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: The Roma people are a nomadic ethnic group native to India, and they are one of the most prevalent minorities in Europe. In the past, Roma were enslaved and they were imprisoned in concentration camps during the Holocaust; today, Roma are subject to hate crimes and are denied access to healthcare, education, and proper housing. The aim of this project is to analyze how the public perception of the Roma people may be influenced by antiziganist and pro-Roma institutions in Europe. In order to carry out this project, we used social network analysis to build two large social networks: The antiziganist network, which is composed of institutions that oppress and racialize Roma, and the pro-Roma network, which is composed of institutions that advocate for and protect Roma rights. Measures of centrality, density, and modularity were obtained to determine which of the two social networks is exerting the greatest influence on the public’s perception of Roma in European societies. Furthermore, data on hate crimes on Roma were gathered from the Organization for Security and Cooperation in Europe (OSCE). We analyzed the trends in hate crimes on Roma for several European countries for 2009-2015 in order to see whether or not there have been changes in the public’s perception of Roma, thus helping us evaluate which of the two social networks has been more influential. Overall, the results suggest that there is a greater and faster exchange of information in the pro-Roma network. However, when taking the hate crimes into account, the impact of the pro-Roma institutions is ambiguous, due to differing patterns among European countries, suggesting that the impact of the pro-Roma network is inconsistent. Despite antiziganist institutions having a slower flow of information, the hate crime patterns also suggest that the antiziganist network has a higher impact on certain countries, which may be due to institutions outside the political sphere boosting the spread of antiziganist ideas and information to the European public.
Abstract: The Internet of Everything (IoE) presents today a very attractive and motivating field of research. It is basically based on Wireless Sensor Networks (WSNs) in which the routing task is the major analysis topic. In fact, it directly affects the effectiveness and the lifetime of the network. This paper, developed from recent works and based on extensive researches, proposes a taxonomy of routing protocols in WSNs. Our main contribution is that we propose a classification model based on nine classes namely application type, delivery mode, initiator of communication, network architecture, path establishment (route discovery), network topology (structure), protocol operation, next hop selection and latency-awareness and energy-efficient routing protocols. In order to provide a total classification pattern to serve as reference for network designers, each class is subdivided into possible subclasses, presented, and discussed using different parameters such as purposes and characteristics.
Abstract: The issue of inclusion - segregation in the current Czech educational system is highly actual due to changes in legislation. It applies primarily to pupils with special educational needs, but it should also apply to pupils with giftedness. The paper presents chosen results of an exploratory survey that was carried out on a convenience sample of 1101 Czech teachers working in lower secondary education (ISCED2). The rate of teachers´ agreement with segregation of gifted pupils in the education system was monitored during this investigation. A validated questionnaire of our own design was used for the purpose of this investigation. The results were compared across groups of teachers in terms of selected variables. Results show that 36,3 % of teachers incline to segregation (rather than inclusion) of gifted pupils. Teachers who are not educated in this field and have no experience in teaching gifted pupils tend to support their segregation more in comparison with other teachers. Teachers of specialized schools for gifted pupils paradoxically agree with segregation to a slightly lesser extent than teachers from traditional schools, but they also manifest the most hesitant attitude in this issue. Preferences for segregation of gifted pupils are not related to attitudes toward gifted pupils or teachers' self-evaluation in terms of care for the gifted. Investigation indicates that the issue of education of gifted children and their inclusion in the educational system needs more space within the further education of teachers.
Abstract: Access to the mass transit system, including rapid elevated and underground transport has become an outstanding issue for many cities. The mass transit access development should focus on behavioral responses of the different passenger groups. Moreover, it should consider about the appearance of intent-oriented action related accessibility that was explored from user’s satisfaction and attitudes related to services quality. This study aims to evaluate mass transit accessibility from passenger’s satisfaction, therefore, understanding the passenger’s attitudes about mass transit accessibility. The study area of this research is Bangkok Mass Transit system (BTS Skytrain) at Saphan Taksin station. 200 passengers at Saphan Taksin station were asked to rate the questionnaires survey that considers accessibility aspects of convenience, safety, feeder connectivity, and other dimensions. The survey was to find out the passenger attitudes and satisfaction for access to the BTS station, and the result shows several factors that influence the passenger choice of using the BTS as a public transportation mode and passenger’s opinion that needs to concern for the development mass transit system and accessibility performance.
Abstract: A numerical study of a design concept for actively controlling wing twist is described in this paper. The concept consists of morphing elements which were designed to provide a rigid and seamless skin while maintaining structural rigidity. The wing structure is first modeled in CATIA V5 then imported into ANSYS for structural analysis. Athena Vortex Lattice method (AVL) is used to estimate aerodynamic response as well as aerodynamic loads of morphing wings, afterwards a structural optimization performed via ANSYS Static. Overall, the results presented in this paper show that the concept provides efficient wing twist while preserving an aerodynamically smooth and compliant surface. Sufficient structural rigidity in bending is also obtained. This concept is suggested as a possible alternative for morphing skin applications.
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: The use of recycled concrete aggregates (RCAs) in hot-mix asphalt (HMA) production could ease natural aggregate shortage and maintain sustainability in modern societies. However, it was the attached cement mortar and other impurities that make the RCAs behave differently than high-quality aggregates. Therefore, different upgrading treatments were suggested to enhance its properties before being used in HMA production. Disappointedly, some of these treatments had caused degradation to some RCA properties. In order to avoid degradation, a coating technique is developed. This technique is based on combining of two main treatments, so it is named as double coating technique (DCT). Dosages of 0%, 20%, 40% and 60% uncoated RCA, RCA coated with Cement Slag Paste (CSP), and Double Coated Recycled Concrete Aggregates (DCRCAs) in place of granite aggregates were evaluated. The results indicated that the DCT improves strength and reduces water absorption of the DCRCAs compared with uncoated RCAs and RCA coated with CSP. In addition, the DCRCA asphalt mixtures exhibit stability values higher than those obtained for mixes made with granite aggregates, uncoated RCAs and RCAs coated with CSP. Also, the DCRCA asphalt mixtures require less bitumen to achieve the optimum bitumen content (OBC) than those manufactured with uncoated RCA and RCA-coated with CSP. Although the results obtained were encouraging, more testing is required in order to examine the effect of the DCT on performance properties of DCRCA- asphalt mixtures such as rutting and fatigue.
Abstract: Income smoothing represents an attempt on the part of the company's management to reduce variations in earnings through the manipulation of the accounting principles. In this study, we aimed to measure income smoothing practices in a sample of 30 French joint stock companies during the period (2007-2009), we used Dummy variables method and “ECKEL” model to measure income smoothing practices and Binomial test accourding to SPSS program, to confirm or refute our hypothesis. This study concluded that there are no significant statistical indicators of income smoothing practices in the sample studied of French companies during the period (2007-2009), so the income series in the same sample studied of is characterized by stability and non-volatility without any intervention of management through accounting manipulation. However, this type of accounting manipulation should be taken into account and efforts should be made by control bodies to apply Eckel model and generalize its use at the global level.
Abstract: Diagnosis error problem is frequent and one of the most important safety problems today. One of the main objectives of our work is to propose an ontological representation that takes into account the diagnostic criteria in order to improve the diagnostic. We choose pneumonia disease since it is one of the frequent diseases affected by diagnosis errors and have harmful effects on patients. To achieve our aim, we use a semi-automated method to integrate diverse knowledge sources that include publically available pneumonia disease guidelines from international repositories, biomedical ontologies and electronic health records. We follow the principles of the Open Biomedical Ontologies (OBO) Foundry. The resulting ontology covers symptoms and signs, all the types of pneumonia, antecedents, pathogens, and diagnostic testing. The first evaluation results show that most of the terms are covered by the ontology. This work is still in progress and represents a first and major step toward a development of a diagnosis decision support system for pneumonia.
Abstract: To transform a space into a better livable and sustainable zone, United Nations Summit in New York 2015, has decided upon 17 sustainable development goals (SDGs) that approach directly to achieve inclusive, people-centric, sustainable developments. Though sustainability has been majorly constructed by four pillars, namely, Ecological, Economic, Social and Cultural, but it is essentially reduced to economic and ecological consideration in the context of developing countries. Therefore, in most cases planning has reduced its ambit to concentrate around the tangible infrastructure, ignoring the fundamentals of socio-cultural heritage. With the accentuating hype of infrastructural augmentation, lack of emphasis of traditional concerns like ethnicity and social connection have further diluted the situation, disintegrating cultural continuity. As cultural continuity lacks its cohesion, it’s growing absence increasingly acts as a catalyst to degrade the heritage structures, spaces around and linking these structures, and the ability of stakeholders in identifying themselves rooted in that particular space. Hence, this paper will argue that sustainability depends on the people and their interaction with their surroundings, their culture and livelihood. The interaction between people and their surroundings strengthen community building and social interaction that abides by stakeholders reverting back to their roots. To assess the socio-cultural sustainability of the city of Kolkata, two study areas are selected, namely, an old settlement from the northern part of the city of Kolkata (KMA), imbued with social connection, age-old cultural and ethnic bonding and, another cluster of new high-rises coming up in the Newtown area having portions of planned city extension on the eastern side of the city itself. Whereas, Newtown prioritizes the surging post-industrial trends of economic aspiration and ecological aspects of urban sustainability; the former settlements of northern Kolkata still continue to represent the earliest community settlement of the British-colonial-cum native era and even the pre-colonial era, permeated with socio-cultural reciprocation. Thus, to compare and assess the inlayed organizational structure of both the spaces in the two cases, selected areas have been surveyed to portray their current imageability. The argument of this paper is structured in 5parts. First, an introduction of the idea has been forwarded, Secondly, a literature review has been conducted to ground the proposed ideas, Thirdly, methodology has been discussed and appropriate case study areas have been selected, Fourthly, surveys and analyses has been forwarded and lastly, the paper has arrived at a set of conclusions by suggesting a threefold development to create happy, healthy and sustainable community.
Abstract: In this paper, we propose an optimized brain computer
interface (BCI) system for unspoken speech recognition, based on
the fact that the constructions of unspoken words rely strongly on the
Wernicke area, situated in the temporal lobe. Our BCI system has four
modules: (i) the EEG Acquisition module based on a non-invasive
headset with 14 electrodes; (ii) the Preprocessing module to remove
noise and artifacts, using the Common Average Reference method;
(iii) the Features Extraction module, using Wavelet Packet Transform
(WPT); (iv) the Classification module based on a one-hidden layer
artificial neural network. The present study consists of comparing
the recognition accuracy of 5 Arabic words, when using all the
headset electrodes or only the 4 electrodes situated near the Wernicke
area, as well as the selection effect of the subbands produced by
the WPT module. After applying the articial neural network on the
produced database, we obtain, on the test dataset, an accuracy of
83.4% with all the electrodes and all the subbands of 8 levels of the
WPT decomposition. However, by using only the 4 electrodes near
Wernicke Area and the 6 middle subbands of the WPT, we obtain
a high reduction of the dataset size, equal to approximately 19% of
the total dataset, with 67.5% of accuracy rate. This reduction appears
particularly important to improve the design of a low cost and simple
to use BCI, trained for several words.
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: The impact of common buildings on climate and environment has prompted people to get involved in the green building standards aimed at implementing rating tools or certifications. Thus, green building rating systems were introduced to the construction industry, and the demand for certified green buildings has increased gradually and succeeded considerably in enhancing people’s environmental awareness. However, the existing certification process has been unsatisfactory in attracting stakeholders and/or professionals who are actively engaged in adopting a rating system. It is because they have faced recurring barriers regarding limited information in understanding the rating process, time-consuming procedures and higher costs, which have a direct influence on pursuing green building rating systems. To promote the achievement of green building certifications within the building industry more successfully, this paper aims at designing a Pre-Assessment Tool (PAT) framework that can help stakeholders and/or professionals engaged in the construction industry to clarify their basic knowledge, timeframe and extra costs needed to activate a green building certification. First, taking the first steps towards the rating tool seems to be complicated because of upfront commitment to understanding the overall rating procedure is required. This conceptual PAT framework can increase basic knowledge of the rating tool and the certification process, mainly in terms of all resources or information of each credit requirements. Second, the assessment process of rating tools is generally known as a “lengthy and time-consuming system”, contributing to unenthusiastic reactions concerning green building projects. The proposed framework can predict the timeframe needed to identify how long it will take for a green project to process each credit requirement and the documentation required from the beginning of the certification process to final approval. Finally, most people often have the initial perception that pursuing green building certification costs more than constructing a non-green building, which makes it more difficult to execute rating tools. To overcome this issue, this PAT will help users to estimate the extra expenses such as certification fees and third-party contributions based on the track of the amount of time it takes to implement the rating tool throughout all the related stages. Also, it can prevent unexpected or hidden costs occurring in the process of assessment. Therefore, this proposed PAT framework can be recommended as an effective method to support the decision-making of inexperienced users and play an important role in promoting green building certification.
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: In this research, TRACE code with the interface code-SNAP was used to simulate and analyze the SBO (station blackout) accident which occurred in Maanshan PWR (pressurized water reactor) nuclear power plant (NPP). There are four main steps in this research. First, the SBO accident data of Maanshan NPP were collected. Second, the TRACE/SNAP model of Maanshan NPP was established by using these data. Third, this TRACE/SNAP model was used to perform the simulation and analysis of SBO accident. Finally, the simulation and analysis of SBO with mitigation equipments was performed. The analysis results of TRACE are consistent with the data of Maanshan NPP. The mitigation equipments of Maanshan can maintain the safety of Maanshan in the SBO according to the TRACE predictions.
Abstract: Microstrip patch antennas are widely used in many wireless communication applications because of their various advantages such as light weight, compact size, inexpensive, ease of fabrication and high reliability. However, narrow bandwidth and low gain are the major drawbacks of microstrip antennas. The radiation properties of microstrip antenna is affected by many designing factors like feeding techniques, manufacturing substrate, patch and ground structure. This manuscript presents a review of the most popular gain and bandwidth enhancement methods of microstrip antenna and reports a brief description of its feeding techniques.
Abstract: The aim of this study is to investigate the fundamental
science/technology related to novel S-glass fiber reinforced polyether-
ketone-ketone (GF/PEKK) composites and to gain insight into
bonding strength and failure mechanisms. Different manufacturing
techniques to make this high-temperature pre-impregnated composite
(prepreg) were conducted i.e. mechanical deposition, electrostatic
powder deposition, and dry powder prepregging techniques.
Generally, the results of this investigation showed that it was difficult
to control the distribution of the resin powder evenly on the both sides
of the fibers within a specific percentage. Most successful approach
was by using a dry powder prepregging where the fibers were coated
evenly with an adhesive that served as a temporary binder to hold the
resin powder in place onto the glass fiber fabric.
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: The concept of financial inclusion has been tabled in the whole world where practitioners, academicians, policy makers and economists are working hard to look for the best possible opportunities in order to enable the whole society to be in the banking cycle. The Islamic banking system is considered to be one of the said opportunities. Countries like the United Kingdom, United States of America, Malaysia, Saudi Arabia, the whole of the United Arab Emirates and many African countries have accommodated the aspect of Islamic banking in the conventional banking system as one of the financial inclusion strategies. This paper tries to analyse the current state of affairs of the Islamic Banking system in Tanzania in order to understand the improvement of the provision of Islamic banking products and services in the said country. The paper discusses the historical background of the banking system in Tanzania, the level of penetration of banking products and services and the coming of the Islamic banking system in the country. Furthermore, the paper discusses banking regulatory bodies, legal instruments governing banking operations as well as number of legal challenges facing Islamic banking operations in the country. Following a critical literature review, the paper discovered that there is no legal instrument which talks about the introduction and provision of Islamic banking system in Tanzania. Furthermore, the Islamic banking system was considered as a banking product which is absolutely incorrect because Islamic banking is considered to be as a banking system of its own. In addition to that, it has been discovered that lack of a proper regulatory system and legal instruments to harmonize the conventional and Islamic banking systems has resulted in the closure of one Islamic window in the country, which in the end affects the credibility of the newly introduced banking system. In its conclusive remarks, the paper suggests that Tanzania should work on all legal challenges affecting the smooth operations of the Islamic banking system. This can be in a way of adopting various Islamic banking legal models which are used in countries like Malaysia and others, or a borrowing legal harmonization process which has been adopted by the UK, Uganda, Nigeria and Kenya.