Search results for: clinical trial development
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 19353

Search results for: clinical trial development

15273 Clinical Case Successful Surgical Treatment of Postinfarction Ventricular Septum Defect

Authors: Melikulov A. A., Toshpulotov Sh. G., Akhmedova M. F., Beshimov A. S., Rakhimov M. K. Zokirov N. K.

Abstract:

Postinfarction ventricular septal defect (PVSD) is a rare but life-threatening complication of acute myocardial infarction. Currently, an alternative direction of minimally invasive treatment of postinfarction ventricular septal defect (PVSD) is being developed - transcatheter closure of the defect using an occluder, but surgical closure of the defect remains the <> correction of post-infarction VSD. Our article presents a case of successful surgical treatment of a patient with a large post-infarction rupture of the interventricular septum (IVS) and post-infarction LV aneurysm under cardiopulmonary bypass and parallel perfusion.

Keywords: echocardiography, myocardial infarction, ventricular septal defect, parallel perfusion

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15272 Recent Developments and Expectations in the Legal Expenses Insurance in Turkey

Authors: İbrahim Arslan, Mücahit Ünal

Abstract:

An important issue to ensure justice is to simplify the right to seek justice. But there is a cost of seeking justice in civil law. It costs at least, attorneys' fees and judicial expenses during the beginning and in case of losing a trial. Indeed, most of the people refrain from seeking justice because of these expenses. Therefore, it is not inappropriate to say that the removal of obstacles staying on the way of seeking justice will increase the belief in justice. Legal expenses insurance is a private law contract of insurance in which the insurer is obliged to pay premiums of the insured, to provide the necessary services for the protection of legal interests of the insured person within the agreed scope. This type of insurance is being practiced in the Western world for a long time. The special rights, duties and obligations of the parties to a legal expenses insurance contract shall be governed by the Turkish Commercial Code (TCC) and the contractual agreements which are regularly closed in the form of general terms and conditions. If the number of the legal expenses insurance contracts concluded increase this will definitely improve the percentage of seeking justice before the courts. The general terms and conditions applicable in Turkey generally include litigation costs, referee fees, guarantee fund , enforcement costs , appeal costs borne decision corrections costs. In addition, besides the insured, other family members or the people specified in the policy are protected in the scope of personal/family legal expenses insurance. The commercial law disputes fall outside the scope of coverage in this insurance branch. The insured person chooses his own lawyer and the insurer is not allowed to give advice during the selection of a lawyer. In April 2015, the Prime Minister announced of a new era in the field of legal expenses insurance in Turkey and this announcement excited the insurance industry and legal community.

Keywords: insurance, in the Turkish law on legal protection insurance, legal protection insurance, legal protection

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15271 Social Economy Effects on Wetlands Change in China during Three Decades Rapid Growth Period

Authors: Ying Ge

Abstract:

Wetlands are one of the essential types of ecosystems in the world. They are of great value to human society thanks to their special ecosystem functions and services, such as protecting biodiversity, adjusting hydrology and climate, providing essential habitats and, products and tourism resources. However, wetlands worldwide are degrading severely due to climate change, accelerated urbanization, and rapid economic development. Both nature and human factors drive wetland change, and the influences are variable from wetland types. Thus, the objectives of this study were to (1) to compare the changes in China’s wetland area during the three decades rapid growth period (1978-2008); (2) to analyze the effects of social economy and environmental factors on wetlands change (area loss and change of wetland types) in China during the high-speed economic development. The socio-economic influencing factors include population, income, education, development of agriculture, industry, infrastructure, wastewater amount, etc. Several statistical methods (canonical correlation analysis, principal component analysis, and regression analysis) were employed to analyze the relationship between socio-economic indicators and wetland area change. This study will determine the relevant driving socio-economic factors on wetland changes, which is of great significance for wetland protection and management.

Keywords: socioeconomic effects, China, wetland change, wetland type

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15270 An Empirical Analysis on the Evolution Characteristics and Textual Content of Campus Football Policy in China

Authors: Shangjun Zou, Zhiyuan Wang, Songhui You

Abstract:

Introduction In recent years, the Chinese government has issued several policies to promote the institutional reform and innovation of the development of campus football, but many problems have been exposed in the process of policy implementation. Therefore, this paper attempts to conduct an empirical analysis of the campus football policy texts to reveal the dynamic development of the microsystem in the process of policy evolution. Methods The selected policy contents are coded by constructing a two-dimensional analysis framework of campus football policy tool-policy objective. Specifically, the X dimension consists of three oriented policy tools: environment, supply and demand, while the Y dimension is divided into six aspects of policy objectives, including institution, competition, player teaching, coach training, resource guarantee and popularization. And the distribution differences of textual analysis units on X and Y dimensions are tested by using SPSS22.0 so as to evaluate the characteristics and development trend of campus football policy on respective subjects. Results 1) In the policy evolution process of campus football stepping into the 2.0 Era, there were no significant differences in the frequency distribution of policy tools(p=0.582) and policy objectives(p=0.603). The collaborative governance of multiple participants has become the primary trend, and the guiding role of Chinese Football Association has gradually become prominent. 2) There were significant differences in the distribution of policy tools before the evolution at a 95% confidence level(p=0.041). With environmental tools always maintaining the dominant position, the overall synergy of policy tools increased slightly. 3) There were significant differences in the distribution of policy objectives after the evolution at a 90% confidence level(p=0.069). The competition system of policy objective has not received enough attention while the construction of institution and resource guarantee system has been strengthened. Conclusion The upgraded version of campus football should adhere to the education concept of health first, promote the coordinated development of youth cultural learning and football skills, and strive to achieve more solid popularization, more scientific institution, more comprehensive resource guarantee and adequate integration. At the same time, it is necessary to strengthen the collaborative allocation of policy tools and reasonable planning of policy objectives so as to promote the high quality and sustainable development of campus football in the New Era. Endnote The policy texts selected in this paper are “Implementation Opinions on Accelerating the Development of Youth Campus Football” and “Action Plans for the Construction of Eight Systems of National Youth Campus Football”, which were promulgated on August 13, 2015 and September 25, 2020 respectively.

Keywords: campus football, content analysis, evolution characteristics, policy objective, policy tool

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15269 Encouraging the Development of Scientific Literacy in Early Childhood Institutions: Croatian Experience

Authors: L. Vujičić, Ž. Ivković, Ž. Boneta

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There is a widespread belief in everyday discourse that science subjects (physics, chemistry and biology) are, along with math, the most difficult school subjects in the education of an individual. This assumption is usually justified by the following facts: low GPA in these subjects, the number of pupils who fail these subjects is high in comparison to other subjects, and the number of pupils interested in continuing their studies in the fields with a focus on science subjects is lower compared to non-science-oriented fields. From that perspective, the project: “Could it be different? How do children explore it?” becomes extremely interesting because it is focused on young children and on the introduction of new methods, with aim of arousing interest in scientific literacy development in 10 kindergartens by applying the methodology of an action research, with an ethnographic approach. We define scientific literacy as a process of encouraging and nurturing the research and explorative spirit in children, as well as their natural potential and abilities that represent an object of scientific research: to learn about exploration by conducting exploration. Upon project completion, an evaluation questionnaire was created for the parents of the children who had participated in the project, as well as for those whose children had not been involved in the project. The purpose of the first questionnaire was to examine the level of satisfaction with the project implementation and its outcomes among those parents whose children had been involved in the project (N=142), while the aim of the second questionnaire was to find out how much the parents of the children not involved (N=154) in this activity were interested in this topic.

Keywords: documenting, early childhood education, evaluation questionnaire for parents, scientific literacy development

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15268 Menopause Hormone Therapy: An Insight into Knowledge and Attitudes of Obstetricians and Gynecologists in Singapore

Authors: Tan Hui Ying Renee, Stella Rizalina Sasha, Farah Safdar Husain

Abstract:

Introduction: Menopause Hormone Therapy (MHT) is an effective drug indicated for the treatment of menopausal symptoms and as replacement therapy in women who undergo premature menopause. In 2020, less than 8.8% of perimenopausal Singaporean women are on hormonal therapy, as compared to the Western population, where up to 50% may be on MHT. Factors associated with MHT utilization have been studied from patient characteristics, but the impact of locally prescribing physicians resulting in low MHT utilization has yet to be evaluated. The aim of the study is to determine the level of knowledge physicians in the Obstetrics and Gynaecology specialty have and their attitudes toward MHT. We believe that knowledge of MHT is lacking and that negative attitudes towards MHT may influence its use and undermine the benefits MHT may have for women. This paper is a part of a larger study on Singaporean physicians’ knowledge and attitudes towards MHT. Methods: This is a cross-sectional study intended to assess the knowledge and attitudes of physicians toward Menopausal Hormone Therapy. An anonymous questionnaire was disseminated via institutional internal circulations to optimize reach to physicians who may prescribe MHT, particularly in the fields of Gynaecology, Family Medicine and Endocrinology. Responses were completed voluntarily. Physicians had the option for each question to declare that they were ‘unsure’ or that the question was ‘beyond their expertise’. 21 knowledge questions tested factual recall on indications, contraindications, and risks of MHT. The remaining 6 questions were clinical scenarios crafted with the intention of testing specific principles related to the use of MHT. These questions received face validation from experts in the field. 198 responses were collected, 79 of which were from physicians in the Obstetrics and Gynaecology specialty. The data will be statistically analyzed to investigate areas that can be improved to increase the overall benefits of MHT for the Singaporean population. Results: Preliminary results show that the prevailing factors that limit Singaporean gynecologists and obstetricians from prescribing MHT are a lack of knowledge of MHT and a lack of confidence in prescribing MHT. Risks and indications of MHT were not well known by many physicians, with the majority of the questions having more than 25% incorrect and ‘unsure’ as their reply. The clinical scenario questions revealed significant shortcomings in knowledge on how to navigate real-life challenges in MHT use, with 2 of 6 questions with more than 50% incorrect or ‘beyond their expertise’ as their reply. The portion of the questionnaire that investigated the attitudes of physicians showed that though a large majority believed MHT to be an effective drug, only 40.5% were confident in prescribing it. Conclusion: Physicians in the Obstetrics and Gynaecology specialty lack knowledge and confidence in MHT. Therefore, it is imperative to formulate solutions on both the individual and institutional levels to fill these gaps and ensure that MHT is used appropriately and prescribed to the patients who need it.

Keywords: menopause, menopause hormone therapy, physician factors, obstetrics and gynecology, menopausal symptoms, Singapore

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15267 An Electrode Material for Ultracapacitors: Hydrothermal Synthesis of Neodymium Oxide/Manganese Oxide/Nitrogen Doped Reduced Graphene Oxide Ternary Nanocomposites

Authors: K. Saravanan, K. A.Rameshkumar, P. Maadeswaran

Abstract:

The depletion of fossil resources and the rise in global temperatures are two of the most important concerns we confront today. There are numerous renewable energy sources like solar power, tidal power, wind energy, radiant energy, hydroelectricity, geothermal energy, and biomass available to generate the needed energy demand. Engineers and scientists around the world are facing a massive barrier in the development of storage technologies for the energy developed from renewable energy sources. The development of electrochemical capacitors as a future energy storage technology is at the forefront of current research and development. This is due to the fact that the electrochemical capacitors have a significantly higher energy density, a faster charging-discharging rate, and a longer life span than capacitors, and they also have a higher power density than batteries, making them superior to both. In this research, electrochemical capacitors using the Nd2O3/Mn3O4/ N-rGO electrode material is chosen since the of hexagonal and tetragonal crystal structures of Nd2O3 and Mn3O4 and also has cycling stability of 68% over a long time at 50mVs-1 and a high coulombic efficiency of 99.64% at 5 Ag-1. This approach may also be used to create novel electrode materials with improved electrochemical and cyclic stability for high-performance supercapacitors.

Keywords: Nd2O3/Mn3O4/N-rGO, nanocomposites, hydrothermal method, electrode material, specific capacitance, use of supercapacitors

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15266 Leadership Process Model: A Way to Provide Guidance in Dealing with the Key Challenges Within the Organisation

Authors: Rawaa El Ayoubi

Abstract:

Many researchers, academics and practitioners have developed leadership theories during the 20th century. This substantial effort has built more leadership theories, generating considerable organisational research on leadership models in contemporary literature. This paper explores the stages and drivers of leadership theory evolution based on the researcher’s personal conclusions and review of leadership theories. The purpose of this paper is to create a Leadership Process Model (LPM) that can provide guidance in dealing with the key challenges within the organisation. This integrative model of organisational leadership is based on inner meaning, leader values and vision. It further addresses the relationships between leadership theory, practice and development, exploring why challenges exist within the field of leadership theory and how these challenges can be mitigated.

Keywords: leadership challenges, leadership process model, leadership |theories, organisational leadership, paradigm development

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15265 Use of Technology Based Intervention for Continuous Professional Development of Teachers in Pakistan

Authors: Rabia Aslam

Abstract:

Overwhelming evidence from all around the world suggests that high-quality teacher professional development facilitates the improvement of teaching practices which in turn could improve student learning outcomes. The new Continuous Professional Development (CPD) model for primary school teachers in Punjab uses a blended approach in which pedagogical content knowledge is delivered through technology (high-quality instructional videos and lesson plans delivered to school tablets or mobile phones) with face-to-face support by Assistant Education Officers (AEOs). The model also develops Communities of Practice operationalized through formal meetings led by the AEOs and informal interactions through social media groups to provide opportunities for teachers to engage with each other and share their ideas, reflect on learning, and come up with solutions to issues they experience. Using Kirkpatrick’s 4 levels of the learning evaluation model, this paper investigates how school tablets and teacher mobile phones may act as transformational cultural tools to potentially expand perceptions and access to teaching and learning resources and explore some of the affordances of social media (Facebook, WhatsApp groups) in learning in an informal context. The results will be used to inform policy-level decisions on what shape could CPD of all teachers take in the context of a developing country like Pakistan.

Keywords: CPD, teaching & learning, blended learning, learning technologies

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15264 Poli4SDG: An Application for Environmental Crises Management and Gender Support

Authors: Angelica S. Valeriani, Lorenzo Biasiolo

Abstract:

In recent years, the scale of the impact of climate change and its related side effects has become ever more massive and devastating. Sustainable Development Goals (SDGs), promoted by United Nations, aim to front issues related to climate change, among others. In particular, the project CROWD4SDG focuses on a bunch of SDGs since it promotes environmental activities and climate-related issues. In this context, we developed a prototype of an application, under advanced development considering web design, that focuses on SDG 13 (SDG on climate action) by providing users with useful instruments to face environmental crises and climate-related disasters. Our prototype is thought and structured for both web and mobile development. The main goal of the application, POLI4SDG, is to help users to get through emergency services. To this extent, an organized overview and classification prove to be very effective and helpful to people in need. A careful analysis of data related to environmental crises prompted us to integrate the user contribution, i.e., exploiting a core principle of Citizen Science, into the realization of a public catalog, available for consulting and organized according to typology and specific features. In addition, gender equality and opportunity features are considered in the prototype in order to allow women, often the most vulnerable category, to have direct support. The overall description of the application functionalities is detailed. Moreover, the implementation features and properties of the prototype are discussed.

Keywords: crowdsourcing, social media, SDG, climate change, natural disasters, gender equality

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15263 Novel EGFR Ectodomain Mutations and Resistance to Anti-EGFR and Radiation Therapy in H&N Cancer

Authors: Markus Bredel, Sindhu Nair, Hoa Q. Trummell, Rajani Rajbhandari, Christopher D. Willey, Lewis Z. Shi, Zhuo Zhang, William J. Placzek, James A. Bonner

Abstract:

Purpose: EGFR-targeted monoclonal antibodies (mAbs) provide clinical benefit in some patients with H&N squamous cell carcinoma (HNSCC), but others progress with minimal response. Missense mutations in the EGFR ectodomain (ECD) can be acquired under mAb therapy by mimicking the effect of large deletions on receptor untethering and activation. Little is known about the contribution of EGFR ECD mutations to EGFR activation and anti-EGFR response in HNSCC. Methods: We selected patient-derived HNSCC cells (UM-SCC-1) for resistance to mAb Cetuximab (CTX) by repeated, stepwise exposure to mimic what may occur clinically and identified two concurrent EGFR ECD mutations (UM-SCC-1R). We examined the competence of the mutants to bind EGF ligand or CTX. We assessed the potential impact of the mutations through visual analysis of space-filling models of the native sidechains in the original structures vs. their respective side-chain mutations. We performed CRISPR in combination with site-directed mutagenesis to test for the effect of the mutants on ligand-independent EGFR activation and sorting. We determined the effects on receptor internalization, endocytosis, downstream signaling, and radiation sensitivity. Results: UM-SCC-1R cells carried two non-synonymous missense mutations (G33S and N56K) mapping to domain I in or near the EGF binding pocket of the EGFR ECD. Structural modeling predicted that these mutants restrict the adoption of a tethered, inactive EGFR conformation while not permitting association of EGFR with the EGF ligand or CTX. Binding studies confirmed that the mutant, untethered receptor displayed a reduced affinity for both EGF and CTX but demonstrated sustained activation and presence at the cell surface with diminished internalization and sorting for endosomal degradation. Single and double-mutant models demonstrated that the G33S mutant is dominant over the N56K mutant in its effect on EGFR activation and EGF binding. CTX-resistant UM-SCC-1R cells demonstrated cross-resistance to mAb Panitumuab but, paradoxically, remained sensitive to the reversible receptor tyrosine kinase inhibitor Erlotinib. Conclusions: HNSCC cells can select for EGFR ECD mutations under EGFR mAb exposure that converge to trap the receptor in an open, constitutively activated state. These mutants impede the receptor’s competence to bind mAbs and EGF ligand and alter its endosomal trafficking, possibly explaining certain cases of clinical mAb and radiation resistance.

Keywords: head and neck cancer, EGFR mutation, resistance, cetuximab

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15262 Dissimilar Welding Of New High Oxidation Material – Thor™ 115 With Vm-12 Shc

Authors: Michal Urzynicok, Krzysztof Kwiecinski

Abstract:

The development of materials used in the power generation industry for the production of boilers and their parts is characterized by high steam parameters, which present new challenges. Implementation of new combinations of alloying elements that lead to the best possible mechanical properties, including creep resistance, greatly affects new steels' weldability. All new grades have to undergo many different examinations, in regards to bending and welding, in order to enable the development of fabrication technologies, ensuring failure-free production and assembly of boiler components. 12% Cr martensitic steels like THOR™ 115 or VM-12 SHC are characterized by high oxidation resistance in high-temperature environments. At the moment, VM-12 SHC can be found in many boilers where both headers and superheater coils were produced. As this material is very difficult to obtain, a search for a proper replacement has begun. A new creep strength-enhanced ferritic steel for service in supercritical and ultra-supercritical boiler applications was developed by Tenaris in Italy and it is designated as Thor™115 (Tenaris High Oxidation Resistance). As high demand in power plants occurred to replace some parts of existing installations fabricated from VM12-SHC with other alternatives, a new development of welding procedures has begun to prepare fabricators for the challenges of joining old components with new THOR™ 115 material. This paper covers the first research of welding of dissimilar joints made out of VM12-SHC and THOR™ 115.

Keywords: thor, vm12, dissimilar welding, weldability

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15261 Bacteriological Spectrum and Resistance Patterns of Common Clinical Isolates from Infections in Cancer Patients

Authors: Vivek Bhat, Rohini Kelkar, Sanjay Biswas

Abstract:

Introduction: Cancer patients are at increased risk of bacterial infections. This may due to the disease process itself, the effect of chemotherapeutic drugs or invasive procedures such as catheterization. A wide variety of bacteria including some emerging pathogens are increasingly being reported from these patients. The incidence of multidrug-resistant organisms particularly in the Gram negative group is also increasing, with higher resistance rates seen to cephalosporins, β-lactam/β-lactam inhibitor combinations, and the carbapenems. This study documents the bacteriological spectrum of infections and their resistance patterns in cancer patients. Methods: This study includes all bacterial isolates recovered from infections cancer patients over a period of 18 months. Samples included Blood cultures, Pus/wound swabs, urine, tissue biopsies, body fluids, catheter tips and respiratory specimens such as sputum and bronchoalveolar lavage (BAL). All samples were processed in the microbiology laboratory as per standard laboratory protocols. Organisms were identified to species level and antimicrobial susceptibility testing was performed manually by the disc diffusion technique or in the Vitek-2 (Biomereux, France) instrument. Interpretations were as per Clinical laboratory Standards Institute (CLSI) guidelines. Results: A total of 1150 bacterial isolates were cultured from 884 test samples during the study period. Of these 227 were Gram-positive and 923 were Gram-negative organisms. Staphylococcus aureus (99 isolates) was the commonest Gram-positive isolate followed by Enterococcus (79) and Gr A Streptococcus (30). Among the Gram negatives, E. coli (304), Pseudomonas aeruginosa (201) and Klebsiella pneumoniae (190) were the most common. Of the Staphylococcus aureus isolates 27.2% were methicillin resistant. Only 5.06% enterococci were vancomycin resistant. High rates of resistance to cefotaxime and ciprofloxacin were seen amongst E. coli (84.8% & 83.55%) and Klebsiella pneumoniae (71 & 62.1%) respectively. Resistance to carbapenems (meropenem) was high at 70% in Acinetobacter spp.; however all isolates were sensitive to colistin. Among the aminoglycosides, amikacin retained good efficacy against Escherichia coli (82.9%) and Pseudomonas aeruginosa (78.1%). Occasional isolates of emerging pathogens such as Chryseobacterium indologens, Roseomonas, and Achromobacter xyloxidans were also recovered. Conclusion: The common infections in cancer patients include respiratory, wound, tract infections and sepsis. The commonest isolates include Staphylococcus aureus, Enterococci, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. There is a high level of resistance to the commonly used antibiotics among Gram-negative organisms.

Keywords: bacteria, resistance, infection, cancer

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15260 Enriching the Effects of Art Therapy Intervention: Reflecting upon Artworks Produced during Intervention to Restructure Adolescent’s Art Expression of Feelings and Emotions

Authors: L. K. Akila

Abstract:

Art activities can fund as a clinical support tool (CST) between interventions in Art Therapy to direct the client back towards better outcome goals. In the present study, during free art sessions, researcher examined the possibilities of motivating the adolescent group to involve in art making process by reflecting upon art intervention administered. Results show that adolescents’ reflecting upon their art works generated during the intervention; could change their perceptions and cognitions to improve their positive approach by restructuring their art expressions. Consequently, such reflections triggered and improved their emotions, feelings and ideas, and produced secure attachment between family, peers and teachers. By the end of interference, transformations experienced were effective more upon depression, self-image, and self-efficacy, and to a certain extent on aggressive patterns represented.

Keywords: adolescent, adolescent psychology, aggression, art, art therapy, cognition, depression, emotion, self-image

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15259 The Maldistribution of Doctors and the Responsibility of Medical Education: A Literature Review

Authors: Catherine Bernard

Abstract:

The maldistribution of clinicians within countries is well documented. It is a common theme throughout the world that rural areas often struggle to recruit and retain health workers resulting in inadequate healthcare for many. This paper will concentrate on the responsibilities that medical schools may have in addressing this shortage of rural health workers. Recommendations are made with regards to targeted rural student admissions, rurally-based medical schools, rural clinical rotations and a curriculum orientated towards rural health issues. The evidence gathered suggests that individual factors are positive in encouraging health workers to practice in rural locations. However, there is strength in numbers, and combining all the recommendations will likely result in a synergistic effect, thereby increasing numbers of rural health workers and achieving accessible healthcare for those living in rural populations.

Keywords: medical education, medical education design, public health, rural health

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15258 A Pilot Study on the Development and Validation of an Instrument to Evaluate Inpatient Beliefs, Expectations and Attitudes toward Reflexology (IBEAR)-16

Authors: Samuel Attias, Elad Schiff, Zahi Arnon, Eran Ben-Arye, Yael Keshet, Ibrahim Matter, Boker Lital Keinan

Abstract:

Background: Despite the extensive use of manual therapies, reflexology in particular, no validated tools have been developed to evaluate patients' beliefs, attitudes and expectations regarding reflexology. Such tools however are essential to improve the results of the reflexology treatment, by better adjusting it to the patients' attitudes and expectations. The tool also enables assessing correlations with clinical results of interventional studies using reflexology. Methods: The IBEAR (Inpatient Beliefs, Expectations and Attitudes toward Reflexology) tool contains 25 questions (8 demographic and 17 specifically addressing reflexology), and was constructed in several stages: brainstorming by a multidisciplinary team of experts; evaluation of each of the proposed questions by the experts' team; and assessment of the experts' degree of agreement per each question, based on a Likert 1-7 scale (1 – don't agree at all; 7 – agree completely). Cronbach's Alpha was computed to evaluate the questionnaire's reliability while the Factor analysis test was used for further validation (228 patients). The questionnaire was tested and re-tested (48h) on a group of 199 patients to assure clarity and reliability, using the Pearson coefficient and the Kappa test. It was modified based on these results into its final form. Results: After its construction, the IBEAR questionnaire passed the expert group's preliminary consensus, evaluation of the questions' clarity (from 5.1 to 7.0), inner validation (from 5.5 to 7) and structural validation (from 5.5 to 6.75). Factor analysis pointed to two content worlds in a division into 4 questions discussing attitudes and expectations versus 5 questions on belief and attitudes. Of the 221 questionnaires collected, a Cronbach's Alpha coefficient was calculated on nine questions relating to beliefs, expectations, and attitudes regarding reflexology. This measure stood at 0.716 (satisfactory reliability). At the Test-Retest stage, 199 research participants filled in the questionnaire a second time. The Pearson coefficient for all questions ranged between 0.73 and 0.94 (good to excellent reliability). As for dichotomic answers, Kappa scores ranged between 0.66 and 1.0 (mediocre to high). One of the questions was removed from the IBEAR following questionnaire validation. Conclusions: The present study provides evidence that the proposed IBEAR-16 questionnaire is a valid and reliable tool for the characterization of potential reflexology patients and may be effectively used in settings which include the evaluation of inpatients' beliefs, expectations, and attitudes toward reflexology.

Keywords: reflexology, attitude, expectation, belief, CAM, inpatient

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15257 The Effects of Impact Forces and Kinematics of Two Different Stance Position at Straight Punch Techniques in Boxing

Authors: Bergun Meric Bingul, Cigdem Bulgan, Ozlem Tore, Mensure Aydin, Erdal Bal

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The aim of the study was to compare the effects of impact forces and some kinematic parameters with two different straight punch stance positions in boxing. 9 elite boxing athletes from the Turkish National Team (mean age± SD 19.33±2.11 years, mean height 174.22±3.79 cm, mean weight 66.0±6.62 kg) participated in this study as voluntarily. Boxing athletes performed one trial in straight punch technique for each two different stance positions (orthodox and southpaw stances) at sandbag. The trials were recorded at a frequency of 120Hz using eight synchronized high-speed cameras (Oqus 7+), which were placed, approximately at right- angles to one another. The three-dimensional motion analysis was performed with a Motion Capture System (Qualisys, Sweden). Data was transferred to Windows-based data acquisition software, which was QTM (Qualisys Track Manager). 11 segment models were used for determination of the kinematic variables (Calf, leg, punch, upperarm, lowerarm, trunk). Also, the sandbag was markered for calculation of the impact forces. Wand calibration method (with T stick) was used for field calibration. The mean velocity and acceleration of the punch; mean acceleration of the sandbag and angles of the trunk, shoulder, hip and knee were calculated. Stance differences’ data were compared with Wilcoxon test for using SPSS 20.0 program. According to the results, there were statistically significant differences found in trunk angle on the sagittal plane (yz) (p<0.05). There was a significant difference also found in sandbag acceleration and impact forces between stance positions (p < 0.05). Boxing athletes achieved more impact forces and accelerations in orthodox stance position. It is recommended that to use an orthodox stance instead of southpaw stance in straight punch technique especially for creating more impact forces.

Keywords: boxing, impact force, kinematics, straight punch, orthodox, southpaw

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15256 Impact of the Simplification of Licensing Procedures for Industrial Complexes on Supply of Industrial Complexes and Regional Policies

Authors: Seung-Seok Bak, Chang-Mu Jung

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An enough amount supply of industrial complexes is an important national policy in South Korea, which is highly dependent on foreign trade. A development process of the industrial complex can distinguish between the planning stage and the construction stage. The planning stage consists of the process of consulting with many stakeholders on the contents of the development of industrial complex, feasibility study, compliance with the Regional policies, and so on. The industrial complex planning stage, including licensing procedure, usually takes about three years in South Korea. The government determined that the appropriate supply of industrial complexes have been delayed, due to the long licensing period and drafted a law to shorten the license period in 2008. The law was expected to shorten the period of licensing, which was about three years, to six months. This paper attempts to show that the shortening of the licensing period does not positively affect the appropriate supply of industrial complexes. To do this, we used Interrupted Time Series Designs. As a result, it was found that the supply of industrial complexes was influenced more by other factors such as actual industrial complex demand of private sector and macro-level economic variables. In addition, the specific provisions of the law conflict with local policy and cause some problems such as damage to nature and agricultural land, traffic congestion.

Keywords: development of industrial complexes, industrial complexes, interrupted time series designs, simplification of licensing procedures for industrial complexes, time series regression

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15255 Activity Antidiarrheal Extract Kedondong Leaf in Balb/C Strain Male Mice Invivo

Authors: Johanrik, Arini Aprilliani, Fikri Haikal, Diyas Yuca, Muhammad A. Latif, Edijanti Goenarwo, Nurita P. Sari

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Diarrhea is one of the leading causes of morbidity and mortality in many countries, as well as responsible for the deaths of millions of people each year. Previous research showed that the leaves, bark, and root bark of kedondong contains saponins, tannins, and flavonoids. Tannins have anti-diarrheal effects that work as the freeze of protein / astrigen, and may inhibit the secretion of chloride over the tannate bonding between protein in the intestines. Chemical compounds of flavonoids also have an effect as anti-diarrheal block receptors Cl ˉ in intestinal thus reducing the secretion of Cl ˉ to the intestinal lume. This research aims to know the anti-diarrheal activity of extracts kedondong leaf in mice Balb/C strain males in vivo. This research also proves kedondong leaves as an anti-diarrhea through trial efficacy of kedondong leaves as antisekretori and antimotilitas. This research using post-test only controlled group design. Analysis of statistical data normality and homogenity were tested by Kolmogorov Smirnov. If the data obtained homogenous then using ANOVA test. This research using ethanolic extracts kedondong leaf 200, 400 and 800 mg/kgBW to prove there is anti-diarrhea it makes into six treatment groups, for anti-secretory it makes into five treatment groups and anti-motility became five treatment groups. The result showed dose of ethanolic extracts kedondong leaf 800 mg/kgBW have significant value (p < 0.005). The conclusion from this extracts kedondong leaf research 800 mg/kgBW have pharmacological effects as antidiarrhea on Balb/C strain male mice with a mechanism of action as antisecretory and antimotility.

Keywords: anti-diarrhea, anti-secretory, anti-motility, kedondong leaf

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15254 Development of Risk Assessment and Occupational Safety Management Model for Building Construction Projects

Authors: Preeda Sansakorn, Min An

Abstract:

In order to be capable of dealing with uncertainties, subjectivities, including vagueness arising in building construction projects, the application of fuzzy reasoning technique based on fuzzy set theory is proposed. This study contributes significantly to the development of a fuzzy reasoning safety risk assessment model for building construction projects that could be employed to assess the risk magnitude of each hazardous event identified during construction, and a third parameter of probability of consequence is incorporated in the model. By using the proposed safety risk analysis methodology, more reliable and less ambiguities, which provide the safety risk management project team for decision-making purposes.

Keywords: safety risk assessment, building construction safety, fuzzy reasoning, construction risk assessment model, building construction projects

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15253 Implementation of an IoT Sensor Data Collection and Analysis Library

Authors: Jihyun Song, Kyeongjoo Kim, Minsoo Lee

Abstract:

Due to the development of information technology and wireless Internet technology, various data are being generated in various fields. These data are advantageous in that they provide real-time information to the users themselves. However, when the data are accumulated and analyzed, more various information can be extracted. In addition, development and dissemination of boards such as Arduino and Raspberry Pie have made it possible to easily test various sensors, and it is possible to collect sensor data directly by using database application tools such as MySQL. These directly collected data can be used for various research and can be useful as data for data mining. However, there are many difficulties in using the board to collect data, and there are many difficulties in using it when the user is not a computer programmer, or when using it for the first time. Even if data are collected, lack of expert knowledge or experience may cause difficulties in data analysis and visualization. In this paper, we aim to construct a library for sensor data collection and analysis to overcome these problems.

Keywords: clustering, data mining, DBSCAN, k-means, k-medoids, sensor data

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15252 ORR Electrocatalyst for Batteries and Fuel Cells Development with SIO₂/Carbon Black Based Composite Nanomaterials

Authors: Maryam Kiani

Abstract:

This study focuses on the development of composite nanomaterials based on SiO₂ and carbon black for oxygen reduction reaction (ORR) electrocatalysts in batteries and fuel cells. The aim was to explore the potential of these composite materials as efficient catalysts for ORR, which is a critical process in energy conversion devices. The SiO₂/carbon black composite nanomaterials were synthesized using a facile and scalable method. The morphology, structure, and electrochemical properties of the materials were characterized using various techniques including scanning electron microscopy (SEM), X-ray diffraction (XRD), and electrochemical measurements. The results demonstrated that the incorporation of SiO₂ into the carbon black matrix enhanced the ORR performance of the composite material. The composite nanomaterials exhibited improved electrocatalytic activity, enhanced stability, and increased durability compared to pure carbon black. The presence of SiO₂ facilitated the formation of active sites, improved electron transfer, and increased the surface area available for ORR. This study contributes to the advancement of battery and fuel cell technology by offering a promising approach for the development of high-performance ORR electrocatalysts. The SiO₂/carbon black composite nanomaterials show great potential for improving the efficiency and durability of energy conversion devices, leading to more sustainable and efficient energy solutions.

Keywords: ORR, fuel cells, batteries, electrocatalyst

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15251 Potentials, Challenges And Prospects Of Halal Tourism Development In Ethiopia

Authors: Mohammed Jemal Ahmed

Abstract:

Some anti-Islam attributes, such as alcoholism and voyeurism, have become de facto manifestations of the tourism sector. This eventually causes a paradoxical relationship between tourism and Islam. Hence, on the one hand, Islam inherently encourages Muslims to engage in tourism, the interest of Muslims to engage in tourism is steadily increasing. On the other hand, haram activities and products that are not allowed to Muslims as per the Islamic law and doctrine have surrounded tourism. Therefore, halal tourism has emerged as the best mediator to reconcile the conflicts between secular interests and religious values. Recent studies have confirmed that halal tourism is an emerging cultural phenomenon and secular rather than religious. The central aim of halal tourism is to have delighted customers irrespective of their religious and cultural backgrounds while promoting environmental conservation and social coexistence. This study appraises halal tourism development in Ethiopia from commercial, socio-cultural and diplomatic perspectives. Employing qualitative methodologies, the study, firstly, tried to clarify the existing terminological ambiguities between halal tourism and Islamic tourism and redefine both concepts. Then, it assessed perceptions of local communities and stakeholders towards halal tourism and identified halal tourism resources of Ethiopia. Accordingly, five clusters of halal visitor attractions and five potential halal tourism routes were identified and proposed. Furthermore, the comparative advantages of Ethiopia in terms of halal tourism development and potential barriers to halal tourism development in the country were rigorously appraised. The findings of this study reveal that halal tourism could inject hard currency into the national economy and create job opportunities for the locals. It could also support the mainstream tourism industry through product diversification and curving seasonality. Moreover, socially, halal tourism reinforces interreligious cohesion, relationship and coextensive in multi-religious, multicultural and multiethnic Ethiopia. Politically, it strengthens Ethiopia's foreign diplomatic relationship with the Islamic world and its near and distant neighbor Muslim Countries.

Keywords: halal-conscious travelers, halal tourism, Islamic tourism, tourism resources

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15250 Higher Education Quality Culture: Case Study: Georgia

Authors: Pikria Vardosanidze

Abstract:

This presentation entitled ”Higher Education Quality Culture – Case Study: Georgia”is concerned with an urgent and crucial issue. Located at the crossroads of Europe and Asia, Georgia is a transnational, post-soviet country. And it is conditioned the peculiarity of our education system. Higher education in Georgia has an extensive history and a challenging period of development consisting of several phases, especially noteworthy of which are 1918 and 1991, marking there storation of Georgia’s independence. Georgia joined the Bologna Process in 2005. Given its geopolitical location, Georgian culture has developed, and still pursues the path of development against the background of the Western and Eastern cultures. Furthermore, socio-politically and culturally, it represents part of Europe. It is of particular interest how post-Soviet states develop in terms of education. What is the path to the European integration for Georgia as a post-Soviet country? How developed is the higher education quality culture in Georgia? And, what should be done in the future? It is important to answer these questions. The research carried out in the field of education is characterized by a certain specificity as does the post-colonial research. The field of education contributes to the development of democratic society as well as to the European integration, the Eastern Partnership and so on. What is crucial for the educational system, apart from transparency and democratization, is the improvement of the quality of education which is one of the most powerful tools dictating the need for a doctoral research as such. As for the research method, the comparative method of research, and the qualitative research are applied.

Keywords: internationalization, higher education, policies, Georgia

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15249 Enhancing Urban Sustainability through Integrated Green Spaces: A Focus on Tehran

Authors: Azadeh Mohajer Milani

Abstract:

Urbanization constitutes an irreversible global trend, presenting myriad challenges such as heightened energy consumption, pollution, congestion, and the depletion of natural resources. Today's urban landscapes have emerged as focal points for economic, social, and environmental challenges, underscoring the pressing need for sustainable development. This article delves into the realm of sustainable urban development, concentrating on the pivotal role played by integrated green spaces as an optimal solution to address environmental concerns within cities. The study utilizes Tehran as a case study. Our findings underscore the imperative of preserving and expanding green spaces in urban areas, coupled with the establishment of well-designed ecological networks, to enhance environmental quality and elevate the sustainability of cities. Notably, Tehran's urban green spaces exhibit a disjointed design, lacking a cohesive network to connect various patches and corridors, resulting in significant environmental impacts. The results emphasize the necessity of a balanced and proportional distribution of urban green spaces and the creation of a cohesive patch-corridor-matrix network tailored to the ecological and social needs of residents. This approach is crucial for fostering a more sustainable and livable urban environment for all species, with a specific focus on humans.

Keywords: ecology, sustainable urban development, sustainable landscape, urban green space network

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15248 Revolution and Nationalism: The Grenada Revolution (1979-83) Contributed Significantly to the Development of a Grenada Nationalism

Authors: Oliver Benoit

Abstract:

On 13 March 1979, a left-wing political party formed in the 1970s overthrew Eric Gairy's government and established the People's Revolutionary Government which governed Grenada from (1979-1983). On the morning of 13 March 1979, the People's Revolutionary Government leader, Maurice Bishop, appealed to the people of Grenada to assist the forces of the revolution in consolidating its newly acquired political power. A cross-section of the Grenadian population responded positively to Maurice Bishop's appeal. Within the four and a half years of the revolution, noticeable social, political, and economic changes affected all areas of social life before internal divisions caused the revolution's collapse. Forty-two years following the revolution's collapse, intellectuals and commentators continue to argue about the impact of the Grenada Revolution on societal and national development. However, the revolution's impact on the spread of nationalism in Grenada is yet to be analyzed. Nationalism, as a modern phenomenon, has impacted many societies since its emergence in England in the seventeenth century, and Grenada is no exception. The paper argues that the Grenada Revolution was motivated by nationalist sentiments and the revolution itself fostered the development of nationalism in Grenada. The argument relies on 40 interviews; people who currently reside in Grenada (2020) and live in Grenada during the revolution as young adults and adults (ages 15 and beyond) and have memories of their experiences of the revolution. The sample of 40 respondence represents about 20,000 people in Grenada who are within the study population between 55 and 75 years today (2020).

Keywords: grenada, motivation, nationalism, revolution

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15247 Tourism Oriented Planning Experience in the Historical City Center of Trabzon (Turkey) with Strategic Spatial Planning Approach: Evaluation of Approach and Process

Authors: Emrehan Ozcan, Dilek Beyazlı

Abstract:

The development of tourism depends on an accurate planning approach as well as on the right planning process. This dependency is also a key factor in ensuring sustainability of tourism. The types of tourism, social expectations, planning practice, the socio-economic and the cultural structure of the region are determinants of planning approaches for tourism development. The tourism plans prepared for the historic city centers are usually based on the revitalization of cultural and historical values. The preservation and development of the tourism potentials of the historic city centers are important for providing an economic contribution to the locality, creating livable solutions for local residents and also the sustainability of tourism. This research is about experiencing and discussing a planning approach that will provide tourism development based on historical and cultural values. Historical and cultural values in the historical city center of Trabzon -which has a settlement history of approximately 4000 years, is located on the Black Sea coast of Turkey- wear out over years and lose their tourism potential. A planning study has been experienced with strategic spatial planning approach for Trabzon, which has not done a tourism-oriented planning study until now. The stages of the planning process provided by strategic spatial planning approach are an assessment of the current situation; vision, strategies, and actions; action planning; designing and implementation of actions and monitoring-evaluation. In the discussion section, the advantages, planning process, methods and techniques of the approach are discussed for the possibilities and constraints in terms of tourism planning. In this context, it is aimed to put forth tourism planning process, stages, and implementation tools within the scope of strategic spatial planning approach by comparing approaches used in the tourism-oriented/priority planning of historical city centers. Suggestions on the position and effect of the preferred planning approach in the existing spatial planning practice are the outputs of the study.

Keywords: cultural heritage, tourism oriented planning, Trabzon, strategic spatial Planning

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15246 Provision of Afterschool Programs: Understanding the Educational Needs and Outcomes of Newcomer and Refugee Students in Canada

Authors: Edward Shizha, Edward Makwarimba

Abstract:

Newcomer and refugee youth feel excluded in the education system in Canada, and the formal education environment does not fully cater for their learning needs. The objective of this study was to build knowledge and understanding of the educational needs and experiences of these youth in Canada and how available afterschool programs can most effectively support their learning needs and academic outcomes. The Employment and Social Development Canada (ESDC), which funded this research, enables and empowers students to advance their educational experience through targeted investments in services that are delivered by youth-serving organizations outside the formal education system through afterschool initiatives. A literature review and a provincial/territorial internet scan were conducted to determine the availability of services and programs that serve the educational needs and academic outcomes of newcomer youth in 10 provinces and 3 territories in Canada. The goal was to identify intersectional factors (e.g., gender, sexuality, culture, social class, race, etc.) that influence educational outcomes of newcomer/refugee students and to recommend ways the ESDC could complement settlement services to enhance students’ educational success. First, data was collected through a literature search of various databases, including PubMed, Web of Science, Scopus, Google docs, ACADEMIA, and grey literature, including government documents, to inform our analysis. Second, a provincial/territorial internet scan was conducted using a template that was created by ESDC staff with the input of the researchers. The objective of the web-search scan was to identify afterschool programs, projects, and initiatives offered to newcomer/refugee youth by service provider organizations. The method for the scan included both qualitative and quantitative data gathering. Both the literature review and the provincial/territorial scan revealed that there are gender disparities in educational outcomes of newcomer and refugee youth. High school completion rates by gender show that boys are at higher risk of not graduating than girls and that girls are more likely than boys to have at least a high school diploma and more likely to proceed to postsecondary education. Findings from literature reveal that afterschool programs are required for refugee youth who experience mental health challenges and miss out on significant periods of schooling, which affect attendance, participation, and graduation from high school. However, some refugee youth use their resilience and ambition to succeed in their educational outcomes. Another finding showed that some immigrant/refugee students, through ethnic organizations and familial affiliation, maintain aspects of their cultural values, parental expectations and ambitious expectations for their own careers to succeed in both high school and postsecondary education. The study found a significant combination of afterschool programs that include academic support, scholarships, bursaries, homework support, career readiness, internships, mentorship, tutoring, non-clinical counselling, mental health and social well-being support, language skills, volunteering opportunities, community connections, peer networking, culturally relevant services etc. These programs assist newcomer youth to develop self-confidence and prepare for academic success and future career development. The study concluded that advantages of afterschool programs are greatest for youth at risk for poor educational outcomes, such as Latino and Black youth, including 2SLGBTQI+ immigrant youth.

Keywords: afterschool programs, educational outcomes, newcomer youth, refugee youth, youth-serving organizations

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15245 The Contribution of Density Fluctuations in Ultrasound Scattering in Cancellous Bone

Authors: A. Elsariti, T. Evans

Abstract:

An understanding of the interaction between acoustic waves and cancellous bone is needed in order to realize the full clinical potential of ultrasonic bone measurements. Scattering is likely to be of central importance but has received little attention to date. Few theoretical approaches have been described to explain scattering of ultrasound from bone. In this study, a scattering model based on velocity and density fluctuations in a binary mixture (marrow fat and cortical matrix) was used to estimate the ultrasonic attenuation in cancellous bone as a function of volume fraction. Predicted attenuation and backscatter coefficient were obtained for a range of porosities and scatterer size. At 600 kHZ and for different scatterer size the effect of velocity and density fluctuations in the predicted attenuation was approximately 60% higher than velocity fluctuations.

Keywords: ultrasound scattering, sound speed, density fluctuations, attenuation coefficient

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15244 Granulomatous Mycoses Fungoides: A Case Report

Authors: Girum Tedla Assefa

Abstract:

Background: Granulomatous mycosis fungoides is an extremely rare type of cutaneous T-cell lymphoma (<55 cases reported worldwide). Case report: A 36-year-old female presented with soft tissue atrophy of right lower limb (dermis + hypodermis) of 22 years and plaques over trunk of 3 years duration. Histological examination of a biopsy taken from the atrophied tissue showed a granulomatous reaction with epidermotropic atypical lymphocytes. However, in other areas there were only findings of conventional MF without granuloma. Conclusion: The diagnosis of a granulomatous mycosis fungoides depends exclusively on the histological demonstration of granulomas. Distinct clinical characteristics are not present. This case highlights the importance of thorough investigation of lipoatrophic skin changes in the adult to exclude underlying causes, including MF.

Keywords: cutaneous lymphoma, granulomatous skin lymphoma, mycoses fungoides, skin atrophy

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