Values-Based Medicine (VsBM) and Evidence-Based Medicine (EBM)

Medical care is a dynamic process to implement and use the most recent technologies, skills, and knowledge to either maintain the good health of people or to treat sick patients. Patients have the right to receive the best possible available treatment. During the course of treatment, the patient’s dignity and rights should be respected and never be compromised. A patient’s right to be properly treated is one of the fundamental human rights. The healthcare system is responsible for providing efficient and sufficient healthcare facilities and training and continuously educating able medical and paramedical teams. Evidence-based medicine has been popularized in the last 40–50 years in order to raise the standard of medical practice. Medical ethics and values have been associated with medical practice for thousands of years since patients felt the need for treatment. There is no conflict between evidence-based medicine and values-based medicine, as the medical practice should be always preformed within a frame of ethics and respect of patient’s values. Observing the principles of values-based medicine became very relevant as multicultural societies are dominant in some countries and hospitals in different corners of the world

Scheduling for Cooperative Energy Harvesting Sensor Networks

In cooperative communication networks, the source node transmits its data to the destination either directly or cooperatively with a cooperating node. When using energy harvesting technology, where nodes collect their energy from the environment, the energy availability at the nodes becomes unpredictable due to the stochastic nature of energy harvesting processes. As a result, when the source has a transmission, it cannot immediately transmit its data cooperatively with the cooperating node. It first needs to determine whether the cooperating node has sufficient energy to forward its transmission or not. Otherwise, its transmitted data may get lost. Therefore, when using energy harvesting, the challenge is for the source to schedule its transmissions whether directly or cooperatively, such that the fraction of its events (sensed data) that are successfully reported to the destination is maximized. Hence, in this dissertation, we address the problem of cooperating node scheduling in energy harvesting sensor networks. We consider the problem for the case of a single cooperating node and the case of multiple cooperating nodes, as well as the scenarios of one-way and two-way cooperative communications. We propose a simple scheduling scheme, called feedback scheme, which enables the source to optimally schedule its transmissions whether directly or cooperatively. We show that the feedback scheme maximizes the system performance, but does not require auxiliary parameter optimization as does the-state-of-the-art scheme, i.e., the threshold-based scheme. However, the feedback scheme has the problem of overhead caused by transmitting the energy status of the cooperating node to the source. To overcome this burden, we introduce a statistical model that enables the source to estimate the energy status of the cooperating node. Because cooperation may result in the cooperating node performing worse than the source, we address this problem through fairness in the performance between the nodes in the network. In addition, we address the problem of scheduling for throughput maximization in a wireless energy harvesting uplink. We propose centralized and distributed algorithms that find the optimal solution, and we address complexity issues. Our algorithms are shown to have a linear or quadratic complexity compared to the exponential complexity of the brute force approach. Compared with cooperative transmission, our approach maximizes the network throughput such that no node\u27s throughput is adversely affected

The effects of strategic attributes on organizational performance in the banking sector of Pakistan

In recent times, there has been an increasing interest in the strategic attributes which aims to achieve the superior organizational performance that allows organizations, including the banks, to be competitive with time. Therefore, to achieve superior organizational performance and successful bank growth, the banks need to focus on their strategic attributes. The key strategic attributes include strategic orientation, organizational culture, organizational IMO, and organizational commitment. Drawing upon the resource-based view theory (RBV) and the social exchange theory (SET), this study examined the influence of these strategic attributes on organizational performance. Moreover, this study also examined the mediating effect of organizational commitment on the relationship between strategic orientation, organizational culture, organizational IMO and organizational performance. The data was collected from the 260 bank managers working in the branches of six-large banks of Pakistan. The results of PLS path modeling revealed the significant positive direct relationships between strategic orientation, organizational culture, organizational IMO and organizational commitment, and organizational performance. Similarly, the study also found significant positive direct relationships between strategic orientation and organizational culture, and organizational commitment. However, no significant relationship existed between organizational IMO and organizational commitment. Furthermore, the bootstrapping results revealed that organizational commitment mediated the relationships between strategic orientation, organizational culture, and organizational performance. In contrast, the study did not find any mediation of organizational commitment between organizational IMO and organizational performance relationship. In general, the findings showcased that organizational performance can be enhanced through the examined key strategic attributes of the study. Accordingly, the study has forwarded noteworthy claims regarding the mediating effect of organizational commitment on these variables. The study offers theoretical and practical contributions. This study also highlights the crucial role of these strategic attributes for performance improvement in the banking sector. Lastly, limitations and scope of further studies are also provided

Performance of the ambient tax: does the nature of the damage matter?

The ambient tax is often considered as an effcient instrument to achieve a …rst best outcome of ambient pollution when the regulator is less informed than the polluters. Since the ambient tax was never imple- mented in the …eld, empirical evidence is missing. Available experimental …ndings provide mixed evidence: effciency is higher under external dam- age, i.e. if ambient pollution affects non-polluters (Spraggon, 2002, 2003) than under internal damage, i.e. if ambient pollution a¤ects polluters themselves (Cochard et al., 2005). Since these two types of experiments relied on very different designs, it is worthwhile to compare them under a common experimental design. Our main …nding is that the ambient tax is equally effcient under external damage than under internal damage.

Role of \u3cem\u3eCryptococcus neoformans\u3c/em\u3e Pyruvate Decarboxylase and Aldehyde Dehydrogenase Enzymes in Acetate Production and Virulence

The basidiomycete Cryptococcus neoformans is is an invasive opportunistic pathogen of the central nervous system and the most frequent cause of fungal meningitis. C. neoformans enters the host by inhalation and protects itself from immune assault in the lungs by producing hydrolytic enzymes, immunosuppressants, and other virulence factors. C. neoformans also adapts to the environment inside the host, including producing metabolites that may confer survival advantages. One of these, acetate, can be kept in reserve as a carbon source or can be used to weaken the immune response by lowering local pH or as a key part of immunomodulatory molecules. Thus, cryptococcosis could be treated by targeting acetate production. The Smith laboratory has identified two potential pathways for acetate production. The xylulose-5-phosphate/fructose-6-phosphate phosphoketolase (Xfp) - acetate kinase (Ack) pathway, previously thought to be present only in bacteria, converts phosphoketose sugars to acetate through acetyl-phosphate. The pyruvate decarboxylase (Pdc) and acetaldehyde dehydrogenase (Ald) pathway, found in other fungi, converts pyruvate to acetate through acetaldehyde. The genes encoding enzymes from these pathways have been shown to be upregulated during infection, suggesting that acetate production may be a necessary and required part of cryptococcal infection. In Saccharomyces cerevisiae, Pdc works with one or more aldehyde dehydrogenases to produce acetate. Eight of the nine C. neoformans aldehyde dehydrogenases and the sole Pdc all contributed to the cellular acetate pool, and loss of some of these enzymes reduced cell survival during growth on various carbon sources, under oxidative or nitrosative stress, under pseudo-hypoxia conditions, and when the cell wall integrity was disrupted. In addition, deletion mutants of of some of these enzymes affected capsule formation and melanization, two primary determinants of Cryptococcus, and led to decreased virulence in macrophages and Galleria mellonella, an invertebrate model of infection. Metabolic adaptability is an important attribute for fungal pathogens to successfully infect and cause disease. Carbon metabolism is critical for virulence in C. neoformans, but little is known about which carbon sources are utilized during infection. Lung alveolar macrophages, the a first line of host defense against C. neoformans infection, provide a glucose- and amino acid-poor environment, and nonpreferred carbon sources such as lactate and acetate are likely important early in establishment of a pulmonary infection. A global screening was undertaken to identify C. neoformans proteins necessary in acetate utilization, as possible drug targets. From two libraries, together comprising 3936 gene knockouts, 41 mutants failed to grow on media with either glucose or acetate as the carbon source, or on both media. Of the known proteins lacking in these mutants, most function in gluconeogenesis, arginine biosynthesis, or mitochondrial transmembrane transport. Overall, this work elucidated the roles of C. neoformans acetate production and utilization pathways in virulence

Low Power Wake-up Signaling for Dense Sensor Networks

In wireless sensor networks, nodes are required to reduce their idle listening time in order to minimize energy consumption and increase their lifetime. The idle listening time is decreased by making the nodes remain in sleep mode and wake up only when they are required to sense or transmit information about an event. This strategy requires the source node to send a wake-up signal before it transmits data to the network. This wake-up signal requires energy and the objective of this work is to lower this signal\u27s energy consumption.;In order to achieve this, this work uses Near Field Magnetic Induction Communication technology (NFMIC) that can communicate wirelessly over short distances using low power. Using this technology, the wake-up signal will be magnetic field lines rather than an RF signal. When a source node wants to wake up its neighbors, it generates magnetic field lines disseminating as bubbles. These lines resonate across the receiver coils of neighboring nodes, thus interrupting the sleeping nodes and waking them. This idea was implemented on a node using three different NFMIC systems. Each system had different combinations of TX and RX coils and communicated using different transmitted power. The most efficient setup was determined based on the wakeup energy efficiency. Finally, this work presents the effect of obstacles on NFMIC systems by testing them on one of our NFMIC systems. As a result of this test, the various obstacles were classified into three categories based on their attenuation effect