Abstract: Background: Excessive and inappropriate use of antimicrobial agents among hospitalized patients remains an important patient safety and public health issue worldwide. Not only does this behavior incur unnecessary cost but it is also associated with increased morbidity and mortality. The objective of this study is to obtain an insight into the prescribing patterns of antibiotics in surgical and medical wards, to help identify a scope for improvement in service delivery. Method: A simple point prevalence survey included a convenience sample of 200 patients admitted to medical and surgical wards in a government teaching hospital in Baghdad between October 2017 and April 2018. Data were collected by a trained pharmacy intern using a standardized form. Patient’s demographics and details of the prescribed antibiotics, including dose, frequency of dosing and route of administration, were reported. Patients were included if they had been admitted at least 24 hours before the survey. Patients under 18 years of age, having a diagnosis of cancer or shock, or being admitted to the intensive care unit, were excluded. Data were checked and entered by the authors into Excel and were subjected to frequency analysis, which was carried out on anonymized data to protect patient confidentiality. Results: Overall, 88.5% of patients (n=177) received 293 antibiotics during their hospital admission, with a small variation between wards (80%-97%). The average number of antibiotics prescribed per patient was 1.65, ranging from 1.3 for medical patients to 1.95 for surgical patients. Parenteral third-generation cephalosporins were the most commonly prescribed at a rate of 54.3% (n=159) followed by nitroimidazole 29.4% (n=86), quinolones 7.5% (n=22) and macrolides 4.4% (n=13), while carbapenems and aminoglycosides were the least prescribed together accounting for only 4.4% (n=13). The intravenous route was the most common route of administration, used for 96.6% of patients (n=171). Indications were reported in only 63.8% of cases. Culture to identify pathogenic organisms was employed in only 0.5% of cases. Conclusion: Broad-spectrum antibiotics are prescribed at an alarming rate. This practice may provoke antibiotic resistance and adversely affect the patient outcome. Implementation of an antibiotic stewardship program is warranted to enhance the efficacy, safety and cost-effectiveness of antimicrobial agents.
Abstract: Introduction: Endometrial Cancer is a common gynecologic malignancy primarily treated with complete surgical staging, which may include complete pelvic and para-aortic lymphadenectomy. The role of lymphadenectomy is controversial, especially the intraoperative indications for the procedure. Three factors are important in decision to proceed with lymphadenectomy: Myometrial invasion, maximum tumor dimension, and histology. Many institutions incorporate these criteria in varying degrees in the decision to proceed with lymphadenectomy. This investigation assesses the use of intraoperatively measured MTD with and without pre-operative histologic grade. Methods: This study compared retrospectively EEC patients with intraoperatively measured MTD ≤2 cm to those with MTD >2 cm from January 1, 2002 to August 31, 2017. This assessment compared those with MTD ≤ 2cm with endometrial biopsy (EB) grade 1-2 to patients with MTD > 2cm with EB grade 3. Lymph node metastasis (LNM), recurrence, and survival were compared in these groups. Results: This study reviewed 222 patient cases. In tumors > 2 cm, LNM occurred in 20% cases while in tumors ≤ 2 cm, LNM was found in 6% cases (p=0.04). Recurrence and mean survival based on last follow up visit in these two groups were not statistically different (p=0.78 and 0.36 respectively). Data demonstrated a trend that when combined with preoperative EB International Federation of Gynecology and Obstetrics (FIGO) grade, a higher proportion of patients with EB FIGO Grade 3 and MTD > 2 cm had LNM compared to those with EB FIGO Grade 1-2 and MTD ≤ 2 cm (43% vs, 11%, p=0.06). LNM was found in 15% of cases in which lymphadenectomy was performed based on current practices, whereas if the criteria of EB FIGO 3 and MTD > 2 cm were used the incidence of LNM would have been 44% cases. However, using this criterion, two patients would not have had their nodal metastases detected. Compared to the current practice, the sensitivity and specificity of the proposed criteria would be 60% and 81%, respectively. The PPV and NPV would be 43% and 90%, respectively. Conclusion: The results indicate that MTD combined with EB FIGO grade can detect LNM in a higher proportion of cases when compared to current practice. MTD combined with EB FIGO grade may eliminate the need of frozen section sampling in a substantial number of cases.
Abstract: Risk assessment and the knowledge provided through this process is a crucial part of any decision-making process in the management of risks and uncertainties. Failure in assessment of risks can cause inadequacy in the entire process of risk management, which in turn can lead to failure in achieving organisational objectives as well as having significant damaging consequences on populations affected by the potential risks being assessed. The choice of tools and techniques in risk assessment can influence the degree and scope of decision-making and subsequently the risk response strategy. There are various available qualitative and quantitative tools and techniques that are deployed within the broad process of risk assessment. The sheer diversity of tools and techniques available to practitioners makes it difficult for organisations to consistently employ the most appropriate methods. This tools and techniques adaptation is rendered more difficult in public risk regulation organisations due to the sensitive and complex nature of their activities. This is particularly the case in areas relating to the environment, food, and human health and safety, when organisational goals are tied up with societal, political and individuals’ goals at national and international levels. Hence, recognising, analysing and evaluating different decision support tools and techniques employed in assessing risks in public risk management organisations was considered. This research is part of a mixed method study which aimed to examine the perception of risk assessment and the extent to which organisations practise risk assessment’ tools and techniques. The study adopted a semi-structured questionnaire with qualitative and quantitative data analysis to include a range of public risk regulation organisations from the UK, Germany, France, Belgium and the Netherlands. The results indicated the public risk management organisations mainly use diverse tools and techniques in the risk assessment process. The primary hazard analysis; brainstorming; hazard analysis and critical control points were described as the most practiced risk identification techniques. Within qualitative and quantitative risk analysis, the participants named the expert judgement, risk probability and impact assessment, sensitivity analysis and data gathering and representation as the most practised techniques.
Abstract: Class III malocclusion shows both skeletal and dentoalveolar component. Sketal Class III malocclusion can have variants in different region, maxilla or mandibular. Skeletal Class III malocclusion during growth period is considered to treat to prevent its severity in adulthood. Orthopedics treatment of skeletal Class III malocclusion in growing patient can be treated by using reverse twin block with expansion screw to modify the growth pattern. The objective of this case report was to describe the functional correction of skeletal Class III maloclussion using reverse twin block with expansion screw in growing patient. A patient with concave profile came with a chief complaint of aesthetic problems. The cephalometric analysis showed that patient had skeletal Class III malocclusion (ANB -50, SNA 75º, Wits appraisal -3 mm) with anterior cross bite and deep bite (overjet -3 mm, overbite 6 mm). In this case report, the patient was treated with reverse twin block appliance with expansion screw. After three months of treatment, the skeletal problems have been corrected (ANB -1°), overjet, overbite and aesthetic were improved. Reverse twin block appliance with expansion screw can be used as orthopedics treatment for skeletal Class III malocclusion in growing patient and can improve the aesthetic with great satisfaction which was the main complaint in this patient.
Abstract: Satellite imagery is one of the emerging technologies which are extensively utilized in various applications such as detection/extraction of man-made structures, monitoring of sensitive areas, creating graphic maps etc. The main approach here is the automated detection of buildings from very high resolution (VHR) optical satellite images. Initially, the shadow, the building and the non-building regions (roads, vegetation etc.) are investigated wherein building extraction is mainly focused. Once all the landscape is collected a trimming process is done so as to eliminate the landscapes that may occur due to non-building objects. Finally the label method is used to extract the building regions. The label method may be altered for efficient building extraction. The images used for the analysis are the ones which are extracted from the sensors having resolution less than 1 meter (VHR). This method provides an efficient way to produce good results. The additional overhead of mid processing is eliminated without compromising the quality of the output to ease the processing steps required and time consumed.
Abstract: Early detection of cancer could save human life and quality in insidious cases by advanced biomedical imaging techniques. Designing targeted detection system is necessary in order to protect of healthy cells. Electrospun nanofibers are efficient and targetable nanocarriers which have important properties such as nanometric diameter, mechanical properties, elasticity, porosity and surface area to volume ratio. In the present study, indocyanine green (ICG) organic dye was stabilized and encapsulated in polymer matrix which polyethylene oxide (PEO) and chitosan (CHI) multilayer nanofibers via co-axial electrospinning method at one step. The co-axial electrospun nanofibers were characterized as morphological (SEM), molecular (FT-IR), and entrapment efficiency of Indocyanine Green (ICG) (confocal imaging). Controlled release profile of PEO/CHI/ICG nanofiber was also evaluated up to 40 hours.
Abstract: Optimization is an important tool in making decisions and in analysing physical systems. In mathematical terms, an optimization problem is the problem of finding the best solution from among the set of all feasible solutions. The paper discusses the Whale Optimization Algorithm (WOA), and its applications in different fields. The algorithm is tested using MATLAB because of its unique and powerful features. The benchmark functions used in WOA algorithm are grouped as: unimodal (F1-F7), multimodal (F8-F13), and fixed-dimension multimodal (F14-F23). Out of these benchmark functions, we show the experimental results for F7, F11, and F19 for different number of iterations. The search space and objective space for the selected function are drawn, and finally, the best solution as well as the best optimal value of the objective function found by WOA is presented. The algorithmic results demonstrate that the WOA performs better than the state-of-the-art meta-heuristic and conventional algorithms.
Abstract: Many of the regeneration failures in conifers are often being attributed to heavy insect attack and pathogens during the period of seed formation and under storage conditions. Conifer berries and seed insects occur throughout the known range of the hosts and also limit the production of seed for nursery stock. On occasion, even entire seed crops are lost due to insect attacks. The berry and seeds of both the species have been found to be infected with insects. Recently, heavy damage to the berry and seeds of Juniper and Chilgoza Pine was observed in the field as well as in stored conditions, leading to reduction in the viability of seeds to germinate. Both the species are under great threat and regeneration of the species is very low. Due to lack of adequate literature, the study on the damage potential of seed insects was urgently required to know the exact status of the insect-pests attacking seeds/berries of both the pine species so as to develop pest management practices against the insect pests attack. As both the species are also under threat and are fighting for survival, so the study is important to develop management practices for the insect-pests of seeds/berries of Juniper and Chilgoza pine so as to evaluate in the nursery, as these species form major vegetation of their distribution zones. A six-year study on the management of insect pests of seeds of Chilgoza revealed that seeds of this species are prone to insect pests mainly borers. During present investigations, it was recorded that cones of are heavily attacked only by Dioryctria abietella (Lepidoptera: Pyralidae) in natural conditions, but seeds which are economically important are heavily infected, (sometimes up to 100% damage was also recorded) by insect borer, Plodia interpunctella (Lepidoptera: Pyralidae) and is recorded for the first time ‘to author’s best knowledge’ infesting the stored Chilgoza seeds. Similarly, Juniper berries and seeds were heavily attacked only by a single borer, Homaloxestis cholopis (Lepidoptera: Lecithoceridae) recorded as a new report in natural habitat as well as in stored conditions. During the present investigation details of insect pest attack on Juniper and Chilgoza pine seeds and berries was observed and suitable management practices were also developed to contain the insect-pests attack.
Abstract: Traditional federated architectures for data warehousing work well when corporations have existing regional data warehouses and there is a need to aggregate data at a global level. Schibsted Media Group has been maturing from a decentralised organisation into a more globalised one and needed to build both some of the regional data warehouses for some brands at the same time as the global one. In this paper, we present the architectural alternatives studied and why a custom federated approach was the notable recommendation to go further with the implementation. Although the data warehouses are logically federated, the implementation uses a single database system which presented many advantages like: cost reduction and improved data access to global users allowing consumers of the data to have a common data model for detailed analysis across different geographies and a flexible layer for local specific needs in the same place.
Abstract: The aim of this research is to remediation of the cadmium (Cd) pollution in agricultural soils by using barley (Hordeum vulgare L.) plant. For this purpose, a pot experiment was done in greenhouse conditions. Cadmium (100 mg/kg) as CdSO4.8H2O forms was applied to each pot and incubated during 30 days. Then Ethylenediamine tetraacetic acid (EDTA) chelate was applied to each pot at five doses (0, 3, 6, 8 and 10 mmol/kg) 20 days before harvesting time of the barley plants. The plants were harvested after two months planting. According to the pot experiment results, Cd and Zn amounts of barley plant increased with increasing EDTA application and Zn and Cd contents of barley 20,13 and 1,35 mg/kg for 0 mmol /kg EDTA; 58,61 and 113,24 mg/kg for 10 mmol/kg EDTA doses, respectively. On the other hand, Cd and Zn concentrations of experiment soil increased with EDTA application to the soil samples. Zinc and Cd concentrations of soil 0,31 and 0,021 mg/kg for 0 mmol /kg EDTA; 2,39 and 67,40 mg/kg for 10 mmol/kg EDTA doses, respectively. These increases were found to be statistically significant at the level of 1 %. According to the results of the pot experiment, some heavy metal especially Cd pollution of barley (Hordeum vulgare L.) plant province can be remediated by the phytoextraction method.
Abstract: The Mexican educational system faces diverse challenges related with the quality and coverage of education. The development of Intelligent Tutoring Systems (ITS) may help to solve some of them by helping teachers to customize their classes according to the performance of the students in online courses. In this work, we propose the adaptation of a functional ITS based on Bloom’s taxonomy called Sistema de Apoyo Generalizado para la Enseñanza Individualizada (SAGE), to measure student’s metacognition and their emotional response based on Marzano’s taxonomy. The students and the system will share the control over the advance in the course, so they can improve their metacognitive skills. The system will not allow students to get access to subjects not mastered yet. The interaction between the system and the student will be implemented through Natural Language Processing techniques, thus avoiding the use of sensors to evaluate student’s response. The teacher will evaluate student’s knowledge utilization, which is equivalent to the last cognitive level in Marzano’s taxonomy.
Abstract: The flue gas from fossil fuels combustion contains harmful pollutants dangerous for human health and environment. One of the air pollution control methods to restrict the emission of these pollutants is based on using the nanoparticle in adsorption process. In the present research, gamma nano-alumina particle is added to polyacrylonitrile (PAN) polymer through simple loading method, and the adsorption capacity of the wet spun fiber is investigated. The results of exposure the fiber to the acid gases including SO2, CO, NO2, NO, and CO2 show the noticeable increase of gas adsorption capacity on fiber contains nanoparticle. The research has been conducted in Acrylic II Plant of Polyacryl Iran Corporation.
Abstract: The practice of open defecation can be devastating for human health as well as the environment, and this practice persistence could be due to ingrained habits that individuals continue to engage in despite having a better alternative. Safe disposal of human excreta is essential for public health protection. This study sought to find if open defecation relates to fecal-oral infections in Burat and Ngaremara Wards in Isiolo County. This was achieved through conducting a cross-sectional study. Simple random sampling technique was used to select 385 households that were used in the study. Data collection was done by use of questionnaires and observation checklists. The result show that 66% of the respondents disposed-off fecal matter in a safe manner, whereas 34% disposed-off fecal matter in unsafe manner through open defecation. The prevalence proportions per 1000 of diarrhea and intestinal worms among children under-5 years of age were 142 and 21, respectively. The prevalence proportions per 1000 of diarrhea and typhoid among children over-5 years of age were 20 and 20, respectively.
Abstract: As a term for characterizing a process of devising a service system, the term ‘service engineering’ is still regarded as an ‘open’ research challenge due to unspecified details and conflicting perspectives. This paper presents consolidated service engineering ontologies in collecting, specifying and defining relationship between components pertinent within the context of service engineering. The ontologies are built by way of literature surveys from the collected conceptual works by collating various concepts into an integrated ontology. Two ontologies are produced: general service ontology and software service ontology. The software-service ontology is drawn from the informatics domain, while the generalized ontology of a service system is built from both a business management and the information system perspective. The produced ontologies are verified by exercising conceptual operationalizations of the ontologies in adopting several service orientation features and service system patterns. The proposed ontologies are demonstrated to be sufficient to serve as a basis for a service engineering framework.
Abstract: Usability testing (UT) is one of the vital steps in the User-centred design (UCD) process when designing a product. In an e-commerce ecosystem, UT becomes primary as new products, features, and services are launched very frequently. And, there are losses attached to the company if an unusable and inefficient product is put out to market and is rejected by customers. This paper tries to answer why UT is important in the product life-cycle of an E-commerce ecosystem. Secondary user research was conducted to find out work patterns, development methods, type of stakeholders, and technology constraints, etc. of a typical E-commerce company. Qualitative user interviews were conducted with product managers and designers to find out the structure, project planning, product management method and role of the design team in a mid-level company. The paper tries to address the usual apprehensions of the company to inculcate UT within the team. As well, it stresses upon factors like monetary resources, lack of usability expert, narrow timelines, and lack of understanding of higher management as some primary reasons. Outsourcing UT to vendors is also very prevalent with mid-level e-commerce companies, but it has its own severe repercussions like very little team involvement, huge cost, misinterpretation of the findings, elongated timelines, and lack of empathy towards the customer, etc. The shortfalls of the unavailability of a UT process in place within the team and conducting UT through vendors are bad user experiences for customers while interacting with the product, badly designed products which are neither useful and nor utilitarian. As a result, companies see dipping conversions rates in apps and websites, huge bounce rates and increased uninstall rates. Thus, there was a need for a more lean UT system in place which could solve all these issues for the company. This paper highlights on optimizing the UT process with a collaborative method. The degree of optimization and structure of collaborative method is the highlight of this paper. Collaborative method of UT is one in which the centralised design team of the company takes for conducting and analysing the UT. The UT is usually a formative kind where designers take findings into account and uses in the ideation process. The success of collaborative method of UT is due to its ability to sync with the product management method employed by the company or team. The collaborative methods focus on engaging various teams (design, marketing, product, administration, IT, etc.) each with its own defined roles and responsibility in conducting a smooth UT with users In-house. The paper finally highlights the positive results of collaborative UT method after conducting more than 100 In-lab interviews with users across the different lines of businesses. Some of which are the improvement of interaction between stakeholders and the design team, empathy towards users, improved design iteration, better sanity check of design solutions, optimization of time and money, effective and efficient design solution. The future scope of collaborative UT is to make this method leaner, by reducing the number of days to complete the entire project starting from planning between teams to publishing the UT report.
Abstract: Electromagnetic Interference (EMI) shielded doors made from brass extruded channels need to be welded with shielded enclosures to attain optimum shielding performance. Control of welding induced distortion is a problem in welding dissimilar metals like steel and brass. In this research, soldering of the steel-brass joint has been proposed to avoid weld distortion. The material used for brass channel is UNS C36000. The thickness of brass is defined by the manufacturing process, i.e. extrusion. The thickness of shielded enclosure material (ASTM A36) can be varied to produce joint between the dissimilar metals. Steel sections of different gauges are soldered using (91% tin, 9% zinc) solder to the brass, and strength of joint is measured by standard test procedures. It is observed that thin steel sheets produce a stronger bond with brass. The steel sections further require to be welded with shielded enclosure steel sheets through TIG welding process. Stresses and deformation in the vicinity of soldered portion is calculated through FE simulation. Crack formation in soldered area is also studied through experimental work. It has been found that in thin sheets deformation produced due to applied force is localized and has no effect on soldered joint area whereas in thick sheets profound cracks have been observed in soldered joint. The shielding effectiveness of EMI shielded door is compromised due to these cracks. The shielding effectiveness of the specimens is tested and results are compared.
Abstract: Obesity and overweight is one of the most common metabolic disorders in industrialized countries and in developing countries. One consequence of pathological obesity is cardiovascular disease and metabolic syndrome. Chemerin is an adipocyne that plays a role in the regulation of the adipocyte function and the metabolism of glucose in the liver and musculoskeletal system. Most likely, chemerin is involved in obesity-related disorders such as type 2 diabetes and cardiovascular disease. Aerobic exercises reduce the level of chemerin and cause macrophage penetration into fat cells and inflammatory factors. Several efforts have been made to clarify the cellular and molecular mechanisms of hypertrophy and muscular atrophy. Myostatin, a new member of the TGF-β family, is a transforming growth factor β that its expression negatively regulates the growth of the skeletal muscle; and the increase of this hormone has been observed in conditions of muscular atrophy. While in response to muscle overload, its levels decrease after the atrophy period, TGF-β is the most important cytokine in the development of skeletal muscle. Myostatin plays an important role in muscle control, and animal and human studies show a negative role of myostatin in the growth of skeletal muscle. Separation of myostatin from Golgi begins on the ninth day of the onset period and continues until birth at all times of muscle growth. Higher levels of myostatin are found in obese people. Resistance training for 10 weeks could reduce levels of plasma myostatin.
Abstract: This paper studies in details about the need of quadcopter in various fields especially in the place of remote area where the road transportation facility is very less. It is used to monitor and collect data in a specific region. The movement of this quadcopter is controlled by the Raspberry Pi. FPV camera is used for capturing the image and will transmit the image to the receiver which can be monitored using an android smart phone. This is mainly used for surveillance purpose and hidden activities can be captured.
Abstract: Feature selection and attribute reduction are crucial
problems, and widely used techniques in the field of machine
learning, data mining and pattern recognition to overcome the
well-known phenomenon of the Curse of Dimensionality. This paper
presents a feature selection method that efficiently carries out attribute
reduction, thereby selecting the most informative features of a dataset.
It consists of two components: 1) a measure for feature subset
evaluation, and 2) a search strategy. For the evaluation measure,
we have employed the fuzzy-rough dependency degree (FRFDD)
of the lower approximation-based fuzzy-rough feature selection
(L-FRFS) due to its effectiveness in feature selection. As for the
search strategy, a modified version of a binary shuffled frog leaping
algorithm is proposed (B-SFLA). The proposed feature selection
method is obtained by hybridizing the B-SFLA with the FRDD. Nine
classifiers have been employed to compare the proposed approach
with several existing methods over twenty two datasets, including
nine high dimensional and large ones, from the UCI repository.
The experimental results demonstrate that the B-SFLA approach
significantly outperforms other metaheuristic methods in terms of the
number of selected features and the classification accuracy.
Abstract: Focus on reducing energy consumption in existing
buildings at large scale, e.g. in cities or countries, has been
increasing in recent years. In order to reduce energy consumption
in existing buildings, political incentive schemes are put in place and
large scale investments are made by utility companies. Prioritising
these investments requires a comprehensive overview of the energy
consumption in the existing building stock, as well as potential
energy-savings. However, a building stock comprises thousands
of buildings with different characteristics making it difficult to
model energy consumption accurately. Moreover, the complexity of
the building stock makes it difficult to convey model results to
policymakers and other stakeholders. In order to manage the complexity of the building stock, building
archetypes are often employed in building stock energy models
(BSEMs). Building archetypes are formed by segmenting the building
stock according to specific characteristics. Segmenting the building
stock according to building type and building age is common, among
other things because this information is often easily available. This
segmentation makes it easy to convey results to non-experts. However, using a single archetypical building to represent all
buildings in a segment of the building stock is associated with
loss of detail. Thermal characteristics are aggregated while other
characteristics, which could affect the energy efficiency of a building,
are disregarded. Thus, using a simplified representation of the
building stock could come at the expense of the accuracy of the
model. The present study evaluates the accuracy of a conventional
archetype-based BSEM that segments the building stock according
to building type- and age. The accuracy is evaluated in terms of the
archetypes’ ability to accurately emulate the average energy demands
of the corresponding buildings they were meant to represent. This is
done for the buildings’ energy demands as a whole as well as for
relevant sub-demands. Both are evaluated in relation to the type- and
the age of the building. This should provide researchers, who use
archetypes in BSEMs, with an indication of the expected accuracy
of the conventional archetype model, as well as the accuracy lost in
specific parts of the calculation, due to use of the archetype method.