Recovery Scheme through Protection Switching in Neighbouring-Line Sharing for Fibre-To-The-Home Application

Optical-fibre line failure is a significant problem that must be addressed due to the many demands of high-capacity data access. Here, we propose a novel protection method for switching devices with neighbouring-line sharing using a proposed recovery scheme. We also developed and investigated this recovery scheme for Fibre-to-the-Home (FTTH) technology application. A protection-switching device called a Customer-Access Protection Unit (CAPU) is a reliable optical-protection switching module that is included in smart and controllable FTTH networks. The CAPU provides a platform for the customer to perform fast self-restoration at their home. The approach used is based on protection switching within a network system to protect against fibre failures in the drop region. A comparison of the simulation and experimental results shows the developed protection-switching scheme was successful. Performance comparisons between the analytic methods (experimental and simulation) showed only small deviations of the value were found

Toward an integrative socio-cognitive approach in autism spectrum disorder: NEAR method adaptation—study protocol

BackgroundThe cognitive impairments exhibited by people with ASD, threaten the development of social skills that are essential for establishing and maintaining harmonious social relationships. Cognitive remediation and social skills training are now considered as crucial therapeutic approaches in the management of these disorders. Several programs have already been validated and have shown improvements in social skills or cognitive performance. However, the effects of these training methods seem to be difficult to generalize to other everyday life. The aim of our study is to alleviate cognitive and social deficiencies by using a socio-cognitive framework to adapt the Neuropsychological Educational Approach to Remediation (NEAR) method for adolescents with ASD.Methods/designAdolescents meeting the DSM-5 criteria for ASD, older than 13 years, and following a regular school curriculum will be recruited from clinical population at the Child and Adolescent Psychiatry in Razi University Hospital-Manouba- Tunisia. Our study is an open and non-randomized controlled trial including 30 patients: NEAR group / control group. The NEAR method combines computerized cognitive exercises and bridging groups inspired from cognitive behavioral therapy. NEAR group will be divided into three groups of five patients each. The duration of the sessions will vary according to the capacities of the participants and the exchanges between them (about 60–120 min). In our study, bridging groups will be amended by adding other tasks including planning role plays and scenarios of problematic social situations in autism, taking into account cultural particularities in order to promote social skills. Computerized exercises will be enriched by adding other tasks aiming to improve the recognition and expression of facial emotions by using digital videos and photographs expressing the six basic emotions. The duration of the program will be about 6 months. All selected patients will have an assessment of cognitive function: social cognition, neurocognition and pragmatic skills, social skills, self-esteem and global functioning at baseline, 1 week after the end of the NEAR program and 6 months later.ConclusionThis adaptive program is a promising socio-cognitive intervention that create new perspectives for adolescents with autism spectrum disorder

Perception of tomorrow’s Health-Care connoisseur and front-runners of their educational environment utilizing DREEM inventory in Bahasa Melayu version, the native language of Malaysia

Background There have been a lot of reports throughout the world that medical students were abused during their undergraduate education and clerkship training. Thereafter, calls for intensifying the evaluation of medical and health schools’ curricula based on students’ perceptions of their educational environment. Several studies, methods, and instruments were developed including the Dundee Ready Education Environment Measure (DREEM) inventory, to evaluate the medical educational environment in last five decades. The DREEM inventory has been translated into minimum eight different native tongues namely Arabic, Chinese, Japanese, Persian, Portuguese, Spanish, Swedish, and Turkish. Aims The objective of this study was to assess the educational environment of the UniSZA undergraduate medical program from the students’ perspective utilizing the DREEM inventory translated in Bahasa Melayu. Methods This was a descriptive cross-sectional survey conducted among the medical students of session 2015-2016 to assess educational environment of the Faculty of Medicine, UniSZA. The study was conducted from December 2015 to January 2016. Universal sampling technique was adopted. Results A total of 277 (95.5 per cent) out of 290 students responded to the questionnaire; among them 27.4 per cent were male and 72.6 per cent were female respondents. The overall mean DREEM scores for both preclinical and clinical students were 67.41±24.06. The scores for pre-clinical and clinical were 64.02±25.10 and 69.65±23.15 respectively; however, no statistically significant (p=0.57) differences was observed between two phases. A significant difference was observed between gender of the respondents in students’ perceptions of teachers (p=0.005) and students’ social self-perceptions (p=0.046)

Developing constructs of anatomy education environment measurement: A Delphi study

Inadequate anatomical knowledge due to unsatisfactory anatomy education environment has contributed to poor clinical performance among medical graduates. Unfortunately, no specific environment measurement tool is available. Delphi technique was conducted to identify the anatomy education environment components and their items. It involved identification of possible components and their definitions by nine anatomists which were then appraised and verified, getting critical appraisal from five medical educationists, determining suitable items for each component and finally appraised by content experts. Eleven components with 129 items that might represent the anatomy education environment were proposed. Further validation is required to determine its psychometric properties

Molecular analysis of HBV genotypes and subgenotypes in the Central-East region of Tunisia

<p>Abstract</p> <p>Background</p> <p>In Tunisia, country of intermediate endemicity for Hepatitis B virus (HBV) infection, most molecular studies on the virus have been carried out in the North of the country and little is known about other regions. The aim of this study was to determine HBV genotype and subgenotypes in Central-East Tunisia. A total of 217 HBs antigen positive patients were enrolled and determination of genotype was investigated in 130 patients with detectable HBV DNA. HBV genotyping methods were: PCR-RFLP on the pre-S region, a PCR using type-specific primers in the S region (TSP-PCR) and partial sequencing in the pre-S region.</p> <p>Results</p> <p>Three genotypes (D, B and A) were detected by the PCR-RFLP method and two (D and A) with the TSP-PCR method, the concordance between the two methods was 93%. Sequencing and phylogenetic analysis of 32 strains, retrieved the same genotype (D and A) for samples with concordant results and genotype D for samples with discordant results. The sequences of discordant genotypes had a restriction site in the pre-S gene which led to erroneous result by the PCR-RFLP method. Thus, prevalence of genotype D and A was 96% and 4%, respectively. Phylogenetic analysis showed the predominance of two subgenotypes D1 (55%) and D7 (41%). Only one strain clustered with D3 subgenotype (3%).</p> <p>Conclusions</p> <p>Predominance of subgenotype D7 appears to occur in northern regions of Africa with transition to subgenotype D1 in the East of the continent. HBV genetic variability may lead to wrong results in rapid genotyping methods and sequence analysis is needed to clarify atypical results.</p

Context Assessment for Agroecology Transformation in the Tunisian Living Landscape

The purpose of this Context Assessment is threefold: first, to characterize the environmental, social and economic and political contexts of the Tunisian ALL; second, to understand the data and information currently available in sub-region of the ALL, and third to characterize the extent to which agroecological principles are already being employed locally at the ALL levels. This report constitutes a basis of information and discussion to conduct the impact assessment. It is also valuable to all WPs in the Initiative as it provides critical quantitative or qualitative data and information regarding capacities assessment, policy influence, and other environmental attributes which can guide the initiative implementation and impact in 2023/2024. The present Context Assessment in Tunisia has been elaborated from primary and secondary sources of data. The primary sources of data are issued from focus groups and formal and informal interviews conducted in the targeted area between June and December 2022, as part of WP1 and WP4 activities. The secondary sources of data came from previous research and development projects, in addition to formal and grey literature or technical reports and policy documents. This report will be enriched with a household survey planned during the first quarter of 2023. This report contributes to Output 2.1. Baseline – current conditions of agricultural systems of small holder farmers in each ALL, Output 1.1 on establishment of the ALL, Output 4.1 on the identification of policies and local institutions and their role in the AE pathways

Anatomy education environment measurement inventory (AEEMI): a cross-validation study in Malaysian medical schools

Background: The Anatomy Education Environment Measurement Inventory (AEEMI) evaluates the perception of medical students of educational climates with regard to teaching and learning anatomy. The study aimed to cross-validate the AEEMI, which was previously studied in a public medical school, and proposed a valid universal model of AEEMI across public and private medical schools in Malaysia. Methods: The initial 11-factor and 132-item AEEMI was distributed to 1930 pre-clinical and clinical year medical students from 11 medical schools in Malaysia. The study examined the construct validity of the AEEMI using exploratory and confirmatory factor analyses. Results: The best-fit model of AEEMI was achieved using 5 factors and 26 items (χ 2 = 3300.71 (df = 1680), P < 0.001, χ 2/df = 1.965, Root Mean Square of Error Approximation (RMSEA) = 0.018, Goodness-of-fit Index (GFI) = 0.929, Comparative Fit Index (CFI) = 0.962, Normed Fit Index (NFI) = 0.927, Tucker–Lewis Index (TLI) = 0.956) with Cronbach’s alpha values ranging from 0.621 to 0.927. Findings of the cross-validation across institutions and phases of medical training indicated that the AEEMI measures nearly the same constructs as the previously validated version with several modifications to the item placement within each factor. Conclusions: These results confirmed that variability exists within factors of the anatomy education environment among institutions. Hence, with modifications to the internal structure, the proposed model of the AEEMI can be considered universally applicable in the Malaysian context and thus can be used as one of the tools for auditing and benchmarking the anatomy curriculum

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions