Search results for: cases
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4412

Search results for: cases

4172 Evaluation of Role of Surgery in Management of Pediatric Germ Cell Tumors According to Risk Adapted Therapy Protocols

Authors: Ahmed Abdallatif

Abstract:

Background: Patients with malignant germ cell tumors have age distribution in two peaks, with the first one during infancy and the second after the onset of puberty. Gonadal germ cell tumors are the most common malignant ovarian tumor in females aged below twenty years. Sacrococcygeal and retroperitoneal abdominal tumors usually presents in a large size before the onset of symptoms. Methods: Patients with pediatric germ cell tumors presenting to Children’s Cancer Hospital Egypt and National Cancer Institute Egypt from January 2008 to June 2011 Patients underwent stratification according to risk into low, intermediate and high risk groups according to children oncology group classification. Objectives: Assessment of the clinicopathologic features of all cases of pediatric germ cell tumors and classification of malignant cases according to their stage, and the primary site to low, intermediate and high risk patients. Evaluation of surgical management in each group of patients focusing on surgical approach, the extent of surgical resection according to each site, ability to achieve complete surgical resection and perioperative complications. Finally, determination of the three years overall and disease-free survival in different groups and the relation to different prognostic factors including the extent of surgical resection. Results: Out of 131 cases surgically explored only 26 cases had re exploration with 8 cases explored for residual disease 9 cases for remote recurrence or metastatic disease and the other 9 cases for other complications. Patients with low risk kept under follow up after surgery, out of those of low risk group (48 patients) only 8 patients (16.5%) shifted to intermediate risk. There were 20 patients (14.6%) diagnosed as intermediate risk received 3 cycles of compressed (Cisplatin, Etoposide and Bleomycin) and all high risk group patients 69patients (50.4%) received chemotherapy. Stage of disease was strongly and significantly related to overall survival with a poorer survival in late stages (stage IV) as compared to earlier stages. Conclusion: Overall survival rate at 3 three years was (76.7% ± 5.4, 3) years EFS was (77.8 % ±4.0), however 3 years DFS was much better (89.8 ± 3.4) in whole study group with ovarian tumors had significantly higher Overall survival (90% ± 5.1). Event Free Survival analysis showed that Male gender was 3 times likely to have bad events than females. Patients who underwent incomplete resection were 4 times more than patients with complete resection to have bad events. Disease free survival analysis showed that Patients who underwent incomplete surgery were 18.8 times liable for recurrence compared to those who underwent complete surgery, and patients who were exposed to re-excision were 21 times more prone to recurrence compared to other patients.

Keywords: extragonadal, germ cell tumors, gonadal, pediatric

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4171 Q-Learning of Bee-Like Robots Through Obstacle Avoidance

Authors: Jawairia Rasheed

Abstract:

Modern robots are often used for search and rescue purpose. One of the key areas of interest in such cases is learning complex environments. One of the key methodologies for robots in such cases is reinforcement learning. In reinforcement learning robots learn to move the path to reach the goal while avoiding obstacles. Q-learning, one of the most advancement of reinforcement learning is used for making the robots to learn the path. Robots learn by interacting with the environment to reach the goal. In this paper simulation model of bee-like robots is implemented in NETLOGO. In the start the learning rate was less and it increased with the passage of time. The bees successfully learned to reach the goal while avoiding obstacles through Q-learning technique.

Keywords: reinforlearning of bee like robots for reaching the goalcement learning for randomly placed obstacles, obstacle avoidance through q-learning, q-learning for obstacle avoidance,

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4170 Review on Japan Environmental Future City: Development, Critics and Cases

Authors: Runlang Zhu, Weijun Gao, Yinqi Zhang, Gangwei Cai

Abstract:

In order to deal with issues such as the environmental problems and aging of the population, the Japanese government wanted to achieve goals like 'a city where everyone wants to live' and 'a city full of energy for everyone' by creating environmental, social, and economic values in the process of urban development. They began to promote the concept of 'Environmental Future City' in 2010, aiming to create cities and regions with excellent environments, sustainable economic development, and social systems. After taking a look at the history, concept, and development of environmental future cities, the paper will discuss the evaluation system of them, introduce representative cases, and point out what other cities can learn from their development process.

Keywords: environmental future city, city concept, CASBEE, environmental performance assessment

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4169 Navigating the Legal Seas: The Freedom to Choose Applicable Law in Tort

Authors: Sara Vora (Hoxha)

Abstract:

An essential feature of any international lawsuit is the ability of the parties to pick the law that would apply in the event of a tort claim. This option to choose the law to use in tort cases is based on Article 14 and 4/3 of the Rome II Regulation. The purpose of this article is to examine the boundaries of this freedom, as well as its relevance in international legal disputes. The article opens with a brief introduction to the basics of tort law. After a short introduction, the article demonstrates why Article 14 and 4/3 of the Rome II Regulation are so crucial to the right to select appropriate law in tort cases. The notion of the right to select the law to use in tort cases is examined, along with its breadth and possible restrictions. The article presents case studies to demonstrate how the right to select relevant law in tort might be put into practise. Case results and the judges' rationales for their rulings are examined. The possible influence of the right to select applicable law in tort on the process of harmonisation is also explored in this study. The results are summarised and the primary research question is addressed in the last section of the paper. In conclusion, the parties' ability to pick the law that rules their dispute via the freedom to choose relevant law in tort is a crucial feature of cross-border litigation. Despite certain restrictions, this freedom is nevertheless an important part of the legal structure that governs international conflicts.

Keywords: applicable law, tort, Rome II regulation, freedom to choose, cross-border litigation, harmonization of tort law

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4168 Importance of Cryptosporidiosis in Dairy Calves

Authors: Mohammad Asadpour

Abstract:

Cryptosporidium spp. is zoonotic pathogens transmissible from a variety of animals to humans and is a considerable public health concern. Calves have been identified in numerous reports as a major source of environmental contamination with this pathogen. Parasite has a different species that are the cases of zoonotic disease in immunodeficient people and neonatal calves. Cryptosporidium oocysts are extremely resistant to chlorine and other physical cases that commonly used in drinking water. Reproduction of resistant oocytes is a way for this monoxenous parasite to remain in the environment. Cryptosporidium parvum is the most important species that has human and cattle genotypes. Cryptosporidium is one of the most important causes of diarrhea in neonatal calves and also, one of the four causes of diarrhea symptoms in pre-weaned calves. Because of the incompetent immune system in calves, Cryptosporidium infection is the cause of a lot of problems in raising farms.

Keywords: Cryptosporidium spp, dairy calves, importance, veterinary medicine

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4167 Numerical Investigation of the Effect of the Spark Plug Gap on Engine-Like Conditions

Authors: Fernanda Pinheiro Martins, Pedro Teixeira Lacava

Abstract:

The objective of this research is to analyze the effects of different spark plug conditions in engine-like conditions by applying computational fluid dynamics analysis. The 3D models applied consist of 3-Zones Extended Coherent Flame (ECFM-3Z) and Imposed Stretch Spark Ignition Model (ISSIM), respectively, for the combustion and the spark plug modelling. For this study, it was applied direct injection fuel system in a single cylinder engine operating with E0. The application of realistic operating conditions (load and speed) to the different cases studied will provide a deeper understanding of the effects of the spark plug gap, a result of parts outwearing in most of the cases, to the development of the combustion in engine-like conditions.

Keywords: engine, CFD, direct injection, combustion, spark plug

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4166 Clinical and Molecular Characterization of Ichthyosis at King Abdulaziz Medical City, Riyadh KSA

Authors: Reema K. AlEssa, Sahar Alshomer, Abdullah Alfaleh, Sultan ALkhenaizan, Mohammed Albalwi

Abstract:

Ichthyosis is a disorder of abnormal keratinization, characterized by excessive scaling, and consists of more than twenty subtypes varied in severity, mode of inheritance, and the genes involved. There is insufficient data in the literature about the epidemiology and characteristics of ichthyosis locally. Our aim is to identify the histopathological features and genetic profile of ichthyosis. Method: It is an observational retrospective case series study conducted in March 2020, included all patients who were diagnosed with Ichthyosis and confirmed by histological and molecular findings over the last 20 years in King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia. Molecular analysis was performed by testing genomic DNA and checking genetic variations using the AmpliSeq panel. All disease-causing variants were checked against HGMD, ClinVar, Genome Aggregation Database (gnomAD), and Exome Aggregation Consortium (ExAC) databases. Result: A total of 60 cases of Ichthyosis were identified with a mean age of 13 ± 9.2. There is an almost equal distribution between female patients 29 (48%) and males 31 (52%). The majority of them were Saudis, 94%. More than half of patients presented with general scaling 33 (55%), followed by dryness and coarse skin 19 (31.6%) and hyperlinearity 5 (8.33%). Family history and history of consanguinity were seen in 26 (43.3% ), 13 (22%), respectively. History of colloidal babies was found in 6 (10%) cases of ichthyosis. The most frequent genes were ALOX12B, ALOXE3, CERS3, CYP4F22, DOLK, FLG2, GJB2, PNPLA1, SLC27A4, SPINK5, STS, SUMF1, TGM1, TGM5, VPS33B. Most frequent variations were detected in CYP4F22 in 16 cases (26.6%) followed by ALOXE3 6 (10%) and STS 6 (10%) then TGM1 5 (8.3) and ALOX12B 5 (8.3). The analysis of molecular genetic identified 23 different genetic variations in the genes of ichthyosis, of which 13 were novel mutations. Homozygous mutations were detected in the majority of ichthyosis cases, 54 (90%), and only 1 case was heterozygous. Few cases, 4 (6.6%) had an unknown type of ichthyosis with a negative genetic result. Conclusion: 13 novel mutations were discovered. Also, about half of ichthyosis patients had a positive history of consanguinity.

Keywords: ichthyosis, genetic profile, molecular characterization, congenital ichthyosis

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4165 Development of E-Tendering Models for Nigerian Public Procuring Entities

Authors: Bello Abdullahi, Kabir Bala, Yahaya M. Ibrahim, Ahmed D. Ibrahim

Abstract:

Public sector tendering has traditionally been conducted using manual paper-based processes which are known to be inefficient, less transparent, and more prone to manipulations and errors. However, the advent of the Internet and its associated technologies has led to the development of numerous e-Tendering systems that addressed many of the problems associated with the manual paper-based tendering system. Currently, in Nigeria, the public tendering processes are largely conducted based on manual paper-based system that is bedevilled by a number of problems such as inordinate delays, inefficiencies, manipulation of the tender evaluation process, corruption, lack of transparency and competition, among other problems. These problems can be addressed through the adoption of existing web-based e-Tendering systems which are known to address most of these problems. However, these existing e-Tendering systems that have been developed are not based on the Nigerian legal procurement processes and as such their suitability for local application is very limited. This paper is part of a larger study that attempt to address this problem through the development of an e-Tendering system that is based on the requirements of the Nigerian public procuring entities. In this paper, the identified tendering processes commonly used by Nigerian public procuring entities in the selection of construction sources are presented. A multi-methods research approach was used to identify those tendering processes. Specifically, 19 existing business use cases used by Nigerian public procuring entities were identified and 61 system use cases were prescribed based on the identified business use cases. The use cases were used as the basis for the development of domain and software conceptual models. The models were successfully used to guide the development of an e-Tendering system called NPS-eTender. Ripple and Unified Process were adopted as the software development methodologies.

Keywords: e-tendering, e-procurement, requirement model, conceptual model, public sector tendering, public procurement

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4164 Development of Time Series Forecasting Model for Dengue Cases in Nakhon Si Thammarat, Southern Thailand

Authors: Manit Pollar

Abstract:

Identifying the dengue epidemic periods early would be helpful to take necessary actions to prevent the dengue outbreaks. Providing an accurate prediction on dengue epidemic seasons will allow sufficient time to take the necessary decisions and actions to safeguard the situation for local authorities. This study aimed to develop a forecasting model on number of dengue incidences in Nakhon Si Thammarat Province, Southern Thailand using time series analysis. We develop Seasonal Autoregressive Moving Average (SARIMA) models on the monthly data collected between 2003-2011 and validated the models using data collected between January-September 2012. The result of this study revealed that the SARIMA(1,1,0)(1,2,1)12 model closely described the trends and seasons of dengue incidence and confirmed the existence of dengue fever cases in Nakhon Si Thammarat for the years between 2003-2011. The study showed that the one-step approach for predicting dengue incidences provided significantly more accurate predictions than the twelve-step approach. The model, even if based purely on statistical data analysis, can provide a useful basis for allocation of resources for disease prevention.

Keywords: SARIMA, time series model, dengue cases, Thailand

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4163 Diversion of Airplanes for Medical Emergencies at Taoyuan International Airport

Authors: Chin-Hsiang Lo, Wey Chia, Shih-Tien Hsu

Abstract:

Introduction: Since 2016, the annual number of passengers on commercial flights at Taoyuan International Airport (TIA) has been ~40 million. Due to the outbreak and spread of COVID-19, the number of international flights sharply diminished in recent years. However, TIA is located at an East-Asian flight transportation junction; thus, many commercial and cargo flights continue service. When severe medical events happen on a commercial airliner, the decision to divert or not is based on consideration of both medical and operational issues. This study discusses the events related to the diversion of airplanes or reentry after taxiing for medical emergencies at Taoyuan International Airport. Background: We analyzed emergency medical records from the medical clinic of TIA from January 1, 2017, to December 31, 2022, for patients who needed emergency medical services but were unable to reach the airport clinic by themselves. We also collected data for patients treated after diversion from other airports or reentry after taxiing due to medical emergencies. Information such as when and where the event occurred, chief signs and symptoms, the tentative diagnosis (using the ICD-9-CM), management, and the sociodemographic features of the passengers were extracted from the medical records. Summary of Cases: TIA handled approximately 152 million passengers and 1,093,762 flights during the study period; a total of 2,804 emergencies occurred during this time period. Thirty-three medical emergencies warranted diversion (21 cases) or reentry (12 cases); 13 cases were diverted from Asia-Pacific flights and five from Asia-North America flights. The age of the passengers with diversion emergencies ranged from 2–85 years (mean, 46±20-years-old). Twenty-seven patients were transported to an emergency department, and four patients died. For all cases of diversion or reentry, the most common diagnoses were neurogenic problems (42.4%), Out-of-hospital cardiac arrest (OHCA) (15.2%), and cardiovascular problems (12.1%). Discussion: Most aircraft diversions were related to syncope, seizure, and OHCA. The decision to divert depends on medical and operational considerations. Emergency conditions are often serious; thus, improvement of the effectiveness of cooperation between airlines and medical teams remains a challenge.

Keywords: diversion, syncope, seizure, OHCA

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4162 Calcitonin gene-related peptide Receptor Antagonists for Chronic Migraine – Real World Outcomes

Authors: B. J. Mahen, N. E. Lloyd-Gale, S. Johnson, W. P. Rakowicz, M. J. Harris, A. D. Miller

Abstract:

Background: Migraine is a leading cause of disability in the world. Calcitonin gene-related peptide (CGRP) receptor antagonists offer an approach to migraine prophylaxis by inhibiting the inflammatory and vasodilatory effects of CGRP. In recent years, NICE licensed the use of three CGRP-receptor antagonists: Fremanezumab, Galcanezumab, and Erenumab. Here, we present the outcomes of CGRP-antagonist treatment in a cohort of patients who suffer from episodic or chronic migraine and have failed at least three oral prophylactic therapies. Methods: We offered CGRP antagonists to 86 patients who met the NICE criteria to start therapy. We recorded the number of headache days per month (HDPM) at 0 weeks, 3 months, and 12 months. Of those, 26 patients were switched to an alternative treatment due to poor response or side effects. Of the 112 total cases, 9 cases did not sufficiently maintain their headache diary, and 5 cases were not followed up at 3 months. We have therefore included 98 sets of data in our analysis. Results: Fremanezumab achieved a reduction in HDPM by 51.7% at 3 months (p<0.0001), with 63.7% of patients meeting NICE criteria to continue therapy. Patients trialed on Galcanezumab attained a reduction in HDPM by 47.0% (p=0.0019), with 51.6% of patients meeting NICE criteria to continue therapy. Erenumab, however, only achieved a reduction in HDPM by 17.0% (p=0.29), and this was not statistically significant. Furthermore, 34.4%, 9.7%, and 4.9% of patients taking Fremanezumab, Galcanezumab, and Erenumab, respectively, continued therapy beyond 12 months. Of those who attempted drug holidays following 12 months of treatment, migraine symptoms relapsed in 100% of cases. Conclusion: We observed a significant improvement in HDPM amongst episodic and chronic migraine patients following treatment with Fremanezumab or Galcanezumab.

Keywords: migraine, CGRP, fremanezumab, galcanezumab, erenumab

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4161 A Closed-Loop Design Model for Sustainable Manufacturing by Integrating Forward Design and Reverse Design

Authors: Yuan-Jye Tseng, Yi-Shiuan Chen

Abstract:

In this paper, a new concept of closed-loop design model is presented. The closed-loop design model is developed by integrating forward design and reverse design. Based on this new concept, a closed-loop design model for sustainable manufacturing by integrated evaluation of forward design, reverse design, and green manufacturing using a fuzzy analytic network process is developed. In the design stage of a product, with a given product requirement and objective, there can be different ways to design the detailed components and specifications. Therefore, there can be different design cases to achieve the same product requirement and objective. Thus, in the design evaluation stage, it is required to analyze and evaluate the different design cases. The purpose of this research is to develop a model for evaluating the design cases by integrated evaluation of forward design, reverse design, and green manufacturing models. A fuzzy analytic network process model is presented for integrated evaluation of the criteria in the three models. The comparison matrices for evaluating the criteria in the three groups are established. The total relational values among the three groups represent the total relational effects. In application, a super matrix can be created and the total relational values can be used to evaluate the design cases for decision-making to select the final design case. An example product is demonstrated in this presentation. It shows that the model is useful for integrated evaluation of forward design, reverse design, and green manufacturing to achieve a closed-loop design for sustainable manufacturing objective.

Keywords: design evaluation, forward design, reverse design, closed-loop design, supply chain management, closed-loop supply chain, fuzzy analytic network process

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4160 Identifying the Sacred in International Relations: A Religion-Based Analysis on Intimacy between Indonesia and Palestine

Authors: Andi Triswoyo

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The sacred has been a dominant influence in the human lives. International relations, as the mirror of the human relations in a whole, reflected such cases. Inter-state relations has been predominantly how the sacred played the main roles of. The relations between Indonesia and Palestine could be shot as the sacred-analyzed case of inter-state relations. The intimacy of them could be analyzed comfortably in IR normal perspective, such as realism, liberalism, and Marxism. Hopefully, Religion perspective would make better explanation how Indonesia-Palestine relations had so worth. This paper will use some narrative-explanatory stage to elaborate that cases. Moreover, the sacred can give such alternative analyses to interpret how international relations occurred in this time regard of the rise a new theory of International Relations.

Keywords: the sacred, international relations, Indonesia, Palestine

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4159 Long Term Survival after a First Transient Ischemic Attack in England: A Case-Control Study

Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski

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Transient ischaemic attacks (TIAs) are warning signs for future strokes. TIA patients are at increased risk of stroke and cardio-vascular events after a first episode. A majority of studies on TIA focused on the occurrence of these ancillary events after a TIA. Long-term mortality after TIA received only limited attention. We undertook this study to determine the long-term hazards of all-cause mortality following a first episode of a TIA using anonymised electronic health records (EHRs). We used a retrospective case-control study using electronic primary health care records from The Health Improvement Network (THIN) database. Patients born prior to or in year 1960, resident in England, with a first diagnosis of TIA between January 1986 and January 2017 were matched to three controls on age, sex and general medical practice. The primary outcome was all-cause mortality. The hazards of all-cause mortality were estimated using a time-varying Weibull-Cox survival model which included both scale and shape effects and a random frailty effect of GP practice. 20,633 cases and 58,634 controls were included. Cases aged 39 to 60 years at the first TIA event had the highest hazard ratio (HR) of mortality compared to matched controls (HR = 3.04, 95% CI (2.91 - 3.18)). The HRs for cases aged 61-70 years, 71-76 years and 77+ years were 1.98 (1.55 - 2.30), 1.79 (1.20 - 2.07) and 1.52 (1.15 - 1.97) compared to matched controls. Aspirin provided long-term survival benefits to cases. Cases aged 39-60 years on aspirin had HR of 0.93 (0.84 - 1.00), 0.90 (0.82 - 0.98) and 0.88 (0.80 - 0.96) at 5 years, 10 years and 15 years, respectively, compared to cases in the same age group who were not on antiplatelets. Similar beneficial effects of aspirin were observed in other age groups. There were no significant survival benefits with other antiplatelet options. No survival benefits of antiplatelet drugs were observed in controls. Our study highlights the excess long-term risk of death of TIA patients and cautions that TIA should not be treated as a benign condition. The study further recommends aspirin as the better option for secondary prevention for TIA patients compared to clopidogrel recommended by NICE guidelines. Management of risk factors and treatment strategies should be important challenges to reduce the burden of disease.

Keywords: dual antiplatelet therapy (DAPT), General Practice, Multiple Imputation, The Health Improvement Network(THIN), hazard ratio (HR), Weibull-Cox model

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4158 PD-L1 Expression in Papillary Thyroid Carcinoma Arising Denovo or on Top of Autoimmune Thyroiditis

Authors: Dalia M. Abouelfadl, Noha N. Yassen, Marwa E. Shabana

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Background: The evolution of immune therapy motivated many to study the relation between immune response and progression of cancer. Little is known about expression of PD-L1 (a newly evolving immunotherapeutic drug) in papillary thyroid carcinoma (PTC) arising de-novo and PTC arising on top of autoimmune thyroiditis (Hashimoto's (HT) and lymphocytic thyroiditis (LT)). The aim of this work is to study the alteration of expression of PD-L1 in PTCs arising from de-novo or on top of HT OR LT using immunohistochemistry and image analyser system. Method: 100 paraffin blocks for PTC cases were collected retrospectively for staining using PD-L1 rabbit monoclonal antibody (BIOCARE-ACI 3171 A, C). The antibody expression is measured digitally using Image Analyzer Leica Qwin 3000, and the membranous and cytoplasmic expression of PD-L1 in tumor cells was considered positive. The results were correlated with tumor grade, size, and LN status. Results: The study samples consisted of 41 cases of PTC arising De novo, 36 cases on top of HT, and 23 on top of LT. Expression of PD-L1 was highest among the PTC-HL group (25 case-69%) followed by PTC-TL group (14 case-60.8%) then de-novo PTC (19 case-46%) with P Value < 0.05. PD-L1 expression correlated with nodal metastasis and was not relevant to tumor size or grade. Conclusion: The severity of the immune response in tumor microenvironment directly influences PTC prognosis. The anti PD-L1 Ab can be a very successful therapeutic agent for PTC arising on top of HT.

Keywords: carcinoma, Hashimoto's, lymphocytic, papillary, PD-L1, thyroiditis

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4157 Potential Distribution and Electric Field Analysis around a Polluted Outdoor Polymeric Insulator with Broken Sheds

Authors: Adel Kara, Abdelhafid Bayadi, Hocine Terrab

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This paper presents a study of electric field distribution along of 72 kV polymeric outdoor insulators with broken sheds. Different cases of damaged insulators are modeled and both of clean and polluted cases. By 3D finite element analysis using the software package COMSOL Multiphysics 4.3b. The obtained results of potential and the electrical field distribution around insulators by 3D simulation proved that finite element computations is useful tool for studying insulation electrical field distribution.

Keywords: electric field distributions, insulator, broken sheds, potential distributions

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4156 Dermatophytoses: Spectrum Evolution of Dermatophytes in Sfax, Tunisia, Between 1999 and 2019

Authors: Khemakhem Nahed, Hammami Fatma, Trabelsi Houaida, Neji Sourour, Sellami Hayet, Makni Fattouma, Turki Hamida, Ayadi Ali

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Dermatophytoses are considered a public health problem and represent 10% of dermatological consultations in our region. Their epidemiology is influenced by various factors, such as lifestyle, human migration patterns, changes in the environment and the host relationship. The understanding of epidemiology has a major impact on their prevention and treatment. The aim of the study is to determine the prevalence pattern of aetiological agents and to describe the clinical characteristics of dermatophytoses between 1999 and 2019. Out of 65 059 subjects suspected to have superficial mycoses, 36 220 (55.67%) were affected with dermatophytoses. The mean age was 40.1 years (range: 10 days to 99 years). The sex ratio was 0.8. Our patients were from urban regions in 80.9% of cases. The most common type of infection was onychomycosis (42.64%), followed by tinea pedis (20.8%), intertrigo (18.3%), tinea corporis (8.48%) and tinea capitis (7.87%). The most isolated dermatophyte was Trichophyton rubrum (76.5%), followed by T. mentagrophytes complex (6.3%), Microsporum canis (5.8%), T. violaceum (5.3%), T. verrucosum (0.83%) and Epidermophyton floccosum (0.3%). Zoophilic agents have become more prevalent and their frequency has been increased from 6.46% in 1999 to 13% in 2019. It is interesting to note that M. canis has been on the rise since 2010 and it was the first etiological agent of tinea capitis (48%), while infections caused by T. violaceum continued to decrease from 1999 (16.2%) to 2019 (4.7%). Other dermatophytes have been rarely isolated: T. tonsurans (9 cases), T. schoenleinii (3 cases), T. soudanense (2 cases), M. fulvum (1 case), M. audouinii (1 case) and M. ferrugineum (2 cases).T. mentagrophytes var. quinckeanum was isolated from an inflammatory tinea capitis lesion in an a-3-year-old girl. T. mentagrophytes var. erinacei was isolated from the first case of tinea manuum, in-a-10-year-old girl. The same fungus was isolated from the hair and scales of the hedgehog. Our study showed significant changes in the dermatophytes spectrum in our region. The prevalence of zoophilic species increased in recent years due to people's behavioral changes with the adoption of pets and animal husbandry in urban settings. Molecular methods are often crucial that help us to refine the identification strains of dermatophytes and to identify their origin of the contamination.

Keywords: dermatophytoses, PCR-sequencing, spectrum, Sfax, Tunisia

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4155 Consumer Welfare in the Platform Economy

Authors: Prama Mukhopadhyay

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Starting from transport to food, today’s world platform economy and digital markets have taken over almost every sphere of consumers’ lives. Sellers and buyers are getting connected through platforms, which is acting as an intermediary. It has made consumer’s life easier in terms of time, price, choice and other factors. Having said that, there are several concerns regarding platforms. There are competition law concerns like unfair pricing, deep discounting by the platforms which affect the consumer welfare. Apart from that, the biggest problem is lack of transparency with respect to the business models, how it operates, price calculation, etc. In most of the cases, consumers are unaware of how their personal data are being used. In most of the cases, they are unaware of how algorithm uses their personal data to determine the price of the product or even to show the relevant products using their previous searches. Using personal or non-personal data without consumer’s consent is a huge legal concern. In addition to this, another major issue lies with the question of liability. If a dispute arises, who will be responsible? The seller or the platform? For example, if someone ordered food through a food delivery app and the food was bad, in this situation who will be liable: the restaurant or the food delivery platform? In this paper, the researcher tries to examine the legal concern related to platform economy from the consumer protection and consumer welfare perspectives. The paper analyses the cases from different jurisdictions and approach taken by the judiciaries. The author compares the existing legislation of EU, US and other Asian Countries and tries to highlight the best practices.

Keywords: competition, consumer, data, platform

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4154 The Analysis of the Effectiveness of the Children’s Act of 2009 in Curbing Child Sexual Abuse: A Case Study of Francistown and the Surrounding Areas

Authors: Gabaikanngwe Ethel Mambo, Kinyanjui Godfrey Gichuhi

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The study analysed the Children’s Act of 2009 of Botswana in curbing child sexual abuse (CSA) in Francistown and its surroundings. The qualitative methodology was used to collect data. Retrospective reports of CSA were obtained from various departments dealing with children. The research findings revealed the ineffectiveness of the Children’s Act of 2009 in identifying and preventing CSA. The Act has failed to deter or prevent the offenders from committing crimes against children. The study demonstrated an increase in CSA cases that were never reported. Lack of skills by the justice system exacerbated sexual molestation. The study also revealed that most CSA cases were underreported. Lastly, the study demonstrated those child victims were sexually molested by someone known to them.

Keywords: sexual abuse, molestation, incest, child

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4153 Using RASCAL Code to Analyze the Postulated UF6 Fire Accident

Authors: J. R. Wang, Y. Chiang, W. S. Hsu, S. H. Chen, J. H. Yang, S. W. Chen, C. Shih, Y. F. Chang, Y. H. Huang, B. R. Shen

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In this research, the RASCAL code was used to simulate and analyze the postulated UF6 fire accident which may occur in the Institute of Nuclear Energy Research (INER). There are four main steps in this research. In the first step, the UF6 data of INER were collected. In the second step, the RASCAL analysis methodology and model was established by using these data. Third, this RASCAL model was used to perform the simulation and analysis of the postulated UF6 fire accident. Three cases were simulated and analyzed in this step. Finally, the analysis results of RASCAL were compared with the hazardous levels of the chemicals. According to the compared results of three cases, Case 3 has the maximum danger in human health.

Keywords: RASCAL, UF₆, safety, hydrogen fluoride

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4152 Radiographic Evaluation of Odontogenic Keratocyst: A 14 Years Retrospective Study

Authors: Nor Hidayah Reduwan, Jira Chindasombatjaroen, Suchaya Pornprasersuk-Damrongsri, Sopee Pomsawat

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INTRODUCTION: Odontogenic keratocyst (OKC) remain as a controversial pathologic entity under the scrutiny of many researchers and maxillofacial surgeons alike. The high recurrence rate and relatively aggressive nature of this lesion demand a meticulous analysis of the radiographic characteristic of OKC leading to the formulation of an accurate diagnosis. OBJECTIVE: This study aims to determine the radiographic characteristic of odontogenic keratocyst (OKC) using conventional radiographs and cone beam computed tomography (CBCT) images. MATERIALS AND METHODS: Patients histopathologically diagnosed as OKC from 2003 to 2016 by Oral and Maxillofacial Pathology Department were retrospectively reviewed. Radiographs of these cases from the archives of the Department of Oral and Maxillofacial Radiology, Faculty of Dentistry Mahidol University were retrieved. Assessment of the location, shape, border, cortication, locularity, the relationship of lesion to embedded tooth, displacement of adjacent tooth, root resorption and bony expansion of the lesion were conducted. RESULTS: Radiographs of 91 patients (44 males, 47 females) with the mean age of 31 years old (10 to 84 years) were analyzed. Among all patients, 5 cases were syndromic patients. Hence, a total of 103 OKCs were studied. The most common location was at the ramus of mandible (32%) followed by posterior maxilla (29%). Most cases presented as a well-defined unilocular radiolucency with smooth and corticated border. The lesion was in associated with embedded tooth in 48 lesions (47%). Eighty five percent of embedded tooth are impacted 3rd molar. Thirty-seven percentage of embedded tooth were entirely encapsulated in the lesion. The lesion attached to the embedded tooth at the cementoenamel junction (CEJ) in 40% and extended to part of root in 23% of cases. Teeth displacement and root resorption were found in 29% and 6% of cases, respectively. Bony expansion in bucco-lingual dimension was seen in 63% of cases. CONCLUSION: OKCs were predominant in the posterior region of the mandible with radiographic features of a well-defined, unilocular radiolucency with smooth and corticated margin. The lesions might relate to an embedded tooth by surrounding an entire tooth, attached to the CEJ level or extending to part of root. Bony expansion could be found but teeth displacement and root resorption were not common. These features might help in giving the differential diagnosis.

Keywords: cone beam computed tomography, imaging dentistry, odontogenic keratocyst, radiographic features

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4151 Prevalence of Mycobacterium Tuberculosis Infection and Rifampicin Resistance among Presumptive Tuberculosis Cases Visiting Tuberculosis Clinic of Adare General Hospital, Southern Ethiopia

Authors: Degineh Belachew Andarge, Tariku Lambiyo Anticho, Getamesay Mulatu Jara, Musa Mohammed Ali

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Introduction: Tuberculosis (TB) is a communicable chronic disease causedby Mycobacterium tuberculosis (MTB). About one-third of the world’s population is latently infected with MTB. TB is among the top 10 causes of mortality throughout the globe from a single pathogen. Objective: The aim of this study was to determine the prevalence of tuberculosis,rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis, and associated factors among presumptive tuberculosis cases attending the tuberculosis clinic of Adare General Hospital located in Hawassa city. Methods: A hospital-based cross-sectional study was conducted among 321 tuberculosis suspected patients from April toJuly 2018. Socio-demographic, environmental, and behavioral data were collected using a structured questionnaire. Sputumspecimens were analyzed using GeneXpert. Data entry was made using Epi info version 7 and analyzed by SPSS version 20. Logistic regression models were used to determine the risk factors. A p-value less than 0.05 was taken as a cut point. Results: In this study, the prevalence of Mycobacterium tuberculosis was 98 (30.5%) with 95% confidence interval (25.5–35.8), and the prevalence of rifampicin-resistant/multidrug-resistantMycobacterium tuberculosis among the 98 Mycobacteriumtuberculosis confirmed cases was 4 (4.1%). The prevalence of rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosisamong the tuberculosis suspected patients was 1.24%. Participants who had a history of treatment with anti-tuberculosisdrugs were more likely to develop rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis. Conclusions: This study identified relatively high rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis amongtuberculosis suspected patients in the study area. Early detection of drug-resistant Mycobacterium tuberculosis should be givenenough attention to strengthen the management of tuberculosis cases and improve direct observation therapy short-course and eventually minimize the spread of rifampicin-resistant tuberculosis strain in the community.

Keywords: rifampicin resistance, mycobacterium tuberculosis, risk factors, prevalence of TB

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4150 Epidemiology of Bone Hydatidosis in Eastern Libya from 1995 to 2013

Authors: Sadek A. Makhlouf, Hassan M. Nouh

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Bone hydatidosis is an infection in worldwide distribution. Although there is no evidence in literature on Bone Hydatid disease in Libya, we tried to present the first epidemiological study of this disease in Eastern Libya through retrospective study from 1995 to 2013. Our data were collected from 3 hospitals in Eastern Libya particularly the sheep-raising areas with total number of musculoskeletal infection cases of two thousand one hundred ninety-four (2,194). There were five (5) five cases of bone infection, four (4) of it have been diagnosed after more than three (3) months. Our study is comparable to other international study but this type of bone infection need further studies for effective control strategies for all dogs to avoid serious complications that might happened from the delay in diagnosing this type of disease.

Keywords: bone infection, hydatidosis, Eastern Libya, sheep-raising areas

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4149 Histochemical Localization of Hepatitis B Surface Antigen in Hepatocellular Carcinoma: An Evaluation of Two Staining Techniques in a Tertiary Hospital in Calabar, Nigeria

Authors: Imeobong Joseph Inyang, Aniekan-Augusta Okon Eyo, Abel William Essien

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Hepatitis B virus (HBV) is one of the known human carcinogens. The presence of HBsAg in liver tissues indicates active viral replication. More than 85% of Hepatocellular Carcinoma (HCC) cases occur in countries with increased rates of chronic HBV infection. An evaluation study to determine the relationship between positivity for HBsAg and development of HCC and its distribution between age and gender of subjects was done. Shikata Orcein and Haematoxylin and Eosin (H&E) staining techniques were performed on liver sections. A total of 50 liver tissue specimens comprising 38 biopsy and 12 post-mortem specimens were processed. Thirty-five of the 50 specimens were positive for HBsAg with Orcein stain whereas only 16 were positive with H&E stain, and these were also positive with Orcein stain, giving an HBsAg prevalence of 70.0% (35/50). The prevalence of HCC in the study was 56.0% (28/50), of which 21 (75.0%) cases were positive for HBsAg, 18 (64.3%) were males while 10 (35.7%) were females distributed within the age range of 20-70 years. The highest number of HBsAg positive HCC cases, 7/21 (33.3%) occurred in the age group 40-49 years. There was no relationship in the pattern of distribution of HCC between age and gender using the Pearson correlation coefficient (r = 0.0474; P < 0.05). HBV infection predisposed to HCC. Orcein technique was more specific and is therefore recommended for screening of liver tissues where facilities for immunohistochemistry are inaccessible.

Keywords: Hepatitis B. surface antigen, hepatocellular carcinoma, orcein, pathology

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4148 Contribution Of Community-based House To House (H2h) Active Tuberculosis (Tb) Case Finding (Acf) To Increase In Tb Notification In Nigeria: Kano State Experience 2012 To 2022

Authors: Ibrahim Umar, S Chindo, A Rajab

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Background: TB remains a disease of public health concern in Nigeria with an estimated incidence rate of 219/100,000. Kano has the second highest TB burden in Nigeria and is the leading state with the highest consistent yearly TB notification. House-to-house (H2H) active case search in the community was found to have major contribution to the total TB notification in the state. Aims and Objective: To showcase the impact of H2H community active TB case search (ACF) to yearly TB notification in Kano State, Northern Nigeria from 2012 to 2022. Methodology: This is a retrospective descriptive study based on the analysis of data collected during the routine quarterly and yearly TB data collected in the state. Data was analyzed using the Power BI with statistical alpha level of significance <0.05. Results: Between 2012 and 2013 there was no House-to-house active TB case search in Nigeria and Kano had zero contribution to TB notification from the community in those years. However, in 2014 with the introduction of H2H Active TB Case Search Kano notified 6,014 TB cases out of which 113 came from the community ACF that translated to 2% contribution to total TB notification. From 2014 to 2022 there was progressive increase in community contribution to TB case notification from 113 out of 6,014 total TB patients notified (2012) to 11,799 out of 26,371 TB patients notified (2022) in Kano State. This translated to 45% increase in community contribution to total TB case notification. Discussion: Remarkable increase in community contribution to total TB case notification in Kano State was achieved in 2022 with 11,799 TB cases notified from the community Active TB case search to the total of 26,731 TB cases notified in Kano State, Nigeria. Conclusion: in research has shown that Community-based H2H Active TB Case Search through Community TB Workers (CTWs) is an excellent strategy in finding the missing TB cases towards Ending TB in the world.

Keywords: tuberculosis(TB), active case search (ACF), house-to-house (H2H), community TB workers (CTWs)

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4147 A Retrospective Study on the Spectrum of Infection and Emerging Antimicrobial Resistance in Type 2 Diabetes Mellitus

Authors: Pampita Chakraborty, Sukumar Mukherjee

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People with diabetes mellitus are more susceptible to developing infections, as high blood sugar levels can weaken the patient's immune system defences. People with diabetes are more adversely affected when they get an infection than someone without the disease, because you have weakened immune defences in diabetes. People who have minimally elevated blood sugar levels experience worse outcomes with infections. Diabetic patients in hospitals do not necessarily have a higher mortality rate due to infections, but they do face longer hospitalisation and recovery times. A study was done in a tertiary care unit in eastern India. Patients with type 2 diabetes mellitus infection were recruited in the study. A total of 520 cases of Type 2 Diabetes Mellitus were recorded out of which 200 infectious cases was included in the study. All subjects underwent detailed history & clinical examination. Microbiological samples were collected from respective site of the infection for microbial culture and antibiotic sensitivity test. Out of the 200 infectious cases urinary tract infection(UTI) was found in majority of the cases followed by diabetic foot ulcer (DFU), respiratory tract infection(RTI) and sepsis. It was observed that Escherichia coli was the most commonest pathogen isolated from UTI cases and Staphylococcus aureus was predominant in foot ulcers followed by other organisms. Klebsiella pneumonia was the major organism isolated from RTI and Enterobacter aerogenes was commonly observed in patients with sepsis. Isolated bacteria showed differential sensitivity pattern against commonly used antibiotics. The majority of the isolates were resistant to several antibiotics that are usually prescribed on an empirical basis. These observations are important, especially for patient management and the development of antibiotic treatment guidelines. It is recommended that diabetic patients receive pneumococcal and influenza vaccine annually to reduce morbidity and mortality. Appropriate usage of antibiotics based on local antibiogram pattern can certainly help the clinician in reducing the burden of infections.

Keywords: antimicrobial resistance, diabetic foot ulcer, respiratory tract infection, urinary tract infection

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4146 Aerodynamic Study of an Open Window Moving Bus with Passengers

Authors: Pawan Kumar Pant, Bhanu Gupta, S. R. Kale, S. V. Veeravalli

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In many countries, buses are the principal means of transport, of which a majority are naturally ventilated with open windows. The design of this ventilation has little scientific basis and to address this problem a study has been undertaken involving both experiments and numerical simulations. The flow pattern inside and around of an open window bus with passengers has been investigated in detail. A full scale three-dimensional numerical simulation has been used for a) a bus with closed windows and b) with open windows. In either simulation, the bus had 58 seated passengers. The bus dimensions used were 2500 mm wide × 2500 mm high (exterior) × 10500 mm long and its speed was set at 40 km/h. In both cases, the flow separates at the top front edge forming a vortex and reattaches close to the mid-length. This attached flow separates once more as it leaves the bus. However, the strength and shape of the vortices at the top front and wake region is different for both cases. The streamline pattern around the bus is also different for the two cases. For the bus with open windows, the dominant airflow inside the bus is from the rear to the front of the bus and air velocity at the face level of the passengers was found to be 1/10th of the free stream velocity. These findings are in good agreement with flow visualization experiments performed in a water channel at 10 m/s, and with smoke/tuft visualizations in a wind tunnel with a free-stream velocity of approximately 40 km/h on a 1:25 scaled Perspex model.

Keywords: air flow, moving bus, open windows, vortex, wind tunnel

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4145 Empirical Analysis of Velocity Behavior for Collaborative Robots in Transient Contact Cases

Authors: C. Schneider, M. M. Seizmeir, T. Suchanek, M. Hutter-Mironovova, M. Bdiwi, M. Putz

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In this paper, a suitable measurement setup is presented to conduct force and pressure measurements for transient contact cases at the example of lathe machine tending. Empirical measurements were executed on a selected collaborative robot’s behavior regarding allowable operating speeds under consideration of sensor- and workpiece-specific factors. Comparisons between the theoretic calculations proposed in ISO/TS 15066 and the practical measurement results reveal a basis for future research. With the created database, preliminary risk assessment and economic assessment procedures of collaborative machine tending cells can be facilitated.

Keywords: biomechanical thresholds, collaborative robots, force and pressure measurements, machine tending, transient contact

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4144 Inter-Communication-Management in Cases with Disabled Children (ICDC)

Authors: Dena A. Hussain

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The objective of this project is to design an Information and Communication Technologies (ICT) tool based on a standardized platform to assist the work-integrated learning process of caretakers of disabled children. The tool should assist the intercommunication between caretakers and improve the learning process through knowledge bridging between all involved caretakers. Some children are born with disabilities while others have special needs after an illness or accident. Special needs children often need help in their learning process and require tools and services in a different way. In some cases the child has multiple disabilities that affect several capabilities in different ways. These needs are to be transformed into different learning techniques that the staff or personal (called caretakers in this project) caring for the child needs to learn and adapt. The caretakers involved are also required to learn new learning or training techniques and utilities specialized for the child’s needs. In many cases the number of people caring for the child’s development is rather large; the parents, specialist pedagogues, teachers, therapists, psychologists, personal assistants, etc. Each group of specialists has different objectives and in some cases the merge between theses specifications is very unique. This makes the synchronization between different caretakers difficult, resulting often in low level cooperation. By better intercommunication between professions both the child’s development could be improved but also the caretakers’ methods and knowledge of each other’s work processes and their own profession. This introduces a unique work integrated learning environment for all personnel involve, merging learning and knowledge in the work environment and at the same time assist the children’s development process. Creating an iterative process generates a unique learning experience for all involved. Using a work integrated platform will help encourage and support the process of all the teams involved in the process.We believe that working with children who have special needs is a continues learning/working process that is always integrated to achieve one main goal, which is to make a better future for all children.

Keywords: information and communication technologies (ICT), work integrated learning (WIL), sustainable learning, special needs children

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4143 Proposition on Improving Environmental Forensic System in China

Authors: Huilei Wang, Yuanfeng Wang

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In the early period of China, economy developed rapidly at the cost of environment. Recently, it is generally recognized that the heavily polluted environment not only puts a brake on economic development but also paces negative impact on people’ health as well as probably next decades of generations. Accordingly, the latest Environmental Protection Law revised in 2014 makes a clear-cut division of environmental responsibility and regulates stricter penalties of breaching law. As the new environmental law is enforced gradually, environmental forensic is increasingly required in the process of ascertaining facts in judicial proceedings of environmental cases. Based on the outcomes of documentary analysis for all environmental cases judged on the basis of new environmental law, it is concluded that there still exists problems in present system of environmental forensic. Thus, this paper is aimed to make proposition on improving Chinese environmental forensic system, which involves: (i) promoting capability of environmental forensic system (EFS) to handle professional questions; (ii) develop price mechanism; (iii) multi-departments cooperate to establish unifying and complete EFS system;(iv) enhance the probative value of results of EFS. Such protocol for amending present regulation on environmental forensic is of significant importance because a quality report of environmental forensic will contributes to providing strong probative evidence of culprits’ activity of releasing contaminant into environment, degree of damages for victims and above all, causality between the behavior of public nuisance and damages.

Keywords: China, environmental cases, environmental forensic system, proposition

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