Search results for: evidence based medicine

Authors: Divi Sharma

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The emergence of positive behaviour support (PBS) is directly linked to applied behaviour analysis that incorporates evidence-based approaches to addressing ethical challenges and improving autonomy, participation, and the overall quality of life of people living and learning in complex social environments. Its features include lifestyle improvement, collaboration with general caregivers, tracking progress with sound steps, comprehensive performance-based interventions, striving for contextual equality, and ensuring entry and implementation. This document aims to summarize its features with the support of case examples such as involving caregivers to play an active role in behavioural interventions, creating effective interventions within natural practices. Additionally, dealing with lifestyle changes, as well as a wide variety of behavioural changes, develop strong strategies which reduce professional dependence.

Keywords: positive behaviour support, quality of life, performance-based interventions, behavioural changes, participation

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Authors: Juha Kettunen

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This study analyzes collaborative and networked academic authorship in higher education. The literature review shows evidence that single authorship has made a gradual paradigm shift to joint authorship. The empirical evidence from the Turku University of Applied Sciences indicates that collaborative authorship has notably increased in the last few years. Co-authorship has extended outside the institution to other domestic and international academic organizations. Co-authorship not only increase the merits of academic scholars but builds and maintains networks of research and development. The results of this study help the authors, editors and partners of research and development projects to have a more concrete understanding of how co-authorship has developed and spread beyond higher education institutions.

Keywords: co-authorship, social networking, higher education, research and development

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Authors: Renée Fregosi

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The contribution presently proposed will report on the beginnings of a Franco-Chilean study to be launched in 2015 by a multidisciplinary team of Renée Fregosi Political Science University Paris 3 / CECIEC, Norma Muñoz Public Policies University of Santiago of Chile, Jean-Daniel Lelievre, Medicine Paris 11 University, Marcelo WOLFF Medicine University of Chile, Cecilia Blatrix Political Science University Paris-Tech, Ernesto OTTONE, Political Science University of Chile, Paul DENY Medicine Paris 13 University, Rafael Bugueno Medicine Hospital Urgencia Pública of Santiago, Eduardo CARRASCO Political Science Paris 3 University. The problem of hidden populations challenges some criteria and concepts to re-examine: in particular the concept of target population, sampling methods to "snowball" and the cost-effectiveness criterion that shows the connection of political and scientific fields. Furthermore, if the pattern of homosexual transmission still makes up the highest percentage of the modes of infection with HIV, there is a continuous increase in the number of people infected through heterosexual sex, including women and persons aged 50 years and older. This group can be described as " unknown risk people." Access to these populations is a major challenge and raises methodological, ethical and political issues of prevention, particularly on the issue of screening. This paper proposes an inventory of these types of problems and their articulation, to define a new phase in the prevention against HIV refocused on women.

Keywords: HIV testing, hidden populations, difficult to reach PLWHA, women, unknown risk people

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Authors: Jennifer Holbein, Maritza Wiedel

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Background: Aging is associated with an increased risk of falls in older adults, and as a result, falls have become public health crises. However, the incidence of falls can be reduced through healthy aging and the implementation of a regular exercise and strengthening program. Public health and healthcare professionals authorize the use of evidence‐based, exercise‐focused fall interventions, but there are major obstacles to translating and disseminating research findings into healthcare practices. The purpose of this study was to assess the feasibility of an intervention, A Matter of Balance, in terms of demand, acceptability, and implementation into current exercise programs. Subjects: Seventy-five participants from rural communities, above the age of sixty, were randomized to an intervention or attention-control of the standardized senior fitness test. Methods: Subject completes the intervention, which combines two components: (1) motivation and (2) fall-reducing physical activities with protocols derived from baseline strength and balanced assessments. Participants (n=75) took part in the program after completing baseline functional assessments as well as evaluations of their personal knowledge, health outcomes, demand, and implementation interventions. After 8-weeks of the program, participants were invited to complete follow-up assessments with results that were compared to their baseline functional analyses. Out of all the participants in the study who complete the initial assessment, approximately 80% are expected to maintain enrollment in the implemented prescription. Furthermore, those who commit to the program should show mitigation of fall risk upon completion of their final assessment.

Keywords: aging population, exercise, falls, functional assessment, healthy aging

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Authors: Daniel Gonzales, Zev Winkelman, Trung Tran, Ricardo Sanchez, Dulani Woods, John Hollywood

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We have developed a distributed computing capability, Digital Forensics Compute Cluster (DFORC2) to speed up the ingestion and processing of digital evidence that is resident on computer hard drives. DFORC2 parallelizes evidence ingestion and file processing steps. It can be run on a standalone computer cluster or in the Amazon Web Services (AWS) cloud. When running in a virtualized computing environment, its cluster resources can be dynamically scaled up or down using Kubernetes. DFORC2 is an open source project that uses Autopsy, Apache Spark and Kafka, and other open source software packages. It extends the proven open source digital forensics capabilities of Autopsy to compute clusters and cloud architectures, so digital forensics tasks can be accomplished efficiently by a scalable array of cluster compute nodes. In this paper, we describe DFORC2 and compare it with a standalone version of Autopsy when both are used to process evidence from hard drives of different sizes.

Keywords: digital forensics, cloud computing, cyber security, spark, Kubernetes, Kafka

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Authors: Ilirian Laçi, Alketa Spahiu

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Big strums of thyroid glandule observed by a simple viewing can be witnessed in everyday life. Medical cabinets evidence patients withpalpablenodes of thyroid glandule, mainly nodes of the size of 10 millimeters. Further, more cases which have resulted in negative under palpation have resulted in positive at ultrasound examination. Therefore, the use of ultrasound for diagnosing has increased the number of patients with nodes of thyroid glandule in the last couple of decades in all countries, Albania included. Thus, there has been evidence of an increased number of patients affected by this pathology, where female patients dominate. Demographically, the capital shows high numbers due to the high population, but of interest is the high incidence of those areas distanced from the sea. While regarding related pathologies, no significant link was evidenced, an element of ancestry was evident in the nodes of the thyroid glandule. When we talk of nodes of the thyroid glandule, we should consider hyperplasia, neoplasia, and inflammatory diseases that cause nodes of the thyroid glandule. This increase parallels the world’s increase of the incidence of thyroid glandule, with malign cases, which are at about 5% and are not depended on size. Given the numbers, with most thyroid glandule nodes being benign, the main objective of the examination of the nodes was the determination of benign and malign cases to avoid undue surgery. Subject of this study were 212 patients that underwent fine-needle aspiration (FNA) under ultrasound guidance at the Medical University Center of Tirana. All the patients came to the Mother Teresa University Hospital from public and private hospitals and other polyclinics. These patients had an ultrasound examination before visiting the Center of Nuclear Medicine for a scintigraph of thyroid glandule in the period September 2016 and September 2017. To correlate, all patients had been examined via ultrasound of the thyroid glandule prior to the scintigraph. The ultrasound included evaluation of the number of nodes, their size, their solid, cystic, or solid-cystic structure, echogenicity according to the gray scale, the presence of calcification, the presence of lymph nodes, the presence of adenopathy, and the correlation of the cytology results from the Laboratory of Pathological Anatomy of Medical University Center of Tirana.

Keywords: thyroid nodes, fine needle aspiration, ultrasound, scintigraphy

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Authors: Fatima Babar, Majid I. Khan, Malik Najmus Saqib, Muhammad Tahir

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This article provides range based improvements over a well-known single-hop range free localization scheme, Approximate Point in Triangulation (APIT) by proposing an energy efficient Barycentric coordinate based Point-In-Triangulation (PIT) test along with PIT based trilateration. These improvements result in energy efficiency, reduced localization error and improved localization coverage compared to APIT and its variants. Moreover, we propose to embed Received signal strength indication (RSSI) based distance estimation in DV-Hop which is a multi-hop localization scheme. The proposed localization algorithm achieves energy efficiency and reduced localization error compared to DV-Hop and its available improvements. Furthermore, a hybrid multi-hop localization scheme is also proposed that utilize Barycentric coordinate based PIT test and both range based (Received signal strength indicator) and range free (hop count) techniques for distance estimation. Our experimental results provide evidence that proposed hybrid multi-hop localization scheme results in two to five times reduction in the localization error compare to DV-Hop and its variants, at reduced energy requirements.

Keywords: Localization, Trilateration, Triangulation, Wireless Sensor Networks

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Authors: Ayesha Akbar

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Public service delivery has witnessed a significant improvement with the integration of information communication technology (ICT). It not only improves management structure with advanced technology for surveillance of service delivery but also provides evidence for informed decisions and policy. Pakistan’s public sector organizations have not been able to produce some good results to ensure service delivery. Notwithstanding, some of the public sector organizations in Pakistan has diffused modern technology and proved their credence by providing better service delivery standards. These good indicators provide sound basis to integrate technology in public sector organizations and shift of policy towards evidence based policy making. Rescue-1122 is a public sector organization which provides emergency services and proved to be a successful model for the provision of service delivery to save human lives and to ensure human development in Pakistan. The information about the organization has been received by employing qualitative research methodology. The information is broadly based on primary and secondary sources which includes Rescue-1122 website, official reports of organizations; UNDP (United Nation Development Program), WHO (World Health Organization) and by conducting 10 in-depth interviews with the high administrative staff of organizations who work in the Lahore offices. The information received has been incorporated with the study for the better understanding of the organization and their management procedures. Rescue-1122 represents a successful model in delivering the services in an efficient way to deal with the disaster management. The management of Rescue has strategized the policies and procedures in such a way to develop a comprehensive model with the integration of technology. This model provides efficient service delivery as well as maintains the standards of the organization. The service delivery model of rescue-1122 works on two fronts; front-office interface and the back-office interface. Back-office defines the procedures of operations and assures the compliance of the staff whereas, front-office equipped with the latest technology and good infrastructure handles the emergency calls. Both ends are integrated with satellite based vehicle tracking, wireless system, fleet monitoring system and IP camera which monitors every move of the staff to provide better services and to pinpoint the distortions in the services. The standard time of reaching to the emergency spot is 7 minutes, and during entertaining the case; driver‘s behavior, traffic volume and the technical assistance being provided to the emergency case is being monitored by front-office. Then the whole information get uploaded to the main dashboard of Lahore headquarter from the provincial offices. The latest technology is being materialized by Rescue-1122 for delivering the efficient services, investigating the flaws; if found, and to develop data to make informed decision making. The other public sector organizations of Pakistan can also develop such models to integrate technology for improving service delivery and to develop evidence for informed decisions and policy making.

Keywords: data, e-governance, evidence, policy

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Authors: Mehani Mouna, Boukhari Nadjet, Ladjal Segni

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The aim of our study is to determine the antimicrobial effect of essential oils of two plants Cotula cinerea and Chamomilla recutita on some pathogenic bacteria. It is a medicinal plant used in traditional therapy. Essential oils have many therapeutic properties. In herbal medicine, they are used for their antiseptic properties against infectious diseases of fungal origin, against dermatophytes, those of bacterial origin. Essential oils have many therapeutic properties. In herbal medicine, they are used for their antiseptic properties against infectious diseases of fungal origin, against dermatophytes, those of bacterial origin. Humans use plants for thousands of years to treat various ailments, in many developing countries; much of the population relies on traditional doctors and their collections of medicinal plants to cure them. The test adopted is based on the diffusion method on solid medium (Antibiogram), this method allows to determine the susceptibility or resistance of an organism according to the sample studied. Our study reveals that the essential oil of the plants Cotula cinerea and Chamomilla recutita have a different effect on the resistance of germs.

Keywords: antibiogram, Chamomilla recutita, Cotula cinerea, essential oil, microorganism

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Authors: Mokganya Mokgaetji Georginah

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Traditional medicine continued to play a pivotal role in treating various diseases affecting VhaVenda people. The Venda region is rich with different types of medicinal plants that are used to treat quite a variety of illnesses. This includes plants that are used as laxative. Laxative can be defined as a food composed of a combination of drugs that help to relieve constipation. The study was conducted in the Muledani Village of the Thulamela Municipality. The study investigated all plant forms that are used by Muledani residents as laxative. The semi-structured questionnaire was used to gather information from the respondents aged forty years and above. The households of the respondents were sampled randomly by visiting every tenth homestead in each street. Total of thirteen different plants was given by all respondents participated in the current research. Different parts of plants like Aloe arborences, Erythrina lysistemon, Terminalia sericea and others are used as laxative. Amongst all the plant parts, roots and barks are used by the respondents. They are either ground or boiled first before consumption. Furthermore, the study indicated that the plants can be used by people of all age groups only when the dosage of the medicine is taken into account. The use of traditional medicine as laxative is recommended as no side effects are experienced if the correct dosage is given to the relevant age group.

Keywords: medicinal plants, Muledani, Venda region, questionnaire

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Authors: Maria Ahmad, Alexandra Valetopoulou, Michael D. Christian

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Background: London’s Air Ambulance (LAA) provides advanced pre-hospital trauma care across London, bringing specialist resources and expert trauma teams to patients. Since its inception 32 years ago, LAA has treated over 40,000 pre-hospital patients and significantly contributed to pre-hospital patient care in London. To the authors’ best knowledge, this is the first analysis to quantify the magnitude of the publication impact of LAA on the international field of pre-hospital medicine. Method: We searched the Scopus, Web of Science, Google Scholar and PubMed databases to identify LAA focused articles. These were defined as articles on the topic of pre-hospital medicine which either utilised data from LAA, or focused on LAA patients, or were authored by LAA clinicians. A bibliometric analysis was conducted and the impact of each eligible article was classified as either: high (article directly influenced the change or creation of clinical guidelines); medium (the article was referenced in clinical guidelines or had >20 Google Scholar citations or >10 PubMed citations); or low impact (article had <20 Google Scholar citations or <10 PubMed citations). Results: The literature search yielded 1,120 articles in total. 198 articles met our inclusion criteria, and their full text was analysed to determine the level of impact. 19 articles were classified as high-impact, 76 as medium-impact, and 103 as low-impact. 20 of the 76 medium-impact articles were referenced in clinical guidelines but had not prompted changes to the guidelines. Conclusion: To our knowledge, this review is the first to quantify the significant publication impact of LAA within the field of pre-hospital medicine over the last 32 years. LAA publications have focused on and driven clinical innovations in trauma care, particularly in pre-hospital anaesthesia, haemorrhage control, and major incidents, with many impacting national and international guidelines. We recommend a greater emphasis on multidisciplinary pre-hospital collaboration in publications in future research and quality improvement projects across all pre-hospital services.

Keywords: air ambulance, pre-hospital medicine, London’s Air Ambulance, London HEMS

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Authors: Isah Yahaya Aliyu

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Research on Internet use has often approached beneficial uses (online opportunities) of the Internet as separate from the risky encounters (online risks) of young people online. However, empirical evidence from diverse contexts appears to increasingly support the fusion of the two sets of online activities. Hence, the current research investigates the correlation between Internet use (IU) and digital literacy (DL) with online opportunities (OP) and risks (OR), using data from a Nigerian context, where there appears a paucity of research and literature on integrating opportunities and risks in the same study. A web-based data collection method was used to administer a survey to 335 undergraduate students in Northeastern Nigeria. Underpinned to Livingstone and Helsper model, findings are largely consistent with existing literature; IU and DL influence OP (R2 = 0.791, SE = 0.265, F-Stats = 626.566, P-value <.001), equally IU and DL influence OR as well (R2 = 0.343, SE = 0.465, F-Stats = 86.671, P-value <.001). OP and OR were found to strongly correlate positively (r = .667, n = 335, p < 0.01). This study has provided buttressing evidence from a Nigerian context of the fusion of benefits and risks of the Internet among young people. It has also upheld the argument for improved literacy as strategy for minimizing risks/harm rather than restricting use. Other theoretical and policy implications of the findings have been discussed in line with local and global debates about the Internet and its attendant effects.

Keywords: digital, internet, literacy, opportunities, risks

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Authors: Abdalla Mansour, Dan Brown, Adel Helmy, Rikin Trivedi, Mathew Guilfoyle

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Introduction: Diagnosing delayed cerebral ischaemia (DCI) following aneurysmal subarachnoid haemorrhage (SAH) can be challenging, particularly in poor-grade patients. Objectives: This study sought to assess the value of routine CTP in identifying (or excluding) DCI and in guiding management. Methods: Eight-year retrospective neuroimaging study at a large UK neurosurgical centre. Subjects included a random sample of adult patients with confirmed aneurysmal SAH that had a CTP scan during their inpatient stay, over a 8-year period (May 2014 - May 2022). Data collected through electronic patient record and PACS. Variables included age, WFNS scale, aneurysm site, treatment, the timing of CTP, radiologist report, and DCI management. Results: Over eight years, 916 patients were treated for aneurysmal SAH; this study focused on 466 patients that were randomly selected. Of this sample, 181 (38.84%) had one or more CTP scans following brain aneurysm treatment (Total 318). The first CTP scan in each patient was performed at 1-20 days following ictus (median 4 days). There was radiological evidence of DCI in 83, and no reversible ischaemia was found in 80. Findings were equivocal in the remaining 18. Of the 103 patients treated with clipping, 49 had DCI radiological evidence, in comparison to 31 of 69 patients treated with endovascular embolization. The remaining 9 patients are either unsecured aneurysms or non-aneurysmal SAH. Of the patients with radiological evidence of DCI, 65 had a treatment change following the CTP directed at improving cerebral perfusion. In contrast, treatment was not changed for (61) patients without radiological evidence of DCI. Conclusion: CTP is a useful adjunct to clinical assessment in the diagnosis of DCI and is helpful in identifying patients that may benefit from intensive therapy and those in whom it is unlikely to be effective.

Keywords: SAH, vasospasm, aneurysm, delayed cerebral ischemia

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Authors: Kelum N. Manamendra-Arachchi, Kalangi Rodrigo

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Bones, teeth, and shells have been acknowledged over the last two centuries as evidence of chronology, Palaeo-environment, and human activity. Faunal traces are valid evidence of past situations because they have properties that have not changed over long periods of time. Sri Lanka has been known as an Island, which has a diverse variation of prehistoric occupation among ecological zones. Defining the Paleoecology of the past societies has been an archaeological thought developed in the 1960s. It is mainly concerned with the reconstruction from available geological and biological evidence of past biota, populations, communities, landscapes, environments, and ecosystems. Sri Lanka has dealt with this subject and considerable research has been already undertaken. The fossil and material record of Sri Lanka’s Wet Zone tropical forests continues from c. 38,000–34,000 ybp. This early and persistent human fossil, technical, and cultural florescence, as well as a collection of well-preserved tropical-forest rock shelters with associated ' on-site ' Palaeoenvironmental records, makes Sri Lanka a central and unusual case study to determine the extent and strength of early human tropical forest encounters. Excavations carried out in prehistoric caves in the low country wet zone has shown that in the last 50,000 years, the temperature in the lowland rainforests has not exceeded 5 degrees. Based on Semnopithecus Priam (Gray Langur) remains unearned from wet zone prehistoric caves, it has been argued that periods of momentous climate changes during the LGM and Terminal Pleistocene/Early Holocene boundary, with a recognizable preference for semi-open ‘Intermediate’ rainforest or edges. Continuous Genus Acavus and Oligospira occupation along with uninterrupted horizontal pervasive of Canarium sp. (‘kekuna’ nut) have proven that temperatures in the lowland rain forests have not changed by at least 5 oC over the last 50,000 years. Site Catchment or Territorial analysis cannot be no longer defensible, due to time-distance based factors as well as optimal foraging theory failed as a consequences of prehistoric people were aware of the decrease in cost-benefit ratio and located sites, and generally played out a settlement strategy that minimized the ratio of energy expanded to energy produced.

Keywords: palaeo-environment, prehistory, palaeo-ecology, zooarchaeology

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Authors: Lucile Rapin, Cynthia El Hage, Rihab Gamaoun, Maria-Fernanda Arboleda, Erin Prosk

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Introduction: Sante Cannabis (SC), a Canadian group of clinics dedicated to medical cannabis, based in Montreal and in the province of Quebec, has served more than 8000 patients seeking cannabis-based treatment over the past five years. As randomized clinical trials with natural medical cannabis are scarce, real-world evidence offers the opportunity to fill research gaps between scientific evidence and clinical practice. Data on the use of medical cannabis products from SC patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to report information on the profiles of both patients and prescribed medical cannabis products at SC clinics, and to assess the safety of medical cannabis among Canadian patients. Methods: This is an observational retrospective study of 1342 adult patients who were authorized with medical cannabis products between October 2017 and September 2019. Information regarding demographic characteristics, therapeutic indications for medical cannabis use, patterns in dosing and dosage form of medical cannabis and adverse effects over one-year follow-up (initial and 4 follow-up (FUP) visits) were collected. Results: 59% of SC patients were female, with a mean age of 56.7 (SD= 15.6, range= (19-97)). Cannabis products were authorized mainly for patients with a diagnosis of chronic pain (68.8% of patients), cancer (6.7%), neurological disorders (5.6%), and mood disorders (5.4 %). At initial visit, a large majority (70%) of patients were authorized exclusively medical cannabis products, 27% were authorized a combination of pharmaceutical cannabinoids and medical cannabis and 3% were prescribed only pharmaceutical cannabinoids. This pattern was recurrent over the one-year follow-up. Overall, oil was the preferred formulation (average over visits 72.5%) followed by a combination of oil and dry (average 19%), other routes of administration accounted for less than 4%. Patients were predominantly prescribed products with a balanced THC:CBD ratio (59%-75% across visits). 28% of patients reported at least one adverse effect (AE) at the 3-month follow-up visit and 12% at the six-month FUP visit. 84.8% of total AEs were mild and transient. No serious AE was reported. Overall, the most common side effects reported were dizziness (11.95% of total AEs), drowsiness (11.4%), dry mouth (5.5%), nausea (4.8%), headaches (4.6%), cough (4.4%), anxiety (4.1%) and euphoria (3.5%). Other adverse effects accounted for less than 3% of total AE. Conclusion: Our results confirm that the primary area of clinical use for medical cannabis is in pain management. Patients in this cohort are largely utilizing plant-based cannabis oil products with a balanced ratio of THC:CBD. Reported adverse effects were mild and included dizziness and drowsiness. This real-world data confirms the tolerable safety profile of medical cannabis and suggests medical indications not yet validated in controlled clinical trials. Such data offers an important opportunity for the investigation of the long-term effects of cannabinoid exposure in real-life conditions. Real-world evidence can be used to direct clinical trial research efforts on specific indications and dosing patterns for product development.

Keywords: medical cannabis, safety, real-world data, Canada

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Authors: Etta Conteh, Tracy Macintosh

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Introduction: Restraints are often used in the Emergency Department when it is necessary for a patient to be restrained in order to decrease their agitation and better treat them. Chemical and physical restraints may be used on these patients at the discretion of the medical provider. Racism and injustice are rampant within our country, and medicine and healthcare are not spared. While racism and racial bias in medicine and healthcare have been studied, information on the differences in the use of restraints by race are scarce. Objective: The objective of this study is to determine if African Americans and Hispanic-American patients are restrained at higher rates compared to their White counterparts. Methods: This study will be carried out through a retrospective analysis utilizing the Hospital Corporation of America (HCA) national Emergency Department (ED) and inpatient database with patient visits from 2016-2019. All patient visits, with patients aged 18 years or older, will be reviewed, looking specifically for the race and the use and type of restraints. Other factors, such a pre-existing psychiatric condition, will be used for sub-analysis. Rationale: The outcome of this project will demonstrate the absence or presence of a racial disparity in the use of restraints in the Emergency Department. These results can be used as a foundation for improving racial equity in healthcare treatment.

Keywords: emergency medicine, public health, racism, restraint use

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Authors: Manirath Wongsim, Chatchawarn Srimontree, Pornpichit Phosri

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Today, the majority of the data innovation may be currently majorly influencing business, what more accepted part of the accountant may be evolving. Information Technology elements have been appearing to be crucial in triggering changes of accountants’ roles. Thus, this study aims to investigate IT competencies among professional accountants to enhance firm performance. This research was conducted with 47 respondents at five organizations in Thailand and used quantitative research. The results indicate that the factor IT competencies for professional accountants in Thai small to medium accounting within the organizational issues defines18 factors. Specifically, these new factors, based on the research findings and the literature, then unique to IT competencies for professional accountants, include ERP software skills and accounting law and legal skills. The evidence in this study suggests that Analytical skills, teamwork skills, and accounting software were ranked as much-needed skills to be acquired by accountants while communication skills were ranked as the most required skills and delegation skills as the least required. The findings of the research’s empirical evidence suggest that organizations should understand appropriate in developing information technology influence competencies for knowledge employees in general and professional accountants in particular and provide assistance in all processes of decision making.

Keywords: IT competencies, IT competences for professional accountants, IT skills for accounting, IT skills in SMEs

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Authors: Ayu Nabila Kusuma Pradana, Aprinaldi Jasa Mantau, Tomohiko Akahoshi

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The incidence of Disseminated intravascular coagulation (DIC) following gastrointestinal surgery has a poor prognosis. Therefore, it is important to determine the factors that can predict the prognosis of DIC. This study will investigate the factors that may influence the outcome of DIC in patients after gastrointestinal surgery. Eighty-one patients were admitted to the intensive care unit after gastrointestinal surgery in Kyushu University Hospital from 2003 to 2021. Acute DIC scores were estimated using the new Japanese Association for Acute Medicine (JAAM) score from before and after surgery from day 1, day 3, and day 7. Acute DIC scores will be compared with The Sequential Organ Failure Assessment (SOFA) score, platelet count, lactate level, and a variety of biochemical parameters. This study applied machine learning algorithms to predict the prognosis of DIC after gastrointestinal surgery. The results of this study are expected to be used as an indicator for evaluating patient prognosis so that it can increase life expectancy and reduce mortality from cases of DIC patients after gastrointestinal surgery.

Keywords: the survival rate, gastrointestinal surgery, JAAM score, neural network, machine learning, disseminated intravascular coagulation (DIC)

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Authors: Liya Abraham

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Eritrea is located along the Red Sea, north of the Horn of Africa, between Djibouti and Sudan and has a population of about 3.2 million as of 2010. It has six administrative regions; Anseba, Debub, Debubawi K’eyih Bahri, Gash-Barka, Ma'akel, and Semenawi K’eyih Bahri. Eritrea has got its independence in 1991 after 30 years war of liberation. The country is blessed with various medicinal flora and fauna, and marine and terrestrial biodiversity. Traditional Medicine (TM) has been an integral part of the Eritrean culture for centuries. So far, more than 19 TM modalities have been recognized, and are broadly categorized as; herbal, procedure-based and spiritual. Despite the availability of modern medicine to the majority of the population, TM is still widely practiced. The rationale behind widespread use is accessibility, affordability and cultural acceptability. Hence, TM is of great contribution to the Eritrean health care system. As a matter of fact, harnessing the potential contribution of effective and safe TM in order to attain Universal Health Coverage (UHC) has been emphasized in the WHO TM strategy 2014-2023. The Eritrean TM, however, was operating without regulation and reliable scientific justification behind its safety and efficacy. Thus, the Ministry of Health (MoH), in recognition of the role of TM in primary healthcare and safeguard public health, established a regulatory body for TM so-called as Traditional Medicine Unit (TMU) in 2012. The mission of the unit is to ensure rational TM use through an integrated health service delivery system and contribute to the country’s economic and social development. The unit has established its national TM policy in 2017. The activities of the unit are guided by the National TM Advisory Committee (TMAC), responsible for the provision of technical assistance and advisory role. Moreover, the Legal Framework and Code of Ethics and Practice which provide a legal basis for the regulation of TM have also been drafted. In recognition of the importance of TM research and development, the unit launched a nationwide TM survey in 2017 and had surveyed two zones (Gash-Barka and Debub). The findings of the survey were subjected to a research dissemination workshop and publication in international journals. Furthermore, TM-related adverse events reporting tool (Green Form) aiming to guide regulatory interventions and researches have been established by the unit, and ever since reports are flowing. The unit has also been offering training to THPs, pharmacy students and health care professionals regarding TM and its regulatory activities. In addition, as part of the establishment of the national medicinal plants' database and herbal monograph, more than 329 and 30 medicinal plants, have been compiled respectively. In conclusion, TM is still widely accepted and practiced in Eritrea. The TMU ever since its establishment is endeavoring to ensure the safety and efficacy of the TM, and its integration in the mainstream health service delivery system.

Keywords: efficacy, regulation, safety, traditional medicine, traditional medicine unit, universal health coverage

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Authors: Mewa Singh

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Nanomedicine, a fusion of nanotechnology and medicine, is an emerging technology ideally suited to the targeted therapies. Nanoparticles overcome the low selectivity of anti-cancer drugs toward the tumor as compared to normal tissue and hence result-in less severe side-effects. Our new technology, HYBRID-NANOENGINEERING™, uses a new molecule (MR007) in the creation of nanoparticles that not only helps in nanonizing the medicine but also provides synergy to the medicine. The simplified manufacturing process will result in reduced manufacturing costs. Treatment is made more convenient because hybrid nanomedicines can be produced in oral, injectable or transdermal formulations. The manufacturing process uses no protein, oil or detergents. The particle size is below 180 nm with a narrow distribution of size. Importantly, these properties confer great stability of the structure. The formulation does not aggregate in plasma and is stable over a wide range of pH. The final hybrid formulation is stable for at least 18 months as a powder. More than 97 drugs, including paclitaxel, docetaxel, tamoxifen, doxorubicinm prednisone, and artemisinin have been nanonized in water soluble formulations. Preclinical studies on cell cultures of tumors show promising results. Our HYBRID-NANOENGINEERING™ platform enables the design and development of hybrid nano-pharmaceuticals that combine efficacy with tolerability, giving patients hope for both extended overall survival and improved quality of life. This study would discuss or present this new discovery of HYBRID-NANOENGINEERING™ which targets drug delivery, synergistic, and potentiating effects, and barriers of drug delivery and advanced drug delivery systems.

Keywords: nano-medicine, nano-particles, drug delivery system, pharmaceuticals

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Authors: A. Priyanka, Sunil Kumar Kainoor, Parinitha Nayaka

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Introduction: Ever since the ancient times, rape and other sexual offences are considered to be heinous crimes. Rape is not just another word in the dictionary, but it is the most barbaric act of violence committed with sex being the weapon. Rape is among the highest forms of crime experienced by women and children in all sectors of the society. In recent years, there has been an alarming rise in ratio of rape in India. The burden of such crimes on the society is very huge. The venereal diseases are the worst consequence along with unwanted pregnancies. Aims and Objectives: To determine the socio-demographic profile of the survivors of sexual offences reported to Dept. of Forensic Medicine of a South Indian medical college. Material methods: This retrospective study was conducted in the Department of Forensic Medicine of Raichur Institute of Medical Sciences, Raichur, Karnataka, India. Only survivors of sexual offences cases were included in the study group. Examination of all survivors was carried out by doctors of the said Department. Study period is one year six months, January 2015 to June 2016. Results/ case history: In total 140 cases of sexual offences were examined during study period of which the total survivors accounted to 62.85% i.e. 88 cases. Of the 88 survivors, 61 (69.31%) were registered under POCSO Act. The most affected age group of victims was 10-18 years in 59 (67%) cases. 61% were in acquaintance with the assailants, 18% were classmates/ friends, 13% of accused were Family members/ Relatives, 8% were strangers. 85% of the survivors were hailing from rural setup, while 15% were from urban. 60.65% of the survivors were students, 37.7% were doing Coolie/ Agricultural works. Conclusion: Delay in reporting of cases resulted in loss of vital physical evidences as no concrete report could be generated from the forensic lab after examination of specimens thus there should be coordination among doctors, forensic experts and investigating agency. It is worth mentioning that though a large number of cases of sexual offences are reported as rape many among them are consented acts and hence definite evidence of forceful sexual intercourse is lagging.

Keywords: consensual sex, India, POCSO Act- 2012, India, pregnancy, rape, sexual offence

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Authors: Demet Yesiltepe, Ruth Dalton, Ayse Ozbil

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The aim of this paper is to understand the effect of landmarks on spatial navigation. For this study, a mobile-based virtual game, 'Sea Hero Quest' (SHQ), was used. At the beginning of the game, participants were asked to look at maps which included the specific locations of players and checkpoints. After the map disappeared, participants were asked to navigate a boat and find the checkpoints in a pre-given order. By analyzing this data, we aim to better understand an important component of cities, namely landmarks, on spatial navigation. Game levels were analyzed spatially and axial-based integration, choice and connectivity values of levels were calculated to make comparisons. To make this kind of a comparison, we focused on levels which include both local and global landmarks and levels which include only local landmarks. The most significant contribution of this study to urban design and planning fields is that it provides mounting evidence about the utility of landmarks and their roles in cities due to the fact that the game was played more than 2.5 million people. Moreover, by using these results, it can be possible to encourage cities with more global and local landmarks to have more identifiable/readable areas.

Keywords: landmarks, mobile-based games, spatial navigation, virtual environment

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Authors: J. A. Lopez, J. E. Olguin, C. Camargo, G. A. Quijano, R. Martinez

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An anthropometric study applied to 1,115 students of the Faculty of Chemical Sciences and Engineering of the Autonomous University of California. Thirteen individual measurements were taken in a sitting position. The results obtained allow forming a reliable anthropometric database for statistical studies and analysis and inferences of specific distributions, so the opinion of experts in occupational medicine recommendations may emit to reduce risks resulting in an alteration of the vital signs during the execution of their school activities. Another use of these analyses is to use them as a reliable reference for future deeper research, to the design of spaces, tools, utensils, workstations, with anthropometric dimensions and ergonomic characteristics suitable to use.

Keywords: anthropometry, vital signs, students, medicine

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Authors: Xinyue Jiao, Yu-Ren Lin

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Argumentation is an essential aspect of scientific thinking which has been widely concerned in recent reform of science education. The purpose of the present studies was to explore the influences of two variables termed ‘the argumentation strategy’ and ‘the kind of science concept’ on student’s web-based argumentation. The first variable was divided into either monological (which refers to individual’s internal discourse and inner chain reasoning) or dialectical (which refers to dialogue interaction between/among people). The other one was also divided into either descriptive (i.e., macro-level concept, such as phenomenon can be observed and tested directly) or theoretical (i.e., micro-level concept which is abstract, and cannot be tested directly in nature). The present study applied the quasi-experimental design in which 138 7th grade students were invited and then assigned to either monological group (N=70) or dialectical group (N=68) randomly. An argumentation learning program called ‘the PWAL’ was developed to improve their scientific argumentation abilities, such as arguing from multiple perspectives and based on scientific evidence. There were two versions of PWAL created. For the individual version, students can propose argument only through knowledge recall and self-reflecting process. On the other hand, the students were allowed to construct arguments through peers’ communication in the collaborative version. The PWAL involved three descriptive science concept-based topics (unit 1, 3 and 5) and three theoretical concept-based topics (unit 2, 4 and 6). Three kinds of scaffoldings were embedded into the PWAL: a) argument template, which was used for constructing evidence-based argument; b) the model of the Toulmin’s TAP, which shows the structure and elements of a sound argument; c) the discussion block, which enabled the students to review what had been proposed during the argumentation. Both quantitative and qualitative data were collected and analyzed. An analytical framework for coding students’ arguments proposed in the PWAL was constructed. The results showed that the argumentation approach has a significant effect on argumentation only in theoretical topics (f(1, 136)=48.2, p < .001, η2=2.62). The post-hoc analysis showed the students in the collaborative group perform significantly better than the students in the individual group (mean difference=2.27). However, there is no significant difference between the two groups regarding their argumentation in descriptive topics. Secondly, the students made significant progress in the PWAL from the earlier descriptive or theoretical topic to the later one. The results enabled us to conclude that the PWAL was effective for students’ argumentation. And the students’ peers’ interaction was essential for students to argue scientifically especially for the theoretical topic. The follow-up qualitative analysis showed student tended to generate arguments through critical dialogue interactions in the theoretical topic which promoted them to use more critiques and to evaluate and co-construct each other’s arguments. More explanations regarding the students’ web-based argumentation and the suggestions for the development of web-based science learning were proposed in our discussions.

Keywords: argumentation, collaborative learning, scientific concepts, web-based learning

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Authors: Edith Esparza-Young, Ángel M. Matos, Yaritza Gonzalez, Kirthana Sugunathevan

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Introduction: This research describes the existing medical school program which supports a multicultural setting and bilingualism. The rise of Spanish speakers in the United States has led to the recruitment of bilingual medical students who can serve the evolving demographics. This paper includes anecdotal evidence, narratives and the latest research on the outcomes of supporting a multilingual academic experience in medical school and beyond. People in the United States will continue to need health care from physicians who have experience with multicultural competence. Physicians who are bilingual and possess effective communication skills will be in high demand. Methodologies: This research is descriptive. Through this descriptive research, the researcher will describe the qualities and characteristics of the existing medical school programs, curriculum, and student services. Additionally, the researcher will shed light on the existing curriculum in the medical school and also describe specific programs which help to serve as safety nets to support diverse populations. The method included observations of the existing program and the implementation of the medical school program, specifically the Accelerated Review Program, the Language Education and Professional Communication Program, student organizations and the Global Health Institute. Concluding Statement: This research identified and described characteristics of the medical school’s program. The research explained and described the current and present phenomenon of this medical program, which has focused on increasing the graduation of bilingual and minority physicians. The findings are based on observations of the curriculum, programs and student organizations which evolves and remains innovative to stay current with student enrollment.

Keywords: bilingual, English, medicine, doctor

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Authors: Clare Victoria Martin

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With reports of increased mental health problems and a lack of proactive, consistent well-being initiatives, well-being is a topical issue in the workplace, as well as a wider public health concern. Additionally, workplace well-being is closely linked to performance, both from a business perspective and in psychological research. Businesses are therefore becoming increasingly motivated to promote well-being, yet there are still barriers, including a lack of evidence-based workplace interventions, issues with measuring effectiveness and problems creating lasting cultural change. This review aimed to collate workplace well-being research to propose a comprehensive new model for delivering evidence-based workplace well-being training with a real potential for lasting impact. Method: A narrative review was conducted to meta-synthesise relevant research. Thematic analysis was then adopted as a systematic method of identifying key themes from the review to lead to practical recommendations. Interventions focusing on strengths, psychological capital, mindfulness and positivity (SPMP) dominated the research in this area, suggesting benefits of incorporating all four into training. However, to avoid a ‘quick fix’ mentality, the concept of training ‘well-being ambassadors’ as a preventative counterpart to mental health ‘first aiders’ was proposed alongside a new ‘REST and RISE’ model: well-being interventions should be ‘relatable’, ‘enjoyable’, ‘sociable’ and ‘trackable’ (REST) in order to increase ‘resilience’, ‘innovation’, ‘strengths’ and ‘engagement’ (RISE). If the REST principles are applied to interventions focusing on SPMP, research suggests individuals will RISE. Future research should empirically test this new well-being ambassador programme and REST/RISE model in an applied setting.

Keywords: performance, positive psychology, thriving, workplace well-being

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Authors: Nour Daoud

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Patriarchy continues to thrive in Jordan where male-controlled values are still entrenched in a society that is suffering from upsetting percentages of Gender-based Violence (GBV). This paper is a systematic review of the literature with an attempt to evaluate and interpret all available research evidence relevant to determining the extent to which patriarchy contributes to the occurrence, re-occurrence, and continuation of GBV in Jordan. Twenty-one (21) full-text articles were selected for the in-depth review due to meeting the established criteria for inclusion. 81 percent of articles included primary data while 19 percent included secondary data. Analysis of data was based on a specific extraction form that was developed using the ‘Excel’ to respond to the main goal of the paper. Interpretation of data was in light of the theorization of different feminism schools on the relationship between patriarchy and gender-based violence. Findings show that 33 percent of the selected articles affirm that the patriarchal standpoint best explains the role of patriarchy in the incidence of gender-based violence in Jordan under its three main themes (Honor-based Violence, Intimate Partner Violence and Street Harassment). Apart from the limited number of articles that were found debating this argument and the low percentage of articles that acknowledged the role of patriarchy in the incidence of gender-based violence in Jordan, this paper breaks the ice to implement future empirical studies on this subject. Also, it is an invitation for all Jordanian women to unite their efforts in order to eradicate all forms of victimization against them.

Keywords: honor-based violence, intimate partner violence, middle-east, street harassment

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Authors: Joanne Haddad

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The distinctive traits of early settlers at initial stages of institutional development may be crucial for cultural formation. In 1973, the cultural geographer Wilbur Zelinsky postulated this in his doctrine of “first effective settlement”. There is however little empirical evidence supporting the role of early settlers in shaping culture over the long run. This paper tests this hypothesis by relating early settlers’ culture to within state variation in gender norms in the United States. Settlers’ culture is captured using past female labor force participation, women’s suffrage, and financial rights at their place of origin. The paper documents the distinctive characteristics of settlers’ populations and provide suggestive evidence in support of the transmission of gender norms across space and time. Results from this analysis show that women’s labor supply is higher, in both the short and long run, in U.S. counties that historically hosted a larger settler population originating from places with favorable gender attitudes. Findings from this study shed new light on the importance of the characteristics of immigrants and their place of origin for cultural formation in hosting societies.

Keywords: female labor force participation, settlers, gender norms, cultural formation.

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Authors: Tuula Heinonen, Wilhelm Gaus

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At present safety, assessment starts with animal tests although their predictivity is often poor. Even after extended human use experimental data are often judged as the core information for risk assessment. However, the best opportunity to generate true evidence is to match all available information. Cross matching methodology combines the different fields of knowledge and types of data (e.g. in-vitro and in-vivo experiments, clinical observations, clinical and epidemiological studies, and daily life observations) and gives adequate weight to individual findings. To achieve a consolidated outcome, the information from all available sources is analysed and compared with each other. If single pieces of information fit together a clear picture becomes visible. If pieces of information are inconsistent or contradictory careful consideration is necessary. 'Cross' can be understood as 'orthographic' in geometry or as 'independent' in mathematics. Results coming from different sources bring independent and; therefore, they result in new information. Independent information gives a larger contribution to evidence than results coming repeatedly from the same source. A successful example of cross matching is the assessment of Ginkgo biloba where we were able to come to the conclusive result: Ginkgo biloba leave extract is well tolerated and safe for humans.

Keywords: cross-matching, human use, safety assessment, Ginkgo biloba leave extract

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Authors: Ravindra N. Singh, Dheerendra P. Singh

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Recent discoveries of Bronze Age artefacts, tin slag, furnaces and crucibles, together with new geological evidence on tin deposits in Tosham area of Bhiwani district in Haryana (India) provide the opportunity to survey the evidence for possible sources of tin and the use of bronze in the Harappan sites of north western India. Earlier, Afghanistan emerged as the most promising eastern source of tin utilized by Indus Civilization copper-smiths. Our excavations conducted at Khanak near Tosham mining area during 2014 and 2016 revealed ample evidence of metallurgical activities as attested by the occurrence of slag, ores and evidences of ashes and fragments of furnaces in addition to the bronze objects. We have conducted petrological, XRD, EDAX, TEM, SEM and metallography on the slag, ores, crucible fragments and bronze objects samples recovered from Khanak excavations. This has given positive indication of mining and metallurgy of poly-mettalic Tin at the site; however, it can only be ascertained after the detailed scientific examination of the materials which is underway. In view of the importance of site, we intend to excavate the site horizontally in future so as to obtain more samples for scientific studies.

Keywords: archaeometallurgy, problem of tin, metallography, indus civilization

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