bluuebunny/crossref_metadata_2025 huggingface dataset:
Incorporation of Preferences in an Evolutionary Algorithm Using an Outranking Relation
Authors: Oliveira Eunice , Antunes Carlos Henggeler , Gomes Álvaro
Published: August 2013

The incorporation of preferences into Evolutionary Algorithms (EA) presents some relevant advantages, namely to deal with complex real-world problems. It enables focus on the search thus avoiding the computation of irrelevant solutions from the point of view of the practical exploitation of results (thus minimizing the computational effort), and it facilitates the integration of the DM’s expertise into the solution search process (thus minimizing the cognitive effort). These issues are particularly important whenever the number of conflicting objective functions and/or the number of non-dominated solutions in the population is large. In EvABOR (Evolutionary Algorithm Based on an Outranking Relation) approaches preferences are elicited from a decision maker (DM) with the aim of guiding the evolutionary process to the regions of the space more in accordance with the DM’s preferences. The preferences are captured and made operational by using the technical parameters of the ELECTRE TRI method. This approach is presented and analyzed using some illustrative results of a case study of electrical networks.
Simulating Spiking Neural P Systems Without Delays Using GPUs
Authors: Cabarle F. , Adorna H. , Martínez-del-Amor M. A.
Published: August 2013

In this paper, the authors discuss the simulation of a P system variant known as Spiking Neural P systems (SNP systems), using Graphics Processing Units (GPUs). GPUs are well suited for highly parallel computations because of their intentional and massively parallel architecture. General purpose GPU computing has seen the use of GPUs for computationally intensive applications, not just in graphics and video processing. P systems, including SNP systems, are maximally parallel computing models taking inspiration from the functioning and dynamics of a living cell. In particular, SNP systems take inspiration from a type of cell known as a neuron. The nature of SNP systems allowed for their representation as matrices, which is an elegant step toward their simulation on GPUs. In this paper, the simulation algorithms, design considerations, and implementation are presented. Finally, simulation results, observations, and analyses using a simple but non-trivial SNP system as an example are discussed, including recommendations for future work.
MP Modelling of Glucose-Insulin Interactions in the Intravenous Glucose Tolerance Test
Authors: Manca Vincenzo , Marchetti Luca , Pagliarini Roberto
Published: August 2013

The Intravenous Glucose Tolerance Test is an experimental procedure used to study the glucose-insulin endocrine regulatory system. An open problem is to construct a model representing simultaneously the entire regulative mechanism. In the past three decades, several models have appeared, but they have not escaped criticisms and drawbacks. In this paper, the authors apply the Metabolic P systems theory for developing new physiologically based models of the glucose-insulin system, which can be applied to the IVGTT. Ten data-sets obtained from literature were considered and an MP model was found for each, which fits the data and explains the regulations of the dynamics. Finally, each model is analysed to define a common pattern which explains, in general, the action of the glucose-insulin control system.
Implementation on CUDA of the Smoothing Problem with Tissue-Like P Systems
Authors: Peña-Cantillana Francisco , Díaz-Pernil Daniel , Christinal Hepzibah A. , Gutiérrez-Naranjo Miguel A.
Published: August 2013

Smoothing is often used in Digital Imagery for improving the quality of an image by reducing its level of noise. This paper presents a parallel implementation of an algorithm for smoothing 2D images in the framework of Membrane Computing. The chosen formal framework has been tissue-like P systems. The algorithm has been implemented by using a novel device architecture called CUDA (Compute Unified Device Architecture) which allows the parallel NVIDIA Graphics Processors Units (GPUs) to solve many complex computational problems. Some examples are presented and compared; research lines for the future are also discussed.
Elementary Active Membranes Have the Power of Counting
Authors: Porreca Antonio E. , Leporati Alberto , Mauri Giancarlo , Zandron Claudio
Published: August 2013

P systems with active membranes have the ability of solving computationally hard problems. In this paper, the authors prove that uniform families of P systems with active membranes operating in polynomial time can solve the whole class of PP decision problems, without using nonelementary membrane division or dissolution rules. This result also holds for families having a stricter uniformity condition than the usual one.
Linear Time Solution to Prime Factorization by Tissue P Systems with Cell Division
Authors: Zhang Xingyi , Niu Yunyun , Pan Linqiang , Pérez-Jiménez Mario J.
Published: August 2013

Prime factorization is useful and crucial for public-key cryptography, and its application in public-key cryptography is possible only because prime factorization has been presumed to be difficult. A polynomial-time algorithm for prime factorization on a quantum computer was given by P. W. Shor in 1997. In this work, it is considered as a function problem, and in the framework of tissue P systems with cell division, a linear-time solution to prime factorization problem is given on biochemical computational devices – tissue P systems with cell division, instead of computational devices based on the laws of quantum physical.
Unorganized Machines
Authors: Boccato Levy , Soares Everton S. , Fernandes Marcos M. L. P. , Soriano Diogo C. , Attux Romis
Published: August 2013

This work presents a discussion about the relationship between the contributions of Alan Turing – the centenary of whose birth is celebrated in 2012 – to the field of artificial neural networks and modern unorganized machines: reservoir computing (RC) approaches and extreme learning machines (ELMs). Firstly, the authors review Turing’s connectionist proposals and also expose the fundamentals of the main RC paradigms – echo state networks and liquid state machines, - as well as of the design and training of ELMs. Throughout this exposition, the main points of contact between Turing’s ideas and these modern perspectives are outlined, being, then, duly summarized in the second and final part of the work. This paper is useful in offering a distinct appreciation of Turing’s pioneering contributions to the field of neural networks and also in indicating some perspectives for the future development of the field that may arise from the synergy between these views.
Ecosystems Computing
Authors: Pasti Rodrigo , Von Zuben Fernando José , Nunes de Castro Leandro
Published: August 2013

The main issue to be presented in this paper is based on the premise that Nature computes, that is, processes information. This is the fundamental of Natural Computing. Biogeographic Computation will be presented as a Natural Computing approach aimed at investigating ecosystems computing. The first step towards formalizing Biogeographic Computation will be given by defining a metamodel, a framework capable of generating models that compute through the elements of an ecosystem. It will also be discussed how this computing can be realized in current computers.
Knowledge Manageability
Authors: Simard Albert J. , Jourdeuil Philippe
Published: August 2013

Although the knowledge society is evolving rapidly, uptake of knowledge management principles and practice in the public sector have lagged well behind that in the private sector. To help overcome this difficulty, the knowledge management mantra that industrial-era cultures must change in order for KM to succeed is reformulated into a new paradigm: Within an existing culture, how can knowledge management increase the value of organizational knowledge and the productivity of knowledge work? The paradigm uses the Cynefin sense-making framework as a foundation for knowledge manageability. Four knowledge manageability regimes are described: authoritative hierarchy (use of explicit knowledge is authorized through organizational decisions), organizational structure (explicit knowledge is codified and interpreted in the context of organizational processes), negotiated agreements (tacit knowledge is exchanged among individuals and within communities to validate new knowledge), and responsible autonomy (innate knowledge is voluntarily used by individuals to create new knowledge). Most organizations use all four regimes, each of which requires a different approach to management. The chapter also describes methods for transferring knowledge across the regions, from creation to application. The knowledge manageability framework encompasses a spectrum from dynamic, unstructured organizational environments to relatively inflexible, highly structured environments. It provides a robust, multi-dimensional framework for managing knowledge and knowledge work across diverse organizational contexts. By avoiding the need to change inherently structured culture and work processes, it greatly reduces the challenges associated with implementing knowledge management in public-sector organizations.
Best Value and Performance Management Inspired Change within UK Councils
Authors: Moffett Sandra , Walker Tim , McAdam Rodney
Published: August 2013

This chapter focuses on an exploratory study from an operational perspective, investigating the role of Knowledge Management (KM) in the UK Public Sector, the case setting being within the council’s waste services. Key literary findings outline that while Government seeks to improve council service delivery, significant legacies remain from earlier change programmes that appeared to be restricting the Local Government Modernisation Agenda (LGMA). Given the exploratory nature of the study, a theory building approach is adopted based on results from the exploratory study. The findings show that although knowledge and information flows could inform performance management frameworks to trigger change, a lack of suitable networks or a culture of knowledge sharing, combined with tight implementation timescales and a shifting agenda, meant that councils did not respond as anticipated due to systemic weaknesses. As with many organisations, KM implementation did not reach full potential. However, there are a number of lessons learned and key findings that can act as a learning process for further knowledge management applications within public sector contexts.
Assessing Knowledge Management Systems Usage in Supporting Decision Making Processes in Organizations
Authors: Abdelrahman Mahmoud , Papamichail K. Nadia , French Simon
Published: August 2013

With the advent of the knowledge economy and the growing importance of knowledge societies, organizations are constantly seeking new ways of leveraging knowledge assets to support Decision Making (DM) processes. This chapter presents an initial insight to the little-researched phenomenon of how Knowledge Management Systems (KMSs) can support DM processes in organizations. A synthesis of ideas from a literature review suggests a new conceptual framework with several critical factors that organizations should take into account to assess the usage of KMSs tools in supporting DM processes in organizations. The proposed framework, “USUQ,” will benefit managers in both public and private sectors in knowing how the Usage, Satisfaction, Usefulness, and the Quality of using KMSs can support DM processes.
Decision-Making Processes Based on Knowledge Gained from Spatial Data
Authors: Malinowski Elzbieta
Published: August 2013

The increasing popularity of spatial data opens up the possibility to include it in decision-making processes in order to help discover existing interrelationships between facts that might otherwise be difficult to describe or explain. To achieve this goal, Spatial Data Infrastructures (SDIs) are seen as a platform to provide and share spatial and conventional data, especially among public institutions. However, SDI initiatives face many problems due to the lack of standards for data publications, the heterogeneity of participants that build and use the system, and participants’ different backgrounds, level of preparation, and perception about the objective that SDIs should fulfill. Furthermore, to obtain better benefits from using spatial data, non-expert users in geo-concepts (i.e., users unfamiliar with complex concepts related to spatial data manipulation) should count on a variety of tools that hide spatial data complexity and facilitate knowledge generation with the goal of shifting from traditional spatial data sharing to an intelligent level. In this chapter, the authors refer to different issues related to knowledge generation from spatial data in order to support decision-making processes with an emphasis on public institutions. They look for the answers to several aspects: what tools are available for non-expert users to handle spatial data, who will provide spatial and related conventional data to stakeholders interested in analyzing them, and how to ensure data quality.
Towards a Competitive Knowledge Management Strategy Approach in the University Setting
Authors: Zanin Filippo , Massaro Maurizio , Bagnoli Carlo
Published: August 2013

The formulation of a competitive strategy requires an appropriate incorporation of knowledge contents for fostering the development of the competitive advantage. Visual artifacts, in the form of strategy maps, are generally considered useful for making the intertwining between different knowledge bases within the strategy making explicit. However, literature has not systematically analyzed the methods and tools for explaining how strategy making is enabled and constrained. Moreover, the public sector is a research field in which there is a call for a deeper understanding of strategic issues. In order to fill this gap, this chapter explores how strategy maps shape the strategy processes mobilizing knowledge across boundaries. Using the case study of Ca’Foscari University of Venice, a public body in the Italian University setting, the authors find that strategy maps function as boundary objects and can make strategizing a joint managerial practice.
Knowledge Management in Public Construction Project Initiation
Authors: Naaranoja Marja , Uden Lorna
Published: August 2013

Despite the importance of knowledge integration in construction project management, it rarely happens in reality. This chapter describes two case studies involving knowledge management of a public construction project for two universities in Finland. There were many different stakeholders involved in the projects. Although much effort has been put into the project during the initial stages, the projects’ starts were delayed. This chapter gives underlying reasons for the delays followed by proposing an approach where co-creation of value for knowledge integration can be used to overcome the problems with the conflicting interests of the stakeholders. The other project introduces a small project where the initiator is a facility owner. This study shows how the selection of the stakeholders for decision-making was a challenge.
Chinese Pedagogy or Western Andragogy?
Authors: Wang Victor X. , Dennett Susan K. , Bryan Valerie C.
Published: August 2013

This chapter reports the results of a study designed to compare Chinese adult education methods with Western (i.e., United States) educational methods using the conceptual framework of the principles of andragogy. Adult educators from two universities in China and one university in the United States responded to an online survey comprised of closed- and open-ended questions about their teaching practices. Study results indicated that while the U.S. educators were consistently andragogical in their approach, Chinese adult educators were less so. Although a few andragogical elements were reported by the Chinese educators, their approach appeared more pedagogical, a finding that was consistent with reports in the literature of adult education in China. Even in 1998, under the leadership of the former administration, the Chinese people were promised the growth of China’s education system. Today, China provides resources to support education so that China is more competitive in the global market today. China’s blueprint for the future is evidence of the commitment to education China emphasizes. China has created its own Ivy League schools to support the next generation workforce that are competitive with Ivy League schools in the United States. China’s Ivy League is funded by the government. It leads to the question of whether the recession of 2008 in the United States will negatively impact the services American institutions will offer and ultimately affect the number of international students enrolling in universities in the United States. It also leads to the question on whether China will surpass the United States in the quality of education it provides to its students and therefore reduce the number of Chinese students who study in the United States. The style of teaching in this new system may impact both the quality of education provided and its impact.
Observations of the Possible Influence of Andragogy on the Economies of World Nations
Authors: Henschke John A.
Published: August 2013

Andragogy has received mixed reviews in the past. Some have analyzed it from a positive perspective. Some have analyzed it from a negative perspective, and some have ignored it altogether. Very little if any effort has been devoted to researching the economic impact of andragogy, especially during this prolonged economic downturn in the USA, in addition to many other countries throughout the world. This chapter looks at the theories undergirding the author’s practice of andragogy, eras of the scope of various writings in English concerning andragogy, economic implications of his application of andragogy, and his thoughts about future research trends in andragogy.
Using Technology to Address Workforce Readiness Skills
Authors: Reio Jr. Thomas G. , Whitehead Chaundra L.
Published: August 2013

All too often, students either drop out of school or graduate with poor workplace readiness skills. The lack of preparedness is costly both on a short- and long-term basis to students, families, employers, and societies in general. In the workplace, employers are forced to be at the vanguard of addressing critical basic skill deficiencies related to reading, writing, mathematics, and using computers, among others, to remain competitive. Addressing these worker skills gaps through training and development activities can be cost prohibitive to organizations, especially in tough economic times. Understandably, business leaders are becoming more critical of an education system that produces individuals with such gaps. The purpose of this chapter is to explore the use of technology as a productive means of meeting the developmental or remedial educational needs of various underprepared workers entering the job market.
A Comparative Study on Undergraduate Computer Science Education between China and the United States
Authors: Jiang Eric P.
Published: August 2013

With the rapid growth of the Internet and telecommunication networks, computer technology has been a driving force in global economic development and in advancing many areas in science, engineering, health care, business, and finance that carry significant impacts on people and society. As a primary source for producing the workforce of software engineers, computer scientists and information technology specialists, computer science education plays a particularly important role in modern economic growth and it has been invested heavily in many countries around the world. This chapter provides a comparative study of undergraduate computer science programs between China and the United States. The study focuses on the current curricula of computer science programs. It in part is based on the author’s direct observation from his recent visits to several universities in China and the conversations he had with administrators and faculty of computer science programs at the universities. It is also based on the author’s over two decades experience as a computer science educator at several public and private American institutions of higher educations. The education systems in China and the United States have different features and each of the systems has its strengths and weaknesses. This is likely also true for education systems in other countries. It would be an interesting and important task for us to explore an innovative computer science education program, which perhaps blends the best features of different systems and helps better prepare graduates for the challenges working in an increasingly globalized world. We hope the study presented in this chapter provides some useful insights in this direction.
Reducing Competitive Risk in Indian Banks through Business Intelligence
Authors: Kumar Dinesh
Published: August 2013

Business Intelligence (BI) uses information technology software, in particular Extensible Markup Language (XML), to provide competitive information in support of competitive risk analysis for executive decision making. Research in the Indian banking industry indicated that BI data suffered from time lag, poor quality, lack of customer-specific data, and improper classification of data. Furthermore, after 1995 there was retail boom in India, which increased the number of banking clients, followed by the use of virtual banking through the Internet, thus increasing the number of transactions. The Reserve Bank of India (RBI) directed all banks to eliminate manual interventions for BI data collection and to establish a centralized BI system by December 31, 2013. This was a problem for the majority of banks who used older systems for BI. This action research study examined how banks were implementing BI while complying with the RBI directive. Several best-practice BI models were developed from interviews with the case study organization and based on analysis of project data.
A Critical Review of Information Technology Innovations
Authors: Xing Ruben , Wang John , Chen Qiyang
Published: August 2013

The authors critically review the history of information technology innovations, from a national competitive advantage perspective. Definitions of key terms are grounded in a thorough literature review, to inform a future meta-analysis. The authors identify the most significant US-based innovations, which in turn are driving future IT development. Propositions are generated for future IT-related studies.
Dermal Regulatory T Cells Display Distinct Migratory Behavior That Is Modulated during Adaptive and Innate Inflammation
Authors: Chow Zachary , Mueller Scott N. , Deane James A. , Hickey Michael J.
Published: August 2013

Regulatory T cells (Tregs) are important in controlling skin inflammation, an effect dependent on their ability to home to this organ. However, little is known regarding their behavior in the skin. In this study, we used multiphoton imaging in Foxp3-GFP mice to examine the behavior of endogenous Tregs in resting and inflamed skin. Although Tregs were readily detectable in the uninflamed dermis, most were nonmotile. Induction of contact sensitivity increased the proportion of motile Tregs, and also induced Treg recruitment. This response was significantly blunted in mice challenged with an irrelevant hapten, or by inhibition of effector cell recruitment, indicating a role for T cell–dependent inflammation in induction of Treg migration. Moreover, induction of Treg migration was inhibited by local injection of a CCR4 antagonist, indicating a role for CCR4 in this response. Exposure of naive mice to hapten also induced an increase in the proportion of migratory Tregs, demonstrating that innate signals can also induce Treg migration. Simultaneous examination of the migration of CD4+ effector cells and Tregs in the same region of uninflamed skin demonstrated that effector cells behaved differently, being uniformly highly migratory. These findings indicate that Treg behavior in skin differs from that of CD4+ effector cells, in that only a low proportion of Tregs is migratory under resting conditions. However, in response to both adaptive and innate inflammation, the proportion of migratory Tregs increases, raising the possibility that this response is important in multiple forms of skin inflammation.
Ubiquitin-Specific Protease 13 Regulates IFN Signaling by Stabilizing STAT1
Authors: Yeh Hom-Ming , Yu Chia-Yi , Yang Ho-Chun , Ko Shih-Han , Liao Ching-Len , Lin Yi-Ling
Published: August 2013

The IFN immune system comprises type I, II, and III IFNs, signals through the JAK-STAT pathway, and plays central roles in host defense against viral infection. Posttranslational modifications such as ubiquitination regulate diverse molecules in the IFN pathway. To search for the deubiquitinating enzymes (DUBs) involved in the antiviral activity of IFN, we used RNA interference screening to identify a human DUB, ubiquitin-specific protease (USP) 13, whose expression modulates the antiviral activity of IFN-α against dengue virus serotype 2 (DEN-2). The signaling events and anti–DEN-2 activities of IFN-α and IFN-γ were reduced in cells with USP13 knockdown but enhanced with USP13 overexpression. USP13 may regulate STAT1 protein because the protein level and stability of STAT1 were increased with USP13 overexpression. Furthermore, STAT1 ubiquitination was reduced in cells with USP13 overexpression and increased with USP13 knockdown regardless of with or without IFN-α treatment. Thus, USP13 positively regulates type I and type II IFN signaling by deubiquitinating and stabilizing STAT1 protein. Overall, to our knowledge, USP13 is the first DUB identified to modulate STAT1 and play a role in the antiviral activity of IFN against DEN-2 replication.
Blockade of TGF-β Signaling Greatly Enhances the Efficacy of TCR Gene Therapy of Cancer
Authors: Bendle Gavin M. , Linnemann Carsten , Bies Laura , Song Ji-Ying , Schumacher Ton N. M.
Published: August 2013

TCR gene therapy is a promising approach for the treatment of various human malignancies. However, the tumoricidal activity of TCR-modified T cells may be limited by local immunosuppressive mechanisms within the tumor environment. In particular, many malignancies induce T cell suppression in their microenvironment by TGF-β secretion. In this study, we evaluate whether blockade of TGF-β signaling in TCR-modified T cells enhances TCR gene therapy efficacy in an autochthonous mouse tumor model. Treatment of mice with advanced prostate cancer with T cells genetically engineered to express a tumor-reactive TCR and a dominant-negative TGF-β receptor II induces complete and sustained tumor regression, enhances survival, and leads to restored differentiation of prostate epithelium. These data demonstrate the potential to tailor the activity of TCR-modified T cells by additional genetic modification and provide a strong rationale for the clinical testing of TGF-β signaling blockade to enhance TCR gene therapy against advanced cancers.
Immune Tolerance Negatively Regulates B Cells in Knock-In Mice Expressing Broadly Neutralizing HIV Antibody 4E10
Authors: Doyle-Cooper Colleen , Hudson Krystalyn E. , Cooper Anthony B. , Ota Takayuki , Skog Patrick , Dawson Phillip E. , Zwick Michael B. , Schief William R. , Burton Dennis R. , Nemazee David
Published: August 2013

A major goal of HIV research is to develop vaccines reproducibly eliciting broadly neutralizing Abs (bNAbs); however, this has proved to be challenging. One suggested explanation for this difficulty is that epitopes seen by bNAbs mimic self, leading to immune tolerance. We generated knock-in mice expressing bNAb 4E10, which recognizes the membrane proximal external region of gp41. Unlike b12 knock-in mice, described in the companion article (Ota et al. 2013. J. Immunol. 191: 3179–3185), 4E10HL mice were found to undergo profound negative selection of B cells, indicating that 4E10 is, to a physiologically significant extent, autoreactive. Negative selection occurred by various mechanisms, including receptor editing, clonal deletion, and receptor downregulation. Despite significant deletion, small amounts of IgM and IgG anti-gp41 were found in the sera of 4E10HL mice. On a Rag1−/− background, 4E10HL mice had virtually no serum Ig of any kind. These results are consistent with a model in which B cells with 4E10 specificity are counterselected, raising the question of how 4E10 was generated in the patient from whom it was isolated. This represents the second example of a membrane proximal external region–directed bNAb that is apparently autoreactive in a physiological setting. The relative conservation in HIV of the 4E10 epitope might reflect the fact that it is under less intense immunological selection as a result of B cell self-tolerance. The safety and desirability of targeting this epitope by a vaccine is discussed in light of the newly described bNAb 10E8.
Disability and poverty – Reflections on research experiences in Africa and beyond
Authors: Eide Arne H. , Ingstad Benedicte
Published: August 2013

Background: Whilst broadly agreed in the literature that disability and poverty are closely interlinked, the empirical basis for this knowledge is relatively weak.Objectives: To describe and discuss the current state of knowledge and to suggest the need for further generation of knowledge on disability and poverty.Method: Two recent attempts at statistically analysing the situation for disabled people and a series of qualitative studies on disability and poverty are applied in a discussion on the state of current knowledge.Results: Firstly, the surveys confirm substantial gaps in access to services, and a systematic pattern of lower levels of living amongst individuals with disability as compared to non-disabled. Existing surveys are however not originally set up to study the disability – poverty relationship and thus have some important limitations. Secondly, the qualitative studies have shown the relevance of cultural, political and structural phenomena in relation to poverty and disability, but also the complexity and the contextual character of these forces that may sometimes provide or create opportunities either at the individual or the collective level. Whilst not establishing evidence as such, the qualitative studies contribute to illustrating some of the mechanisms that bring individuals with disability into poverty and keep them there.Conclusions: A longitudinal design including both quantitative and qualitative methods and based on the current conceptual understanding of both disability and poverty is suggested to pursue further knowledge generation on the relationship between disability and poverty.
‘Die pen is magtiger as die swaard’: Oor skrifgeletterdheid, skrifgeleerdes en Israel se Tweede Tempeltydperk
Authors: De Villiers Gerda
Published: August 2013

‘The pen is mightier than the sword’: Literacy and scribes in Israel during the Second Temple period. This article is divided in two parts. Part one examines scribal education and scribes in the ancient Near East and Israel. Although no real evidence exists for scribal schools and education in Israel, it is argued that some form of institutionalised training must have taken place in order to produce literary texts of such a high quality as are found in the Hebrew Bible. Comparative material from Mesopotamia serves to trace the education of scribes in general. Part two focuses on the Second Temple period in ancient Israel. Ezra the scribe emerges as a typical scribe from that era. Post-exilic Israel was grappling with its identity, and sought guidance from ַ [as was written in the Torah]. However, it appears that there were different interpretations of the written Law during this period. Scribes of the Ezra circle advocated a radical policy of exclusivity on the basis of what was written in the Law; others who wrote the texts of Trito-Isaiah and Ruth pleaded for a more inclusive attitude towards foreigners. The conclusion is that the battle was fought not with the sword, but with the pen, therefore: ‘The pen is mightier than the sword.’
Gender inequality, health expenditure and maternal mortality in sub-Saharan Africa: A secondary data analysis
Authors: Chirowa Frank , Atwood Stephen , Van der Putten Marc
Published: August 2013

Background: This article provided an analysis of gender inequality, health expenditure and its relationship to maternal mortality.Objective: The objective of this article was to explore gender inequality and its relationship with health expenditure and maternal mortality in sub-Saharan Africa (SSA). A unique analysis was used to correlate the Gender Inequality Index (GII), Health Expenditure and Maternal Mortality Ratio (MMR). The GII captured inequalities across three dimensions – Reproductive health, Women empowerment and Labour force participation between men and women. The GII is a composite index introduced by the UNDP in 2010 and corrects for the disadavanatges of the other gender indices. Although the GII incorporates MMR in its calculation, it should not be taken as a substitute for, but rather as complementary to, the MMR.Method: An exploratory and descriptive design to a secondary documentary review using quantitative data and qualitative information was used. The article referred to sub-Saharan Africa, but seven countries were purposively selected for an in-depth analysis based on the availability of data. The countries selected were Angola, Botswana, Malawi, Mozambique,South Africa, Zambia and Zimbabwe.Results: Countries with high gender inequality captured by the gender inequality index were associated with high maternal mortality ratios as compared with countries with lower gender inequality, whilst countries that spend less on health were associated with higher maternal deaths than countries that spend more.Conclusion: A potential relationship exists between gender inequality, health expenditure, and maternal mortality. Gender inequalities are systematic and occur at the macro, societal and household levels.
Teaching Open Distance Learning undergraduates in Theology to become effective change agents
Authors: Oliver Erna
Published: August 2013

Teaching Theology in the African context presents unique challenges. In general, living conditions in South Africa did not improve much since the first democratic elections were held in 1994. Students have to cope with extreme living conditions whilst also focusing on their distance learning activities. Reflexive research that started in 2010 showed that opportunities could be created to make a greater impact on the students� lives through innovative and interactive study material and teaching methods. The second year course �World Christianity and ecumenism� provided ample opportunity to be used in an experiment to interact with students during the course of the semester in such a way that they could be challenged to act as change agents in their congregations and communities. By helping students to practise the values and skills learned and to transfer the knowledge gained from the course, they could be motivated to see themselves not only as learners, but also as teachers and educators. This motivated students to take greater responsibility for their own learning and also help to create a more favourable learning environment for others by acting as educators and leaders in their respective communities. By advocating, planning and implementing actions to promote positive change, students could become actively involved in ecumenical activities, upliftment projects and environmental awareness programmes. The positive impact of this study could be expanded into the wider B.Th. programme at University of South Africa through the current process of re-curriculating.
Chordoma of skull base presenting as nasopharyngeal mass
Authors: Kataria Sant Prakash , Batra Ashima , Singh Gajender , Kumar Sanjay , Sen Rajeev
Published: August 2013

While the nasopharynx is most commonly regarded by the otolaryngologist as a primary site of neoplastic involvement, it is also an avenue of spread of base?of?the?skull tumors presenting as bulging nasopharyngeal masses. Chordoma is a relatively rare tumor of the skull base and sacrum thought to originate from embryonic remnants of the notochord. Chordomas arising from the skull base/clivus are typically locally aggressive with lytic bone destruction. The optimal treatment may be photon/proton radiotherapy alone or combined with a gross total resection, when feasible. We report a case of intracranial chordoma presenting as nasopharyngeal mass.
Association between anxiety and obesity: A study of a young.adult Nigerian population
Authors: Ejike Chukwunonso ECC
Published: August 2013

Background: The relationship between anxiety and obesity is still debatable and seems to vary between cultures. The subject has been scarcely investigated in Nigeria, hence this study. Materials and Methods: A total of 1584 young‑adult Nigerians (56.4% males) of mean age 21.8 ± 2.2 years were studied. Anxiety was assessed using the Beck’s Anxiety Index (BAI), while obesity was determined using the bioelectrical impedance analysis (BIA) and body mass index (BMI) methods. Standard protocols were followed for all assessments and measurements. Appropriate descriptive statistics were carried out, while regression and correlation analyses (for continuous variables) and the Chi square tests (for categorical variables) were used to assess the relationship between anxiety and obesity. Results: The degree of adiposity of the subjects (males and females alike) classified by %BF standards did not significantly (P > 0.05) affect the proportion of the population with any degree of anxiety. The proportion of population with high anxiety (for both sexes) was similar (P > 0.05) irrespective of their BMI status. All the obese (BMI‑wise only) males had low anxiety, while the proportion of thin females (in the low anxiety group) was significantly (P < 0.05) higher than that of their normal weight counterparts. There was neither a significant correlation nor a significant association (P > 0.05) between the BAI scores and the studied measures of adiposity in both male and female subjects. Conclusion: The low prevalence of both anxiety and obesity in the studied population may explain the observed lack of association between the studied variables. These findings do not support the “jolly fat” hypothesis.
Identifying elders with neuropsychiatric problems in a clinical setting
Authors: Sadanand Shilpa , Shivakumar Prafulla , Girish N , Loganathan Santosh , Bagepally Bhavani Shankara , Kota Lakshmi Narayanan , Reddy Nalini Narayana , Sivakumar Palanimuthu Thangaraju , Bharath Srikala , Varghese Mathew
Published: August 2013

Objective: Multiple health problems among the elderly necessitate a comprehensive enquiry to detect problems early and also initiate treatment. We utilized available validated instruments to comprehensively identify older persons with neuro‑psychiatric problems including dementia and comorbid medical ailments in the screening desk of the geriatric clinic. Materials and Methods: Individuals aged 60 years and above seeking outpatient care at NIMHANS during a 2‑year period (October 2008‑September 2010) participated. We used General Health Questionnaire (12-item), AD8, questions to identify psychoses and neurological problems and a checklist of common medical ailments. A probable clinical diagnosis was made at the end by medical personnel based on ICD-10. Results: A total of 5,260 individuals were screened and more than one-third (36.7%) were women. About 50% had psychological distress (≥2 on GHQ-12), 20.1% had probable cognitive impairment (≥2 on AD8) and about 17% had symptoms suggestive of psychoses (≥1 on Psychoses screener). More than 65% had either a neurological or neurosurgical problems (≥1 on Neurological screener) and headache was the commonest complaint. At probable diagnosis, more than 50% had a neurological problem and over 30% had psychiatric disorders. Of these the most common psychiatric illnesses were psychotic disorders (22.0%), mood disorders (21.4%) and dementia (14.4%). The most common medical comorbidity included hypertension (36.4%), visual impairment (31.8%) and joint pains (30.5%). Nearly 80% had one or more medical comorbidity in addition to psychiatric illness. The overall set of instruments took about 15-20 minutes. It systematically and comprehensively guided in evaluating the elderly for neuropsychiatric problems and hence was collated to constitute the Instruments for Comprehensive Evaluation of the Elderly (ICE-E). Conclusions: ICE-E was brief, easy to administer and improved decision making even by personnel from a non-medical background. The instrument aided in systematically detecting neuro-psychiatric problems among the elderly (including psychological distress and cognitive changes) and other medical comorbidities.
Giant cavernous carotid aneurysm with spontaneous ipsilateral ICA occlusion: Report of 2 cases and review of literature
Authors: Sastri Savitr BV , Sadasiva Nishanth , Pandey Paritosh
Published: August 2013

Giant aneurysms of the cavernous carotid artery are rare entities which present predominantly with features of compression of the adjacent neural structures, most commonly the III, IV, VI and V cranial nerves. Historically, treatment options included occlusion of the feeding vessel, direct surgery on the aneurysm, bypass procedures and in recent times, the use of endovascular devices. While intramural thrombus formation is commonly seen in giant aneurysms, we present 2 cases of giant cavernous aneurysms which on evaluation were found to have spontaneous occlusion of the feeding internal carotid artery secondary to thrombus formation, and review the available literature regarding the same.
Value of neuroimaging in epilepsy: An experience from Pakistan
Authors: Bakhsh Ahmed
Published: August 2013

Purpose: To detect the possible structural brain lesions in the patients suffering from various kinds of epilepsy during the routine neuroimaging. Materials and Methods: Prospective study of 366 epileptic patients conducted at epilepsy clinic, Rawalpindi-Islamabad Pakistan in an outpatient setting. MRI or CT scan of the brain without contrast was advised in all patients to detect any underlying pathology. Results: A total 21.31% scans were found to be abnormal. Many cases of familial, idiopathic epilepsy and patients without any neurological deficit were found to have structural brain lesions, which might be responsible for their seizures. Conclusion: CT/MRI scan of the brain should be advised in all patients of epilepsy regardless of cause and type of epilepsy. The presence of neurological deficit should not be the sole indication for neuroimaging.
Organizational issues in stroke treatment: The Swiss paradigm - Stroke units
Authors: Matis Georgios K , Chrysou Olga I , Birbilis Theodossios A
Published: August 2013

Stroke represents the leading cause of acquired disability in adults and poses a tremendous socioeconomic burden both on patients and the society. In this sense, prompt diagnosis and urgent treatment are needed in order to radically reduce the devastating consequences of this disease. Herein the authors present the new guidelines recently adopted by the Swiss Stroke Society concerning the establishment of stroke units. Standardized treatment and allocation protocols along with an acute rehabilitation concept seem to be the core of the Swiss stroke management system. Coordinated multidisciplinary care provided by specialized medical, nursing and therapy staff is of utmost importance for achieving a significant dependency and death reduction. It is believed that the implementation of these guidelines in the stroke care system would be beneficial not only for the stroke patients, but also for the health system.
Determinants of quality of life among people with epilepsy attending a secondary care rural hospita in south India
Authors: Ashwin M , Rakesh PS , Pricilla Ruby A , Manjunath K , Jacob KS , Prasad Jasmin
Published: August 2013

Context: Epilepsy is associated with profound physical, psychological, and social consequences. Aims : To assess the quality of life (QOL) among people with epilepsy attending the outpatient department of a secondary care hospital and to determine the various social and demographic factors affecting it. Materials and Methods: The QOL of 100 people with epilepsy attending the outpatient department of a community-based secondary care hospital was assessed using the WHOQOL-BREF (WHOQOL: World Health Organization QOL) questionnaire. Univariate analysis and logistic regression was done to determine the factors associated with poor QOL. Results: The QOL scores for all the domains ranged between 15.7 and 74.55 with a mean score of 51.49 [standard deviation (SD) 12.3]. The mean scores in the physical, psychological, social, and environmental domains were 55.7, 37.92, 57.75, and 50.56, respectively. Age more than 30 years [odds ratio (OR): 4.33, 95% confidence interval (CI): 1.73-10.82], female gender (OR: 2.90, 95% CI: 1.16-7.28), and currently married (OR: 3.82, 95% CI: 1.21-12.11) were the factors significantly associated with lower QOL scores. Conclusions: The QOL among people with epilepsy was lower in the psychological domain. Age more than 30 years, female gender, and being married were identified as the factors associated with poor QOL scores among people with seizure disorders.
Brain abscess: Current management
Authors: Panigrahi Souvagya , Mishra Sudhansu Sekhar , Das Srikant , Dhir Manmath Kumar
Published: August 2013

Malignant peripheral nerve sheath tumor (MPNST) is a rare soft tissue sarcoma. Most arise in association with major nerve trunks. Their most common anatomical sites are the proximal portions of the upper and lower extremities and the trunk. MPNSTs have rarely been reported in literature to occur in other unusual body parts. We review all such cases reported till now in terms of site of origin, surgical treatment, adjuvant therapy and outcome and shortly describe our experience with two of these cases. Both of our case presented with lump at unusual sites resembling neurofibroma, one at orbitotemporal area and other in the paraspinal region with characteristic feature of neurofibroma with the exception that both had very short history of progression. They underwent gross total removal of the tumor with adjuvant radiotherapy postoperatively. At 6‑month follow‑up both are doing well with no evidence of recurrence.
Impact of Regular Soap Provision to Primary Schools on Hand Washing and E. coli Hand Contamination among Pupils in Nyanza Province, Kenya: A Cluster-Randomized Trial
Authors: Saboori Shadi , Greene Leslie E. , Moe Christine L. , Freeman Matthew C. , Caruso Bethany A. , Akoko Daniel , Rheingans Richard D.
Published: August 2013

We assessed whether supplying soap to primary schools on a regular basis increased pupil hand washing and decreased Escherichia coli hand contamination. Multiple rounds of structured observations of hand washing events after latrine use were conducted in 60 Kenyan schools, and hand rinse samples were collected one time in a subset of schools. The proportion of pupils observed practicing hand washing with soap (HWWS) events was significantly higher in schools that received a soap provision intervention (32%) and schools that received soap and latrine cleaning materials (38%) compared with controls (3%). Girls and boys had similar hand washing rates. There were non-significant reductions in E. coli contamination among intervention school pupils compared with controls. Removing the barrier of soap procurement can significantly increase availability of soap and hand washing among pupils; however, we discuss limitations in the enabling policy and institutional environment that may have prevented reaching desired levels of HWWS.