Search results for: debt burden

Authors: Lie-Fen Lin, Tzu-Hsuan Lin, Ching-Heng Lin

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Hospice care for terminally ill patients provides not only a better quality of life but also cost-saving benefits. However, the utilization of home-based hospice care (HBH care) remains low even for countries covered by National Health Insurance (NHI) programs in Taiwan. In the current commercial insurance policy, only hospital-based hospice benefits were covered. It may have an influence on the insureds chosen to receive end-of-life care in a hospitalized manner. Thus, how to propose a feasible method to advocate HBH care utilization rate of public health policies is an important issue. A total of 130,219 cancer decedents in the year 2011-2013 from the National Health Insurance Research Database (NHIRD) in Taiwan were included in this study. By adding a day volume pays benefits of HBH care as a commercial insurance rider, will provide alternative benefits for the insureds. A multiple-state Markov chain model was incorporated to estimate the transition intensities of patients in different states at the end of their lives (Non-hospice, HBH, hospital-based hospice), and the premiums were estimated. HBH care insurance benefits provide financial support and reduce the burden of care for patients. The rate-making of this product is very sensitive while the utilization rate is rising, especially for high ages. The proposed HBH care insurance is a feasible way to reduce the financial burden, enhance the care quality and family satisfaction of insureds. Meanwhile, insurance companies can participate in advocating a good medical policy to enhance the social image. In addition, the medical costs of NHI can reduce effectively.

Keywords: home-based hospice care, commercial insurance, Markov chain model, the day volume pays

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Authors: Sanchai Ratthanakwan

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This research aims to study situations and characteristics of the problems facing the urban poor. The data and information are collected by focus group and in-depth interview leader and members of Four Regions Slum Network, community representatives and the social welfare officer. The research can be concluded that the problems of the urban poor faced with three major problems: Firstly, the shortage of housing and stability issues in housing; secondly, the problem of substandard quality of life; and thirdly, the debt problem. The study found that a solution will be found in two ways: First way is the creation of housing for the urban poor in slums or community intrusion by the state. Second way is the stability in the housing and subsistence provided by the community center called “housing stability”.

Keywords: urban poor, social welfare, Bangkok metropolis, housing stability

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Authors: Abeer A. Aljohani

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COVID-19 virus spread has been one of the extreme pandemics across the globe. It is also referred to as coronavirus, which is a contagious disease that continuously mutates into numerous variants. Currently, the B.1.1.529 variant labeled as omicron is detected in South Africa. The huge spread of COVID-19 disease has affected several lives and has surged exceptional pressure on the healthcare systems worldwide. Also, everyday life and the global economy have been at stake. This research aims to predict COVID-19 disease in its initial stage to reduce the death count. Machine learning (ML) is nowadays used in almost every area. Numerous COVID-19 cases have produced a huge burden on the hospitals as well as health workers. To reduce this burden, this paper predicts COVID-19 disease is based on the symptoms and medical history of the patient. This research presents a unique architecture for COVID-19 detection using ML techniques integrated with feature dimensionality reduction. This paper uses a standard UCI dataset for predicting COVID-19 disease. This dataset comprises symptoms of 5434 patients. This paper also compares several supervised ML techniques to the presented architecture. The architecture has also utilized 10-fold cross validation process for generalization and the principal component analysis (PCA) technique for feature reduction. Standard parameters are used to evaluate the proposed architecture including F1-Score, precision, accuracy, recall, receiver operating characteristic (ROC), and area under curve (AUC). The results depict that decision tree, random forest, and neural networks outperform all other state-of-the-art ML techniques. This achieved result can help effectively in identifying COVID-19 infection cases.

Keywords: supervised machine learning, COVID-19 prediction, healthcare analytics, random forest, neural network

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Authors: Li Sheng

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Based on an extended post-Keynesian model, we find that the association between the savings rate and income inequality is negative if savers’ funds are borrowed by spending households for consumption but positive if savings are channeled to investing firms for production. A negative association, such as the one that exists in the U.S., hinges on an income illusion created by an asset bubble and cheap credit. Thus, financial globalization leads consumption and income inequality to diverge, and the divergence is more extreme if lower-income groups have higher debt ratios. A positive association, such as the one that exists in China, relates to liquidity constraints faced by consumers such that consumption inequality closely follows income inequality. Our results imply that income inequality must be reduced in both types of countries to increase savings in deficit economies with negative associations and to reduce savings in surplus economies with positive associations.

Keywords: savings rate, income inequality, financial globalization, global imbalances

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Authors: Abdulaziz Abdulrahman Albahar

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This paper aims to answer the question of: is oil as a natural resource with all the wealth that it brings an economic burden? And how can resource curse be mitigated in such oil dependent nations? The case of Kuwait will be used as an example. The paper begins with an introduction of the resource curse and the Kuwaiti economy in general. Then there is an attempt to see that does the curse exist in the case for Kuwait. Furthermore, in the analysis section, an exploration on how the economy is dependent on oil and how oil is more of a burden if there is mismanagement is conducted. Later on, in answering on how to mitigate the problem of a resource curse, the case of Norway is explored. In concluding the paper, the results do show that oil rentals affects the Kuwaiti economy via 2 main channels, these are government spending that are mainly financed via oil rentals and exportation of oil based products. The surprising result was that government spending had a negative impact on GDP (gross domestic product) growth when oil rentals where instrumented on government expenditure, this is due to the issue of rent seeking in which government spending in Kuwait is financing things such as stimulus packages and raising the nominal wages. Yet, when comparing the magnitude of both oil exportation and government spending, the latter has a stronger effect on the GDP (gross domestic product) growth than the former. A resource curse doesn’t seem to exist in the case of Kuwait however, the characteristics of a curse do show in the form of rent seeking in the political sphere, the disruption of the traditional sectors like that of pearl trade and fishing markets. Yet, a curse doesn’t show due to the fact that the currency of the nation is very stable and hasn’t experienced any appreciation because of the fixed exchange rate system. Moreover, even if we can’t say that a curse exists, it is clear to see that the Kuwaiti economy is heading towards one. Whether or not it faces a resource curse will be based on how judicious the nation will be in exploiting their sovereign wealth fund and implementing diversification strategies to be less oil dependent like the vision “New Kuwait-2035” which has been underway since 2017.

Keywords: economic development, Kuwait, oil curse, dutch disease

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Authors: Israel Oguche

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Journalism practice has faced several challenges across the globe, particularly in developing countries such as Nigeria. While Nigeria has thrived under democratic experiment for twenty years since the return to democracy in 1999, there is still a great lacuna in freedom of expression, such that the presidents, though elected democratically, have had the tendencies to use military might in clamping down on journalism practices across the country. Under Muhammadu Buhari, it seems Nigeria has returned to the military era when powers were used against who says what, on a media, so today, in Nigeria, there are obvious cases of outright human rights violations and detention of journalists whose offenses were not spelled out. From Abiri Jones to Abba Jalingo and Omoyele Sowore, Nigeria journalists have been placed under the cocoon of the tyrannical administration of Muhammadu Buhari, the president, with subsequent clamping down on the instruments of freedoms such as access to justice and fair hearing. This paper gave vivid analytical and empirical perspectives of journalism practice under the dark days of Muhammadu Buhari as Nigeria’s president. The objectives include; examining the core cases of attacks on journalists since 2015 to date, determining the burden of practicing journalism in a tyrannical government, reeling out the effects of restrictive practices of journalism on freedom of expression among Nigerians and proffering solutions for improvement in the years ahead. Using the cognitive dissonance theory, the survey method was used for the study, with qualitative research analysis as a tool for data presentation. In the findings, the number of journalists in jail for publishing objectively under the Buhari administration remains high while the government has clamped down on freedom of expression among the people. The study concluded that there is a need for repelling of laws made by the Nigeria government in order to save the Nigerian journalism industry from total collapse.

Keywords: communication, developing democracy, press freedom, journalism practices

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Authors: Norazlan Alias, Mohd. Hasimi Yaacob

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This study examines the impact of governance structure via corporate restructuring decision on selected firm characteristics and performance. Results of selected ratios that represent corporate decision, governance structure and performance in pre and post restructuring are analyzed for some conclusions. This study uses annual data of companies that are consistently listed on the Main Board of Bursa Malaysia and announced completed corporate restructuring. The results show that only debt ratio is significantly different before and after asset restructuring. This study concludes that firms do not view corporate restructuring namely asset restructuring as an opportunity to simultaneous enhance governance structure that could also contribute enhance firm performance and board of directors’ structure subsequent to asset restructuring only has significantly influence on changing capital structure but not on firm performance.

Keywords: board of directors, capital structure, corporate restructuring, performance

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Authors: Ahmad Dahlan, Aries Indrianto

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Conceptually, mudarabah is the practice of fiqh (jurisprudence) in the bank institutions business that became the basis of the economic development model of modern Islamic financial system. In mudarabah, profit and loss sharing mechanism are integrated between mudarabah on liability side (funding) with mudarabah on the asset side (financing). Islamic (Sharia) Bank is positioned as an intermediary institution like investment manager, although the bank is also involved in direct investment based on bank equity. In practice, mudarabah cannot be done as much as effective at financing because the dominance of debt-financing products. This is a major criticism among experts and Islamic banks practitioners. Ironically, the criticism gets less attention by practitioners of Islamic banks due to many factors. The epistemologies of Islamic banks prioritize shareholder values than stakeholder values, and social culture that has not been ready with the mudarabah totally.

Keywords: two tier mudarabah, intermediary institution, shareholder value, stakeholder value

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Authors: Taner Ersoz, Filiz Ersoz, Seyma Ozbilge

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In this study, the clients who applied to a bank branch for loan were analyzed through data mining. The study was composed of the information such as amounts of loans received by personal and SME clients working with the bank branch, installment numbers, number of delays in loan installments, payments available in other banks and number of banks to which they are in debt between 2010 and 2013. The client risk profile was examined through Classification and Regression Tree (CART) analysis, one of the decision tree classification methods. At the end of the study, 5 different types of customers have been determined on the decision tree. The classification of these types of customers has been created with the rating of those posing a risk for the bank branch and the customers have been classified according to the risk ratings.

Keywords: client classification, loan suitability, risk rating, CART analysis

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Authors: Pamela Ventola, Laurel Bales, Sara Florczyk

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Background: Fully remote or hybrid administration of clinical outcome measures in rare neurodevelopmental disorders trials is increasing due to the ongoing pandemic and recognition that remote assessments reduce the burden on families. Many assessments in rare neurodevelopmental disorders trials are complex; however, remote/hybrid trials readily allow for the use of centralized raters to administer and score the scales. The use of centralized raters has many benefits, including reducing site burden; however, a specific impact on data quality has not yet been determined. Purpose: The current study has two aims: a) evaluate differences in data quality between administration of a standardized clinical interview completed by centralized raters compared to those completed by site raters and b) evaluate improvement in accuracy of scoring standardized developmental assessments when scored centrally compared to when scored by site raters. Methods: For aim 1, the Vineland-3, a widely used measure of adaptive functioning, was administered by site raters (n= 52) participating in one of four rare disease trials. The measure was also administered as part of two additional trials that utilized central raters (n=7). Each rater completed a comprehensive training program on the assessment. Following completion of the training, each clinician completed a Vineland-3 with a mock caregiver. Administrations were recorded and reviewed by a neuropsychologist for administration and scoring accuracy. Raters were able to certify for the trials after demonstrating an accurate administration of the scale. For site raters, 25% of each rater’s in-study administrations were reviewed by a neuropsychologist for accuracy of administration and scoring. For central raters, the first two administrations and every 10th administration were reviewed. Aim 2 evaluated the added benefit of centralized scoring on the accuracy of scoring of the Bayley-3, a comprehensive developmental assessment widely used in rare neurodevelopmental disorders trials. Bayley-3 administrations across four rare disease trials were centrally scored. For all administrations, the site rater who administered the Bayley-3 scored the scale, and a centralized rater reviewed the video recordings of the administrations and also scored the scales to confirm accuracy. Results: For aim 1, site raters completed 138 Vineland-3 administrations. Of the138 administrations, 53 administrations were reviewed by a neuropsychologist. Four of the administrations had errors that compromised the validity of the assessment. The central raters completed 180 Vineland-3 administrations, 38 administrations were reviewed, and none had significant errors. For aim 2, 68 administrations of the Bayley-3 were reviewed and scored by both a site rater and a centralized rater. Of these administrations, 25 had errors in scoring that were corrected by the central rater. Conclusion: In rare neurodevelopmental disorders trials, sample sizes are often small, so data quality is critical. The use of central raters inherently decreases site burden, but it also decreases rater variance, as illustrated by the small team of central raters (n=7) needed to conduct all of the assessments (n=180) in these trials compared to the number of site raters (n=53) required for even fewer assessments (n=138). In addition, the use of central raters dramatically improves the quality of scoring the assessments.

Keywords: neurodevelopmental disorders, clinical trials, rare disease, central raters, remote trials, decentralized trials

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Authors: F. Fatoye, C. E. Mbada, T. Gebrye, A. O. Ogunsola, C. Fatoye, O. Oyewole

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Musculoskeletal disorders (MSDs) are a major cause of pain and disability. It is likely to become a greater economic and public health burden that is unnecessary. Thus, reliable prevalence figures are important for both clinicians and policy-makers to plan health care needs for those affected with the disease. This study estimated hospital based real-world prevalence of MSDs in Nigeria. A review of medical charts for adult patients attending Physiotherapy Outpatient Clinic at the Obafemi Awolowo University Teaching Hospitals Complex, Osun State, Nigeria between 2009 and 2018 was carried out to identify common MSDs including low back pain (LBP), cervical spondylosis (CSD), post immobilization stiffness (PIS), sprain, osteoarthritis (OA), and other conditions. Occupational class of the patients was determined using the International Labour Classification (ILO). Data were analysed using descriptive statistics of frequency and percentages. Overall, medical charts of 3,340 patients were reviewed within the span of ten years (2009 to 2018). Majority of the patients (62.8%) were in the middle class, and the remaining were in low class (25.1%) and high class (10.5%) category. An overall prevalence of 47.35% of MSD was found within the span of ten years. Of this, the prevalence of LBP, CSD, PIS, sprain, OA, and other conditions was 21.6%, 10%, 18.9%, 2%, 6.3%, and 41.3%, respectively. The highest (14.2%) and lowest (10.5%) prevalence of MSDs was recorded in the year of 2012 and 2018, respectively. The prevalence of MSDs is considerably high among Nigerian patients attending outpatient a physiotherapy clinic. The high prevalence of MSDs underscores the need for clinicians and decision makers to put in place appropriate strategies to reduce the prevalence of these conditions. In addition, they should plan and evaluate healthcare services to improve the health outcomes of patients with MSDs. Further studies are required to determine the economic burden of the condition and examine the clinical and cost-effectiveness of physiotherapy interventions for patients with MSDs.

Keywords: musculoskeletal disorders, Nigeria, prevalence, real world

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Authors: Claire Williams

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Randomised controlled Trials (RCTs) of efficacy are still perceived as the gold standard for the generation of evidence, and whilst advances in data collection methods are well developed, this progress has not been matched for the reporting of adverse events (AEs). Assessment and reporting of AEs in clinical trials are fraught with human error and inefficiency and are extremely time and resource intensive. Recent research conducted into the quality of reporting of AEs during clinical trials concluded it is substandard and reporting is inconsistent. Investigators commonly send reports to sponsors who are incorrectly categorised and lacking in critical information, which can complicate the detection of valid safety signals. In our presentation, we will describe an electronic data capture system, which has been designed to support clinical trial processes by reducing the resource burden on investigators, improving overall trial efficiencies, and making trials safer for patients. This proprietary technology was developed using expertise proven in the delivery of the world’s first prospective, phase 3b real-world trial, ‘The Salford Lung Study, ’ which enabled robust safety monitoring and reporting processes to be accomplished by the remote monitoring of patients’ EHRs. This technology enables safety alerts that are pre-defined by the protocol to be detected from the data extracted directly from the patients EHR. Based on study-specific criteria, which are created from the standard definition of a serious adverse event (SAE) and the safety profile of the medicinal product, the system alerts the investigator or study team to the safety alert. Each safety alert will require a clinical review by the investigator or delegate; examples of the types of alerts include hospital admission, death, hepatotoxicity, neutropenia, and acute renal failure. This is achieved in near real-time; safety alerts can be reviewed along with any additional information available to determine whether they meet the protocol-defined criteria for reporting or withdrawal. This active surveillance technology helps reduce the resource burden of the more traditional methods of AE detection for the investigators and study teams and can help eliminate reporting bias. Integration of multiple healthcare data sources enables much more complete and accurate safety data to be collected as part of a trial and can also provide an opportunity to evaluate a drug’s safety profile long-term, in post-trial follow-up. By utilising this robust and proven method for safety monitoring and reporting, a much higher risk of patient cohorts can be enrolled into trials, thus promoting inclusivity and diversity. Broadening eligibility criteria and adopting more inclusive recruitment practices in the later stages of drug development will increase the ability to understand the medicinal products risk-benefit profile across the patient population that is likely to use the product in clinical practice. Furthermore, this ground-breaking approach to AE detection not only provides sponsors with better-quality safety data for their products, but it reduces the resource burden on the investigator and study teams. With the data taken directly from the source, trial costs are reduced, with minimal data validation required and near real-time reporting enables safety concerns and signals to be detected more quickly than in a traditional RCT.

Keywords: more comprehensive and accurate safety data, near real-time safety alerts, reduced resource burden, safer trials

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Authors: Anna Bohers, Emília Hroncová, Juraj Ladomerský

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Oil sludge with its main characteristic of high acidity is a waste product generated from the operation of refinery and petrochemical plants. Former refinery and petrochemical plant - Petrochema Dubová is present in Slovakia as well. Its activities was to process the crude oil through sulfonation and adsorption technology for production of lubricating and special oils, synthetic detergents and special white oils for cosmetic and medical purposes. Seventy years ago – period, when this historical acid sludge burden has been created – comparing to the environmental awareness the production was in preference. That is the reason why, as in many countries, also in Slovakia a historical environmental burden is present until now – 229 211 m3 of oil sludge in the middle of the National Park of Nízke Tatry mountain chain. Neither one of tried treatment methods – bio or non-biologic one - was proved as suitable for processing or for recovery in the reason of different factors admission: i.e. strong aggressivity, difficulty with handling because of its sludgy and liquid state et sim. As a potential solution, also incineration was tested, but it was not proven as a suitable method, as the concentration of SO2 in combustion gases was too high, and it was not possible to decrease it under the acceptable value of 2000 mg.mn-3. That is the reason why the operation of incineration plant has been terminated, and the acid sludge landfills are present until nowadays. The objective of this paper is to present a new possibility of processing and valorization of acid sludgy-waste. The processing of oil sludge was performed through the effective separation - thermal desorption technology, through which it is possible to split the sludgy material into the matrix (soil, sediments) and organic contaminants. In order to boost the efficiency in the processing of acid sludge through thermal desorption, the work will present the possibility of application of an original technology – Method of Blowing Decomposition for recovering of organic matter into technological lubricating oil.

Keywords: hazardous waste, oil sludge, remediation, thermal desorption

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Authors: Shoumodip Roy, Ankit Singhania, K. R. K. Rao, Ravi Shankar, M. K. Agarwal, R. V. Ramna, Uttam Singh

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The productivity of a blast furnace and the quality of the hot metal produced are significantly dependent on the smoothness and stability of furnace operation. The permeability of the furnace bed, as well as the gas flow pattern, influences the steady control of process parameters. The softening – melting zone that is formed inside the furnace contributes largely in distribution of the gas flow and the bed permeability. A better shape of softening-melting zone enhances the performance of blast furnace, thereby reducing the fuel rates and improving furnace life. Therefore, predictive model of the softening- melting zone profile can be utilized to control and improve the furnace operation. The shape of softening-melting zone depends upon the physical and chemical properties of the agglomerates and iron ore charged in the furnace. The variations in the agglomerate proportion in the burden at G Blast furnace disturbed the furnace stability. During such circumstances, it was analyzed that a w-shape softening-melting zone profile was formed inside the furnace. The formation of w-shape zone resulted in poor bed permeability and non-uniform gas flow. There was a significant increase in the heat loss at the lower zone of the furnace. The fuel demand increased, and the huge production loss was incurred. Therefore, visibility of softening-melting zone profile was necessary in order to pro-actively optimize the process parameters and thereby to operate the furnace smoothly. Using stave temperatures, a model was developed that predicted the shape of the softening-melting zone inside the furnace. It was observed that furnace operated smoothly during inverse V-shape of the zone and vice-versa during w-shape. This model helped to control the heat loss, optimize the burden distribution and lower the fuel rate at G Blast Furnace, TSL Jamshedpur. As a result of furnace stabilization productivity increased by 10% and fuel rate reduced by 80 kg/thm. Details of the process have been discussed in this paper.

Keywords: agglomerate, blast furnace, permeability, softening-melting

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Authors: Gayani K. Nandasiri, Tilak Dias, William Hurley

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Venous disease of human lower limb could range from minor asymptomatic incompetence of venous valves to chronic venous ulceration. The sheer prevalence of varicose veins and its associated significant costs of treating late complications such as chronic ulcers contribute to a higher burden on health care resources. In most of western countries with developed health care systems, treatment costs associated with Venous disease accounts for a considerable portion of their total health care budget, and it has become a high-cost burden to National Health Service (NHS), UK. The established gold standard of treatment for the venous disease is the graduated compression, where the pressure at the ankle being highest and decreasing towards the knee and thigh. Currently, medical practitioners use two main methods to treat venous disease; i.e. compression bandaging and compression stockings. Both these systems have their own disadvantages which lead to the current programme of research. The aim of the present study is to revolutionize the compression therapy by using a novel active compression system to deliver a controllable and more accurate pressure profiles using a series of inflatable mini bladders. Two types of commercially available silicones were tested for the application. The mini bladders were designed with a special fabrication procedure to provide required pressure profiles, and a series of experiments were conducted to characterise the mini bladders. The inflation/deflation heights of these mini bladders were investigated experimentally and using a finite element model (FEM), and the experimental data were compared to the results obtained from FEM simulations, which showed 70-80% agreement. Finally, the mini bladders were tested for its pressure transmittance characteristics, and the results showed a 70-80% of inlet air pressure transmitted onto the treated surface.

Keywords: finite element analysis, graduated compression, inflatable bladders, venous disease

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Authors: J. Yan, B. Pieper, B. Bucsky, B. Nasseri, S. Klotz, H. H. Sievers, S. Mohamed

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Cryoablation is evermore applied for interventional treatment of paroxysmal (PAAF) or persistent atrial fibrillation (PEAF). In the cardiac surgery, this procedure is often combined with coronary arterial bypass graft (CABG) and valve operations. Three different methods are feasible in this sense in respect to practicing extents and mechanisms such as lone left atrial cryoablation, Cox-Maze IV and III in our heart center. 415 patients (68 ± 0.8ys, male 68.2%) with predisposed atrial fibrillation who initially required either coronary or valve operations were enrolled and divided into 3 matched groups according to deployed procedures: CryoLA-group (cryoablation of lone left atrium, n=94); Cox-Maze-IV-group (n=93) and Cox-Maze-III-group (n=8). All patients additionally received closure of the left atrial appendage (LAA) and regularly underwent three-year ambulant follow-up assessments (3, 6, 9, 12, 18, 24, 30 and 36 months). Burdens of atrial fibrillation were assessed directly by means of cardiac monitor (Reveal XT, Medtronic) or of 3-day Holter electrocardiogram. Herewith, attacks frequencies of AF and their circadian patterns were systemically analyzed. Furthermore, anticoagulants and regular rate-/rhythm-controlling medications were evaluated and listed in terms of anti-rate and anti-rhythm regimens. Concerning PAAF treatment, Cox Maze IV procedure provided therapeutically acceptable effect as lone left atrium (LA) cryoablation did (5.25 ± 5.25% vs. 10.39 ± 9.96% AF-burden, p > 0.05). Interestingly, Cox Maze III method presented a better short-term effect in the PEAF therapy in comparison to lone cryoablation of LA and Cox Maze IV (0.25 ± 0.23% vs. 15.31 ± 5.99% and 9.10 ± 3.73% AF-burden within the first year, p < 0.05). But this therapeutic advantage went lost during ongoing follow-ups (26.65 ± 24.50% vs. 8.33 ± 8.06% and 15.73 ± 5.88% in 3rd follow-up year). In this way, lone LA-cryoablation established its antiarrhythmic efficacy and 69.5% patients were released from the Vit-K-antagonists, while Cox Maze IV liberated 67.2% patients from continuous anticoagulant medication. The AF-recurrences mostly performed such attacks property as less than 60min duration for all 3 procedures (p > 0.05). In the sense of the circadian distribution of the recurrence attacks, weighted by ongoing follow-ups, lone LA cryoablation achieved and stabilized the antiarrhythmic effects over time, which was especially observed in the treatment of PEAF, while Cox Maze IV and III had their antiarrhythmic effects weakened progressively. This phenomenon was likewise evaluable in the therapy of circadian rhythm of reverting AF-attacks. Furthermore, the strategy of rate control was much more often applied to support and maintain therapeutic successes obtained than the one of rhythm control. Derived from experiences in our heart center, lone LA cryoablation presented equivalent effects in the treatment of AF in comparison to Cox Maze IV and III procedures. These therapeutic successes were especially investigable in the patients suffering from persistent AF (PEAF). Additional supportive strategies such as rate control regime should be initialized and implemented to improve the therapeutic effects of the cryoablations according to appropriate criteria.

Keywords: AF-burden, atrial fibrillation, cardiac monitor, COX MAZE, cryoablation, Holter, LAA

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Authors: Muhammad Sohail Sajid, Hafiz Muhammad Rizwan, Ashfaq Ahmad Chatta, Zafar Iqbal, Muhammad Saqib

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Changes in the climate are posing threats to the livestock community throughout the globe. Agro-grazing animals and natural vegetation as their forages are the most important components of animal production. Climate and local conditions not only determine the nature and kind of plants, their distribution, composition and nutritive value in different cropping belts and grazing sites but also influence number and kinds of grazing animals. Phytomineral supplementation can act as an indirect tool to boost-up immunological profile of animals leading to the development of resilience against parasitic infections. The present study correlates the trace element (Cu, Co, Mn, Zn) profile of grazing sheep, feedstuffs, respective soils and their GI helminths in a selected district of Sialkot, Punjab, Pakistan. Ten species of GI helminths were found during the survey. A significant (P < 0.05) variation in the concentrations (conc.) of Zn, Cu, Mn and Co was recorded in a total of 16 collected forages. During autumn, mean conc. of Cu, Zn and Co in sera were inversely proportional to the GI helminth burden; while, during spring, only Zn was inversely proportional to the GI helminth burden in grazing sheep. During autumn the highest conc. of Zn, Cu, Mn and Co were recorded in Echinochloa colona, Amaranthus viridis, Cannabis sativa, and Brachiaria ramose and during spring in Cichorium intybus, Cynodon dactylon, Parthenium hysterophorus and Coronopus didymus respectively. The trace element-rich forages, preferably Zn, found effective against helminth infection are advisable supplemental remedies to improve the trace element profile in grazing sheep. This mitigation strategy may ultimately improve the resilience against GI helminth infections especially in the resource poor countries like Pakistan.

Keywords: coprological examination, Trace elements, Sheep, Gastro-intestinal parasites, Prevalence, Sialkot, Pakistan

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Authors: Afsane Amiri

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Electric Vehicle (EV) technology is expected to take a major share in the light-vehicle market in the coming decades. Charging of EVs will put an extra burden on the distribution grid and in some cases adjustments will need to be made. In this paper a review of different plug-in and vehicle to grid (V2G) capable vehicles are given along with their power electronics topologies. The economic implication of charging the vehicle or sending power back to the utility is described in brief.

Keywords: energy storage system, battery unit, cost, optimal sizing, plug-in electric vehicles (PEVs), smart grid

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Authors: Eliane Abdo, Olivier Colot

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SMEs are always considered as a national priority due to their contribution to job creation, innovation and growth. Once the start-up phase is crossed with encouraging results, the company enters the phase of growth. In order to improve its competitiveness, maintain and increase its market share, the company is in the necessity even the obligation to develop its tangible and intangible investments. SMEs are generally closed companies with special and critical financial situation, limited resources and difficulty to access the capital markets; their shareholders are always living in a conflict between their independence and their need to increase capital that leads to the entry of new shareholder. The capital structure was always considered the core of research in corporate finance; moreover, the financial crisis and its repercussions on the credit’s availability, especially for SMEs make SME financing a hot topic. On the other hand, financial theories do not provide answers to capital structure’s questions; they offer tools and mode of financing that are more accessible to larger companies. Yet, SME’s capital structure can’t be independent of their governance structure. The classic financial theory supposes independence between the investment decision and the financing decision. Thus, investment determines the volume of funding, but not the split between internal or external funds. In this context, we find interesting to study the hypothesis that SMEs respond positively to the financial theories applied to large firms and to check if they are constrained by conventional solutions used by large companies. In this context, this research focuses on the analysis of the resource’s structure of SME in parallel with their investments’ structure, in order to highlight a link between their assets and liabilities structure. We founded our conceptual model based on two main theoretical frameworks: the Pecking order theory, and the Trade Off theory taking into consideration the SME’s characteristics. Our data were generated from DIANE database. Five hypotheses were tested via a panel regression to understand the type of dependence between the financing methods of 3,244 French SMEs and the development of their investment over a period of 10 years (2007-2016). The results show dependence between equity and internal financing in case of intangible investments development. Moreover, this type of business is constraint to financial debts since the guarantees provided are not sufficient to meet the banks' requirements. However, for tangible investments development, SMEs count sequentially on internal financing, bank borrowing, and new shares issuance or hybrid financing. This is compliant to the Pecking Order Theory. We, therefore, conclude that unlisted SMEs incur more financial debts to finance their tangible investments more than their intangible. However, they always prefer internal financing as a first choice. This seems to be confirmed by the assumption that the profitability of the company is negatively related to the increase of the financial debt. Thus, the Pecking Order Theory predictions seem to be the most plausible. Consequently, SMEs primarily rely on self-financing and then go, into debt as a priority to finance their financial deficit.

Keywords: capital structure, investments, life cycle, pecking order theory, trade off theory

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Authors: Nisful Laila, Fatin Fadhilah Hasib, Puji Sucia Sukmaningrum, Achsania Hendratmi

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The purpose of this study is to determine and comparing the level of efficiency of Islamic Banks in Indonesia and United Kingdom during eurozone sovereign debt crisis. This study using a quantitative non-parametric approach with Data Envelopment Analysis (DEA) VRS assumption, and a statistical tool Mann-Whitney U-Test. The samples are 11 Islamic Banks in Indonesia and 4 Islamic Banks in England. This research used mediating approach. Input variable consists of total deposit, asset, and the cost of labour. Output variable consists of financing and profit/loss. This study shows that the efficiency of Islamic Bank in Indonesia and United Kingdom are varied and fluctuated during the observation period. There is no significant different the efficiency performance of Islamic Banks in Indonesia and United Kingdom.

Keywords: data envelopment analysis, efficiency, eurozone crisis, islamic bank

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Authors: Uyen Tran Tu

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The decision on capital structure is one of the most important and sophisticated decisions in financial management in order to improve firm performance. This article would study the two-way impact between capital structure and firm performance. The study use EVIEWS 6.0 software to determine a two-way relationship between the capital structure and firm performance based on two-stage regression (2SLS - Two-Stage Least Squares). The findings are: capital structure has the opposite effect on the business efficiency and vice versa, factors that effect on business efficiency include Size and Opportunities. Factors effects on the capital structure are size; liquidity. These factors also affect the ratio of capital structure (total debt/ total asset) of companies. In particular, liquidity has the opposite effect; and the size of the business has the same impact. The results of the study are in line with the theory and empirical studies presented, and the results of the study are unchanged for all three years 2015-2017.

Keywords: capital structure, firm performance, factors, two-way relationship

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Authors: Junaid Jibran Jawed, Prasanta Saini, Subrata Majumdar

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Background: Leishmania donovani infection causes severe host immune-suppression through the modulation of pathogen recognition receptors. Apart from TLRs (Toll Like Receptor), recent studies focus on the important contribution of NLR (NOD-Like Receptor) family member NOD1 and NOD2 as these receptors are capable of triggering host innate immunity. The aim of this study was to decipher the role of NOD1/NOD2 receptors during experimental visceral leishmaniasis (VL) and the important link between host failure and parasite evasion strategy. Method: The status of NOD1 and NOD2 receptors were analysed in uninfected and infected cells through western blotting and RT-PCR. The active contributions of these receptors in reducing parasite burden were confirmed by siRNA mediated silencing, and over-expression studies and the parasite numbers were calculated through microscopic examination of the Giemsa-stained slides. In-vivo studies were done by using non-toxic dose of Mw (Mycobacterium indicus pranii), Ara-LAM(Arabinoasylated lipoarabinomannan) along with MDP (Muramyl dipeptide) administration. Result: Leishmania donovani infection of the macrophages reduced the expression of NOD2 receptors whereas NOD1 remain unaffected. MDP, a NOD2-ligand, treatment during over-expression of NOD2, reduced the parasite burden effectively which was associated with increased pro-inflammatory cytokine generation and NO production. In experimental mouse model, Ara-LAM treatment increased the expression of NOD2 and in combination with MDP it showed active therapeutic potential against VL and found to be more effective than Mw which was already reported to be involved in NOD2 modulation. Conclusion: This work explores the essential contribution of NOD2 during experimental VL and mechanistic understanding of Ara-LAM + MDP combination therapy to work against this disease and highlighted NOD2 as an essential therapeutic target.

Keywords: Ara-LAM (Arabinoacylated Lipoarabinomannan), NOD2 (nucleotide binding oligomerization receptor 2), MDP (muramyl di peptide), visceral Leishmaniasis

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Authors: Amirreza Fazely Hamedani, Muzzamil Aziz, Philipp Wieder, Ramin Yahyapour

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Software-defined networking in recent years came into the sight of so many network designers as a successor to the traditional networking. Unlike traditional networks where control and data planes engage together within a single device in the network infrastructure such as switches and routers, the two planes are kept separated in software-defined networks (SDNs). All critical decisions about packet routing are made on the network controller, and the data level devices forward the packets based on these decisions. This type of network is vulnerable to DDoS attacks, degrading the overall functioning and performance of the network by continuously injecting the fake flows into it. This increases substantial burden on the controller side, and the result ultimately leads to the inaccessibility of the controller and the lack of network service to the legitimate users. Thus, the protection of this novel network architecture against denial of service attacks is essential. In the world of cybersecurity, attacks and new threats emerge every day. It is essential to have tools capable of managing and analyzing all this new information to detect possible attacks in real-time. These tools should provide a comprehensive solution to automatically detect, predict and prevent abnormalities in the network. Big data encompasses a wide range of studies, but it mainly refers to the massive amounts of structured and unstructured data that organizations deal with on a regular basis. On the other hand, it regards not only the volume of the data; but also that how data-driven information can be used to enhance decision-making processes, security, and the overall efficiency of a business. This paper presents an intelligent big data framework as a solution to handle illegitimate traffic burden on the SDN network created by the numerous DDoS attacks. The framework entails an efficient defence and monitoring mechanism against DDoS attacks by employing the state of the art machine learning techniques.

Keywords: apache spark, apache kafka, big data, DDoS attack, machine learning, SDN network

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Authors: Adekemi Adebowale

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The duty of disclosure in Nigerian insurance law is in need of reform. The materiality of an undisclosed fact (notwithstanding that it was an honest and innocent non-disclosure) currently entitles insurers to avoid insurance policies, leaving an insured with an uncovered loss. While the test of materiality requires an insured to voluntarily disclose facts that will influence an insurer's decision without proper guidelines from the insurer, the insurer is only expected to prove that the undisclosed fact had influenced its judgment in fixing the premium or determining whether to accept the risk. This problem places an onerous duty on the assured to volunteer to the insurer every material fact even though the insured only has a slight idea about the mind of a hypothetical prudent insurer. This paper explores the modern approach to revisiting the problem of an insured’s pre-contractual obligation to determine material facts in Nigerian insurance law. The aim is to build upon the change in the structure of insurance contract obligations in other common law jurisdictions such as the United Kingdom. The doctrinal and comparative methodology captures the burden imposed on the insured under the existing Nigerian insurance law. It finds that the continued application of the law leaves the insured in the weakest position, and he stands to lose in a contract supposedly created for his benefit. It is apparent that if this problem remains unresolved, the over-all consequence will contribute to a significant decline in the insurance contract, which may affect the Nigerian economy. The paper aims to evaluate the risks of the continuous application of the traditional law, which does not keep with the pace of modern insurance practice. It will ultimately produce a legally compliant reform, along with a significant deviation from the archaic structure that exists in the Nigerian insurance law. This paper forms part of an on-going PhD research on "The insured’s pre-contractual duty of utmost of utmost good faith". The outcome from the research to date finds that the insured bears the burden of the obligation to act in utmost good faith where it concerns disclosure of material facts.

Keywords: disclosure, materiality, Nigeria, United Kingdom, utmost good faith

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Authors: Dhananjay W. Bansod, Santosh Phad

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Non-Communicable Diseases (NCD) are major contributing factors to the disease burden in the world as well as in India. With a growing proportion of older persons in India gives rise to several challenges. With the advancement of age, elderly is exposed to various kinds of health problems more specifically NCDs. Therefore, an effort has been made to examine the prevalence of NCDs among older persons and its treatment-seeking behaviour, also it is tried to explore the association between the NCDs and its effect on the overall wellbeing of older persons. Data used from “Building Knowledge Base of Population Ageing Survey” conducted in 2011 in seven states of India. Six chronic diseases used (non-communicable diseases) namely Arthritis, Hypertension, Cataract, Diabetes, Asthma and Heart diseases to understand the issues related to NCDs. Also seen the effect of NCDs on the wellbeing of the elderly, the subjective well-being consists of nine questions from which SUBI score generated for mental health status, which ranges from 9 to 27. This Index indicates that lower the score better is the mental health status. Further, this index modified and generated three categories of Better (9-15), Average (16-20) and Worse (21-27). The reliability analysis is carried out with the coefficient (Cronbach’s alpha) of the scale was 0.8884. The result shows that Orthopedic / musculoskeletal ailments involving arthritis, rheumatism and osteoarthritis are the most common type of ailment followed by hypertension. Two-thirds of the elderly reported suffering from at least one chronic ailment. Most chronic illness conditions received some form of treatment and mainly depend on public health facilities. Financial insecurity is the primary obstruction in seeking treatment for most of the chronic ailments which typically require a longer duration of medication and repeated medical consultations, both having significant economic implications. According to SUBI index, only 15 per cent of the elderly are in Better mental health status, and one-third of the elderly are with the worse score. Elderly with the ailments like Cataract, Asthma and Arthritis have worse mental health. It depicts that the burden of disease is more among the elderly and it is directly affecting the overall wellbeing of older persons.

Keywords: NCD, well-being, older person, India

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Authors: Gordon Newlove Asamoah, Wendy Ama Oti

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This study focused on evaluating access to finance for local oil field companies in Ghana. The study adopted a census survey design in evaluating access to finance for local oil field companies in Ghana. The respondents of this study were 30 management members of three oil field companies in Ghana. The data collected was analysed using Statistical Package for Social Scientists (SPSS) to generate tables and graphs for interpretation. The results show that most companies use equity financing in combination with other forms of financing to finance their business activities. This research has shown the various challenges bordering on the financing of local oil and gas projects, with emphasis on the challenges of raising funds by indigenous oil companies. Financing of the projects by indigenous oil field companies in Ghana is preferably achieved through equity finance mainly because it is the easiest to get compared to all the other forms of financing available. Other sources of financing available are debt financing, joint venture, and retained earnings from the profits generated from their operations. The study made recommendations to local oil field companies as to how they can make good use of the capital market to raise financing.

Keywords: access, financing, oil fields, Ghana

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Authors: Drago Jakovcevic, Mihovil Andelinovic, Igor Husak

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The aim of this paper is to explore the economic circumstances in which the selective credit policy, the least used instrument of four types of instruments on disposal to central banks, should be used. The most significant example includes the use of selective credit policies in response to the emergence of the global financial crisis by the FED. Specifics of the potential use of selective credit policies as the instigator of economic growth in Croatia, a small open economy, are determined by high euroization of financial system, fixed exchange rate and long-term trend growth of external debt that is related to the need to maintain high levels of foreign reserves. In such conditions, the classic forms of selective credit policies are unsuitable for the introduction. Several alternative approaches to implement selective credit policies are examined in this paper. Also, thorough analysis of distribution of selective monetary policy loans among economic sectors in Croatia is conducted in order to minimize the risk of investing funds and maximize the return, in order to influence the GDP growth.

Keywords: global crisis, selective credit policy, small open economy, Croatia

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Authors: Kazi Rafikoddin

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Conditionality refers to a precondition for getting external funds from IMF or WB by giving consent for implementation of the program of economic or political reforms especially relating to open economies. These are put forth under the label of structural adjustment. It is a kind of challenge on the part of borrowing government to exercise balance between the domestic obligations and the expectations of external funding agencies. Countries have to take loans under certain criteria and regulations because better loans are often not readily available. Therefore taking loans and renewing them to pay the same with new interest rates and conditions makes the governments entangled in the circle of debt. They are forced to compete with well-established multinational companies. If their access to industrialized countries' markets is impaired through protectionism, the developed world will be condemning the indebted nations to perpetual financial crisis. On the other hand, the ability to sell their goods free in the world market is reduced through the introduction of Structural Adjustment Programmes. Although there are examples of positive effects on certain economies like India, some Third World, and poor countries have experienced the ire of these remedies. This paper tries to find out the effects of SAPs on some borrowing countries.

Keywords: IMF, world bank, conditionalities, SAPs, Third World Countries

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Authors: Vaiddehi Bansal, Ridhi Sahai, Kareem Kysia

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Overseas labor migration is currently one of the most important contributors to the economy of Bangladesh and is a highly profitable form of labor for Gulf Cooperative Council (GCC) countries. In 2019, 700,159 migrant workers from Bangladeshtraveled abroad for employment. GCC countries are a major destination for Bangladeshi migrant workers, with Saudi Arabia being the most common destination for Bangladeshi migrant workers since 2016. Despite the high rate of migration between these countries every year, the OLR industry remains complex and often leaves migrants susceptible to human trafficking, forced labor, and modern slavery. While the prevalence of forced labor among Bangladeshi migrants in GCC countries is still unknown, the IOM estimates international migrant workers comprise one fourth of the victims of forced labor. Moreover, the onset of the global COVID-19 pandemic has exposed migrant workers to additional adverse situations, making them even more vulnerable to forced labor and health risks. This paper presents findings from a rapid assessment of the impacts of COVID-19 on OLR in Bangladesh, with an emphasis on the increased risk of forced labor among vulnerable migrant worker populations, particularly women.Rapid reviews are a useful approach to swiftly provide actionable evidence for informed decision-making during emergencies, such as the COVID-19 pandemic. The research team conducted semi-structured key information interviews (KIIs) with a range of stakeholders, including government officials, local NGOs, international organizations, migration researchers, and formal and informal recruiting agencies, to obtain insights on the multi-facted impacts of COVID-19 on the OLR sector. The research team also conducted a comprehensive review of available resources, including media articles, blogs, policy briefs, reports, white papers, and other online content, to triangulate findings from the KIIs. After screening for inclusion criteria, a total of 110 grey literature documents were included in the review. A total of 31 KIIs were conducted, data from which was transcribed and translated from Bangla to English, andanalyzed using a detailed codebook. Findings indicate that there was limited reintegration support for returnee migrants. Facing increasing amounts of debt, financial insecurity, and social discrimination, returnee migrants, were extremely vulnerable to forced labor and exploitation. Growing financial debt and limited job opportunities in their home country will likely push migrants to resort to unsafe migration channels. Evidence suggests that women, who are primarily domestic works in GCC countries, were exposed to increased risk of forced labor and workplace violence. Due to stay-at-home measures, women migrant workers were tasked with additional housekeeping working and subjected to longer work hours, wage withholding, and physical abuse. In Bangladesh, returnee women migrant workers also faced an increased risk of domestic violence.

Keywords: forced labor, migration, gender, human trafficking

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Authors: Pauliasi Tony Fakahau

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This paper provides an overview of the impact of the revenue reform programme on vulnerable communities in the Kingdom of Tonga. Economic turmoil and mismanagement during the late 1990s forced the government to seek technical and financial assistance from the Asian Development Bank to undertake a comprehensive Economic and Public Sector Reform (EPSR) programme. The EPSR is a Western model recommended by donor agencies as the solution to Tonga’s economic challenges. The EPSR programme included public sector reform, private sector growth, and revenue generation. Tax reform was the main tool for revenue generation, which set out to strengthen tax compliance and administration as well as implement a value-added consumption tax. The EPSR is based on Western values and ideology but failed to recognise that Tongan cultural values are important to the local community. Two participant groups were interviewed. Participant group one consisted of 51 people representing vulnerable communities. Participant group two consisted of six people from the government and business sector who were from the elite of Tongan society. The Kakala Research Methodology provided the framework for the research, and the Talanoa Research Method was used to conduct semi-structured interviews in the homes of the first group and in the workplaces of the second group. The research found a heavy burden of the consumption tax on the purchasing power of participant group one (vulnerable participants), having an impact on nearly every financial transaction they made. Participant group ones’ main financial priorities were kavenga fakalotu (obligations to the church), kavenga fakafāmili (obligations to the family) and kavenga fakafonua (obligations to cultural events for the village, nobility, and royalty). The findings identified inequalities of the revenue reform, especially from consumption tax, for vulnerable people and communities compared to the elite of society. The research concluded that government and donor agencies need ameliorating policies to reduce the burden of tax on vulnerable groups more susceptible to the impact of revenue reform.

Keywords: tax reform, tonga vulnerable community revenue, revenue reform, public sector reform

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