this specific platform can be used to easily develop decentralize applications. Future papers will attempt to further experiment with other blockchain platforms and assess which has the best potential.

Keywords: blockchain, degree verification, higher education certificates, Hyperledger Iroha

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Authors: Larry Lai, Evans Leung

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Falun gong is a self-proclaimed religious group that has been under crackdown by Beijing for more than two decades. Diaosi, on the other hand, is an emerging community with members loosely connected on the internet through different online social platforms, centering around the sharing of different hobbies and interests. Diaosi community has been transformed from a potential threat to the Chinese authority for different causes to a pro-government force. This paper seeks to explain the different strategies adopted by the People's Republic of China (PRC) regime in handling these two potential threatening communities. Both communities share some obvious similarities: (1) both have massive nation-wide participation; (2) both have attempted to challenge the PRC's authority through contentious means; (3) both have high level of mobility, online or offline; and (4) both have at first been unnoticed until the threat against the PRC have taken form. But the strategies the PRC endorsed against the communities were, in many ways, different. The question is: if the strategy against Falun Gong has been an effective one, why used other strategies against Diaosi? The authors argue that the main reason for using different strategies lies in the differences between the two communities in terms of (i) the nature of the groups, and (ii) the group dynamics. Lastly, based on this analysis, the authors attempt to explore the possible strategies that the PRC would adopt against the Hong Kong cyber-world political community in light of the latest national security law in Hong Kong.

Keywords: contentious politics, Diaosi, Falun Gong, Hong Kong, People's Republic of China

Procedia PDF Downloads 133

Authors: Vahab Behmanesh

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Metabolic syndrome is defined as having at least three of the five metabolic risk factors, including abdominal obesity, high blood pressure, high triglycerides, low HDL, and insulin resistance. Lifestyle changes towards reducing physical activity, unhealthy eating habits Especially the high-fat and high-carbohydrate diet is directly related to metabolic syndrome, and due to the epidemic of overweight and sedentary life, metabolic syndrome is a serious problem worldwide. On the other hand, vitamin D deficiency is considered as one of the most common problems in the world, which is related to the dysfunction of beta cells and insulin resistance, and therefore, vitamin D deficiency is considered as a factor in the occurrence of metabolic syndrome. 40 subjects (age: 16.12 ± 4.4 years and body mass index 25.61 ± 4.4 kg/m2) were randomly assigned to groups of aerobic exercise and placebo, aerobic exercise and vitamin D and placebo (no exercise) were divided. Vitamin D was taken at a dose of 50,000 units per week in a double-blind format for eight weeks, and the daily aerobic exercise program was performed for 50 to 60 minutes, three doses per week, with an intensity of 50-60% of the maximum heart rate. From one-way analysis of variance, Factorial variance analysis (2x2) repeated measurement and correlated t-test were used for data analysis. Aerobic exercise and vitamin D intake reduced all metabolic risk indicators and blood insulin (P < 0.05). However, the subjective feeling of hunger did not change significantly (P < 0.05). Regarding waist circumference and blood glucose, the effect of exercise combined with vitamin D consumption was greater than the corresponding effect in the vitamin D group (P < 0.05). Aerobic exercises and vitamin D intake are safe and effective for improving cardiometabolic health, Imam adds vitamin D to the exercise program has more benefits for weight and blood sugar control, which suggests prescribing it for patients with metabolic syndrome.

Keywords: vitamin D, aerobic exercise, metabolic control, adolescents

Procedia PDF Downloads 90

Authors: Hsien Hwa Kuo, Lin Wen Chun, Lin Wen Chun, Hsien Wen Kuo

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Objective: Nurses represent an important occupational group frequently affected by wrist musculoskeletal disorders (WMSDs) due to a heavy workload, working shifts, poor posture, giving shots, making beds, lifting patients, bending their waist and insufficient rest time every day. However, lack of research reported nurses whether workload in household correlated with the severity of WMSDs. Methods: 550 nurses from a hospital in Taoyuan were interviewed using a modified standardized Nordic Musculoskeletal (NMQ) questionnaire including the demographic information, workplace condition and nine body parts of musculoskeletal disorders. Results: 17.9% and 23.9% of severity and symptoms in WMSDs among nurses with children were significant higher than among nurses without children (1​2.4% and 15.9%). Based on multiple logistic regression models adjusted for age, work duration, job title and body mass index (BMI), we found that heavy workload in hospital had higher odds ratio (OR) of the severity and symptoms of WMSD among nurses with children (OR= 8.67 and OR= 4.30, p<0.05) compared to nurses without children (OR= 1.94 and OR= 1.70). Conclusion: The severity and symptoms of WMSDs among nurses significantly correlated with workload in hospital among nurses with children. If women are at greater risk because of the combination of their work and family demands, synergistic effect of WMSDs was found among nurses. Comment: Women's domestic work, especially once they become mothers, they invest more time and energy caring for children, helping others, and doing housework. Thus domestic work, per se, may be a risk factor for wrist musculoskeletal problems, and, more importantly, it may constrain women's ability to protect themselves from the effects of their paid work. If nurses with more domestic work periodically make efforts to physical activity or modify inappropriate posture, their WMSDs symptoms will be alleviated.

Keywords: musculoskeletal disorders, nurse, NMQ, WMSDs

Procedia PDF Downloads 340