Search results for: visual outcome

Authors: Arul Aram, Vishnu Priya, Monicka Karunanithi

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In India, in particular, festivals are the occasions of celebrations. They create beautiful moments to cherish. Mostly, people pay a visit to their native places to celebrate with their loved ones. So are wedding celebrations. The Covid-19 pandemic came upon us unexpectedly, and to fight it, the festivals and weddings are celebrated unusually. Crowded places are deserted. Mass gatherings are avoided, changes and alterations are made in our rituals and celebrations. The warmth usually people have at their heart during any festival and wedding has disappeared. Some aspects of the celebrations become virtual/digital rather than real -- for instance, digital greetings/invitations, digital conduct of ceremonies by priests, YouTube worship, online/digital cash gifts, and digital audience for weddings. Each festival has different rituals which are followed with the divine nature in every family, but the pandemic warranted some compromises on the traditions. Likewise, a marriage is a beautiful bond between two families where a lot of traditional customs are followed. The wedding ceremonies are colorful and celebrations may extend for several days. People in India spend financial resources to prepare and celebrate weddings. The bride's and the groom's homes are fully decorated with colors, balloons and other decorations. The wedding rituals and celebrations vary by religion, region, preference and the resources of the groom, bride and their families. They can range from one day to multiple-days events. But the Covid-19 pandemic situation changes the mindset of people over ceremonies. This lockdown has affected those weddings and industries that support them and make the people postpone or at times advance without fanfare their 'big day.' People now adopt the protocols, guidelines and safety measures to reduce the risk and minimize the fear during celebrations. The study shall look into: how the pandemic shattered the expectations of people celebrating; problems faced economically by people/service providers who are benefited by the celebrations; and identify the alterations made in the rituals or the practices of our culture for the safety of families. The study shall employ questionnaires, interviews and visual ethnography to collect data. The study found that during a complete lockdown, people have not bought new clothes, sweets, or snacks, as they generally do before a pandemic. Almost all of them kept their celebrations low-key, and some did not celebrate at all. Digital media played a role in keeping the celebration alive, as people used it to wish their friends and families virtually. During partial unlock, the situation was under control, and people began to go out and see a few family and friends. They went shopping and bought new clothes and needs, but they did it while following safety precautions. There is also an equal percentage of people who shopped online. Although people continue to remain disappointed, they were less stressed up as life was returning to normal.

Keywords: covid-19, digital, festivals, India, wedding

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Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Hamza Al-Salhi, Salameh Alarood, Ibraheem Alkhawaldeh, Obada Abunar, Adam Abdallah

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Obstructive sleep apnea (OSA) is a disorder caused by the repeated collapse of the upper airway during sleep. It is the most common cause of sleep-related breathing disorder, as OSA can cause loud snoring, daytime fatigue, or more severe problems such as high blood pressure, cardiovascular disease, coronary artery disease, insulin-resistant diabetes, and depression. The hypoglossal nerve stimulator (HNS) is an implantable medical device that reduces the occurrence of obstructive sleep apnea by electrically stimulating the hypoglossal nerve in rhythm with the patient's breathing, causing the tongue to move. This stimulation helps keep the patient's airways clear while they sleep. This systematic review and meta-analysis aimed to assess the clinical outcome of hypoglossal nerve stimulation as a treatment of obstructive sleep apnea. A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until August 2022. Studies assessing the following clinical outcomes (Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Oxygen Desaturation Indices (ODI), (Oxygen Saturation (SaO2)) were pooled in the meta-analysis using Review Manager Software. We assessed the quality of studies according to the Cochrane risk-of-bias tool for randomized trials (RoB2), Risk of Bias In Non-randomized Studies - of Interventions (ROBINS-I), and a modified version of NOS for the non-comparative cohort studies.13 Studies (Six Clinical Trials and Seven prospective cohort studies) with a total of 817 patients were included in the meta-analysis. The results of AHI were reported in 11 studies examining OSA 696 patients. We found that there was a significant improvement in the AHI after 12 months of HNS (MD = 18.2 with 95% CI, (16.7 to 19.7; I2 = 0%); P < 0.00001). Further, 12 studies reported the results of ESS after 12 months of intervention with a significant improvement in the range of sleepiness among the examined 757 OSA patients (MD = 5.3 with 95% CI, (4.75 to 5.86; I2 = 65%); P < 0.0001). Moreover, nine studies involving 699 participants reported the results of FOSQ after 12 months of HNS with a significant reported improvement (MD = -3.09 with 95% CI, (-3.41 to 2.77; I2 = 0%); P < 0.00001). In addition, ten studies reported the results of ODI with a significant improvement after 12 months of HNS among the 817 examined patients (MD = 14.8 with 95% CI, (13.25 to 16.32; I2 = 0%); P < 000001). The Hypoglossal Nerve Stimulation showed a significant positive impact on obstructive sleep apnea patients after 12 months of therapy in terms of apnea-hypopnea index, oxygen desaturation indices, manifestations of the behavioral morbidity associated with obstructive sleep apnea, and functional status resulting from sleepiness.

Keywords: apnea, meta-analysis, hypoglossal, stimulation

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Authors: I. L. Kim, J. Y. Lee, A. K. Tekile

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In consequence of the very high urbanization rate of Korea, the number of traffic noise damages in areas congested with population and facilities is steadily increasing. The current environmental noise levels data in major cities of the country show that the noise levels exceed the standards set for both day and night times. This research was about comparative analysis in search for optimal soundproof panel shape and design factor that can minimize sound reflection noise. In addition to the normal flat-type panel shape, the reflection noise reduction of swelling-type, combined swelling and curved-type, and screen-type were evaluated. The noise source model Nord 2000, which often provides abundant information compared to models for the similar purpose, was used in the study to determine the overall noise level. Based on vehicle categorization in Korea, the noise levels for varying frequency from different heights of the sound source (directivity heights of Harmonize model) have been calculated for simulation. Each simulation has been made using the ray-tracing method. The noise level has also been calculated using the noise prediction program called SoundPlan 7.2, for comparison. The noise level prediction was made at 15m (R1), 30 m (R2) and at middle of the road, 2m (R3) receiving the point. By designing the noise barriers by shape and running the prediction program by inserting the noise source on the 2nd lane to the noise barrier side, among the 6 lanes considered, the reflection noise slightly decreased or increased in all noise barriers. At R1, especially in the cases of the screen-type noise barriers, there was no reduction effect predicted in all conditions. However, the swelling-type showed a decrease of 0.7~1.2 dB at R1, performing the best reduction effect among the tested noise barriers. Compared to other forms of noise barriers, the swelling-type was thought to be the most suitable for reducing the reflection noise; however, since a slight increase was predicted at R2, further research based on a more sophisticated categorization of related design factors is necessary. Moreover, as swellings are difficult to produce and the size of the modules are smaller than other panels, it is challenging to install swelling-type noise barriers. If these problems are solved, its applicable region will not be limited to other types of noise barriers. Hence, when a swelling-type noise barrier is installed at a downtown region where the amount of traffic is increasing every day, it will both secure visibility through the transparent walls and diminish any noise pollution due to the reflection. Moreover, when decorated with shapes and design, noise barriers will achieve a visual attraction than a flat-type one and thus will alleviate any psychological hardships related to noise, other than the unique physical soundproofing functions of the soundproof panels.

Keywords: reflection noise, shaped noise barriers, sound proof panel, traffic noise

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Authors: Dana R. Thomson, Catherine Linard, Sabine Vanhuysse, Jessica E. Steele, Michal Shimoni, Jose Siri, Waleska Caiaffa, Megumi Rosenberg, Eleonore Wolff, Tais Grippa, Stefanos Georganos, Helen Elsey

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The Sustainable Development Goals (SDGs) and Urban Health Equity Assessment and Response Tool (Urban HEART) identify dozens of key indicators to help local decision-makers prioritize and track inequalities in health outcomes. However, presentations and discussions at the International Conference on Urban Health (ICUH) 2017 suggested that additional indicators are needed to make decisions and policies. A local decision-maker may realize that malaria or road accidents are a top priority. However, s/he needs additional health determinant indicators, for example about standing water or traffic, to address the priority and reduce inequalities. Health determinants reflect the physical and social environments that influence health outcomes often at community- and societal-levels and include such indicators as access to quality health facilities, access to safe parks, traffic density, location of slum areas, air pollution, social exclusion, and social networks. Indicator identification and disaggregation are necessarily constrained by available datasets – typically collected about households and individuals in surveys, censuses, and administrative records. Continued advancements in earth observation, data storage, computing and mobile technologies mean that new sources of health determinants indicators derived from 'big data' are becoming available at fine geographic scale. Big data includes high-resolution satellite imagery and aggregated, anonymized mobile phone data. While big data are themselves not representative of the population (e.g., satellite images depict the physical environment), they can provide information about population density, wealth, mobility, and social environments with tremendous detail and accuracy when combined with population-representative survey, census, administrative and health system data. The aim of this paper is to (1) flag to data scientists important indicators needed by health decision-makers at the city and sub-city scale - ideally free and publicly available, and (2) summarize for local decision-makers new datasets that can be generated from big data, with layperson descriptions of difficulties in generating them. We include SDGs and Urban HEART indicators, as well as indicators mentioned by decision-makers attending ICUH 2017.

Keywords: health determinant, health outcome, mobile phone, remote sensing, satellite imagery, SDG, urban HEART

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Authors: Rune Bjerke

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Psychologists incline to see creativity as a mental and psychological process. However, creativity is as well results of cultural and social interactions. Therefore, creativity is not a product of individuals in isolation, but of social systems. Creative people get ideas from the influence of others and the immediate cultural environment – a space of knowledge, situations, and practices. Therefore, in this study we apply the systems theory in practice to activate creativity processes in the production of our novel and screenplay writing. We, as storytellers actively seek to get into situations in our everyday lives, our systems, to generate ideas. Within our personal systems, we have the potential to induce situations to realise ideas to our texts, which may be accepted by our gate-keepers and can become socially validated. This is our method of writing – get into situations, get ideas to texts, and test them with family and friends in our social systems. Example of novel text as an outcome of our method is as follows: “Is it a matter of obviousness or had I read it somewhere, that the one who increases his knowledge increases his pain? And also, the other way around, with increased pain, knowledge increases, I thought. Perhaps such a chain of effects explains why the rebel August Strindberg wrote seven plays in ten months after the divorce with Siri von Essen. Shortly after, he tried painting. Neither the seven theatre plays were shown, nor the paintings were exhibited. I was standing in front of Munch's painting Women in Three Stages with chaotic mental images of myself crumpled in a church and a laughing x-girlfriend watching my suffering. My stomach was turning at unpredictable intervals and the subsequent vomiting almost suffocated me. Love grief at the worst. Was it this pain Strindberg felt? Despite the failure of his first plays, the pain must have triggered a form of creative energy that turned pain into ideas. Suffering, thoughts, feelings, words, text, and then, the reader experience. Maybe this negative force can be transformed into something positive, I asked myself. The question eased my pain. At that moment, I forgot the damp, humid air in the Munch Museum. Is it the similar type of Strindberg-pain that could explain the recurring, depressive themes in Munch's paintings? Illness, death, love and jealousy. As a beginning art student at the master's level, I had decided to find the answer. Was it the same with Munch's pain, as with Strindberg - a woman behind? There had to be women in the case of Munch - therefore, the painting “Women in Three Stages”? Who are they, what personality types are they – the women in red, black and white dresses from left to the right?” We, the writers, are using persons, situations and elements in our systems, in a systems theory perspective, to prompt creative ideas. A conceptual model is provided to advance creativity theory.

Keywords: creativity theory, systems theory, novel writing, screenplay writing, sources of creativity in social systems

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Authors: Nynke de Jong, Inge G. P. Duimel-Peeters

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The flipped classroom as an instructional strategy and a type of blended learning that reverses the traditional learning environment by delivering instructional content, off- and online, in- and outside the classroom, has been implemented in a 4-weeks module focusing on ageing in Europe at the Maastricht University. The main aim regarding the organization of this module was implementing flipped classroom-principles in order to create meaningful learning opportunities, while educational technologies are used to deliver content outside of the classroom. Technologies used in this module were an online interactive real time lecture from England, two interactive face-to-face lectures with visual supports, one group session including role plays and team-based learning meetings. The cohort of 2015-2016, using educational technologies, was compared with the cohort of 2014-2015 on module evaluation such as organization and instructiveness of the module, who studied the same content, although conforming the problem-based educational strategy, i.e. educational base of the Maastricht University. The cohort of 2015-2016 with its specific organization, was also more profound evaluated on outcomes as (1) experienced duration of the lecture by students, (2) experienced content of the lecture, (3) experienced the extent of the interaction and (4) format of lecturing. It was important to know how students reflected on duration and content taken into account their background knowledge so far, in order to distinguish between sufficient enough regarding prior knowledge and therefore challenging or not fitting into the course. For the evaluation, a structured online questionnaire was used, whereby above mentioned topics were asked for to evaluate by scoring them on a 4-point Likert scale. At the end, there was room for narrative feedback so that interviewees could express more in detail, if they wanted, what they experienced as good or not regarding the content of the module and its organization parts. Eventually, the response rate of the evaluation was lower than expected (54%), however, due to written feedback and exam scores, we dare to state that it gives a good and reliable overview that encourages to work further on it. Probably, the response rate may be explained by the fact that resit students were included as well, and that there maybe is too much evaluation as some time points in the program. However, overall students were excited about the organization and content of the module, but the level of self-directed behavior, necessary for this kind of educational strategy, was too low. They need to be more trained in self-directness, therefore the module will be simplified in 2016-2017 with more clear and fewer topics and extra guidance (step by step procedure). More specific information regarding the used technologies will be explained at the congress, as well as the outcomes (min and max rankings, mean and standard deviation).

Keywords: blended learning, flipped classroom, public health, self-directness

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Authors: Saliha Ozcan

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Technology has become an integral part of our lives, aiding individuals in accessing higher order competencies, such as global awareness, creativity, collaborative problem solving, and self-directed learning. Students need to acquire these competencies, often referred to as 21st century skills, in order to adapt to a fast changing world. Today, an ever-increasing number of schools are exploring how engagement through telecollaboration can support language learning and promote 21st century skill development in classrooms. However, little is known regarding how telecollaboration may influence the way students acquire 21st century skills. In this paper, we aim to shed light to the potential implications of telecollaborative practices in acquisition of 21st century skills. In our context, telecollaboration, which might be carried out in a variety of settings both synchronously or asynchronously, is considered as the process of communicating and working together with other people or groups from different locations through online digital tools or offline activities to co-produce a desired work output. The study presented here will describe and analyse the implementation of a telecollaborative project between two high school classes, one in Spain and the other in Sweden. The students in these classes were asked to carry out some joint activities, including creating an online platform, aimed at raising awareness of the situation of the Syrian refugees. We conduct a qualitative study in order to explore how language, culture, communication, and technology merge into the co-construction of knowledge, as well as supporting the attainment of the 21st century skills needed for network-mediated communication. To this end, we collected a significant amount of audio-visual data, including video recordings of classroom interaction and external Skype meetings. By analysing this data, we verify whether the initial pedagogical design and intended objectives of the telecollaborative project coincide with what emerges from the actual implementation of the tasks. Our findings indicate that, as well as planned activities, unplanned classroom interactions may lead to acquisition of certain 21st century skills, such as collaborative problem solving and self-directed learning. This work is part of a wider project (KONECT, EDU2013-43932-P; Spanish Ministry of Economy and Finance), which aims to explore innovative, cross-competency based teaching that can address the current gaps between today’s educational practices and the needs of informed citizens in tomorrow’s interconnected, globalised world.

Keywords: 21st century skills, telecollaboration, language learning, network mediated communication

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Authors: Dr. Jenit Gandhi, Dr. Manojith SS, Dr. Nakul GV, Dr. Sharath Honnani, Dr. Shaurav Ghosh, Dr. Neel Shetty, Dr. Nagabhushan JS, Dr. Manish Joshi

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Introduction: Acute pancreatitis is an inflammatory condition of the pancreas which begins in pancreatic acinar cells and triggers local inflammation that may progress to systemic inflammatory response (SIRS) and causing distant organ involvement and its function and ending up with multiple organ dysfunction syndromes (MODS). Aim: A comparative study in acute pancreatitis to find out the effectiveness of early addition of Ulinastatin to current standard care in Indian subjects . Methodology: A current prospective observational study is done during study period of 1year (Dec 2018 –Dec 2019) duration to evaluate the effect of early addition of Ulinastatin to the current standard treatment and its efficacy to reduce the early complication, analgesic requirement and duration of hospital stay in patients with Acute Pancreatitis. Results: In the control group 25 were males and 05 were females. In the test group 18 were males and 12 females. Majority was in the age group between 30 - 70 yrs of age with >50% in the 30-50yrs age group in both test and control groups. The VAS was median grade 3 in control group as compared to median grade 2 in test group , the pain was more in the initial 2 days in test group compared to 4 days in test group , the analgesic requirement was used for more in control group (median 6) to test group( median 3 days ). On follow up after 5 days for a period of 2 weeks none of the patients in the test group developed any complication. Where as in the control group 8 patients developed pleural effusion, 04-Pseudopancreatic cyst, 02 – patient developed portal vein and splenic vein thrombosis, 02 patients – ventilator with ARDS which were treated symptomatically whereas in test group 02 patient developed pleural effusions and 01 pseudo pancreatic cyst with splenic artery aneurysm, 01 – patient with AKI and MODS symptomatically treated. The duration of hospital stay for a median period of 4 days (2 – 7 days) in test group and 7 days (4 -10 days) in control group. All patients were able to return to normal work on an average of 5days compared 8days in control group, the difference was significant. Conclusion:The study concluded that early addition of Ulinastatin to current standard treatment of acute Pancreatitis is effective in reducing pain, early complication and duration of hospital stay in Indian subject

Keywords: Ulinastatin, VAS – visual analogue score , AKI – acute kidney injury , ARDS – acute respiratory distress syndrome

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Authors: Favour Makuochukwu Orji, Yingkui Zhao

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A myriad of environmental issues face the Nigerian industrial region, resulting from; oil and gas production, mining, manufacturing and domestic wastes. Amidst these, much effort has been directed by stakeholders in the Nigerian oil producing regions, because of the impacts of the region on the wider Nigerian economy. Research to date has suggested that collaborative environmental management could be an effective approach in managing environmental issues; but little attention has been given to the roles and practices of stakeholders in effecting a collaborative environmental management framework for the Nigerian oil-producing region. This paper produces a framework to expand and deepen knowledge relating to stakeholders aspects of collaborative roles in managing environmental issues in the Nigeria oil-producing region. The knowledge is derived from analysis of stakeholders’ practices – studied through multiple case studies using document analysis. Selected documents of key stakeholders – Nigerian government agencies, multi-national oil companies and host communities, were analyzed. Open and selective coding was employed manually during document analysis of data collected from the offices and websites of the stakeholders. The findings showed that the stakeholders have a range of roles, practices, interests, drivers and barriers regarding their collaborative roles in managing environmental issues. While they have interests for efficient resource use, compliance to standards, sharing of responsibilities, generating of new solutions, and shared objectives; there is evidence of major barriers which includes resource allocation, disjointed policy and regulation, ineffective monitoring, diverse socio- economic interests, lack of stakeholders’ commitment and limited knowledge sharing. However, host communities hold deep concerns over the collaborative roles of stakeholders for economic interests, particularly, where government agencies and multi-national oil companies are involved. With these barriers and concerns, a genuine stakeholders’ collaboration is found to be limited, and as a result, optimal environmental management practices and policies have not been successfully implemented in the Nigeria oil-producing region. A framework is produced that describes practices that characterize collaborative environmental management might be employed to satisfy the stakeholders’ interests. The framework recommends critical factors, based on the findings, which may guide a collaborative environmental management in the oil producing regions. The recommendations are designed to re-define the practices of stakeholders in managing environmental issues in the oil producing regions, not as something wholly new, but as an approach essential for implementing a sustainable environmental policy. This research outcome may clarify areas for future research as well as to contribute to industry guidance in the area of collaborative environmental management.

Keywords: collaborative environmental management framework, case studies, document analysis, multinational oil companies, Nigerian oil producing regions, Nigerian government agencies, stakeholders analysis

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Authors: D. M. Lewis, L. Frisby, U. Stead

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Objective: Many patients are receiving invasive treatments in acute care or are dying in hospital without having had comprehensive goals of care conversations. Some of these treatments may not align with the patient’s wishes, may be futile, and may cause unnecessary suffering. While many staff may recognize the benefits of engaging patients and families in Serious Illness Conversations (a goal of care framework developed by Ariadne Labs in Boston), few staff feel confident and/or competent in having these conversations in acute care. Another barrier to having these conversations may be due to a lack of incorporation in the current workflow. An educational exercise, titled the Two Question Challenge, was initiated on four medical units across two Vancouver Coastal Health (VCH) hospitals in attempt to engage the entire interdisciplinary team in asking patients and families questions around goals of care and to improve the documentation of these expressed wishes and preferences. Methods: Four acute care units across two separate hospitals participated in the Two Question Challenge. On each unit, over the course of two eight-hour shifts, all members of the interdisciplinary team were asked to select at least two questions from a selection of nine goals of care questions. They were asked to pose these questions of a patient or family member throughout their shift and then asked to document their conversations in a centralized Advance Care Planning/Goals of Care discussion record in the patient’s chart. A visual representation of conversation outcomes was created to demonstrate to staff and patients the breadth of conversations that took place throughout the challenge. Staff and patients were interviewed about their experiences throughout the challenge. Two palliative approach leads remained present on the units throughout the challenge to support, guide, or role model these conversations. Results: Across four acute care medical units, 47 interdisciplinary staff participated in the Two Question Challenge, including nursing, allied health, and a physician. A total of 88 questions were asked of patients, or their families around goals of care and 50 newly documented goals of care conversations were charted. Two code statuses were changed as a result of the conversations. Patients voiced an appreciation for these conversations and staff were able to successfully incorporate these questions into their daily care. Conclusion: The Two Question Challenge proved to be an effective way of having teams explore the goals of care of patients and families in an acute care setting. Staff felt that they gained confidence and competence. Both staff and patients found these conversations to be meaningful and impactful and felt they were notably different from their usual interactions. Documentation of these conversations in a centralized location that is easily accessible to all care providers increased significantly. Application of the Two Question Challenge in non-medical units or other care settings, such as long-term care facilities or community health units, should be explored in the future.

Keywords: advance care planning, goals of care, interdisciplinary, palliative approach, serious illness conversations

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Authors: Mansur Agzamov, Valery Bersnev, Natalia Ivanova, Istam Agzamov, Timur Khayrullaev, Yulduz Agzamova

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Objectives. Treatment of hypertensive intracerebral hematoma (ICH) is controversial. Advantage of one surgical method on other has not been established. Recent reports suggest a favorable effect of minimally invasive surgery. We conducted a small comparative study of different surgical methods. Methods. We analyzed the result of surgical treatment of 176 patients with intracerebral hematomas at the age from 41 to 78 years. Men were been113 (64.2%), women - 63 (35.8%). Level of consciousness: conscious -18, lethargy -63, stupor –55, moderate coma - 40. All patients on admission and in the dynamics underwent computer tomography (CT) of the brain. ICH was located in the putamen in 87 cases, thalamus in 19, in the mix area in 50, in the lobar area in 20. Ninety seven patients of them had an intraventricular hemorrhage component. The baseline volume of the ICH was measured according to a bedside method of measuring CT intracerebral hematomas volume. Depending on the intervention of the patients were divided into three groups. Group 1 patients, 90 patients, operated open craniotomy. Level of consciousness: conscious-11, lethargy-33, stupor–18, moderate coma -18. The hemorrhage was located in the putamen in 51, thalamus in 3, in the mix area in 25, in the lobar area in 11. Group 2 patients, 22 patients, underwent smaller craniotomy with endoscopic-assisted evacuation. Level of consciousness: conscious-4, lethargy-9, stupor–5, moderate coma -4. The hemorrhage was located in the putamen in 5, thalamus in 15, in the mix area in 2. Group 3 patients, 64 patients, was conducted minimally invasive removal of intracerebral hematomas using the original device (patent of Russian Federation № 65382). The device - funnel cannula - which after the special markings introduced into the hematoma cavity. Level of consciousness: conscious-3, lethargy-21, stupor–22, moderate coma -18. The hemorrhage was located in the putamen in 31, in the mix area in 23, thalamus in 1, in the lobar area in 9. Results of treatment were evaluated by Glasgow outcome scale. Results. The study showed that the results of surgical treatment in three groups depending on the degree of consciousness, the volume and localization of hematoma. In group 1, good recovery observed in 8 cases (8.9%), moderate disability in 22 (24.4%), severe disability - 17 (18.9%), death-43 (47.8%). In group 2, good recovery observed in 7 cases (31.8%), moderate disability in 7 (31.8%), severe disability - 5 (29.7%), death-7 (31.8%). In group 3, good recovery was observed in 9 cases (14.1%), moderate disability-17 (26.5%), severe disability-19 (29.7%), death-19 (29.7%). Conclusions. The method of using cannulae allowed to abandon from open craniotomy of the majority of patients with putaminal hematomas. Minimally invasive technique reduced the postoperative mortality and improves treatment outcomes of these patients.

Keywords: nontraumatic intracerebral hematoma, minimal invasive surgical technique, funnel canula, differentiated surcical treatment

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Authors: Erin Lawlor

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In 2008 Time magazine named terrorist rehabilitation as one of the best ideas of the year. The term deradicalisation has become synonymous with rehabilitation within security discourse. The allure for a “quick fix” when managing terrorist populations (particularly within prisons) has led to a focus on prescriptive programmes where there is a distinct lack of exploration into the drivers for a person to disengage or deradicalise from violence. It has been argued that to tackle a snowballing issue that interventions have moved too quickly for both theory development and methodological structure. This overly quick acceptance of a term that lacks rigorous testing, measuring, and monitoring means that there is distinct lack of evidence base for deradicalisation being a genuine process/phenomenon, leading to academics retrospectively attempting to design frameworks and interventions around a concept that is not truly understood. The UK Home Office has openly acknowledged the lack of empirical data on this subject. This lack of evidence has a direct impact on policy and intervention development. Extremism and deradicalisation are issues that affect public health outcomes on a global scale, to the point that terrorism has now been added to the list of causes of trauma, both in the direct form of being victim of an attack but also the indirect context of witnesses, children and ordinary citizens who live in daily fear. This study critiques current deradicalisation discourses to establish whether public health approaches offer opportunities for development. The research begins by exploring the theoretical constructs of both what deradicalisation, and public health issues are. Questioning: What does deradicalisation involve? Is there an evidential base on which deradicalisation theory has established itself? What theory are public health interventions devised from? What does success look like in both fields? From establishing this base, current deradicalisation practices will then be explored through examples of work already being carried out. Critiques can be broken into discussion points of: Language, the difficulties with conducting empirical studies and the issues around outcome measurements that deradicalisation interventions face. This study argues that a public health approach towards deradicalisation offers the opportunity to attempt to bring clarity to the definitions of radicalisation, identify what could be modified through intervention and offer insights into the evaluation of interventions. As opposed to simply focusing on an element of deradicalisation and analysing that in isolation, a public health approach allows for what the literature has pointed out is missing, a comprehensive analysis of current interventions and information on creating efficacy monitoring systems. Interventions, policies, guidance, and practices in both the UK and Australia will be compared and contrasted, due to the joint nature of this research between Sheffield Hallam University and La Trobe, Melbourne.

Keywords: radicalisation, deradicalisation, violent extremism, public health

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Authors: Shirin Alabdulqader

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This research aims to investigate the concept of code-switching (CS) between English, Arabic, and the CS practices of Saudi online users via a Translanguaging (TL) lens for more inclusive view towards the nature of the data from the study. It employs Digitally Mediated Communication (DMC), specifically the WhatsApp and Twitter platforms, in order to understand how the users employ online resources to communicate with others on a daily basis. This project looks beyond language and considers the multimodal affordances (visual and audio means) that interlocutors utilise in their online communicative practices to shape their online social existence. This exploratory study is based on a data-driven interpretivist epistemology as it aims to understand how meaning (reality) is created by individuals within different contexts. This project used a mixed-method approach, combining a qualitative and a quantitative approach. In the former, data were collected from online chats and interview responses, while in the latter a questionnaire was employed to understand the frequency and relations between the participants’ linguistic and non-linguistic practices and their social behaviours. The participants were eight bilingual Saudi nationals (both men and women, aged between 20 and 50 years old) who interacted with others online. These participants provided their online interactions, participated in an interview and responded to a questionnaire. The study data were gathered from 194 WhatsApp chats and 122 Tweets. These data were analysed and interpreted according to three levels: conversational turn taking and CS; the linguistic description of the data; and CS and persona. This project contributes to the emerging field of analysing online Arabic data systematically, and the field of multimodality and bilingual sociolinguistics. The findings are reported for each of the three levels. For conversational turn taking, the CS analysis revealed that it was used to accomplish negotiation and develop meaning in the conversation. With regard to the linguistic practices of the CS data, the majority of the code-switched words were content morphemes. The third level of data interpretation is CS and its relationship with identity; two types of identity were indexed; absolute identity and contextual identity. This study contributes to the DMC literature and bridges some of the existing gaps. The findings of this study are that CS by its nature, and most of the findings, if not all, support the notion of TL that multiliteracy is one’s ability to decode multimodal communication, and that this multimodality contributes to the meaning. Either this is applicable to the online affordances used by monolinguals or multilinguals and perceived not only by specific generations but also by any online multiliterates, the study provides the linguistic features of CS utilised by Saudi bilinguals and it determines the relationship between these features and the contexts in which they appear.

Keywords: social media, code-switching, translanguaging, online interaction, saudi bilinguals

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Authors: Suzanne Strauss, Leandi Steenkamp

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The Finnish symphonic metal band Nightwish is the brainchild of songwriter and lyricist TuomasHolopainen and the band recorded their first demonstration recording in 1996. The band has since produced nine full-length studio albums, the most recent being the 2020 album Human. :||: Nature., and has reached massive international success. The band is well known for songs about fantasy and escapism and employs many sonic, visual and branding tools and techniques to communicate these constructs to the audience. Among these, is the band’s creation of the so-called “Nightwish world and mythology” with a set of recurring characters and narratives which, in turn, creates a psychological anchor and safe space for Nightwish fans around the globe. Nature and the reverence of nature are central themes in Nightwish’s self-created mythology.Swiss psychologist Carl Jung’s theory of the collective unconscious identified a mysterious reservoir of psychological constructs common to all people, being derived from ancestral memory and experience, common to all humankind, and distinct from the individual’s personal unconscious. Furthermore, he defined archetypes as timeless collective patterns and images that springs forth from the collective unconscious. Archetypes can be actualized when they enter consciousness as images in interaction with the outside world. Archetypal patterns or images can manifest in different ways across world cultures, but follow common patterns, also known as archetypal themes and symbols. The Jungian approach to the psyche places great emphasis on nature, positing a direct link betweenthe concept of wholeness and responsible care for nature and the environment.In our proposed paper, we examine, by means of thematic content analysis, how Nightwish makes use of archetypal themes and symbols referring to nature and the environment in selected songs from their ninth full-length album Human. II Nature. Furthermore, we argue that the longing for and reverence of nature in selected Nightwish songs may serve as a type of “social intervention” and social critique on modern capitalist society. The type of social critique that the band offers is generally connoted intertextually and is not equally explicit in their songs. The band uses a unique combination of escapism, fantasy, and nature narratives to inspire a sense of wonder, enchantment, and magic in the listener. In this way, escapism, fantasy, and nature serve as postmodern frames of reference that aim to “re-enchant” the disenchanted and de-spiritualized. In this way, re-enchantment could also refer to spiritual and/or psychological healing and rebirth.

Keywords: archetypes, metal music, nature, Nightwish, social interventions

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Authors: Vilma Zydziunaite, Gitana Balezentiene, Vilma Zydziunaite

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Teaching is one of most responsible profession, and it is not only a job of an artisan. This profes-sion needs a developed ability to identify oneself with the chosen teaching profession. Research questions: How teachers characterize their authentic individual professional identity? What factors teachers exclude, which support and limit the professional identity? Aim was to develop the grounded theory (GT) about teacher’s professional identity (TPI). Research methodology is based on Charmaz GT version. Data were collected via semi-structured interviews with the he sample of 12 teachers. Findings. 15 extracted categories revealed that the core of TPI is teacher’s professional calling. Premises of TPI are family support, motives for choos-ing teacher’s profession, teacher’s didactic competence. Context of TPI consists of teacher compli-ance with the profession, purposeful preparation for pedagogical studies, professional growth. The strategy of TPI is based on teacher relationship with school community strengthening. The profes-sional frustration limits the TPI. TPI outcome includes teacher recognition, authority; professional mastership, professionalism, professional satisfaction. Dimensions of TPI GT the past (reaching teacher’s profession), present (teacher’s commitment to professional activity) and future (teacher’s profession reconsideration). Conclusions. The substantive GT describes professional identity as complex, changing and life-long process, which develops together with teacher’s personal identity and is connected to professional activity. The professional decision "to be a teacher" is determined by the interaction of internal (professional vocation, personal characteristics, values, self-image, talents, abilities) and external (family, friends, school community, labor market, working condi-tions) factors. The dimensions of the TPI development includes: the past (the pursuit of the teaching profession), the present (the teacher's commitment to professional activity) and the future (the revi-sion of the teaching profession). A significant connection emerged - as the teacher's professional commitment strengthens (creating a self-image, growing the teacher's professional experience, recognition, professionalism, mastery, satisfaction with pedagogical activity), the dimension of re-thinking the teacher's profession weakens. This proves that professional identity occupies an im-portant place in a teacher's life and it affects his professional success and job satisfaction. Teachers singled out the main factors supporting a teacher's professional identity: their own self-image per-ception, professional vocation, positive personal qualities, internal motivation, teacher recognition, confidence in choosing a teaching profession, job satisfaction, professional knowledge, professional growth, good relations with the school community, pleasant experiences, quality education process, excellent student achievements.

Keywords: grounded theory, teacher professional identity, semi-structured interview, school, students, school community, family

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Authors: Mishell E. Cabrera, Bryan G. Valencia, Anderson I. Guamán

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Human dependence on plastic products has led to global pollution, with plastic particles ranging in size from 0.001 to 5 millimeters, which are called microplastics (hereafter, MPs). The abundance of microplastics is used as an indicator of pollution. However, reports of pollution (abundance of MPs) in river sediments do not consider that the accumulation of sediments and MPs depends on the energy of the river. That is, the abundance of microplastics will be underestimated if the sediments analyzed come from places where the river flows with a lot of energy, and the abundance will be overestimated if the sediment analyzed comes from places where the river flows with less energy. This bias can generate an error greater than 300% of the MPs value reported for the same river and should increase when comparisons are made between 2 rivers with different characteristics. Sections where the river flows with higher energy allow sands to be deposited and limit the accumulation of MPs, while sections, where the same river has lower energy, allow fine sediments such as clays and silts to be deposited and should facilitate the accumulation of MPs particles. That is, the abundance of MPs in the same river is underrepresented when the sediment analyzed is sand, and the abundance of MPs is overrepresented if the sediment analyzed is silt or clay. The present investigation establishes a protocol aimed at incorporating sample granulometry to calibrate MPs quantification and eliminate over- or under-representation bias (hereafter granulometric bias). A total of 30 samples were collected by taking five samples within six work zones. The slope of the sampling points was less than 8 degrees, referred to as low slope areas, according to the Van Zuidam slope classification. During sampling, blanks were used to estimate possible contamination by MPs during sampling. Samples were dried at 60 degrees Celsius for three days. A flotation technique was employed to isolate the MPs using sodium metatungstate with a density of 2 gm/l. For organic matter digestion, 30% hydrogen peroxide and Fenton were used at a ratio of 6:1 for 24 hours. The samples were stained with rose bengal at a concentration of 200 mg/L and were subsequently dried in an oven at 60 degrees Celsius for 1 hour to be identified and photographed in a stereomicroscope with the following conditions: Eyepiece magnification: 10x, Zoom magnification (zoom knob): 4x, Objective lens magnification: 0.35x for analysis in ImageJ. A total of 630 fibers of MPs were identified, mainly red, black, blue, and transparent colors, with an overall average length of 474,310 µm and an overall median length of 368,474 µm. The particle size of the 30 samples was calculated using 100 g per sample using sieves with the following apertures: 2 mm, 1 mm, 500 µm, 250 µm, 125 µm and 0.63 µm. This sieving allowed a visual evaluation and a more precise quantification of the microplastics present. At the same time, the weight of sediment in each fraction was calculated, revealing an evident magnitude: as the presence of sediment in the < 63 µm fraction increases, a significant increase in the number of MPs particles is observed.

Keywords: microplastics, pollution, sediments, Tena River

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Authors: Orhan Akınoğlu, Arif Çömek, Ersin Elmacı, Tuğba Gündoğdu

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The concept map is known to be a powerful tool to organize the ideas and concepts of an individuals’ mind. This tool is a kind of visual map that illustrates the relationships between the concepts of a certain subject. The effect of concept mapping on cognitive and affective qualities is one of the research topics among educational researchers for last decades. We educators want to utilize it both as an instructional tool or an assessment tool in classes. For that reason, this study aimed to determine the effect of concept mapping as a learning strategy in science classes on students’ academic achievement and attitude. The research employed a randomized pre-test post-test control group design. Data collected from 60 sixth grade students participated in the study from a randomly selected primary school in Turkey. Sixth-grade classes of the school were analyzed according to students’ academic achievement, science attitude, gender, mathematics, science courses grades, and their GPAs before the implementation. Two of the classes found to be equivalent (t=0,983, p>0,05) and one of them was defined as experimental and the other one control group randomly. During a 5-weeks period, the experimental group students (N=30) used the paper-based concept mapping method while the control group students (N=30) were taught with the traditional approach according to the science and technology education curriculum for light and sound subject. Both groups were taught by the same teacher who is experienced using concept mapping in science classes. Before the implementation, the teacher explained the theory of the concept maps and showed how to create paper-based concept mapping individually to the experimental group students for two hours. Then for two following hours she asked them to create some concept maps related to their former science subjects and gave them feedback by reviewing their concept maps to be sure that they can create during the implementation. The data were collected by science achievement test, science attitude scale and personal information form. Science achievement test and science attitude scale were implemented as pre-test and post-test while personal information form was implemented just as once. The reliability coefficient of the achievement test was KR20=0,76 and Cronbach’s Alpha of the attitude scale was 0,89. SPSS statistical software was used to analyze the data. According to the results, there was a statistically significant difference between the experimental and control group for academic achievement but not for attitude. The experimental group had significantly greater gains from academic achievement test than the control group (t=0,02, p<0,05). The findings showed that the paper-and-pencil concept mapping can be used as an effective method for students’ academic achievement in science classes. The results have implications for further researches.

Keywords: concept mapping, science education, constructivism, academic achievement, science attitude

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Authors: M. Shukry

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According to the United Nations Declaration of Human Rights in 1948, every human being is entitled to rights in life that should be respected by others and protected by the state and community. Such rights are inherent regardless of colour, ethnicity, gender, religion or otherwise, and it is expected that all humans alike have the right to live without discrimination of any sort. However, that has not been the case with Aborigines in Australia. Over a long period of time, the governments of the State and the Territories and the Australian Commonwealth denied the Aboriginal and Indigenous inhabitants of the Torres Strait Islands such rights. Past Australian governments set policies and laws that enabled them to forcefully remove Indigenous children from their parents, which resulted in creating lost generations living the trauma of the loss of cultural identity, alienation and even their own selfhood. Intending to reduce that population of natives and their Aboriginal culture while, on the other hand, assimilate them into mainstream society, they gave themselves the right to remove them from their families with no hope of return. That practice has led to tragic consequences due to the trauma that has affected those children, an experience that is depicted by Jane Harrison in her play Stolen. The drama is the outcome of a six-year project on lost children and which was first performed in 1997 in Melbourne. Five actors only appear on the stage, playing the role of all the different characters, whether the main protagonists or the remaining cast, present or non-present ones as voices. The play outlines the life of five children who have been taken from their parents at an early age, entailing a disastrous negative impact that differs from one to the other. Unknown to each other, what connects between them is being put in a children’s home. The purpose of this paper is to analyse the play’s text in light of the 1948 Declaration of Human Rights, using it as a lens that reflects the atrocities practiced against the Aborigines. It highlights how such practices formed an outrageous violation of those natives’ rights as human beings. Harrison’s dramatic technique in conveying the children’s experiences is through a non-linear structure, fluctuating between past and present that are linked together within each of the five characters, reflecting their suffering and pain to create an emotional link between them and the audience. Her dramatic handling of the issue by fusing tragedy with humour as well as symbolism is a successful technique in revealing the traumatic memory of those children and their present life. The play has made a difference in commencing to address the problem of the right of all children to be with their families, which renders the real meaning of having a home and an identity as people.

Keywords: aboriginal, audience, Australia, children, culture, drama, home, human rights, identity, Indigenous, Jane Harrison, memory, scenic effects, setting, stage, stage directions, Stolen, trauma

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Authors: Paulo Da Silva Quadros

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This work aims to point out comparative parameters between the artistic production of two exponents of the contemporary popular culture scene: Caetano Veloso (Brazil) and David Bowie (England). Both Caetano Veloso and David Bowie were pioneers in establishing an aesthetic game between various artistic expressions at the service of the music-visual scene, that is, the conceptual interconnections between several forms of aesthetic processes, such as fine arts, theatre, cinema, poetry, and literature. There are also correlations in their expressive attitudes of art, especially regarding the dialogue between the fields of art and politics (concern with respect to human rights, human dignity, racial issues, tolerance, gender issues, and sexuality, among others); the constant tension and cunning game between market, free expression and critical sense; the sophisticated, playful mechanisms of metalanguage and aesthetic metacritique. Fact is that both of them almost came to cooperate with each other in the 1970s when Caetano was in exile in England, and when both had at the same time the same music producer, who tried to bring them closer, noticing similar aesthetic qualities in both artistic works, which was later glimpsed by some music critics. Among many of the most influential issues in Caetano's and Bowie's game of artistic-aesthetic expression are, for example, the ideas advocated by the sensation of strangeness (Albert Camus), art as transcendence (Friedrich Nietzsche), the deconstruction and reconstruction of auratic reconfiguration of artistic signs (Walter Benjamin and Andy Warhol). For deepen more theoretical issues, the following authors will be used as supportive interpretative references: Hans-Georg Gadamer, Immanuel Kant, Friedrich Schiller, Johan Huizinga. In addition to the aesthetic meanings of Ars Ludens characteristics of the two artists, the following supporting references will be also added: the question of technique (Martin Heidegger), the logic of sense (Gilles Deleuze), art as an event and the sense of the gesture of art ( Maria Teresa Cruz), the society of spectacle (Guy Debord), Verarbeitung and Durcharbeitung (Sigmund Freud), the poetics of interpretation and the sign of relation (Cremilda Medina). The purpose of such interpretative references is to seek to understand, from a cultural reading perspective (cultural semiology), some significant elements in the dynamics of aesthetic and media interconnections of both artists, which made them as some of the most influential interlocutors in contemporary music aesthetic thought, as a playful vivid experience of life and art.

Keywords: Caetano Veloso, David Bowie, music aesthetics, symbolic playfulness, cultural reading

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Authors: Mateusz Bilski, Jakub Klas, Emilia Kowalczyk, Sylwia Koziej, Katarzyna Kulszo, Ludmiła Grzybowska- Szatkowska

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Background: Liver metastases are a common complication of primary solid tumors and sig-nificantly reduce patient survival. In the era of increasing diagnosis of oligometastatic disease and oligoprogression, methods of local treatment of metastases, i.e. MDT, are becoming more important. Implementation of such treatment can be considered for liver metastases, which are a common complication of primary solid tumors and significantly reduce patient survival. To date, the mainstay of treatment for oligometastatic disease has been surgical resection, but not all patients qualify for the procedure. As an alternative to surgical resection, radiotherapy techniques have become available, including stereotactic body radiation therapy (SBRT) or high-dose interstitial brachytherapy (iBT). iBT is an invasive method that emits very high doses of radiation from the inside of the tumor to the outside. This technique provides better tumor coverage than SBRT while having little impact on surrounding healthy tissue and elim-inates some concerns involving respiratory motion. Methods: We conducted a systematic re-view of the scientific literature on the use of brachytherapy in the treatment of liver metasta-ses from 2018 - 2023 using PubMed and ResearchGate browsers according to PRISMA rules. Results: From 111 articles, 18 publications containing information on 729 patients with liver metastases were selected. iBT has been shown to provide high rates of tumor control. Among 14 patients with 54 unresectable RCC liver metastases, after iBT LTC was 92.6% during a median follow-up of 10.2 months, PFS was 3.4 months. In analysis of 167 patients after treatment with a single fractional dose of 15-25 Gy with brachytherapy at 6- and 12-month follow-up, LRFS rates of 88,4-88.7% and 70.7 - 71,5%, PFS of 78.1 and 53.8%, and OS of 92.3 - 96.7% and 76,3% - 79.6%, respectively, were achieved. No serious complications were observed in all patients. Distant intrahepatic progression occurred later in patients with unre-sectable liver metastases after brachytherapy (PFS: 19.80 months) than in HCC patients (PFS: 13.50 months). A significant difference in LRFS between CRC patients (84.1% vs. 50.6%) and other histologies (92.4% vs. 92.4%) was noted, suggesting a higher treatment dose is necessary for CRC patients. The average target dose for metastatic colorectal cancer was 40 - 60 Gy (compared to 100 - 250 Gy for HCC). To better assess sensitivity to therapy and pre-dict side effects, it has been suggested that humoral mediators be evaluated. It was also shown that baseline levels of TNF-α, MCP-1 and VEGF, as well as NGF and CX3CL corre-lated with both tumor volume and radiation-induced liver damage, one of the most serious complications of iBT, indicating their potential role as biomarkers of therapy outcome. Con-clusions: The use of brachytherapy methods in the treatment of liver metastases of various cancers appears to be an interesting and relatively safe therapeutic method alternative to sur-gery. An important challenge remains the selection of an appropriate brachytherapy method and radiation dose for the corresponding initial tumor type from which the metastasis origi-nated.

Keywords: liver metastases, brachytherapy, CT-HDRBT, iBT

Procedia PDF Downloads 88

Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski

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Stroke is associated with a significant risk of morbidity and mortality. There is scarcity of research on the long-term survival after first-ever ischaemic stroke (IS) events in England with regards to effects of different medical therapies and comorbidities. The objective of this study was to model the all-cause mortality after an IS diagnosis in the adult population of England. Using a retrospective case-control design, we extracted the electronic medical records of patients born prior to or in year 1960 in England with a first-ever ischaemic stroke diagnosis from January 1986 to January 2017 within the Health and Improvement Network (THIN) database. Participants with a history of ischaemic stroke were matched to 3 controls by sex and age at diagnosis and general practice. The primary outcome was the all-cause mortality. The hazards of the all-cause mortality were estimated using a Weibull-Cox survival model which included both scale and shape effects and a shared random effect of general practice. The model included sex, birth cohort, socio-economic status, comorbidities and medical therapies. 20,250 patients with a history of IS (cases) and 55,519 controls were followed up to 30 years. From 2008 to 2015, the one-year all-cause mortality for the IS patients declined with an absolute change of -0.5%. Preventive treatments to cases increased considerably over time. These included prescriptions of statins and antihypertensives. However, prescriptions for antiplatelet drugs decreased in the routine general practice since 2010. The survival model revealed a survival benefit of antiplatelet treatment to stroke survivors with hazard ratio (HR) of 0.92 (0.90 – 0.94). IS diagnosis had significant interactions with gender and age at entry and hypertension diagnosis. IS diagnosis was associated with high risk of all-cause mortality with HR= 3.39 (3.05-3.72) for cases compared to controls. Hypertension was associated with poor survival with HR = 4.79 (4.49 - 5.09) for hypertensive cases relative to non-hypertensive controls, though the detrimental effect of hypertension has not reached significance for hypertensive controls, HR = 1.19(0.82-1.56). This study of English primary care data showed that between 2008 and 2015, the rates of prescriptions of stroke preventive treatments increased, and a short-term all-cause mortality after IS stroke declined. However, stroke resulted in poor long-term survival. Hypertension, a modifiable risk factor, was found to be associated with poor survival outcomes in IS patients. Antiplatelet drugs were found to be protective to survival. Better efforts are required to reduce the burden of stroke through health service development and primary prevention.

Keywords: general practice, hazard ratio, health improvement network (THIN), ischaemic stroke, multiple imputation, Weibull-Cox model.

Procedia PDF Downloads 149

Authors: Saheb Yousefi, Kim T. Zebehazy, Parviz Sharifi Daramadi, Tahereh Najafi Fard, Kevin Murfitt

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Context: Children with visual impairments often face challenges in their cognitive, motor, and social development. Sensory-motor and spatial perception therapies can be beneficial for these children, but many existing programs only focus on a limited set of therapies. This study aims to investigate the effectiveness of a rehabilitation program for sensory- motor and spatial perception in reducing the fear of mobility in visually impaired children. Research Aim: The aim of this study is to determine if a rehabilitation program based on parent-child interaction can reduce the fear of mobility in visually impaired children. Methodology: This study uses a semi-experimental approach with an uneven control group design. Visually impaired children aged 10 to 14 and their parents from the Board of the Blind and Visually Impaired in Tehran Province were included in the study. The sample was divided into experimental and control groups, with a total of 30 participants. The experimental group participated in a rehabilitation program for sensory-motor and spatial perception based on parent-child interaction, while the control group did not receive this intervention. Data was collected using questionnaires on transportation issues and analyzed using multivariate and univariate mixed analysis of variance tests. Findings: The analysis of the data showed that the fear of movement was significantly improved in the experimental group compared to the control group after the intervention. Theoretical Importance: This study highlights the effectiveness of a rehabilitation program for sensory- motor and spatial perception based on parent-child interaction in reducing the fear of mobility in visually impaired children. It contributes to the existing knowledge by demonstrating the positive impact of this type of intervention on the cognitive, motor, and social development of these children. Data Collection and Analysis Procedures: Data was collected through the use of questionnaires administered to the children before and after the intervention. The data was analyzed using multivariate and univariate mixed analysis of variance tests to examine the effects of the rehabilitation program. Questions Addressed: This study addresses the question of whether a rehabilitation program based on parent-child interaction can reduce the fear of mobility in visually impaired children. Conclusion: The findings of this study support the effectiveness of the sensory-motor and spatial perception rehabilitation program based on parent-child interaction in reducing the fear of movement in visually impaired children. This intervention can be considered as a suitable method to enhance the fear of mobility in these children.

Keywords: vision impairment, sensory-motor rehabilitation, space perception, parent-child interaction, fear of movement.

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Authors: A. Onur Kutlu, H. Tolga Bolukbasi

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Since the 1990s, governments, international organizations and scholars have drawn increasing attention to the significance of women in the labour force. While advanced industrial countries in North Western Europe and North America have managed to increase female labour force participation (FLFP) in the early post world war two period, emerging economies of the 1970s have only been able to increase FLFP only a decade later. Among these areas, Southern Europe features a wave of remarkable bounce backs in FLFP. However, despite striking similarities between the features in Southern Europe and those in Turkey, Turkey has not been able to pull women into the labour force. Despite a host of institutional similarities, Turkey has failed to reach to the level of her Southern European neighbours. This paper addresses the puzzle why Turkey lag behind in FLFP in comparison to her Southern European neighbours. There are signs showing that FLFP is currently reaching a critical threshold at a time when structural factors may allow a trend. It is not known, however, the constellation of conditions which may bring rising FLFP in Turkey. In order to gain analytical leverage from similar transitions in countries that share similar labour market and welfare state regime characteristics, this paper identifies the conditions in Southern Europe that brought rising FLFP to be able to explore the prospects for Turkey. Second, this paper takes these variables in the fuzzy set Qualitative Comparative Analysis (fsQCA) as conditions which can potentially explain the outcome of rising FLFP in Portugal, Spain, Italy, Greece and Turkey. The purpose here is to identify any causal pathway there may exist that lead to rising FLFP in Southern Europe. In order to do so, this study analyses two time periods in all cases, which represent different periods for different countries. The first period is identified on the basis of low FLFP and the second period on the basis of the transition to significantly higher FLFP. Third, the conditions are treated following the standard procedures in fsQCA, which provide equifinal: two distinct paths to higher levels of FLFP in Southern Europe, each of which may potentially increase FLFP in Turkey. Based on this analysis, this paper proposes that there exist two distinct paths leading to higher levels of FLFP in Southern Europe. Among these paths, salience of left parties emerges as a sufficient condition. In cases where this condition was not present, a second path combining enlarging service sector employment, increased tertiary education among women and increased childcare enrolment rates led to increasing FLFP.

Keywords: female labour force participation, fsQCA, Southern Europe, Turkey

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Authors: Ronit Chakraborty

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Kolkata, formerly known as Calcutta, is the capital of West Bengal state and the former capital of India (1722-1911) of British India. Located at the heart of Hugli river (one of the main channels of Ganges river), the city is the heart of the state, which forms a base for commerce, transport and manufacture. The large and vibrant city thrives amidst the economic, social and political issues arising from the pages of history to the contemporary times. The unique nature, grandeurs, public debates on tea-stalls and obviously the charismatic scenic beauty and heritage keep the city to be criticized in all horizons, across the world. Movies in India are a big source of knowledge, which can be used as a powerful tool for political mobilization and to indirectly communicate with voters since cinema can be used as a tool of propaganda as it has a wide range of public interests. History proves the fact that films produced in India have been apt enough in making public interests be deeply portrayed through their content in a versatile manner. Such is the portrayal of India’s first capital, Kolkata and its ultimate truth being organizingly laid over by the trilogy of two international fame directors-Mrinal Sen and Satyajit Ray, through their ‘magnum opus- the ‘Kolkata trilogy’. Mrinal Sen’s Interview(1971), Calcutta 71(1972), Padatik(The Guerilla Fighter)(1973) and Satyajit Ray’s Pratidwandi (The Adversary)(1970), Seemabaddha(Company Limited)(1971), Jana Aranya(1976). These films picturized the contemporary Kolkata trends, issues and crises arising amidst the political set-up both by the positive and negative variables attributing to the day-to-day happenings of the city. The movies have been set amidst the turmoil that the nation was going through during Indira Gandhi’s declaration of Emergency, resulting from the general sense of disillusionment that prevailed during that time. Ray wasn't affiliated to any political party and his films largely contributed towards the contemporary conditions prevailing in the society. Mrinal Sen, being a Marxist was in constant search of the bitter truth that the society had to offer through his lens under the prevailing darkness through his trilogy. The research paper attempts to widely view and draw a comparative study of the overall description of the city of Kolkata as portrayed by Sen and Ray in their respective trilogies. By the usage of the visual content analysis method, the researcher has explored the six movies; both the trilogies of Mrinal Sen and Satyajit Ray and tried to analyse the differences as well as the similarities pertaining to understand India’s first capital city Kolkata in various dimensions along with its circumference.

Keywords: Kolkata, trilogy, Satyajit Ray, Mrinal Sen, films, comparative study

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Authors: Neha P. Amin, Maliha Zainib, Sean Parker, Malcolm Mattes

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Purpose/Objectives: Combination immunotherapy (IT) and radiation therapy (RT) is an actively growing field of clinical investigation due to promising findings of synergistic effects from immune-mediated mechanisms observed in preclinical studies and clinical data from case reports of abscopal effects. While there are many ongoing trials of combined IT-RT, there are still limited data on toxicity and outcome optimization regarding RT dose, fractionation, and sequencing of RT with IT. Nivolumab (NIVO), an anti-PD-1 monoclonal antibody, has been rapidly adopted in the clinic over the past 2 years, resulting in more patients being considered for concurrent RT-NIVO. Knowledge about the toxicity profile of combined RT-NIVO is important for both the patient and physician when making educated treatment decisions. The acute toxicity profile of concurrent RT-NIVO was analyzed in this study. Materials/Methods: A retrospective review of all consecutive patients who received NIVO from 1/2015 to 5/2017 at 4 separate centers within two separate institutions was performed. Those patients who completed a course of RT from 1 day prior to initial NIVO infusion through 1 month after last NIVO infusion were considered to have received concurrent therapy and included in the subsequent analysis. Descriptive statistics are reported for patient/tumor/treatment characteristics and observed acute toxicities within 3 months of RT completion. Results: Among 261 patients who received NIVO, 46 (17.6%) received concurrent RT to 67 different sites. The median f/u was 3.3 (.1-19.8) months, and 11/46 (24%) were still alive at last analysis. The most common histology, RT prescription, and treatment site included non-small cell lung cancer (23/46, 50%), 30 Gy in 10 fractions (16/67, 24%), and central thorax/abdomen (26/67, 39%), respectively. 79% (53/67) of irradiated sites were treated with 3D-conformal technique and palliative dose-fractionation. Grade 3, 4, and 5 toxicities were experienced by 11, 1, and 2 patients, respectively. However all grade 4 and 5 toxicities were outside of the irradiated area and attributed to the NIVO alone, and only 4/11 (36%) of the grade 3 toxicities were attributed to the RT-NIVO. The irradiated site in these cases included the brain [2/10 (20%)] and central thorax/abdomen [2/19 (10.5%)], including one unexpected grade 3 pancreatitides following stereotactic body RT to the left adrenal gland. Conclusions: Concurrent RT-NIVO is generally well tolerated, though with potentially increased rates of severe toxicity when irradiating the lung, abdomen, or brain. Pending more definitive data, we recommend counseling patients on the potentially increased rates of side effects from combined immunotherapy and radiotherapy to these locations. Future prospective trials assessing fractionation and sequencing of RT with IT will help inform combined therapy recommendations.

Keywords: combined immunotherapy and radiation, immunotherapy, Nivolumab, toxicity of concurrent immunotherapy and radiation

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Authors: Kirsi Snellman, Johannes Gartner, , Katja Upadaya

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A transition towards a future where the economy serves society so that it evolves within the safe operating space of the planet calls for fundamental changes in the way managers think, feel and act, and make decisions that relate to social and environmental issues. Sustainable decision-making in organizations are often challenging tasks characterized by trade-offs between environmental, social and financial aspects, thus often bringing forth ethical concerns. Although there have been significant developments in incorporating uncertainty into environmental decision-making and measuring constructs and dimensions in ethical behavior in organizations, the majority of sustainable decision-making models are rationalist-based. Moreover, research in psychology indicates that one’s readiness to make a decision depends on the individual’s state of mind, the feasibility of the implied change, and the compatibility of strategies and tactics of implementation. Although very informative, most of this extant research is limited in the sense that it often directs attention towards the rational instead of the emotional. Hence, little is known about the role of emotions in sustainable decision making, especially in situations where decision-makers evaluate a variety of options and use their feelings as a source of information in tackling the uncertainty. To fill this lacuna, and to embrace the uncertainty and perceived risk involved in decisions that touch upon social and environmental aspects, it is important to add emotion to the evaluation when aiming to reach the one right and good ethical decision outcome. This analysis builds on recent findings in moral psychology that associate feelings and intuitions with ethical decisions and suggests that emotions can sensitize the manager to evaluate the rightness or wrongness of alternatives if ethical concerns are present in sustainable decision making. Capturing such sensitive evaluation as triggered by intuitions, we suggest that rational justification can be complemented by using emotions as a tool to tune in to what feels right in making sustainable decisions. This analysis integrates ethical decision-making theories with recent advancements in emotion theories. It determines the conditions under which emotions play a role in sustainability decisions by contributing to a personal equilibrium in which intuition and rationality are both activated and in accord. It complements the rationalist ethics view according to which nothing fogs the mind in decision making so thoroughly as emotion, and the concept of cheater’s high that links unethical behavior with positive affect. This analysis contributes to theory with a novel theoretical model that specifies when and why managers, who are more emotional, are, in fact, more likely to make ethical decisions than those managers who are more rational. It also proposes practical advice on how emotions can convert the manager’s preferences into choices that benefit both common good and one’s own good throughout the transition towards a more sustainable future.

Keywords: emotion, ethical decision making, intuition, sustainability

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Authors: Cristina Felipeto, Catherine Bore, Eduardo Calil

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This work aims to analyze and compare the punctuation marks (PM) in school texts of Brazilian and French students and the comments on these PM made spontaneously by the students during the ongoing text. Assuming textual genetics as an investigative field within a dialogical and enunciative approach, we defined a common methodological design in two 1st year classrooms (7 years old) of the primary school, one classroom in Brazil (Maceio) and the other one in France (Paris). Through a multimodal capture system of writing processes in real time and space (Ramos System), we recorded the collaborative writing proposal in dyads in each of the classrooms. This system preserves the classroom’s ecological characteristics and provides a video recording synchronized with dialogues, gestures and facial expressions of the students, the stroke of the pen’s ink on the sheet of paper and the movement of the teacher and students in the classroom. The multimodal register of the writing process allowed access to the text in progress and the comments made by the students on what was being written. In each proposed text production, teachers organized their students in dyads and requested that they should talk, combine and write a fictional narrative. We selected a Dyad of Brazilian students (BD) and another Dyad of French students (FD) and we have filmed 6 proposals for each of the dyads. The proposals were collected during the 2nd Term of 2013 (Brazil) and 2014 (France). In 6 texts written by the BD there were identified 39 PMs and 825 written words (on average, a PM every 23 words): Of these 39 PMs, 27 were highlighted orally and commented by either student. In the texts written by the FD there were identified 48 PMs and 258 written words (on average, 1 PM every 5 words): Of these 48 PM, 39 were commented by the French students. Unlike what the studies on punctuation acquisition point out, the PM that occurred the most were hyphens (BD) and commas (FD). Despite the significant difference between the types and quantities of PM in the written texts, the recognition of the need for writing PM in the text in progress and the comments have some common characteristics: i) the writing of the PM was not anticipated in relation to the text in progress, then they were added after the end of a sentence or after the finished text itself; ii) the need to add punctuation marks in the text came after one of the students had ‘remembered’ that a particular sign was needed; iii) most of the PM inscribed were not related to their linguistic functions, but the graphic-visual feature of the text; iv) the comments justify or explain the PM, indicating metalinguistic reflections made by the students. Our results indicate how the comments of the BD and FD express the dialogic and subjective nature of knowledge acquisition. Our study suggests that the initial learning of PM depends more on its graphic features and interactional conditions than on its linguistic functions.

Keywords: collaborative writing, erasure, graphic marks, learning, metalinguistic awareness, textual genesis

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Authors: Pauline Blanchet

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In a world where images are a prominent part of our daily lives and a way of absorbing information, the analysis of the representation of migration narratives is vital. This thesis raises questions concerning the power of illustrations, drawings and visual culture in order to represent the migration narratives in the age of Instagram. The rise of graphic novels and comics has come about in the last fifteen years, specifically regarding contemporary authors engaging with complex social issues such as migration and refugeehood. Due to this, refugee subjects are often in these narratives, whether they are autobiographical stories or whether the subject is included in the creative process. Growth in discourse around migration has been present in other art forms; in 2018, there has been dedicated exhibitions around migration such as Tania Bruguera at the TATE (2018-2019), ‘Journeys Drawn’ at the House of Illustration (2018-2019) and dedicated film festivals (2018; the Migration Film Festival), which have shown the recent considerations of using the arts as a medium of expression regarding themes of refugeehood and migration. Graphic visuals are fast becoming a key instrument when representing migration, and the central thesis of this paper is to show the strength and limitations of this form as well the methodology used by the actors in the production process. Recent works which have been released in the last ten years have not being analysed in the same context as previous graphic novels such as Palestine and Persepolis. While a lot of research has been done on the mass media portrayals of refugees in photography and journalism, there is a lack of literature on the representation with illustrations. There is little research about the accessibility of graphic novels such as where they can be found and what the intentions are when writing the novels. It is interesting to see why these authors, NGOs, and curators have decided to highlight these migrant narratives in a time when the mainstream media has done extensive coverage on the ‘refugee crisis’. Using primary data by doing one on one interviews with artists, curators, and NGOs, this paper investigates the efficiency of graphic novels for depicting refugee stories as a viable alternative to other mass medium forms. The paper has been divided into two distinct sections. The first part is concerned with the form of the comic itself and how it either limits or strengthens the representation of migrant narratives. This will involve analysing the layered and complex forms that comics allow such as multimedia pieces, use of photography and forms of symbolism. It will also show how the illustration allows for anonymity of refugees, the empathetic aspect of the form and how the history of the graphic novel form has allowed space for positive representations of women in the last decade. The second section will analyse the creative and methodological process which takes place by the actors and their involvement with the production of the works.

Keywords: graphic novel, refugee, communication, media, migration

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Authors: Nermeen Elbeltagy, Helmy abd Elsatar, Sara Hassan, Mohamed Darwish

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Introduction: with the inial appearance in Wuhan, China, in December 2019, the coronavirus disease-related respiratory infection (COVID-19) has rapidly spread among people all over the world. The WHO considered it a pandemic in March 2020. The severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) outbreaks have proved that pregnant females as well as their fetuses are exposed to adverse outcomes, including high rates of intensive care unit (ICU) admission and case fatality. Physiological changes occurring during pregnancy such as the increased transverse diameter of the thoracic cage as well as the elevation of the diaphragm can expose the mother to severe infections because of her decreased tolerance for hypoxia. Furthermore, vasodilation and changes in lung capacity can cause mucosal edema and an increase in upper respiratory tract secretions. In addition, the increased susceptibility to infection is enhanced by changes in cellmediated immunity. Aim of the work: to study the effect of COVID-19 on pregnant females admitted to El-Shatby Maternity University Hospital regarding maternal antepartum, intrapartum and postpartum adverse effects on the mothers and their neonates. Method: A retrospective cohort study was done between October 2020 and October 2022. Maternal characteristics and associated health conditions of COVID-19 positive parents were investigated. Also, the severity of their conditions and me of infection (first or second or third trimester)were explored. Cases were diagnosed based on presence of symptoms suggestive of COVID-19, laboratory tests (other than PCR) and radiological findings.all cases were confirmed by positive PCR test results. Results: The most common adverse maternal outcomes were pre-term labor (11.6%) followed by premature rupture of membranes (5.7%), post-partum hemorrhage (5.4%), preeclampsia (5.0%) and placental abrupon (4.3%). One sixth of the neonates of the studied paents were admied to NICUs and 6.5% of them had respiratory distress with no neonatal deaths. The majority of neonates (85.4%) had a birth weight of 2500- 4000g (normal range). Most of the neonates (77.9%) had an APGAR score of equal or more than 7 in 5 minutes. Conclusion: the most common comorbidity that might increase the incidence of COVID-19 before pregnancy were diabetes, cardiac disorders/ chronic hypertension and chronic obstructive lung diseases (non-asthma). During pregnancy, anemia followed by gestational diabetes and pre-eclampsia/gestational hypertension were the most prevalent comorbidity. So, severity of infection can be reduced by good antenatal care.

Keywords: COVID-19, pregnancy outcome, complicated pregnancy., COVID in Egypt

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Authors: Mary Jane B. Suarez

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Public speaking anxiety (PSA), also known as speech anxiety, is innumerably persistent in any traditional communication classes, especially for students who learn English as a second language. The speech anxiety intensifies when communication skills assessments have taken their toll in an online or a remote mode of learning due to the perils of the COVID-19 virus. Both teachers and students have experienced vast ambiguity on how to realize a still effective way to teach and learn speaking skills amidst the pandemic. Communication skills assessments like public speaking, oral presentations, and student reporting have defined their new meaning using Google Meet, Zoom, and other online platforms. Though using such technologies has paved for more creative ways for students to acquire and develop communication skills, the effectiveness of using such assessment tools stands in question. This mixed method study aimed to determine the factors that affected the public speaking skills of students in a communication class, to probe on the assessment gaps in assessing speaking skills of students attending online classes vis-à-vis the implementation of remote and blended modalities of learning, and to recommend ways on how to address the public speaking anxieties of students in performing a speaking task online and to bridge the assessment gaps based on the outcome of the study in order to achieve a smooth segue from online to on-ground instructions maneuvering towards a much better post-pandemic academic milieu. Using a convergent parallel design, both quantitative and qualitative data were reconciled by probing on the public speaking anxiety of students and the potential assessment gaps encountered in an online English communication class under remote and blended learning. There were four phases in applying the convergent parallel design. The first phase was the data collection, where both quantitative and qualitative data were collected using document reviews and focus group discussions. The second phase was data analysis, where quantitative data was treated using statistical testing, particularly frequency, percentage, and mean by using Microsoft Excel application and IBM Statistical Package for Social Sciences (SPSS) version 19, and qualitative data was examined using thematic analysis. The third phase was the merging of data analysis results to amalgamate varying comparisons between desired learning competencies versus the actual learning competencies of students. Finally, the fourth phase was the interpretation of merged data that led to the findings that there was a significantly high percentage of students' public speaking anxiety whenever students would deliver speaking tasks online. There were also assessment gaps identified by comparing the desired learning competencies of the formative and alternative assessments implemented and the actual speaking performances of students that showed evidence that public speaking anxiety of students was not properly identified and processed.

Keywords: blended learning, communication skills assessment, public speaking anxiety, speech anxiety

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