The International Multilateral System: Imperatives of Change, Potential Scenarios and Suggestions for the Future

Thesis presented to satisfy the necessary requirements for obtaining a PhD degree in International Relation with specialization in Globalization and the Environment,This research on the international multilateral system has its raison-de-être in the problems of lack of effective global governance manifested in areas such as global politics, security, economy, environment and others. A fundamental focus of the research is on the latest changes in world politics, including state power shifts, power diffusion from state to non-state actors and the implications of the rapid evolution of globalization over the last two decades, with its proliferating challenges and opportunities. In addition, the research examines reform efforts in multilateral institutions and some of the reform proposals suggested in academic circles. The main objective of the research is to provide a holistic analysis of the current state of the multilateral system, the imperatives of reform in the system, its potential future scenarios as well as some suggestions for the future. No doubt, the United Nations (UN) is the core hub of the current system. Hence, the research principally approaches its subject from the perspective of the UN. In particular, the UN General Assembly is the subject of a case study that aims, among others, to highlight the predicament and potential of this unique forum of multilateral cooperation

The Feasibility Analysis of Mathematics Textbook Material based on Bell's Criteria

The purpose of this study is to determine the feasibility of Mathematics textbook material for Grade VII 1st semester on 2017 Revised Edition based on Bell's criteria. So that if there is an error, it can be fixed. Then, this type of research is descriptive research. In the descriptive analysis, there is no need to find or explain its relationships and test hypotheses. The approach used is qualitative. Moreover, this study uses a qualitative approach because the data collected are described in sentences. This study will be obtained from two sources, namely the main source of the Mathematics Textbook Grade VII of 2013 curriculum and peer-discussion support sources. The method used in this research is the documentation method. The documentation data used in this research is the textbook itself. However, the data obtained by using the Analysis Instrument Result shows that the suitability of the mathematics textbook material of Grade VII with the material based on Bell's criteria for the numbers and algebra chapters includes a good category. Meanwhile, the sets and equations and linear inequalities of one variable chapter belong to be an excellent category. The average suitability of the mathematics material from each chapter in the textbook toward Bell's criteria is 83.75% and is supported by the validity data results through forms and peer discussions. As a result, the feasibility of the mathematics textbook material for grade VII of the 2017 revised edition based on Bell's criteria is very good

PEMBELAJARAN BLENDED LEARNING DALAM MENINGKATKAN MINAT BELAJAR WARGA BELAJAR PROGRAM KESETARAAN PAKET C DI SANGGAR KEGIATAN BELAJAR (SKB) BEKASI

Penelitian ini bertujuan untuk mendeskripsikan pembelajaran blended learning dalam meningkatkan minat belajar warga belajar program kesetaraan paket C di Sanggar Kegiatan Belajar (SKB) Bekasi. Pendekatan yang digunakan dalam penelitian ini adalah pendekatan kualitatif dengan metode deskriptif kualitatif. Teknik pengumpulan data dalam penelitian ini menggunakan observasi, wawancara dan studi dokumentasi. Subjek penelitian terdiri dari tutor dan warga belajar. Hasil penelitian yang diperoleh sebagai berikut : (1) Pembelajaran blended learning yang diterapkan SKB Bekasi pada program paket C telah memuat tahapan atau sintaks pembelajaran blended learning berbasis ICT baik pada pembelajaran online yang meliputi seeking of information dan acquisition of knowledge maupun pada pembelajaran offline meliputi seeking of information, acquisition of knowledge serta synthesizing of information. (2) Terdapat faktor pendukung dan faktor penghambat pembelajaran blended learning dalam meningkatkan minat belajar warga belajar paket C ditinjau dari aspek internal dan eksternal. Faktor pendukung internal meliputi minat, perhatian, kesadaran, ketertarikan keterlibatan, dan dorongan, sedangkan faktor pendukung ekternal meliputi sarana prasarana, dukungan orang tua, tutor, teman sebaya, partisipasi masyarakat dan biaya. Faktor penghambat eksternal meliputi kejenuhan dalam pembelajaran online, kendala kuota warga belajar serta keterbatasan waktu dan ruangan pada pembelajaran offline. (3) Pembelajaran blended learning meningkatkan minat belajar warga belajar paket C yang berdampak juga pada peningkatan aspek pengetahuan, aspek keterampilan serta aspek sikap warga belajar

The Impact of Endonasal Endoscopic Sinus Surgery on Patients with Chronic Pulmonary Diseases

Introduction: The impact of endoscopic sinus surgery on bronchial asthma has been studied by several groups. According to the latest studies, patients with chronic obstructive pulmonary disease (COPD) seem to have frequent symptoms of chronic rhinosinusitis. Our study compares the impact of endoscopic sinus surgery on both the upper and lower airways of patients with bronchial asthma as well as those with COPD. Methods: This study includes 43 patients (bronchial asthma, n = 32, COPD, n = 11) undergoing surgical treatment for chronic rhinosinusitis at the ENT-Department, University of Homburg (Homburg, Germany). To assess the effect of sinus surgery, the Sino-Nasal Outcome Test 20 German Adapted Version (SNOT-20 GAV) and St. George’s Respiratory Questionnaire (SGRQ) were used both pre- and postoperatively. Results: Both SNOT-20 (p < 0.001) and SGRQ (p = 0.021) scores improved significantly after sinus surgery. The postoperative improvement in bronchial asthma and COPD was similar in both groups, indicating no difference of the diseases in regards to postoperative symptom improvement. There was no difference indicated in SNOT-20 GAV or SGRQ when grouping patients by polyps, aspirin (ASS) intolerance, allergies, eosinophilia or previous surgery. Conclusions: The treatment of chronic rhinosinusitis by sinus surgery may help to improve the therapy outcome of patients with bronchial asthma as well as patients with COPD

Progressive Magnetic Resonance Image Reconstruction Based on Iterative Solution of a Sparse Linear System

Image reconstruction from nonuniformly sampled spatial frequency domain data is an important problem that arises in computed imaging. Current reconstruction techniques suffer from limitations in their model and implementation. In this paper, we present a new reconstruction method that is based on solving a system of linear equations using an efficient iterative approach. Image pixel intensities are related to the measured frequency domain data through a set of linear equations. Although the system matrix is too dense and large to solve by direct inversion in practice, a simple orthogonal transformation to the rows of this matrix is applied to convert the matrix into a sparse one up to a certain chosen level of energy preservation. The transformed system is subsequently solved using the conjugate gradient method. This method is applied to reconstruct images of a numerical phantom as well as magnetic resonance images from experimental spiral imaging data. The results support the theory and demonstrate that the computational load of this method is similar to that of standard gridding, illustrating its practical utility

Diffuse liver disease classification from ultrasound surface characterization, clinical and laboratorial data

In this work liver contour is semi-automatically segmented and quantified in order to help the identification and diagnosis of diffuse liver disease. The features extracted from the liver contour are jointly used with clinical and laboratorial data in the staging process. The classification results of a support vector machine, a Bayesian and a k-nearest neighbor classifier are compared. A population of 88 patients at five different stages of diffuse liver disease and a leave-one-out cross-validation strategy are used in the classification process. The best results are obtained using the k-nearest neighbor classifier, with an overall accuracy of 80.68%. The good performance of the proposed method shows a reliable indicator that can improve the information in the staging of diffuse liver disease

Design and Synthesis of Novel NSAIDs Class Acting as Anticancer Agents

Several effective anticancer therapeutic drugs containing coumarin nucleus. Thus, some coumarin derivatives 3-2

Histological Examination in Obtaining a Diagnosis in Patients with Lymphadenopathy in Lima, Peru.

The differential diagnosis for lymphadenopathy is wide and clinical presentations overlap, making obtaining an accurate diagnosis challenging. We sought to characterize the clinical and radiological characteristics, histological findings, and diagnoses for a cohort of patients with lymphadenopathy of unknown etiology. 121 Peruvian adults with lymphadenopathy underwent lymph node biopsy for microbiological and histopathological evaluation. Mean patient age was 41 years (Interquartile Range 26-52), 56% were males, and 39% were HIV positive. Patients reported fever (31%), weight loss (23%), and headache (22%); HIV infection was associated with fever (P < 0.05) and gastrointestinal symptoms (P < 0.05). Abnormalities were reported in 40% of chest X-rays (N = 101). Physicians suspected TB in 92 patients (76%), lymphoma in 19 patients (16%), and other malignancy in seven patients (5.8%). Histological diagnoses (N = 117) included tuberculosis (34%), hyperplasia (27%), lymphoma (13%), and nonlymphoma malignancy (14%). Hyperplasia was more common (P < 0.001) and lymphoma less common (P = 0.005) among HIV-positive than HIV-negative patients. There was a trend toward reduced frequency of caseous necrosis in samples from HIV-positive than HIV-negative TB patients (67 versus 93%, P = 0.055). The spectrum of diagnoses was broad, and clinical and radiological features correlated poorly with diagnosis. On the basis of clinical features, physicians over-diagnosed TB, and under-diagnosed malignancy. Although this may not be inappropriate in resource-limited settings where TB is the most frequent easily treatable cause of lymphadenopathy, diagnostic delays can be detrimental to patients with malignancy. It is important that patients with lymphadenopathy undergo a full diagnostic work-up including sampling for histological evaluation to obtain an accurate diagnosis

High probability of comorbidities in bronchial asthma in Germany

Clinical experience has shown that allergic and non-allergic respiratory, metabolic, mental, and cardiovascular disorders sometimes coexist with bronchial asthma. However, no study has been carried out that calculates the chance of manifestation of these disorders with bronchial asthma in Saarland and Rhineland-Palatinate, Germany. Using ICD10 diagnoses from health care institutions, the present study systematically analyzed the co-prevalence and odds ratios of comorbidities in the asthma population in Germany. The odds ratios were adjusted for age and sex for all comorbidities for patients with asthma vs. without asthma. Bronchial asthma was strongly associated with allergic and with a lesser extent to non-allergic comorbidities: OR 7.02 (95% CI:6.83–7.22) for allergic rhinitis; OR 4.98 (95%CI:4.67–5.32) allergic conjunctivitis; OR 2.41 (95%CI:2.33–2.52) atopic dermatitis; OR 2.47 (95%CI:2.16–2.82) food allergy, and OR 1.69 (95%CI:1.61–1.78) drug allergy. Interestingly, increased ORs were found for respiratory diseases: 2.06 (95%CI:1.64–2.58) vocal dysfunction; 1.83 (95%CI:1.74–1.92) pneumonia; 1.78 (95%CI:1.73–1.84) sinusitis; 1.71 (95%CI:1.65–1.78) rhinopharyngitis; 2.55 (95%CI:2.03–3.19) obstructive sleep apnea; 1.42 (95%CI:1.25–1.61) pulmonary embolism, and 3.75 (95%CI:1.64–8.53) bronchopulmonary aspergillosis. Asthmatics also suffer from psychiatric, metabolic, cardiac or other comorbidities. Myocardial infarction (OR 0.86, 95%CI:0.79–0.94) did not coexist with asthma. Based on the calculated chances of manifestation for these comorbidities, especially allergic and respiratory, to a lesser extent also metabolic, cardiovascular, and mental disorders should be taken into consideration in the diagnostic and treatment strategy of bronchial asthma

Augmented reality-enhanced navigation in endoscopic sinus surgery: A prospective, randomized, controlled clinical trial

Objective: Endoscopic sinus surgery represents the gold standard for surgical treatment of chronic sinus diseases. Thereby, navigation systems can be of distinct use. In our study, we tested the recently developed KARL STORZ NAV1 SinusTracker navigation software that incorporates elements of augmented reality (AR) to provide a better preoperative planning and guidance during the surgical procedure. Methods: One hundred patients with chronic sinus disease were operated on using either a conventional navigation software (n = 52, non‐AR, control group) or a navigation software incorporating AR elements (n = 48, AR, intervention group). Incidence of postoperative complications, duration of surgery, surgeon‐reported benefit from the navigation system and patient‐reported postoperative rehabilitation were assessed. Results: The surgeons reported a higher benefit during surgery, used the navigation system for more surgical steps and spent longer time with preoperative image analysis when using the AR system as compared with the non‐AR system. No significant differences were seen in terms of postoperative complications, target registration error, operation time and postoperative rehabilitation. Conclusion: The AR enhanced navigation software shows a high acceptance by sinus surgeons in different stages of surgical training and offers potential benefits during surgery without affecting the duration of the operation or the incidence of postoperative complications