bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors associated with disparities in out-of-pocket expenditure on dental care: results from two cross-sectional national surveys
Authors: Orenstein Liat , Chetrit Angela , Oberman Bernice , Benderly Michal , Kalter-Leibovici Ofra
Published: June 2020

Background

Socioeconomic differences in oral health and dental care utilization are a persistent problem in many high-income countries. We evaluated demographic, geographic and socioeconomic factors associated with disparities in households’ out-of-pocket expenditure (OOPE) on dental care, and the effect of ongoing dental health reform on these disparities.

Methods

This cross-sectional analysis used data collected in two Israeli Household Expenditure Surveys conducted in 2014 and 2018. OOPE for dental care was estimated using a two-part multivariable model. A logistic regression was used to examine the likelihood of reporting any OOPE, and a log-transformed linear regression model examined the level of expenditure among those who reported any OOPE.

Results

In 2018, OOPE on dental care accounted for 22% of total health expenditure for all households, whereas among those who reported dental OOPE it reached 43%. Households with children up to age 14 years reported lower OOPE, regardless of ownership of supplementary health insurance. Owning supplementary health insurance had a heterogeneous effect on the level of OOPE, with a significant increase among those with 0–8 years of education, compared to households without such insurance, but not among those of higher educational level. In 2014, Arab ethnic minority and residence in the country periphery were associated with a greater likelihood for any OOPE and higher amounts of OOPE on dental care. While the gaps between Jewish and Arab households persisted into 2018, those between peripheral and non-peripheral localities seem to have narrowed.

Conclusions

The burden of dental OOPE on Israeli households remains heavy and some disparities still exist, even after the implementation of the dental health reform. Expanding the dental health reform and addressing barriers to preventive dental care, especially among Arabs and those of lower educational level, may help in reducing households’ private expenses on dental care.
The r-central factorial numbers with even indices
Authors: Shiha F. A.
Published: June 2020

In this paper, we introduce the r-central factorial numbers with even indices of the first and second kind as extended versions of the central factorial numbers with even indices of both kinds. We obtain several fundamental properties and identities related to these numbers. The connections between the new numbers and the Stirling numbers are presented. In addition, we give the probability distribution of the unsigned r-central factorial numbers with even indices. Finally, we consider the r-central factorial matrices and study some of their properties.
Opioid-free anesthesia—caution for a one-size-fits-all approach
Authors: Gupta Sushan , Mohta Avani , Gottumukkala Vijaya
Published: June 2020

Post-operative pain management should ideally be optimized to ensure patient’s mobilization and ability to partake in effective pulmonary exercises for patient’s early recovery. Opioids have traditionally been the main mode for analgesia strategy in the perioperative period. However, the recent focus on opioid crisis in the USA has generated a robust discussion on rational use of opioids in the perioperative period and also raised the concept of “opioid-free anesthesia” in certain circles. Opioid-related adverse drug events (ORADE) and questionable role of opioids in cancer progression have further deterred some anesthesiologists from the routine perioperative use of opioids including their use for breakthrough pain. However, judicious use of opioid in conjunction with the use of non-opioid analgesics and regional anesthetic techniques may allow for optimal analgesia while reducing the risks associated with the use of opioids. Importantly, the opioid epidemic and opioid-related deaths seem more related to the prescription practices of physicians and post-discharge misuse of opioids. Focus on patient and clinician education, identification of high-risk patients, and instituting effective drug disposal and take-back policies may prove useful in reducing opioid misuse.
Discursive conflicts in news media and the suspension of a government-led test of English in Korea
Authors: Shin Dongil , Cho Eunhae
Published: June 2020

Drawing on critical discourse analysis methodologies, this study examines the discursive conflicts and strategies employed by newspaper media surrounding the National English Ability Test (NEAT) in Korea. NEAT was reported to cause severe competition among young learners of English and lacked public support. Discursive conflicts over whether NEAT would be legitimized flourished in the media. In this study, the discursive practices adopted by both proponents and opponents of NEAT in two leading Korean newspapers of different political orientations—Chosun Ilbo and Hankyoreh—were analyzed from 2006 to 2016. Over this decade, there were three periods of transformation: creation, expansion, and extinction. During the creation period, the discursive conflict focused on the TOEFL crisis in Korea, expansion on the implementation of NEAT, and extinction on its abolition. From creation to abolition, there were competing rationales for developing, suspending, or abolishing NEAT. This study investigated the underlying orientations (neoliberal and evaluative state) of the two newspapers and found that they examined the pros and cons of using the test. Moreover, the government’s implementation of high-stakes testing and its attempt to reward those who complied and to curb the private education sector stresses market-friendly state interaction, which accordingly perpetuates neoliberal conditions.
Utilization of isoniazid prophylaxis therapy and its associated factors among HIV positive clients taking antiretroviral therapy at Fre Semaetat primary hospital, Hawzien districts, Tigrai, Northern Ethiopia
Authors: Legese Haftom , Degefa Hagos , Gebrewahd Aderajew , Gebremedhin Haftay
Published: June 2020

Background

Isoniazid prophylaxis therapy is a significant public health intervention to prevent the progression of latent tuberculosis to active tuberculosis disease among people living with HIV. Those with HIV are at high risk to develop active Tuberculosis from latent Tuberculosis than those without HIV. Even though there is strong evidence supporting Isoniazid Prophylaxis therapy for Tuberculosis prevention, there is limited information about the implementation of isoniazid prophylaxis therapy in Ethiopia as well as in the study area.

Objective

To determine the effects of Isoniazid Prophylaxis therapy and its associated factors among HIV positive clients taking antiretroviral therapy at Fre Semaetat primary Hospital, Hawzien districts, Tigray, northern Ethiopia.

Method

Institutional based cross-sectional study design was conducted from April to August 2019 among HIV positive clients who came to Fre Semaetat primary Hospital. Data related to socio-demographic characteristics and associated risk factors were taken from 372 HIV positive clients who were selected by a simple random sampling method. Data was coded and cleaned by using SPSS version 23.0 for the final analysis.

Results

A total of 372 HIV positive clients taking antiretroviral therapy were included in the study. Of those, the overall prevalence that took and completed their Isoniazid Prophylaxis therapy for 6 months was found to be 231(62.1%). From those who completed Isoniazid Prophylaxis therapy (IPT), 13(3.5%) was developed active Tuberculosis (TB) incidence. Gender, co-trimexazol Prophylaxis therapy users, HIV positive clients who took Anti-pain and married clients were the predictor among statistically significant variables of Isoniazid Prophylaxis therapy.

Conclusions

Isoniazid Prophylaxis therapy utilization found to below. Therefore, health education and counseling of patients who are in their first 2 months of therapy should be strengthened further. Prophylaxis should be given by service providers, medication side effects should be addressed rapidly.
Conceptualisation of Cyberattack prediction with deep learning
Authors: Ibor Ayei E. , Oladeji Florence A. , Okunoye Olusoji B. , Ekabua Obeten O.
Published: June 2020

The state of the cyberspace portends uncertainty for the future Internet and its accelerated number of users. New paradigms add more concerns with big data collected through device sensors divulging large amounts of information, which can be used for targeted attacks. Though a plethora of extant approaches, models and algorithms have provided the basis for cyberattack predictions, there is the need to consider new models and algorithms, which are based on data representations other than task-specific techniques. Deep learning, which is underpinned by representation learning, has found widespread relevance in computer vision, speech recognition, natural language processing, audio recognition, and drug design. However, its non-linear information processing architecture can be adapted towards learning the different data representations of network traffic to classify benign and malicious network packets. In this paper, we model cyberattack prediction as a classification problem. Furthermore, the deep learning architecture was co-opted into a new model using rectified linear units (ReLU) as the activation function in the hidden layers of a deep feed forward neural network. Our approach achieves a greedy layer-by-layer learning process that best represents the features useful for predicting cyberattacks in a dataset of benign and malign traffic. The underlying algorithm of the model also performs feature selection, dimensionality reduction, and clustering at the initial stage, to generate a set of input vectors called hyper-features. The model is evaluated using CICIDS2017 and UNSW_NB15 datasets on a Python environment test bed. Results obtained from experimentation show that our model demonstrates superior performance over similar models.
Chemoradiotherapy With or Without Surgery for Esophageal Squamous Cancer According to Hospital Volume
Authors: Duarte Mateus Bringel Oliveira , Pereira Eduardo Baldon , Lopes Luiz Roberto , Andreollo Nelson Adami , Carvalheira José Barreto Campello
Published: June 2020

PURPOSE

Esophageal squamous cell cancer (ESCC) is still associated with a dismal prognosis. However, surgical series have shown that high-volume hospitals have better outcomes and that the impact of center volume on definitive chemoradiotherapy (dCRT) or CRT plus surgery (CRT + S) remains unknown.

METHODS

We performed a retrospective analysis of patients with locally advanced stage II-III (non-T4) ESCC treated with dCRT or CRT + S in São Paulo state, Brazil. Descriptive variables were assessed with the χ2 test after categorization of hospital volume (high-volume [HV] center, top 5 higher volume, or low-volume [LV] center). Overall survival (OS) was assessed with Kaplan-Meier curves, log-rank tests, and Cox proportional hazards. Finally, an interaction test between each facility’s treatments was performed.

RESULTS

Between 2000 and 2013, 1,347 patients were analyzed (77% treated with dCRT and 65.7% in HV centers) with a median follow-up of 23.7 months. The median OS for dCRT was 14.1 months (95% CI, 13.3 to 15.3 months) and for CRT + S, 20.6 months (95% CI, 16.1 to 24.9 months). In the multivariable analysis, dCRT was associated with worse OS (hazard ratio [HR], 1.38; 95% CI, 1.19 to 1.61; P < .001) compared with CRT + S. HV hospitals were associated with better OS (HR, 0.82; 95% CI, 0.71 to 0.94; P = .004) compared with LV hospitals. Importantly, CRT + S superiority was restricted to HV hospitals (dCRT v CRT + S: HR, 1.56; 95% CI, 1.29 to 1.89; P < .001), while in LV hospitals, there was no statistically significant difference (HR, 1.23; 95% CI, 0.88 to 1.43; P = .350), with a significant interaction test ( P interaction = .035).

CONCLUSION

Our data show that CRT + S is superior to dCRT in the treatment of ESCC exclusively in HV hospitals, which favors the literature trend to centralize the treatment of ESCC in HV centers.
The yeast cell wall protein Pry3 inhibits mating through highly conserved residues within the CAP domain
Authors: Cottier Stéphanie , Darwiche Rabih , Meyenhofer Felix , Debelyy Mykhaylo O. , Schneiter Roger
Published: June 2020

Members of the CAP/SCP/TAPS superfamily have been implicated in many different physiological processes, including pathogen defense, sperm maturation, and fertilization. The mode of action of this class of proteins, however, remains poorly understood. The genome of S. cerevisiae encodes three CAP superfamily members, Pry1-3. We have previously shown that Pry1 function is required for the secretion of sterols and fatty acids. Here, we analyze the function of Pry3, a GPI-anchored cell wall protein. Overexpression of Pry3 results in strong reduction of mating efficiency, providing for a cell-based readout for CAP protein function. Mating inhibition is a conserved function of the CAP domain and depends on highly conserved surface exposed residues that form part of a putative catalytic metal-ion binding site. Pry3 displays polarized cell surface localization adjacent to bud scars, but is absent from mating projections. When overexpressed, however, the protein leaks onto mating projections, suggesting that mating inhibition is due to mislocalization of the protein. Trapping of the CAP domain within the cell wall through a GPI-anchored nanobody results in a dose dependent inhibition of mating, suggesting that a membrane proximal CAP domain inhibits a key step in the mating reaction, which is possibly related to the function of CAP domain proteins in mammalian fertilization.
Effect of Ramadan fasting on disease activity in patients with rheumatoid arthritis presenting in tertiary care hospital
Authors: Siddique Samara , Imran M. Yaser , Afzal Muhammad Naeem , Malik Uzma
Published: June 2020

Background and objective: Rheumatoid Arthritis (RA) is a common inflammatory disorder affected by various factors, including fasting. The objective of the study was to establish the effect of Ramadan fasting on DAS 28 in Rheumatoid Arthritis patients.

Methods: In this observational cohort study done in department of rheumatology, Mayo hospital, Lahore, between May 2019 to July 2019, 240 patients were divided in fasting (n=120) and non-fasting cohort (n=120) based on their own choice. Mean DAS-28 scores before and after Ramadan was compared in both cohorts with appropriate statistical analyses.

Results: Two hundred forty participants, (74 males, 166 females), were recruited. Baseline DAS of fasting group was significantly low (4.35±0.9) as compared to non-fasting group (5.07±0.91). Paired t-test showed statistically significant improvement in fasting and non-fasting groups in total and in both genders (p=0.000). Mean improvement in DAS was numerically greater and statistically significant (p=0.000) in non-fasting group (1.08±0.62) as compared to fasting ones (0.86±0.61). Post-Ramadan DAS was, however, significantly low in fasting group (3.49±0.9) versus non-fasting group (3.98±1.0) (p=0.000).

Conclusion: DAS 28 score decreased in both non-fasting as well as fasting patients of RA during the month of Ramadan. RA patients with moderate disease activity, who want to keep fast, can be allowed to do so without any fear of disease worsening.

doi: https://doi.org/10.12669/pjms.36.5.2099

How to cite this:Siddique S, Imran Y, Afzal MN, Malik U. Effect of Ramadan fasting on disease activity in patients with rheumatoid arthritis presenting in tertiary care hospital. Pak J Med Sci. 2020;36(5):1032-1035. doi: https://doi.org/10.12669/pjms.36.5.2099

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Sigmoid volvulus: An update for Atamanalp classification
Authors: Atamanalp Sabri Selcuk
Published: June 2020

Sigmoid volvulus (SV), the wrapping of the sigmoid colon around itself, is a rare colonic obstruction form. SV requires emergency endoscopic or surgical treatment following an urgent resuscitation and the prognosis is relatively poor. Although many different classifications have been made for SV in the past, the unique classification system, which assists the decision making in the management in addition to the estimation of the prognosis, was described in 2017. Thereafter, a great number of relevant subjects were discussed in the literature. The aim of this study is to update the present classification system in light of above-mentioned discussions and our experience with 1,028 SV patients, which is the largest single-centre SV series over the world.

doi: https://doi.org/10.12669/pjms.36.5.2320

How to cite this:Atamanalp SS. Sigmoid volvulus: An update for Atamanalp classification. Pak J Med Sci. 2020;36(5):1137-1139. doi: https://doi.org/10.12669/pjms.36.5.2320

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Convergent validity and reliability of a novel repeated agility protocol in junior rugby league players
Authors: Nicholls Anthony , Leicht Anthony , Connor Jonathan , Halliday Aaron , Doma Kenji
Published: June 2020

Background: Rugby league involves repeated, complex, change-of-direction movements, although there are no test protocols that specifically assesses these physical fitness profiles. Thus, the current study examined the convergent validity and reliability of a repeated Illinois Agility (RIA) protocol in adolescent Rugby League players.

Methods: Twenty-two junior Rugby League players completed 4 sessions with each separated by 7 days. Initially, physical fitness characteristics at baseline (i.e., multi-stage fitness, countermovement jump, 30-m sprint, single-effort agility and repeated sprint ability [RSA]) were assessed. The second session involved a familiarisation of RIA and repeated T-agility test (RTT) protocols. During the third and fourth sessions, participants completed the RIA and RTT protocols in a randomised, counterbalanced design to examine the validity and test-retest reliability of these protocols.

Results: For convergent validity, significant correlations were identified between RIA and RTT performances (r= >0.80; p<0.05). For contributors to RIA performance, significant correlations were identified between all baseline fitness characteristics and RIA (r = >0.71; p < 0.05). Reliability of the RIA protocol was near perfect with excellent intra-class correlation coefficient (0.87-0.97), good ratio limits of agreement (×/÷ 1.05-1.06) and low coefficient of variations (1.77-1.97%).

Conclusions: The current study has demonstrated the RIA to be a simple, valid and reliable field test that can provide coaches with information about their athlete’s ability to sustain high intensity, multi-directional running efforts.
Development and feasibility testing of an interactive avatar education application for education of patients with heart failure
Authors: Du Huiyun , Wonggom Parichat , Burdeniuk Christine , Wight Justin , Nolan Paul , Barry Tracey , Nesbitt Katie , Clark Robyn A
Published: June 2020

Background/aims

Heart failure self-care is important for achieving optimal patient outcomes. Interactive information technology has been shown to enhance self-care knowledge and behaviours. This study aimed to codevelop and evaluate with consumers an avatar app for teaching heart failure self-care.

Methods

Consumer participation and pre-post test methods.

Findings

A total of six heart failure patients, two patients' family members and 15 heart failure clinicians and app developers participated in the development of the app. Overall, 13 people completed the app's feasibility testing and demonstrated a significant improvement in heart failure knowledge (P=0.020), self-care maintenance (P=0.027) and self-care confidence (P=0.002). Self-care management did not improve significantly (P=0.113) and satisfaction with learning using the app was very high (90%).

Conclusions

The codevelopment approach used in this project resulted in a high level of user satisfaction. Consumers felt the app was a very feasible mechanism of heart failure education delivery.
Recovery planning must include an overhaul of staff and pupil wellbeing strategies
Authors: Shaw Pam
Published: June 2020

As we consider a return to school, recovery planning must include an overhaul of how we focus on staff and pupil wellbeing, Pam Shaw explains
Hand hygiene and stopping the spread of COVID-19
Authors: Aziz Ann-Marie
Published: June 2020

Health professionals' lack of compliance with hand hygiene is a problem in both hospitals and emergency medical services. The 2019 coronavirus disease (COVID-19), caused by SARS-CoV-2, is spreading around the world and practitioners must play their part to contain the outbreak. Hand hygiene is one of the most important measures to prevent the transmission of SARS-CoV-2 and stop the spread of COVID-19. A range of products (including alcohol-based handrub and personal and respiratory protective equipment), procedures and strategies can improve compliance with hand hygiene in emergency medical services. Incorporating hand-hygiene strategies into policy can help providers to improve compliance. Effectiveness of infection prevention and control measures should be assessed by audit. All health professionals should contribute to improving infection prevention and control, including in the prehospital environment and during transfer between settings.
Spectral invariance of Gaussian Schell-model beams
Authors: Gao Yaru , Li Xiaofei , Cai Yangjian , Schouten Hugo F. , Visser Taco D.
Published: June 2020

It is well known that in general the spectrum of a beam that is generated by a partially coherent source will change on propagation. Here we derive necessary and sufficient conditions under which the often-used Gaussian Schell-model sources can produce beams whose normalized spectrum is invariant everywhere, or is invariant just along the beam axis. These sources are not necessarily quasi-homogeneous or obeying the scaling law.
Design for society: Ageing communities as co-designers in processes of social innovation
Authors: Sarantou Melanie , Pan Shaohua
Published: June 2020

This article addresses the role of social innovation in ageing communities. Two cases are considered, namely the Life 2.0 project that focuses on generating information and communication technology services for ageing individuals and groups across Europe, while the second case is a project that was conducted with the BoAi aged care facility in China in which food services were (re)designed through insights stemming from the community. A comparative analysis will investigate how ageing communities collaboratively work with stakeholders, including designers and other professionals, to develop new services with the elderly. The comparative analysis presents insights into the role of ageing communities in service design processes and their roles as co-creators in new futures.
Ethnographic encounters and local musical theatre in the United States
Authors: Wolf Stacy
Published: June 2020

In this article, I reflect on some of the research and writing choices I made while engaged in ethnographic research for Beyond Broadway: The Pleasure and Promise of Musical Theatre Across America. I consider several challenges, including how to navigate my role and point of view as an empathetic insider or advocating outsider of local musical theatre; how to conceptualize the project’s scope and scale; how to articulate the strengths and weaknesses of a multi-site, limited-view project; how to manage relationships with corporations that challenged my politics; and how to deal with revisions, which I invited, requested by people I interviewed and observed. I also discuss how I understood non-professional theatre-makers’ disavowal of the label ‘amateur’ and came to appreciate the untenable distinction between ‘amateur’ and ‘professional’.
The Cambridge Companion to Operetta, Anastasia Belina and Derek B. Scott (eds) (2020)
Authors: Woller Megan
Published: June 2020

Review of: The Cambridge Companion to Operetta, Anastasia Belina and Derek B. Scott (eds) (2020)

Cambridge and New York: Cambridge University Press, 319 pp.,

ISBN 978-1-31663-334-2, p/bk, £22.99
Boho Days: The Wider Works of Jonathan Larson, J. Collis (2018)
Authors: Robbins Hannah
Published: June 2020

Review of: Boho Days: The Wider Works of Jonathan Larson, J. Collis (2018)

Sheffield: Jonathon Collis, 404 pp.,

ISBN 978-3-00059-113-6, h/bk, $46.00
Does Genetics Play a Role in Acute Liver Injury After Amoxicillin Exposure?
Authors: Schosheim Alexander , Mockler Daniel , Chawla Anupama
Published: June 2020

Amoxicillin-clavulanate has long been associated with drug-induced liver injury (DILI) and although approximately 4 times less common, amoxicillin has also been implicated. Many studies have associated possible genetic factors with susceptibility to DILI, but there is currently no literature with evidence of instances of DILI within the same family. Two sisters presented with similar symptoms and signs of liver injury including jaundice, scleral icterus, abdominal pain, and anorexia with transaminitis and abnormal coagulation studies. Both sisters were started on amoxicillin approximately 2–3 weeks before presentation. They both had progression of the liver injury, and on biopsies, they had similar findings indicative of DILI as well.
NÍVEL DE ADEQUABILIDADE SOCIOAMBIENTAL DE ÁREAS DE ATERROS EM OPERAÇÃO
Authors: Maezano Faita Pinheiro Mayara , De Oliveira Dias Noemi , Prado Osco Lucas , Sussel Gonçalves Mendes Tatiana , Ennes Cicerelli Rejane , Marques Ramos Ana Paula
Published: June 2020

A definição de área para disposição final de resíduos sólidos é uma tarefa complexa. No Brasil, existem regulamentos de caráter obrigatório (restritivo) e de orientação para a implantação de aterros. Todavia, a análise de aterros em operação segundo esses regulamentos é ainda algo pouco explorada, mas que pode trazer importantes informações à gestão territorial. Este trabalho investiga se os aterros no oeste do estado de São Paulo atendem aos critérios restritivos e qual o seu nível de adequabilidade ambiental e socioeconômica. Analisou-se 32 aterros, segundo quatro critérios restritivos, e um mapa de adequabilidade produzido em um trabalho anterior. Aproximadamente 41% dos aterros em operação descumprem a legislação. Daqueles em áreas legais, somente 25% encontram-se em áreas de alto nível de adequabilidade ambiental e socioeconômica. Isso demonstra a importância de se investigar os impactos socioambientais relacionados aos aterros segundo ambos os regulamentos, de caráter obrigatório e de orientação, visando uma eficaz gestão territorial.
ÍNDICE DE RESILIÊNCIA NATURAL EM BACIAS HIDROGRÁFICAS: O CASO DO BAIXO CURSO DO RIO POTI
Authors: Oliveira Livania Norberta , Cunha Lúcio José Sobral , Cruz Maria Lúcia Brito , Pereira Eugenia C.
Published: June 2020

O processo de apropriação dos recursos naturais tem ocorrido desrespeitando suas características físico-naturais e capacidade de resiliência. Neste sentido, a determinação de um Índice de Resiliência Natural (IRN) constitui importante ferramenta para a conservação e gestão ambiental. Objetivou-se neste estudo desenvolver um índice para identificar a capacidade de resiliência natural do baixo curso do rio Poti (BCRP) com base nas suas caraterísticas de declividade, temperatura e tipos do solo, vegetação e recursos hídricos, associando-os às atividades desenvolvidas pela população, consideradas indicadores de pressão para o aumento ou diminuição da resiliência. Utilizou-se do Sistema de Informações Geográficas (SIG) para a interpretação da área e elaboração do IRN através da técnica fuzzy do ArcMap 10.3. A análise temporal do IRN do BCRP demonstrou ser uma eficaz ferramenta para gestão ambiental, por permitir um diagnóstico da bacia para subsidiar ações que favoreçam a resiliência do ambiente. Na área urbana, o IRN demonstrou-se regressivo, com classificação de baixa a muito baixa. Em contrapartida, na área rural o índice resultou de moderado a alto, perante as formas de uso e ocupação do solo. Constatou-se que a utilização de técnicas sustentáveis de manejo do solo e da vegetação pode favorecer a resiliência do ambiente.
OPTIMIZING EXPERIMENTAL SIMULATION DESIGN FOR THE EMERGENCY DEPARTMENTS
Authors: Atalan Abdulkadir , Dönmez Cem Cagri
Published: June 2020

Goal: this study aimed to use the experimental simulation method to obtain the optimum results by using the simulation technique of the models, which are modeled mathematically but not solved.

Design/Methodology/Approach: a case study was conducted to apply the discrete-event simulation (DES) approach based on the design of experiment (DOE) technique to derive strategies and analyze situations in an emergency department (ED).

Results: by integrating the DOE approach with the DES technique for the ED, the average waiting time for a patient in a small ED was reduced from 40.09 minutes to 9.83 minutes (75.48%), which is a significant result. Increasing the capacity of the resources without increasing the number of daily resources for the ED resulted in an increase from 133 to 147 (10.53%) in the number of patients treated. Additionally, the optimum number of healthcare resources to employ in EDs was calculated.

Limitations: there is no shift system for healthcare resources in the DES model. Since the ED was considered in this study, the same number of resources was run during the working hours of the DES model.

Practical implications: for researchers and healthcare professionals, the developed method is used to obtain results that cannot be obtained through the mathematical modeling of healthcare problems. The results of the changes in health resources on the outputs are obtained by this method as the shortest time frame and lowest cost.

Originality/Value: there is almost no detailed study of DES with the DOE technique. Providing high reliability has resulted in obtaining optimum values through the integration of the DOE approach with the DES technique in the healthcare area. It is very difficult to get accurate results anywhere where the human factor is present.
Tourism, Poverty and Carbon Emissions in Newly Industrialized Countries
Authors: GARIDZIRAI Rufaro , MOYO Clement
Published: June 2020

Poverty has become one of the major concerns in Newly Industrialized Countries (NIC). NIC are shifting from primary sectors to modern sectors, such as tourism, which are envisaged to improve economic growth, employment and eventually minimize poverty. On the other hand, the sector is likely to cause carbon emission, a factor which has created several debates in academic research. To contribute to this academic research, the study examines the effect of tourism on poverty and carbon emissions in NIC. To achieve this purpose, the study employs the Pooled Mean Group model from 1995-2017. Two regression models are used namely: the poverty and carbon emission models. The poverty model reveals that tourism activities promote poverty alleviation both in the short-run and long-run. On the other hand, the carbon emission model suggests that tourism activities contribute positively to carbon emissions in the long run. Furthermore, the results suggest that tourism activities may have a larger effect on carbon emission over the long-term. Based on the results, the study therefore recommends the introduction of measures to accelerate sustainable tourism which will strike a balance between the current as well the future impact of tourism activities.
Improving Public Water Resources Policy in Ukraine: Municipal and Environmental Issues
Authors: DIEGTIAR Oleg A. , HORNYK Volodymyr H. , KRAVCHENKO Sergii O. , KARLOVA Valentyna V. , SHTAL Tatyana V.
Published: June 2020

The article focuses on the current topic of public water resources management. Globalization presents new challenges and demands for sustainable development for society. The current problem of modern humanity is the rational use of limited water resources. Water management is closely linked to the harmonization of social, economic and environmental requirements. The domestic water use system cannot meet European requirements for effective water supply due to moral and physical wear. An inadequate regulatory framework reduces the effectiveness of management processes and requires finding ways to attract investment to the industry, including in public-private cooperation. The analysis of the main problems of water management development, including non-compliance with European standards, moral and physical wear, lack of effective systems of water resources planning, monitoring and control of use of water resources, showed that these problems are primarily the result of an imperfect system of public water management. Based on commercialization processes, the water supply system through the implementation of public-private partnership mechanisms, provided that private entities are clearly monitored by public authorities, can produce significant socio-economic and environmental results. The research developed an algorithm for implementing an effective water management system at the state level by developing and implementing public-private partnership projects in accordance with the requirements of an effective water management system. The mathematical model of information and analytical support of processes of monitoring of rational water use in conditions of implementation of public-private partnership projects is defined.
The Waste-Free Production Development for the Energy Autonomy Formation of Ukrainian Agricultural Enterprises
Authors: KALETNIK Grygorii , HONCHARUK Inna , OKHOTA Yuliia
Published: June 2020

Agriculture has been considered as one of the priority countries sectors in our research; the share of agriculture in the gross domestic product of the world leading countries was investigated. The theoretical and practical aspects of non-waste agricultural production development using animal waste and crop residues fermented in biogas plants are revealed. The authors substantiate the relevance and potential of the introduction of waste-free technology which has considerable advantages of energy autonomy both for the enterprise and the country. The state of humus content in soils of Ukraine is also considered. International experience has been evaluated, which consists in the ability of agricultural waste both to produce alternative sources of energy and to use the products of their processing as organic fertilizers that significantly increase crop yields.

The first steps of the Ukrainian agricultural enterprises to introduction of non-waste production on the example of the company LLC Organic-D have been presented; it heats and electrifies the complex, dries crops, and also uses organic fertilizer (digestate) due to waste processing in the biogas station. As a result of the research, it was found that the application of organic fertilizer can have a positive effect on soil recovery, because the soil acidity has changed from a level of weak acid (5.4 pH) to a level close to neutral (6 pH) for one year of its application. To conclude, the obtained results prove the relevance of the research problem.
Influence of Atmospheric Air Quality on the Morbidity of the Population Living in the Region of Oil and Gas Production in the Republic of Kazakhstan
Authors: AITMAGANBET Perizat , UMAROVA Gulmira , SABYRAKHMETOVA Valentina , PEREPELKIN Sergey , DOSKABULOVA Dariya , URGUSHBAEVA Gulnur , EGIZBAEVA Dina
Published: June 2020

Sarkuland Kenkiyak settlements are located in the Aktobe province, at18-20 km from the oil and gas producing field "Zhanazhol", in the northwest region of the Republic of Kazakhstan. To evaluate the exposure of the adult male and female population living in Sarkul and Kenkiyak settlements, a single medical study was conducted. The nonparametric method of the Spearman correlation analysis was performed between the mean concentration of substances exceeding the Maximum Permissible Concentration and the classes of newly diagnosed diseases. Selection and analysis of air samples was carried out according to the developed research protocol; the qualitative-quantitative analysis was carried out on the Gas analyzer HANK-4 apparatus. Significant pollution of atmospheric air by carbon monoxide, benzapyrene, dust and phenol were identified in places. Correlation dependencies between these pollutants of air and the diseases of the population revealed as a result of medical examination are established, as a result of diseases of the circulatory system, ear and mastoid process, nervous system and digestive organs; between the concentration of carbon monoxide and diseases of the circulatory system, the digestive system, the genitourinary system and the musculoskeletal system; between nitric oxide and diseases of the digestive system and the circulatory system; between benzopyrene and diseases of the digestive system, the genitourinary system and the nervous system.
Assessment of Environmental and Occupational Safety in Mining Industry during Underground Coal Mining
Authors: RUDAKOV Marat L. , KOLVAKH Konstantin A. , DERKACH Iana V.
Published: June 2020

Ensuring the ever-increasing demands of society for energy resources is a key problem for the development of the economy of all countries of the world. At this stage, to improve the living and working conditions of a person, the development of industry and transport, the growth of production based on scientific and technological progress, a continuous increase in energy use is required. Analysis of the environmental consequences of coal mining shows that the human impact on the environment in the process of economic activity becomes global. Therefore, the main goal of the work is to assess the environmental safety in production because of a decrease in rock mass during underground coal mining. The work analyses the levels of negative environmental impact of coal industry enterprises. The relationship between the key statistical indicator that affects the accident rate and the value of professional risk is demonstrated. It is shown that despite the general tendency to reduce the number of cases of fatal injuries to coal mine workers, the procedure for assessing the risk caused by rock falls needs to be improved. In this regard, when assessing occupational risk, it becomes relevant to use information from multifunctional systems of safety (MSS). The complex method of effective control of mountain pressure is illustrated by application of the developed methodology of computer modelling of geo-mechanical processes, instrumental and geophysical methods for protection and maintenance of mine workings at development of a coal seam of the Barentsburg field.
Education System Environmentalization in Ukraine within the Modern Context
Authors: KHARCHENKO Tetiana , HATSKA Liudmyla , SAGAYDACK Julia , CHUBUK Lesia
Published: June 2020

The article covers the key approaches to the formulation of the education system's environmentalization concept against the backdrop of rising environmental awareness and the need to foster better environmental literacy in modern society. In order to achieve this objective, the authors have come up with an integrated indicator of the education system’s environmental sustainability which provides for environmental assessment at various educational levels. The said approach allows ensuring the comprehensive evaluation and avoiding subjectiveness. In addition, it serves as an efficiency indicator of the entire process of educational service provision under present-day conditions. Based on the aforementioned methodology, the Ukrainian education system was evaluated from the standpoint of its compliance with sustainable development requirements. The pain points of the system were identified, particularly, the absence of thoroughness, error in the logical sequence of shaping environmental knowledge, and uneven distribution thereof at different educational levels. The authors presented the measures aimed at increasing the degree of education system environmentalization, namely making environmental matters, including sound management of natural resources, and environmental protection a part of the curriculum; training the teaching staff capable of implementing the concept of continuous environmental and economic education; forming close links between secondary and higher education, and their cooperation with businesses and governmental institutions.
Effect of Swine Bone Powder for Reduce Cadmium Uptake by Rice
Authors: PECHRSAN Sasithorn , SRISATIT Thares
Published: June 2020

The effect of swine bone powder application on bioavailability of Cd in contaminated soil from Tak Province, Thailand were conducted. The bioavailability of Cd was investigated in term of the uptake by rice plant (Oryza sativa L.) in green house at three different application rates of swine bone powder amended soil, including 5, 10 and 15%, respectively. The result demonstrated that the efficiency of cadmium uptake in Khao Dawk Mali 105 rice were in range 0.18-0.20 % and the 5% swine bone amended soil had a positive effect on promoting plant growth and seed yield. Cd concentration in both of shoot and roots decreased with increasing the swine bone application rates. Cadmium bioaccumulation in plant root to soil and translocation factor from root to shoot was less than one. The results indicated that swine bone powder-amended soil could be an alternative and cost-effective method to support plant growth and decrease Cd mobility in soil.
Theoretical Perspectives and Current Challenges of Outcome-Based Education Framework
Authors: Shaheen Saima
Published: June 2020

AbstractOutcome-Based education is a performance-based approach for the curriculum development, a future-oriented learner-centered ‘Empowerment Paradigm’ that empowers and endorses all learners with future success. It is an influential and tempting way of restructuring and reorganizing engineering education. Washington Accord, an International accreditation convention, an independent agreement between signatory organizations to provide an external accreditation to undergraduate engineering programs. The accredited engineering programs that qualify an engineer to enter into the practice of professional engineers are equally recognized and acknowledged by other signatory countries and responsible organizations Pakistan Engineering Council (PEC) is a full signatory to the Washington Accord and a regulatory organization for the accreditation of engineering programs in Pakistan. To keep up the permanent membership status, it is the requirement of PEC to implement Outcome-Based in engineering degree awarding institutes in Pakistan. The main aim of Outcome-Based education in engineering education is to empower engineering students with the essential characteristics required to switch themselves into the engineering profession as a global and professional engineer. The focus of current research is to explore the philosophical and theoretical underpinnings of Outcome-Based education. Moreover, to unveil the current challenges in the implementation of OBE framework in engineering education.
Developing systems thinking in a Project-Based Learning environment
Authors: Kordova Sigal
Published: June 2020

As science and engineering projects are becoming increasingly more complex, sophisticated, comprehensive and multidisciplinary, there is a growing need for systems thinking skills to ensure successful project management. Systems thinking plays a major role in the initiation, effective management, and in facilitating inter-organizational tasks. This research assesses the capacity for engineering systems thinking and its contribution in carrying out a multidisciplinary project. The research also reviews the cognitive process through which systems thinking skill is acquired. The study focused on a group of students who have completed their senior design projects in high-tech industry, while their plans were being integrated into existing larger projects in the respective industrial sites. The systems thinking skill of the students was examined according to a questionnaire for assessing the Capacity for Engineering Systems Thinking (CEST). Statistical analysis shows significant differences in the students capacity for systems thinking at the beginning and end of the work (p<0.001). This research demonstrates that systems thinking skills can be improved through awareness and involvement in multidisciplinary projects.
Life Threatening Delayed Complication of Botulinum Toxin Injection for Treatment of Spasmodic Dysphonia
Authors: Yershov Danylo , Partridge Richard
Published: June 2020

Spasmodic dysphonia is a primary task specific focal dystonia affecting the laryngeal muscles during speech. Most medical and surgical approaches to treatment of spasmodic dysphonia are aimed at the denervation of the laryngeal muscles to block symptom expression in the voice. The standard of care for the adductor form of spasmodic dysphonia is botulinum toxin chemodenervation. The common side effects of treatment with Botox are excessive breathiness and aspiration of fluids. We present the report of a delayed presentation of upper airway obstruction due to a complete vocal cords adduction requiring intubation ten days post Botox injection for the adductor form of spasmodic dysphonia. This presentation may be preceded by a change in voice, productive cough, shortness of breath, or odynophagia. We would recommend supportive treatment in an Intensive Care Unit and close liaison with the otolaryngology team for the management of this complication. Acute upper airway obstruction requiring tracheal intubation is a delayed complication of botulinum toxin administration in the adductor form of spasmodic dysphonia.
The Silencing of Children’s Literature
Authors: Pankenier Weld Sara
Published: June 2020

The silencing of childhood continues in discrimination against children’s literature today. Yet children’s literature should be taken seriously not only for its own sake. Children’s literature can and should illuminate our understanding of literature for adults, while literature for adults can and should illuminate our understanding of children’s literature. Failure to recognize this mutualism risks silencing children’s literature and ghettoizing children’s literature research while impoverishing literary studies. To show the value of examining literature for all audiences together, this article examines the example of silenced Russian writer Daniil (Yuvachev) Kharms, a late avant-garde and absurdist writer who wrote in the 1920s and 1930s before his premature death as a result of repression by the Soviet regime. Like that of others who wrote for both adults and children, Kharms’s example illustrates the arbitrariness of subdividing the literary production of one individual into two mutually exclusive categories. In the case of Daniil Kharms, and others, literary scholarship benefits from examining an author’s oeuvre collectively and disregarding the bifurcation of audiences of which literary studies may at times be guilty. To show this, the present article focuses on the example of the little old lady, a marginal figure who recurs in Kharms’s writings regardless of audience, including in the children’s picturebook O tom kak starushka chernila pokupala (How a Little Old Lady Went Shopping for Ink, 1929) and the absurdist novella for adults “Starukha” (The Old Woman, 1939). Examining the old lady as an anachronistic wizened old muse and embodiment of writing itself across these boundaries in Kharms’s authorship illuminates the theme of silencing across both realms of the author’s oeuvre, since this figure, who stands for Kharms’s silenced authorship itself, embodies Kharms’s own marginalization, silencing, and censorship. Ultimately this article argues for the reunification of divided audiences to repair the fissure dividing the fields of children’s literature and literature for adults.