Search results for: instrumental records

Authors: Sulemana Ibrahim

Abstract:

Food security remains a paramount global challenge, with vulnerable regions grappling with issues of hunger and malnutrition. This study embarks on a comprehensive exploration of data-driven strategies aimed at ameliorating food security in such regions. Our research employs a multifaceted approach, integrating data analytics to predict crop yields, optimizing supply chains, and enhancing food distribution networks. The study unfolds as a multi-dimensional analysis, commencing with the development of robust machine learning models harnessing remote sensing data, historical crop yield records, and meteorological data to foresee crop yields. These predictive models, underpinned by convolutional and recurrent neural networks, furnish critical insights into anticipated harvests, empowering proactive measures to confront food insecurity. Subsequently, the research scrutinizes supply chain optimization to address food security challenges, capitalizing on linear programming and network optimization techniques. These strategies intend to mitigate loss and wastage while streamlining the distribution of agricultural produce from field to fork. In conjunction, the study investigates food distribution networks with a particular focus on network efficiency, accessibility, and equitable food resource allocation. Network analysis tools, complemented by data-driven simulation methodologies, unveil opportunities for augmenting the efficacy of these critical lifelines. This study also considers the ethical implications and privacy concerns associated with the extensive use of data in the realm of food security. The proposed methodology outlines guidelines for responsible data acquisition, storage, and usage. The ultimate aspiration of this research is to forge a nexus between data science and food security policy, bestowing actionable insights to mitigate the ordeal of food insecurity. The holistic approach converging data-driven crop yield forecasts, optimized supply chains, and improved distribution networks aspire to revitalize food security in the most vulnerable regions, elevating the quality of life for millions worldwide.

Keywords: data-driven strategies, crop yield prediction, supply chain optimization, food distribution networks

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Authors: Ibrahim Burki

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Unfortunately, all organizations (Industrial and Humanitarian/ Non-governmental organizations) are prone to fraud and corruption in their supply chain management routines. The reputational and financial fallout can be disastrous. With the growing number of companies using suppliers based in the local market has certainly increased the threat of fraud as well as corruption. There are various potential threats like, poor or non-existent record keeping, purchasing of lower quality goods at higher price, excessive entertainment of staff by suppliers, deviations in communications between procurement staff and suppliers, such as calls or text messaging to mobile phones, staff demanding extended periods of notice before they allow an audit to take place, inexperienced buyers and more. But despite all the above-mentioned threats, this research paper emphasize upon the effectiveness of well-maintained vendor/s records and sorting/filtration of vendor/s to cut down the possible threats of corruption and fraud. This exercise is applied in a humanitarian organization of Pakistan but it is applicable to whole South Asia region due to the similarity of culture and contexts. In that firm, there were more than 550 (five hundred and fifty) registered vendors. As during the disasters or emergency phases requirements are met on urgent basis thus, providing golden opportunities for the fake companies or for the brother/sister companies of the already registered companies to be involved in the tendering process without declaration or even under some different (new) company’s name. Therefore, a list of required documents (along with checklist) was developed and sent to all of the vendor(s) in the current database and based upon the receipt of the requested documents vendors were sorted out. Furthermore, these vendors were divided into active (meeting the entire set criterion) and non-active groups. This initial filtration stage allowed the firm to continue its work without a complete shutdown that is only vendors falling in the active group shall be allowed to participate in the tenders by the time whole process is completed. Likewise only those companies or firms meeting the set criterion (active category) shall be allowed to get registered in the future along with a dedicated filing system (soft and hard shall be maintained), and all of the companies/firms in the active group shall be physically verified (visited) by the Committee comprising of senior members of at least Finance department, Supply Chain (other than procurement) and Security department.

Keywords: corruption reduction, fraud prevention, supplier management, industrial/humanitarian organizations

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Authors: Hakan Duger, Alparslan Ersoy, Canan Ersoy

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The improvement of surgical techniques in recent years has reduced the frequency of postoperative complications in kidney transplant recipients. Novel immunosuppressive agents have reduced rates of graft loss due to acute rejection to less than 1%. However, surgical complications may still lead graft loss and morbidity in recipients. Because of potent immunosuppression, impaired wound healing and complications are frequent after transplantation. We compared the frequency of post-operative surgical complications in diabetic and non-diabetic patients after kidney transplantation. Materials and Methods: This retrospective study conducted in consecutive patients (213 females, 285 males, median age 39 years) who underwent kidney transplant surgery at our center between December 2005 and October 2015. The patients were divided into two groups: diabetics (46 ± 10 year, 26 males, 16 females) and non-diabetics (39 ± 12 year, 259 males, 197 females). Characteristics of both groups were obtained from medical records. Results: We performed 225 living and 273 deceased donor transplantations. Renal replacement type was hemodialysis in 60.8%, peritoneal dialysis in 17.3% and preemptive in 12%. The mean body mass indexes of the recipients were 24 ± 4.6 kg/m², donor age was 48.6 ± 14.3 years, cold ischemic time was 11.3 ± 6.1 hours, surgery time was 4.9 ± 1.2 hours, and recovery time was 54±31 min. The mean hospitalization duration was 19.1 ± 13.5 days. The frequency of postoperative surgical complications was 43.8%. There was no significant difference between the ratios of post-operative surgical complications in non-diabetic (43.5%) and diabetic (47.4%) groups (p=0.648). Post-operative surgical complications were lymphocele (24.6% vs. 23.7%), delayed wound healing (13.2% vs. 7.6%), hematoma (7.8% vs.15.8 %), urinary leak (4.6% vs. 5.3%), hemorrhage (5.1% vs. 0%), hydronephrosis (2.2% vs. 0%), renal artery thrombosis (1.5% vs. 0%), renal vein thrombosis (1% vs. 2.6%), urinoma (0.7% vs. 0%), urinary obstruction (0.5% vs. 0%), ureteral stenosis (0.5% vs. 0%) and ureteral reflux (0.2% vs. 0%) in non-diabetic and diabetic groups, respectively (p > 0.05). Mean serum creatinine levels in non-diabetics and diabetics were 1.43 ± 0.81 and 1.61 ± 0.96 mg/dL at 1st month (p=0.198). At the 6th month, the mean graft and patient survival times in patients with post-operative surgical complications were significantly lower than in those who did not (162.9 ± 3.4 vs. 175.6 ± 1.5 days, p=0.008, and 171 ± 2.9 vs. 176.1 ± 1.6 days, p=0.047, respectively). However, patient survival durations of non-diabetic (173 ± 27) and diabetic (177 ± 13 day) groups were comparable (p=0.396). Conclusion: As a result, we concluded that surgical complications such as lymphocele and delayed wound healing were common and that frequency of these complications in diabetic recipients did not differ from non-diabetic one. All persons involved in the postoperative care of kidney transplant recipients be aware of the potential surgical complications for rapid diagnosis and treatment.

Keywords: kidney transplantation, diabetes mellitus, surgery, complication

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Authors: Sidra Suleman, Maliha Suleman, Stephen Brindley

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Oral rehabilitation of head and neck cancer patients plays a crucial role in the quality of life for such individuals post-treatment. Placement of dental implants or implant-retained prostheses can help restore oral function and aesthetics, which is often compromised following surgery. Conventional prosthodontic techniques can be insufficient in rehabilitating such patients due to their altered anatomy and reduced oral competence. Hence, there is a strong clinical need for the placement of dental implants. With an increasing incidence of head and neck cancer patients, the demand for such treatment is rising. Aim: The aim of the study was to determine the survival rate of dental implants in head and neck cancer patients placed at the Restorative and Maxillofacial Department, Royal Stoke University Hospital (RSUH), United Kingdom. Methodology: All patients who received dental implants between January 1, 2013 to December 31, 2020 were identified. Patients were excluded based on three criteria: 1) non-head and neck cancer patients, 2) no outpatient follow-up post-implant placement 3) provision of non-dental implants. Scanned paper notes and electronic records were extracted and analyzed. Implant survival was defined as fixtures that had remained in-situ / not required removal. Sample: Overall, 61 individuals were recruited from the 143 patients identified. The mean age was 64.9 years, with a range of 35 – 89 years. The sample included 37 (60.7%) males and 24 (39.3%) females. In total, 211 implants were placed, of which 40 (19.0%) were in the maxilla, 152 (72.0%) in the mandible and 19 (9.0%) in autogenous bone graft sites. Histologically 57 (93.4%) patients had squamous cell carcinoma, with 43 (70.5%) patients having either stage IVA or IVB disease. As part of treatment, 42 (68.9%) patients received radiotherapy, which was carried out post-operatively for 29 (69.0%) cases. Whereas 21 (34.4%) patients underwent chemotherapy, 13 (61.9%) of which were post-operative. The Median follow-up period was 21.9 months with a range from 0.9 – 91.4 months. During the study, 23 (37.7%) patients died and their data was censored beyond the date of death. Results: In total, four patients who had received radiotherapy had one implant failure each. Two mandibular implants failed secondary to osteoradionecrosis, and two maxillary implants did not survive as a result of failure to osseointegrate. The overall implant survival rates were 99.1% at three years and 98.1% at both 5 and 7 years. Conclusions: Although this data shows that implant failure rates are low, it highlights the difficulty in predicting which patients will be affected. Future studies involving larger cohorts are warranted to further analyze factors affecting outcomes.

Keywords: oncology, dental implants, survival, restorative

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Authors: Michelle Eichinger, Upali Nanda

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Behavior choices during college years can establish the pattern of lifelong healthy living. Nearly 1/3rd of American college students are either overweight (25 < BMI < 30) or obese (BMI > 30). In addition, overweight/obesity contributes to depression, which is a rising epidemic among college students, affecting academic performance and college drop-out rates. Overweight and obesity result in an imbalance of energy consumption (diet) and energy expenditure (physical activity). Overweight/obesity is a significant contributor to heart disease, diabetes, stroke, physical disabilities and some cancers, which are the leading causes of death and disease in the US. There has been a significant increase in obesity and obesity-related disorders such as type 2 diabetes, hypertension, and dyslipidemia among people in their teens and 20s. Historically, the evidence-based interventions for obesity prevention focused on changing the health behavior at the individual level and aimed at increasing awareness and educating people about nutrition and physical activity. However, it became evident that the environmental context of where people live, work and learn was interdependent to healthy behavior change. As a result, a comprehensive approach was required to include altering the social and built environment to support healthy living. College campus provides opportunities to support lifestyle behavior and form a health-promoting culture based on some key point of decisions such as stairs/ elevator, walk/ bike/ car, high-caloric and fast foods/balanced and nutrient-rich foods etc. At each point of decision, design, can help/hinder the healthier choice. For example, stair well design and motivational signage support physical activity; grocery store/market proximity influence healthy eating etc. There is a need to collate the vast information that is in planning and public health domains on a range of successful point of decision prompts, and translate it into architectural guidelines that help define the edge condition for critical point of decision prompts. This research study aims to address healthy behaviors through the built environment with the questions, how can we make the healthy choice an easy choice through the design of critical point of decision prompts? Our hypothesis is that well-designed point of decision prompts in the built environment of college campuses can promote healthier choices by students, which can directly impact mental and physical health related to obesity. This presentation will introduce a combined health and architectural framework aimed to influence healthy behaviors through design applied for college campuses. The premise behind developing our concept, point-of-decision design (PODD), is healthy decision-making can be built into, or afforded by our physical environments. Using effective design intervention strategies at these 'points-of-decision' on college campuses to make the healthy decision the default decision can be instrumental in positively impacting health at the population level. With our model, we aim to advance health research by utilizing point-of-decision design to impact student health via core sectors of influences within college settings, such as campus facilities and transportation. We will demonstrate how these domains influence patterns/trends in healthy eating and active living behaviors among students. how these domains influence patterns/trends in healthy eating and active living behaviors among students.

Keywords: architecture and health promotion, college campus, design strategies, health in built environment

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Authors: Geng Cui, Naoto Imura, Katsuhiro Nishinari, Takahiro Ezaki

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The bullwhip effect, which refers to the amplification of demand variance as one moves up the supply chain, has been observed in various industries and extensively studied through analytic approaches. Existing methods to mitigate the bullwhip effect, such as decentralized demand information, vendor-managed inventory, and the Collaborative Planning, Forecasting, and Replenishment System, rely on the willingness and ability of supply chain participants to share their information. However, in practice, information sharing is often difficult to realize due to privacy concerns. The purpose of this study is to explore new ways to mitigate the bullwhip effect without the need for information sharing. This paper proposes a 'bullwhip absorption strategy' (BAS) to alleviate the bullwhip effect by absorbing it downstream in the supply chain. To achieve this, a two-stage supply chain system was employed, consisting of a single retailer and a single manufacturer. In each time period, the retailer receives an order generated according to an autoregressive process. Upon receiving the order, the retailer depletes the ordered amount, forecasts future demand based on past records, and places an order with the manufacturer using the order-up-to replenishment policy. The manufacturer follows a similar process. In essence, the mechanism of the model is similar to that of the beer game. The BAS is implemented at the retailer's level to counteract the bullwhip effect. This strategy requires the retailer to reduce the uncertainty in its orders, thereby absorbing the bullwhip effect downstream in the supply chain. The advantage of the BAS is that upstream participants can benefit from a reduced bullwhip effect. Although the retailer may incur additional costs, if the gain in the upstream segment can compensate for the retailer's loss, the entire supply chain will be better off. Two indicators, order variance and inventory variance, were used to quantify the bullwhip effect in relation to the strength of absorption. It was found that implementing the BAS at the retailer's level results in a reduction in both the retailer's and the manufacturer's order variances. However, when examining the impact on inventory variances, a trade-off relationship was observed. The manufacturer's inventory variance monotonically decreases with an increase in absorption strength, while the retailer's inventory variance does not always decrease as the absorption strength grows. This is especially true when the autoregression coefficient has a high value, causing the retailer's inventory variance to become a monotonically increasing function of the absorption strength. Finally, numerical simulations were conducted for verification, and the results were consistent with our theoretical analysis.

Keywords: bullwhip effect, supply chain management, inventory management, demand forecasting, order-to-up policy

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Authors: Sikhou Drame, Arfang Diamanka

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In Senegal, the fishing sector plays an important role in socio-economic development. However, he is going through enormous difficulties, caused by the scarcity of fish on the Senegalese coast, the overexploitation of fishery resources. Based on this observation, the authorities are betting on the development of aquaculture. It is in this context that the exploration of fish from the highly consumed Sparidae family remains a good solution. Indeed, the Sparidae family has good characteristics for farming at sea. However, parasites can proliferate and destroy the efforts made to cultivate fish in confined areas. the knowledge of these parasites in particular the monogeneans, very specific to the sparidae fishes will allow to better know the bio-ecology of the fishes. Better know the main parasitic monogeneans of the genus Lamellodiscus of sparidae fish of the genus Pagrus harvested in Senegal. It will first be a question of identifying from the observation of the morpho-anatomical characters, Monogeneans of the genus Lamellodiscus, branchial parasites collected from three species of host: Pagrus caeruleostictus , Pagrus auriga and Pagrus africanus. Then to evaluate the spatial and temporary distribution of parasitic indices on two Dakar landing sites (Soumbédioune and Yarakh) and finally to determine their specificity. The fish examined were purchased directly from the landing sites in Dakar and then transported to the laboratory where they were identified, then dissected. The gills were examined under a magnifying glass and the monogeneans were harvested, fixed in 70% ethanol and then mounted between slide and coverslip. The identification of the parasites is based on the observation of the morpho-anatomical characters and on the measurements of the sclerified organs of the haptor and the male copulatory organ. In total out of the 90 individuals examined: Pagrus auriga (30), Pagrus africanus (30) and Pagrus caeruleostictus (30), 6 species of monogeneans of the genus Lamellodiscus (Monogenea, Diplectanidae) are obtained: L. sarculus, L. sigillatus, L.vicinus, L. rastellus, L. africanus n.sp and L. yarakhensis n.sp. Our results show that specimens of small sizes [15-20[cm are the most infested. The values of infestation intensity and abundance are higher in fish from Yarakh and also during the cold season. it is the species Pagrus caeruleostictus which records the highest parasitic loads in the two localities. the majority of the parasites identified have a strict or oioxene specificity. It appears from this study that fish of the genus Pagrus are highly parasitized by monogeneans of the genus Lamellodiscus with a general prevalence of 87.78%. Each infested fish has an average of 30 monogeneans of the genus Lamellodiscus.

Keywords: monogeneans, Lamellodiscus, Dakar coast, genus Pagrus

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Authors: Nirmal Kundu, Chandan Bhar, Visveswaran Pandurangan

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Technology is the most valued possession for a country or an organization. The economic development depends not on stock of technology but on the capabilities how the technology is being exploited. The technology transfer is the best way how the developing countries have an access to state-of- the-art technology. Traditional technology transfer is a unidirectional phenomenon where technology is transferred from developed to developing countries. But now there is a change of wind. There is a general agreement that global shift of economic power is under way from west to east. As China and India are making the transition from users to producers, and producers to innovators, this has increasing important implications on economy, technology and policy of global trade. As a result, Reverse technology transfer has become a phenomenon and field of study in technology management. The term “Reverse Technology Transfer” is not well defined. Initially the concept of Reverse technology transfer was associated with the phenomenon of “Brain drain” from developing to developed countries. In the second phase, Reverse Technology Transfer was associated with the transfer of knowledge and technology from subsidiaries to multinationals. Finally, time has come now to extend the concept of reverse technology transfer to two different organizations or countries related or unrelated by traditional technology transfer but the transfer or has essentially received the technology through traditional mode of technology transfer. The objective of this paper is to study; 1) the present status of Reverse technology transfer, 2) the factors which are the enablers and barriers of Reverse technology transfer and 3) how the reverse technology transfer strategy can be integrated in the technology policy of a country which will give the countries an economic boost. The research methodology used in this study is a combination of literature review, case studies and key informant interviews. The literature review includes both published as well as unpublished sources of literature. In case study, attempt has been made to study the records of reverse technology transfer that have been occurred in developing countries. In case of key informant interviews, informal telephonic discussions have been carried out with the key executives of the organizations (industry, university and research institutions) who are actively engaged in the process of technology transfer- traditional as well as reverse. Reverse technology transfer is possible only by creating technological capabilities. Following four important enablers coupled with government active and aggressive action can help to build technology base to reach to the goal of Reverse technology transfer 1) Imitation to innovation, 2) Reverse engineering, 3) Collaborative R & D approach, and 4) Preventing reverse brain drain. The barriers that come in the way are the mindset of over dependence, over subordination and parent–child attitude (not adult attitude). Exploitation of these enablers and overcoming the barriers of reverse technology transfer, the developing countries like India and China can prove that going “reverse” is the best way to move forward and again establish themselves as leader of the future world.

Keywords: barriers of reverse technology transfer, enablers of reverse technology transfer, knowledge transfer, reverse technology transfer, technology transfer

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Authors: Bansal Ashwani

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Cartographic depiction and visualization of wetland changes is an important tool to map spatial-temporal information about the wetland dynamics effectively and to comprehend the response of these water bodies in maintaining the groundwater and surrounding ecosystem. This is true for the states of North Western India, i.e., J&K, Himachal, Punjab, and Haryana that are bestowed upon with several natural wetlands in the flood plains or on the courses of its rivers. Thus, the present study documents, analyses and reconstructs the lost wetlands, which existed in the flood plains of the major river basins of these states, i.e., Chenab, Jhelum, Satluj, Beas, Ravi, and Ghagar, in the beginning of the 20th century. To achieve the objective, the study has used multi-temporal datasets since the 1960s using high to medium resolution satellite datasets, e.g., Corona (1960s/70s), Landsat (1990s-2017) and Sentinel (2017). The Sentinel (2017) satellite image has been used for making the wetland inventory owing to its comparatively higher spatial resolution with multi-spectral bands. In addition, historical records, repeated photographs, historical maps, field observations including geomorphological evidence were also used. The water index techniques, i.e., band rationing, normalized difference water index (NDWI), modified NDWI (MNDWI) have been compared and used to map the wetlands. The wetland types found in the north-western states have been categorized under 19 classes suggested by Space Application Centre, India. These enable the researcher to provide with the wetlands inventory and a series of cartographic representation that includes overlaying multiple temporal wetlands extent vectors. A preliminary result shows the general state of wetland shrinkage since the 1960s with varying area shrinkage rate from one wetland to another. In addition, it is observed that majority of wetlands have not been documented so far and even do not have names. Moreover, the purpose is to emphasize their elimination in addition to establishing a baseline dataset that can be a tool for wetland planning and management. Finally, the applicability of cartographic depiction and visualization, historical map sources, repeated photographs and remote sensing data for reconstruction of long term wetlands fluctuations, especially in the northern part of India, will be addressed.

Keywords: cartographic depiction and visualization, wetland changes, NDWI/MDWI, geomorphological evidence and remote sensing

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Authors: Nicole Harley, Mahmoud Eid, Abdurahman Tarmal, Vishal Dey

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Histological sampling plays an integral role in the diagnostic process of renal diseases. Percutaneous native renal biopsy is typically performed under ultrasound guidance, with this service usually being provided by nephrologists. In some centers, there is a role for radiologists in performing renal biopsies. Previous comparative studies have demonstrated non-inferiority between outcomes of percutaneous native renal biopsies performed by nephrologists compared with radiologists. We sought to compare biopsy adequacy between nephrologists and radiologists in University Hospital Crosshouse. The online system SERPR (Scottish Electronic Renal Patient Record) contains information pertaining to patients who have undergone renal biopsies. An online search was performed to acquire a list of all patients who underwent renal biopsy between 2013 and 2020 in University Hospital Crosshouse. 355 native renal biopsies were performed in total across this 7-year period. A retrospective analysis was performed on these cases, with records and reports being assessed for: the total number of glomeruli obtained per biopsy, whether the number of glomeruli obtained was adequate for diagnosis, as per an internationally agreed standard, and whether a histological diagnosis was achieved. Nephrologists performed 43.9% of native renal biopsies (n=156) and radiologists performed 56.1% (n=199). The mean number of glomeruli obtained by nephrologists was 17.16+/-10.31. The mean number of glomeruli obtained by radiologists was 18.38+/-10.55. T-test demonstrated no statistically significant difference between specialties comparatively (p-value 0.277). Native renal biopsies are required to obtain at least 8 glomeruli to be diagnostic as per internationally agreed criteria. Nephrologists met these criteria in 88.5% of native renal biopsies (n=138) and radiologists met this criteria in 89.5% (n=178). T-test and Chi-squared analysis demonstrate there was no statistically significant difference between the specialties comparatively (p-value 0.663 and 0.922, respectively). Biopsies performed by nephrologists yielded tissue that was diagnostic in 91.0% (n=142) of sampling. Biopsies performed by radiologists yielded tissue that was diagnostic in 92.4% (n=184) of sampling. T-test and Chi-squared analysis demonstrate there was no statistically significant difference between the specialties comparatively (p-value 0.625 and 0.889, respectively). This project demonstrates that at University Hospital Crosshouse, there is no statistical difference between radiologists and nephrologists in terms of glomeruli acquisition or samples achieving a histological diagnosis. Given the non-inferiority between specialties demonstrated by previous studies and this project, this evidence could support the restructuring of services to allow more renal biopsies to be performed by renal services and allow reallocation of radiology department resources.

Keywords: biopsy, medical imaging, nephrology, radiology

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Authors: Alina Rahim, Joanne Moffatt, Jessica Taylor, Joseph Hartland, Tamer Abdelrazik

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Background: In 2011, 15% of maternal deaths in Uganda were due to hypertensive disorders (pre-eclampsia and eclampsia). The majority of these deaths are avoidable with optimum antenatal care. The aim of the study was to evaluate how antenatal monitoring of pre-eclampsia was carried out in a low resource setting and to identify barriers to best practice as recommended by the World Health Organisation (WHO) as part of a 4th year medical student External Student Selected component field trip. Method: Women admitted to hospital with pre-eclampsia in rural Uganda (Villa Maria and Kitovu Hospitals) over a year-long period were identified using the maternity register and antenatal record book. It was not possible to obtain notes for all cases identified on the maternity register. Therefore a total of thirty sets of notes were reviewed. The management was recorded and compared to Ugandan National Guidelines and WHO recommendations. Additional qualitative information on routine practice was established by interviewing staff members from the obstetric and midwifery teams. Results: From the records available, all patients in this sample were managed according to WHO recommendations during labour. The rate of Caesarean section as a mode of delivery was noted to be high in this group of patients; 56% at Villa Maria and 46% at Kitovu. Antenatally two WHO recommendations were not routinely met: aspirin prophylaxis and calcium supplementation. This was due to lack of resources, and lack of attendance at antenatal clinic leading to poor detection of high-risk patients. Medical management of pre-eclampsia varied between individual patients, overall 93.3% complied with Ugandan national guidelines. Two patients were treated with diuretics, which is against WHO guidance. Discussion: Antenatal monitoring of pre-eclampsia is important in reducing severe morbidity, long-term disability and mortality amongst mothers and their babies 2 . Poor attendance at antenatal clinic is a barrier to healthcare in low-income countries. Increasing awareness of the importance of these visits for women should be encouraged. The majority of cases reviewed in this sample of women were treated according to Ugandan National Guidelines. It is recommended to commence the use of aspirin prophylaxis for women at high-risk of developing pre-eclampsia and the creation of detailed guidelines for Uganda which would allow for standardisation of care county-wide.

Keywords: antenatal monitoring, low resource setting, pre-eclampsia, Uganda

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Authors: E. Isaac, I. Jalo, Y. Alkali, A. Ajani, A. Rasaki, Y. Jibrin, K. Mustapha, A. Ayuba, S. Charanchi, H. Danlami

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Introduction: Hepatitis B infection continues to be a serious global health problem with about 2 billion people infected worldwide, many of these in sub-Saharan Africa. Nigeria is one of the countries with the highest incidence, with a prevalence of 10-15%. Methods: Records of Hepatitis B surface and envelope antigen test results in adults in Federal Teaching Hospital, Gombe between May 2000 and May 2015 were retrieved and analyzed. Findings: Adult out-patient consultations and in-patient admissions were 343,083 and 67,761 respectively, accounting for 87% of total. Hepatitis B surface antigenaemia was tested for in 23,888 adults and children. 88.9% (21240) were adults. Males constituted 56% (11902/21240) and females 44% (9211/21240). 5104 (24.0%) of tested individuals were 19-25years; 12,039 (56.7%) 26-45years; 21119 (9.0%) 46-55years; 2.8% (590/21240) and 766 (3.6%) >65years. Among adult males, 17% (2133/11902) was contributed by ages 19-25. 58% (7017/11902), 11.9% (1421/11902), 6.4% (765/11902) and 4.7% (563/11902) of males were 26-45 years old, 46-55 years old and 56-65 years and >65year old respectively. Adults aged 19-25years, 26-45 years, 46-55years, 56-65 and > 65years each constituted 32% (2966/9211); 54.4% (5009/9211); 7.4% (684/9211), 3.8% (350/9211) and 2.2% (201/9211) of females respectively. 16.2% (3431/21,240) demonstrated Hepatitis B surface antigenaemia. The sero-positivity rate was 16.9% (865//5104) between 19-25years, 21.2% (2559/12,039) among 26-45year old individuals. 17.9% (377/2111); 14.1% (83/590) and 7.3% (56/766) of 46-55year old, 56-65year old and >65year old individuals screened were seropositive. The highest sero-positivity rate was found in male young adults aged 19-25years 27.9% (398/1426) and lowest in elderly males 7.4% (28/377). HBe antigen testing rate among HbSAg seropositive individuals was 97.3% (3338/3431). Males constituted 59.7% (1992/3338) and females 40.3% (1345/3338). 25.3% (844/3338) were aged 19-25years; 61.1% (2039/3338) 26-45years; 10.2% (340/3338) 46-55years; 2.7% (90/3338) 56-65years and 0.7% >65years old. HB e antigenaemia was positive in 8.2% (275/3338) of those tested. 41% (113/275); 50.2% (138/275); 5.4% (15/275); 1.8% (5/275) and 1.1 (3/275) of HB e sero-positivity was among age groups 19-25, 26-45, 46-55, 56-65 and > 65year old individuals. Dual sero-positivity rate was highest 13% (113/844) in young adults 19-25years and lowest between 46-55years; 15/340 (4.4%). 4.2% (15/360); 13.5% (69/512); 6.7% (90/1348); 4.6% (10/214); 5% (2/40) and 6.7% (1/15) of males aged 19-25; 26-45; 46-55; 56-65; and >65years had HB e antigenaemia respectively. Among females - 27/293 (9.2%) aged 19-25; 26/500 (5.2%) 26-45; 2/84 (2.4%) 46-55; 1/12 (8.3%) 56-65 and 1/9(11.1%) >65years had dual antigenaemia. In women of childbearing age, 6.9% (53/793) had a dual carriage. Conclusion: Dual hepatitis B surface and envelope antigenaemia are highest in young adult males. This will have significant implications for the development of chronic liver disease and hepatocellular carcinoma.

Keywords: adult, Hepatitis B, Nigeria, dual carriage

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Authors: Hani M. Alothaid, Louise Robson, Richmond Muimo

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Cystic fibrosis (CF) is a disease that affects respiratory function and in EU it affects about 1 in 2,500 live births with an average 40-year life expectancy. This disease caused by mutations within the gene encoding the CFTR (Cystic Fibrosis Transmembrane Conductance Regulator) chloride channel leading to dysregulation of epithelial fluid transport and chronic lung inflammation, suggesting functional alterations of immune cells. In airways, CFTR been found to form a functional complex with S100A10 and AnxA2 in a cAMP/PKA dependent manner. The multiprotein complex of AnxA2-S100A10 and CFTR is also regulated by calcineurin. The aim of this study was i) to investigate whether chloride ion (Cl−) channels are activated by Pseudomonas aeruginosa lipopolysaccharide (LPS from PA), ii) if this activation is regulated by cAMP/PKA/calcineurin pathway and iii) to investigate the role of LPS-activated Cl− channels in the release of pro-inflammatory cytokines by immune cells. Human peripheral blood monocytes were used in the study. Whole-cell patch records showed that LPS from PA can activate Cl− channels, including CFTR and outwardly-rectifying Cl− channel (ORCC). This activation appears to require an intact PKA/calcineurin signalling pathway. The Gout in the presence of LPS was significantly inhibited by diisothiocyanatostilbene-disulfonic acid (DIDS), an ORCC blocker (p<0.001). The Gout was further suppressed by CFTR(inh)-172, a specific inhibitor for CFTR channels (p<0.001). Monocytes pre-incubated with PKA inhibitor or calcineurin inhibitor before stimulated with LPS from PA that were resulted in DIDS and CFTR(inh)-172 insensitive currents. Activation of both ORCC and CFTR was however, observed in response to monocytes exposure to LPS. Additionally, ELISA showed that the CFTR and ORCC play a role in mediating the release of pro-inflammatory cytokines such as IL-1β upon exposure of monocytes to LPS. However, this secretion was significantly inhibited due to CFTR and ORCC inhibition. However, Cl− may play a role in IL-1β release independent of cAMP/PKA/calcineurin signalling due to the enhancement of IL-1β secretion even when cAMP/PKA/calcineurin pathway was inhibited. In conclusion, our data confirmed that LPS from PA activates Cl− channels in human peripheral blood monocytes. Our data also confirmed that Cl− channels were involved in IL-1β release in monocytes upon exposure to LPS. However, it has been found that PKA and calcineurin does not seem to influence the Cl− dependent cytokine release.

Keywords: cystic fibrosis, CFTR, Annexin A2, S100A10, PP2B, PKA, outwardly-rectifying Cl− channel, Pseudomonas aeruginosa

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Authors: M. Sakthivel, A. Devaki, D. Balasubramanyam, P. Kumarasamy, A. Raja, R. Anilkumar, H. Gopi

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The New Zealand White breed of rabbit is one of the most commonly used, well adapted exotic breeds in India. Earlier studies were limited only to analyze the environmental factors affecting the growth and reproductive performance. In the present study, the population of the New Zealand White rabbits in a closed herd was evaluated for its genetic structure. Data on pedigree information (n=2508) for 18 years (1995-2012) were utilized for the study. Pedigree analysis and the estimates of population genetic parameters based on gene origin probabilities were performed using the software program ENDOG (version 4.8). The analysis revealed that the mean values of generation interval, coefficients of inbreeding and equivalent inbreeding were 1.489 years, 13.233 percent and 17.585 percent, respectively. The proportion of population inbred was 100 percent. The estimated mean values of average relatedness and the individual increase in inbreeding were 22.727 and 3.004 percent, respectively. The percent increase in inbreeding over generations was 1.94, 3.06 and 3.98 estimated through maximum generations, equivalent generations, and complete generations, respectively. The number of ancestors contributing the most of 50% genes (fₐ₅₀) to the gene pool of reference population was 4 which might have led to the reduction in genetic variability and increased amount of inbreeding. The extent of genetic bottleneck assessed by calculating the effective number of founders (fₑ) and the effective number of ancestors (fₐ), as expressed by the fₑ/fₐ ratio was 1.1 which is indicative of the absence of stringent bottlenecks. Up to 5th generation, 71.29 percent pedigree was complete reflecting the well-maintained pedigree records. The maximum known generations were 15 with an average of 7.9 and the average equivalent generations traced were 5.6 indicating of a fairly good depth in pedigree. The realized effective population size was 14.93 which is very critical, and with the increasing trend of inbreeding, the situation has been assessed to be worse in future. The proportion of animals with the genetic conservation index (GCI) greater than 9 was 39.10 percent which can be used as a scale to use such animals with higher GCI to maintain balanced contribution from the founders. From the study, it was evident that the herd was completely inbred with very high inbreeding coefficient and the effective population size was critical. Recommendations were made to reduce the probability of deleterious effects of inbreeding and to improve the genetic variability in the herd. The present study can help in carrying out similar studies to meet the demand for animal protein in developing countries.

Keywords: effective population size, genetic structure, pedigree analysis, rabbit genetics

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Authors: N. Khursheed, M. Fatima, S. Jamal, A. Raza, S. Rattani, Q. Ahsan, A. Rasheed, M. Jawed

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Introduction: Antibiotics are among the commonly prescribed medicines to treat bacterial infections. Their misuse intensifies resistance, and overuse incurs heavy losses to the healthcare system in terms of increased treatment costs and enhanced disease burden. Studies show that 40% of empirically used antibiotics are irrationally utilized. The objective of this study was to evaluate prescribing pattern of antibiotics at six public sector tertiary care hospitals across Pakistan. Methods: A multicenter cross-sectional point prevalence survey (PPS) was conducted in selected wards of six public sector tertiary care hospitals in Pakistan as part of the Clinical Engagement program by Fleming Fund Country Grant Pakistan in collaboration with Indus Hospital & Health Network (IHHN) from February to March 2021, these included Jinnah Postgraduate Medical Center and Dr. Ruth K. M. Pfau Civil Hospital from Karachi, Sheikh Zayed Hospital Lahore, Nishtar Medical University Hospital Multan, Medical Teaching Institute Hayatabad Medical Complex Peshawar, and Provincial Headquarters Hospital Gilgit. WHO PPS methodology was used for data collection (Hospital, ward, and patient level data was collected). Data was entered into the open-source Kobo Collect application and was analyzed using SPSS (version 22.0). Findings: Medical records of 837 in-patients were surveyed, of which the prevalence of antibiotics use was 78.5%. The most commonly prescribed antimicrobial was Ceftriaxone (21.7%) which is categorized in the Watch group of WHO AWaRe Classification, followed by Metronidazole (17.3%), Cefoperazone/Sulbactam (8.4%), Co-Amoxiclav (6.3%) and Piperacillin/Tazobactam (5.9%). The antibiotics were prescribed largely for surgical prophylaxis (36.7%), followed by community-acquired infections (24.7%). One antibiotic was prescribed to 46.7%, two to 39.9%, and three or more to 12.5 %. Two of six (30%) hospitals had functional drug and therapeutic committees, three (50%) had infection prevention and control committees, and one facility had an antibiotic formulary. Conclusion: Findings demonstrate high consumption of broad-spectrum antimicrobials and emphasizes the importance of expanding the antimicrobial stewardship program. Mentoring clinical teams will help to rationalize antimicrobial use.

Keywords: antimicrobial resistance, antimicrobial stewardship, point prevalence survey, antibiotics

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Authors: Yi-Ting Chen, Yu-Fang Huang, Pei-Wei Wang, Hai-Wei Liang, Chun-Hao Lai, Mei-Lien Chen

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Background: Bisphenol A (BPA) is commonly used in consumer products, such as inner coatings of cans and polycarbonated bottles. BPA is considered to be an endocrine disrupting substance (EDs) that affects normal human hormones and may cause adverse effects on human health. Pregnant women and fetuses are susceptible groups of endocrine disrupting substances. Prenatal exposure to BPA has been shown to affect the fetus through the placenta. Therefore, it is important to evaluate the potential health risk of fetal exposure to BPA during pregnancy. The aims of this study were (1) to determine the urinary concentration of BPA in pregnant women, and (2) to investigate the association between BPA exposure during pregnancy and birth outcomes. Methods: This study recruited 117 pregnant women and their fetuses from 2012 to 2014 from the Taiwan Maternal- Infant Cohort Study (TMICS). Maternal urine samples were collected in the third trimester and questionnaires were used to collect socio-demographic characteristics, eating habits and medical conditions of the participants. Information about birth outcomes of the fetus was obtained from medical records. As for chemicals analysis, BPA concentrations in urine were determined by off-line solid-phase extraction-ultra-performance liquid chromatography coupled with a Q-Tof mass spectrometer. The urinary concentrations were adjusted with creatinine. The association between maternal concentrations of BPA and birth outcomes was estimated using the logistic regression model. Results: The detection rate of BPA is 99%; the concentration ranges (μg/g) from 0.16 to 46.90. The mean (SD) BPA levels are 5.37(6.42) μg/g creatinine. The mean ±SD of the body weight, body length, head circumference, chest circumference and gestational age at birth are 3105.18 ± 339.53 g, 49.33 ± 1.90 cm, 34.16 ± 1.06 cm, 32.34 ± 1.37 cm and 38.58 ± 1.37 weeks, respectively. After stratifying the exposure levels into two groups by median, pregnant women in higher exposure group would have an increased risk of lower body weight (OR=0.57, 95%CI=0.271-1.193), smaller chest circumference (OR=0.70, 95%CI=0.335-1.47) and shorter gestational age at birth newborn (OR=0.46, 95%CI=0.191-1.114). However, there are no associations between BPA concentration and birth outcomes reach a significant level (p < 0.05) in statistics. Conclusions: This study presents prenatal BPA profiles and infants in northern Taiwan. Women who have higher BPA concentrations tend to give birth to lower body weight, smaller chest circumference or shorter gestational age at birth newborn. More data will be included to verify the results. This report will also present the predictors of BPA concentrations for pregnant women.

Keywords: bisphenol A, birth outcomes, biomonitoring, prenatal exposure

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Authors: Sarah Atalla, Shubham Gupta, Kim Alipio, Tanya Maric

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Background: Chelsea and Westminster Hospital have introduced the Birmingham Symptom Specific Obstetric Triage System (BSOTS) for patients who present acutely to the Maternity Assessment Suite (MAS) to prioritise care by urgency. The primary objective was to evaluate whether BSOTS was used appropriately to assess patients (defined as a 90% threshold). The secondary objective was to assess whether patients were seen within their designated triaged timeframe (defined as a 90% threshold). Methodology: MAS records were retrospectively reviewed for a randomly selected one-week period of data from 2020 (21/09/2020 - 27/09/2020). 189 patients presented to MAS during this time. Data were collected on the presenting complaint, time of attendance (divided into four time categories), and triage colour code for the urgency of a review by a doctor (red: immediately, orange: within 15 minutes, yellow: within 1 hour, green: within 4 hours). The number of triage waiting times that were breached and the outcome of the attendance was noted. Results: 49% of patients presenting to MAS during this time period were triaged, which therefore did not meet the 90% target. 67% of patients who were triaged were seen within their allocated timeframe as designated by their triage colour code, which therefore did not meet the 90% target. The most frequent reason for patient attendance was reduced fetal movements (30.5% of attendances). The busiest time of day (when most patients presented) was between 06:01-12:00, and this was also when the highest number of patients were not triaged (26 patients or 54% of patients presenting in this time category). The most used triage category (59%) was the green colour code (to be seen by a doctor within 4 hours), followed by orange (24%), yellow (14%), and red (3%). 45% of triaged patients were admitted, whilst 55% were discharged. 62% of patients allocated to the green triage category were discharged, as compared to 56% of yellow category patients, 27% of orange category patients, and 50% of red category patients. The time of patient presentation to the hospital was also associated with the level of urgency and outcome. Patients presenting from 12:01 to 18:00 were more likely to be discharged (72% discharged) compared to 00:01-06:00 where only 12.5% of patients were discharged. Conclusion: The triage system for assessing the urgency of acutely presenting obstetric patients is only being effectively utilised for 49% of patients. There is potential for enhancing the employment of the triage system to enable further efficiency and boost the promotion of patient safety. It is noted that MAS was busiest at 06:01 - 12:00 when there was also the highest number of non-triaged patients – this highlights some areas where we can improve, including higher levels of staffing, better use of BSOTS to triage patients, and patient education.

Keywords: birmingham, BSOTS, maternal, obstetric, pregnancy, specific, symptom, triage

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Authors: Sara A. Ben Lashihar

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The heritage building information modelling (HBIM) of the historical masonry buildings has expanded lately to meet the urgent needs for conservation and structural analysis. The masonry structures are unique features for ancient building architectures worldwide that have special cultural, spiritual, and historical significance. However, there is a research gap regarding the reliability of the HBIM modeling process of these structures. The HBIM modeling process of the masonry structures faces significant challenges due to the inherent complexity and uniqueness of their structural systems. Most of these processes are based on tracing the point clouds and rarely follow documents, archival records, or direct observation. The results of these techniques are highly abstracted models where the accuracy does not exceed LOD 200. The masonry assemblages, especially curved elements such as arches, vaults, and domes, are generally modeled with standard BIM components or in-place models, and the brick textures are graphically input. Hence, future investigation is necessary to establish a methodology to generate automatically parametric masonry components. These components are developed algorithmically according to mathematical and geometric accuracy and the validity of the survey data. The main aim of this paper is to provide a comprehensive review of the state of the art of the existing researches and papers that have been conducted on the HBIM modeling of the masonry structural elements and the latest approaches to achieve parametric models that have both the visual fidelity and high geometric accuracy. The paper reviewed more than 800 articles, proceedings papers, and book chapters focused on "HBIM and Masonry" keywords from 2017 to 2021. The studies were downloaded from well-known, trusted bibliographic databases such as Web of Science, Scopus, Dimensions, and Lens. As a starting point, a scientometric analysis was carried out using VOSViewer software. This software extracts the main keywords in these studies to retrieve the relevant works. It also calculates the strength of the relationships between these keywords. Subsequently, an in-depth qualitative review followed the studies with the highest frequency of occurrence and the strongest links with the topic, according to the VOSViewer's results. The qualitative review focused on the latest approaches and the future suggestions proposed in these researches. The findings of this paper can serve as a valuable reference for researchers, and BIM specialists, to make more accurate and reliable HBIM models for historic masonry buildings.

Keywords: HBIM, masonry, structure, modeling, automatic, approach, parametric

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Authors: Ana Carolina Felizardo Da Silva

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People with disabilities are those who have limitations of a physical, mental, intellectual or sensory nature and who, therefore, should not be excluded or marginalized. In Brazil, the Brazilian Law for the Inclusion of People with Disabilities defines that people with disabilities have the right to culture, sport, tourism and leisure on an equal basis with other people. Sport for people with disabilities, in its genesis, had a character aimed at rehabilitating men and soldiers, that is, the male figure who returned wounded from war and needed care. By gaining practitioners, the marketing issue emerges and, successively, high performance, what we call Paralympic sport. We found that sport for people with disabilities was designed for men, corroborating the social idea that sport is a masculine and masculinizing environment. In this way, the inclusion of women with disabilities in sports becomes a double challenge because they are women and have a disability. From data collected from official documents of the International Paralympic Committee, it is found that the first report on the participation of women in the Paralympic Games was in 1948, in England, in Stoke Mandeville, a championship considered the firstborn of the games, later, became called the “Paralympic Games”. However, due to the lack of information, the return of the appearance of women participating in the Paralympics took place after long 40 years, in 1984, which demonstrates a large gap of records on the official website referring to women in the games. Despite the great challenge, the number of women has been growing substantially. When collecting data from participants of all 16 editions of the Paralympic Games, in its last edition, held in Tokyo, out of 4,400 competing athletes, 1,853 were women, which represents 42% of the total number of athletes. In this same edition, we had the largest delegation of Brazilian women, represented by 96 athletes out of a total of 260 Brazilian athletes. It is estimated that in the next edition, to be taken place in Paris in 2024, the participation of women will equal or surpass that of men. The certain invisibility of women participating in the Paralympic Games is noticed when we access the database of the Brazilian Paralympic Committee website. It is possible to identify all women medalists of a given edition. On the other side, participating female athletes who did not medal are not registered on the site. Regarding the participation of Brazilian women in the Paralympics, there was a considerable growth in the last two editions, in 2012 there were only 69 women participating, going to 102 in 2016 and 96 in 2021. The same happened in relation to the medalists, going from 8 Brazilians in 2012 to 33 in 2016 and 27 in 2021. In this sense, the present study, aims to analyze how Brazilian women participate in the Paralympics, giving visibility and voice to female athletes. Structured interviews are being carried out with the participants of the games, identifying the difficulties and potentialities of participating with athletes in the competition. The analysis will be carried out through Bardin’s content analysis.

Keywords: paralympics, sport for people with disabilities, woman, woman in sport

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Authors: Ambika Roy Bardhan

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Kolkata, the City of Joy, is a greying metropolis not only in respect of its concrete jungle but also because of the largest population of 60-plus residents that it shelters among all other cities in India. Declining birth and death rates and a negative growth of population indicate that the city has reached the last stage of demographic transition. Thus, the obvious consequence has been the ageing of its population. With this background, the present paper attempts to study the demographic and socio-economic status of the elderly population in Kolkata. Analysis and findings have been based on secondary data obtained from Census of India of various years, Sample Registration System Reports and reports by HelpAge India. Findings show that the elderly population is increasing continuously. With respect to gender, the male elderly outnumbers the female elderly population. The percentage of households having one elderly member is more in the city due to the emergence of the nuclear families and erosion of joint family system. With respect to socio-economic status, those elderly who are the heads of the family are lower in percentages than those in the other age groups. Also, male elderly as head of the family are greater in percentage than female elderly. Elderly in the category of currently married records the highest percentage followed by widowed, never married and lastly, separated or divorced. Male elderly outnumber the female elderly as currently married, while female elderly outnumbers the male elderly in the category of widowed. In terms of living status, the percentage of elderly who are living alone is highest in Kolkata and the reason for staying alone as no support from children also happens to be highest in this city. The literacy rate and higher level of education is higher among the male than female elderly. Higher percentages of female elderly have been found to be with disability. Disability in movement and multiple disabilities have been found to be more common among the elderly population in Kolkata. Percentages of male literate pensioners are highest than other categories. Also, in terms of levels of education male elderly who are graduate and above other than technical degree are the highest receivers of pension. Also, in terms of working status, elderly as non-workers are higher in percentages with the population of elderly females outnumbering the males. The old age dependency ratio in the city is increasing continuously and the ratio is higher among females than male. Thus, it can be stated that Kolkata is witnessing continuous and rapid ageing of its population. Increasing dependency ratio is likely to create pressure on the working population, available civic, social and health amenities. This requires intervention in the form of planning, formulation and implementation of laws, policies, programs and measures to safeguard and improve the conditions of the elderly in Kolkata.

Keywords: demographic, elderly, population, socio-economic

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Authors: Alireza Karimi

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Artificial Intelligence (AI) is reshaping various industries, and accounting is no exception. With the ability to process vast amounts of data quickly and accurately, AI is revolutionizing how financial professionals manage, analyze, and report financial information. In this article, we will explore the diverse applications of AI in accounting and its profound impact on the field. Automation of Repetitive Tasks: One of the most significant contributions of AI in accounting is automating repetitive tasks. AI-powered software can handle data entry, invoice processing, and reconciliation with minimal human intervention. This not only saves time but also reduces the risk of errors, leading to more accurate financial records. Pattern Recognition and Anomaly Detection: AI algorithms excel at pattern recognition. In accounting, this capability is leveraged to identify unusual patterns in financial data that might indicate fraud or errors. AI can swiftly detect discrepancies, enabling auditors and accountants to focus on resolving issues rather than hunting for them. Real-Time Financial Insights: AI-driven tools, using natural language processing and computer vision, can process documents faster than ever. This enables organizations to have real-time insights into their financial status, empowering decision-makers with up-to-date information for strategic planning. Fraud Detection and Prevention: AI is a powerful tool in the fight against financial fraud. It can analyze vast transaction datasets, flagging suspicious activities and reducing the likelihood of financial misconduct going unnoticed. This proactive approach safeguards a company's financial integrity. Enhanced Data Analysis and Forecasting: Machine learning, a subset of AI, is used for data analysis and forecasting. By examining historical financial data, AI models can provide forecasts and insights, aiding businesses in making informed financial decisions and optimizing their financial strategies. Artificial Intelligence is fundamentally transforming the accounting profession. From automating mundane tasks to enhancing data analysis and fraud detection, AI is making financial processes more efficient, accurate, and insightful. As AI continues to evolve, its role in accounting will only become more significant, offering accountants and finance professionals powerful tools to navigate the complexities of modern finance. Embracing AI in accounting is not just a trend; it's a necessity for staying competitive in the evolving financial landscape.

Keywords: artificial intelligence, accounting automation, financial analysis, fraud detection, machine learning in finance

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Authors: Wing Mui Winnie So, Tian Luo, Zeyu Han

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To fully explore and develop the potentials of gifted students systematically and strategically by providing them with opportunities to receive education at appropriate levels, schools in Hong Kong are encouraged to adopt the "Three-Tier Implementation Model" to plan and implement the school-based gifted education, with Level Three refers to the provision of learning opportunities for the exceptionally gifted students in the form of specialist training outside the school setting by post-secondary institutions, non-government organisations, professional bodies and technology enterprises. Due to the growing concern worldwide about low interest among students in pursuing STEM (Science, Technology, Engineering, and Mathematics) careers, cultivating and boosting STEM career interest has been an emerging research focus worldwide. Although numerous studies have explored its critical contributors, little research has examined the effectiveness of comprehensive interventions such as “Studying with STEM professional”. This study aims to examine the effect on gifted students’ career interest during their participation in an off-school support programme designed and supervised by a team of STEM educators and STEM professionals from a university. Gifted students were provided opportunities and tasks to experience STEM career topics that are not included in the school syllabus, and to experience how to think and work like a STEM professional in their learning. Participants involved 40 primary school students joining the intervention programme outside the normal school setting. Research methods included adopting the STEM career interest survey and drawing tasks supplemented with writing before and after the programme, as well as interviews before the end of the programme. The semi-structured interviews focused on students’ views regarding STEM professionals; what’s it like to learn with a STEM professional; what’s it like to work and think like a STEM professional; and students’ STEM identity and career interest. The changes in gifted students’ STEM career interest and its well-recognised significant contributors, for example, STEM stereotypes, self-efficacy for STEM activities, and STEM outcome expectation, were collectively examined from the pre- and post-survey using T-test. Thematic analysis was conducted for the interview records to explore how studying with STEM professional intervention can help students understand STEM careers; build STEM identity; as well as how to think and work like a STEM professional. Results indicated a significant difference in STEM career interest before and after the intervention. The influencing mechanism was also identified from the measurement of the related contributors and the analysis of drawings and interviews. The potential of off-school support programme supervised by STEM educators and professionals to develop gifted students’ STEM career interest is argued to be further unleashed in future research and practice.

Keywords: gifted students, STEM career, STEM education, STEM professionals

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Authors: Ludmila Vucolova

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The thought is a process that underlies consciousness and cognition and understanding its origin and processes is a longstanding goal of many academic disciplines. By integrating over twenty novel ideas and hypotheses of this theoretical proposal, we can speculate that thought is an emergent property of coded neural events, translating the electro-chemical interactions of the body with its environment—the objects of sensory stimulation, X, and Y. The latter is a self- generated feedback entity, resulting from the arbitrary pattern of the motion of a body’s motor repertory (M). A culmination of these neural events gives rise to a thought: a state of identity between an observed object X and a symbol Y. It manifests as a “state of awareness” or “state of knowing” and forms our perception of the physical world. The values of the variables of a construct—X (object), S1 (sense for the perception of X), Y (object), S2 (sense for perception of Y), and M (motor repertory that produces Y)—will specify the particular conscious percept at any given time. The proposed principle of interaction between the elements of a construct (X, Y, S1, S2, M) is universal and applies for all modes of communication (normal, deaf, blind, deaf and blind people) and for various language systems (Chinese, Italian, English, etc.). The particular arrangement of modalities of each of the three modules S1 (5 of 5), S2 (1 of 3), and M (3 of 3) defines a specific mode of communication. This multifaceted paradigm demonstrates a predetermined pattern of relationships between X, Y, and M that passes from generation to generation. The presented analysis of a cognitive experience encompasses the key elements of embodied cognition theories and unequivocally accords with the scientific interpretation of cognition as the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses, and cognition means thinking and awareness. By assembling the novel ideas presented in twelve sections, we can reveal that in the invisible “chaos”, there is an order, a structure with landmarks and principles of operations and mental processes (thoughts) are physical and have a biological basis. This innovative proposal explains the phenomenon of mental imagery; give the first insight into the relationship between mental states and brain states, and support the notion that mind and body are inseparably connected. The findings of this theoretical proposal are supported by the current scientific data and are substantiated by the records of the evolution of language and human intelligence.

Keywords: agent, awareness, cognitive, element, experience, feedback, first person, imagery, language, mental, motor, object, sensory, symbol, thought

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Authors: Maisa Haj-Tas, Jehad Alaraifi

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The significance of the study: This retrospective study examined the speech and language profiles of patients who received clinical services at the University of Jordan Hearing and Speech Clinic (UJ-HSC) from 2009 to 2014. The UJ-HSC clinic is located in the capital Amman and was established in the late 1990s. It is the first hearing and speech clinic in Jordan and one of first speech and hearing clinics in the Middle East. This clinic provides services to an annual average of 2000 patients who are diagnosed with different communication disorders. Examining the speech and language profiles of patients in this clinic could provide an insight about the most common disorders seen in patients who attend similar clinics in Jordan. It could also provide information about community awareness of the role of speech therapists in the management of speech and language disorders. Methodology: The researchers examined the clinical records of 1140 patients (797 males and 343 females) who received clinical services at the UJ-HSC between the years 2009 and 2014 for the purpose of data analysis for this study. The main variables examined in the study were disorder type and gender. Participants were divided into four age groups: children, adolescents, adults, and older adults. The examined disorders were classified as either speech disorders, language disorders, or dysphagia (i.e., swallowing problems). The disorders were further classified as childhood language impairments, articulation disorders, stuttering, cluttering, voice disorders, aphasia, and dysphagia. Results: The results indicated that the prevalence for language disorders was the highest (50.7%) followed by speech disorders (48.3%), and dysphagia (0.9%). The majority of patients who were seen at the JU-HSC were diagnosed with childhood language impairments (47.3%) followed consecutively by articulation disorders (21.1%), stuttering (16.3%), voice disorders (12.1%), aphasia (2.2%), dysphagia (0.9%), and cluttering (0.2%). As for gender, the majority of patients seen at the clinic were males in all disorders except for voice disorders and cluttering. Discussion: The results of the present study indicate that the majority of examined patients were diagnosed with childhood language impairments. Based on this result, the researchers suggest that there seems to be a high prevalence of childhood language impairments among children in Jordan compared to other types of speech and language disorders. The researchers also suggest that there is a need for further examination of the actual prevalence data on speech and language disorders in Jordan. The fact that many of the children seen at the UJ-HSC were brought to the clinic either as a result of parental concern or teacher referral indicates that there seems to an increased awareness among parents and teachers about the services speech pathologists can provide about assessment and treatment of childhood speech and language disorders. The small percentage of other disorders (i.e., stuttering, cluttering, dysphasia, aphasia, and voice disorders) seen at the UJ-HSC may indicate a little awareness by the local community about the role of speech pathologists in the assessment and treatment of these disorders.

Keywords: clinic, disorders, language, profile, speech

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Authors: Tugba Altin

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In an era marked by pronounced climate change consequences, communities are observed to confront traumatic events that yield both tangible and intangible repercussions. Such events not only cause discernible damage to the landscape but also deeply affect the intangible aspects, including emotional distress and disruptions to cultural landscapes. The Lytton Creek Fire of 2021 serves as a case in point. Beyond the visible destruction, the less overt but profoundly impactful disturbance to place attachment (PA) is scrutinized. PA, representing the emotional and cognitive bonds individuals establish with their environments, is crucial for understanding how such events impact cultural identity and connection to the land. The study underscores the significance of addressing both tangible and intangible traumas for holistic community recovery. As communities renegotiate their affiliations with altered environments, the cultural landscape emerges as instrumental in shaping place-based identities. This renewed understanding is pivotal for reshaping adaptation planning. The research advocates for adaptation strategies rooted in the lived experiences and testimonies of the affected populations. By incorporating both the tangible and intangible facets of trauma, planning efforts are suggested to be more culturally attuned and emotionally insightful, fostering true resonance with the affected communities. Through such a comprehensive lens, this study contributes enriching the climate change discourse, emphasizing the intertwined nature of tangible recovery and the imperative of emotional and cultural healing after environmental disasters. Following the pronounced aftermath of the Lytton Creek Fire in 2021, research aims to deeply understand its impact on place attachment (PA), encompassing the emotional and cognitive bonds individuals form with their environments. The interpretive phenomenological approach, enriched by a hermeneutic framework, is adopted, emphasizing the experiences of the Lytton community and co-researchers. Phenomenology informed the understanding of 'place' as the focal point of attachment, providing insights into its formation and evolution after traumatic events. Data collection departs from conventional methods. Instead of traditional interviews, walking audio sessions and photo elicitation methods are utilized. These allow co-researchers to immerse themselves in the environment, re-experience, and articulate memories and feelings in real-time. Walking audio facilitates reflections on spatial narratives post-trauma, while photo voices captured intangible emotions, enabling the visualization of place-based experiences. The analysis is collaborative, ensuring the co-researchers' experiences and interpretations are central. Emphasizing their agency in knowledge production, the process is rigorous, facilitated by the harmonious blend of interpretive phenomenology and hermeneutic insights. The findings underscore the need for adaptation and recovery efforts to address emotional traumas alongside tangible damages. By exploring PA post-disaster, the research not only fills a significant gap but advocates for an inclusive approach to community recovery. Furthermore, the participatory methodologies employed challenge traditional research paradigms, heralding potential shifts in qualitative research norms.

Keywords: wildfire recovery, place attachment, trauma recovery, cultural landscape, visual methodologies

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Authors: Terefe Fuge, George Tsourtos , Emma Miller

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Objectives: Maintaining optimal adherence and viral suppression in people living with HIV (PLWHA) is essential to ensure both preventative and therapeutic benefits of antiretroviral therapy (ART). Prisoners bear a particularly high burden of HIV infection and are highly likely to transmit to others during and after incarceration. However, the level of adherence and viral suppression, as well as its associated factors in incarcerated populations in low-income countries is unknown. This study aimed to determine the prevalence of non-adherence and viral failure, and contributing factors to this amongst prisoners in South Ethiopia. Methods: A prospective cohort study was conducted between June 1, 2019 and July 31, 2020 to compare the level of adherence and viral suppression between incarcerated and non-incarcerated PLWHA. The study involved 74 inmates living with HIV (ILWHA) and 296 non-incarcerated PLWHA. Background information including sociodemographic, socioeconomic, psychosocial, behavioural, and incarceration-related characteristics was collected using a structured questionnaire. Adherence was determined based on participants’ self-report and pharmacy refill records, and plasma viral load measurements which were undertaken within the study period were prospectively extracted to determine viral suppression. Various univariate and multivariate regression models were used to analyse data. Results: Self-reported dose adherence was approximately similar between ILWHA and non-incarcerated PLWHA (81% and 83% respectively), but ILWHA had a significantly higher medication possession ratio (MPR) (89% vs 75%). The prevalence of viral failure (VF) was slightly higher (6%) in ILWHA compared to non-incarcerated PLWHA (4.4%). The overall dose non-adherence (NA) was significantly associated with missing ART appointments, level of satisfaction with ART services, patient’s ability to comply with a specified medication schedule and types of methods used to monitor the schedule. In ILWHA specifically, accessing ART services from a hospital compared to a health centre, an inability to always attend clinic appointments, experience of depression and a lack of social support predicted NA. VF was significantly higher in males, people of age 31-35 years and in those who experienced social stigma, regardless of their incarceration status. Conclusions: This study revealed that HIV-infected prisoners in South Ethiopia were more likely to be non-adherent to doses and so to develop viral failure compared to their non-incarcerated counterparts. A multitude of factors was found to be responsible for this requiring multilevel intervention strategies focusing on the specific needs of prisoners.

Keywords: Adherence , Antiretroviral therapy, Incarceration, South Ethiopia, Viral suppression

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Authors: Radu Deju, Carmen Mustata

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The VVR-S nuclear research reactor owned by Horia Hubulei National Institute of Physics and Nuclear Engineering (IFIN-HH) was designed for research and radioisotope production, being permanently shut-down in 2002, after 40 years of operation. All amount of the nuclear spent fuel S-36 and EK-10 type was returned to Russian Federation (first in 2009 and last in 2012), and the radioactive waste resulted from the reprocessing of it will remain permanently in the Russian Federation. The decommissioning strategy chosen is immediate dismantling. At this moment, the radionuclides with half-life shorter than 1 year have a minor contribution to the contamination of materials and equipment used in reactor department. The decommissioning of the reactor has started in 2010 and is planned to be finalized in 2020, being the first nuclear research reactor that has started the decommissioning project from the South-East of Europe. The management system applied in the decommissioning of the VVR-S research reactor integrates all common elements of management: nuclear safety, occupational health and safety, environment, quality- compliance with the requirements for decommissioning activities, physical protection and economic elements. This paper presents the application of integrated management system in decommissioning of systems, structures, equipment and components (SSEC) from pumps room, including the management of the resulted radioactive waste. The primary cooling system of this type of reactor includes circulation pumps, heat exchangers, degasser, filter ion exchangers, piping connection, drainage system and radioactive leaks. All the decommissioning activities of primary circuit were performed in stage 2 (year 2014), and they were developed and recorded according to the applicable documents, within the requirements of the Regulatory Body Licenses. In the presentation there will be emphasized how the integrated management system provisions are applied in the dismantling of the primary cooling system, for elaboration, approval, application of necessary documentation, records keeping before, during and after the dismantling activities. Radiation protection and economics are the key factors for the selection of the proper technology. Dedicated and advanced technologies were chosen to perform specific tasks. Safety aspects have been taken into consideration. Resource constraints have also been an important issue considered in defining the decommissioning strategy. Important aspects like radiological monitoring of the personnel and areas, decontamination, waste management and final characterization of the released site are demonstrated and documented.

Keywords: decommissioning, integrated management system, nuclear reactor, waste management

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Authors: Daniela Magalhaes, Jorge Pedro, Pedro Souteiro, Joao S. Neves, Sofia Castro-Oliveira, Vanessa Guerreiro, Rita Bettencourt- Silva, Maria M. Costa, Ana Varela, Joana Queiros, Paula Freitas, Davide Carvalho

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Introduction: Obesity is an independent risk factor for renal dysfunction. Our aims were: (1) evaluate the impact of bariatric surgery (BS) on renal function; (2) clarify the factors determining the postoperative evolution of the glomerular filtration rate (GFR); (3) access the occurrence of oxalate-mediated renal complications. Methods: We investigated a cohort of 1448 obese patients who underwent bariatric surgery. Those with basal GFR (GFR0) < 30mL/min or without information about the GFR 2-year post-surgery (GFR2) were excluded. Results: We included 725 patients, of whom 647 (89.2%) women, with 41 (IQR 34-51) years, a median weight of 112.4 (IQR 103.0-125.0) kg and a median BMI of 43.4 (IQR 40.6-46.9) kg/m2. Of these, 459 (63.3%) performed gastric bypass (RYGB), 144 (19.9%) placed an adjustable gastric band (AGB) and 122 (16.8%) underwent vertical gastrectomy (VG). At 2-year post-surgery, excess weight loss (EWL) was 60.1 (IQR 43.7-72.4) %. There was a significant improve of metabolic and inflammatory status, as well as a significant decrease in the proportion of patients with diabetes, arterial hypertension and dyslipidemia (p < 0.0001). At baseline, 38 (5.2%) of subjects had hyperfiltration with a GFR0 ≥ 125mL/min/1.73m2, 492 (67.9%) had a GFR0 90-124 mL/min/1.73m2, 178 (24.6%) had a GFR0 60-89 mL/min/1.73m2, and 17 (2.3%) had a GFR0 < 60 mL/min/1.73m2. GFR decreased in 63.2% of patients with hyperfiltration (ΔGFR=-2.5±7.6), and increased in 96.6% (ΔGFR=22.2±12.0) and 82.4% (ΔGFR=24.3±30.0) of the subjects with GFR0 60-89 and < 60 mL/min/1.73m2, respectively ( p < 0.0001). This trend was maintained when adjustment was made for the type of surgery performed. Of 321 patients, 10 (3.3%) had a urinary albumin excretion (UAE) > 300 mg/dL (A3), 44 (14.6%) had a UAE 30-300 mg/dL (A2) and 247 (82.1%) has a UAE < 30 mg/dL (A1). Albuminuria decreased after surgery and at 2-year follow-up only 1 (0.3%) patient had A3, 17 (5.6%) had A2 and 283 (94%) had A1 (p < 0,0001). In multivariate analysis, the variables independently associated with ΔGFR were BMI (positively) and fasting plasma glucose (negatively). During the 2-year follow-up, only 57 of the 725 patients had transient urinary excretion of calcium oxalate crystals. None has records of oxalate-mediated renal complications at our center. Conclusions: The evolution of GFR after BS seems to depend on the initial renal function, as it decreases in subjects with hyperfiltration, but tends to increase in those with renal dysfunction. Our results suggest that BS is associated with improvement of renal outcomes, without significant increase of renal complications. So, apart the clear benefits in metabolic and inflammatory status, maybe obese adults with nondialysis-dependent CKD should be referred for bariatric surgery evaluation.

Keywords: albuminuria, bariatric surgery, glomerular filtration rate, renal function

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Authors: Vanlounni Sibounheuang, Wanarat Anusornsangiam, Pattarin Kittiboonyakun, Chanthanom Manithip

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In worldwide, one of the most common use of oral anticoagulant is warfarin. Its margin between therapeutic inhibition of clot formation and bleeding complications is narrow. Mahosot Hospital, warfarin clinic had not been established yet. The descriptive study was conducted by investigating drug-related problems of outpatients using warfarin, the value of the international normalized ratio (INR) higher than normal ranges (25.40 % of the total 272 outpatients) were mostly identified at Lao-Luxembourg Heart Centre, Mahosot Hospital, Lao PDR. This result led to the present study conducting qualitative interviews in order to help establish a warfarin clinic at Mahosot Hospital for the better outcomes of patients using warfarin. The purpose of this study was to explore perspectives of healthcare professional providing services for outpatients using warfarin. The face to face, in-depth interviews were undertaken among nine healthcare professionals (doctor=3, nurse=3, pharmacist=3) working at out-patient clinic, Lao-Luxembourg Heart Centre, Mahosot Hospital, Lao PDR. The interview guides were developed, and they were validated by the experts in the fields of qualitative research. Each interview lasted approximately 20 minutes. Three major themes emerged; healthcare professional’s experiences of current practice problems with warfarin therapy, healthcare professionals’ views of medical problems related to patients using warfarin, and healthcare professionals’ perspectives on ways of service improvement. All healthcare professionals had the same views that it’s difficult to achieve INR goal for individual patients because of some important patient barriers especially lack of knowledge about to use warfarin properly and safety, patients not regularly follow-up due to problems with transportations and financial support. Doctors and nurses agreed to have a pharmacist running a routine warfarin clinic and provided counselling to individual patients on the following points: how to take drug properly and safety, drug-drug and food-drug interactions, common side effects and how to manage them, lifestyle modifications. From the interviews, some important components of the establishment of a warfarin clinic included financial support, increased human resources, improved the system of keeping patients’ medical records, short course training for pharmacists. This study indicated the acceptance of healthcare professionals on the important roles of pharmacists and the feasibility of setting up warfarin clinic by working together with the multidisciplinary health care team in order to help improve health outcomes of patients using warfarin at Mahosot Hospital, Lao PDR.

Keywords: perspectives, healthcare professional, warfarin therapy, Mahosot Hospital

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Authors: Yael Wolff Sagy, Yiska Loewenberg Weisband, Vered Kaufman Shriqui, Michal Krieger, Arie Ben Yehuda, Ronit Calderon Margalit

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Background: Obesity is both a risk factor and common comorbidity of diabetes. Obesity impedes the achievement of glycemic control, and enhances damage caused by hyperglycemia to blood vessels; thus it increases diabetes-related complications. This study assessed the prevalence of obesity and morbid obesity among Israeli adults with diabetes, and estimated disparities associated with sex and socioeconomic position (SEP). Methods: A cross-sectional study was conducted in the setting of the Israeli National Program for Quality Indicators in Community Healthcare. Data on all the Israeli population is retrieved from electronic medical records of the four health maintenance organizations (HMOs). The study population included all Israeli patients with diabetes aged 20-64 with documented body mass index (BMI) in 2016 (N=180,451). Diabetes was defined as the existence of one or more of the following criteria: (a) Plasma glucose level >200 mg% in at least two tests conducted at least one month apart in the previous year; (b) HbA1c>6.5% at least once in the previous year (c) at least three prescriptions of diabetes medications were dispensed during the previous year. Two measures were included: the prevalence of obesity (defined as last BMI≥ 30 kg/m2 and <35 kg/m2) and the prevalence of morbid obesity (defined as last BMI≥ 35 kg/m2) in individuals aged 20-64 with diabetes. The cut-off value for morbid obesity was set in accordance with the eligibility criteria for bariatric surgery in diabetics. Data were collected by the HMOs and aggregated by age, sex and SEP. SEP was based on statistical areas ranking by the Israeli Central Bureau of Statistics and divided into 4 categories, ranking from 1 (lowest) to 4 (highest). Results: BMI documentation among adults with diabetes was 84.9% in 2016. The prevalence of obesity in the study population was 30.5%. Although the overall rate was similar in both sexes (30.8% in females, 30.3% in males), SEP disparities were stronger in females (32.7% in SEP level 1 vs. 27.7% in SEP level 4; 18.1% relative difference) compared to males (30.6% in SEP level 1 vs. 29.3% in SEP level 4; 4.4% relative difference). The overall prevalence of morbid obesity in this population was 20.8% in 2016. The rate among females was almost double compared to the rate in males (28.1% and 14.6%, respectively). In both sexes, the prevalence of morbid obesity was strongly associated with lower SEP. However, in females, disparities between SEP levels were much stronger (34.3% in SEP level 1 vs. 18.7% in SEP level 4; 83.4% relative difference) compared to SEP-disparities in males (15.7% in SEP level 1 vs. 12.3% in SEP level 4; 27.6% relative difference). Conclusions: The overall prevalence of BMI≥ 30 kg/m2 among adults with diabetes in Israel exceeds 50%; and the prevalence of morbid obesity suggests that 20% meet the BMI-criteria for bariatric surgery. Prevalence rates show major SEP- and sex-disparities; especially strong SEP disparities in morbid obesity among females. These findings highlight the need for greater consideration of different population groups when implementing interventions.

Keywords: diabetes, health disparities, health policy, obesity, socio-economic position

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