The Snowball Effect of Multiple Value Co-Creation (VCC) Interactions Leading to Value Co-Destruction (VCD), (Research-in-Progress)

This work-in-progress research initiative aims to explore the adverse effects of the extensive involvement in various Value Co-Creation (VCC) instances on the part of the customer as they engage in a multitude of value streams offered from multiple service providers, thus presumably resulting in Value Co-Destruction (VCD). This research work is of practical importance for professional managers who must protect their investments in digital Value Co-Creation (VCC) Platforms. Thus, they can continue to leverage the benefits that VCC offers such as enhanced customer engagement, increased customer loyalty, customization and personalization, cost savings, efficiency, and brand differentiation. This research effort addresses a gap in the literature, as the extant literature focuses on the different sources of Value of Co-Destruction arising within a single value stream. Such a research enquiry will be linked to contemporary phenomena, applicable scientific theories and standard performance metrics that are well established in the literature. Additionally, a question begs to be asked whether an authoritative organization should act on behalf of the customer/end-user and govern the “implied” involvement in numerous VCC streams. These proposals align with the principles of Industry 5.0 and Society 5.0, thus aim to serve the purpose of augmenting the role of human-centricity along with sustainability and resilience in a technology-centric world of Industry 4.0

Iec 61850-based communication networks of distribution system against cyber and physical failures

This paper proposes a decentralized control approach using a co-simulation platform to monitor protective elements and provide complete protection scheme for distribution systems. Real time measurements are obtained by interfacing the system model in RSCAD/RTDS with SEL 421 protective relays and publish/subscribe the voltage and current signals of the buses and transmission lines based on IEC 61850 communication protocol to isolate the fault correctly. The proposed technique helps to identify the location of the fault and introduces primary and buck protection for the system. The communication networks assists in facing cyber and physical threats and finding a new path for healthy relays to remove faults from the system. This technique is investigated on an IEEE 14 bus system for all possible fault locations. The proposed scheme can clear the fault by isolating the minimum part of the system and improving the endurance of the power in it. The system shows the smooth information flow between the cyber and physical parts to isolate faults in it in different cases

Rapid Pleurodesis: Single Agent Single Session Vs. Multiple Sessions Using Multiple Agents in the Treatment of Recurrent Malignant Pleural Effusion

Background: One prevalent, upsetting side effect of several oncological conditions is malignant pleural effusion. Pleurodesis is one of the most effective ways to reduce symptoms, stop recurrence, and enhance quality of life. This prospective study aimed at evaluating the performance of three rapid pleurodesis procedures and determine which modality achieved the most positive results, the fewest problems, and the most cost-efficiency. Methods: This study included 91 patients with recurrent and rapidly collecting malignant pleural effusion. They were distributed into three groups: Group A (single session, single agent), Group B (single session, combined agents), and Group C (multiple sessions, multiple agents) pleurodesis through a catheter which was closed for 2 hours and then opened to drain. The catheter was then removed, and the patient was discharged to continue outpatient follow-up. Results: Group A included 28 patients, Group B included 29 patients, and Group C included 34 patients. The most common primary malignancy was breast cancer in Group A (46.4 %), and lung cancer in Group B (48.3%) and Group C (47.1 %). Frequently encountered complications following pleurodesis were fever (7.1%, 10.3% and 11.8 % for group A, B and C respectively); and dyspnea (7.1 % in Group A), (13.8% in Group B), and (8.8% in Group C). Hospital stay was longer in the third group with (p<0.001) without significant difference in the outpatient follow-up for lung inflation and recurrence as in one week was (3.6 % in Group A), (0 % in Group B and Group C), in one month was (10.7 % in Group A), (6.9 % in Group B), and (2.9 % in Group C), in 3 months was (14.3 %  in Group A), (17.2 in Group B), and (11.8% in Group C). Conclusion: Rapid pleurodesis – either with a single agent in a single session, a combined agent in a single session, or multiple sessions using multiple agents – is an effective treatment to avoid the recurrence of malignant pleural effusion with minimal side effects. Since the first protocol is equally successful and requires only a short hospital stay at a moderate cost, we recommend it

Causative organisms of pyospermia in infertile male patients

Background: Male urogenital tract infection is one of the most important causes of male infertility worldwide. Infection processes may lead to impairment of sperm quality, and obstruction of the seminal tract. On the light of this, there is a need to institute a microbiological intervention to detect the probable causative microbial agents.Objective: The aim of the work was to detect the common bacteria causing pyospermia in a cross-section of infertile men and the sensitive antimicrobials against these bacteria.Patients and methods: This study included 205 infertile men who were recruited from the outpatient clinic, Andrology Unit, Dermatology and Andrology & STDs Department, Mansoura University Hospital for management of infertility. Patients with grade II or grade III varicocele, more than 60-year, smoker, drug abuser and those who were treated with antibiotics during last 3 months were excluded from the study.Results: Over the period of the study, out of 205 infertile male patients with documented pyospermia, 95.6 % of semen samples revealed bacteriologic growth. It was obvious that gram positive bacteria (75.1%) were common than the gram-negative bacteria (20.5%). Six bacterial species (Staphylococcus aureus, Streptococci, Enterococci, E. coli, Klebsiella and Pseudomonas) were isolated from semen samples. The most common causative organisms were Staph. Aureus (49.3%) followed by Streptococci (22.4%) then E. Coli (8.3%), Klebsiella (8.3%) then Pseudomonas (3.9%) and finally Enterococci (3.4%).Conclusion: It could be concluded that semen analysis with peroxidase stain and semen culture are an important diagnostic tool in all patients undergoing fertility investigations to detect genitourinary infections and pyospermia

Immunohistochemical and Histopathological Study of Anaplastic Lymphoma Kinase and Tyrosine-kinase Receptor Expression in Bronchogenic Carcinoma

BACKGROUND: Adenocarcinoma of the lung is the most common tumor type of primary lung cancer and is characterized by heterogeneity on the molecular, clinical, and pathological levels. The presence of an anaplastic lymphoma kinase (ALK) fusion oncogene defines a molecular subset of non-small cell lung cancer with distinct clinical and pathologic features. Furthermore, the tyrosine-kinase receptor (C-kit) is considered to be expressed in various solid tumors, including carcinomas of the lung. AIM: This study aims to correlate immunohistochemical (IHC) expression of ALK and C-kit with pathological features of lung carcinoma and to correlate IHC expression of ALK with IHC expression of C-kit in lung carcinoma. MATERIALS AND METHODS: The material of this study consists of paraffin blocks of 60 cases of patients with bronchogenic carcinoma, IHC staining with ALK and C-kit then analysis of immunoreactivity scoring was done. RESULTS: As regards ALK expression, 3 (5%) cases showed positive expression of ALK and 57 (95%) cases showed negative expression of ALK with no statistically significant correlation between the ALK expression and the histopathological type. While C-kit expression, 4 (6.7%) cases showed positive expression and 56 (93.3%) cases showed negative expression of C-kit with statistically significant correlation between the C-kit expression and the histopathological type. CONCLUSION: There is an association between expression of c-kit and tumor histological type in lung carcinoma. Expression was notably significant among adenocarcinomas and small cell carcinomas

Addressing the challenges of ECMO simulation

This document is the Accepted Manuscript. The final, definitive version of this paper has been published in Perfusion, May 2018, published by SAGE Publishing, All rights reserved.Introduction/Aim: The patient’s condition and high-risk nature of extracorporeal membrane oxygenation (ECMO) therapy force clinical services to ensure clinicians are properly trained and always ready to deal effectively with critical situations. Simulation-based education (SBE), from the simplest approaches to the most immersive modalities, helps promote optimum individual and team performance. The risks of SBE are negative learning, inauthenticity in learning and over-reliance on the participants’ suspension of disbelief. This is especially relevant to ECMO SBE as circuit/patient interactions are difficult to fully simulate without confusing circuit alterations. Methods: Our efforts concentrate on making ECMO simulation easier and more realistic in order to reduce the current gap there is between SBE and real ECMO patient care. Issues to be overcome include controlling the circuit pressures, system failures, patient issues, blood colour and cost factors. Key to our developments are the hospital-university collaboration and research funding. Results: A prototype ECMO simulator has been developed that allows for realistic ECMO SBE. The system emulates the ECMO machine interface with remotely controllable pressure parameters, haemorrhaging, line chattering, air bubble noise and simulated blood colour change. Conclusion: The prototype simulator allows the simulation of common ECMO emergencies through innovative solutions that enhance the fidelity of ECMO SBE and reduce the requirement for suspension of disbelief from participants. Future developments will encompass the patient cannulation aspect.Peer reviewe

Partial versus Full Sternotomy for Aortic Valve Replacement

Background: Minimal invasive approaches are used more frequently for aortic valve replacement (AVR). This study aimed to compare the outcomes of both minimally invasive upper mini-sternotomy and full sternotomy for AVR. Methods: 100 patients with isolated aortic valve disease were enrolled in this prospective observational study. We grouped the patients according to the technique, group A (n=40) underwent upper J-shaped mini-sternotomy, and group B (n=60) underwent full sternotomy. Study endpoints were operative times and pain score. Results: The mean age of the patients was 46.4±10.1 years. There was no difference in preoperative data between both groups. There was a significant difference in aortic cross-clamp time (87.2± 8.6 vs. 59.2± 6.6  min in group A and B, respectively, p= 0.001), and total bypass time (115.1± 9.2 vs. 75.3± 4.3 min in group A and B, respectively, p= 0.001) between both groups. The total operative time was 341±11.7 and 196.1±18.4 min in groups A and B, respectively (p= 0.001). The ICU stay was 29.4±8.2 hours in group A and 41.2±13.3 hours in group B (p= 0.001). Patients who had mini-sternotomy had lower pain (p= 0.001) and better patient satisfaction score (p< 0.001). Conclusion: J-shaped upper mini-sternotomy is a safe and effective strategy for aortic valve replacement. The procedure may be associated with decreased pain and comparable morbidity to the conventional approach

Employing The Vocabulary Of Jordanian Heritage In The Interior Design Of Accommodation Units In Tourist Facilities

The national heritage is considered important pillars of tourism development, Tourism is also considered a mean of spreading mutual cultures between countries, Further, tourism in the Hashemite Kingdom of Jordan represents one of the most important activities that work on development and prosperity. Jordan hosts a number of important tourist archaeological sites,such as the pink city of Petra;Jerash; the Roman amphitheater, these places are considered a destination for all tourists. Tourism facilities are considered one of the components of civilization and a vital element in its constructions, this requires the interior designer to link the surrounding environment with the interior design to maintain its originality and heritage identity Therefore, the interior designer goal is to create a design vision to attract the tourist and push him to interact with the surrounding environment, Moreover, many tourist facilities have appeared in Jordan, but it lacks the local identity in interior design and it are not connected to the surrounding environment,Such facilities also established on architectural models that do not suit the cultural and civilizational richness of Jordan, Therefore This research aims to create a design vision to employ Jordanian heritage in interior design and furniture for tourist facilities to preserve its originality and identity, and creating a distinctive and special character for the interior design stemming from the surrounding environment;as well as supporting the functional, aesthetic and cultural aspects of the design process, Hence the importance of research lies in analyzing the design elements of Jordanian heritage and reviving its design lines to be used in interior design in order to develop aesthetic sense and general taste in the community, which leads to increase the elements of tourist attractions for tourist facilities, The research went on to study and analyze the heritage elements and reduce lines that can be employed in interior design supporting the aesthetic values of the place, this research has reached a design vision to employ Jordanian heritage in interior design in the hotel accommodation room, The researcher also presented a proposal to design a hotel residence room that employed design lines inspired by Jordanian heritage in a reduced style to suit contemporary life and achieve functional and aesthetic aspects in tourist facilities. So, the research leads to a vision of design style for tourist facilities with a heritage identity has been drawn through two main directions:First: studying heritage elements and analyzing its design lines

Priprava derivata 4-aminofeniloctene kiseline s antimikrobnim djelovanjem

Condensation of 4-APAA with phthalic anhydride gave (dioxoisoindolin-2-yl)phenylacetic acid 1, which is employed as key intermediate in the synthesis of title compounds 2-8. The products have been characterized by analytical and spectral data (IR, 1H NMR, 13C NMR and mass spectra). Antimicrobial activities were also studied and some of these compounds gave promising results.Kondenzacijom 4-APAA s anhidridom ftalne kiseline dobivena je (dioksoizoindolin-2-il)feniloctena kiselina 1, koja je upotrebljena kao ključni intermedijer u sintezi spojeva 2-8. Produkti su karakterizirani analitičkim i spektroskopskim metodama (IR, 1H NMR, 13C NMR i MS). Neki od sintetiziranih spojeva ima značajno antimikrobno djelovanje