Search results for: nursing interventions classification
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4457

Search results for: nursing interventions classification

1307 Dairy Products on the Algerian Market: Proportion of Imitation and Degree of Processing

Authors: Bentayeb-Ait Lounis Saïda, Cheref Zahia, Cherifi Thizi, Ri Kahina Bahmed, Kahina Hallali Yasmine Abdellaoui, Kenza Adli

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Algeria is the leading consumer of dairy products in North Africa. This is a fact. However, the nutritional quality of the latter remains unknown. The aim of this study is to characterise the dairy products available on the Algerian market in order to assess whether they constitute a healthy and safe choice. To do this, it collected data on the labelling of 390 dairy products, including cheese, yoghurt, UHT milk and milk drinks, infant formula and dairy creams. We assessed their degree of processing according to the NOVA classification, as well as the proportion of imitation products. The study was carried out between March 2020 and August 2023. The results show that 88% are ultra-processed; 84% for 'cheese', 92% for dairy creams, 92% for 'yoghurt', 100% for infant formula, 92% for margarines and 36% for UHT milk/dairy drinks. As for imitation/analogue dairy products, the study revealed the following proportions: 100% for infant formula, 78% for butter/margarine, 18% for UHT milk/milk-based drinks, 54% for cheese, 2% for camembert and 75% for dairy cream. The harmful effects of consuming ultra-processed products on long-term health are increasingly documented in dozens of publications. The findings of this study sound the alarm about the health risks to which Algerian consumers are exposed. Various scientific, economic and industrial bodies need to be involved in order to safeguard consumer health in both the short and long term. Food awareness and education campaigns should be organised.

Keywords: dairy, UPF, NOVA, yoghurt, cheese

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1306 Factors Adversely Associated with Breastfeeding among Obese Mothers in Malaysia

Authors: Syahrul Bariah Abdul Hamid, Colin W. Binns, Jun Hui Chih

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The total of obese mothers is growing throughout Asia. Breastfeeding provides the perfect nutrition for infants, by promoting a higher IQ and protecting against childhood and adult diseases. A prospective cohort study was carried out of mothers attending eight antenatal clinics run by the Ministry of Health in Selangor, Malaysia to document the prevalence of obesity and its relationship with breastfeeding outcomes. Mothers were enrolled during the antenatal period and followed up until 6 months postpartum to document breastfeeding outcomes. A total of 652 Malay mothers were recruited for the study a response rate of 93.1 %. The pre-pregnancy body mass index (BMI) of the mothers showed that 36.5% of the mothers were overweight or obese. There were a total of 78 obese mothers in the sample and 41 (52.6%) of these mothers were able to initiate breastfeeding within one hour of birth compared to 238/337 (70.6 %, χ² 9.35, p<0.001) of those with a normal BMI. At 6 months, 23.1 % of obese mothers were exclusively breastfeeding their infants, compared to 56.0 % of the normal BMI mothers. On the other hand, the rate of infant formula feeding was higher in the obese mothers by 53.8 % compared to 19.0 % among normal weight mothers, χ² 37.6, p<0.001). Further analysis suggested these factors were found to be positively associated with discontinued exclusive breastfeeding at 6 months among obese mothers; mothers whom delayed breastfeeding initiation, had health problems during pregnancy, caesarean delivery, reported had insufficient colostrum/milk and babies had sucking problems at or before 4 weeks. Besides that, mothers who perceived their biological mothers had preference towards formula feeding or were ambivalent about the feeding method and had biological mothers without experience in breastfeeding for more than 1 month also were more likely to discontinue exclusive breastfeeding at 6 months. These findings suggested that the greater the pre-pregnant BMI, the earlier the cessation of exclusive breastfeeding and they were also less likely to initiate breastfeeding and have less adequate milk supply. Future investigations of the effects of maternal obesity on breastfeeding outcomes should be conducted along with effective interventions to advance the care of obese women at reproductive age and their children.

Keywords: exclusive breastfeeding, body mass index (BMI), breastfeeding discontinuation, maternal obesity

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1305 Decisional Regret in Men with Localized Prostate Cancer among Various Treatment Options and the Association with Erectile Functioning and Depressive Symptoms: A Moderation Analysis

Authors: Caren Hilger, Silke Burkert, Friederike Kendel

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Men with localized prostate cancer (PCa) have to choose among different treatment options, such as active surveillance (AS) and radical prostatectomy (RP). All available treatment options may be accompanied by specific psychological or physiological side effects. Depending on the nature and extent of these side effects, patients are more or less likely to be satisfied or to struggle with their treatment decision in the long term. Therefore, the aim of this study was to assess and explain decisional regret in men with localized PCa. The role of erectile functioning as one of the main physiological side effects of invasive PCa treatment, depressive symptoms as a common psychological side effect, and the association of erectile functioning and depressive symptoms with decisional regret were investigated. Men with localized PCa initially managed with AS or RP (N=292) were matched according to length of therapy (mean 47.9±15.4 months). Subjects completed mailed questionnaires assessing decisional regret, changes in erectile functioning, depressive symptoms, and sociodemographic variables. Clinical data were obtained from case report forms. Differences among the two treatment groups (AS and RP) were calculated using t-tests and χ²-tests, relationships of decisional regret with erectile functioning and depressive symptoms were computed using multiple regression. Men were on average 70±7.2 years old. The two treatment groups differed markedly regarding decisional regret (p<.001, d=.50), changes in erectile functioning (p<.001, d=1.2), and depressive symptoms (p=.01, d=.30), with men after RP reporting higher values, respectively. Regression analyses showed that after adjustment for age, tumor risk category, and changes in erectile functioning, depressive symptoms were still significantly associated with decisional regret (B=0.52, p<.001). Additionally, when predicting decisional regret, the interaction of changes in erectile functioning and depressive symptoms reached significance for men after RP (B=0.52, p<.001), but not for men under AS (B=-0.16, p=.14). With increased changes in erectile functioning, the association of depressive symptoms with decisional regret became stronger in men after RP. Decisional regret is a phenomenon more prominent in men after RP than in men under AS. Erectile functioning and depressive symptoms interact in their prediction of decisional regret. Screening and treating depressive symptoms might constitute a starting point for interventions aiming to reduce decisional regret in this target group.

Keywords: active surveillance, decisional regret, depressive symptoms, erectile functioning, prostate cancer, radical prostatectomy

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1304 A Cross-Sectional Study on Management of Common Mental Disorders Among Patients Living with HIV/AIDS Attending Antiretroviral Treatment (ART) Clinic in Hoima Regional Referral Hospital Uganda

Authors: Agodo Mugenyi Herbert

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Background: A high prevalence of both HIV infection and mental disorders exists in Sub-Saharan Africa, however there is little integration of care for mental health disorders among HIV-infected individuals. The study aimed at determining the management of common mental disorders among HIV/AIDS clients attending Antiretroviral clinic in Hoima regional referral hospital. Significancy of the study: The information generated by this study would help mental health advocates, ministry of health, Civil society organizations in HIV programming to advocate for enhanced mental health care for PLWHA. The result will be used in policy development and lobbying for integration of mental health care in HIV/AIDS care. Methods: This study applied a cross sectional design. It involved data collection from clients with HIV/AIDS attending ART clinic in Hoima regional referral hospital at one specific point in time. It aimed at providing data on the entire population under study. Data was collected from Hoima Regional Referral Hospital at the ART clinic. Data analysis was performed using SPSS version 24. Results: 66 HIV/AIDS clients and 10 health workers in the ART clinic who participated fully completed the study. The overall prevalence of at least one form of mental disorder was 83%. Majority of the health care practitioner do not use pharmacological, psychological, and social interventions to manage such disorders. Conclusion: These results are suggestive of a significant proportion of the HIV-infected patients experiencing psychological difficulty for which they do not receive treatment Recommendations: Current care practices applied to patients with HIV/AIDS should be integrated more generally to include treatment services to identify and manage common mental disorders.

Keywords: common mental disorders, mental health, mental illness, and severe mental illness

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1303 Exploring Academic Writing Challenges of First Year English as an Additional Language Students at an ODeL Institution in South Africa

Authors: Tumelo Jaquiline Ntsopi

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This study explored the academic writing challenges of first-year students who use English as an Additional Language (EAL) registered in the EAW101 module at an ODeL institution. Research shows that academic writing is a challenge for EAL teaching and learning contexts across the globe in higher education institutions (HEIs). Academic writing is an important aspect of academic literacy in any institution of higher learning, more so in an ODeL institution. This has probed research that shows that academic writing is and continues to pose challenges for EAL teaching and learning contexts in higher education institutions. This study stems from the researcher’s experience in teaching academic writing to first-year students in the EAW101 module. The motivation for this study emerged from the fact that EAW101 is a writing module that has a high number of students in the Department of English Studies with an average of between 50-80 percent pass rate. These statistics elaborate on the argument that most students registered in this module struggle with academic writing, and they need intervention to assist and support them in achieving competence in the module. This study is underpinned by Community of Inquiry (CoI) framework and Transactional distance theory. This study adopted a qualitative research methodology and utilised a case study approach as a research design. Furthermore, the study gathered data from first year students and the EAW101 module’s student support initiatives. To collect data, focus group discussions, structured open-ended evaluation questions, and an observation schedule were used to gather data. The study is vital towards exploring academic writing challenges that first-year students in EAW101 encounter so that lecturers in the module may consider re-evaluating their methods of teaching to improve EAL students’ academic writing skills. This study may help lecturers towards enhancing academic writing in a ODeL context by assisting first year students through using student support interventions.

Keywords: academic writing, academic writing challenge, ODeL, EAL

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1302 Innovation and Employment in Sub-Saharan Africa: Evidence from Uganda Microdata

Authors: Milton Ayoki, Edward Bbaale

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This paper analyses the relationship between innovation and employment at firm level with the objective of understanding the contribution of the different innovation strategies in fostering employment growth in Uganda. We use National Innovation Survey (micro-data of 705 Ugandan firms) for the period 2011-2014 and follow closely Harrison et al. (2014) structured approach, and relate employment growth to process innovations and to the growth of sales separately due to innovative and unchanged products. We find positive effects of product innovation on employment at firm level, while process innovation has no discernable impact on employment. Although there is evidence to suggest displacement of labour in some cases where firms only introduce new process, this effect is compensated by growth in employment from new products, which for most firms are introduced simultaneously with new process. Results suggest that source of innovation as well as size of innovating firms or end users of innovation matter for job growth. Innovation that develops from within the firm itself (user) and involving larger firms has greater impact on employment than that developed from outside or coming from within smaller firms. In addition, innovative firms are one and half times more likely to survive in the innovation driven economy environment than those that do not innovate. These results have important implications for policymakers and stakeholders in innovation ecosystem. Supporting policies need to be correctly tailored since the impacts depend on the innovation strategy (type) and characteristics and sector of the innovative firms (small, large, industry, etc.). Policies to spur investment, particularly in innovative sectors and firms with high growth potential would have long lasting effects on job creation. JEL Classification: D24, J0, J20, L20, O30.

Keywords: employment, process innovation, product innovation, Sub-Saharan Africa

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1301 Artificial Intelligence Based Abnormality Detection System and Real Valuᵀᴹ Product Design

Authors: Junbeom Lee, Jaehyuck Cho, Wookyeong Jeong, Jonghan Won, Jungmin Hwang, Youngseok Song, Taikyeong Jeong

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This paper investigates and analyzes meta-learning technologies that use multiple-cameras to monitor and check abnormal behavior in people in real-time in the area of healthcare fields. Advances in artificial intelligence and computer vision technologies have confirmed that cameras can be useful for individual health monitoring and abnormal behavior detection. Through this, it is possible to establish a system that can respond early by automatically detecting abnormal behavior of the elderly, such as patients and the elderly. In this paper, we use a technique called meta-learning to analyze image data collected from cameras and develop a commercial product to determine abnormal behavior. Meta-learning applies machine learning algorithms to help systems learn and adapt quickly to new real data. Through this, the accuracy and reliability of the abnormal behavior discrimination system can be improved. In addition, this study proposes a meta-learning-based abnormal behavior detection system that includes steps such as data collection and preprocessing, feature extraction and selection, and classification model development. Various healthcare scenarios and experiments analyze the performance of the proposed system and demonstrate excellence compared to other existing methods. Through this study, we present the possibility that camera-based meta-learning technology can be useful for monitoring and testing abnormal behavior in the healthcare area.

Keywords: artificial intelligence, abnormal behavior, early detection, health monitoring

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1300 Sexual Behaviours among Iranian Men and Women Aged 15 to 49 Years in Metropolitan Tehran, Iran: A Cross-Sectional Study

Authors: Mahnaz Motamedi, Mohammad Shahbazi, Shahrzad Rahimi-Naghani, Mehrdad Salehi

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Introduction and Aim: This study assessed sexual behaviours among men and women aged 15 to 49 years in Tehran. Material and Methods: This was a cross-sectional study conducted on 755 men and women aged 15 to 49 years who were residents of Tehran. To select the participants, a multistage, cluster, random sampling method was used and included different regions of Tehran. The data were collected using the WHO-endorsed Questionnaire of Sexual and Reproductive Health. Descriptive, bivariate, and multivariate analyses were conducted using SPSS version 20. Sexual and reproductive health (SRH) behaviours was a scale variable that was constructed from items of six sections: sexual experiences, characteristics of the first sexual partner, characteristics of the first intercourse, next sexual contact and the consequences of the first sexual contact, homosexual experiences and the causes of sexual abstinence. Results: The mean age at the time of sexual intercourse with penetration (vaginal, anal) was 19.88 in men and 21.82 in women. Multivariate analysis using linear regression showed that by controlling for other variables, gender had a significant relationship with having sexual experience, mean age of first sexual intercourse, and being multi-partner. Thus, women with sexual experience were 0.158 units less than men. The mean age of first intercourse in women was 1.57 units higher than men and being a multi-partner in women was 0.247 less than men (P < 0.001). Sexual experience in very religious and relatively religious individuals was 0.332 and 0.218 units less than those for whom religion did not matter (P < 0.001). 25.6% of men and 40.7% of women who did not have sexual experience at the time of the study stated that their reason for abstinence was their unwillingness to have sex (P < 0.05). 35.9% of men and 16.5% of women stated that the reason for abstinence was not providing a suitable opportunity (P < 0.001). 4.7% of men and 1.7% of women had sexual attraction to the same sex. The difference between men and women was significant (P < 0.001). Conclusion: Sexual relation is also present in singles and younger groups and is not limited to married or final marriage candidates. Therefore, more evaluation should be done in national research and interventions for sexual and reproductive health services should be done at the macro level of policy making.

Keywords: sexual behaviours, Iranian men and women, Iran, cross-sectional study

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1299 A Neurofeedback Learning Model Using Time-Frequency Analysis for Volleyball Performance Enhancement

Authors: Hamed Yousefi, Farnaz Mohammadi, Niloufar Mirian, Navid Amini

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Investigating possible capacities of visual functions where adapted mechanisms can enhance the capability of sports trainees is a promising area of research, not only from the cognitive viewpoint but also in terms of unlimited applications in sports training. In this paper, the visual evoked potential (VEP) and event-related potential (ERP) signals of amateur and trained volleyball players in a pilot study were processed. Two groups of amateur and trained subjects are asked to imagine themselves in the state of receiving a ball while they are shown a simulated volleyball field. The proposed method is based on a set of time-frequency features using algorithms such as Gabor filter, continuous wavelet transform, and a multi-stage wavelet decomposition that are extracted from VEP signals that can be indicative of being amateur or trained. The linear discriminant classifier achieves the accuracy, sensitivity, and specificity of 100% when the average of the repetitions of the signal corresponding to the task is used. The main purpose of this study is to investigate the feasibility of a fast, robust, and reliable feature/model determination as a neurofeedback parameter to be utilized for improving the volleyball players’ performance. The proposed measure has potential applications in brain-computer interface technology where a real-time biomarker is needed.

Keywords: visual evoked potential, time-frequency feature extraction, short-time Fourier transform, event-related spectrum potential classification, linear discriminant analysis

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1298 In-Situ Studies of Cyclohexane Oxidation Using Laser Raman Spectroscopy for the Refinement of Mechanism Based Kinetic Models

Authors: Christine Fräulin, Daniela Schurr, Hamed Shahidi Rad, Gerrit Waters, Günter Rinke, Roland Dittmeyer, Michael Nilles

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The reaction mechanisms of many liquid-phase reactions in organic chemistry have not yet been sufficiently clarified. Process conditions of several hundred degrees celsius and pressures to ten megapascals complicate the sampling and the determination of kinetic data. Space resolved in-situ measurements promises new insights. A non-invasive in-situ measurement technique has the advantages that no sample preparation is necessary, there is no change in sample mixture before analysis and the sampling do no lead to interventions in the flow. Thus, the goal of our research was the development of a contact-free spatially resolved measurement technique for kinetic studies of liquid phase reaction under process conditions. Therefore we used laser Raman spectroscopy combined with an optical transparent microchannel reactor. To show the performance of the system we choose the oxidation of cyclohexane as sample reaction. Cyclohexane oxidation is an economically important process. The products are intermediates for caprolactam and adipic acid, which are starting materials for polyamide 6 and 6.6 production. To maintain high selectivities of 70 to 90 %, the reaction is performed in industry at a low conversion of about six percent. As Raman spectroscopy is usually very selective but not very sensitive the detection of the small product concentration in cyclohexane oxidation is quite challenging. To meet these requirements, an optical experimental setup was optimized to determine the concentrations by laser Raman spectroscopy with respect to good detection sensitivity. With this measurement technique space resolved kinetic studies of uncatalysed and homogeneous catalyzed cyclohexane oxidation were carried out to obtain details about the reaction mechanism.

Keywords: in-situ laser raman spectroscopy, space resolved kinetic measurements, homogeneous catalysis, chemistry

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1297 From Colonial Outpost to Cultural India: Folk Epics of India

Authors: Jyoti Brahma

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Folk epics of India are found in various Indian languages. The study of folk epics and its importance in folkloristic study in India came into prominence only during the nineteenth century. The British administrators and missionaries collected and documented folk epics from various parts of the country. The paper is an attempt to investigate how colonial outpost appears to penetrate the interiors of Indian land and society and triggered off the Indian Renaissance. It takes into account the compositions of the epics of India and the attention it received during the nineteenth century, which in turn gave, rise to the national consciousness shaping the culture of India. Composed as oral traditions these folk epics are now seen as repositories of historical consciousness whereas in earlier times societies without literacy were said to be without history. So, there is an urgent need to re-examine the British impact on Indian literary traditions. The Bhakti poets through their nuanced responses in their efforts to change the behavior of Indian society gives us the perfect example of deferment in the clear cut distinction between the folk and the classical in the context of India. It evades a pure categorization and classification of the classical and constitutes part of the folk traditions of the cultural heritage of India. Therefore, the ethical question of what is ontologically known as ordinary discourse in the case of the “folk” forms metaphors and folk language gains importance once more. The paper also thus seeks simultaneously to outline the significant factors responsible for shaping the destiny of folklore in South India particularly the four political states of the Indian Union: Andhra Pradesh, Karnataka, Kerala and Tamil Nadu, what could be termed as South Indian “cultural zones”.

Keywords: colonial, folk, folklore, tradition

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1296 Prioritizing Forest Conservation Strategies Using a Multi-Attribute Decision Model to Address Concerns with the Survival of the Endangered Dragon Tree (Dracaena ombet Kotschy and Peyr.)

Authors: Tesfay Gidey, Emiru Birhane, Ashenafi Manaye, Hailemariam Kassa, Tesfay Atsbha, Negasi Solomon, Hadgu Hishe, Aklilu Negussie, Petr Madera, Jose G. Borges

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The globally endangered Dracaena ombet is one of the ten dragon multipurpose tree species in arid ecosystems. Anthropogenic and natural factors are now impacting the sustainability of the species. This study was conducted to prioritize criteria and alternative strategies for the conservation of the species using the analytical hierarchy process (AHP) model by involving all relevant stakeholders in the Desa'a dry Afromontane forest in northern Ethiopia. Information about the potential alternative strategies and the criteria for their evaluation was first collected from experts, personal experiences, and literature reviews. Afterward, they were validated using stakeholders' focus group discussions. Five candidate strategies with three evaluation criteria were considered for prioritization using the AHP techniques. The overall priority ranking value of the stakeholders showed that the ecological criterion was deemed as the most essential factor for the choice of alternative strategies, followed by the economic and social criteria. The minimum cut-off strategy, combining exclosures with the collection of only 5% of plant parts from the species, soil and water conservation, and silviculture interventions, was selected as the best alternative strategy for sustainable D. ombet conservation. The livelihood losses due to the selected strategy should be compensated by the collection of non-timber forest products, poultry farming, home gardens, rearing small ruminants, beekeeping, and agroforestry. This approach may be extended to study other dragon tree species and explore strategies for the conservation of other arid ecosystems.

Keywords: conservation strategies, analytical hierarchy process model, Desa'a forest, endangered species, Ethiopia, overexploitation

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1295 Giving Right-of-Way to Emergency Ambulances: Attitude and Behavior of Road Users in Developing Countries

Authors: Mahmoud T. Alwidyan, Ahmad Alrawashdeh, Alaa O. Oteir

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Background: Emergency medical service (EMS) providers, oftentimes, use the lights and sirens (L&S) of their ambulances to warn road users, navigate through traffic, and expedite transport to save lives of ill and injured patients. Despite the contribution of road users in the effectiveness of reducing transport time of EMS ambulances using L&S, there is a lack of empirical assessments exploring the road user’s attitude and behavior in such situations. This study, therefore, aimed to assess the attitude and behavior of road users in response to EMS ambulances with warning L&S in use. Methods: This was a cross-sectional survey developed and distributed to adult road users in Northern Jordan. The questionnaire included 20 items addressing demographics, attitudes, and behavior toward emergency ambulances. We described the participants’ responses and assessed the association between demographics and attitude statements using logistic regression. Results: A total of 1302 questionnaires were complete and appropriate for analysis. The mean age was 34.2 (SD± 11.4) years, and the majority were males (72.6%). About half of road users (47.9%) in our sample would perform inappropriate action in response to EMS ambulances with L&S in use. The multivariate logistic regression model show that being female (OR, 0.63; 95% CI = 0.48-0.81), more educated (OR, 0.68; 95% CI = 0.53-0.86), or public transport driver (OR, 0.55; 95% CI = 0.34-0.90) is significantly associated with inappropriate response to EMS ambulances. Additionally, a significant proportion of road users may perform inappropriate and lawless driving practices such as crossing red traffic lights or following the passing by EMS ambulances, which would, in turn, increase the risk on ambulances and other road users. Conclusions: A large proportion of road users in Jordan may respond inappropriately to the EMS ambulances, and many engage in risky driving behaviors due perhaps to the lack of procedural knowledge. Policy-related interventions and educational programs are crucially needed to increase public awareness of the traffic law concerning EMS ambulances and to enhance appropriate driving behavior, which, in turn, improves the efficiency of ambulance services.

Keywords: EMS ambulances, lights and sirens, road users, attitude and behavior

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1294 Efficient Human Motion Detection Feature Set by Using Local Phase Quantization Method

Authors: Arwa Alzughaibi

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Human Motion detection is a challenging task due to a number of factors including variable appearance, posture and a wide range of illumination conditions and background. So, the first need of such a model is a reliable feature set that can discriminate between a human and a non-human form with a fair amount of confidence even under difficult conditions. By having richer representations, the classification task becomes easier and improved results can be achieved. The Aim of this paper is to investigate the reliable and accurate human motion detection models that are able to detect the human motions accurately under varying illumination levels and backgrounds. Different sets of features are tried and tested including Histogram of Oriented Gradients (HOG), Deformable Parts Model (DPM), Local Decorrelated Channel Feature (LDCF) and Aggregate Channel Feature (ACF). However, we propose an efficient and reliable human motion detection approach by combining Histogram of oriented gradients (HOG) and local phase quantization (LPQ) as the feature set, and implementing search pruning algorithm based on optical flow to reduce the number of false positive. Experimental results show the effectiveness of combining local phase quantization descriptor and the histogram of gradient to perform perfectly well for a large range of illumination conditions and backgrounds than the state-of-the-art human detectors. Areaunder th ROC Curve (AUC) of the proposed method achieved 0.781 for UCF dataset and 0.826 for CDW dataset which indicates that it performs comparably better than HOG, DPM, LDCF and ACF methods.

Keywords: human motion detection, histograms of oriented gradient, local phase quantization, local phase quantization

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1293 Acculturation Impact on Mental Health Among Arab Americans

Authors: Sally Kafelghazal

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Introduction: Arab Americans, who include immigrants, refugees, or U.S. born persons of Middle Eastern or North African descent, may experience significant difficulties during acculturation to Western society. Influential stressors include relocation, loss of social support, language barriers, and economic factors, all of which can impact mental health. There is limited research investigating the effects of acculturation on the mental health of the Arab American population. Objectives: The purpose of this study is to identify ways in which acculturation impacts the mental health of Arab Americans, specifically the development of depression and anxiety. Method: A literature search was conducted using PubMed and PsycArticles (ProQuest), utilizing the following search terms: “Arab Americans,” “Arabs,” “mental health,” “depression,” “anxiety,” “acculturation.” Thirty-nine articles were identified and of those, nine specifically investigated the relationship between acculturation and mental health in Arab Americans. Three of the nine focused exclusively on depression. Results: Several risk factors were identified that contribute to poor mental health associated with acculturation, which include immigrant or refugee status, facing discrimination, and religious ideology. Protective factors include greater levels of acculturation, being U.S. born, and greater heritage identity. Greater mental health disorders were identified in Arab Americans compared to normative samples, perhaps particularly depression; none of the articles specifically addressed anxiety. Conclusion: The current research findings support the potential association between the process of acculturation and greater levels of mental health disorders in Arab Americans. However, the diversity of the Arab American population makes it difficult to draw consistent conclusions. Further research needs to be conducted in order to assess which subgroups in the Arab American population are at highest risk for developing new or exacerbating existing mental health disorders in order to devise more effective interventions.

Keywords: arab americans, arabs, mental health, anxiety, depression, acculturation

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1292 The Effectiveness of Laser In situ Keratomileusis for Correction Various Types of Refractive Anomalies

Authors: Yuliya Markava

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The laser in situ keratomileusis (LASIK) is widely common surgical procedure, which has become an alternative for patients who are not satisfied with the performance of other correction methods. A high level of patient satisfaction functional outcomes after refractive surgery confirms the high reliability and safety of LASIK and provides a significant improvement in the quality of life and social adaptation. Purpose: To perform clinical analysis of the results of correction made to the excimer laser system SCHWIND AMARIS 500E in patients with different types of refractive anomalies. Materials and Methods: This was a retrospective analysis of 1581 operations (812 patients): 413 males (50.86%) and 399 females (49.14%) at the age from 18 to 47 years with different types of ametropia. All operations were performed on excimer laser SCHWIND AMARIS 500E in the LASIK procedure. Formation of the corneal flap was made by mechanical microkeratome SCHWIND. Results: Analyzing the structure of refractive anomalies: The largest number of interventions accounted for myopia: 1505 eyes (95.2%), of which about a low myopia: 706 eyes (44.7%), moderate myopia: 562 eyes (35.5 %), high myopia: eyes 217 (13.7%) and supermyopia: 20 eyes (1.3%). Hyperopia was 0.7% (11 eyes), mixed astigmatism: 4.1% (65 eyes). The efficiency was 80% (in patients with supermyopia) to 91.6% and 95.4% (in groups with myopia low and moderate, respectively). Uncorrected visual acuity average values before and after laser operation was in groups: a low myopia 0.18 (up 0.05 to 0.31) and 0.80 (up 0.60 to 1.0); moderate myopia 0.08 (up 0.03 to 0.13) and 0.87 ( up 0.74 to 1.0); high myopia 0.05 (up 0.02 to 0.08) and 0.83 (up 0.66 to 1.0); supermyopia 0.03 (up 0.02 to 0.04) and 0.59 ( up 0.34 to 0.84); hyperopia 0.27 (up 0.16 to 0.38) and 0.57 (up 0.27 to 0.87); mixed astigmatism of 0.35 (up 0.19 to 0.51) and 0.69 (up 0.44 to 0.94). In all cases, after LASIK indicators uncorrected visual acuity significantly increased. Reoperation was 4.43%. Significance: Clinical results of refractive surgery at the excimer laser system SCHWIND AMARIS 500E in different ametropia correction is characterized by high efficiency.

Keywords: effectiveness of laser correction, LASIK, refractive anomalies, surgical treatment

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1291 A Proposed Inclusive Motor Skill Intervention Programme for Pre-schoolers in Low Resources Areas in Preparation of School Readiness

Authors: J. Van der Walt, N. A. Plastow, M. Unger

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Gross and fine motor skill difficulties among children affect their ability to learn and progress in school. Research indicates that children in low socio-economic areas are at a higher risk of motor skill difficulties, while therapy resources are limited. The Hopscotch motor skill programme is a well-researched accessible in-school intervention developed by occupational and physiotherapists through complex intervention development. The development stage of the complex intervention development model firstly included a prevalence study in a low-resourced area in the West Coast of South Africa, indicating a high prevalence with significant motor skill difficulties among pre-school children at 14.5% with fine motor skill difficulties at 24.6%. A scoping review identifies motor skill interventions for pre-school children and a proposed a framework of fundamental concepts to consider when developing a motor skill intervention. a Delphi-study considered the framework and encouraged collaboration between therapists and educators to make the programme accessible, resource and cost effective, specifically geared towards a rural, low resourced area. The results from the Delphi study, together with the proposed framework from the scoping review was used to develop the Hopscotch programme, adopting a task-shifting approach. The eight-week small-group programme is facilitated by teachers with the support of therapists. The programme aims to improve the motor skills of pre-school aged children with motor skill difficulties to promote academic readiness through obstacle courses, ball skill games and fine motor games and crafts. A randomised controlled trial is planned as a next stage to determine the preliminary effect of the programme on the motor and early academic skills of pre-school children.

Keywords: accesible learning, motor skill intervention, school readiness, task shifting

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1290 Evaluation of the Analytic for Hemodynamic Instability as a Prediction Tool for Early Identification of Patient Deterioration

Authors: Bryce Benson, Sooin Lee, Ashwin Belle

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Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring

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1289 Effects of Using Clinical Practice Guidelines for Caring for Patients with Severe Sepsis or Septic Shock on Clinical Outcomes Based on the Sepsis Bundle Protocol at the ICU of Songkhla Hospital Thailand

Authors: Pornthip Seangsanga

Abstract:

Sepsis or septic shock needs urgent care because it is a cause of the high mortality rate if patients do not receive timely treatment. Songkhla Hospital does not have a clear system or clinical practice guidelines for treatment of patients with severe sepsis or septic shock, which contributes to the said problem.To compare clinical outcomes based on the protocol after using the clinical guidelines between the Emergency Room, Intensive Care Unit, and the Ward. This quasi-experimental study was conducted on the population and 50 subjects who were diagnosed with severe sepsis or septic shock from December 2013 to May 2014. The data were collected using a nursing care and referring record form for patients with severe sepsis or septic shock at Songkhla Hospital. The record form had been tested for its validity by three experts, and the IOC was 1.The mortality rate in patients with severe sepsis or septic shock who were moved from the ER to the ICU was significantly lower than that of those patients moved from the Ward to the ICU within 48 hours. This was because patients with severe sepsis or septic shock who were moved from the ER to the ICU received more fluid within the first six hours according to the protocol which helped patients to have adequate tissue perfusion within the first six hours, and that helped improve blood flow to the kidneys, and the patients’ urine was found to be with a higher quantity of 0.5 cc/kg/hr, than those patients who were moved from the Ward to the ICU. This study shows that patients with severe sepsis or septic shock need to be treated immediately. Using the clinical practice guidelines along with timely diagnosis and treatment based on the sepsis bundle in giving sufficient and suitable amount of fluid to help improve blood circulation and blood pressure can clearly prevent or reduce severity of complications.

Keywords: clinical practice guidelines, caring, septic shock, sepsis bundle protocol

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1288 Evaluation of the Impact of Telematics Use on Young Drivers’ Driving Behaviour: A Naturalistic Driving Study

Authors: WonSun Chen, James Boylan, Erwin Muharemovic, Denny Meyer

Abstract:

In Australia, drivers aged between 18 and 24 remained at high risk of road fatality over the last decade. Despite the successful implementation of the Graduated Licensing System (GLS) that supports young drivers in their early phases of driving, the road fatality statistics for these drivers remains high. In response to these statistics, studies conducted in Australia prior to the start of the COVID-19 pandemic have demonstrated the benefits of using telematics devices for improving driving behaviour, However, the impact of COVID-19 lockdown on young drivers’ driving behaviour has emerged as a global concern. Therefore, this naturalistic study aimed to evaluate and compare the driving behaviour(such as acceleration, braking, speeding, etc.) of young drivers with the adoption of in-vehicle telematics devices. Forty-two drivers aged between 18 and 30 and residing in the Australian state of Victoria participated in this study during the period of May to October 2022. All participants drove with the telematics devices during the first 30-day. At the start of the second 30-day, twenty-one participants were randomised to an intervention group where they were provided with an additional telematics ray device that provided visual feedback to the drivers, especially when they committed to aggressive driving behaviour. The remaining twenty-one participants remined their driving journeys without the extra telematics ray device (control group). Such trustworthy data enabled the assessment of changes in the driving behaviour of these young drivers using a machine learning approach in Python. Results are expected to show participants from the intervention group will show improvements in their driving behaviour compared to those from the control group.Furthermore, the telematics data enable the assessment and quantification of such improvements in driving behaviour. The findings from this study are anticipated to shed some light in guiding the development of customised campaigns and interventions to further address the high road fatality among young drivers in Australia.

Keywords: driving behaviour, naturalistic study, telematics data, young drivers

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1287 Military Role of Russia beyond Its National Boundary

Authors: Nipuli Gajanayake

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The Russian military role beyond its national frontier has become a debatable hot topic in the international political arena. It’s advanced, and strategic responses in combating regional and international security problems have always been a factor to debate and criticize. Under such critical circumstances, Russia is attentive to play its military role according to the provisions of the Military Doctrine of the Russian Federation. Most importantly, the legal basis of the doctrine has also consisted with the generally recognized principles and norms of international law. Therefore, Russian international military assistances are pledged to accomplish international peace and security. The expansion of Russian military participation in the United Nations Peacekeeping operations, and military- political, and technical cooperation have largely evident the great effort of Russia in maintaining and restoring international peace and security. Moreover, the conflict management diplomacy and the development of dialogue with nation states to confront military risks and threats can also identify as a part of preserving international peace and security. In addition, Russia strives to strengthen the system of collective security with regional and international organizations through the legal framework of the Collective Security Treaty Organization (CSTO). Maintaining cooperative ties with the Commonwealth of Independent States (CIS), the Organization for Security and Cooperation in Europe (OSCE) and the Shanghai Cooperation Organization (SCO) have highlighted the Russian deliberation on maintaining regional peace and security. Nevertheless, the extension of cordial relations with nation states and providing of military assistances during tensions and conflicts on their territories can also underscore as Russians commitments on maintaining international peace and security. Observing and recognizing the disparity between the West portrayed terms like ‘illegal Russian interventions’ and the comprehensive reality behind the ‘Russian military assistances’ are important to understand. However, a lopsided vision or a perspective towards the Russian international military role would not present a clear understanding about its valued and also dedicated hard work on maintaining international peace and security.

Keywords: collective security, diplomacy, international military role of Russia, international peace and security

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1286 Internet of Things Networks: Denial of Service Detection in Constrained Application Protocol Using Machine Learning Algorithm

Authors: Adamu Abdullahi, On Francisca, Saidu Isah Rambo, G. N. Obunadike, D. T. Chinyio

Abstract:

The paper discusses the potential threat of Denial of Service (DoS) attacks in the Internet of Things (IoT) networks on constrained application protocols (CoAP). As billions of IoT devices are expected to be connected to the internet in the coming years, the security of these devices is vulnerable to attacks, disrupting their functioning. This research aims to tackle this issue by applying mixed methods of qualitative and quantitative for feature selection, extraction, and cluster algorithms to detect DoS attacks in the Constrained Application Protocol (CoAP) using the Machine Learning Algorithm (MLA). The main objective of the research is to enhance the security scheme for CoAP in the IoT environment by analyzing the nature of DoS attacks and identifying a new set of features for detecting them in the IoT network environment. The aim is to demonstrate the effectiveness of the MLA in detecting DoS attacks and compare it with conventional intrusion detection systems for securing the CoAP in the IoT environment. Findings: The research identifies the appropriate node to detect DoS attacks in the IoT network environment and demonstrates how to detect the attacks through the MLA. The accuracy detection in both classification and network simulation environments shows that the k-means algorithm scored the highest percentage in the training and testing of the evaluation. The network simulation platform also achieved the highest percentage of 99.93% in overall accuracy. This work reviews conventional intrusion detection systems for securing the CoAP in the IoT environment. The DoS security issues associated with the CoAP are discussed.

Keywords: algorithm, CoAP, DoS, IoT, machine learning

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1285 Analysis of the Unmanned Aerial Vehicles’ Incidents and Accidents: The Role of Human Factors

Authors: Jacob J. Shila, Xiaoyu O. Wu

Abstract:

As the applications of unmanned aerial vehicles (UAV) continue to increase across the world, it is critical to understand the factors that contribute to incidents and accidents associated with these systems. Given the variety of daily applications that could utilize the operations of the UAV (e.g., medical, security operations, construction activities, landscape activities), the main discussion has been how to safely incorporate the UAV into the national airspace system. The types of UAV incidents being reported range from near sightings by other pilots to actual collisions with aircraft or UAV. These incidents have the potential to impact the rest of aviation operations in a variety of ways, including human lives, liability costs, and delay costs. One of the largest causes of these incidents cited is the human factor; other causes cited include maintenance, aircraft, and others. This work investigates the key human factors associated with UAV incidents. To that end, the data related to UAV incidents that have occurred in the United States is both reviewed and analyzed to identify key human factors related to UAV incidents. The data utilized in this work is gathered from the Federal Aviation Administration (FAA) drone database. This study adopts the human factor analysis and classification system (HFACS) to identify key human factors that have contributed to some of the UAV failures to date. The uniqueness of this work is the incorporation of UAV incident data from a variety of applications and not just military data. In addition, identifying the specific human factors is crucial towards developing safety operational models and human factor guidelines for the UAV. The findings of these common human factors are also compared to similar studies in other countries to determine whether these factors are common internationally.

Keywords: human factors, incidents and accidents, safety, UAS, UAV

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1284 Image Recognition Performance Benchmarking for Edge Computing Using Small Visual Processing Unit

Authors: Kasidis Chomrat, Nopasit Chakpitak, Anukul Tamprasirt, Annop Thananchana

Abstract:

Internet of Things devices or IoT and Edge Computing has become one of the biggest things happening in innovations and one of the most discussed of the potential to improve and disrupt traditional business and industry alike. With rises of new hang cliff challenges like COVID-19 pandemic that posed a danger to workforce and business process of the system. Along with drastically changing landscape in business that left ruined aftermath of global COVID-19 pandemic, looming with the threat of global energy crisis, global warming, more heating global politic that posed a threat to become new Cold War. How emerging technology like edge computing and usage of specialized design visual processing units will be great opportunities for business. The literature reviewed on how the internet of things and disruptive wave will affect business, which explains is how all these new events is an effect on the current business and how would the business need to be adapting to change in the market and world, and example test benchmarking for consumer marketed of newer devices like the internet of things devices equipped with new edge computing devices will be increase efficiency and reducing posing a risk from a current and looming crisis. Throughout the whole paper, we will explain the technologies that lead the present technologies and the current situation why these technologies will be innovations that change the traditional practice through brief introductions to the technologies such as cloud computing, edge computing, Internet of Things and how it will be leading into future.

Keywords: internet of things, edge computing, machine learning, pattern recognition, image classification

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1283 Exploring Gender-Based Violence in Indigenous Communities in Argentina and Costa Rica: A Review of the Current Literature

Authors: Jocelyn Jones

Abstract:

The objective of this literature review is to provide an assessment of the current literature concerning gender-based violence (GBV) within indigenous communities in Argentina and Costa Rica, and various public intervention strategies that have been implemented to counter the increasing rates of violence within these populations. The review will address some of the unique challenges and contextual factors influencing the prevalence and response to such violence, including the enduring impact of colonialism on familial structures, community dynamics, and the perpetuation of violence. Drawing on indigenous feminist perspectives, the paper critically assesses the intersectionality of gender, ethnicity, and socio-economic status in shaping the experiences of indigenous women, men, and gender-diverse individuals. In comparing the two nations, the literature review identifies commonalities and divergences in policy frameworks, legal responses, and grassroots initiatives aimed at addressing GBV. Regarding the assessment of the efficacy of existing interventions, the paper will consider the role of cultural revitalization, community engagement, and collaborative efforts between indigenous communities and external agencies in the development of future policies. Moreover, the review will highlight the importance of decolonizing methodologies in research and intervention strategies, and the need to emphasise culturally sensitive approaches that respect and integrate indigenous worldviews and traditional knowledge systems. Additionally, the paper will explore the potential impact of colonial legacies, resource extraction, and land dispossession on exacerbating vulnerabilities to GBV within indigenous communities. The aim of this paper is to contribute to a more in-depth understanding of GBV in indigenous contexts in order to promote cross-cultural learning and inform future research. Ultimately, this review will demonstrate the necessity of adopting a holistic and context-specific approach to address gender-based violence in indigenous communities.

Keywords: gender based violence, indigenous, colonialism, literature review

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1282 The Impact of Rapid Urbanisation on Public Transport Systems in the Gauteng Region of South Africa

Authors: J. Chakwizira, P. Bikam, T. A. Adeboyejo

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This paper seeks to illustrate the impact of rapid urbanization (in terms of both increase in people and vehicles) in the Gauteng region (which includes Johannesburg, Pretoria and Ekurhuleni). The impact that existing transport systems and options place on the capacity of residents from low income areas to travel and conduct various socio-economic activities is discussed. The findings are drawn from a 2013 analysis of a random transport household survey of 1550 households carried out in Gauteng province. 91.4% of the study respondents had access to public transport, while 8.6% had no access to public transport. Of the 91.4% who used public transport, the main reason used to explain this state of affairs was that it was affordable (54.3%), convenient (15.9%), Accessible (11.9%), lack of alternatives (6.4%) and reliable at 4.1%. Recommendations advanced revolve around the need to reverse land use and transportation effects of apartheid planning, growing and developing a sustainable critical mass of public transport interventions supported by appropriate transport systems that are environmentally sustainable through proper governance. 38.5% of the respondents indicated that developing compact, smart and integrated urban land spaces was key to reducing travel challenges in the study area. 23.4% indicated that the introduction and upgrading of BRT buses to cover all areas in the study area was a step in the right direction because it has great potential in shifting travel patterns to favor public modes of transport. 15.1% indicated that all open spaces should be developed so that fragmentation of land uses can be addressed. This would help to fight disconnected and fragmented space and trip making challenges in Gauteng. 13.4% indicated that improving the metro rail services was critical since this is a mass mover of commuters. 9.6% of the respondents highlighted that the bus subsidy policy has to be retained in the short to medium term since the spatial mismatches and challenges created by apartheid are yet to be fully reversed.

Keywords: urbanisation, population, public, transport systems, Gauteng

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1281 Assessment of the Effects of Water Harvesting Technology on Downstream Water Availability Using SWAT Model

Authors: Ayalkibet Mekonnen, Adane Abebe

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In hydrological cycle there are many water-related human interventions that modify the natural systems. Rainwater harvesting is one such intervention that involves harnessing of water in the upstream. Water harvesting used in upstream prevents water runoff on downstream mainly disturbance on biodiversity and ecosystems. The main objectives of the study are to assess the effects of water harvesting technologies on downstream water availability in the Woreda. To address the above problem, SWAT model, cost-benefit ratio and optimal control approach was used to analyse the hydrological and socioeconomic impact and tradeoffs on water availability of the community, respectively. The downstream impacts of increasing water consumption in the upstream rain-fed areas of the Bilate and Shala Catchment are simulated using the semi-distributed SWAT model. The two land use scenarios tested at sub basin levels (1) conventional land use represents the current land use practice (Agri-CON) and (2) in-field rainwater harvesting (IRWH), improving soil water availability through rainwater harvesting land use scenario. The simulated water balance results showed that the highest peak mean monthly direct flow obtained from Agri-CON land use (127.1 m3/ha), followed by Agri-IRWH land use (11.5 mm) and LULC 2005 (90.1 m3/ha). The Agri-IRWH scenario reduced direct flow by 10% compared to Agri-CON and more groundwater flow contributed by Agri-IRWH (190 m3/ha) than Agri-CON (125 m3/ha). The overall result suggests that the water yield of the Woreda may not be negatively affected by the Agri-IRWH land use scenario. The technology in the Woreda benefited positively having an average benefit cost ratio of 4.2. Water harvesting for domestic use was not optimal that the value of the water per demand harvested was less than the amount of water needed. Storage tanks, series of check dams, gravel filled dams are an alternative solutions for water harvesting.

Keywords: water harvesting, SWAT model, land use scenario, Agri-CON, Agri-IRWH, trade off, benefit cost ratio

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1280 Geosynthetic Reinforced Unpaved Road: Literature Study and Design Example

Authors: D. Jayalakshmi, S. S. Bhosale

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This paper, in its first part, presents the state-of-the-art literature of design approaches for geosynthetic reinforced unpaved roads. The literature starting since 1970 and the critical appraisal of flexible pavement design by Giroud and Han (2004) and Jonathan Fannin (2006) is presented. The design example is illustrated for Indian conditions. The example emphasizes the results computed by Giroud and Han's (2004) design method with the Indian road congress guidelines by IRC SP 72 -2015. The input data considered are related to the subgrade soil condition of Maharashtra State in India. The unified soil classification of the subgrade soil is inorganic clay with high plasticity (CH), which is expansive with a California bearing ratio (CBR) of 2% to 3%. The example exhibits the unreinforced case and geotextile as reinforcement by varying the rut depth from 25 mm to 100 mm. The present result reveals the base thickness for the unreinforced case from the IRC design catalogs is in good agreement with Giroud and Han (2004) approach for a range of 75 mm to 100 mm rut depth. Since Giroud and Han (2004) method is applicable for both reinforced and unreinforced cases, for the same data with appropriate Nc factor, for the same rut depth, the base thickness for the reinforced case has arrived for the Indian condition. From this trial, for the CBR of 2%, the base thickness reduction due to geotextile inclusion is 35%. For the CBR range of 2% to 5% with different stiffness in geosynthetics, the reduction in base course thickness will be evaluated, and the validation will be executed by the full-scale accelerated pavement testing set up at the College of Engineering Pune (COE), India.

Keywords: base thickness, design approach, equation, full scale accelerated pavement set up, Indian condition

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1279 Quantification of Global Cerebrovascular Reactivity in the Principal Feeding Arteries of the Human Brain

Authors: Ravinder Kaur

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Introduction Global cerebrovascular reactivity (CVR) mapping is a promising clinical assessment for stress-testing the brain using physiological challenges, such as CO₂, to elicit changes in perfusion. It enables real-time assessment of cerebrovascular integrity and health. Conventional imaging approaches solely use steady-state parameters, like cerebral blood flow (CBF), to evaluate the integrity of the resting parenchyma and can erroneously show a healthy brain at rest, despite the underlying pathogenesis in the presence of cerebrovascular disease. Conversely, coupling CO₂ inhalation with phase-contrast MRI neuroimaging interrogates the capacity of the vasculature to respond to changes under stress. It shows promise in providing prognostic value as a novel health marker to measure neurovascular function in disease and to detect early brain vasculature dysfunction. Objective This exploratory study was established to:(a) quantify the CBF response to CO₂ in hypocapnia and hypercapnia,(b) evaluate disparities in CVR between internal carotid (ICA) and vertebral artery (VA), and (c) assess sex-specific variation in CVR. Methodology Phase-contrast MRI was employed to measure the cerebrovascular reactivity to CO₂ (±10 mmHg). The respiratory interventions were presented using the prospectively end-tidal targeting RespirActTM Gen3 system. Post-processing and statistical analysis were conducted. Results In 9 young, healthy subjects, the CBF increased from hypocapnia to hypercapnia in all vessels (4.21±0.76 to 7.20±1.83 mL/sec in ICA, 1.36±0.55 to 2.33±1.31 mL/sec in VA, p < 0.05). The CVR was quantitatively higher in ICA than VA (slope of linear regression: 0.23 vs. 0.07 mL/sec/mmHg, p < 0.05). No statistically significant effect was observed in CVR between male and female (0.25 vs 0.20 mL/sec/mmHg in ICA, 0.09 vs 0.11 mL/sec/mmHg in VA, p > 0.05). Conclusions The principal finding in this investigation validated the modulation of CBF by CO₂. Moreover, it has indicated that regional heterogeneity in hemodynamic response exists in the brain. This study provides scope to standardize the quantification of CVR prior to its clinical translation.

Keywords: cerebrovascular disease, neuroimaging, phase contrast MRI, cerebrovascular reactivity, carbon dioxide

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1278 Whey Protein in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

Authors: Zyrah Lou R. Samar, Genecarlo Liwanag

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Type 2 Diabetes Mellitus is the more prevalent type, caused by a combination of insulin resistance and inadequate insulin response to hyperglycemia1. Aside from pharmacologic interventions, medical nutrition therapy is an integral part of the management of patients with Type 2 Diabetes Mellitus. Whey protein, which is one of the best protein sources, has been investigated for its applicability in improving glycemic control in patients with Type 2 Diabetes Mellitus. This systematic review and meta-analysis was conducted to measure the magnitude of the effect of whey protein on glycemic control in type 2 diabetes mellitus. The aim of this review is to evaluate the efficacy and safety of whey protein in patients with type 2 diabetes mellitus. Methods: A systematic electronic search for studies in the PubMed and Cochrane Collaboration database was done. Included in this review were randomized controlled trials of whey protein enrolling patients with type 2 diabetes mellitus. Three reviewers independently searched, assessed, and extracted data from the individual studies. Results: A systematic literature search on online databases such as Cochrane Central Registry, PubMed, and Herdin Plus was conducted in April to September 2021 to identify eligible studies. The search yielded 21 randomized controlled trials after removing duplicates. Only 5 articles were included after reviewing the full text, which met the criteria for selection. Conclusion: Whey protein supplementation significantly reduced fasting blood glucose. However, it did not reduce post-prandial blood glucose, HbA1c level, and weight when compared with the placebo. There has been a considerate heterogeneity across all studies, which may have contributed/confounded its effects. A larger sample size and better inclusion, and a more specific study may be included in the future reviews.

Keywords: whey protein, diabetes, nutrition, fasting blood sugar, postprandial glucose, HbA1c, weight reduction

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