SMART AUTHORING AND SHARING OF MULTIMEDIA CONTENT IN PERSONAL AREA NETWORKS BASED ON SUBJECT OF INTEREST

ABSTRACT The evolution of smart phones' hardware and operating systems, users tendency to join social networks and to share multimedia content and daily life events, well-established methods and technologies of Semantic web, and the increasing establishment of Linked Open Data (LOD) APIs, motivate us to introduce a new approach in multimedia content composition and sharing in personal area networks that automatically analyzes, selects, composes, and shares the authored content. The capabilities of social network applications and the application

Maternal mortality in the Gaza strip: a look at causes and solutions

Background: Maternal mortality is an important health indicator for the overall health of a population. This study assessed the causes and contributing factors to maternal mortality that occurred in the Gaza-Strip between July 2014 and June 2015. Methods: This is a retrospective study that used both quantitative and qualitative data. The data were collected from available medical records, investigation reports, death certificates, and field interviews with healthcare professionals as well as families. Results: A total of 18 maternal mortalities occurred in Gaza between 1st July 2014 and June 30th 2015. Age at time of death ranged from 18 to 44 years, with 44.4% occurring before the age of 35 years. About 22.2% were primiparous, while 55.6% were grand multiparous women. The most common causes of death were sepsis, postpartum haemorrhage, and pulmonary embolism. The most striking deficiency was very poor medical documentation which was observed in 17 cases (94%). In addition, poor communication between doctors and women and their families or among healthcare teams was noticed in nine cases (50%). These were repeatedly described by families during interviews. Further aspects surfacing in many interviews were distrust by families towards clinicians and poor understanding of health conditions by women. Other factors included socioeconomic conditions, poor antenatal attendance and the impact of the 2014 war. Low morale among medical staff was expressed by most interviewed clinicians, as well as the fear of being blamed by families and management in case of adverse events. Substandard care and lack of appropriate supervision were also found in some cases. Conclusions: This study revealed deficiencies in maternity care, some of which were linked to the socioeconomic situation and the 2014 war. Others show poor implementation of clinical guidelines and lack of professional skills in communication and teamwork. Specialised training should be offered for clinicians in order to improve these aspects. However, the most striking deficiency was the extremely poor documentation, reflecting a lack of awareness among clinicians regarding its importance. Local policymakers should focus on systematic application of quality improvement strategies in order to achieve greater patient safety and further reductions in the maternal mortality rate.Background: Maternal mortality is an important health indicator for the overall health of a population. This study assessed the causes and contributing factors to maternal mortality that occurred in the Gaza-Strip between July 2014 and June 2015. Methods: This is a retrospective study that used both quantitative and qualitative data. The data were collected from available medical records, investigation reports, death certificates, and field interviews with healthcare professionals as well as families. Results: A total of 18 maternal mortalities occurred in Gaza between 1st July 2014 and June 30th 2015. Age at time of death ranged from 18 to 44 years, with 44.4% occurring before the age of 35 years. About 22.2% were primiparous, while 55.6% were grand multiparous women. The most common causes of death were sepsis, postpartum haemorrhage, and pulmonary embolism. The most striking deficiency was very poor medical documentation which was observed in 17 cases (94%). In addition, poor communication between doctors and women and their families or among healthcare teams was noticed in nine cases (50%). These were repeatedly described by families during interviews. Further aspects surfacing in many interviews were distrust by families towards clinicians and poor understanding of health conditions by women. Other factors included socioeconomic conditions, poor antenatal attendance and the impact of the 2014 war. Low morale among medical staff was expressed by most interviewed clinicians, as well as the fear of being blamed by families and management in case of adverse events. Substandard care and lack of appropriate supervision were also found in some cases. Conclusions: This study revealed deficiencies in maternity care, some of which were linked to the socioeconomic situation and the 2014 war. Others show poor implementation of clinical guidelines and lack of professional skills in communication and teamwork. Specialised training should be offered for clinicians in order to improve these aspects. However, the most striking deficiency was the extremely poor documentation, reflecting a lack of awareness among clinicians regarding its importance. Local policymakers should focus on systematic application of quality improvement strategies in order to achieve greater patient safety and further reductions in the maternal mortality rate

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Dynamic cross-model multimedia content composition in Personal Area Networks

Das aktuelle Zeitalter lässt sich auf Grund der Evolution der Informationstechnologie während der letzten Jahrzehnten als Informationszeitalter charakterisieren. Aus dieser Entwicklung heraus, die Software und Hardware gleichermaßen betrifft, lassen sich vier, für diese Arbeit relevante, technologische Bereiche unterscheiden: Smartphones, Semantische Web-Technologien, Sozial-Media-Plattformen und Netzwerk-technologien. Diese vier Bereiche haben signifikante Einfluss auf die Erstellung und das Teilen von Multimedia-Inhalten. In dieser Arbeit analysieren wir diesen Einfluss, indem wir angelagerte Aspekte des Themas mit Bezug auf diese Technologiebereiche untersuchen. Im Anschluss präsentieren wir unseren eigenen Ansatz, der diese vier Technologiebereiche einbezieht und Themen umfasst, die noch nicht von anderen Ansätzen abgedeckt sind. Mit der massiven Verbreitung von intelligenten Mobilgeräten hat das Mobile-Computing eine zentrale Rolle übernommen und ersetzt in etlichen Fällen das Desktop-Computing. Dies hat zum Aufkommen neuer Dienste, Plattformen und Technologien geführt. Die ständig wachsende Bedeutung von Sozial-Media-Plattformen im Alltag hat den Begriff des Multimedia-Content-Sharing verändert. Multimedia-Content-Sharing kann nun als Austausch von benutzergenerierten Inhalten sowohl auf privater als auch auf öffentlicher Ebene mittels unterschiedlicher Plattformen, Geräte und Technologien verstanden werden. Dadurch sind neue Anforderungen an die Bereitstellung und das Teilen von Multimedia-Inhalten entstanden. In dieser Arbeit identifizieren wir diese neuen Anforderungen und präsentieren unseren innovativen Ansatz namens Dynamic Cross-Model Composition (DCMC). Der DCMC-Ansatz zielt auf die automatische Analyse, die Bereitstellung und das Teilen von augmentierten Multimedia-Inhalten, angestoßen in einem Personal Area Networks (PAN) über die ermittelten Subjects of Interest (SOI) eines Anwenders. Der DCMC-Ansatz stellt einen erweiterten Multimedia-Content-Bereitstellungsprozess dar. Dieser Prozess baut auf einer generischen Prozesskette für die Zusammensetzung von Multimediainhalten auf und fügt weitere Phasen hinzu. Die Phasen umfassen: PAN-Bildung, Analyse, SOI-Inferenz, Anreicherung, Selektion, Komposition, Transformation und Darstellung. Der erweiterte Bereitstellungsprozess wird durch eine flexible und generische serviceorientierte Architektur unterstützt, die eine SOI-gestützte, regelbasierte Erstellung und gemeinsame Nutzung von Multimedia-Inhalten ermöglicht.The past few decades witnessed the evolution of the Information Technology that characterized our epoch as the Information Age. This evolution impacting both software and hardware inspired us to identify four main technology areas relevant to this thesis: smart devices, Semantic Web technologies, the Social-Network platforms, and networking technologies. These four technology areas have an impact on multimedia content authoring and sharing. In this thesis, we analyze this impact by examining related aspects to this topic considering these technology areas. Then, we present our own approach that incorporates these four technology areas and covers topics not yet covered by other approaches. With the massive proliferation of smart devices, mobile computing has taken over a significant role, replacing in some cases desktop computing and motivating the existence of new services, platforms, and technologies. The ever-expanding role of Social-Network platforms in our lives has changed the notion of multimedia content sharing. Hence, multimedia content sharing can be perceived as the exchange of user generated content both at private and public levels by means of different platforms, devices, and technologies. Consequently, new requirements for multimedia content authoring and sharing emerged. In this thesis, we identify these new requirements and present our innovative approach called Dynamic Cross-Model Composition (DCMC). The DCMC approach aims at the automatic analysis, authoring, and sharing of augmented multimedia presentations driven by a user’s detected Subject of Interest (SOI) in personal area networks (PAN). The DCMC approach introduces an enhanced multimedia content authoring process. This process builds on a generic process chain for multimedia content composition and adds additional phases. The phases include: PAN formation, Analysis, SOI inference, Enrichment, Selection, Composition, Transformation, and Presentation. The enhanced authoring process is supported by a flexible and generic service-oriented architecture enabling a SOI-driven rule-based authoring and sharing of multimedia content

Maternal mortality in the Gaza strip: a look at causes and solutions

Abstract Background Maternal mortality is an important health indicator for the overall health of a population. This study assessed the causes and contributing factors to maternal mortality that occurred in the Gaza-Strip between July 2014 and June 2015. Methods This is a retrospective study that used both quantitative and qualitative data. The data were collected from available medical records, investigation reports, death certificates, and field interviews with healthcare professionals as well as families. Results A total of 18 maternal mortalities occurred in Gaza between 1st July 2014 and June 30th 2015. Age at time of death ranged from 18 to 44 years, with 44.4% occurring before the age of 35 years. About 22.2% were primiparous, while 55.6% were grand multiparous women. The most common causes of death were sepsis, postpartum haemorrhage, and pulmonary embolism. The most striking deficiency was very poor medical documentation which was observed in 17 cases (94%). In addition, poor communication between doctors and women and their families or among healthcare teams was noticed in nine cases (50%). These were repeatedly described by families during interviews. Further aspects surfacing in many interviews were distrust by families towards clinicians and poor understanding of health conditions by women. Other factors included socioeconomic conditions, poor antenatal attendance and the impact of the 2014 war. Low morale among medical staff was expressed by most interviewed clinicians, as well as the fear of being blamed by families and management in case of adverse events. Substandard care and lack of appropriate supervision were also found in some cases. Conclusions This study revealed deficiencies in maternity care, some of which were linked to the socioeconomic situation and the 2014 war. Others show poor implementation of clinical guidelines and lack of professional skills in communication and teamwork. Specialised training should be offered for clinicians in order to improve these aspects. However, the most striking deficiency was the extremely poor documentation, reflecting a lack of awareness among clinicians regarding its importance. Local policymakers should focus on systematic application of quality improvement strategies in order to achieve greater patient safety and further reductions in the maternal mortality rate