Search results for: rural healthcare settings
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4432

Search results for: rural healthcare settings

1282 Digital Twin for University Campus: Workflow, Applications and Benefits

Authors: Frederico Fialho Teixeira, Islam Mashaly, Maryam Shafiei, Jurij Karlovsek

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The ubiquity of data gathering and smart technologies, advancements in virtual technologies, and the development of the internet of things (IoT) have created urgent demands for the development of frameworks and efficient workflows for data collection, visualisation, and analysis. Digital twin, in different scales of the city into the building, allows for bringing together data from different sources to generate fundamental and illuminating insights for the management of current facilities and the lifecycle of amenities as well as improvement of the performance of current and future designs. Over the past two decades, there has been growing interest in the topic of digital twin and their applications in city and building scales. Most such studies look at the urban environment through a homogeneous or generalist lens and lack specificity in particular characteristics or identities, which define an urban university campus. Bridging this knowledge gap, this paper offers a framework for developing a digital twin for a university campus that, with some modifications, could provide insights for any large-scale digital twin settings like towns and cities. It showcases how currently unused data could be purposefully combined, interpolated and visualised for producing analysis-ready data (such as flood or energy simulations or functional and occupancy maps), highlighting the potential applications of such a framework for campus planning and policymaking. The research integrates campus-level data layers into one spatial information repository and casts light on critical data clusters for the digital twin at the campus level. The paper also seeks to raise insightful and directive questions on how digital twin for campus can be extrapolated to city-scale digital twin. The outcomes of the paper, thus, inform future projects for the development of large-scale digital twin as well as urban and architectural researchers on potential applications of digital twin in future design, management, and sustainable planning, to predict problems, calculate risks, decrease management costs, and improve performance.

Keywords: digital twin, smart campus, framework, data collection, point cloud

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1281 Compliance of Systematic Reviews in Plastic Surgery with the PRISMA Statement: A Systematic Review

Authors: Seon-Young Lee, Harkiran Sagoo, Katherine Whitehurst, Georgina Wellstead, Alexander Fowler, Riaz Agha, Dennis Orgill

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Introduction: Systematic reviews attempt to answer research questions by synthesising the data within primary papers. They are an increasingly important tool within evidence-based medicine, guiding clinical practice, future research and healthcare policy. We sought to determine the reporting quality of recent systematic reviews in plastic surgery. Methods: This systematic review was conducted in line with the Cochrane handbook, reported in line with the PRISMA statement and registered at the ResearchRegistry (UIN: reviewregistry18). MEDLINE and EMBASE databases were searched in 2013 and 2014 for systematic reviews by five major plastic surgery journals. Screening, identification and data extraction was performed independently by two teams. Results: From an initial set of 163 articles, 79 met the inclusion criteria. The median PRISMA score was 16 out of 27 items (59.3%; range 6-26, 95% CI 14-17). Compliance between individual PRISMA items showed high variability. It was poorest for items related to the use of review protocol (item 5; 5%) and presentation of data on risk of bias of each study (item 19; 18%), while being the highest for description of rationale (item 3; 99%) and sources of funding and other support (item 27; 95%), and for structured summary in the abstract (item 2; 95%). Conclusion: The reporting quality of systematic reviews in plastic surgery requires improvement. ‘Hard-wiring’ of compliance through journal submission systems, as well as improved education, awareness and a cohesive strategy among all stakeholders is called for.

Keywords: PRISMA, reporting quality, plastic surgery, systematic review, meta-analysis

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1280 European Union Health Policy and the Response to COVID-19 Pandemic: Building a European Health Union

Authors: Aikaterini Tsalampouni

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The European Union has long been the most developed model of economic and political integration that has brought a common market, a common currency and a standardization of national policies in certain areas in consistent with EU values and principles. To this direction, there is a parallel process of social integration that effect public policy decisions of member states. Even though social policy, i.e. social protection and moreover healthcare policy, still remains in state's responsibility to develop, EU applies different mechanisms in order to influence health policy systems, since from a more federalist point of view, EU ought to expand its regulatory and legislative roles in as many policy areas as possible. Recently, the pandemic has become a turning point for health care provision and at the same time has also highlighted the need to strengthen the EU’s role in coordinating health care. This paper analyses the EU health policy in general, as well as the response to COVID-19 pandemic with an attempt to identify indications of interaction between EU policies and the promotion of sustainable and resilient health systems. More analytically, the paper investigates the EU binding legal instruments, non-binding legal instruments, monitoring and assessment instruments and instruments for co-financing concerning health care provision in member states and records the evolution of health policies before and during the COVID-19 pandemic. The paper concludes by articulating some remarks regarding the improvement of health policy in EU. Since the ability to deal with a pandemic depends on continuous and increased investment in health systems, the involvement of the EU can lead to a policy convergence, necessary for the resilience of the systems, maintaining at the same time, a strong health policy framework in Europe.

Keywords: EU health policy, EU response to COVID-19, European Health Union, health systems in Europe

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1279 Multiplying Vulnerability of Child Health Outcome and Food Diversity in India

Authors: Mukesh Ravi Raushan

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Despite consideration of obesity as a deadly public health issue contributing 2.6 million deaths worldwide every year developing country like India is facing malnutrition and it is more common than in Sub-Saharan Africa. About one in every three malnourished children in the world lives in India. The paper assess the nutritional health among children using data from total number of 43737 infant and young children aged 0-59 months (µ = 29.54; SD = 17.21) of the selected households by National Family Health Survey, 2005-06. The wasting was measured by a Z-score of standardized weight-for-height according to the WHO child growth standards. The impact of education with place of residence was found to be significantly associated with the complementary food diversity score (CFDS) in India. The education of mother was positively associated with the CFDS but the degree of performance was lower in rural India than their counterpart from urban. The result of binary logistic regression on wasting with WHO seven types of recommended food for children in India suggest that child who consumed the milk product food (OR: 0.87, p<0.0001) were less likely to be malnourished than their counterparts who did not consume, whereas, in case of other food items as the child who consumed food product of seed (OR: 0.75, p<0.0001) were less likely to be malnourished than those who did not. The nutritional status among children were negatively associated with the protein containing complementary food given the child as those child who received pulse in last 24 hour were less likely to be wasted (OR: 0.87, p<0.00001) as compared to the reference categories. The frequency to feed the indexed child increases by 10 per cent the expected change in child health outcome in terms of wasting decreases by 2 per cent in India when place of residence, education, religion, and birth order were controlled. The index gets improved as the risk for malnutrition among children in India decreases.

Keywords: CFDS, food diversity index, India, logistic regression

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1278 A Dataset of Program Educational Objectives Mapped to ABET Outcomes: Data Cleansing, Exploratory Data Analysis and Modeling

Authors: Addin Osman, Anwar Ali Yahya, Mohammed Basit Kamal

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Datasets or collections are becoming important assets by themselves and now they can be accepted as a primary intellectual output of a research. The quality and usage of the datasets depend mainly on the context under which they have been collected, processed, analyzed, validated, and interpreted. This paper aims to present a collection of program educational objectives mapped to student’s outcomes collected from self-study reports prepared by 32 engineering programs accredited by ABET. The manual mapping (classification) of this data is a notoriously tedious, time consuming process. In addition, it requires experts in the area, which are mostly not available. It has been shown the operational settings under which the collection has been produced. The collection has been cleansed, preprocessed, some features have been selected and preliminary exploratory data analysis has been performed so as to illustrate the properties and usefulness of the collection. At the end, the collection has been benchmarked using nine of the most widely used supervised multiclass classification techniques (Binary Relevance, Label Powerset, Classifier Chains, Pruned Sets, Random k-label sets, Ensemble of Classifier Chains, Ensemble of Pruned Sets, Multi-Label k-Nearest Neighbors and Back-Propagation Multi-Label Learning). The techniques have been compared to each other using five well-known measurements (Accuracy, Hamming Loss, Micro-F, Macro-F, and Macro-F). The Ensemble of Classifier Chains and Ensemble of Pruned Sets have achieved encouraging performance compared to other experimented multi-label classification methods. The Classifier Chains method has shown the worst performance. To recap, the benchmark has achieved promising results by utilizing preliminary exploratory data analysis performed on the collection, proposing new trends for research and providing a baseline for future studies.

Keywords: ABET, accreditation, benchmark collection, machine learning, program educational objectives, student outcomes, supervised multi-class classification, text mining

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1277 Internet of Things as a Source of Opportunities for Entrepreneurs

Authors: Svetlana Gudkova

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The Internet of Things experiences a rapid growth bringing inevitable changes into many spheres of human activities. As the Internet has changed the social and business landscape, IoT as its extension, can bring much more profound changes in economic value creation and competitiveness of the economies. It has been already recognized as the next industrial revolution. However, the development of IoT is in a great extent stimulated by the entrepreneurial activity. To expand and reach its full potential it requires proactive entrepreneurs, who explore the potential and create innovative ideas pushing the boundaries of IoT technologies' application further. The goal of the research is to analyze, how entrepreneurs utilize the opportunities created by IoT and how do they stimulate the development of IoT through discovering of new ways of generating economic value and creating opportunities, which attract other entrepreneurs. The qualitative research methods have been applied to prepare the case studies. Entrepreneurs are recognized as an engine of economic growth. They introduce innovative products and services into the market through the creation of a new combination of the existing resources and utilizing new knowledge. Entrepreneurs not only create economic value but what is more important, they challenge the existing business models and invent new ways of value creation. Through identification and exploitation of entrepreneurial opportunities, they create new opportunities for other entrepreneurs. It makes the industry more attractive to other profit/innovation-driven start-ups. IoT creates numerous opportunities for entrepreneurs in the different industries. Smart cities, healthcare, manufacturing, retail, agriculture, smart vehicles and smart buildings benefit a lot from IoT-based breakthrough innovations introduced by entrepreneurs. They reinvented successfully the business models and created new entrepreneurial opportunities for other start-ups to introduce next innovations.

Keywords: entrepreneurship, internet of things, breakthrough innovations, start-ups

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1276 Assessment of Dimensions and Gully Recovery With GPS Receiver and RPA (Drone)

Authors: Mariana Roberta Ribeiro, Isabela de Cássia Caramello, Roberto Saverio Souza Costa

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Currently, one of the most important environmental problems is soil degradation. This wear is the result of inadequate agricultural practices, with water erosion as the main agent. As the runoff water is concentrated in certain points, it can reach a more advanced stage, which are the gullies. In view of this, the objective of this work was to evaluate which methodology is most suitable for the purpose of elaborating a project for the recovery of a gully, relating work time, data reliability, and the final cost. The work was carried out on a rural road in Monte Alto - SP, where there is 0.30 hectares of area under the influence of a gully. For the evaluation, an aerophotogrammetric survey was used with RPA, with georeferenced points, and with a GNSS L1/L2 receiver. To assess the importance of georeferenced points, there was a comparison of altimetric data using the support points with altimetric data using only the aircraft's internal GPS. Another method used was the survey by conventional topography, where coordinates were collected by total station and L1/L2 Geodetic GPS receiver. Statistical analysis was performed using analysis of variance (ANOVA) using the F test (p<0.05), and the means between treatments were compared using the Tukey test (p<0.05). The results showed that the surveys carried out by aerial photogrammetry and by conventional topography showed no significant difference for the analyzed parameters. Considering the data presented, it is possible to conclude that, when comparing the parameters of accuracy, the final volume of the gully, and cost, for the purpose of elaborating a project for the recovery of a gully, the methodologies of aerial photogrammetric survey and conventional topography do not differ significantly. However, when working time, use of labor, and project detail are compared, the aerial photogrammetric survey proves to be more viable.

Keywords: drones, erosion, soil conservation, technology in agriculture

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1275 Lessons Learned in Implementing Programs to Delay Diabetic Nephropathy Management in Primary Health Care: Case Study in Sakon Nakhon Province

Authors: Sasiwan Tassana-iem, Sumattana Glangkarn

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Diabetic nephropathy is a major complication in diabetic patients whom as the glomerular filtration rate falls. The affects their quality of life and results in loss of money for kidney replacement therapy costs. There is an existing intervention, but the prevalence remains high, thus this research aims to study lessons learned in implementing programs to delay diabetic nephropathy management in primary health care. Method: The target settings are, 24 sub-district health promoting hospital in Sakon Nakhon province. Participants included the health care professionals, head of the sub-district health promoting hospital and the person responsible for managing diabetic nephropathy in each hospital (n= 50). There are 400 patients with diabetes mellitus in an area. Data were collected using questionnaires, patient records data, interviews and focus groups and analyzed by statistics and content analysis. Result: Reflection of participants that the interventions to delay diabetic nephropathy management in each area, the Ministry of Public Health has a policy to screen and manage this disease. The implementing programs aimed to provide health education, innovative teaching media used in communication to educate. Patients and caregivers had misunderstanding about the actual causes and prevention of this disease and how to apply knowledge suitable for daily life. Conclusion: The obstacles to the success of the implementing programs to delay diabetic nephropathy management in primary health care were most importantly, the patient needs self-care and should be evaluated for health literacy. This is crucial to promote health literacy; to access and understand health information as well to decide their health-related choices based on health information which will promote and maintain a good health. This preliminary research confirms that situation of diabetic nephropathy still exists. The results of this study will lead to the development of delay in diabetic nephropathy implementation among patients in the province studied.

Keywords: diabetic nephropathy, chronic kidney disease, primary health care, implementation

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1274 Improving the Health of Communities: Students as Leaders in a Community Clinical Health Promotion and Disease Prevention Immersion

Authors: Samawi Zepure, Beck Christine, Gallagher Peg

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This community immersion employs the NLN Excellence Model which challenges nursing programs to create student-centered, interactive, and innovative experiences to prepare students for roles in providing high quality care, effective teaching, and leadership in the delivery of nursing services to individuals, families, and communities (NLN, 2006). Senior nursing students collaborate with ethnically and linguistically diverse participants at community-based sites and develop leadership roles of coordination of care linkage within the larger healthcare system, adherence, and self-care management. The immersion encourages students to develop competencies of the NLN Nursing Education Competencies Model (NLN, 2012), proposed to address fast changes in health care delivery, which include values of caring, diversity, and holism; and integrating concepts of context and environment, relationship, and teamwork. Students engage in critical thinking and leadership as they: 1) assess health/illness beliefs, values, attitudes, and practices, explore community resources, interview key informants, and collaborate with community participants to identify learning goals, 2) develop and implement appropriate holistic health promotion and disease prevention teaching interventions promoting continuity, sustainability, and innovation, 3) evaluate interventions through participant feedback and focus groups and, 4) reflect on the immersion experience and future professional role as advocate and citizen.

Keywords: quality of care, health of communities, students as leaders, health promotion

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1273 The Effect of Geographical Differentials of Epidemiological Transition on Health-Seeking Behavior in India

Authors: Sumit Kumar Das, Laishram Ladusingh

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Aim: The aim of the study is to examine the differential of epidemiological transition across fifteen agro-climatic zones of India and its effect on health-seeking behavior. Data and Methods: Unit level data on consumption expenditure on health of India from three decadal rounds conducted by National Sample Survey Organization are used for the analysis. These three rounds are 52nd (1995-96), 60th (2004-05) and 71st (2014-15). The age-adjusted prevalence rate for communicable diseases and non-communicable diseases are estimated for fifteen agro-climatic zones of India for three time periods. Bivariate analysis is used to find out determinants of health-seeking behavior. Multilevel logistic regression is used to examine factors effecting on household health-seeking behavior. Result: The prevalence of communicable diseases is increasing in most of the zones of India. Every South Indian zones, Gujarat plains, and lower Gangetic plain are facing the severe attack of dual burden of diseases. Demand for medical advice has increased in southern zones, and east zones, reliance on private healthcare facilities are increasing in most of the zone. Demographic characteristics of the household head have a significant impact on health-seeking behavior. Conclusion: Proper program implementation is required considering the disease prevalence and differential in the pattern of health seeking behavior. Along with initiation and strengthening of programs for non-communicable, existing programs for communicable diseases need to monitor and supervised strictly.

Keywords: agro-climatic zone, epidemiological transition, health-seeking behavior, multilevel regression

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1272 Climate Change and Its Impacts: The Case of Coastal Fishing Communities of the Meghna River in South-Central Bangladesh

Authors: Md. Royhanur Islam, Thomas Cansse, Md. Sahidul Islam, Atiqur Rahman Sunny

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The geographical location of Bangladesh makes it one of the most vulnerable countries to climate change. Climate-induced phenomena mainly affect the south-central region of Bangladesh (Laxmipur district) where they have begun to occur more frequently. The aim of the study was to identify the hydro-climatic factors that lead to weather-related disasters in the coastal areas and analyse the consequences of these factors on coastal livelihoods, with possible adaptation options using participatory rural appraisal (PRA) tools. The present study showed several disasters such as land erosion, depressions and cyclones, coastal flooding, storm surge, and precipitation. The frequency of these disasters is of a noticeable rate. Surveys have also discovered that land erosion is ongoing. Tidal water is being introduced directly into the mainland, and as a result of the salt intrusion, production capacity is declining. The coastal belt is an important area for fishing activities, but due to changed fishing times and a lack of Alternative Income Generating Activities (AIGAs), people have been forced to search for alternative livelihood options by taking both short-term and long-term adaptation options. Therefore, in order to increase awareness and minimize the losses, vulnerable communities must be fully incorporated into disaster response strategies. The government as well as national and international donor organizations should come forward and resolve the present situation of these vulnerable groups since otherwise, they will have to endure endless and miserable suffering due to the effects of climate change ahead in their lives.

Keywords: adaptation, community, fishery development, livelihood

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1271 Environmental Drivers of Ichthyofauna Species Diversity and Richness in the Lower Reaches of Warri River, a Typical Mangrove Ecosystem in the Niger Delta, Nigeria

Authors: F. O. Arimoro, F. N. Okonkwo, R. B. Ikomi

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The environmental determinants structuring species richness has been generating interest recently but we still lack an understanding of these patterns in various regions (e.g. Afrotropical), and how seasons help to structure these patterns. Our aim was to assessed the environmental drivers importance in regulating species richness and community structure of fish species. The lchthyofauna assemblage of Warri River, Niger Delta area of Nigeria was studied between August 2013 and July 2014. A total of 1152 individuals representing 43 species in 23 families and 30 genera were caught. Of the 43 species recorded, 67.4%, 53.5% and 67.4% of the species occurred in Stations 1, 2 and 3 respectively. Eight taxa representing 18.6% of the total abundance were ubiquitous. The claroteid, Chrysichthys walkeri and the cichlid, Chromidotilapia guentheri were the most dominant species accounting for 19.2% and 6.0% respectively of the total catch. The species richness and general diversity were relatively higher in station 1 although Jaccard similarity index revealed that stations 1 and 3 were significantly similar while station 2 showed complete dissimilarity with stations 1 and 3. Canonical correspondence analysis indicated that dissolved oxygen, electrical conductivity, total nitrogen, Biochemical Oxygen demand and temperature were important variables structuring the overall fish assemblages. The presence of appreciable number of juveniles in this water body suggests that the Warri River is a breeding and nursery ground for fish species particularly those of brackish origin. These findings indicate that the water body is still useful as a good fishing ground for the rural communities and every effort should be put in place to ensure its protection and conservation for the production of healthy fish.

Keywords: Chrysichthys walkeri, fish communities, mangrove ecosystem, physicochemical parameters, Warri River

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1270 Impact of Out-Of-Pocket Payments on Health Care Finance and Access to Health Care Services: The Case of Health Transformation Program in Turkey

Authors: Bengi Demirci

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Out-of-pocket payments have become one of the common models adopted by health care reforms all over the world, and they have serious implications for not only the financial set-up of the health care systems in question but also for the people involved in terms of their access to the health care services provided. On the one hand, out-of-pocket payments are used in raising resources for the finance of the health care system and in decreasing non-essential health care expenses by having a deterrent role on the patients. On the other hand, out-of-pocket payment model causes regressive distribution effect by putting more burdens on the lower income groups and making them refrain from using health care services. Being a relatively incipient country having adopted the out-of-pocket payment model within the context of its Health Transformation Program which has been ongoing since the early 2000s, Turkey provides a good case for re-evaluating the pros and cons of this model in order not to sacrifice equality in access to health care for raising revenue for health care finance and vice versa. Therefore this study aims at analyzing the impact of out-of-pocket payments on the health finance system itself and on the patients’ access to healthcare services in Turkey where out-of-pocket payment model has been in use for a while. In so doing, data showing the revenue obtained from out-of-pocket payments and their share in health care finance are analyzed. In addition to this, data showing the change in the amount of expenditure made by patients on health care services after the adoption of out-of-pocket payments and the change in the use of various health care services in the meanwhile are examined. It is important for the incipient countries like Turkey to be careful in striking the right balance between the objective of cost efficiency and that of equality in accessing health care services while adopting the out-of-pocket payment model.

Keywords: health care access, health care finance, health reform, out-of-pocket payments

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1269 The Gastroprotective Potential of Clematis Flammula Leaf Extracts

Authors: Dina Atmani-Kilani, Farah Yous, Djebbar Atmani

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The etiology of peptic ulcer is closely related to stress, excessive consumption of nonsteroidal anti-inflammatory drugs, or ethanol. Clematis flammula (Ranunculaceae) is a medicinal plant widely used by rural populations to treat inflammatory disorders. This study was designed to assess the gastroprotective potential of C. flammula extracts. Gastric ulcer was induced by stress, indomethacin, HCl / ethanol, and absolute ethanol on NMRI-type mice. The antioxidant potency of the ethanolic extract of Clematis flammula (EECF) was evaluated on catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx) activities. Glutathione (GSH) and malonaldehyde (MDA) levels were also quantified. The anti-inflammatory potential was evaluated through the effect of EECF on myeloperoxidase activity (MPO) and vascular permeability. Complementary tests concerning the quantification of mucus levels, gastric motility, inhibition of ATPase H+/K+activity, as well as a histopathological study were also undertaken to explore the mechanism of action of the EECF. The EECF exhibited a significant (p <0.001) and optimal (100 mg/kg) gastroprotective effect by elevating SOD, CAT, and GSH levels, thereby minimizing the production of MDA and lowering the activity of MPO and vascular permeability. EECF also increased the rate of mucus production, decreased gastric motility, and completely suppressed the H+/K+ ATPase activity. Histopathological study confirmed the effectiveness of the extract in the prevention of peptic ulcer. The results obtained in this study demonstrated the gastro-protective effect of EECF via acidic antioxidant, anti-inflammatory, cytoprotective and anti-secretory mechanisms, which may justify its use as a substitute in peptic ulcer treatment.

Keywords: clematis flammula, superoxide dismutase, myeloperoxidase, ATPase, pump

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1268 Enhanced Cytotoxic Effect of Expanded NK Cells with IL12 and IL15 from Leukoreduction Filter on K562 Cell Line Exhibits Comparable Cytotoxicity to Whole Blood

Authors: Abdulbaset Mazarzaei

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Natural killer (NK) cells are innate immune effectors that play a pivotal role in combating tumors and infected cells. In recent years, the therapeutic potential of NK cells has gained significant attention due to their remarkable cytotoxic ability. This study focuses on investigating the cytotoxic effect of expanded NK cells enriched with interleukin 12 (IL12) and interleukin 15 (IL15), derived from the leukoreduction filter, on the K562 cell line. Firstly, NK cells were isolated from whole blood samples obtained from healthy volunteers. These cells were subsequently expanded ex vivo using a combination of feeder cells, IL12, and IL15. The expanded NK cells were then harvested and assessed for their cytotoxicity against K562, a well-established human chronic myelogenous leukemia cell line. The cytotoxicity was evaluated using flow cytometry assay. Results demonstrate that the expanded NK cells significantly exhibited enhanced cytotoxicity against K562 cells compared to non-expanded NK cells. Interestingly, the expanded NK cells derived specifically from IL12 and IL15-enriched leukoreduction filters showed a robust cytotoxic effect similar to the whole blood-derived NK cells. These findings suggest that IL12 and IL15 in the leukoreduction filter are crucial in promoting NK cell cytotoxicity. Furthermore, the expanded NK cells displayed relatively similar cytotoxicity profiles to whole blood-derived NK cells, indicating their comparable capability in targeting and eliminating tumor cells. This observation is of significant relevance as expanded NK cells from the leukoreduction filter could potentially serve as a readily accessible and efficient source for adoptive immunotherapy. In conclusion, this study highlights the significant cytotoxic effect of expanded NK cells enriched with IL12 and IL15 obtained from the leukoreduction filter on the K562 cell line. Moreover, it emphasizes that these expanded NK cells exhibit comparable cytotoxicity to whole blood-derived NK cells. These findings reinforce the potential clinical utility of using expanded NK cells from the leukoreduction filter as an effective strategy in adoptive immunotherapy for the treatment of cancer. Further studies are warranted to explore the broader implications of this approach in clinical settings.

Keywords: natural killer (NK) cells, Cytotoxicity, Leukoreduction filter, IL-12 and IL-15 Cytokines

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1267 Growth and Yield Potential of Quinoa genotypes on Salt Affected Soils

Authors: Shahzad M. A. Basra, Shahid Iqbal, Irfan Afzal, Hafeez-ur-Rehman

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Quinoa a facultative halophyte crop plant is a new introduction in Pakistan due to its superior nutritional profile and its abiotic stress tolerance, especially against salinity. Present study was conducted to explore halophytic behavior of quinoa. Four quinoa genotypes (A1, A2, A7 and A9) were evaluated against high salinity (control, 100, 200, 300 and 400 mM). Evaluation was made on the basis of ionic analysis (Na+, K+ and K+: Na+ ratio in shoot) and root- shoot fresh and dry weight at four leaf stage. Seedling growth i.e. fresh and dry weight of shoot and root increased by 100 mM salinity and then growth decreased gradually with increasing salinity level in all geno types. Mineral analysis indicated that A2 and A7 have more tolerant behavior having low Na+ and high K+ ¬concentration as compared to A1 and A9. Same geno types as above were also evaluated against high salinity (control, 10, 20, 30, and 40 dS m-1) in pot culture during 2012-13. It was found that increase in salinity up to 10 dS m-1 the plant height, stem diameter and yield related traits increased but decreased with further increase in salinity. Same trend was observed in ionic contents. Maximum grain yield was achieved by A7 (100 g plant-1) followed by A2 (82 g plant-1) at salinity level 10 dS m-1. Next phase was carried out through field settings by using salt tolerant geno types (A2 and A7) at Crop Physiology Research Area Farm (non saline soil as control)/ Proka Farm (salt affected with EC up to 15 dS m-1), University of Agriculture, Faisalabad and Soil Salinity Research Institute, Pindi Bhtiaan (SSRI) Farm (one normal as control and two salt affected fields with EC values up to 15 and 30 dS m-1) during 2013-14. Genotype A7 showed maximum growth and gave maximum yield (3200 kg ha-1) at Proka Farm which was statistically at par to the values of yield obtained on normal soils of Faisalabad. Geno type A7 also gave maximum yield 2800 kg ha-1 on normal field of Pindi bhtiaan followed by as obtained (2340) on salt problem field (15 dS m-1) of same location.

Keywords: quinoa, salinity, halophyte, genotype

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1266 Reducing Per-and Polyfluoroalkyl Substances (PFAS) Water Contamination with Mycorrhizal Hydroponics Plants

Authors: Neel Ahuja

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Per- and polyfluoroalkyl substances (PFAS), known as ”forever chemicals”, are one of the most common and dangerous water pollutants, having carcinogenic effects and causing 382,000 global deaths annually. Current methods to purify PFAS-contaminated water can cost millions of dollars and require existing infrastructure, making them difficult to implement in low-income and rural areas without industrial treatment plants. Hydroponics plants colonized by beneficial mycorrhizal fungi present an affordable and sustainable solution to purifying PFAS-contaminated water. In this study, mycorrhizal-inoculated basil and lettuce plants were cultivated in hydroponics systems under controlled conditions. Root samples were stained and analyzed under a light microscope to confirm mycorrhizal presence. PFAS was added to the systems and an LC/QQQ-MS instrument was used to measure the reduction in PFAS concentrations over 72 hours. Results showed that mycorrhizal plants removed 71.1% of PFAS in a water system compared to 59.9% by non-mycorrhizal plants, and a t-test (p-value=0.00367) was used to prove statistical significance. Relative health of plants was measured through root length, with results revealing that mycorrhizal plant roots were 2.8 inches longer on average than non-mycorrhizal roots. Further analysis revealed a direct relationship between plant root length and PFAS purification, indicating the suitability of species with naturally longer roots for real-world phytoremediation applications, such as at stormwater detention ponds. This study provided a proof-of-concept of the effectiveness of mycorrhizal hydroponics plants in reducing PFAS contamination in water systems, presenting applications as an inexpensive and large-scale purification system.

Keywords: Perfluoroalkyl and polyfluoroalkyl substances, hydroponics, mycorrhizal fungi, water contamination, stormwater detention ponds

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1265 A Multivariate Statistical Approach for Water Quality Assessment of River Hindon, India

Authors: Nida Rizvi, Deeksha Katyal, Varun Joshi

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River Hindon is an important river catering the demand of highly populated rural and industrial cluster of western Uttar Pradesh, India. Water quality of river Hindon is deteriorating at an alarming rate due to various industrial, municipal and agricultural activities. The present study aimed at identifying the pollution sources and quantifying the degree to which these sources are responsible for the deteriorating water quality of the river. Various water quality parameters, like pH, temperature, electrical conductivity, total dissolved solids, total hardness, calcium, chloride, nitrate, sulphate, biological oxygen demand, chemical oxygen demand and total alkalinity were assessed. Water quality data obtained from eight study sites for one year has been subjected to the two multivariate techniques, namely, principal component analysis and cluster analysis. Principal component analysis was applied with the aim to find out spatial variability and to identify the sources responsible for the water quality of the river. Three Varifactors were obtained after varimax rotation of initial principal components using principal component analysis. Cluster analysis was carried out to classify sampling stations of certain similarity, which grouped eight different sites into two clusters. The study reveals that the anthropogenic influence (municipal, industrial, waste water and agricultural runoff) was the major source of river water pollution. Thus, this study illustrates the utility of multivariate statistical techniques for analysis and elucidation of multifaceted data sets, recognition of pollution sources/factors and understanding temporal/spatial variations in water quality for effective river water quality management.

Keywords: cluster analysis, multivariate statistical techniques, river Hindon, water quality

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1264 The Role of Cultural Expectations in Emotion Regulation among Nepali Adolescents

Authors: Martha Berg, Megan Ramaiya, Andi Schmidt, Susanna Sharma, Brandon Kohrt

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Nepali adolescents report tension and negative emotion due to perceived expectations of both academic and social achievement. These societal goals, which are internalized through early-life socialization, drive the development of self-regulatory processes such as emotion regulation. Emotion dysregulation is linked with adverse psychological outcomes such as depression, self-harm, and suicide, which are public health concerns for organizations working with Nepali adolescents. This study examined the relation among socialization, internalized cultural goals, and emotion regulation to inform interventions for reducing depression and suicide in this population. Participants included 102 students in grades 7 through 9 in a post-earthquake school setting in rural Kathmandu valley. All participants completed a tablet-based battery of quantitative measures, comprising transculturally adapted assessments of emotion regulation, depression, and self-harm/suicide ideation and behavior. Qualitative measures included two focus groups and semi-structured interviews with 22 students and 3 parents. A notable proportion of the sample reported depression symptoms in the past 2 weeks (68%), lifetime self-harm ideation (28%), and lifetime suicide attempts (13%). Students who lived with their nuclear family reported lower levels of difficulty than those who lived with more distant relatives (z=2.16, p=.03), which suggests a link between family environment and adolescent emotion regulation, potentially mediated by socialization and internalization of cultural goals. These findings call for further research into the aspects of nuclear versus extended family environments that shape the development of emotion regulation.

Keywords: adolescent mental health, emotion regulation, Nepal, socialization

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1263 Teacher Professional Development: Preparing African Secondary School Teachers towards Enhancing Peaceful Coexistence in Multi-Ethnic Classroom Communities

Authors: Badamasi Tarda Ayuba

Abstract:

African countries contend with many developmental challenges particularly that of overcoming ethnic and religious conflicts. There is the recent wave of terrorism which is also ascribed to religious intolerance. It is a reality that most sub-Saharan African countries/communities consist of several distinct ethnic groups. In a typical classroom, within both rural and urban contexts, children from diverse ethnic and socio-cultural backgrounds converge to learn and grow together. This implies that education has the potentials for fostering inter-communal understanding such that young people could learn, grow together and assume leadership positions to work in pursuit of common goals of nation building. However, given the spate of inter communal clashes erupting too frequently in many parts of the continent and the dangerous trend of ethnicization of serious national affairs, it is doubtful if these objectives are being realized through education. Thus, this paper argued that the current developments indicate failure of the education system in the realization of the countries’ educational goals of creating united, peaceful and indivisible nations, thus far. Further, the failure occurred and would continue to persist unless teachers are purposefully prepared in terms of professional competencies and attitudes to entrench in their students the culture of peaceful coexistence through the various professional roles they play within the schools and communities. Therefore, the paper examined the changing context and challenging roles expected of sub-Saharan African teachers in engendering peaceful coexistence and the need to purposefully develop their capacity and mindset for the new roles. The paper then recommended programs to expose and re-educate teachers towards such roles.

Keywords: sub-Saharan Africa, teacher, professional development, peaceful coexistence, multi-ethnicity, communities

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1262 Identification of Crimean-Congo Hemorrhagic Fever Virus in Patients Referred to Ahvaz and Gilan Hospitals in Iran by real-time PCR Technique

Authors: Najmeh Jafari, Sona Rostampour Yasouri

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Crimean-Congo hemorrhagic fever (CCHF) is an acute hemorrhagic disease. This disease is one of the common diseases between humans and animals, transmitted through tick bites or contact with the blood and secretions or carcasses of infected animals and humans. CCHF is more common in people who work with livestock, such as ranchers, butchers, farmers, slaughterhouse workers, healthcare workers, etc. Its hospital prevalence is also very high. Considering that CCHF can be transmitted through the consumption of food such as beef and sheep meat, this study aims to quickly identify and diagnose the Crimean-Congo fever virus in suspected patients through real-time PCR technique. In the summer of 1402, 20 blood samples were collected separately from Ahvaz and Gilan hospitals. An extraction kit was used to extract the virus RNA. Primers and probes were designed based on the S genomic region, the conserved region in CCHFV. Then, a real-time PCR technique was performed with specific primers and probes. It should be noted that the mentioned technique was repeated several times. The number of 4 samples from the examined samples was determined positive by real-time PCR. This technique has high sensitivity and specificity and the possibility of rapid detection of CCHFV. Therefore, the above method is a good candidate for quick disease diagnosis. By diagnosing the disease, the treatment process can be done faster, and the best prevention methods can be used to control the disease and prevent the death of patients.

Keywords: ahvaz, crimean-congo hemorrhagic fever, gilan, real time PCR

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1261 Adoption of Green Supply Chain Practices and Their Impact on a Firm's Economic and Environmental Performance

Authors: Qingyu Zhang, Helin Ma, Lili Weng, Mei Cao

Abstract:

Green supply chain management has been an important organizational strategy to reduce environmental risks and improve financial performance. Firms have to adopt green supply chain practices to meet the official regulations and reduce peer pressure in China. This paper exhibits an empirical study of the drivers of green supply chain management practices and the environmental and economic performance of green supply chain management implementation in Chinese firms. While China is the fastest-growing emerging economy, it has paid a high ecological price. It is reported that China hosts 7 of the world’s 10 most polluted cities. The continued environmental deterioration and the resultant heightened regulatory control and public scrutiny have posed new operating challenges to firms conducting business in China. These challenges make the country an ideal setting to conduct the present study. A research questionnaire was developed to gather data in China. The questionnaire targeted managers and employees in Chinese companies. The data were collected in the last quarter of 2015, involving industries such as electronic & communicational equipment, textile & clothing, pharmaceutical & healthcare, and so on. This study confirms and validates that (1) both internal and external drivers play a significant role in the implementation of green supply chain management practices; (2) green purchase and investment recovery have a significant impact on firms’ environmental and economic performance; (3) with the improvement of the firms’ environmental performance, their economic performance will improve.

Keywords: economic performance, environmental performance, external driver, green supply chain management

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1260 Appropriate Technology: Revisiting the Movement in Developing Countries for Sustainability

Authors: Jayshree Patnaik, Bhaskar Bhowmick

Abstract:

The economic growth of any nation is steered and dependent on innovation in technology. It can be preferably argued that technology has enhanced the quality of life. Technology is linked both with an economic and a social structure. But there are some parts of the world or communities which are yet to reap the benefits of technological innovation. Business and organizations are now well equipped with cutting-edge innovations that improve the firm performance and provide them with a competitive edge, but rarely does it have a positive impact on any community which is weak and marginalized. In recent times, it is observed that communities are actively handling social or ecological issues with the help of indigenous technologies. Thus, "Appropriate Technology" comes into the discussion, which is quite prevalent in the rural third world. Appropriate technology grew as a movement in the mid-1970s during the energy crisis, but it lost its stance in the following years when people started it to describe it as an inferior technology or dead technology. Basically, there is no such technology which is inferior or sophisticated for a particular region. The relevance of appropriate technology lies in penetrating technology into a larger and weaker section of community where the “Bottom of the pyramid” can pay for technology if they find the price is affordable. This is a theoretical paper which primarily revolves around how appropriate technology has faded and again evolved in both developed and developing countries. The paper will try to focus on the various concepts, history and challenges faced by the appropriate technology over the years. Appropriate technology follows a documented approach but lags in overall design and diffusion. Diffusion of technology into the poorer sections of community remains unanswered until the present time. Appropriate technology is multi-disciplinary in nature; therefore, this openness allows having a varied working model for different problems. Appropriate technology is a friendly technology that seeks to improve the lives of people in a constraint environment by providing an affordable and sustainable solution. Appropriate technology needs to be defined in the era of modern technological advancement for sustainability.

Keywords: appropriate technology, community, developing country, sustainability

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1259 Online Information Seeking: A Review of the Literature in the Health Domain

Authors: Sharifah Sumayyah Engku Alwi, Masrah Azrifah Azmi Murad

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The development of the information technology and Internet has been transforming the healthcare industry. The internet is continuously accessed to seek for health information and there are variety of sources, including search engines, health websites, and social networking sites. Providing more and better information on health may empower individuals, however, ensuring a high quality and trusted health information could pose a challenge. Moreover, there is an ever-increasing amount of information available, but they are not necessarily accurate and up to date. Thus, this paper aims to provide an insight of the models and frameworks related to online health information seeking of consumers. It begins by exploring the definition of information behavior and information seeking to provide a better understanding of the concept of information seeking. In this study, critical factors such as performance expectancy, effort expectancy, and social influence will be studied in relation to the value of seeking health information. It also aims to analyze the effect of age, gender, and health status as the moderator on the factors that influence online health information seeking, i.e. trust and information quality. A preliminary survey will be carried out among the health professionals to clarify the research problems which exist in the real world, at the same time producing a conceptual framework. A final survey will be distributed to five states of Malaysia, to solicit the feedback on the framework. Data will be analyzed using SPSS and SmartPLS 3.0 analysis tools. It is hoped that at the end of this study, a novel framework that can improve online health information seeking is developed. Finally, this paper concludes with some suggestions on the models and frameworks that could improve online health information seeking.

Keywords: information behavior, information seeking, online health information, technology acceptance model, the theory of planned behavior, UTAUT

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1258 Evaluating the Effectiveness of Critical Thinking Skills on Job Performance among Neonatal Nurses: A Cross-Sectional Study

Authors: Mehrdad Akbarzadeh, Afsaneh Abrisham

Abstract:

Introduction: Critical thinking skills are crucial for nurses, particularly those working in neonatal care, where quick and informed decision-making is essential. This study aims to evaluate the effectiveness of critical thinking skills on job performance among neonatal nurses. Methods: A cross-sectional study was conducted with 450 neonatal nurses from a hospital in Mashhad. Participants were assessed using the Critical Thinking Questionnaire (CThQ) to measure their critical thinking abilities across various subscales, including Analyzing, Evaluating, Creating, Remembering, Understanding, and Applying. Additionally, a custom Job Performance Checklist completed by supervising nurses, was used to evaluate job performance across several dimensions. Data were collected and analyzed using SPSS V.23. Correlation analysis was conducted to determine the relationship between critical thinking skills and job performance. Results: The mean age of the nurses was 33.46 ± 14.2 years, with 79.15% being female. The nurses demonstrated high proficiency in critical thinking, with notable scores in the Creating (23.98 ± 4.8), Applying (17.35 ± 3.2), and Evaluating (16.67 ± 3.4) subscales. The results indicate a significant positive correlation between several critical thinking subscales and job performance. The Creating subscale exhibited the strongest correlation (R = 0.79, p < 0.001), followed by Overall CThQ (R = 0.68, p = 0.039) and Evaluating (R = 0.67, p = 0.041). Analyzing (R = 0.45, p = 0.013) and Understanding (R = 0.41, p = 0.015) also showed significant correlations with job performance. Remembering (R = 0.29, p = 0.061) and Applying (R = 0.43, p = 0.057) were not significantly correlated with job performance. Conclusion: The findings indicate that critical thinking skills, especially in creating and evaluating, are strongly associated with job performance in neonatal nurses. Enhancing these skills through targeted training programs could improve job performance, particularly in decision-making and time management. This study underscores the importance of critical thinking in neonatal care and its impact on nursing efficacy and patient outcomes.

Keywords: critical thinking, job performance, neonatal nurses, healthcare quality

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1257 Promoting Girls’ and Women’s Right to Education: Challenges and Strategies

Authors: Kwizera Mireille, Kharesh Ahmed Al-Khadher

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This paper explores the critical issue of girls' and women's right to education, exploring the challenges they face in accessing and benefiting from quality education. Gender disparities in education have persisted globally, hindering social progress and sustainable development. The fundamental importance of education in empowering individuals and promoting gender equality is acknowledged, making it imperative to address the disparities that hinder girls' and women's educational opportunities. The paper discusses various factors contributing to these disparities, including cultural norms(common in third-world countries), socio-economic constraints, and systemic biases. Drawing on a wide range of scholarly sources, empirical studies, and reports from international organizations, this paper highlights the broader societal benefits of educating girls and women, ranging from improved health outcomes to enhanced economic development and greater social and political participation. The paper further outlines strategies and initiatives aimed at overcoming these challenges. These include policy interventions, community-based programs, and international collaborations that work towards eliminating gender-based discrimination in educational settings. The paper emphasizes the significance of not only ensuring access but also fostering an inclusive and safe learning environment that encourages girls and women to thrive academically and personally. By analyzing successful case studies and best practices from around the world, the paper offers insights into effective approaches that can be adopted to enhance girls' and women's right to education globally. Furthermore, it emphasizes the importance of raising awareness of girl's and women's education. In conclusion, this paper underscores the urgency of prioritizing and protecting the educational rights of girls and women's right to education as a fundamental human right and catalyst for gender equality. It calls for a concerted effort from governments, NGOs, educational institutions, and society as a whole to create an equitable and empowering educational landscape that contributes to gender equality and sustainable development.

Keywords: empowerment, gender equality, inclusive education, right to education

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1256 Prevalence of Urinary Tract Infections and Risk Factors among Pregnant Women Attending Ante Natal Clinics in Government Primary Health Care Centres in Akure

Authors: Adepeju Simon-Oke, Olatunji Odeyemi, Mobolanle Oniya

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Urinary tract infection has become the most common bacterial infections in humans, both at the community and hospital settings; it has been reported in all age groups and in both sexes. This study was carried out in order to determine and evaluate the prevalence, current drug susceptibility pattern of the isolated organisms and identify the associated risk factors of UTIs among the pregnant women in Akure, Ondo State, Nigeria. A cross-sectional study was conducted on the urine of pregnant women, and socio-demographic information of the women was collected. A total of 300 clean midstream urine samples were collected, and a general urine microscopic examination and culture were carried out, the Microbact identification system was used to identify gram-negative bacteria. Out of the 300 urine samples cultured, 183(61.0%) yielded significant growth of urinary pathogens while 117(39.0%) yielded either insignificant growth or no growth of any urinary pathogen. Prevalence of UTI was significantly associated with the type of toilet used, symptoms of UTI, and previous history of urinary tract infection (p<0.05). Escherichia coli 58(31.7%) was the dominant pathogen isolated, and the least isolated uropathogens were Citrobacter freudii and Providencia retgerri 2(1.1%) respectively. Gram-negative bacteria showed 77.6%, 67.9%, and 61.2% susceptibility to ciprofloxacin, augmentin, and chloramphenicol, respectively. Resistance against septrin, chloramphenicol, sparfloxacin, amoxicillin, augmentin, gentamycin, pefloxacin, trivid, and streptomycin was observed in the range of 23.1 to 70.1%. Gram-positive uropathogens isolated showed high resistance to amoxicillin (68.4%) and high susceptibility to the remaining nine antibiotics in the range 65.8% to 89.5%. This study justifies that pregnant women are at high risk of UTI. Therefore screening of pregnant women during antenatal clinics should be considered very important to avoid complications. Health education with regular antenatal and personal hygiene is recommended as precautionary measures to UTI.

Keywords: pregnant women, prevalence, risk factor, UTIs

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1255 Early Childhood Developmental Delay in 63 Low- and Middle-Income Countries: Prevalence and Inequalities Estimated from National Health Surveys

Authors: Jesus D. Cortes Gil, Fernanda Ewerling, Leonardo Ferreira, Aluisio J. D. Barros

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Background: The sustainable development goals call for inclusive, equitable, and quality learning opportunities for all. This is especially important for children, to ensure they all develop to their full potential. We studied the prevalence and inequalities of suspected delay in child development in 63 low- and middle-income countries. Methods and Findings: We used the early child development module from national health surveys, which covers four developmental domains (physical, social-emotional, learning, literacy-numeracy) and provides a combined indicator (early child development index, ECDI) of whether children are on track. We calculated the age-adjusted prevalence of suspected delay at the country level and stratifying by wealth, urban/rural residence, sex of the child, and maternal education. We also calculated measures of absolute and relative inequality. We studied 330.613 children from 63 countries. The prevalence of suspected delay for the ECDI ranged from 3% in Barbados to 67% in Chad. For all countries together, 25% of the children were suspected of developmental delay. At regional level, the prevalence of delay ranged from 10% in Europe and Central Asia to 42% in West and Central Africa. The literacy-numeracy domain was by far the most challenging, with the highest proportions of delay. We observed very large inequalities, and most markedly for the literacy-numeracy domain. Conclusions: To date, our study presents the most comprehensive analysis of child development using an instrument especially developed for national health surveys. With a quarter of the children globally suspected of developmental delay, we face an immense challenge. The multifactorial aspect of early child development and the large gaps we found only add to the challenge of not leaving these children behind.

Keywords: child development, inequalities, global health, equity

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1254 Comparison of Health Related Quality of Life in End Stage Renal Diseases Undergoing Twice and Thrice Hemodialysis

Authors: Anamika A. Sharma, Arezou Ahmadi R. A., Narendra B. Parihar, Manjusha Sajith

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Introduction: Hemodialysis is the most effective therapeutic technique for patient with ESRD second to renal transplantation. However it is a lifelong therapy which requires frequent hospital, or dialysis centers visits mainly twice and thrice weekly, thus considerably changes the normal way of patient’s living. So this study aimed to Assess Health-Related Quality of life in End-Stage Renal Disease (ESRD) Undergoing Twice and Thrice weekly Hemodialysis. Method: A prospective observational, cross-sectional study was carried out from September 2016 to April 2017 in end-stage renal disease patients undergoing hemodialysis. Socio-demographic and clinical details of patients were obtained from the medical records. WHOQOL-BREF questionnaire was used to Access Health-Related Quality Of Life. Quality of Life scores of Twice weekly and Thrice weekly hemodialysis was analyzed by Kruskal Wallis Test. Results: Majority of respondents were male (72.55%), married (89.31%), employed (58.02%), belong to middle class (71.00%) and resides in rural area (58.78%). The mean ages in the patient undergoing twice weekly and thrice weekly hemodialysis were 51.89 ± 15.64 years and 51.33 ± 15.70 years respectively. Average Quality of Life scores observed in twice weekly and thrice weekly hemodialysis was 52.07 ± 13.30 (p=0.0037) and 52.87 ± 13.47 (p=0.0004) respectively. The hemoglobin of thrice weekly dialysis patients (10.28 gm/dL) was high as compared to twice weekly dialysis (9.23 gm/dL). Patients undergoing thrice weekly dialysis had improved serum urea, serum creatinine values (95.85 mg/dL, 8.32 mg/dL) as compared to twice weekly hemodialysis ( 104.94 mg/dL, 8.68 mg/dL). Conclusion: Our study concluded that there was no significant difference between overall Health-Related Quality Of Life in twice weekly and thrice weekly hemodialysis. Frequent hemodialysis was associated with improved control of hypertension, serum urea, serum creatinine levels.

Keywords: end stage renal disease, health related quality of life, twice weekly hemodialysis, thrice weekly hemodialysis

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1253 Accuracy Analysis of the American Society of Anesthesiologists Classification Using ChatGPT

Authors: Jae Ni Jang, Young Uk Kim

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Background: Chat Generative Pre-training Transformer-3 (ChatGPT; San Francisco, California, Open Artificial Intelligence) is an artificial intelligence chatbot based on a large language model designed to generate human-like text. As the usage of ChatGPT is increasing among less knowledgeable patients, medical students, and anesthesia and pain medicine residents or trainees, we aimed to evaluate the accuracy of ChatGPT-3 responses to questions about the American Society of Anesthesiologists (ASA) classification based on patients’ underlying diseases and assess the quality of the generated responses. Methods: A total of 47 questions were submitted to ChatGPT using textual prompts. The questions were designed for ChatGPT-3 to provide answers regarding ASA classification in response to common underlying diseases frequently observed in adult patients. In addition, we created 18 questions regarding the ASA classification for pediatric patients and pregnant women. The accuracy of ChatGPT’s responses was evaluated by cross-referencing with Miller’s Anesthesia, Morgan & Mikhail’s Clinical Anesthesiology, and the American Society of Anesthesiologists’ ASA Physical Status Classification System (2020). Results: Out of the 47 questions pertaining to adults, ChatGPT -3 provided correct answers for only 23, resulting in an accuracy rate of 48.9%. Furthermore, the responses provided by ChatGPT-3 regarding children and pregnant women were mostly inaccurate, as indicated by a 28% accuracy rate (5 out of 18). Conclusions: ChatGPT provided correct responses to questions relevant to the daily clinical routine of anesthesiologists in approximately half of the cases, while the remaining responses contained errors. Therefore, caution is advised when using ChatGPT to retrieve anesthesia-related information. Although ChatGPT may not yet be suitable for clinical settings, we anticipate significant improvements in ChatGPT and other large language models in the near future. Regular assessments of ChatGPT's ASA classification accuracy are essential due to the evolving nature of ChatGPT as an artificial intelligence entity. This is especially important because ChatGPT has a clinically unacceptable rate of error and hallucination, particularly in pediatric patients and pregnant women. The methodology established in this study may be used to continue evaluating ChatGPT.

Keywords: American Society of Anesthesiologists, artificial intelligence, Chat Generative Pre-training Transformer-3, ChatGPT

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